3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item A prospective pedometer study of doctors working in an Emergency department(2018) Beringer, Craig BrianObjective The positive impact of physical activity and exercise on health is well known; conversely a lack of physical activity has been clearly demonstrated to increase the risk of several non-communicable diseases. Individuals who walk 10 000 steps per day or more are likely to meet recommended physical activity guidelines. Very little is known about the physical activity levels of doctors at work, in particular those working in busy Emergency Departments (ED). Our primary objective was to determine how many steps per shift doctors working in a South African ED took. The secondary objectives were to assess what factors influenced the number of steps taken. Methods This was a prospective observational cohort study undertaken at Helen Joseph Hospital ED, Johannesburg, South Africa over a one-month period. The 32 participating doctors wore pedometers during their day shifts in the ED and the number of steps taken during their shifts were measured; as well as the number and triage category of patients seen; and whether chest compressions were performed. Results The median number of steps taken per shift was 6328 (Interquartile Range [IQR] 4646-8409). This was significantly less than the 10 000 recommended steps per day (p<0.0001). In only 11.7% (37/317) of shifts did the number of steps taken exceed the target of 10 000 steps. Factors which significantly increased the number of steps taken included shift duration and the performance of chest compressions. Each additional hour of shift led to a mean increase of 600 steps (95% CI: 548-772 steps). The mean number of steps for shift with chest compressions was 8308 (95% CI:7479- 9137) while the mean number of steps for shifts without chest compressions was 6503 (95% CI: 6121-6885). A low patient per hour rate was shown with an average rate, for all participants over the one month period of 0.9. Conclusions The results show that doctors working in the ED are not achieving the recommended number of daily steps while at work. Failing to meet the current physical activity guidelines can be explained by the overall low rate of patients seen per hour as well as the general layout of the ED. With little time outside of working hours for exercise and further physical activity, achieving the desired steps per day seems unlikely, which could potentially increase the risk of ill health and burnout.