The Identification of Modifiable Emergency Department and Sleep Factors Contributing to Psychological and Cardiovascular Risk in Clinicians
确定导致临床医生心理和心血管风险的可修改急诊室和睡眠因素
基本信息
- 批准号:10547767
- 负责人:
- 金额:$ 76.75万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-01-01 至 2024-12-31
- 项目状态:已结题
- 来源:
- 关键词:Accident and Emergency departmentAcuteAddressAgeBlood PressureBody mass indexCardiovascular DiseasesChronic stressCircadian desynchronyCoronary heart diseaseCrowdingDataDepersonalizationDiné NationDisease OutcomeEmergency Department PhysicianEmergency department crowdingEmotionalEnvironmentEnvironmental Risk FactorEventExposure toHealthHourInstitute of Medicine (U.S.)InterventionLinkLipidsMediatingMedicalMedical ErrorsMental disordersMeta-AnalysisNursesOccupationsParticipantPathway interactionsPatient CarePatient riskPatient-Focused OutcomesPatientsPhysiciansPhysiologicalPolysomnographyPost-Traumatic Stress DisordersProviderPsychological StressPsychosocial FactorReportingResearchResearch DesignRestaurantsRiskRisk FactorsRoleSleepSleep disturbancesSmokingSocietiesStressSymptomsSystemTestingWorkWorkplaceacute careacute stressbehavioral cardiologyblood pressure elevationburnoutcardiovascular disorder riskcardiovascular risk factorcohortdesignexhaustionfollow-upheart disease riskimprovedinnovationpoor sleepprospectivepsychologicpsychological outcomessafety netshift workstressor
项目摘要
Emergency department (ED) overcrowding was declared a “crisis” by the Institute of Medicine 10 years ago,
and EDs have become more crowded since. Patients treated in overcrowded EDs are at increased risk for
subsequent cardiovascular disease (CVD) and psychiatric disorder, largely due to increases in patients’
psychological stress during their acute care stay. While the association of ED stressors with patient CVD and
psychological outcomes is established, little work has explored the impact of ED environmental factors on the
nurses and doctors who spend years exposed to stressful and frequently overcrowded EDs—often after poor
sleep due to shift-work. This study will test whether modifiable ED factors and/or short sleep increase
ambulatory blood pressure (ABP) and psychological risk in ED clinicians
Whereas 45% of the 1 million physicians in the U.S. report symptoms of burnout, an astonishing 70% of ED
providers report burnout symptoms (i.e., emotional exhaustion, depersonalization, and reduced personal
accomplishment). There is evidence that aspects of acute care work (crowding, acute and chronic stress, shift
work) may contribute to burnout risk, which is related to worse patient care and more medical errors, and is
also an independent risk factor for CVD. Burnout is associated with 37% increased risk for coronary heart
disease (CHD) events, independent of age, body mass index, smoking, and lipid levels. Proposed physiological
mechanisms for the association of burnout with CVD include autonomic dysregulation and increased blood
pressure. Similarly, recent meta-analyses have shown short sleep (<6 hours) is associated with incident CHD
risk (RR=1.26), likely through similar pathways. Circadian misalignment, another consequence of shift work
common in ED providers, also increases CVD risk.
We will test the influence of ED factors, sleep, and circadian misalignment on ABP (a primary marker of CVD
risk) and burnout in an innovative study design, leveraging our expertise in ED research, behavioral cardiology,
and sleep. We will prospectively follow a cohort of ED physicians and nurses for 3 years, testing the hypothesis
that ED work factors (e.g. ED overcrowding, short sleep, and circadian misalignment due to shift work),
increase burnout and contribute to increased ABP. We will continually capture ED data on patient volume,
acuity, and staffing. Annually, participants will complete a 2-week burst, monitoring sleep duration, circadian
misalignment, and work-related stress. During each burst, we will assess burnout, job strain, and 24-hour ABP.
This design will allow us to: 1) evaluate the short-term contribution of ED crowding, circadian misalignment,
and short sleep to acute changes in ABP and psychological risk 2) characterize the relationship of cumulative
ED stress exposures and sleep impairment to 3-year progression of CVD and psychological risk.
10年前,美国医学研究所(Institute of Medicine)就宣布急诊科人满为患是一种“危机”,
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Bernard P. Chang其他文献
The Value of Measuring Diabetes Burnout
- DOI:
10.1007/s11892-021-01392-6 - 发表时间:
2021-06-16 - 期刊:
- 影响因子:6.400
- 作者:
Samereh Abdoli;Danielle Hessler;Mehri Doosti-Irani;Bernard P. Chang;Heather Stuckey - 通讯作者:
Heather Stuckey
Investigating graphesthesia task performance in the biological relatives of schizophrenia patients.
研究精神分裂症患者的生物学亲属的书写感觉任务表现。
- DOI:
- 发表时间:
2004 - 期刊:
- 影响因子:6.6
- 作者:
Bernard P. Chang;M. Lenzenweger - 通讯作者:
M. Lenzenweger
Methodological excursions in pursuit of a somatosensory dysfunction in schizotypy and schizophrenia
寻找精神分裂症和精神分裂症体感功能障碍的方法学探索
- DOI:
- 发表时间:
2003 - 期刊:
- 影响因子:0
- 作者:
M. Lenzenweger;K. Nakayama;Bernard P. Chang;J. Hooley - 通讯作者:
J. Hooley
Frequency of Fentanyl Exposure in Emergency Department Patients With Illicit Drug Use
急诊科非法药物使用患者的芬太尼接触频率
- DOI:
10.1016/j.annemergmed.2024.10.016 - 发表时间:
2025-03-01 - 期刊:
- 影响因子:5.000
- 作者:
Dana L. Sacco;Marc A. Probst;Zachary L. Mannes;Sandra D. Comer;Silvia S. Martins;Bernard P. Chang - 通讯作者:
Bernard P. Chang
Accuracy of the Denver-II in developmental screening.
Denver-II 在发育筛查中的准确性。
- DOI:
- 发表时间:
1992 - 期刊:
- 影响因子:8
- 作者:
F. Glascoe;K. E. Byrne;L. Ashford;K. Johnson;Bernard P. Chang;Bryan Strickland - 通讯作者:
Bryan Strickland
Bernard P. Chang的其他文献
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{{ truncateString('Bernard P. Chang', 18)}}的其他基金
Psychological symptoms in healthcare workers following the COVID-19 pandemic and relationship to long-term cardiovascular risk
COVID-19 大流行后医护人员的心理症状及其与长期心血管风险的关系
- 批准号:
10365638 - 财政年份:2022
- 资助金额:
$ 76.75万 - 项目类别:
Daily personal light exposure patterns and sleep in emergency department healthcare workers (administrative supplement to R01 HL146911)
急诊科医护人员的每日个人光照模式和睡眠(R01 HL146911 的行政补充)
- 批准号:
10666252 - 财政年份:2022
- 资助金额:
$ 76.75万 - 项目类别:
Psychological symptoms in healthcare workers following the COVID-19 pandemic and relationship to long-term cardiovascular risk
COVID-19 大流行后医护人员的心理症状及其与长期心血管风险的关系
- 批准号:
10558672 - 财政年份:2022
- 资助金额:
$ 76.75万 - 项目类别:
The Identification of Modifiable Emergency Department and Sleep Factors Contributing to Psychological and Cardiovascular Risk in Clinicians
确定导致临床医生心理和心血管风险的可修改急诊室和睡眠因素
- 批准号:
9886646 - 财政年份:2020
- 资助金额:
$ 76.75万 - 项目类别:
The Identification of Modifiable Emergency Department and Sleep Factors Contributing to Psychological and Cardiovascular Risk in Clinicians
确定导致临床医生心理和心血管风险的可修改急诊室和睡眠因素
- 批准号:
10319929 - 财政年份:2020
- 资助金额:
$ 76.75万 - 项目类别:
Testing a rapid outpatient management strategy on PTSD, cardiovascular and rehospitalization risk in TIA and minor stroke survivors evaluated in the Emergency Department
测试针对 PTSD、TIA 心血管和再住院风险以及急诊科评估的轻微中风幸存者的快速门诊管理策略
- 批准号:
10448410 - 财政年份:2018
- 资助金额:
$ 76.75万 - 项目类别:
Testing a rapid outpatient management strategy on PTSD, cardiovascular and rehospitalization risk in TIA and minor stroke survivors evaluated in the Emergency Department
测试针对 PTSD、TIA 心血管和再住院风险以及急诊科评估的轻微中风幸存者的快速门诊管理策略
- 批准号:
10208939 - 财政年份:2018
- 资助金额:
$ 76.75万 - 项目类别:
Testing a rapid outpatient management strategy on PTSD, cardiovascular and rehospitalization risk in TIA and minor stroke survivors evaluated in the Emergency Department
测试针对 PTSD、TIA 心血管和再住院风险以及急诊科评估的轻微中风幸存者的快速门诊管理策略
- 批准号:
9754258 - 财政年份:2018
- 资助金额:
$ 76.75万 - 项目类别:
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