University of Tsukuba Hospital is an academic medical center with a medical school. Niigata City Hospital is located in the northern part of Japan, while the other hospitals are located in the greater Tokyo area. All hospitals are the tertiary care medical institutions (more than 300 beds). The abovementioned hospitals are teaching hospitals that have both a junior residency program and a senior residency program. Japanese residents who worked at Tokyo Bay Medical Center, Shonan Kamakura General Hospital, Asahi General Hospital, University of Tsukuba Hospital, and Niigata City General Hospital participated in this multicenter randomized crossover survey in 2016. We performed a multicenter randomized crossover survey to examine the effect of a night on call or an overnight shift on physicians’ empathy. To address this knowledge gap, we tested the hypothesis that the sleep deprivation caused by a night on call or an overnight shift diminishes physicians’ empathy. However, no empirical evidence correlates the postgraduate physicians’ empathy with sleep deprivation. Having a brief look at international situations, heavy on-call work might cause sleep deprivation, and a night shift work is characterized by increased sleepiness during the shift. A large-scale survey indicated that 26.4% of Japanese residents worked more than 80 h a week. Unfortunately, in Japan, most of on-call doctors are not able to leave in the next morning, but must stay at the hospital to perform their usual daytime tasks. Based on a previous Japanese study, sleep deprivation after a night on call is estimated to be sleep hour less than 4 h. Currently, most doctors work on call at night instead of overnight shift in Japan. A night shift mostly starts from 5 pm without a preceding daytime work and ends at 8 am–9 am time range. Ī night on call mostly starts from 5 pm after a daytime work and ends at 8 am–9 am time range. One study revealed that post-call performance showed impairments similar to those associated with a 0.04 to 0.05 g % blood alcohol concentration. During overwhelming on-call rotations or overnight shifts, physicians display lower attention and vigilance. A night on call or an overnight shift provides the physician with a challenging situation with high responsibility, which may affect the physician’s well-being, sleep quality, and fatigue and may therefore result in poor communication and patient complaints. This decline in empathy is attributed to a high volume of learning materials and to sleep deprivation. Hojat proposed that a significant decline in empathy occurs during the third year of medical school, when the curriculum shifts toward patient-care activities. Guadagni reported that sleep deprivation had a negative effect on emotional empathy among healthy volunteers. Despite the consensus of professional organizations and medical education leaders on the importance of empathy, empirical research on the relation between sleep deprivation and the erosion of empathy is scarce. Therefore, physicians need to be educated on the importance of empathy as an integral part of healthcare professionalism. It represents the capacity of the physician to perceive the world from the patient’s perspective. To the best of our knowledge, this is the first study on physicians’ empathy after a night on call or an overnight shift.Įmpathy is essential in achieving an optimal patient outcome. ConclusionĪs per our results, a night on call or an overnight shift did not reduce the Japanese physicians’ empathy. (Group A before night vs Group B after night, p = 0.40, Group A after night vs Group B before night, p = 0.68). There was no significant difference in the JSE scores between pre- and post-night on call or overnight shift. ResultsĪ total of 117 Group A physicians and 112 Group B physicians returned a completed JSE. Statistical analyses were performed to compare the JSE scores of pre- and post-night on call or overnight shifts. Group B first completed the JSE after a night on call or an overnight shift then, 8 weeks later, Group B completed the JSE prior to a night on call or an overnight shift. Group A first completed the JSE prior to a night on call or an overnight shift then, 8 weeks later, Group A completed the JSE after a night on call or an overnight shift. A total of 260 physicians who worked at academic hospitals and community hospitals in Japan in 2016 were recruited and randomized into two groups. We conducted a multicenter randomized crossover survey using the Jefferson Scale of Physician Empathy (JSE). Hence, we aimed to examine whether a night on call or an overnight shift reduces the physicians’ empathy. Yet, little is known about the empathy after a night on call or an overnight shift among resident physicians. Studies have shown that sleep deprivation may reduce empathy among medical students.
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