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Aim To investigate the influence of irregular shifts on increased emotional, physical, and cognitive exhaustion and decreased working performance expressed by the phenomenon of presenteeism. Methods The study sample of 405 healthcare workers from Family medicine centres completed questionnaires in two measurement time points, in 2014 (TP1) and repeated in 2019 (TP2), when 301 respondents remained in the study. Healthcare workers completed questionnaires assessing demographics, work schedules, job burnout, and presenteeism. Results Repeated long-term exposure to rotating day-evening shifts was a significant risk for increased presenteeism (OR=1.689, 95%CI 1.042-2.739; p=0.001) and burnout (OR=1.705, 95%CI 1.237-2.352; p=0.001). Extended working hours are a predictor of presenteeism (OR=1.989, 95%CI 1.042-2.739; p=0.008). Conclusion The adverse effects of rotating day-evening shifts on burnout and presenteeism among healthcare workers in a family medicine centre was little researched, particularly the issue of managing the risks of exposure to rotating day-evening shifts and extended working hours. This study reflects a situation of uncertainty, in which the logic of precaution is imposed on mental health, and keeps working engagements in health care workers. Appropriate management of shift work and better organization of work schedules in the primary healthcare sector protects the wellbeing of healthcare workers and patients, efficient work, and quality of health care, and invites for future research on better working schedules and introducing preventive interventions with available flexibility of working times.
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OBJECTIVE: The objective of this work was to determine the quality of life in patients with heart failure using the SF-36 and Minnesota questionnaire and to determine the importance of applying Framingham criteria as predictors of the value of these questionnaires. PATIENTS AND METHODS: This cross-sectional study analyzed the quality of life in 120 subjects of both sexes and all age groups suffering from heart failure, according to the severity of clinical presentation. Subjects were divided into 4 equal groups according to NYHA classification of heart failure. Selection of subjects was made using the Framingham criteria for confirming already diagnosed heart failure. Control group included 30 patients not suffering from heart failure. Quality of life was assessed by use of the SF-36 and Minnesota questionnaire. RESULTS: In the study population of 150 subjects, there were 76 (51%) male and 74 (49%) female subjects divided into 4 NYHA groups of 30 subjects (20.0%) and control group of 30 subjects (20.0%). The analysis of within-group sex representation yielded no statistically significant difference (chi2 = 1.70, df = 4; p = 0.79). There was no statistically significant between-group age difference either (ANOVA, F = 0.74; p = 0.57). The values of SF-36 and Minnesota score expressed as median in the control and 4 NYHA groups were 98.6, 90.76, 70.14, 36.45 and 25.41 (Ht = 116.84; p < 0.0001) and 0.0, 0.47, 1.64, 2.99 and 3.42 (Ht = 113.42; p < 0.0001), respectively. The correlation coefficient r between heart failure NYHA classes expressed in the values of SF-36 and Minnesota score was r = -0950; p < 0.0001 and r = 0.931; p < 0.0001, respectively. The correlation coefficient r between the number of major and minor Framingham criteria and the values of SF-36 and Minnesota score was r = -0.790, -0.660; p < 0.0001 and r = 0.774, 0.671; p < 0.0001, respectively. CONCLUSION: The findings suggested that the quality of life in patients with heart failure was impaired and associated with the severity of clinical presentation, and that Framingham criteria could serve as significant predictors of the value of SF-36 and Minnesota scores and quality of life in patients with heart failure.