Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Examining self-reported and biological stress and near misses among Emergency Medicine residents: a single-centre cross-sectional assessment in the USA
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Family Medicine, College of Human Medicine, Michigan State University, Michigan, USA; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Family Medicine, College of Human Medicine, Michigan State University, Michigan, USA; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Show others and affiliations
2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 8, article id e016479Article in journal (Refereed) Published
Abstract [en]

Objectives: To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents.

Design: Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses.

Setting: The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA. Participants Residents in Emergency Medicine volunteered to participate. The sample consisted of 32 residents, with complete data on 28 subjects. Residents' supervising physicians assessed the clinical performance of each resident.

Primary and secondary outcome measures: Participants' preshift and postshift stress, biological stress (salivary cortisol, plasma interleukin-6, tumour necrosis factor-alpha (TNF-alpha) and high-sensitivity C-reactive protein), residents' and supervisors' reports of near misses, number of critically ill and patients with trauma seen during the shift.

Results: Residents' self-reported stress increased from an average preshift level of 2.79 of 10 (SD 1.81) to a postshift level of 5.82 (2.13) (p<0.001). Residents cared for an average of 2.32 (1.52) critically ill patients and 0.68 (1.06) patients with trauma. Residents reported a total of 7 near misses, compared with 11 reported by the supervising physicians. After controlling for baseline work-related exhaustion, residents that cared for more patients with trauma and had higher levels of TNF-a reported a higher frequency of near misses (R-2=0.72; p=0.001). Residents' preshift ratings of how stressful they expected the shift to be were related to the supervising physicians' ratings of residents' near misses during the shift.

Conclusion: Residents' own ratings of near misses were associated with residents' TNF-alpha, a biomarker of systemic inflammation and the number of patients with trauma seen during the shift. In contrast, supervisor reports on residents' near misses were related only to the residents' preshift expectations of how stressful the shift would be.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2017. Vol. 7, no 8, article id e016479
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-141492DOI: 10.1136/bmjopen-2017-016479ISI: 000411802700163PubMedID: 28814584OAI: oai:DiVA.org:umu-141492DiVA, id: diva2:1157162
Available from: 2017-11-15 Created: 2017-11-15 Last updated: 2017-11-29Bibliographically approved

Open Access in DiVA

fulltext(541 kB)3 downloads
File information
File name FULLTEXT01.pdfFile size 541 kBChecksum SHA-512
5b30f4eda211a10326912f9bcd0e29417a287b97017892ce787bd2dc9376db58ea4ab4231d666dac0e40fc5f6422cbbfb4c7c4ae5555d9a5a2189c6d34fb8ef8
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Arnetz, Bengt B.Arnetz, Judy
By organisation
Department of Public Health and Clinical Medicine
In the same journal
BMJ Open
NursingPublic Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 3 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 136 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf