Sleep quality as a mediator in the relationship between doctors' worktime control and patient safety

• Objective: Poorer worktime control is associated with greater sleep disturbances. The fatigue that results from poor quality sleep may pose a threat job performance. Thus the current study seeks to determine whether the relationship between doctors' worktime control and their perceptions of the risk of medical error is mediated by sleep quality.Method: A representative sample of doctors in Sweden (N = 1534) completed a questionnaire about working conditions, wellbeing and patient safety (response rate 53.1%). Worktime control was measured by two items which asked respondents: (1) whether they could influence their work hours; and (2) whether they had access to flexitime (response options ‘‘yes’’, ‘‘yes, to some extent’’ and ‘‘no’’). Concerns about patient safety were measured by two items which asked respondents: (1) how much they worried about the risk of making mistakes (five response options from ‘‘no, never’’ to ‘‘yes, constantly’’); and (2) how often they felt that their workload increased the risk of malpractice (four response options from ‘‘daily’’ to ‘‘less than once a month’’). Sleep quality was measured by the Karolinska Sleep Quality Index (KSQI), calculated as the mean score of responses to four items which asked participants how often they had experienced each of the following sleep symptoms in the last three months: difficulty falling asleep, repeated awakenings with difficulty falling back to sleep, too early (final) awakening and interrupted / restless sleep (range of possible scores: 1 – Never; 5 – Always/5 times or more per week).Results: There were significant associations between both worktime control measures, both patient safety measures and scores on the KSQI. Mediation analyses (Sobel test for mediation) indicated that the associations between each worktime control measure and each patient safety measure were mediated by sleep quality (P < 0.0001 in each case).Conclusion: Worktime control allows doctors to optimise the fit between the demands of their work schedule, and their own personal needs and circumstances. In doing so, it facilitates sleep and recovery between duty periods, thereby enhancing job performance and promoting patient safety.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

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