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1.
Clin Nurse Spec ; 34(2): 70-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32068635

RESUMO

BACKGROUND: Night-shift nurses care for complex and acutely ill patients but are frequently more junior compared with day shift. They often have less access to support resources such as educators and clinical nurse specialists (CNSs). This article describes the addition of night CNS positions, their roles, and associated outcomes. INTERVENTION: The night CNSs were implemented to perform a highly flexible set of activities including proactive rounding on high-risk patients and medications; code/rapid response support; education; nursing practice/policy reinforcement; providing psychosocial support to nurses, patients, and families; and responding to consults. To capture work effort at night and truly define the role of the night CNS, a shared consultation log was created. OUTCOMES: Between October 2017 to April 2019, 6053 CNS encounters were captured in 24 different categories. The top 5 reasons for consultation included policy/procedure education or change, education/in-service, nursing practice review/reinforcement, medication/blood administration, and clinical assist. Five hundred sixty-nine rapid response/codes have been responded to. There was also a 17% increase in event reporting on the night shift. Outcomes have continued to support additional budgeted positions for the nights and weekends. IMPLICATIONS: Night CNS expertise and knowledge are vital to offsetting novice nurse deficits in advanced assessment, which is paramount to patient outcomes. They provide support with on-the-spot education and empower individual development. Organizations should strongly consider implementation of this role or, if that is not possible, consider flexible scheduling into evening hours to support night staff.


Assuntos
Enfermeiras Clínicas , Jornada de Trabalho em Turnos , Humanos , Papel do Profissional de Enfermagem , Pesquisa em Avaliação de Enfermagem
2.
Ann R Coll Surg Engl ; 102(1): 36-42, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31660752

RESUMO

INTRODUCTION: The temporal patterns and unit-based distributions of trauma patients requiring surgical intervention are poorly described in the UK. We describe the distribution of trauma patients in the UK and assess whether changes in working patterns could provide greater exposure for operative trauma training. METHODS: We searched the Trauma Audit and Research Network database to identify all patients between 1 January 2014 to 31 December 2016. Operative cases were defined as all patients who underwent laparotomy, thoracotomy or open vascular intervention. We assessed time of arrival, correlations between mechanism of injury and surgery, and the effect of changing shift patterns on exposure to trauma patients by reference to a standard 10-hour shift assuming a dedicated trauma rotation or fellowship. RESULTS: There were 159,719 patients from 194 hospitals submitted to the Network between 2014 and 2016. The busiest 20 centres accounted for 57,568 (36.0%) of cases in total. Of these 2147/57,568 patients (3.7%) required a general surgical operation; 43% of penetrating admissions (925 cases) and 2.2% of blunt admissions (1222 cases). The number of operations correlated more closely with the number of penetrating rather than blunt admissions (r = 0.89 vs r = 0.51). A diurnal pattern in trauma admissions enabled significant increases in trauma exposure with later start times. CONCLUSIONS: Centres with high volume and high penetrating rates are likely to require more general surgical input and should be identified as locations for operative trauma training. It is possible to improve the number of trauma patients seen in a shift by optimising shift start time.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Cirurgia Geral/educação , Admissão do Paciente/estatística & dados numéricos , Traumatologia/educação , Ferimentos e Lesões/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Inglaterra , Feminino , Hospitais com Alto Volume de Atendimentos , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Admissão e Escalonamento de Pessoal/organização & administração , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Estudos Retrospectivos , Jornada de Trabalho em Turnos/estatística & dados numéricos , Fatores de Tempo , Centros de Traumatologia/organização & administração , Centros de Traumatologia/estatística & dados numéricos , País de Gales , Local de Trabalho/organização & administração , Local de Trabalho/estatística & dados numéricos , Ferimentos e Lesões/cirurgia
3.
J Clin Nurs ; 29(1-2): 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31241794

RESUMO

AIMS AND OBJECTIVES: To examine the association between registered nurses' (referred to as "nurses" for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers. BACKGROUND: The introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps. DESIGN: Cross-sectional survey of 31,627 nurses within 487 hospitals in 12 European countries. METHODS: The associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist. RESULTS: When nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant. CONCLUSION: Working shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care. RELEVANCE TO CLINICAL PRACTICE: Implementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients.


Assuntos
Continuidade da Assistência ao Paciente/normas , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Jornada de Trabalho em Turnos/estatística & dados numéricos , Estudos Transversais , Educação Continuada/estatística & dados numéricos , Europa (Continente) , Feminino , Hospitais , Humanos , Relações Interprofissionais , Masculino , Recursos Humanos de Enfermagem no Hospital/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Jornada de Trabalho em Turnos/psicologia , Inquéritos e Questionários
4.
Nurs Adm Q ; 44(1): E1-E10, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31789753

RESUMO

The objective of this study was to evaluate sleep quality and its relationship to cognitive factors among nurses. Sleep quality among nurses is an important issue, which requires more extensive study. Its correlation with cognitive ability has not been sufficiently considered. Five hundred forty nurses (66.3% female) working in 6 hospitals were selected as the sample of the study. Results show that nurses do not experience good quality of sleep. That is, 77.4% of the sample population of nurses have a poor quality of sleep, and nurses working the night shift have more sleep problems than other nurses. The results show that there is a relationship between dysfunctional beliefs and attitudes about sleep and metacognitive process and the quality of sleep, and that these variables can predict sleep quality. Based on the results of the study, it can be said that cognitive and metacognitive processes play an important role in sleep quality. Lack of sufficient sleep can create numerous problems for nurses and patients. Attention to the role of cognitive and metacognitive processes can help improve the sleep quality of nurses.


Assuntos
Cognição , Recursos Humanos de Enfermagem no Hospital/psicologia , Transtornos do Sono-Vigília , Sono/fisiologia , Adulto , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Enfermeiras Internacionais , Jornada de Trabalho em Turnos , Tolerância ao Trabalho Programado , Adulto Jovem
5.
Medicine (Baltimore) ; 98(49): e18059, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804312

RESUMO

Chronic urticaria has a high economic burden and reduces patient's quality of life. Nurses experience insomnia because of their shifting work, especially if they work night shifts and 3-shift rotational schedules. This study aimed to examine whether insomnia is a risk factor of chronic urticaria in nurses.Data were obtained from the Registry for Medical Personnel, which contains all registered medical staff between 2007 and 2008. All study subjects were divided into those with insomnia and without insomnia. The primary exposure of interest was chronic urticaria. In addition, potential comorbidities including diabetes mellitus, hypertension, hyperlipidemia, anxiety, and depression were estimated.A total of 103,242 registered nurses between 2007 and 2008 were enrolled. Around 97,899 (94.8%) nurses did not have insomnia, and 5343 (5.2%) had insomnia. The proportion of chronic urticaria in nurses with insomnia was significantly higher than those without (0.92% vs 0.50%, P < .0001). The odds ratio of chronic urticaria in nurses with insomnia was 1.67 (95% confidence interval: 1.22-2.29, P = 0.0014) compared to those without insomnia after adjusting for age, sex, hospital level, and comorbidities.The risk of chronic urticaria was higher in nurses with insomnia than in those without insomnia. The relationship between insomnia and chronic urticaria might not be a direct causal association. Other contributing factors of insomnia include different perceptions of stress from night shift work, stress coping and adaptation, positive self-image, and emotional equilibrium related to person's capacity to adapt to change. The same situation may have different effects on different individuals.


Assuntos
/epidemiologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adaptação Psicológica , Fatores Etários , Comorbidade , Emoções , Feminino , Humanos , Masculino , Estresse Ocupacional/epidemiologia , Qualidade de Vida , Fatores de Risco , Autoimagem , Fatores Sexuais , Jornada de Trabalho em Turnos , Tolerância ao Trabalho Programado
6.
Rev. enferm. UERJ ; 27: :e31273, jan.-dez. 2019. tab, ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1009804

RESUMO

Objetivo: avaliar as alterações de peso corporal em trabalhadores de enfermagem do turno noturno. Metodologia: estudo quantitativo, exploratório, descritivo, realizado em um hospital federal de grande porte do Rio de Janeiro. Foram estudadas variáveis sóciodemográficas; influências do turno noturno sobre o organismo e índice de massa corporal, após aprovação do Comitê de Ética em Pesquisa da instituição. Resultados: os 89 trabalhadores de enfermagem apresentaram ganho de peso médio de aproximadamente 20Kg a partir da admissão no turno noturno, sendo que os enfermeiros referiram maior influência da ausência de sono sobre o organismo, e maior exaustão quando comparados aos dados das demais categorias. Conclusão: considerando as desordens hormonais e os impactos sociais do serviço noturno, é imprescindível a implementação de mudanças para uma cultura prevencionista, seja por programas institucionais ou pesquisas intervencionistas, capazes de desenvolver medidas que conduzam ao autorreconhecimento e à promoção do bem-estar físico, mental e social dos trabalhadores de enfermagem.


Objective: to evaluate body weight changes in nursing workers on the night shift. Methodology: this quantitative, exploratory, descriptive study, conducted at a large federal hospital in Rio de Janeiro, after approval of the institution's research ethics committee, considered socio-demographic variables, influence of the night work on the organism, and body mass index. Results: average weight gain among the 89 nursing workers was approximately 20kg since admission to night work, and nurses reported greater influence of lack of sleep on the body, and greater exhaustion as compared with data on the other categories. Conclusion: considering the hormonal disorders and social impacts of night work, it is essential to implement changes towards a culture of prevention, through either institutional programs or interventionist research able to develop measures that lead to self-recognition and promotion of nursing workers' physical, mental and social wellbeing.


Objetivo: evaluar las alteraciones de peso corporal en trabajadores de enfermería del turno nocturno. Metodología: estudio cuantitativo, exploratorio, descriptivo, realizado en un gran hospital federal en Río de Janeiro. Se estudiaron las variables sociodemográficas, la influencia reportada de la guardia nocturna en el organismo y el índice de masa corporal, tras la aprobación del Comité de Ética de Investigación de la Institución. Resultados: Los 89 trabajadores de enfermería tuvieron un aumento de peso promedio de aproximadamente 20 kg desde el ingreso en el turno nocturno, y los enfermeros informaron una mayor influencia de la falta de horas dormidas sobre el cuerpo y un mayor agotamiento en comparación con los datos de las otras categorías. Conclusión: Teniendo en cuenta los trastornos hormonales y los impactos sociales del servicio nocturno, es esencial implementar cambios hacia una cultura de prevención, ya sea a través de programas institucionales o de investigación intervencionista, capaces de desarrollar medidas que conduzcan al auto reconocimiento y a la promoción del bienestar físico, mentales y social de los trabajadores de enfermería.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Saúde do Trabalhador , Sobrepeso/prevenção & controle , Jornada de Trabalho em Turnos/efeitos adversos , Jornada de Trabalho em Turnos/psicologia , Promoção da Saúde , Assistência Noturna , Análise Qualitativa , Sobrepeso
7.
Nihon Koshu Eisei Zasshi ; 66(11): 690-701, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31776311

RESUMO

Objectives The purpose of this ecological study was to clarify the relationship between the manpower of full-time and part-time public health nurses (PHNs) and standardized mortality ratios (SMRs) in municipalities in Japan.Methods We divided 1,225 municipalities with a population over 10,000 for which SMRs were officially published into two groups based on whether the municipality had established a public health center (PHC): general municipalities and PHC-established cities. A linear mixed model was used to examine the relationships among the number of full-time PHNs; cumulative total number of workdays for part-time PHNs; and other healthcare and social welfare resources for SMRs for all causes, malignant neoplasms, cerebrovascular disease, and heart disease.Results A higher cumulative total number of workdays for part-time PHNs was significantly associated with lower SMRs in both groups for all causes (males and females), lower SMRs in the general municipalities for malignant neoplasms (males) and heart disease (males), and lower SMRs in PHC-established cities for malignant neoplasms (males and females). The number of full-time PHNs had no effect on SMRs.Conclusion This study suggested that an increase in the manpower of municipal PHNs improves the health and wellbeing of residents.


Assuntos
Promoção da Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Enfermeiras de Saúde Pública/estatística & dados numéricos , Saúde Pública , Jornada de Trabalho em Turnos , Causas de Morte , Cidades , Ecologia , Feminino , Humanos , Japão , Masculino , Modelos Estatísticos , Mortalidade
8.
Artigo em Inglês | MEDLINE | ID: mdl-31658715

RESUMO

Nurses are frequently required to engage in shift work given the 24/7 nature of modern healthcare provision. Despite the health and wellbeing costs associated with shift work, little is known about the types of coping strategies employed by nurses. It may be important for nurses to adopt strategies to cope with shift work in order to prevent burnout, maintain wellbeing, and ensure high quality care to patients. This paper explores common strategies employed by nurses to cope with shift work. A workforce survey was completed by 449 shift working nurses that were recruited from a major metropolitan health service in Melbourne, Australia. Responses to open-ended questions about coping strategies were analysed using the framework approach to thematic analysis. Four interconnected main themes emerged from the data: (i) health practices, (ii) social and leisure, (iii) cognitive coping strategies, and (iv) work-related coping strategies. Although a range of coping strategies were identified, sleep difficulties often hindered the effective use of coping strategies, potentially exacerbating poor health outcomes. Findings suggest that in addition to improving nurses' abilities to employ effective coping strategies on an individual level, workplaces also play an important role in facilitating nurses' wellbeing.


Assuntos
Adaptação Psicológica , Enfermeiras e Enfermeiros/psicologia , Jornada de Trabalho em Turnos/psicologia , Adulto , Austrália , Esgotamento Profissional/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Local de Trabalho
9.
Cien Saude Colet ; 24(9): 3283-3292, 2019 Sep 09.
Artigo em Português | MEDLINE | ID: mdl-31508749

RESUMO

The scope of this study was to identify dietary patterns and their association with abdominal obesity in female shift workers in southern Brazil. A non-matched case-control study was conducted, including a total of 541 women aged between 18 and 53 years old (215 cases; 326 controls). The presence of abdominal obesity was assessed by measuring waist circumference ≥ 88 cm and dietary patterns were obtained by principal component analysis of 53 food items. The name of dietary patterns was assigned based on higher load factor and nutritional characteristics of foods. The association between abdominal obesity and dietary patterns was obtained by non-conditional logistic regression. Three dietary patterns were identified: "animal fat/calories," "snacks/fast-food" and "fruits/vegetables." After adjusted analysis, the cases presented a greater chance of adherence to the "fruits/vegetables" dietary pattern (OR = 2.26; 95% CI: 1.30 to 3.93) and a lower chance of adherence to the "snacks/fast food" pattern (OR = 0.60; 95% CI: 0.36 to 1.01). In conclusion, this study identified three dietary patterns in female shift workers, and there was an improvement in nutrition in workers with abdominal obesity, representing a possible change in eating habits after their occurrence.


Assuntos
Dieta , Comportamento Alimentar , Obesidade Abdominal/epidemiologia , Circunferência da Cintura/fisiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Estudos Transversais , Ingestão de Energia , Fast Foods/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Jornada de Trabalho em Turnos , Adulto Jovem
10.
Biomed Res Int ; 2019: 4616417, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31534960

RESUMO

Several studies suggested that migraine attack onset shows a circadian variation; however, there has not been an overview and synthesis of these findings. A PubMed search with keywords "migraine" AND "circadian" resulted in ten studies directly investigating this topic. Results of these studies mostly show that migraine attacks follow a monophasic 24-hour cyclic pattern with an early morning or late night peak while other studies reported an afternoon peak and also a biphasic 24-hour cycle of attacks. The identified studies showed methodological variation including sample size, inclusion of medication use, comorbidities, and night or shift workers which could have contributed to the contradictory results. Several theories emerged explaining the diurnal distribution of migraine attacks suggesting roles for different phenomena including a morning rise in cortisol levels, a possible hypothalamic dysfunction, a circadian variation of migraine triggers, sleep stages, and a potentially different setting of the circadian pacemaker among migraineurs. At the moment, most studies show an early morning or late night peak of migraine attack onset, but a significant amount of studies reveals contradictory results. Further studies should investigate the arising hypotheses to improve our understanding of the complex mechanism behind the circadian variation of migraine attacks that can shed light on new targets for migraine therapy.


Assuntos
Ritmo Circadiano , Hidrocortisona/sangue , Transtornos de Enxaqueca/sangue , Transtornos de Enxaqueca/fisiopatologia , Jornada de Trabalho em Turnos , Fases do Sono , Feminino , Humanos , Masculino , Transtornos de Enxaqueca/terapia
11.
Acta Chir Orthop Traumatol Cech ; 86(4): 281-285, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31524590

RESUMO

PURPOSE OF THE STUDY The specialty of orthopedics and traumatology that is completed in the 5 years period in our country is a challenging educational process and our purpose in this study is to demonstrate through a survey training conditions of the orthopedic assistants in our country and the effects of this process on assistants. MATERIAL AND METHODS 524 (70.05%) of 748 assistants who receive specialization training in Turkey were reached. There were 20 multiple choice questions ( 1 mark each) and 3 questions (more than 1 mark each) in the survey consisting of twenty-three questions. Our study group was formed by doctors who have still worked as assistant in our country and have accepted to participate in the study. The doctors who finished assistantship with any reason and did assistantship for time less than 6 months and did not exactly fill the questionnaire form were excluded from the study. RESULTS 524 (71.97%) of 728 assistant who are in 40 (100%) of 40 provinces where assistant training given in Turkey were reached. 474 (90.45%) participants were satisfied to do orthopedic specialization. When considering working hours, it was observed that 337 (64.31%) participants had over 90 hours weekly including night shift and 521 (99.42%) participants had to work after night shift. The majority of participants (361 persons 68.89%) were receiving salaries between TL 4000-6000. When looking at the entire working group, the rate of participants who said that scientific training is weak or there is no scientific training was 427 (81.48%). CONCLUSIONS Our survey study is one of the first statistical study which investigating professional and social problems of orthopedic assistants. Some of important problems as training satisfaction, abuse by patients and/or manager, the average monthly income and psychological status assessment is emphasized. Orthopedics and Traumatology assistantship is a challenging process to cause physical and psychological problems with the hard working conditions in our Turkey. Key words:residency training, orthopedic surgery, life quality, salary.


Assuntos
Internato e Residência/normas , Estresse Ocupacional , Ortopedia/educação , Traumatologia/educação , Humanos , Internato e Residência/organização & administração , Ortopedia/organização & administração , Ortopedia/normas , Admissão e Escalonamento de Pessoal , Jornada de Trabalho em Turnos/psicologia , Jornada de Trabalho em Turnos/normas , Inquéritos e Questionários , Fatores de Tempo , Traumatologia/organização & administração , Traumatologia/normas , Turquia
13.
Nutrients ; 11(9)2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31480696

RESUMO

Unfavourable dietary behaviours of female nurses, especially among shift-working nurses, including high snacking frequency, short fasting period and large day-to-day energy intake variability may be linked with adverse health. In this study we: (1) examined the relationship between dietary behaviour and cardiometabolic and psychological health in female nurses; and, (2) compared dietary behaviour, cardiometabolic and psychological health between shift-working and non-shift-working female nurses. A total of 73 nurses had their cardiometabolic health indicators evaluated and completed psychological health questionnaires; 55 completed a 3-day dietary log. Associations between dietary behaviour and health measures were examined using Spearman's partial correlation analysis. Analysis of covariance (ANCOVA) was used to compare dietary behaviour and health indicators between shift- and non-shift-working nurses. The majority of snacks consumed by nurses (70%) were unhealthy snacks (e.g., chocolate and chips), and higher snacking frequency was associated with greater percent body fat (r(50) = 0.287, p = 0.039), and worse mood-tension (r(48) = 0.327, p = 0.021) and anger-hostility (r(48) = 0.289, p = 0.042) scores. Day-to-day energy intake variability was positively associated with body mass index (BMI, r(50) = 0.356, p = 0.010) and waist circumference (r(50) = 0.283, p = 0.042). Shift-working nurses exhibited shorter fasting duration, larger day-to-day energy intake variability and higher total mood disturbance score when compared to their non-shift-working colleagues (all p < 0.05). The results of the present study suggested that addressing dietary behaviours may improve the cardiometabolic and psychological health of female nurses. Shift-working nurses may require a more specific dietary program to improve their psychological health.


Assuntos
Doenças Cardiovasculares , Comportamento Alimentar , Doenças Metabólicas , Enfermeiras e Enfermeiros , Adulto , Estudos Transversais , Dieta , Exercício , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Jornada de Trabalho em Turnos
14.
Artigo em Chinês | MEDLINE | ID: mdl-31495115

RESUMO

Objective: To investigate the detection of thyroid nodules and related risk factors in nuclear power workers, and to provide scientific evidence for thyroid protection of nuclear power workers. Methods: In December 2018, select 295 workers of a nuclear power production enterprise and 238 administrative staff of it, and select 250 staff members of a thermal power generation enterprise 70 kilometers away from the nuclear power station to conduct thyroid ultrasound examination and questionnaire survey for single factor. Analysis and further multivariate logistic regression analysis were used to study the risk factors of thyroid nodules in the population. Results: Women and smoking history were independent risk factors for the increased incidence of thyroid nodules in the study population; three shifts work pattern was an independent risk factor for the increased prevalence of thyroid nodules in nuclear power workers (P<0.05) , and other factors such as the history of nuclear exposure had no significant correlation with thyroid nodules (P>0.05) . Conclusion: Nuclear exposure has little effect on the prevalence of thyroid nodules in nuclear power workers.


Assuntos
Centrais Nucleares , Exposição Ocupacional , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia , Feminino , Humanos , Prevalência , Fatores de Risco , Jornada de Trabalho em Turnos , Fumar/efeitos adversos
15.
Med Pr ; 70(5): 611-616, 2019 Sep 18.
Artigo em Polonês | MEDLINE | ID: mdl-31483414

RESUMO

BACKGROUND: The aim of this study was to assess the prevalence of insomnia among the employees of a zinc smelter in Miasteczko Slaskie using the Athens Insomnia Scale. MATERIAL AND METHODS: The examined group of plant employees and the control group were asked to fill in a questionnaire composed of the AIS and questions relating to the place and nature of their work, accidents over the last year, medications, diseases and conditions, sleep, naps and sleepiness during the day. RESULTS: The result leading to a diagnosis of insomnia as indicated by the AIS was found in significantly more instances in the test group than in the control group (29.5% vs. 8.4%). While comparing the test subgroup, which was not employed in shift-work, with the control group did not result in a statistically significant difference, slightly more respondents from the day-work test subgroup obtained the result of ≥ 8 pts. CONCLUSIONS: The prevalence of insomnia assessed by means of the AIS in the group of employees of a zinc smelter is significantly higher than in the control group. Based on the AIS, the highest percentage of individuals with insomnia occurred in the subgroup employed in shift-work. Med Pr. 2019;70(5):611-6.


Assuntos
Metalurgia , Doenças Profissionais/epidemiologia , Jornada de Trabalho em Turnos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Zinco , Humanos , Masculino , Polônia/epidemiologia , Prevalência
16.
Maturitas ; 129: 62-67, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31547916

RESUMO

OBJECTIVE: To examine the association between irregular menstrual cycles and occupational characteristics among Korean female workers. STUDY DESIGN: We analyzed data on paid female workers from the Korea National Health and Nutrition Examination Survey (KNHANES) V (2010-2012). MAIN OUTCOME MEASURES: We evaluated the possible associations between irregular menstrual cycles and work variables (occupational classification, working hours, and shift work) using univariate and multivariate logistic regression analyses. Weighted prevalence was calculated according to each work variable to approximate the Korean population. RESULTS: Irregular menstrual cycles were the most common in women in the 'pink collar' group (16.61%). The frequency of irregular menstrual cycles was 2-fold higher in women working >60 h per week (25.64%) than in those working 20-60 h per week (11.09%). Irregular menstrual cycles were more prevalent in shift workers (15.85%) than in non-shift workers (11.06%). A significantly high risk of irregular menstrual cycles was found for pink-collar occupations (adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.044-2.710, reference: white-collar occupation group) and in women with long working hours (adjusted OR = 2.139, 95% CI = 1.243-3.559, reference: 20-60 working hours group) and shift work (adjusted OR = 1.487, 95% CI = 1.028-2.118, reference: fixed working schedule group). CONCLUSIONS: Our study showed associations between irregular menstrual cycles and occupational characteristics of female workers. Long working hours, shift work, and pink-collar occupations are positively associated with irregular menstrual cycles. Therefore, working hours and shift schedules for female workers should be structured considering these factors. Further research is needed to determine the optimal working time and shift schedules for female workers.


Assuntos
Distúrbios Menstruais/epidemiologia , Saúde do Trabalhador , Ocupações , Jornada de Trabalho em Turnos , Mulheres Trabalhadoras/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , República da Coreia/epidemiologia , Adulto Jovem
17.
Biomed Res Int ; 2019: 7582734, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467910

RESUMO

Objective: The NOCTURNIN gene links nutrient absorption and metabolism to the circadian clock. Shift workers are at a heightened risk of overweight and of developing obesity and metabolic syndrome. This study investigates the diurnal variation of NOCTURNIN in healthy volunteers and its expression levels in rotational shift and daytime workers. Methods: NOCTURNIN expression levels were evaluated in peripheral blood lymphocytes from 15 healthy volunteers at 4-hour intervals for 24 h. Metabolic parameters and NOCTURNIN expression were measured in workers engaged in shift and daytime work. Results: In the group of volunteers NOCTURNIN expression showed diurnal variation, with a peak at 8:00 AM. NOCTURNIN expression was higher in shift workers than in daytime workers. Multivariate analysis confirmed the role of shift work as an independent factor affecting NOCTURNIN expression. Notably, its level correlated directly with body mass index and inversely with total energy expenditure. Conclusions: Measuring NOCTURNIN expression levels in human peripheral blood lymphocytes can improve investigations on the relationship between changes in circadian rhythm and metabolic disorders. Shift workers show higher NOCTURNIN levels than daytime workers.


Assuntos
Ritmo Circadiano/genética , Proteínas Nucleares/genética , Obesidade/genética , Fatores de Transcrição/genética , Tolerância ao Trabalho Programado/fisiologia , Adulto , Ritmo Circadiano/fisiologia , Feminino , Regulação da Expressão Gênica/genética , Voluntários Saudáveis , Humanos , Linfócitos/metabolismo , Masculino , Proteínas Nucleares/sangue , Obesidade/sangue , Obesidade/fisiopatologia , Jornada de Trabalho em Turnos , Fatores de Transcrição/sangue
18.
BMJ ; 366: l4134, 2019 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-31292124

RESUMO

OBJECTIVE: To determine whether 30 day mortality, 30 day readmissions, and inpatient spending vary according to whether physicians were exposed to work hour reforms during their residency. DESIGN: Retrospective observational study. SETTING: US Medicare. PARTICIPANTS: 20% random sample (n=485 685) of Medicare beneficiaries aged 65 years or more admitted to hospital and treated by a general internist during 2000-12. MAIN OUTCOME MEASURES: 30 day mortality, 30 day readmissions, and inpatient Medicare Part B spending among patients treated by first year internists who were fully exposed to the 2003 Accreditation Council for Graduate Medical Education (ACGME) work hour reforms during their residency (completed residency after 2006) compared with first year internists with partial or no exposure to reforms (completed residency before 2006). Senior internists not exposed to reforms during their residency served as a control group (10th year internists) for general trends in hospital care: a difference-in-difference analysis. RESULTS: Exposure of physicians to work hour reforms during their residency was not associated with statistically significant differences in 30 day mortality, 30 day readmissions, or inpatient spending. Among 485 685 hospital admissions, 30 day mortality rates during 2000-06 and 2007-12 for patients of first year internists were 10.6% (12 567 deaths/118 014 hospital admissions) and 9.6% (13 521/140 529), respectively, and for 10th year internists were 11.2% (11 018/98 811) and 10.6% (13 602/128 331), for an adjusted difference-in-difference effect of -0.1 percentage points (95% confidence interval -0.8% to 0.6%, P=0.68). 30 day readmission rates for first year internists during 2000-06 and 2007-12 were 20.4% (24 074/118 014) and 20.4% (28 689/140 529), respectively, and for 10th year internists were 20.1% (19 840/98 811) and 20.5% (26 277/128 331), for an adjusted difference-in-difference effect of 0.1 percentage points (-0.9% to 1.1%, P=0.87). Medicare Part B inpatient spending for first year internists during 2000-06 and 2007-12 was $1161 (£911; €1024) and $1267 per hospital admission, respectively, and for 10th year internists was $1331 and $1599, for an adjusted difference-in-difference effect of -$46 (95% confidence interval -$94 to $2, P=0.06). CONCLUSIONS: Exposure of internists to work hour reforms during their residency was not associated with post-training differences in patient mortality, readmissions, or costs of care.


Assuntos
Custos de Cuidados de Saúde/normas , Mortalidade Hospitalar , Hospitalização/economia , Internato e Residência , Readmissão do Paciente/economia , Garantia da Qualidade dos Cuidados de Saúde , Jornada de Trabalho em Turnos , Idoso , Idoso de 80 Anos ou mais , Feminino , Mortalidade Hospitalar/tendências , Hospitalização/tendências , Humanos , Internato e Residência/normas , Masculino , Medicare/economia , Readmissão do Paciente/normas , Readmissão do Paciente/tendências , Estudos Retrospectivos , Estados Unidos
19.
PLoS One ; 14(7): e0219087, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31276523

RESUMO

BACKGROUND: We compared psychomotor vigilance in female shift workers of the Bergmannsheil University Hospital in Bochum, Germany (N = 74, 94% nurses) after day and night shifts. METHODS: Participants performed a 3-minute Psychomotor Vigilance Task (PVT) test bout at the end of two consecutive day and three consecutive night shifts, respectively. Psychomotor vigilance was analyzed with respect to mean reaction time, percentage of lapses and false starts, and throughput as an overall performance score, combining reaction time and error frequencies. We also determined the reaction time coefficient of variation (RTCV) to assess relative reaction time variability after day and night shifts. Further, we examined the influence of shift type (night vs. day) by mixed linear models with associated 95% confidence intervals (CI), adjusted for age, chronotype, study day, season, and the presence of obstructive sleep apnea (OSA). RESULTS: At the end of a night shift, reaction times were increased (ß = 7.64; 95% CI 0.94; 14.35) and the number of lapses higher compared to day shifts (exp(ß) = 1.55; 95% CI 1.16-2.08). By contrast, we did not observe differences in the number of false starts between day and night shifts. Throughput was reduced after night shifts (ß = -15.52; 95% CI -27.49; -3.46). Reaction times improved across consecutive day and night shifts, whereas the frequency of lapses decreased after the third night. RTCV remained unaffected by both, night shifts and consecutive shift blocks. DISCUSSION: Our results add to the growing body of literature demonstrating that night-shift work is associated with decreased psychomotor vigilance. As the analysis of RTCV suggests, performance deficits may selectively be driven by few slow reactions at the lower end of the reaction time distribution function. Comparing intra-individual PVT-performances over three consecutive night and two consecutive day shifts, we observed performance improvements after the third night shift. Although a training effect cannot be ruled out, this finding may suggest better adaptation to the night schedule if avoiding fast-changing shift schedules.


Assuntos
Pessoal de Saúde/psicologia , Desempenho Psicomotor/fisiologia , Jornada de Trabalho em Turnos/efeitos adversos , Vigília/fisiologia , Adulto , Feminino , Alemanha , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Tempo de Reação , Tolerância ao Trabalho Programado
20.
Ann Ist Super Sanita ; 55(2): 161-169, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31264639

RESUMO

BACKGROUND: Job quality and evaluation of workers' health have both medical and social important implications. We studied health-related quality of life (HRQL) in nurses who perform their activity in night shifts. METHODS: A cross-sectional study was conducted between October and November 2014. Nurses who attended night shift in the Siena Teaching Hospital (Azienda Ospedaliera Universitaria Senese - AOUS) were sampled using EpiInfo software (confidence interval 95%) and investigated using the SF-36 Questionnaire. Our results were compared with the Italian general population (Apolone, 1997). A Descriptive analysis was conducted. Wilcoxon test, Pearson coefficient, t-test, Wilcoxon signed-rank test and logistic regression were used for the statistical investigation. RESULTS: 197 questionnaires were analyzed. Females were 71.7%; mean age was 39.2 years (DS 8.6); smokers were 37.8%. Males scores were higher than those of females in all dimensions of physical and mental health (p <0.05). The time taken to reach the place of work appeared to influence the dimension of General Health (coeff. -0.17); we found a worsening of 0.17 points of this dimension for every minute spent in travel. Men and nurses with more working years had a better score in Physical Pain dimension. AOUS nurses scored significantly (p <0.05) less compared with the correspondent Italian general population in General Health, Energy-fatigue, Social functioning, Physical functioning and Bodily pain. CONCLUSIONS: There is a significant relationship between night work and HRQL of nurses. The health profile of AOUS nurses' ranks below the values of the Italian general population in various dimensions.


Assuntos
Recursos Humanos de Enfermagem no Hospital/psicologia , Qualidade de Vida , Jornada de Trabalho em Turnos/psicologia , Tolerância ao Trabalho Programado/psicologia , Adulto , Estudos Transversais , Características da Família , Fadiga/epidemiologia , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Fumar/epidemiologia , Fatores Socioeconômicos , Inquéritos e Questionários , Transportes , Tolerância ao Trabalho Programado/fisiologia
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