Self-Reported Surgeon Health Behaviours: A Multicentre, Observational Exploration With the Association of Surgeons in Training Into the Modifiable Factors That Impact Surgical Performance

Introduction: Surgeons regularly educate patients on health promoting behaviours including diet, sleep and exercise. No study thus far has explored surgeons' personal compliance with these health-behaviours and their relationship with surgical performance.

The primary outcomes this study were self-reported health, health related behaviours, wellbeing, fatigue and surgical performance. Methods: A survey of validated themes on health-related behaviours, workplace variables and performance was distributed to surgical trainees and consultants in the UK and Ireland through the Association for Surgeons in Training (ASiT). Non-parametric analysis was used to determine inferential associations. Results: Ninety five surgeons (median age 35-44, 51.5 % female, 39.9% registrars) completed the survey. 94% reported having at least 'good' overall health. . A majority (54.7%) report inconsistent sleep patterns, while less than a quarter engage in regular exercise. 74% reported having at least 'good' overall mental and emotional well being.

Sixty two and 64.2% reported being regularly fatigued and bothered by feelings of anxiety and/or depression respectively. Poor self-reported health and wellbeing were associated with poorer reported off-call performance (p<.01). Higher levels of fatigue negatively impacted self-reported surgical and non-surgical task proficiency (p<.01). Discussion and Conclusion: Surgeons reported high levels of overall health. However, healthy behaviours around sleep, diet and exercise were not consistently reported. Fatigue, anxiety and regular rumination were reported by greater than half of respondents. When compared to overall health numbers, 20% less surgeons reported overall mental health and emotional well-being that good or better. Self-reported health behaviours including sleep and physical activity were associated with surgical performance. Strategies to improve modifiable lifestyle factors, which will optimise physical health, mental wellbeing and levels of fatigue may optimise surgical performance. Further research should target these behaviours to elicit desired changes.

Study Overview

• Status: Completed
• Conditions: Health Behavior
• Intervention / Treatment: Other: No intervention is given

• Study Type: Observational
• Enrollment (Actual): 100

Contacts and Locations

Study Locations

• Ireland
  • XX - Other State/Province/Territory
    • Dublin 24, XX - Other State/Province/Territory, Ireland, 0000
      • Tallaght University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Trainees and consultant surgeons

Description

Inclusion Criteria:

• surgeon
• working in TUH or member of ASIT

Exclusion Criteria:

• non surgeon
• not a member of ASIT or TUH

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
TUH Staff; Staff within Tallaght University Hospital - anonymised	Other: No intervention is given; No intervention given; Other Names: No intervention given
ASIT Members; Members of the Association of Surgeons in Training - anonymised	Other: No intervention is given; No intervention given; Other Names: No intervention given

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-reported health and wellbeing [This was a survey which was designed and validated as part of the study]	Likert scale: In general, how would you rate your overall health? In general, how would you rate your overall mental or emotional health? During the past 4 weeks, how disruptive were your physical health or emotional problems to your normal professional activities?	June-August 2020
Levels of Fatigue	Likert Scale: In a typical week, how often do you feel fatigued at work? I manage work-related fatigue effectively.	June-August 2020

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sleep Outcomes	How many caffeinated drinks do you have each day? How often do you complete on-call work? How many hours do you sleep on average each night on a week without on-call? How many hours do you sleep on average each night on a week without on-call? How many hours on average do you sleep after on-call?	June-August 2020
Performance Outcomes	In general, how would you rate your overall daily work performance when you're not on-call? In general, how would you rate your overall daily work performance when on-call? In a typical week, how often do you feel fatigue negatively impacts your ability to perform surgical tasks optimally?	June-August 2020
Stress Outcomes	In a typical week, how often do you feel stressed at work? I find it easy to switch off after work.	June-August 2020
Commuting Outcomes	How long do you typically spend commuting to work daily? How long do you typically spend commuting from work daily?	June-August 2020
Physical Activity Outcomes	How many times in the average week do you engage in 30 minutes of light activity (i.e. leisurely walking, gardening, cleaning around the house)? How many times in the average week do you engage in 30 minutes of moderate activity (i.e. brisk walking, light bicycling)? How many times in the average week do you engage in 30 minutes of strenuous activity (i.e. running or jogging)? Do you feel you get too much exercise, too little exercise, or about the right amount of exercise?	June-August 2020
Diet Outcomes	How often do you eat breakfast? How often do you eat lunch? How often do you eat dinner? How often do you eat fast food? How many portions of fruit do you eat each day? If you don't know for certain, please provide an estimate. How often do eat sweet things e.g. sweets, chocolate, crisps?	June-August 2020
Health Check Outcome	When is the last time that you saw a doctor? When is the last time that you saw a dentist?	June-August 2020
Work Culture Outcome	In my experience, surgery staff are treated fairly when they make mistakes. We have enough staff to handle the workload.; Error disclosure is promoted and implemented effectively in our profession.; I have made major work-errors as a result of fatigue.	June-August 2020

Collaborators and Investigators

• Sponsor: University of Dublin, Trinity College
• Investigators: Principal Investigator: Dale F Whelehan, BSc, University of Dublin, Trinity College

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2020
• Primary Completion (Actual): August 1, 2020
• Study Completion (Actual): October 1, 2020

Study Registration Dates

• First Submitted: November 27, 2020
• First Submitted That Met QC Criteria: December 18, 2020
• First Posted (Actual): December 21, 2020

Study Record Updates

• Last Update Posted (Actual): December 21, 2020
• Last Update Submitted That Met QC Criteria: December 18, 2020
• Last Verified: December 1, 2020

More Information

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No