英国兰开夏郡教学医院国家卫生局（NHS）信托基金会Charlotte R Brookfield小组取得一项新突破。他们的研究对避免使用“安静”一词作为应对机制的迷信进行了验证。相关论文发表在2019年12月18日出版的《英国医学杂志》上。

为探讨临床环境中使用“安静”一词会增加工作量的迷信是否为真，研究组在英国兰开夏郡一家大型教学医院的微生物科进行了一项前瞻性、随机对照、非劣效性研究。

医学微生物学小组中选取两名成员负责工作日，一名成员负责周末的值班工作。随机分配某天让工作人员说“今天将是安静的一天”（干预组，共29天），或一天内任何情况下都不说“安静”一词（对照组，共32天）。对每天的总工作量进行统计，其中临床发作定义为24小时内由值班小组处理的临床相关电话、临床重要结果、或验证结果的总数。

2019年5月1日至6月30日，对照组平均每天有139.0次临床发作，而干预组为144.9次，差异为5.9，符合非劣效性标准。无论这些分析是否校正，还是工作日与周末的亚组，在四个组成部分的任何一个干预措施中均未发现工作量存在差异。

研究结果破除了长久以来的迷信，即“安静”一词的使用会影响临床工作量，该词应当正常使用。在员工严重短缺和工作压力增加的时代，医生们应寻求其他方法来提高适应力，从而保护他们的身心健康。

附：英文原文

Title: Q fever—the superstition of avoiding the word “quiet” as a coping mechanism: randomised controlled non-inferiority trial

Author: Charlotte R Brookfield, Patrick P J Phillips, Robert J Shorten

Issue&Volume: 2019/12/18

Abstract: 

Objective To determine the validity of the superstition that utterance of the word “quiet” in a clinical setting increases workload.

Design Prospective randomised controlled non-inferiority study.

Setting Microbiology department of a large teaching hospital in Lancashire, UK.

Participants Two members of the medical microbiology team carried out the duty work on any given week day and an on-call team member on any weekend day. 29 days were assigned in which staff were to say “Today will be a quiet day” and 32 days were assigned in which staff were to refrain from saying the word “quiet” in any context.

Interventions Each day was randomly allocated to either saying “Today will be a quiet day” (intervention group) or refraining from saying the word “quiet” (control group) in any context.

Main outcome measures The primary outcome was mean overall workload: a composite of number of clinically related telephone calls, clinically significant results, or validated results processed by the duty medical microbiology team during a 24 hour period referred to collectively as “clinical episodes.” A difference of 30 clinical episodes was considered as the margin of non-inferiority. Secondary outcomes included the individual components of the primary outcome.

Results Workload was measured each day over a 61 day period (1 May to 30 June 2019). A mean 139.0 clinical episodes occurred on control days compared with 144.9 on days when the experimental intervention was uttered, a difference of 5.9 (95% confidence interval−12.9 to 24.7). The upper bound was less than the specified margin of 30, providing evidence for non-inferiority. No evidence of a difference in workload was found between interventions with any of the four components, whether considering unadjusted or adjusted analyses, or looking at the subgroups of week days or weekends.

Conclusions The study findings refute the long held superstition that utterance of the word “quiet” impacts on clinical workload, and therefore it should not be avoided. In the era of considerable staff shortages and increased work related stress, doctors should look to other methods to increase resilience and protect their wellbeing and mental health.

DOI: 10.1136/bmj.l6446

Source: https://www.bmj.com/content/367/bmj.l6446