The Effect of the Duty Loading on the Stress Response of Physician

Study Overview
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Brief Summary
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The investigators will study in the possibility of cardiovascular disease, caused by the duty loading, of physician of internal medicine. The investigators will also explore if there {dose response effect} between the duty loading and the stress response of physicians of internal medicine. Therefore, the investigators will compare the stress responses of physicians of internal medicine during with different duty loading ( non-duty day, one duty area with 3 wards, 2 duty areas with 6 wards) in a observational method. Those stress response will be measured by cardiovascular risk indicators, including blood pressure, heart rate variability, blood sampling and urine sampling.

Official Title
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The Effect of the Duty Loading on the Stress Response of Physician

Conditions
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Physiological Stress, Psychological Stress

Intervention / Treatment
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* Procedure: 24 hour EKG and blood pressure monitor
* Other: Blood and urine sampling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Attending physicians of internal medicine of Taipei municipal hospital, certified by Taiwan society of internal medicine. Exclusion Criteria: thyroid dysfunction pregnancy, diabetes mellitus history of cardiovascular disease (stroke, coronary arterial disease, or myocardial infraction) current smokers, or taking sleeping pills or B-blocker

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Physician of internal medicine in Taipei city hospital<br> | Procedure: 24 hour EKG and blood pressure monitor<br>* All subjects will have non-invasive 24 hour EKG and 24 hour EKG monitoring for 24 hours.<br>Other: Blood and urine sampling<br>* Right before and after the duty loading, all subjects will have blood samplings, including CRP, WBC, IL-6, Fibrinogen, insulin, IL-6, Procalcitonin, TNF-alfa, catecholamine level. Right after the duty loading, all subjects will have urine samplings for cortisol and catecholamine level.(blood : 15CC/time and 2 4 times/month)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The physiological change of physician during different duty loadings | The investigators will also explore if there {dose response effect} between the duty loading and the stress response of physicians of internal medicine, and will compare the stress responses of physicians of internal medicine during with different duty loading in a observational method. Those stress response will be measured by cardiovascular risk indicators, including blood pressure, heart rate variability, blood sampling and urine sampling. | 4 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Physician, duty loading, stress response, Physician with different amount of duty area