Prieto-Miranda SE, Jiménez-Bernardino CA, Cázares-Ramírez G, Vera-Haro MJ, Esparza-Pérez RI

Language: Spanish
References: 24
Page: 669-679
PDF size: 438.60 Kb.

ABSTRACT

Background: The education authorities in developed countries such as the United States and the European Union are concerned about the work of medical residents and have changed their laws and regulated their working hours at a total of 56-72 hours per week in all their university specialization courses; this is something that has not happened in our country. We don’t know, in our country, the number of hours that our medical residents work and its potential impact in the different specialization courses in a second-level hospital.
Objective: To determine the workdays and their impact on medical residents in a second-level hospital.
Material and method: A descriptive-cross sectional study. We included residents of medical and surgical specialties in the Regional General Hospital Number 46 of the Mexican Social Security Institute in Guadalajara, Jalisco. After signing the informed consent, we applied the survey: “Work days in medical residents”, previously developed by those responsible for this research, which consisted of two sections, the first with some demographic data (five questions) and the second with 46 items, seven open questions and 39 questions with a Likert-type data. The following dimensions were evaluated: working hours, work organization, harassment, psychosocial factors, health, professional skills and career prospects. Descriptive and inferential statistics were used and a p‹0.05 was considered statistically significant.
Results: In the evaluation of working hours for medical residents we found an average of 70.1±21.1 hours/week for all specialties; however, in the surgical specialties the average was of 89.1±21.5, while in the medical specialties was of 67.1±19.1 hours (p‹0.0001). In relation to its effects, we found impact on the following dimensions: stress, harassment, work organization, psychosocial factors, professional skills and career prospects.
Conclusion: The number of working hours in medical resident in a secondary hospital is much higher than those recommended in most specialties, and has an impact on all dimensions studied.

REFERENCES

1. Norma Oficial Mexicana en materia de información en salud. NOM-035-SSA3-2012, Viernes 30 de Noviembre de 2012 DIARIO OFICIAL (Segunda Sección) 97- 128. (en línea) http://www.dgis.salud.gob.mx/descargas/pdf/NOM-035-SSA3-2012.pdf (con acceso el 11 de marzo de 2015).

2. Ley Federal del Trabajo. Cámara de Diputados del H. Congreso de la Unión. Secretaría General. Secretaría de Servicios Parlamentarios. Nueva Ley Publicada En el Diario Oficial de la Federación El 1º de abril de 1970. Última Reforma Publicada DOF 30-11-2012. (en línea) http://www.diputados.gob.mx/LeyesBiblio/pdf/125.pdf (con acceso el 10 de marzo de 2015).

3. Medición del tiempo de trabajo. Organización Internacional del Trabajo. Programa de actividades sectoriales informe II. Reunión de expertos en estadísticas del trabajo Ginebra, 1.º-10 de abril de 2008, pág. 1-41. (en línea) http://www.ilo.org/public/spanish/bureau/stat/download/mels2008/reptwo.pdf (con acceso el 10 de marzo de 2015).

4. Instituto Mexicano del Seguro Social. Contrato colectivo de trabajo 2011-2013. Talleres gráficos de México, 2012;400-406.

5. Blum AB, Raiszadeh F, Shea S, Mermin D, et al. US public opinion regarding proposed limits on resident physician work hours. BMC Med 2010;8:33.

6. Rosenbaum L, Lamas D. Residents’ duty hours-toward an empirical narrative. N Engl J Med 2012;367:2044-2049.

7. Lockley SW, Barger LK, Ayas NT, Rothschild JM, et al. Effects of health care provider work hours and sleep deprivation on safety and performance. Jt Comm J Qual Patient Saf 2007;33:7-18.

8. Barger LK, Cade BE, Ayas NT, Cronin JW, et al. Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med 2005;352:125-134.

9. Landrigan CP, Barger LK, Cade BE, Ayas NT, Czeisler CA. Interns’ compliance with accreditation council for graduate medical education work-hour limits. JAMA 2006;296:1063-1070.

10. Lockley SW, Cronin JW, Evans EE, Cade BE, et al. Effect of reducing interns’ weekly work hours on sleep and attentional failures. N Engl J Med 2004;351:1829-1837.

11. Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med 2004;351:1838-1848.

12. Bocanegra Rivera JC. Sobrecarga laboral en los profesionales de la salud y su relación con la seguridad del paciente. Revista Médico Legal. Volumen XVIII. Mayo de 2012 Nº1, 2012 6-13. (en línea) http://www.medicolegal.com.co/articulo/subtema/898 (con acceso el 11 de marzo de 2015)

13. Rodríguez Bermúdez IP. Efectos de la guardia de 24 horas sobre el desempeño del personal médico y la calidad de atención al paciente. Revista Medicina 2004;10. Nº 1. (en línea) http://editorial.ucsg.edu.ec/medicina/article/view/429/388 (con acceso el 10 de marzo de 2015).

14. Fletcher KE, Underwood W 3rd, Davis SQ, Mangrulkar RS, et al. Effects of work hour reduction on residents’ lives: a systematic review. JAMA 2005;294:1088-1100.

15. Prieto-Miranda SE, López-Benítez W, Jiménez-Bernardino CA. Medición de la calidad de vida en médicos residentes. Educ Med (Barc) 2009;12:169-177.

16. Harrocks N, Pounder R. Work group of Royal College of Physicians of United Kingdom. Working the night shift: preparation, survival and recovery. A Guide for junior doctors. Clin Med 2006;6:61-67.

17. Questionnaire for Fifth European Survey on Working Conditions (2010). (En línea) http://doc.ukdataservice.ac.uk/doc/6971/mrdoc/pdf/6971_ewcs5_2010_questionnaire.pdf (con acceso el 10 de marzo de 2015).

18. Cedillo L, Karasek R. Reliability and validity of the spanish version of the job content questionnaire among maquiladora women workers. JCQ-Center (En línea) Disponible en www.jcqcenter.org (con acceso el 15 de marzo de 2015).

19. Cohen JS, Patten S. Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Med Educ 2005;5:21.

20. Prieto-Miranda SE, Rodríguez-Gallardo GB, Jiménez-Bernardino CA, Guerrero-Quintero LG. Desgaste profesional y calidad de vida en médicos residentes. Rev Med Inst Mex Seguro Soc 2013;51:574-579.

21. Baldwin DC Jr, Daugherty SR, Tsai R, Scotti MJ Jr. A National survey of residents’ self-reported work hours: thinking beyond specialty. Acad Med 2003;11:1154-1163.

22. Acero I. Disminuirán horas de trabajo y guardias a médicos residentes para mejorar su calidad de atención médica. La Jornada Aguascalientes. 17 de enero del 2013; Sección Local, Sociedad y justicia. http://www.lja.mx/2013/01/disminuiran-horas-de-trabajo-y-guardias-a-medicosresidentes-para-mejorar-su-calidad-de-atencion/ (con acceso el 10 de marzo de 2015).

23. Aranda Beltrán C, Pando Moreno M, Salazar Estrada JG, Torres López TM, Aldrete Rodríguez MG. Factores de riesgo psicosociales laborales incidentes en la salud de los médicos de familia en Guadalajara, México. Revista Iberoamericana de Psicología: Ciencia y Tecnología 2012;5:45-54. (En línea) http://works.bepress.com/cgi/viewcontent. cgi?article=1045&context=jose_salazar (con acceso el 10 de marzo de 2015)

24. Blum AB, Raiszadeh F, Shea S, Mermin D, et al. US public opinion regarding proposed limits on resident physician work hours. BMC Med Educ 2010;8:33.