There has been a concern especially in surgery training programs, reduction of working hours adversely affects the quality of surgical training. The problem is the focus of an article in the June issue of Archives of Surgery.
In an attempt to see how these restrictions affect teaching and patient care, Daniel Oertli, MD, of University Hospital Basel, Basel, Switzerland, and colleagues conducted an anonymous survey of residents and consultants in 52 countries from 93 surgical departments. Of 281 residents and 337 consultants, 405 responded.
In Switzerland, from January 1, 2005 population was limited to an hour to 50 hours per week. Every day, day and night work should be limited to 14 hours including all breaks and rest time each day must equal or exceed 11 consecutive hours. Residents are not allowed to work more than two hours overtime except in rare cases and overtime can not exceed 140 hours per year.
Oertli and his colleagues found that only 8.1% of the population and only 4.9% of surgical consultants feel the changes have been useful for surgical training.
More than half of those who responded to the survey (62.8% or residents, 77% of consultants) felt limited the working week had a negative impact on surgical training.
Both residents and consultants (76.9% and 73.4% respectively) said that while the fallen. It has long been one of the questions that critics reduced working hours for surgical residents worry will lead to a decrease in surgical skills.
More consultant than residents (70.1% compared to 43%) thought the quality of patients care has decreased.
Both residents and consultants (58.4% and 81.5% respectively) said the quality of life of residents has improved.
Oertli and colleagues fell 50 hours of constraint failure in Switzerland, but this one study will not address issues on the surgical residents work hours. Controversy over resident fatigue leads to medical errors that undermine the safety of patients and shorter working hours leads to a decrease in surgical skills will continue at this time.
Research shows that poor recovery frequent among patients who undergo elective surgery, up to one year. One of the seven patients reported more pain, disability and emotional problems, and one fourth report of the less viable a year after the operation, which ranged from plastic surgery to orthopedic surgery.
Researchers from the Netherlands surveyed 216 women and 185 men who underwent elective surgery. "Our study showed poor recovery was relatively frequent six and 12 months after surgery and may be partly explained by different physical and psychological factors," says Dr. Madelon Peters from the Department of Clinical Psychological Science at Maastricht University. "These include acute postoperative pain and preoperative anxiety."Seventeen Percent of Patients have More Pain one Year After Surgery
Researchers say the results show the importance of monitoring patients on the results. Seventeen percent of respondents had more pain one year after surgery, 16 percent reported emotional problems, and 24 percent reported less vitality.
Of the 400 patients interviewed, only 47 percent said they felt completely recovered after one year.
Peters said: "Our study showed that 15% of patients reporting pain still, and physical and emotional problems, one year after surgery, while 24% felt they had less energy than before their operation." Researchers say that patients who were concerned about before having surgery were lower than the average improvement in physical function and buy Valium.
Most of the changes in quality of life after surgery was scheduled for six months and then remained stabilnym.Avtory say: "It is clearly important to monitor how patients recover during this period, as initially poor recovery may have lasting consequences." More painful operations were associated with worse physical functioning after a year and a lower perception of recovery.
