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Cognitive Empathy is relevant in clinical practice and will be assessed based on the accuracy of pain recognition and the pain intensity evaluation in a computerised task using facial expressions. Repeated measures across day and night shifts will provide the basis to understand the impact of shift work on those abilities in health care professionals.
Assessment and management of the pain patients experience is one of the key skills needed in the field of anesthesiology. The consideration of non-verbal cues is essential, especially the recognition of facial expressions. The human ability to recognize emotions in others depends on the capacity for empathy of an individual, specifically cognitive empathy. In the clinical context empathy is understood as a set of skills and competences rather than a character trait. It may therefore vary due to various parameters. Currently there is no research available on the influence of shift work on the human ability to recognize pain in facial expressions. However, work schedules that do not fit the natural circadian rhythm are known to alter the processing of emotions. In particular the ability to judge the intensity of an emotion is influenced. Therefore, the hypothesis of the present study will be, that shift work impairs the pain assessment performance of an individual. To test this hypothesis, the effect of shift work on the performance in recognizing and assessing pain intensity of faces by health care professionals in the anesthesia department will be assessed. A repeated measures assessment will be used.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| health care professionals | Staff from the department of anesthesia and general resuscitation and thoracic cardiac pediatric with patient contact that regularly works in shifts including night shifts |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Night shift work | Behavioral | Subjects are exposed to irregular sleep and sleep misalignment due to hospital night shifts. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of pain recognition accuracy during day or night | Pain recognition ability measured as accuracy (percentage correct responses / total responses) when subliminally presented with faces of different emotions in a computerised task : 48 trials including 1/3 of painful stimuli and 2/3 of non-pain stimuli (other distractor emotions are happy, disgusted, sad, angry, surprised). Stimuli from Delaware Pain Database. The change of accuracy during a shift (baseline measure at beginning of shift, post measure after shift) is compared between a day shift and a night shift | 1 day, 1 night |
| Comparison in pain intensity on NPRS - numerical pain rating scale | Pain assessment ability is measured as intensity rating on the common NPRS 11-point Likert scale of 0 - 10 (0 representing no pain and 10 indicating maximum pain) when consciously presented with faces (48 trials) showing pain in different intensity levels in a computerized task including neutral distractors. Stimuli from Delaware Pain Database. The change of intensity evaluation during a shift (baseline measure at beginning of shift, post measure after shift) is compared between a day shift and a night shift | 1 day, 1 night |
| Measure | Description | Time Frame |
|---|---|---|
| Prior Shift - Total Sleep Time in h compared between shift types | Before any shift participants are asked to give information on their sleeping behavior within the last 72 hours. The Total Sleep Time (TST = time asleep in bed excluding sleep latency and nocturnal awakenings) will be accumulated. | 1 day, 1 night |
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Exclusion criteria:
Inclusion criteria:
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Health Care Professionals:
Nurses, nursing assistants, child care nurses and volunteer doctors from the department of anesthesia and general resuscitation and thoracic cardiac pediatric
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Claude Bernard University | Lyon | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23336899 | Background | Czeisler CA, Pellegrini CA, Sade RM. Should sleep-deprived surgeons be prohibited from operating without patients' consent? Ann Thorac Surg. 2013 Feb;95(2):757-66. doi: 10.1016/j.athoracsur.2012.11.052. No abstract available. | |
| 16823021 | Background | Gelinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. Am J Crit Care. 2006 Jul;15(4):420-7. |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000073577 | Shift Work Schedule |
| ID | Term |
|---|---|
| D010561 | Personnel Staffing and Scheduling |
| D010559 | Personnel Management |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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| Nap Time during Shift in h compared between shift types |
After any shift participants are asked to give information on their sleeping behavior during the course of the shift. The Total Sleep Time (time asleep in bed excluding sleep latency and nocturnal awakenings) will be accumulated. |
| 1 day, 1 night |
| Empathy - Jefferson Scale of Physician Empathy | Empathy assessment by Jefferson Scale of Physician Empathy (JSPE; Zenasni et al., 2012). It is a brief self-report scale of 20 items with a 7-point Likert scale, ranging from 1= strongly disagree to 7=strongly agree (average Score between 1 and 7). Higher scores are indicating a higher level of empathy. | 1 day |
| Prior Shift Recovery Quality on 5 point Likert Scale compared between shift types | Before any shift participants are asked to give information on their sleeping behavior within the last 72 hours which also includes the subjective evaluation of sleep quality, waking quality and form of the day on a five point likert scale (1 = very bad to 5 = very good). A composed score of these three evaluations will be created and compared according to shift type. ((average Sleep + average Wakening + average Form)/3) | 1 day, 1 night |
| Comparison of speed in pain recognition task as cognitive performance during day or night shift | Reaction time during the subliminal pain recognition task as additional marker of cognitive performance. The change of reaction time during a shift (baseline measure at beginning of shift, post measure after shift) is compared between a day shift and a night shift | 1 day, 1 night |
| Health Care Professional Work Expertise in years | Self-reported years of work experience as a health care professional | 1 day |
| Shift Work Expertise in years | Self-reported years of work experience in a shift work system | 1 day |
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| 37434490 | Derived | Schmidt L, Zabelberg S, Schlatter S, Adams I, Douplat M, Perchet C, Lilot M, Rey AE, Mazza S. The impact of shift work on pain recognition, a robust ability among intensive care nurses. Eur J Pain. 2023 Nov;27(10):1203-1215. doi: 10.1002/ejp.2150. Epub 2023 Jul 12. |