Perubahan Fungsi Kognitif Peserta Program Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran Setelah 24 Jam Kerja

Ati Nurchaeni Nurchaeni, Doddy Tavianto, Ezra Oktaliansah

Abstract


Latar Belakang dan Tujuan: Profesi dokter anestesi merupakan profesi dengan beban kerja tinggi yang dituntut untuk berpikir dan bertindak cepat dan tepat dalam situasi kritis. Kekurangan tidur, kelelahan, dan perubahan irama sirkadian mempengaruhi fungsi kognitif dokter anestesi. Tujuan penelitian ini untuk mengetahui perubahan fungsi kognitif peserta Peserta Program Pendidikan Dokter Spesialis (PPDS) Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran setelah 24 jam kerja yang diperiksa menggunakan Montreal Cognitive Assessment versi Indonesia (MoCA-INA).
Subjek dan Metode: Penelitian ini merupakan penelitian deskriptif observasional prospektif dengan pendekatan cross sectional yang dilakukan pada 62 subjek dengan memeriksa MoCA-INA jam ke-0 dan jam ke-24.
Hasil: Pada penelitian ini didapatkan penurunan nilai rata-rata MoCA-INA dengan nilai jam ke-0 yaitu 29,84 ± 0,365 dan jam ke-24 yaitu 28,92 ± 1,010. Berdasarkan aspek kognitif yang diperiksa, fungsi atensi merupakan aspek yang mengalami penurunan setelah jam ke-24. Penurunan nilai MoCA-INA paling banyak terdapat pada subjek yang bertugas di kamar operasi. Penurunan nilai rata-rata MoCA-INA setelah 24 jam kerja tersebut masih dalam batas normal karena masih di atas nilai acuan dan secara klinis tidak menunjukkan gangguan.
Simpulan: Terdapat penurunan fungsi kognitif peserta PPDS Anestesiologi dan Terapi Intensif Fakultas Kedokteran Universitas Padjadjaran setelah 24 jam kerja.

Cognitive Function Alterations on Residents Anesthesiology and Intensive Care of Medical Faculty Universitas Padjadjaran after 24 Hours Shift

Abstract

Background and Objective: Anesthesiologist is a profession with a heavy workload which is need fast thinking and rapid decision making in a critical and life-threatening situation. Sleep deprivation, extended workshifts, exhaustion and circardian cycle changes can affect anesthesiologist’s cognitive function. This aim of this study was to evaluate cognitive function changes in Residents of Anesthesiology and Intensive Therapy in Medical Faculty Universitas Padjadjaran after 24 hours shift using Montreal Cognitive Assesment-Indonesia Version (MoCA-INA).
Subject and Method: This study was an observational-descriptive-prospective study using crosss sectional approach evaluating MoCA-INA score in 0th hour and 24th hour after shift in 62 subjects.
Result: The result of this study shown an average MoCA-INA score at 0th hour was 29.84 ± 0.365 while at 24th hours the average score was 28.92 ± 1.010. According to MoCA-INA, attention is the deprived domain at 24th hour after shift. MoCA-INA score declines mostly in subjects working in the operating room. According to MoCA-INA cut off value, the score of 26 is considered normal after 24 hours shift and not showing any clinical disturbance.
Conclusion: The conclusion of this study is decreasing cognitive function among Anesthesiology Medical Faculty Universitas Padjadjaran residents after 24 hours shift.


Keywords


anestesi; atensi; fungsi kognitif; kelelahan; montreal cognitive assessment versi Indonesia; anesthesiologists; attention; cognitive function; fatigue; montreal cognitive assessment Indonesian version

Full Text:

PDF

References


Gregory P, Edsell M. Fatigue and the anaesthetist. Br J Anaesth. 2014;14(1):18–22.

Chandran R, DeSousa KA. Human factors in anaesthetic crisis. WJA 2014;3(3):203–12

Verma R, Mohan B, Attri JP, Chatrath V, Bala A, Singh M. Anesthesiologist: the silent force behind the scene. Anesth Essays Res. 2015;9:293–7.

Rall M, Gaba DM, Howard SK, Dieckmann P. Human performance and patient safety. Dalam: Miller R, penyunting. Miller's Anesthesia Edisi Ke-7. Philadelphia: Elsevier; 2010: 113–21.

Daret SA, Buleon C, Bocca ML, Denise P, Gerard JL, Hanouz JL. Effect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study. Anaesth Crit Care Pain Med. 2017;37(2):161–6.

Maltese F, Adda M, Bablon A, Hraeich S, Guervilly C, Lehingue S, dkk. Night shift decreases cognitive performance of ICU physicians. Intensive Care Med J. 2015:2–9.

Kaliyaperumal D, Elango Y, Alagesan M, Santhanakrishanan I. Effects of sleep deprivation on the cognitive performance of nurses working in shift. J Clin Diagn Res. 2017;11(8):1–3.

Freddi Segai-Gidan PA. Cognitive screening tools. Clinician Reviews. 2013 Jan;23(1):12.

Husein N, Lumempouw S, Herqutanto YR. Uji validitas dan reliabilitas montreal cognitive assessment versi Indonesia untuk skrining gangguan kognitif. Neurona. 2010;27(4):2–8.

Santangelo G, Siciliano M, Pedone R, Vitale C, Falco F, Bisogno R, dkk. Normative data for the montreal cognitive assessment in an Italian population sample. Neurol Sci. 2015;36:585–91.

Freitas S, Simoes MR, Alves L, Santana I. Montreal cognitive assessment influence of sociodemographic and health variables. Arch Clin Neuropsychol. 2012:165–75.

Landolt HP, Sousek A, Holst SC. Effects of acute and chronic sleep deprivation. J Sleep Res. 2014:1–14.

Tadinac M, Sekulic A, Hromatko I, Sunko BM, Ivancic R. Age and individual sleep characteristics affect cognitive performance in anesthesiology residents after 24-hour shift. Acta Clin Croat. 2014;53:22–30.

Suozzo AC, Malta SM, Gil G, Tintori F, Lacerda SS, Martins LAN. Attention and memory of medical residents after a night on call: a crosssectional study. Clinics. 2011;66(3):505–8.

Arnsten AFT. Stress signaling pathways that impair prefrontal cortex structure and function. Nat Rev Neurosci. 2009;10(6):410–22.

Goel N, Rao H, Durmer JS, Dinges DF. Neurocognitive cosequences of sleep deprivation. Semin Neurol. 2009; 29 (4): 320–39.




DOI: https://doi.org/10.24244/jni.v8i3.3

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

DOI:  https://doi.org/10.24244/jni 

pISSN: 2088-9674 | eISSN: 2460-2302

This Journal Indexed on:

 

 

 

 

  

    

 

                                                                    

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.