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

Study Overview
=================
Brief Summary
-----------------
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&lt;.01). Higher levels of fatigue negatively impacted self-reported surgical and non-surgical task proficiency (p&lt;.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.

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

Conditions
-----------------
Health Behavior

Intervention / Treatment
-----------------
* Other: No intervention is given


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: surgeon working in TUH or member of ASIT Exclusion Criteria: non surgeon not a member of ASIT or TUH
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| TUH Staff<br>Staff within Tallaght University Hospital - anonymised | Other: No intervention is given<br>* No intervention given<br>* Other names: No intervention given;|
| ASIT Members<br>Members of the Association of Surgeons in Training - anonymised | Other: No intervention is given<br>* No intervention given<br>* 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 |