Ophthalmology physicians and residents work under stress conditions during night emergency ophthalmology shifts. Under time pressure, that is a characteristic of the urgency of care, they must use all their cognitive resources to make an accurate diagnosis and to provide accurate decisions, with sometimes surgical emergency acts. In addition, in France, they work at night following by an usual day work, and they can also work 48 consecutive hours during weekends, followed by a work day … i.e. 60 consecutive hours of work … Long working hours with a short recovery time has been demonstrated to be a major factor of stress and fatigue. Even if not demonstrated on ophthalmologists, those working conditions may contribute to symptoms of mental exhaustion and physical fatigue (sleep deprivation), often accompanied by a loss of motivation at work. This may leads to a feeling of loss of time control; stress can also distort the perception of time and leads to hasty actions or delayed decision-making. The combined effects of stress, feelings of loss of time control, and fatigue necessarily have an impact on work performance and work quality, with a high risk of medical error. Moreover, prolonged stress may expose ophthalmologists to a higher risk of multiple diseases, predominantly systemic inflammation and coronary heart disease. The main hypothesis is that prolonged work (up to 60 consecutive working hours) may impact on HRV, comparatively to a typical working day.
The JOBSTRESS.OPH protocol was designed to study the impact of prolonged work (up to 60 consecutive working hours) on HRV, comparatively to a typical working day. Each residents and / or ophthalmology physicians participates up to a maximum of 5 times. Participants wears a heart rate belt and a watch that measures physical activity and skin conductance for 34 hours straight. Participants only wears an EEG monitor while sleeping to assess its quality. At the end of the evaluation session, a simulator test mimicking the successive stages of cataract surgery is performed, as well as the performance of saliva tests. Short quality of life assessment questionnaires are completed at the start and end of the day, supplemented by a general questionnaire completed only once during the study. Statistical analysis will be performed using Stata software (v15, Stata-Corp, College Station, US). Categorical parameters will be described in terms of numbers and frequencies, whereas continuous variables will be expressed as mean and standard deviation or median and \[inter-quartile range\] according to statistical distribution. All statistical tests will be two-sided and p\<0.05 will be considered significant. Graphic representations will be complete presentations of results. Investigators process multivariate physiological series (HRV, SC, biomarkers) in order to build a stress index. For such multivariate physiological series, investigators first use change point analysis on each univariate series in order to get clusters with constant parameters, then investigators use classification algorithm on the constant parameters obtained in first step in order to obtain different classes corresponding to different levels of stress. Eventually, investigators obtain at each time the level of stress and can compare it to the environmental conditions.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
Enrollment
30
Evaluate the impact of prolonged work (up to 60 consecutive hours) on the surgical capacities evaluated on a simulator, as well as on stress markers (questionnaires, saliva assays, skin conductance, quality of sleep) compared to a standard day.
CHU clermont-ferrand
Clermont-Ferrand, France
RECRUITINGHeart rate variability
HRV will be explored in time and frequency domains Abrupt changes in HRV signals will be explored.
Time frame: During 34 hours in the five different conditions
change in stress levels
measure of stress using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in stress levels
measure of stress using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in fatigue levels
measure of fatigue using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in fatigue levels
measure of fatigue using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in burnout levels
measure of burnout using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in burnout levels
measure of burnout using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in depression levels
measure of depression using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in depression levels
measure of depression using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in anxiety levels
measure of anxiety using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in anxiety levels
measure of anxiety using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in "Job demand control support" levels
measure of job demand, job control and support levels using visual analogue scale of 100 mm, from 0 to 100. Higher scores of demand mean a worse level. Higher scores of control and support mean a better level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in "Job demand control support" levels
measure of job demand, job control and support levels using visual analogue scale of 100 mm, from 0 to 100. Higher scores of demand mean a worse level. Higher scores of control and support mean a better level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in "Effort reward imbalance" levels
measure of effort reward imbalance using visual analogue scale of 100 mm, from 0 to 100. Higher scores of mean a better outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in "Effort reward imbalance" levels
measure of effort reward imbalance using visual analogue scale of 100 mm, from 0 to 100. Higher scores of mean a better outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in work addiction levels
measure of work addiction using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in work addiction levels
measure of work addiction using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
change in sleep quality
measure of sleep quality using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 8am, beginning of the 34 hours follow-up, in the five different conditions
change in sleep quality
measure of sleep quality using visual analogue scale of 100 mm, from 0 to 100. Higher scores mean a worse outcome level.
Time frame: at 6pm, end of the 34 hours follow-up, in the five different conditions
Saliva biomarkers cortisol
measure on Cortisol
Time frame: baseline of the 34 hours procedure, in the five different conditions
Saliva biomarkers cortisol
measure on Cortisol
Time frame: 24hours after the beginning of the procedure, in the five different conditions
Saliva biomarkers dheas
measure on dheas
Time frame: baseline of the 34 hours procedure, in the five different conditions
Saliva biomarkers dheas
measure on dheas
Time frame: 24 hours after the beginning of the procedure, in the five different conditions
Saliva biomarkers lgAs
measure on lgAs
Time frame: baseline of the 34 hours procedure, in the five different conditions
Saliva biomarkers lgAs
measure on lgAs
Time frame: 24 hours after the beginning of the procedure, in the five different conditions
Saliva biomarkers Leptine
measure on Leptine
Time frame: baseline of the 34 hours procedure, in the five different conditions
Saliva biomarkers Leptine
measure on Leptine
Time frame: 24 hours after the beginning of the procedure, in the five different conditions
Saliva biomarkers Ghrelin
measure on Ghrelin
Time frame: baseline of the 34 hours procedure, in the five different conditions
Saliva biomarkers Ghrelin
measure on Ghrelin
Time frame: 24 hours after the beginning of the procedure, in the five different conditions
Declared level of physical activity
Physical activity is assessed with one question
Time frame: once at 8am, at the beginning of the procedure
Level of physical activity
Physical activity is assessed with a 3-Axis accelerometer
Time frame: during 34 hours, in the five different conditions
Level of sedentary
Sedentary is assessed regarding the time spent sitting assessed with one question
Time frame: once at 8am, at the beginning of the procedure
Food intake
assessing food intake with ingesta
Time frame: 34 hours recording, in the five different conditions
Sick leave
assessing the number of absence days the previous 6 months using a questionnaire
Time frame: once at 8am, at the beginning of the procedure
Height
measure of height in cm using a questionnaire
Time frame: once at 8am, at the beginning of the procedure
Weight
measure of weight in kilograms using a questionnaire
Time frame: once at 8am, at the beginning of the procedure
Age
measure of age in years using a questionnaire
Time frame: once at 8am, at the beginning of the procedure
Gender
measure of gender using a questionnaire
Time frame: once at 8am, at the beginning of the procedure
Qualification
measure of qualification using a questionnaire
Time frame: once at 8am, at the beginning of the procedure
Personal status
measure of personal status using a questionnaire
Time frame: once at 8amat the beginning of the procedure
Lifestyle
Assessing factors related to lifestyle as smoking, alcohol and coffee consumption using a questionnaire
Time frame: once at 8am, at the beginning of the procedure
Skin conductance
measure of the skin conductance using Wrist band electrodes
Time frame: during 34 hours , in the five different conditions
Sleep quality
measure of sleep quality using Sleep profiler
Time frame: measure for about 7 hours the night of the control day (no work)
Sleep quality
measure of sleep quality using Sleep profiler
Time frame: measure for about 7 hours during the night of the typical working day
Surgical performance
assessing surgical performance using a high-end virtual reality simulator for intraocular surgery training
Time frame: Once at 6pm, at the end of the 34 hours follow-up , in the five different conditions
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