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PubMedDate not supplied

Effect of a skills programme on minor surgical workload in general practice.

It is important that educational programmes designed to meet the surgical training needs of general practitioners be demonstrably effective. To measure change in surgical workload and repertoire among participants in a surgical skills training programme. Log diary of surgical workload of five general practitioners during and four years following a surgical skills programme in 1992. Respondents operated on twice as many surgical cases in the follow-up period as in the baseline period. The increased volume of work was made up of a wider range of procedures for all respondents. Referral of minor surgical cases fell from 22% to 1.4% between periods. Surgical workload and repertoire is increased among participants in a minor surgical skills programme four years later.

Clinical Competence↗

PubMed2001

[General practitioner's workload: objective increase in 9 practices in Rotterdam and surroundings, 1992-1997 and an extrapolation to 2005].

OBJECTIVE: To assess the change in general practitioners' (GPs') workload during the period 1992-1997, calculated as consult frequency and GP-patient contact time, and to estimate the workload in 2005. DESIGN: Descriptive. METHOD: During the period 1992 to 1997, data from all GP-patient contacts from nine general practices in and around Rotterdam, the Netherlands, were registered and stored in a central database. The yearly GP-patient contact time in 1992 and 1997 was calculated using the measured contact frequencies and known figures from the medical literature on the distribution and average duration of the different contact types (consultation, home visit, telephonic consultation, other). The contact time in 2005 was estimated by extrapolating the contact time for the period 1992 to 1997, whilst bearing in mind the expected population composition in 2005. RESULTS: The number of GP consultations increased from 4.26 in 1992 to 5.16 in 1997 (+21%). Compared with 1992, the yearly GP-patient contact time in 1997 was at least 90 hours higher. Extrapolation to 2005, revealed a further increase in this contact time of 667 (+36%) hours compared to 1997. This predicted increase in the workload could mostly be attributed to an increase in the number of elderly patients and the number of contacts with these patients. CONCLUSION: The number of hours worked by GPs increased by 20% over a six year period and is expected to increase by about a third over the next few years.

Adult↗

PubMed1997

[Application of mean EMG to the evaluation of human workload during manual operation].

To evaluate human workload during manual operation, 9 subjects participated in the attitude maintaining experiment with simulated earth scenery as the display and a stick as the controller. Mean-rectified EMG was chosen as the index. Surface EMG was recorded in a couple of agonist and antagonist. Kinematics equation was simulated on a analog computer, and three difficulty of work were controlled by changing the amplifier's coefficients. 486 Computer was used to record the quantity of subject's operation and the data of Mean EMG from amplifier. Relevant software was compiled. The results showed that there was a linear relationship between mean-rectified EMG and difficulty of work. The effects of training on workload were also discussed. Mean EMG can be used as an index for evaluating human workload.

Electromyography↗

PubMed2001

[Application of brain state related EEG complexity measure in mental workload evaluation].

Objective. The Application of Cs to mental workload evaluation was investigated. Method. EEG of 47 male (aged 23-33) were recorded during rest or doing mental arithmetic, and changes of Cs with relation to mental arithmetic load were analyzed and compared by means of Cs analysis method. Result. Cs distribution was laterally symmetry, higher in temporal and lower in occiput. The changes of Cs over some brain areas were outstanding and stable while doing mental arithmetic: type A, 38 subjects (81%), Cs under mental arithmetic were significantly higher than Cs under rest except over prefrontal, and the most outstanding areas were post-temporal and left parieto-occipital regions; type B, 9 subjects (19%), Cs over post-temporal and parieto-occipital under rest is higher than type A, and Cs under mental arithmetic descend significantly (the most outstanding areas were right central and mid-temporal, then left frontal-central and pre-temporal). Moreover there were some possible relationship among Cs, mental arithmetic score and subjective evaluation of mental workload. Conclusion. There exists high correlation between Cs and mental arithmetic activity, and Cs could well reflect brain function state. It provide a new method and a possible way for objective evaluation of mental workload and studies of brain cognitive activities.

Adult↗

PubMed1998

[Heat strain for personnel wearing three levels of protective ensembles at moderate and heavy workloads].

The effects of individual protective ensembles and workloads on personnel's physiological heat strain were experienced by personnel in a hot environment (35 degrees C, 55% relative humidity). Six young males performed treadmill tests at both moderate (ML: 1.11 m/s, 5% grade) and heavy (HL: 1.34 m/s, 5% grade) workloads. They wore three levels of protective ensembles: protective mask only (PM), protective clothing only (PC), and full protective ensembles (FP). Tests lasted 60 min and 45 min, respectively, for ML and HL. Physiological measurements included heart rate (HR), rectal (Tre) and skin (Tsk) temperature, sweat rate (SR), and sweat evaporative rate (ER). Differences between the ensembles and the workloads were significant for HR responses. The increase rate in Tre and Tsk, and SR, ER were significantly reduced from PM and PC to FP condition during ML and Hl tests. The sweat evaporation restriction of ensembles and the increase of heat production from exercise are the main factors of enhancing the heat strain.

Adult↗

PubMed2002

Attentional processes in time perception: effects of mental workload and event structure.

The role of attention in timing was evaluated in 2 experiments. In Experiment 1, participants reproduced the durations of melodies with either a coherent or an incoherent structure. Participants were tested under control (timing only) and detection (timing plus target detection) workload conditions. Reproductions were shorter and more inaccurate under detection conditions, and incoherent event structure extended the effect to a wider range of durations. In Experiment 2, participants reproduced the durations of auditory prose passages that represented 3 levels of mental workload and 3 levels of event structure. Both increases in workload and the degradation of structure led to inaccurate reproductions. The results point to the central role of attention in temporal experience.

Adult↗

PubMed2003

Addressing the problems associated with general practitioners' workload in nursing and residential homes: findings from a qualitative study.

BACKGROUND: Caring for older people in residential and nursing homes makes major demands on general practitioners (GPs). AIM: To investigate the perceptions and experiences of home managers and GPs of the provision of general medical services for older residents. DESIGN OF STUDY: In-depth qualitative study. SETTING: Forty-two nursing and residential homes in five locations in England, interviewing home managers and eight of their residents' GPs. METHOD: Semi-structured face-to-face and telephone interviews. RESULTS: Most homes endorse principles of continuity of care and patient choice. Although many homes therefore deal with a large number of GPs, with the inherent difficulties of coordinating care and duplication of GP effort, limitations in residents' choice of GP result in the majority of residents in many homes being registered with only one or two practices. Contracts between homes and GPs may provide opportunities for improving medical care but do not guarantee additional services and have implications for patient choice and residents' fees. Visits on request form the bulk of GPs' workload in homes but can be hard to obtain for residents and may not be appropriate. Regular weekly surgeries are preferred by many homes but may have additional workload implications for GPs. CONCLUSION: The assumption that patient choice and continuity in medical care are paramount for older people in nursing and residential homes is questioned. While recognition of the additional workload for GPs working in these settings is necessary, this should be accompanied by additional NHS remuneration. Further research is urgently required to identify which models of GP provision would most benefit both residents and GPs.

Aged↗

PubMed1992

Perceived workload and performance of shift workers.

The present paper is based on the results of a study conducted to investigate whether the relationship between perceived workload and quality of performance, if any, holds true if controlled for shift system, type of task, age, and skill level of the workers. The sample of the study comprised 279 blue-collar workers of a jute industry operating under fixed three-shift system. The subjects were all males selected by random sampling method. The method of data collection was a field study through questionnaire. The collected data were analyzed by employing zero-order and partial correlation coefficients. The results indicate that workload and performance were negatively correlated but the strength of the relationship reduced substantially when the effects of the control variables were partialled out simultaneously. It was concluded that the control variables had joint effect on the relationship between workload and performance but skill level of the employees appeared to be the variable having the greatest contaminating effect.

Adolescent↗

PubMed2004

[The length of the patient list, waiting lists, workload and job satisfaction among general practitioners in Bergen].

BACKGROUND: A list patient system was established in Norway in June 2001. Among general practitioners (GPs) there were much concern about workload according to list length, and about uneven distribution of workload among GPs. MATERIAL AND METHODS: In February 2003 a questionnaire about working hours, waiting time for appointments and job satisfaction was sent to all GPs in Bergen. RESULTS: 160 out of 185 (85%) GPs replied. Working hours were closely related to list length, waiting time was not. 79% had a waiting time of less than eight "days in practice". 46% rated their job satisfaction within the list system as "good/very good", 37% were moderately satisfied. We found lower scores among GPs with long waiting time and a full list. No relevant differences between male and female GPs were found. INTERPRETATION: GPs adjust their working hours in order to cope with waiting time. Job satisfaction is lower when the GP has a waiting time of more than three weeks and a full list, factors that could indicate a heavy workload.

Adult↗

PubMed2005

New Zealand general practitioners' characteristics and workload: the National Primary Medical Care Survey.

AIMS: To describe the characteristics and workload of New Zealand general medical practitioners (GPs). METHODS: Data were collected from a stratified random sample of GPs as part of the The National Primary Medical Care Survey carried out in 2001. RESULTS: Data were submitted by 244 practitioners; a 62% response rate. Women made up 63% of the GP workforce aged under 40 years, but only 19% of those aged over 50 years. New Zealand graduates made up 69% of GPs; graduates from other areas occupied particular niches in the GP workforce. Each week, GPs worked (on average) 4 days and saw 102 patients. Eighty percent undertook after-hours work, and the average on-call roster was 1-in-8. At least 8% of visits to GPs occurred after-hours. Parameters of workload were lower for women and for those working in community-owned clinics, and higher for those working outside cities. CONCLUSIONS: An increasing proportion of GPs are women, and more GPs are working part time. In addition, if the changes in primary healthcare add to GPs' responsibilities, then more doctors will be needed. At present, GPs' workload is high in rural areas, which suggests inadequate recruitment; the distribution of GPs is a more important workforce issue than absolute numbers.

Adult↗

PubMed2003

Workload of the steering work on a high-speed vessel.

The higher incidence of accidents occurring on board among the high-speed vessels has motivated this study focusing on the actual operating conditions contributing to the incidence. The working activities and workload of the officers and quartermasters were compared between the conventional and high-speed vessels of regular service ferry, by recording video-pictures and heart rate of the crews during actual navigations. An autopilot equipment was installed in the conventional vessel of over 6000 tons, but not in the high-speed vessel of about 1500 tons. Either on the conventional or high-speed vessel, dominant activities of the officers were lookout and watching radar, which were conducted in standing on the conventional vessel and in sitting on the high-speed vessel. Major works of the quartermasters were lookout and radar watch in standing on the conventional vessel and steering operations with a joystick in sitting on the high-speed vessel. Despite these differences in postural conditions, the mean % heart rate increase in both crews was significantly higher on the high-speed than on the conventional vessel. In the quartermaster, the events requiring steering maneuvers on the high-speed vessel were associated with increase in heart rate. The findings as a whole suggest occurrence of substantial mental strains in the crew on the high-speed vessel. These strains, certainly derived from caring for the safety in the absence of autopilot equipment, must have intensified the workload in the crew. In connection with the workload, the necessity for some fail-safe systems, including the autopilot facilities, and educational systems for techniques of steering high-speed vessels was discussed.

Accident Prevention↗

PubMed2005

The workload of GPs: consultations of patients with psychological and somatic problems compared.

BACKGROUND: GPs report that patients' psychosocial problems play a part in 20% of all consultations. GPs state that these consultations are more time-consuming and the perceived burden on the GP is higher. AIM: To investigate whether GPs' workload in consultations is related to psychological or social problems of patients. DESIGN OF STUDY: A cross-sectional national survey in general practice, conducted in the Netherlands from 2000-2002. SETTING: One hundred and four general practices in the Netherlands. METHOD: Videotaped consultations (n = 1392) of a representative sample of 142 GPs were used. Consultations were categorised in three groups: consultations with a diagnosis in the International Classification of Primary Care chapter P 'psychological' or Z 'social' (n = 138), a somatic diagnosis but with a psychological background according to the GP (n = 309), or a somatic diagnosis and background (n = 945). Workload measures were consultation length, number of diagnoses and GPs' assessment of sufficiency of patient time. RESULTS: Consultations in which patients' mental health problems play a part (as a diagnosis or in the background) take more time and involve more diagnoses, and the GP is more heavily burdened with feelings of insufficiency of patient time. In consultations with a somatic diagnosis but psychological background, GPs more often experienced a lack of time compared to consultations with a psychological or social diagnosis. CONCLUSION: Consultations in which the GP notices psychosocial problems make heavier demands on the GP's workload than other consultations. Patients' somatic problems that have a psychological background induce the highest perceived burden on the GP.

Adult↗

PubMed2005

[The appraisal of reliability and validity of subjective workload assessment technique and NASA-task load index].

OBJECTIVE: To test the reliability and validity of two mental workload assessment scales, i.e. subjective workload assessment technique (SWAT) and NASA task load index (NASA-TLX). METHODS: One thousand two hundred and sixty-eight mental workers were sampled from various kinds of occupations, such as scientific research, education, administration and medicine, etc, with randomized cluster sampling. The re-test reliability, split-half reliability, Cronbach's alpha coefficient and correlation coefficients between item score and total score were adopted to test the reliability. The test of validity included structure validity. RESULTS: The re-test reliability coefficients of these two scales and their items were ranged from 0.516 to 0.753 (P < 0.01), indicating the two scales had good re-test reliability; the split-half reliability of SWAT was 0.645, and its Cronbach's alpha coefficient was more than 0.80, all the correlation coefficients between its items score and total score were more than 0.70; as for NASA-TLX, both the split-half reliability and Cronbach's alpha coefficient were more than 0.80, the correlation coefficients between its items score and total score were all more than 0.60 (P < 0.01) except the item of performance. Both scales had good inner consistency. The Pearson correlation coefficient between the two scales was 0.492 (P < 0.01), implying the results of the two scales had good consistency. Factor analysis showed that the two scales had good structure validity. CONCLUSION: Both SWAT and NASA-TLX have good reliability and validity and may be used as a valid tool to assess mental workload in China after being revised properly.

Adolescent↗

PubMed2005

[Application of heart rate variability in evaluation of mental workload].

OBJECTIVE: To investigate if heart rate variability (HRV) can be used to evaluate mental workload. METHODS: Forty-six volunteers were selected to simulate mental work by inputting the random number through keyboards. ECG was recorded by Holter 8800 during the performance and transferred into digital signal. Total power (TP), low frequency (LF), high frequency (HF) were analysed by Holter software. RESULTS: Along with time, the inputting speed increased but accuracy decreased, and was positively correlated with TP, LF (r = 0.851 and 0.827 respectively, P < 0.05), showing a distinct dose-effect relationship. HRV values at rest were higher than during mental work [TP: (2 745.4 +/- 1 301.6) vs (686.2 +/- 420.7) ms(2)/Hz; HF: (670.6 +/- 393.8) vs (202.6 +/- 171.7) ms(2)/Hz; LF: (870.5 +/- 553.7) vs (206.0 +/- 187.9) ms(2)/Hz] indicating that they were decreased remarkably as the mental work started. Then, they were gradually increased with the workload (intensity and time) increased, but still at lower level. CONCLUSION: HRV may be used as a parameter to evaluate mental workload but the change pattern of HRV needs to study further.

Adult↗

PubMed2005

[Experimental study of pilots' scan and performance, workloads].

OBJECTIVE: To study the problems of pilots' scan, performance, workload. METHOD: An experimental system for evaluating pilots' scan, performance, workload was built up based on previous studies. RESULT: After theoretical consideration and analysis of experimental results, the difference between expert pilots and novice pilots were disclosed preliminarily. CONCLUSION: Expert pilots demonstrates more frequent fixations with shorter dwell time than novice pilots do; to both pilots, the conclusion can be drawn that the variation between workloads and performance is not fixed.

Aerospace Medicine↗

PubMed2000

Increase in information content in histopathology reports: a concealed workload for histopathologists.

INTRODUCTION: The workload of histopathologists is traditionally assessed by the total number of specimens handled annually (TSA). Development in medical science has resulted in an increased demand by clinicians for more information in histopathology reports. Inclusion of this information requires more work. Annual information output (AIO) is the total number of specimens handled annually multiplied by the average number of items of information per histopathology report (AIR). An item of information is any pathological feature of prognostic or therapeutic relevance. OBJECTIVE: This study aims to determine whether there has been an increase in annual information output (AIO) during a 17-year period. METHOD: This is a retrospective study in a University Department of Pathology. 200 histopathology reports per year at 4 yearly intervals from 1982 to 1998 were examined. TSA, AIR and AIO were calculated. RESULTS: TSA increased from 2912 in 1982 to 3919 in 1998 (34.6% increase). AIR increased from 1.11 to 3.12 (181.1% increase). AIO increased from 3232.3 to 12227.3 (278.3% increase). CONCLUSION: The increase in AIO was greater than the increase in TSA. Thus the use of TSA alone will not reflect the increase in workload accurately. We recommend the use of AIO rather than TSA to quantify workload and staffing requirements of histopathologists.

Forms and Records Control↗

PubMed2006

Significance of posture and workload in exercise renography.

BACKGROUND: Exercise-induced alteration in renal function has been described in patients with essential hypertension. The aim of our study was to assess the significance of adopting a supine posture and the degree of workload required to induce these changes in patients with essential hypertension. The second aim was to assess whether the severity of hypertension had any influence on the development of exercise related renal dysfunction. MATERIAL AND METHODS: Fifteen patients were studied (nine patients with mild and untreated hypertension and six patients with drug resistant hypertension). Exercise renography was carried out using a cycloergometer with the patient lying in supine posture and a target exercise rate of 20 bpm over baseline rate. Each patient was injected with 100 MBq of 99mTc-MAG3 and renography was carried out for 20 minutes. Renography was repeated in rest condition only when an abnormality was observed in exercise scans. RESULTS: Exercise renography was normal in 12 patients, while in 3 patients minor abnormalities were observed during exercise related to a minimal degree of pelvic dilatation. These changes remained substantially unmodified at rest. In none of the 15 patients did we find positive studies (i.e. reversible exercise induced prolongation of tracer transit caused by cortical retention). There was no difference in the results between patients with mild or severe hypertension. CONCLUSIONS: Our results are different from previous reports on exercise renography since different groups have demonstrated exercise-induced renal dysfunction in the majority of patients with essential hypertension. The main differences between our protocol and that adopted in the literature relate to posture during exercise (upright vs. supine) and degree of workload (minor in supine exercise with less workload). These differences may have contributed to our results but further and larger studies are required to address the pathophysiological basis of exercise-induced alteration in renal function in association with essential hypertension.

Adult↗

PubMed1994

Out-of-hours workload of junior and senior house surgeons in a district general hospital.

The objective of this study was to assess the out-of-hours workload of junior and senior house officers in general surgery working in a busy DGH in relation to the 'New Deal' guidelines on junior doctors' hours of work. We also wanted to identify safe levels of manning for these grades of staff and to collect accurate data on workload upon which decisions could be made regarding any change in manning levels consequent upon the 'New Deal'. The study is a prospective audit of all work undertaken by 11 junior and senior house surgeons attached to six consultants between 1700 hrs and 0800 hrs during a 16-day period in August 1992. The results showed that the out-of-hours workload of the five JHOs and six SHOs proved to be very onerous. The rotas were 1:5 or 1:6 for emergencies depending on grade plus 1:11 for ward cover. The JHOs were occupied for 70 per cent of the period between 1700 hrs and 2400 hrs and 32.5 per cent of the period after 2400 hrs. For the same periods the SHOs were busy for 61 per cent and 29 per cent respectively. The doctors covering ward duties were occupied for 48 per cent of the period up to midnight when the duty period ended. Both grades got four hours sleep on five of 16 nights. Non-medical tasks accounted for 29 per cent of the ward doctors working time but were a small part of the other doctors work. It was concluded that in this typical busy DGH junior and senior house officers work extremely hard when on call, and that they cannot be reasonably be asked to further increase their level of activity. It follows that a reduction in the hours of work will require additional staff if the standard of care delivered to the patients is to be maintained.

Hospitals, District↗