The effects of stress on surgical performance
The effects of stress on surgical performance
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DOI：
10.1016/j.amjsurg.2005.08.034
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发表时间：
2006-01-01
影响因子：
3
通讯作者：
Darzi, A
中科院分区：
文献类型：
--
作者：
Wetzel, CM;Kneebone, RL;Darzi, A
背景：虽然关于压力和表现的一般文献是广泛的，但很少有人知道压力在外科实践中的具体影响。本定性研究探讨了外科手术的主要压力源，它们对手术表现的影响，以及外科医生使用的应对策略。方法：由2位独立研究人员对外科医生进行深度半结构化访谈。研究小组讨论了关键主题。结果：共进行了16次访谈，包括对顾问（n = 9）和正在培训的外科医生（n = 7）的访谈。术中压力源范围广泛。尽管压力既有积极的影响，也有消极的影响，但过度的压力会损害判断、决策和沟通。虽然初级外科医生对自己的应对能力表现出不确定，但高级外科医生已经制定了复杂的策略来控制每种情况。结论：虽然压力会带来明显的风险，但在外科培训中并没有明确地教授应对策略。本文提出了手术应激分类的框架，并提出了有效应对策略的关键要素。(c) 2006年摘录医药有限公司版权所有。
Background: Although the general literature on stress and performance is extensive, little is known about specific effects of stress in surgical practice. This qualitative study explored key surgical stressors, their impact on performance, and coping strategies used by surgeons.Methods: Individual in-depth semistructured interviews with surgeons were analyzed by 2 researchers independently. Key themes were discussed within the research team.Results: Sixteen interviews were performed, including interviews with Consultants (n = 9) and surgeons in training (n = 7). A wide range of intraoperative stressors was identified. Although stress had both positive and negative effects, undue levels of stress impaired judgment, decision making, and communication. Although junior surgeons showed uncertainty about their ability to cope, senior surgeons had developed sophisticated strategies for controlling each situation.Conclusions: Although stress poses significant risks, coping strategies are not taught explicitly during surgical training. This article presents a framework for categorizing surgical stress and suggests key elements for effective coping strategies. (c) 2006 Excerpta Medica Inc. All rights reserved.