Table 2.
Association between resident duty hours and mental health outcomes (n = 6045).
| Outcome | DH category | N | Outcome prevalence (%) | Univariable model | Multivariable model† | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| PR | 95% CI | P | PR | 95% CI | P | ||||||
| Depression | C1: < 50 h | 861 | 39.5 | 1.09 | 0.98 | 1.22 | 0.128 | 1.07 | 0.96 | 1.20 | 0.213 |
| C2: ≥ 50 and < 60 h | 1687 | 35.9 | 0.99 | 0.90 | 1.08 | 0.807 | 0.99 | 0.90 | 1.08 | 0.829 | |
| C3: ≥ 60 and < 70 h | 1580 | 36.3 | 1 | Reference | 1 | Reference | |||||
| C4: ≥ 70 and < 80 h | 709 | 34.0 | 0.94 | 0.83 | 1.06 | 0.297 | 0.94 | 0.83 | 1.06 | 0.290 | |
| C5: ≥ 80 and < 90 h | 741 | 38.9 | 1.07 | 0.96 | 1.20 | 0.222 | 1.07 | 0.96 | 1.20 | 0.222 | |
| C6: ≥ 90 and < 100 h | 258 | 43.0 | 1.19 | 1.02 | 1.38 | 0.030 | 1.15 | 0.99 | 1.34 | 0.061 | |
| C7: ≥ 100 h | 209 | 45.9 | 1.27 | 1.08 | 1.49 | 0.004 | 1.21 | 1.04 | 1.41 | 0.016 | |
| Burnout | C1: < 50 h | 861 | 23.8 | 1.09 | 0.94 | 1.27 | 0.231 | 1.05 | 0.90 | 1.22 | 0.542 |
| C2: ≥ 50 and < 60 h | 1687 | 19.5 | 0.90 | 0.78 | 1.03 | 0.119 | 0.88 | 0.77 | 1.02 | 0.082 | |
| C3: ≥ 60 and < 70 h | 1580 | 21.8 | 1 | Reference | 1 | Reference | |||||
| C4: ≥ 70 and < 80 h | 709 | 19.2 | 0.88 | 0.74 | 1.04 | 0.145 | 0.87 | 0.73 | 1.03 | 0.107 | |
| C5: ≥ 80 and < 90 h | 741 | 19.7 | 0.90 | 0.76 | 1.08 | 0.259 | 0.91 | 0.77 | 1.09 | 0.303 | |
| C6: ≥ 90 and < 100 h | 258 | 30.6 | 1.41 | 1.15 | 1.72 | 0.001 | 1.36 | 1.11 | 1.66 | 0.003 | |
| C7: ≥ 100 h | 209 | 31.6 | 1.45 | 1.17 | 1.80 | 0.001 | 1.36 | 1.10 | 1.68 | 0.005 | |
| High stress | C1: < 50 h | 861 | 35.4 | 0.88 | 0.79 | 0.98 | 0.025 | 0.86 | 0.77 | 0.96 | 0.007 |
| C2: ≥ 50 and < 60 h | 1687 | 35.2 | 0.88 | 0.80 | 0.96 | 0.004 | 0.87 | 0.80 | 0.95 | 0.002 | |
| C3: ≥ 60 and < 70 h | 1580 | 40.1 | 1 | Reference | 1 | Reference | |||||
| C4: ≥ 70 and < 80 h | 709 | 40.8 | 1.02 | 0.92 | 1.13 | 0.743 | 1.02 | 0.92 | 1.14 | 0.643 | |
| C5: ≥ 80 and < 90 h | 741 | 43.2 | 1.08 | 0.98 | 1.19 | 0.134 | 1.09 | 0.99 | 1.20 | 0.083 | |
| C6: ≥ 90 and < 100 h | 258 | 48.4 | 1.21 | 1.04 | 1.40 | 0.012 | 1.20 | 1.04 | 1.38 | 0.013 | |
| C7: ≥ 100 h | 209 | 51.2 | 1.28 | 1.09 | 1.50 | 0.003 | 1.26 | 1.07 | 1.48 | 0.005 | |
| Satisfaction | C1: < 50 h | 861 | 59.5 | 0.94 | 0.88 | 1.00 | 0.044 | 0.97 | 0.92 | 1.04 | 0.407 |
| C2: ≥ 50 and < 60 h | 1687 | 61.6 | 0.97 | 0.92 | 1.03 | 0.327 | 0.99 | 0.94 | 1.04 | 0.643 | |
| C3: ≥ 60 and < 70 h | 1580 | 63.4 | 1 | Reference | 1 | Reference | |||||
| C4: ≥ 70 and < 80 h | 709 | 63.8 | 1.01 | 0.94 | 1.08 | 0.853 | 1.00 | 0.93 | 1.06 | 0.880 | |
| C5: ≥ 80 and < 90 h | 741 | 64.1 | 1.01 | 0.95 | 1.08 | 0.725 | 0.99 | 0.93 | 1.06 | 0.768 | |
| C6: ≥ 90 and < 100 h | 258 | 62.8 | 0.99 | 0.90 | 1.09 | 0.858 | 0.97 | 0.88 | 1.07 | 0.540 | |
| C7: ≥ 100 h | 209 | 60.3 | 0.95 | 0.85 | 1.07 | 0.411 | 0.92 | 0.82 | 1.04 | 0.176 | |
There was a higher proportion of burnout and depression among residents with DHs > 90 h weekly. High stress was positively correlated with DH; however, satisfaction was not. †Adjusted for gender, postgraduate year, hospital type, hospital region, specialty preference, scholarship activities (case report or conference presentation), number of assigned inpatients, number of ED duties per month, and self-study time per day.
DH, duty hour; PR, prevalence ratio; CI, confidence interval; C1–C8, Categories 1 to 8; h, hours.