Self-reported health and sleep complaints among nursing personnel working under 12 h night and day shifts
Self-reported health and sleep complaints among nursing personnel working under 12 h night and day shifts
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DOI：
10.1081/cbi-200038513
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发表时间：
2004-01-01
影响因子：
2.8
通讯作者：
Waissmann, W
中科院分区：
文献类型：
--
作者：
Portela, LF;Rotenberg, L;Waissmann, W
这项横断面探索性研究涉及各种技能类型和水平的卫生保健工作者。我们检验了一个假设，即夜间工作者的疾病患病率、睡眠投诉和非专业活动（家庭、休闲和休息）时间不足的比例高于白天工作者。数据收集在两所公立医院进行问卷调查和其他形式。夜班工作被视为一个风险因素，认为夜班工人是指在研究期间至少有一份夜班工作的人。通过单变量分析评估数据。通过估计患病率来评估工作时间表与因变量（健康状况、睡眠投诉和非专业活动时间不足）之间的关联，置信区间为95%。258名女性护理人员参加，41.5%是兼职，只有20个轮班工作的长度小于12小时。调查前2周报告的偏头痛和需要医疗护理在白天工作者中比夜间工作者更普遍（PR = 0.71; CI = 0.55-0.92和PR = 0.71; CI = 0.52-0.95）。通过比较夜班工人和工作史总是白班的白班工人的报告，证实夜班工人偏头痛发生率低于白班工人（PR = 0.74; CI = 0.57-0.96）。轻度情绪障碍（轻度抑郁、紧张、焦虑或失眠）的报告在夜班工人（PR = 0.76; CI = 0.59-0.98）和前夜班工人（PR = 0.68; CI = 0.50-0.91）中的发生率低于从未从事过夜班工作的白班工人。健康工人效应似乎不能解释白天和夜间工人之间的比较结果。有人提出，这些结果可能是由于白天工作者暴露于某些危险因素（如压力）所致。夜间和白天的工人之间没有显着差异，观察到陡峭的投诉，结果可能受到轮班工作时间表（没有连续的夜班）的性质，并可能在夜班午睡。此外，在巴西常见的医疗保健工作者的长时间工作和兼职可能掩盖了白天和夜间工作者之间的其他可能差异。在夜间工作者中，发现夜间工作时间（超过10年）与高胆固醇值之间存在显着关系（PR = 2.58; CI = 1.07-6.27），这一结果值得进一步研究。每2周内上夜班超过4次与孩子时间不足（PR = 1.96; CI = 1.38-2.78）和休息/休闲时间不足（PR = 1.54; CI = 1.20-1.99）有关。这些结果可能与“时间的社会价值”有关，因为晚上和夜晚通常是家人一起度过的时间。职业生活的复杂性和随之而来的工人群体的异质性下轮班工作计划混淆的结果。对这里提出的问题进行更深入的研究需要更复杂的流行病学处理和更大的样本规模。
This cross-sectional exploratory study involved health care workers of various skill types and levels. We tested the hypothesis that the prevalence of diseases, sleep complaints, and insufficient time for nonprofessional activities (family, leisure, and rest) are higher among night than day workers. Data collection was carried out in two public hospitals using questionnaires and other forms. Night work was explored as a risk factor, considering a night worker as one who had at least one night job on the occasion of the research. Data were assessed by a univariate analysis. The association between work schedule and the dependent variables-health conditions, sleep complaints, and insufficient time for nonprofessional activities-was evaluated through the estimation of the prevalence ratio, with a confidence interval of 95%. Two hundred and fifty-eight female nursing personnel participated; 41.5% were moonlighters, and only 20 worked a shift of less than 12 h in length. Reports of migraine and need of medical care the 2 weeks before the survey were more prevalent among day than night workers (PR = 0.71; CI = 0.55-0.92 and PR = 0.71; CI = 0.52-0.95, respectively). Migraine headaches occurred less frequently among night than day workers as confirmed by comparing the reports of the night workers and day workers whose work history was always day shifts (PR = 0.74; CI = 0.57-0.96). Reports of mild emotional disorders (mild depression, tension, anxiety, or insomnia) were less frequent among night (PR = 0.76; CI = 0.59-0.98) and ex-night workers (PR = 0.68; CI = 0.50-0.91) than day workers who never had worked a night job. The healthy worker effect does not seem to explain the results of the comparisons between day and night workers. The possible role of exposure by day workers to some risk factors, such as stress, was suggested as an explanation for these results. No significant difference was observed between night and day workers as to steep complaints, a result that may have been influenced by the nature of the shift-work schedule (no successive night shifts) and possibly nap taking during the night shift. Moreover, the long work hours and moonlighting of the healthcare workers, which is common in Brazil, may have masked other possible differences between the day and night workers. Among night workers, a significant relation was found between years working nights (more than 10 yrs) and high cholesterol values (PR = 2.58; CI = 1.07-6.27), a result that deserves additional study. Working nights more than four times per 2-week span was related to complaints about insufficient time for children (PR = 1.96; CI = 1.38-2.78) and rest/leisure (PR = 1.54; CI = 1.20-1.99). These results can be related to the "social value of time," as evenings and nights are when families usually spend time together. The complexity of the professional life and the consequent heterogeneity of the group of workers under shift-work schemes confound the results. More in-depth study of the questions raised here demands a more sophisticated epidemiological treatment and larger sample size.