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Trabalho por turnos e noturno : impacto na qualidade de vida e automedicação dos enfermeiros
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RESUMO - Ao longo das últimas décadas, a temática do trabalho por turnos com trabalho noturno tem levantado algumas preocupações por parte dos enfermeiros relativamente ao impacto na sua saúde (física e mental), qualidade de vida e consequentemente à possibilidade deste tipo de horário laboral contribuir para a prática da automedicação.
Objetivo: Avaliar o impacto do trabalho por turnos com trabalho noturno na saúde (física e mental), qualidade de vida e automedicação dos enfermeiros de três serviços de um Hospital Central.
Tipo de estudo: Foi efetuado um estudo observacional, transversal e com uma componente descritiva e uma componente analítica, comparando a qualidade de vida, o estado de saúde e a automedicação dos enfermeiros que trabalhavam por turnos dos que tinham horário fixo. Utilizaram-se os seguintes testes estatísticos: coeficiente de Pearson (r), teste de U de Mann-Whitney, teste Qui-quadrado e teste Exato de Fisher. E um nível de significância de 5%.
Amostra: A amostra é de conveniência, constituída por enfermeiros de três serviços de um hospital Central da região de Lisboa, que concordaram em participar no estudo (n=51).
Dos 51 profissionais que aderiram ao estudo, 37 exerciam em horário fixo e diurno e 14 em horário por turnos com trabalho noturno.
Instrumento de recolha de dados: Os instrumentos de colheita de dados utilizados foram: EPTT (Estudo Padronizado do Trabalho por Turnos), traduzido e adaptado para a versão portuguesa por Carlos Silva (1995) e Whoqol-bref, questionário de avaliação da qualidade de vida desenvolvido pela OMS, traduzido e adaptado para a versão portuguesa por Canavarro et al (2006).
Resultados: No que concerne às caraterísticas sociodemográficas da amostra estudada, verificou-se que apesar do trabalho por turnos com trabalho noturno ser mais frequente nos homens, não se obtiveram diferenças estatisticamente significativas (Teste Exato de Fisher; p=0,120). Relativamente ao estado civil verificou-se que o trabalho por turnos era mais frequente nos enfermeiros solteiros, separados ou viúvos (19/22; 86,4%) do que nos casados ou união de facto (18/29; 62,1%) (Teste Exato de Fisher; p=0,052). Maior proporção de enfermeiros que trabalhavam em horário diurno fixo tinham filhos a cargo e essa diferença era significativa quando comparada com a proporção de enfermeiros que trabalhavam por turnos.
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Relativamente à análise do estado de saúde (físico e mental) e qualidade de vida dos enfermeiros verificou-se que os enfermeiros que trabalhavam por turnos com trabalho noturno referiram um efeito mais negativo na saúde e qualidade de vida comparativamente aos enfermeiros com horário fixo, mas não se verificou diferença estatisticamente significativa (Teste Exato de Fisher; p= 0,141).
No que respeita à avaliação das perturbações de saúde física, psicológica, sociofamiliar e do sono verificou-se que, tanto os trabalhadores com horário fixo e diurno, como os trabalhadores com horário por turnos com trabalho noturno, apresentaram valores de score entre 22 e 27 (numa escala de 0 a 100) nos domínios de avaliação física, psicológica, social e ambiental, mas não havia diferença estatisticamente significativa entre os dois grupos (teste U de Mann- Whitney: p= 0,849; 0,983; 0,399; 0,340 respetivamente).
Verificou-se também que não existia uma associação significativa entre o trabalho por turnos com trabalho noturno e a dificuldade em adormecer, em comparação com os trabalhadores com horário fixo e diurno (Teste qui-quadrado de Pearson; p=0,588).
A automedicação apresentou uma prevalência de 35,7% nos trabalhadores com horário fixo e diurno, contrapondo com 24,3% nos trabalhadores com trabalho rotativo e noturno, sem diferença estatisticamente significativa (teste qui-quadrado, p=0,316). Também não houve diferenças com significado estatístico no consumo de psicofármacos e analgésicos (teste exato de Fisher, p= 0,619; p=0,170, respetivamente).
Neste estudo, não se verificou qualquer diferença com significado estatístico no que respeita à qualidade de vida, estado de saúde físico e mental e automedicação entre enfermeiros que trabalham por turnos com horário noturno e enfermeiros com horário fixo. Contudo, uma das grandes limitações deste estudo é a dimensão da própria amostra, pelo que outros estudos com amostras de maiores dimensões deverão ser realizados.
ABSTRACT - Over the last decades, the issue of night shift work has raised some concerns on the part of nurses regarding the impact on their health (physical and mental), quality of life and consequently the possibility of Practice of self-medication. Objective: To evaluate the impact of shift work with night work on health (physical and mental), quality of life and self-medication of nurses from three services of a Central Hospital. Type of study: An observational, cross-sectional study with a descriptive component and an analytical component was carried out, comparing the quality of life, health status and self-medication of nurses who worked in shifts of those who had a fixed schedule. The following statistical tests were used: Pearson's coefficient (r), Mann-Whitney U test, Chi-square test and Fisher's exact test. And a significance level of 5%. Sample: The sample is of convenience, consisting of nurses from three services of a central hospital in the Lisbon region, who agreed to participate in the study (n = 51). Of the 51 professionals who joined the study, 37 worked in fixed and daytime hours and 14 in shift hours with night work. Data collection instrument: Data collection instruments used were: EPTT (Standardized Study of Shift Work), translated and adapted to the Portuguese version by Carlos Silva (1995) and Whoqol-bref, quality of life assessment questionnaire Developed by WHO, translated and adapted to the Portuguese version by Canavarro et al (2006). Results: As regards the sociodemographic characteristics of the sample studied, it was verified that although night shift work was more frequent in men, no statistically significant differences were obtained (Fisher's exact test, p = 0.120). Concerning marital status, it was found that shift work was more frequent in single, separated or widowed nurses (19/22, 86.4%) than married or de facto union (18/29, 62.1%), (Fisher's Exact Test, p = 0.052). A higher proportion of nurses working at fixed daytime had dependent children, and this difference was significant when compared to the proportion of nurses who worked in shifts. Regarding the analysis of the health status (physical and mental) and quality of life of the nurses, it was verified that the nurses who worked in shifts with night work reported a more negative effect on health and quality of life compared to nurses with fixed schedule, but There was no statistically significant difference (Fisher's Exact Test, p = 0.141). 8 Regarding the evaluation of physical, psychological, socio-familial and sleep disorders, it was found that both fixed and daytime workers and shift workers with night work presented score values between 22 and 27 (On a scale of 0 to 100) in the physical, psychological, social, and environmental assessment domains, but there was no statistically significant difference between the two groups (Mann-Whitney U test: p = 0.849, 0.983, 0.399, 0.340 respectively). It was also found that there was no significant association between shift work with night work and difficulty falling asleep compared to workers with fixed and daytime schedules (Pearson's chi-square test, p = 0.588). Self-medication presented a prevalence of 35.7% in workers with fixed and daytime hours, compared with 24.3% in workers with rotational and nocturnal work, with no statistically significant difference (chi-square test, p = 0.316). There were also no statistically significant differences in the consumption of psychoactive drugs and analgesics (Fisher's exact test, p = 0.619, p = 0.170, respectively). In this study, there was no statistically significant difference in quality of life, physical and mental health status and self-medication among night shift nurses and fixed-time nurses. However, one of the major limitations of this study is the size of the sample itself, so further studies with larger samples should be performed.
ABSTRACT - Over the last decades, the issue of night shift work has raised some concerns on the part of nurses regarding the impact on their health (physical and mental), quality of life and consequently the possibility of Practice of self-medication. Objective: To evaluate the impact of shift work with night work on health (physical and mental), quality of life and self-medication of nurses from three services of a Central Hospital. Type of study: An observational, cross-sectional study with a descriptive component and an analytical component was carried out, comparing the quality of life, health status and self-medication of nurses who worked in shifts of those who had a fixed schedule. The following statistical tests were used: Pearson's coefficient (r), Mann-Whitney U test, Chi-square test and Fisher's exact test. And a significance level of 5%. Sample: The sample is of convenience, consisting of nurses from three services of a central hospital in the Lisbon region, who agreed to participate in the study (n = 51). Of the 51 professionals who joined the study, 37 worked in fixed and daytime hours and 14 in shift hours with night work. Data collection instrument: Data collection instruments used were: EPTT (Standardized Study of Shift Work), translated and adapted to the Portuguese version by Carlos Silva (1995) and Whoqol-bref, quality of life assessment questionnaire Developed by WHO, translated and adapted to the Portuguese version by Canavarro et al (2006). Results: As regards the sociodemographic characteristics of the sample studied, it was verified that although night shift work was more frequent in men, no statistically significant differences were obtained (Fisher's exact test, p = 0.120). Concerning marital status, it was found that shift work was more frequent in single, separated or widowed nurses (19/22, 86.4%) than married or de facto union (18/29, 62.1%), (Fisher's Exact Test, p = 0.052). A higher proportion of nurses working at fixed daytime had dependent children, and this difference was significant when compared to the proportion of nurses who worked in shifts. Regarding the analysis of the health status (physical and mental) and quality of life of the nurses, it was verified that the nurses who worked in shifts with night work reported a more negative effect on health and quality of life compared to nurses with fixed schedule, but There was no statistically significant difference (Fisher's Exact Test, p = 0.141). 8 Regarding the evaluation of physical, psychological, socio-familial and sleep disorders, it was found that both fixed and daytime workers and shift workers with night work presented score values between 22 and 27 (On a scale of 0 to 100) in the physical, psychological, social, and environmental assessment domains, but there was no statistically significant difference between the two groups (Mann-Whitney U test: p = 0.849, 0.983, 0.399, 0.340 respectively). It was also found that there was no significant association between shift work with night work and difficulty falling asleep compared to workers with fixed and daytime schedules (Pearson's chi-square test, p = 0.588). Self-medication presented a prevalence of 35.7% in workers with fixed and daytime hours, compared with 24.3% in workers with rotational and nocturnal work, with no statistically significant difference (chi-square test, p = 0.316). There were also no statistically significant differences in the consumption of psychoactive drugs and analgesics (Fisher's exact test, p = 0.619, p = 0.170, respectively). In this study, there was no statistically significant difference in quality of life, physical and mental health status and self-medication among night shift nurses and fixed-time nurses. However, one of the major limitations of this study is the size of the sample itself, so further studies with larger samples should be performed.
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Trabalho por turnos e nocturno Automedicação Qualidade de vida Enfermeiros Shift work and night shift Self-medication Quality of life Nurses