Avaliação da qualidade do sono em profissionais de saúde da emergência / Evaluación de la calidad del sueño en profesionales de la salud de emergencia / Sleep quality assessment in emergency health professionals

Resumo Objetivo Avaliar a qualidade do sono de profissionais dos serviços de emergência e sua associação com o nível de fadiga e qualidade de vida. Métodos Estudo descritivo, transversal e correlacional, realizado nas unidades do Serviço de Atendimento Móvel de Urgência (SAMU) e na Unidade de Pronto Atendimento (UPA), no ano de 2021, com 108 participantes. Para avaliação da qualidade do sono, foi utilizado o Índice de Qualidade do Sono de Pittsburgh versão Brasileira (PSQI-BR); para avaliação da Fadiga, foi utilizada a Escala de Fadiga de Chalder, em conjunto com a Escala de Necessidade de Descanso (ENEDE); e para avaliação da qualidade de vida, foi utilizado o World Health Organization Quality of Life Brief Version (WHOQOL-bref), sendo que os instrumentos utilizados foram adaptados para a língua portuguesa em estudos anteriores. Foram aplicados testes de associação para a análise estatística, tendo sido utilizados o Teste Qui-Quadrado de Pearson, o Teste U Mann-Whitney ou Kruskal Wallis e a correlação de Spearman. Valores de p <0,05 foram considerados como significativos. Resultados Foi identificado que 72,2% dos participantes apresentaram má qualidade do sono e 75,9% estavam fadigados. Foi observada associação significativa entre a qualidade do sono e a fadiga, a necessidade de descanso e a qualidade de vida. Conclusão Foi identificado que os profissionais de saúde que trabalham em serviço de urgência e emergência apresentam má qualidade do sono e de vida e níveis elevados de fadiga e necessidade de descanso, o que pode impactar diretamente suas atividades pessoais e profissionais.

Resumen Objetivo Evaluar la calidad del sueño de profesionales de los servicios de emergencia y su relación con el nivel de fatiga y calidad de vida. Métodos Estudio descriptivo, transversal y correlacional, realizado en las unidades del Servicio de Atención Móbil de Urgencia (SAMU) y en la Unidad de Pronta Atención (UPA), en el año 2021, con 108 participantes. Para evaluar la calidad del sueño, se utilizó el Índice de Calidad del Sueño de Pittsburgh, versión brasileña (PSQI-BR). Para evaluar la fatiga, se utilizó la Escala de Fatiga de Chalder, junto con la Escala de Necesidad de Descanso (ENEDE). Para evaluar la calidad de vida, se utilizó el World Health Organization Quality of Life Brief Version (WHOQOL-bref). Los instrumentos utilizados fueron adaptados al idioma portugués en estudios anteriores. Se aplicaron pruebas de asociación para el análisis estadístico, para lo cual se utilizó la Prueba χ2 de Pearson, la Prueba U de Mann-Whitney o la prueba de Kruskal-Wallis y la correlación de Spearman. Se consideraron valores de p<0,05 como significativos. Resultados Se identificó que el 72,2 % de los participantes presentó una mala calidad de sueño y el 75,9 % tenía fatiga. Se observó una asociación significativa entre la calidad del sueño y la fatiga, la necesidad de descanso y la calidad de vida. Conclusión Se identificó que los profesionales de la salud que trabajan en servicios de urgencia y emergencia presentaron mala calidad de sueño y de vida y niveles elevados de fatiga y necesidad de descanso, lo que puede impactar directamente en sus actividades personales y profesionales.

Abstract Objective To assess emergency service professionals' sleep quality and its association with the level of fatigue and quality of life. Methods A descriptive, cross-sectional and correlational study, carried out in the units of the Mobile Emergency Care Service (SAMU) and in the Emergency Care Unit (ECU), in 2021, with 108 participants. To assess sleep quality, the Pittsburgh Sleep Quality Index, Brazilian version (PSQI-BR), was used; to assess fatigue, the Chalder Fatigue Scale was used, together with the Need for Recovery Scale (NFR); and to assess quality of life, the World Health Organization Quality of Life Brief Version (WHOQOL-bref) was used, and the instruments used were adapted to Portuguese in previous studies. Association tests were applied for statistical analysis, using Pearson's chi-square test, Mann-Whitney U test or Kruskal Wallis and Spearman's correlation. P-values <0.05 were considered significant. Results It was identified that 72.2% of participants had poor sleep quality and 75.9% were fatigued. A significant association was observed between sleep quality and fatigue, the need for recovery and quality of life. Conclusion It was identified that health professionals working in emergency services have poor sleep quality and life, and high levels of fatigue and need for recovery, which can directly impact their personal and professional activities.

Effects of life satisfaction and shift work and their interaction on cumulative fatigue in petrochemical employees / 环境与职业医学

Background Cumulative fatigue without intervention will seriously threaten the physical and mental health of workers. Shift work and life satisfaction are strongly associated with fatigue accumulation. Objective To explore the effects of life satisfaction, shift work, and their interaction on cumulative fatigue in petrochemical employees, and to provide a scientific basis for preventing cumulative fatigue. Methods All staff of a petrochemical enterprise were selected by cluster sampling for a cross-sectional study from July to October 2021 in Jiangsu Province. A questionnaire designed by the project team was used to collect information on shift work; and life satisfaction and cumulative fatigue were investigated by the World Health Organization Five-item Well-Being Index and the Self-diagnosis Checklist for Assessment of Worker’s Fatigue Accumulation respectively. A logistic regression model was used to analyze the influences of life satisfaction and shift work on cumulative fatigue. Multiplicative and additive models were applied to analyze the interaction effect of life satisfaction and shift work. Results A total of 4066 questionnaires were returned, of which 3763 were valid, with an effective recovery rate of 92.5%. The percentage of cumulative fatigue in the petrochemical employees was 63.2% (2377/3763), and the percentages of low life satisfaction and shift work in the petrochemical employees were 53.6% (2016/3763) and 54.2% (2041/3763), respectively. The results of univariate analysis showed no significant difference in cumulative fatigue among different marital status groups (P=0.176), and there were statistically significant differences in cumulative fatigue among the petrochemical employees in different groups of age, gender, educational level, average monthly income, job title, length of service, working hours, night shift, smoking, drinking, physical exercise, life satisfaction, and shift work (P<0.001). After adjustment for covariates such as age, gender, educational level, average monthly income, job title, length of service, working hours, night shift, smoking, drinking, and physical activity, the unconditional logistic regression model showed that the risk of reporting cumulative fatigue in high life satisfaction participants was 0.129 (95%CI: 0.109, 0.154) times of that in participants of low life satisfaction; the risk of reporting cumulative fatigue in shift work participants was 3.792 (95%CI: 2.713, 5.300) times of that in no shift work participants; and the risk of reporting cumulative fatigue in participants with both high life satisfaction and shift work was 0.105 (95%CI: 0.081, 0.135) times of that in participants with low life satisfaction and shift work. The relative excess risk due to interaction, the attributable proportion due to interaction, and the synergy index of coexisting life satisfaction and shift work were −5.504 (95%CI: −7.247, −3.760), −4.728 (95%CI: −7.575, −1.880), and 0.029 (95%CI: 0.002, 0.351) respectively, which suggested that life satisfaction and shift work have an additive interaction effect on cumulative fatigue. A significant multiplicative interaction was also found between life satisfaction and shift work (OR=0.688, 95%CI: 0.476, 0.936). Conclusion Life satisfaction and shift work are the influencing factors of cumulative fatigue among petrochemical employees, and they interact with each other on the risk of cumulative fatigue. High life satisfaction can reduce the risk of accumulated fatigue associated with shift work.

Research progress on the relation and related mechanism of night shift work and cardiovascular disease / 中华劳动卫生职业病杂志

Cardiovascular disease is a class of diseases involving the heart or blood vessels, which accounts for about one-third of all deaths worldwide each year. Unhealthy diet, lack of physical activity, smoking and excessive alcohol consumption are all risk factors for cardiovascular disease. With the increasing number of night shift workers, the number of patients with cardiovascular disease has increased, and night shift work has gradually become a risk factor of cardiovascular disease. At present, the mechanism of cardiovascular disease caused by night shift work is still unclear. This review summarizes the relationship between night shift work and cardiovascular disease and its related biochemical indicators, and discusses the research on related mechanisms.

Transtorno de trabalho em turnos entre enfermeiros durante a pandemia da COVID-19 na Arábia Saudita / Shift work disorder among nurses during the COVID-19 pandemic in Saudi Arabia

RESUMO Objetivo avaliar a prevalência de sintomas de transtorno de trabalho em turnos entre enfermeiros em vários turnos por longas horas durante a pandemia da COVID-19. Métodos estudo descritivo de corte transversal com 120 enfermeiros em hospitais governamentais na Arábia Saudita. Utilizaram-se questionários estruturados: Escala Hospitalar de Ansiedade e Depressão, para medir ansiedade e depressão, Escala de Sonolência de Epworth, para sonolência e insônia, e Escala de Gravidade da Fadiga, para fadiga. Resultados Mostrou-se alta prevalência de sintomas de transtorno de trabalho em turnos, como sonolência diurna (59,2%), fadiga e ansiedade (42,5%) em todos os departamentos durante a pandemia da COVID-19. Também, registrou-se depressão limítrofe de 30,5%. Evidenciou-se diferença significativa entre nível de escolaridade, horas de trabalho e departamentos de trabalho com ansiedade, e entre nível de escolaridade e horas de trabalho com depressão. Conclusão enfermeiros apresentaram sintomas de transtorno de jornada de trabalho em turnos durante a pandemia da COVID-19. Contribuições para a prática: trabalho em turnos altera estilo de vida e saúde dos enfermeiros. Poucas pesquisas foram realizadas sobre transtorno do trabalho em turnos entre enfermeiros sobre a prevalência e seus efeitos. Os resultados são úteis para identificar problemas, superar dificuldades e manter os fundamentos da qualidade do atendimento

ABSTRACT Objective to assess the prevalence of shift work disorder symptoms among nurses who work multiple shifts for long hours during COVID-19 pandemic. Methods descriptive cross-sectional study was utilized in this study of 120 nurses working in governmental hospitals in Saudi Arabia. The study used structured questionnaires: Hospital Anxiety and Depression Scale, to measure anxiety and depression, Epworth Sleepiness Scale to measure sleepiness and insomnia, and Fatigue Severity Scale to measure fatigue. Results this study showed high prevalence shift work disorder symptoms such as daytime sleepiness (59.2%), fatigue and anxiety (42.5%) across all departments during the COVID-19 pandemic. Also, it showed a 30.5% borderline depression. Significant difference between the educational attainment, hours of working and working departments with Anxiety was identified. Significant difference was found between educational attainment and hours of working with depression. Conclusion the nurses suffered shift work disorder symptoms during the COVID-19 pandemic. Contributions to practice: shift work alters the nurses' lifestyle and their health. Little research has conducted on shift work disorder among the nurses on the prevalence and its effects. The results are useful to identify the issues and to overcome the difficulties, which will help to keep the essentials of quality of care.

O trabalho terceirizado e por turnos está associado ao aumento do risco de COVID-19? Descobertas de um estudo com trabalhadores da mineração / Is outsourced and shift work associated with an increased risk of COVID-19? Findings from a study about mining workers

Resumo Objetivos: investigar os fatores de risco sociodemográficos e ocupacionais associados à infeção por COVID-19 em trabalhadores da mineração. Métodos: estudo de coorte retrospectivo com dados secundários dos trabalhadores de uma empresa multinacional de mineração, de março de 2020 a abril de 2021. Casos de COVID-19 foram definidos por meio do resultado do teste reação em cadeia da polimerase (PCR) positivo para SARS-CoV-2. Riscos relativos (RR) para testes positivos foram obtidos por regressão de Poisson. Resultados: dos 10.484 trabalhadores testados, 2.578 (24,6%) tiveram pelo menos um resultado positivo. Foi realizada uma média de 4,0 (desvio-padrão: 3,6) testes para cada trabalhador, totalizando 41.962 testes. A maioria dos trabalhadores eram do sexo masculino (88,3%), com idade entre 30 e 39 anos (38,7%), terceirizados (74,1%) e que não trabalhavam em turnos (70,5%). No modelo múltiplo, os trabalhadores terceirizados (RR: 1,39; intervalo de confiança de 95% [IC95%]: 1,27;1,51) e trabalhadores por turnos (RR: 1,10; IC95%: 1,01;1,20) apresentavam maior risco de infecção quando comparados com seus homólogos. Conclusões: os trabalhadores terceirizados e por turnos exibiram maior risco de infecção pelo SARS-CoV-2 quando comparados com seus homólogos. Portanto, é necessário fornecer monitoramento contínuo com oferta regular e adequada de testes para mitigação e prevenção da COVID-19 nestes grupos ocupacionais.

Abstract Objectives: to investigate the sociodemographic and occupational risk factors associated with COVID-19 infection in mining workers. Methods: a retrospective cohort study, using secondary workers' health data from a multinational mining company, from March 2020 to April 2021. A COVID-19 case was defined based on a SARS-CoV-2 positive result in a polymerase chain reaction (PCR) test. Risk ratios (RRs) for positive testing were estimated using Poisson's regression model. Results: of 10,484 workers, 2,578 (24.6%) had at least one positive result for COVID-19. Each worker underwent an average of 4.0 (standard deviation: 3.6) tests, totaling 41,962 PCR tests. Most of the evaluated workers were male (88.3%), aged from 30 to 39 years (38.7%), outsourced (74.1%) and non-shift workers (70.5%). Our multivariate model showed that outsourced (RR: 1.39; 95% confidence interval [95%CI]: 1.27;1.51) and shift workers (RR: 1.10; 95%CI: 1.01;1.20) had a higher risk of SARS-CoV-2 infection than their counterparts. Conclusions: outsourced and shift workers have a higher risk of COVID-19 infection than their counterparts. Therefore, it is necessary to provide continuous monitoring with regular and adequate testing for mitigation and prevention of COVID-19 in these occupational groups.

Factors Associated With Elevated Blood Pressure in Nursing Workers

Abstract Introduction Nurses from the night shift are exposed to sleep deprivation, which is associated with circadian rhythm alteration, lifestyle changes, psychosocial stress, and, consequently, increased risk of blood pressure (BP) deregulation and hypertension. Objective To analyze risk factors associated with elevated BP levels in nursing workers. Methods A transversal, quantitative study was conducted with 172 nursing professionals of a large hospital in the state of Minas Gerais, Brazil. The following data were collected: anthropometric and BP measurements, sociodemographic characteristics, clinical variables, and lifestyle habits. Results were evaluated by bivariate analysis and logistic regression. The level of significance adopted in the statistical analysis was 5%. Results Participants' average age was 42.7 ± 9.6 years old; 86.6% (n = 149) were female, and 20.3% (n = 35) had previous diagnosis of hypertension. Overweight and obesity (odds ratio [OR]: 2.187, 95% confidence interval [CI]: 1.060 - 4.509) and night shift (OR: 2.100, CI 95%: 1.061 - 4.158) were statistically significant (p < 0.05) for increased risk of elevated BP level. Conclusion Excessive weight and night shift were significant factors for increased BP in nursing workers.

Correlation between insomnia and job performance in shift nurses / Монголын Анагаах Ухаан

@#Sleep and wakefulness are physiological processes in our lives that are regulated by circadian rhythms. The level of melatonin, the "sleep hormone", increases with the onset of darkness, and its production slows down in the morning. Exposure to artificial light at night disrupts our circadian rhythm and the processes it controls. Shift work is when an individual works from 9 am to 5 pm. But the night shift refers to the time when a group of workers who work at night in factories and enterprises work in the evening or at night, especially from 4 p.m. to 8 a.m. according to a regular schedule. One in five people in industrialized countries work night shifts, and studies in America and Europe show that between 15 and 30% of adult workers have some form of shift work. Between 10% and 30% of shift workers meet the diagnosis of shift work disorder (SWD). 5-10% of shift workers experience severe shift insomnia and sleepiness. At least ¾ of shift workers suffer from insomnia. Excessive sleepiness usually occurs during shifts (mainly at night) and is associated with impaired cognitive ability due to the need for sleep and reduced alertness, and decreased alertness reduces performance. Job performance is influenced by many workplace environmental factors, including workload, coworker relationships, stress levels, and extended hours. A nurse specialist provides nursing care by monitoring and evaluating 24 hours a day, and by working night shifts, the circadian system of sleep is disturbed, causing sleep problems and insomnia. When examining how night shift work affects nurses' ability to concentrate, the decline in concentration (33.3%) was twice as high as that of day shift nurses (16.7%). found that shift nurses who worked the night shift had higher rates of insomnia and chronic fatigue compared to nurses who stopped working the night shift. Lack of sleep manifests as a decline in cognitive functions such as attention, decision making, and reaction time. These cognitive and functional declines can negatively affect quality of life and lead to impaired job performance. An Australian study by Winwood et al found that fatigue associated with night shifts increases the risk of human error and injury, and negatively affects the quality of patient care. Lack of sleep significantly affects nurses' alertness, concentration, and job performance. This review article discusses the relation between shift work-related sleep and job performance based on international research findings.

Association of long working hours and shift work with occupational stress in level A tertiary hospitals / 预防医学

Objective@#To examine the association of long working hours and shift work with occupational stress among medical staff in level A tertiary hospitals, so as to provide insights into promotion of physical and mental health among medical personnel. @*Methods@#One level A tertiary hospital was sampled using a stratified cluster sampling method from southern and northern Xinjiang Uygur Autonomous Region, and all medical personnel were recruited from these two hospitals. Participants' demographics, working duration, and working in shifts were collected using questionnaires, and occupational stress was measured using the Core Scale for Measurement of Occupational Stress proposed by National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention. The associations of long working hours (weekly working duration of >40 hours) and shift work with occupational stress were examined using a multiple linear regression model.@*Results@#A total of 2 529 questionnaires were allocated, and 2 262 were valid, with an effective rate of 89.44%. The respondents had a mean age of (35.12±8.71) years, and included 1 696 women (74.98%). Of all respondents, there were 722 doctors (31.92%), 1 033 nurses (45.67%), 361 medical or pharmaceutical technicians (15.96%), 1 808 with long working hours (79.93%) and 1 264 with shift work (55.88%). The score of occupational stress was (44.79±8.49) points, and the prevalence of occupational stress was 28.69% among respondents. Multiple linear regression analysis showed that after adjustment for age, marital status, length of service, position, smoking and physical exercise, long working hours (>40 h, β'=0.124; >48 h, β'=0.175; ≥55 h, β'=0.323) and shift work (β'=0.203) were influencing factors for occupational stress among medical personnel（P<0.05）; however, there was no interaction between long working hours and shift work (P>0.05). @*Conclusion@#Long working hours and shift work may increase the risk of occupational stress among medical personnel in level A tertiary hospitals.

Association between long working hours and occupational stress/fatigue accumulation in medical staff of tertiary grade A hospitals in Shanghai / 环境与职业医学

Background Long working hours are a common occupational health risk factor. The problem of long working hours and its impact on health of medical staff cannot be ignored. Objective To investigate long working hours in medical staff of tertiary grade A hospitals in Shanghai, and evaluate the relationships of long working hours with occupational stress and fatigue accumulation. Methods A total of 1531 medical staff in departments of emergency, internal medicine, surgery, intensive care unit (ICU), anesthesiology, and obstetrics and gynecology from 6 hospitals in 6 districts of Shanghai were selected using stratified random sampling. A structured questionnaire was used to collect information on social demographics, occupational characteristics, andbehavior and lifestyle. The Core Occupational Stress Scale (COSS) and the Self-diagnostic Questionnaire on the Accumulation of Fatigue of Laborers were used to assess occupational stress and fatigue accumulation condition. Chi-square test and Kruskal-Wallis H test were used to analyze the distributions of long working hours, occupational stress, and fatigue accumulation, log-binomial models were used to analyze the relationships of long working hours with occupational stress and fatigue accumulation, and job title stratified models were also constructed. Results The average weekly working hours of the study subjects was (47.84±11.40) h, 65.90% of the medical staff worked more than 40 h every week. The percentages of the weekly working hours categories of 41-48 h, 49-54 h, and ≥55 h were 31.42%, 13.46%, and 21.03%, respectively. The positive rates of occupational stress and fatigue accumulation were 25.87% and 65.64% respectively, and the differences among different age, gender, job title, education, length of service, and shift system groups were statistically significant (P<0.05). The results of log-binomial regression showed that after adjusting for gender, age, monthly income, marital status, education, physical exercise, smoking, job position, length of service, and shift system, weekly working hours were an influencing factor of occupational stress and fatigue accumulation (P<0.05). Compared with weekly working hours≤40 h, the risk, PR(95%CI), of reporting occupational stress and fatigue accumulation increased to 2.595 (1.989, 3.385) and 1.578 (1.349, 1.845) times respectively for weekly working hours≥55 h (P<0.001). The results of job title stratification analysis showed that the risk of occupational stress among physicians, nurses, and medical technicians increased when weekly working hours≥55 h versus ≤40 h, and the PR (95%CI) values were 2.003 (1.383, 2.902), 1.971 (1.068, 3.636), and 2.770 (1.220, 6.288), respectively (P<0.05). The risk of fatigue accumulation was increased in physicians when weekly working hour≥55 h versus ≤40 h, with a PR (95%CI) value of 1.594 (1.208, 2.103) (P<0.001). Conclusion Long working hours are common among medical personnel and related to the occurrence of occupational stress and fatigue accumulation.

DEVELOPMENT AND VALIDATION OF YOGA MODULE FOR OBSTRUCTIVE SLEEP APNEA

Background: Sleep is an essential component of human life because it provides for relaxation and recovery from the stresses of everyday living. Reduced sleep quantity or quality leads to sleep deprivation which may offer indirect dangers by affecting cognitive and physical performance and raising the chance of motor vehicle and occupational accidents. Insomnia chronic sleep debt snoring sleep apnea circadian rhythm disturbances (including shift work syndrome) RLS parasomnias and uncommon diseases such as narcolepsy are the most common sleep disorders found in sleep clinics according to experts. Obstructive Sleep apnea is a common disorder in which your breathing stops and starts periodically while you sleep. To determine the design and validation of an Integrated Yoga Module (IYM) for OSA patients. The ?rst phase - IYM for OSA - was created based on a survey of classic books and Materials and Procedures: recently available research studies. The designed IYM was validated by 20 subject matter (yoga) experts in the second phase. Lawshe's formula was used to calculate the content-validity ratio (CVR). Yoga practices were created for the OSA Results: Integrated Yoga Module. The ?nal Integrated Yoga Module featured yoga practises with CVR ?0.5 that were assessed by 20 yoga experts and agreed in faculty group discussion. The yoga practices were designed and validated for IYM for Conclusion: OSA. By applying Lawshe's content validity criteria 20 yoga professionals veri?ed the IYM design.

SNORE (Sleep Deprivation Among Night Shift Health Staff on Rotation Evaluation) Study Protocol

Background: SNORE (Sleep deprivation among Night shift health staff On Rotation-Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation. Materials and Methods: A comparative cross-sectional study is devised including health-care profes-sionals working night shifts on rotation at a tertiary level health-care facility, using a semi-structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to ap-proach 309 probable study participants based on stratified random sampling, after exclusion of health-care professionals with other factors which may interfere with sleep deprivation testing. Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive im-pairment, especially among health care professionals working night shifts.

Cardiovascular Risk Factors in Haul Truck Operators of the Mining Sector Working a Rotational Schedule

Abstract Background: Due to the growing concern about work-related social and health aspects, occupational health and safety has become relevant. Objective: This work aims to develop a model to assist cardiovascular risk management in a team of haul truck operators, who work in rotating shifts at a mining company in Brazil. Methods: This longitudinal study evaluated risk factors for cardiovascular diseases of 191 mineworkers at three times points - 2010, 2012, and 2015. In addition, the risk of developing cardiovascular diseases was calculated, and the risk factors were analyzed using the chi-square test, the U Mann-Whitney test, and binary logistic regression. The significance level was set at 5%. Results: In the study period, body weight, body mass index (BMI), waist-to-height ratio (WHR), systolic (SBP), and diastolic blood pressure (DBP), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides levels of the study group increased. In 2015, there was a high prevalence of alcohol intake, overweight or obesity, central obesity, inadequate WHR, high blood pressure, total cholesterol above 190 mg/dL, and triglycerides above 150 mg/dL. An association was identified between increased cardiovascular risk and age, SBP, HDL-C, low-density lipoprotein cholesterol (LDL-C), and elevated glucose levels. Conclusion: Intense interventions for reduction and prevention of elevated alcohol intake, blood pressure levels, WHR, metabolic syndrome, blood glucose, and LDL-C levels, and low HDL-C levels are needed. In addition, a close monitoring of mine workers over 38 years of age who smoke, consume alcoholic beverages, and have altered blood glucose levels is important.

Passagem de plantão, comunicação efetiva e o método sbar, na percepção dos enfermeiros de uma unidade coronariana / El cambio de turno, la comunicación efectiva y el método sbar en la percepción de los enfermeros de una unidad de cuidados coronarios / Shift handover, effective communication, and the sbar method, in the perception of nurses in a coronary care unit

RESUMO Objetivo: identificar as percepções dos enfermeiros de uma unidade coronariana sobre a relação entre a passagem de plantão, comunicação efetiva e o método SBAR. Método: estudo descritivo exploratório com abordagem qualitativa que buscou identificar as percepções dos enfermeiros sobre a relação entre a passagem de plantão, a comunicação efetiva e o método SBAR na unidade de terapia intensiva no processo realizado entre os turnos de trabalho, com indicativos para a construção de um instrumento estruturado para orientar e conduzir a troca de turnos, com a participação de 12 enfermeiros de uma unidade intensiva coronariana. Os dados foram obtidos no período de janeiro a julho de 2020 por meio oficina presencial antes da pandemia, e questionários foram submetidos à análise temática. Resultados: foram elencadas três categorias: Organização da passagem de plantão com enfermeiro e técnico de Enfermagem; Instrumentalização da passagem de plantão entre as equipes de Enfermagem; e Método SBAR na passagem de plantão, como base para a elaboração do instrumento de passagem de plantão. Evidenciou-se que a comunicação efetiva é um fator influenciador na passagem de plantão para a realização do cuidado de Enfermagem de forma continuada, evitando eventos adversos aos pacientes. Conclusão: confirma-se que, estratégias envolvendo a gestão hospitalar, como instrumentalizar e capacitar a equipe que está na linha de frente da atividade do plantão, acrescentam e enriquecem o cuidado sistematizado e humanizado.

RESUMEN Objetivo: identificar las percepciones del personal de enfermería de una unidad de cuidados coronarios sobre la relación entre el rostering, la comunicación efectiva y el método SBAR. Método: Estudio exploratorio descripti-vo con abordaje cualitativo, que buscaba identificar las percepciones de los enfermeros sobre la relación entre el paso de planta, la comunicación efectiva y el método SBAR, en la unidad de terapia intensiva en el proceso realizado entre los turnos de trabajo, con indicaciones para construir un instrumento estructurado para orientar y conducir la búsqueda de turnos con la participación de 12 enfermeros de una unidad intensiva coronaria. Los datos se obtuvieron de enero a julio de 2020, mediante un taller presencial antes de la pandemia y cuestionarios sometidos a análisis temáticos. Resultados: Se enumeraron tres categorías: Organización del paso de planta con el enfermero y el técnico de enfermería, instrumentalización del cambio de turno entre los equipos de enferme-ría y método SBAR en el cambio de turno, como base para la elaboración del instrumento de cambio de turno. Se demostró que la comunicación eficaz es un factor que influye en el paso de la planta para la realización del cuidado de la salud de forma continuada, evitando eventos adversos a los pacientes. Conclusión: Se confirma que las estrategias que implican a la dirección del hospital, como: potenciar y formar a este equipo que está en primera línea, en el liderazgo de la actividad de guardia, suma y enriquece la atención sistematizada y humanizada.

ABSTRACT Objective: to identify the perceptions of nurses in a coronary care unit about the relationship between shift change, effective communication, and the SBAR method. Method: descriptive exploratory study with a qualitative approach that sought to identify nurses' perceptions about the relationship between shift change, effective communication, and the SBAR method in the intensive care unit in the process carried out between work shifts, with indications for the construction of a structured instrument to guide and lead the shift change, with the participation of 12 nurses from a coronary intensive care unit. Data were obtained from January to July 2020 through a face-to-face workshop before the pandemic, and questionnaires were subjected to thematic analysis. Results: three categories were listed: Organization of the shift change with nurses and Nursing technicians; Instrumentalization of the shift change between the Nursing teams; and SBAR Method in the shift change, as a basis for the elaboration of the shift change instrument. It was evidenced that effective communication is an influencing factor in the shift change to carry out Nursing care in a continuous way, avoiding adverse events to patients. Conclusion: it is confirmed that strategies involving hospital management, such as equipping and training the team that is in the front line of the duty activity, add and enrich the systematized and humanized care.

Cardiovascular risk behavior among industrial workers in the Northeast of Brazil: a cluster analysis / Comportamento de risco cardiovascular entre trabalhadores industriais no nordeste do Brasil: uma análise de cluster

Abstract This research aimed to investigate the occurrence of clusters of cardiovascular risk behaviors and their association with social demographic and occupational characteristics in a population of industrial workers in the metropolitan area of Recife, Brazil. It was a transversal study with 727 workers of both genders. We identified cluster distribution from the variables: smoking, alcohol consumption, physical activity and waist circumference, by a combination of hierarchical and non-hierarchical analysis. We later tested the association with the social demographic and occupational variables with a multi-varied analysis. We have identified a protection cluster (sufficient physical activity, moderate alcohol consumption) and a risk cluster (high waist circumference, sedentarism, smoking, excessive alcohol consumption). The protection cluster was positively associated with night shift or variable shift work (RP: 1.66, IC95%: 1.26-2.17), and the risk cluster was associated with women (RP: 1.15, IC95%: 1.01-1.31). Cluster analysis allowed to identify that, for day shift workers and women, the shortest daytime outside the work environment can influence the adoption of cardiovascular risk behaviors.

Resumo Esta pesquisa teve como objetivo investigar a ocorrência de clusters de comportamentos de risco cardiovascular e sua associação com características sociodemográficas e ocupacionais em uma população de trabalhadores da indústria da região metropolitana de Recife, Brasil. Trata-se de um estudo transversal com 727 trabalhadores de ambos os gêneros. Identificou-se a distribuição do cluster a partir das variáveis: tabagismo, etilismo, atividade física e circunferência da cintura, por meio de uma combinação de análise hierárquica e não hierárquica. Posteriormente, testamos a associação às variáveis sociodemográficas e ocupacionais com uma análise multivariada. Identificamos a formação consistente de um cluster de proteção (atividade física suficiente, consumo moderado de álcool) e de um cluster de risco (circunferência da cintura elevada, sedentarismo, tabagismo, consumo excessivo de álcool). O cluster de proteção associou-se positivamente ao turno noturno ou turnos variáveis (RP: 1,66, IC95%: 1,26-2,17) e o cluster de risco esteve associado às mulheres (RP: 1,15, IC95%: 1,01-1,31). A análise de cluster permitiu identificar que, para trabalhadores diurnos e mulheres, a menor jornada diurna fora do trabalho pode influenciar na adoção de comportamentos de risco cardiovascular.

Condicionantes de calidad de los cuidados enfermeros durante el turno de noche / Factors Influencing Quality of Nursing Care during the Night Shifts

Introducción: El turno nocturno provoca efectos físicos y psicológicos en las enfermeras. Fatiga, estrés, ansiedad, alteraciones del sueño y percepción negativa del entorno laboral pueden condicionar la calidad del cuidado. Objetivo: Identificar las condiciones relacionadas con la calidad de los cuidados enfermeros durante los turnos de noche en los hospitales. Métodos: Se realiza una revisión sistemática según criterios PRISMA. Se utilizó como estrategia común en las bases consultadas la combinación de las palabras clave y booleanos: ("Quality of Care") AND ("Nurse"OR"Nurses") AND ("Night shift"OR"Shift"). Se exploraron las bases de datos PubMed, Cinahl, Scopus y Cochrane. Se Incluyeron ensayos, estudios transversales, revisiones y estudios cualitativos entre 2009 y 2018. Se excluyeron los que no cumplieron requisitos de contenido y criterios de evaluación de calidad metodológica descritos a priori. Se incluyeron 20 trabajos. Conclusiones: Para la mayoría de autores la calidad de los cuidados nocturnos es menor que durante el día y puede estar condicionada por exceso de horas trabajadas, percepción de salud, fatiga, calidad del sueño, menor ratio enfermera-paciente, menor apoyo institucional y menor satisfacción profesional. Los indicadores de calidad más utilizados fueron incidencia de úlceras por presión, errores en identificación de pacientes, errores de medicación, errores de comunicación, cuidados sin realizar, desmotivación profesional, despersonalización y retención institucional. La heterogeneidad de los estudios hace que pueda aumentar el sesgo en los resultados. Muchos indicadores descritos son evaluados mediante percepciones, ocasionalmente por métodos objetivos. La identificación de condicionantes clave en la calidad de cuidados nocturnos permite iniciativas institucionales de gran impacto(AU)

Introduction: The night shift causes physical and psychological effects on nurses. Fatigue, stress, anxiety, sleep disturbances and negative perception of the work environment can affect the quality of care. Objective: To identify the conditions related to the quality of nursing care during night shifts in hospitals. Methods: A systematic review was carried out according to PRISMA criteria. As a common strategy in the consulted databases, the combination of the following keywords and Booleans was used: ("Quality of Care") AND ("Nurse "OR "Nurses") AND ("Night shift "OR "Shift"). The PubMed, Cinahl, Scopus and Cochrane databases were explored. Trials, cross-sectional studies, reviews and qualitative studies between 2009 and 2018 were included. Those that did not meet content requirements and methodological quality assessment criteria described a priori were excluded. Twenty papers were included. Conclusions: For most authors, the quality of night care is lower than during the day and may be affected by an excess of working hours, health perception, fatigue, sleep quality, lower nurse-patient ratio, lower institutional support and lower professional satisfaction. The most frequently used quality indicators were incidence of pressure ulcers, patient identification errors, medication errors, communication errors, unperformed care, professional demotivation, depersonalization and institutional retention. The heterogeneity of the studies may increase bias in the results. Many of the indicators described are assessed by perceptions, occasionally using objective methods. The identification of key determinants in the quality of night care allows for high-impact initiatives at the institutional level(AU)

Epidemiological research progress on effects of night shift work on female reproductive health / 环境与职业医学

The International Agency for Research on Cancer (IARC) defines shift work as any arrangement of daily working hours other than the standard daylight hours (typically 7:00/8:00 am–5:00/6:00 pm). To meet the needs of rapid socioeconomic development, shift work is becoming more and more common. The impact of shift work, especially night shift work, on human health cannot be ignored. Female's health is not only important to the well-being of themselves, but also has a far-reaching impact on their children and even their entire family. Increasing epidemiological studies have focused on the effects of night shift work on female's reproductive health. This article reviewed epidemiological evidence of the associations between night shift work and reproductive outcomes, e.g. menstrual cycle, endometriosis, pregnancy rate, adverse pregnancy outcomes, and ovarian cancer. The potential biological mechanisms connecting night shift work to female reproductive health were also introduced, e.g. melatonin regulation, clock gene regulation, and sex hormone regulation. Through this review, we propose to provide a reference for determining occupational risk factors, conducting subsequent relevant studies, and formulating rational health promotion strategies.

Correlations of long working hours and shift work with sleep of migrant workers / 环境与职业医学

Background Long working hours (LWH) and shift work are harmful to the physical and mental health of occupational groups. Objective To understand the status quo of LWH and shift work of migrant workers in Shanghai, and to analyze the influence of the above two factors on sleep of the population. Methods From July to September 2018, a cross-sectional survey using questionnaires was conducted among 3215 in-service employees at seven workplaces with more than 300 employees in six selected districts of Shanghai using multi-stage random sampling method. A total of 2976 valid questionnaires were collected, with a valid response rate of 92.6%. The questionnaires included general demographic characteristics, personal health behavior, work-related factors, weekly working hours, shift work, and sleep. Univariate analysis and logistic regression analysis were used to investigate the relationships of LWH and shift work with sleep, and an interaction item was included to evaluate potential interaction between LWH and shift work. Result The average age of the subjects was (30.98±9.49) years old, the male to female ratio was 1∶1.20, and 2382 workers were reported without local residency (80.0%). Among the migrant workers, the average weekly working hours was (57.23±13.14) h, the proportions of LWH (weekly working hours>40 h), extra LWH (weekly working hours>55 h), and shift work were 80.6% (1919/2382), 60.3% (1436/2382), and 25.4% (600/2366), respectively, all above were significantly higher than those of local workers. The prevalence rates of insomnia and lack of sleep among the migrant workers were 46.3% (1091/2356) and 25.4% (597/2354), respectively. The results of logistic regression model showed that after adjusting demographic characteristics such as gender, age, education level, and monthly income, as well as occupation and personal health behavior, compared with working hours ≤40 h per week, working 55-60 h per week was a risk factor for insomnia of migrant workers (OR=1.33, 95%CI: 1.02-1.72), while working >60 h per week was a risk factor for both insomnia (OR=1.37, 95%CI: 1.05-1.78) and insufficient sleep (OR=1.73, 95%CI: 1.28-2.35) of migrant workers. Shift work was only associated with insomnia (OR=1.37, 95%CI: 1.11-1.69). Meanwhile, working hours>60 h per week and shift work had an interaction effect on insomnia of migrant workers (OR=2.35, 95%CI: 1.20-4.60). Conclusion LWH and shift work are prominent among migrant workers, and there is an interaction between LWH and shift work with insomnia.

Qualidade do sono, variáveis pessoais e laborais e hábitos de vida de enfermeiros hospitalares / Sleep quality, personal and work variables and life habits of hospital nurses / Calidad de sueño, variables personales, laborales y estilo de vida de enfermeros de hospital

Resumo Objetivo: identificar as possíveis associações entre a qualidade do sono, as variáveis pessoais e laborais e os hábitos de vida de enfermeiros hospitalares. Método: estudo transversal, exploratório, correlacional, quantitativo, realizado no período de outubro a dezembro de 2019. Os dados foram coletados com a aplicação de um questionário que abordou as características pessoais, hábitos de vida e as condições de trabalho dos pesquisados. Para avaliação da qualidade do sono, utilizou-se a Pittsburgh Sleep Quality Index (PSQI), versão do português do Brasil. Resultados: participaram 42 profissionais, 31 (73,8%) mulheres, entre 26-66 anos (média de 40,2); 61,9% realizavam horas extras; 26,2% possuíam duplo vínculo empregatício e 40,5% tiveram ausências no trabalho. A qualidade do sono foi considerada boa por 9,5% dos participantes, má por 64,3% e com distúrbios do sono por 26,2%. Na população que realizava turnos rotativos, essa qualidade foi identificada como má por 26,2%. Os piores resultados foram encontrados na faixa etária de 30-39 anos e houve significância estatística na variável "viver com companheiro(a)". Conclusão: houve prejuízo na qualidade de sono dos enfermeiros; há a necessidade de monitoramento desses trabalhadores, particularmente dos que realizam trabalhos em turnos, com o intuito de propiciar medidas preventivas, visando mitigar os danos à sua saúde.

Abstract Objective: to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. Method: a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents' personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. Results: the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the "living with a partner" variable. Conclusion: there was impairment in the nurses' sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.

Resumen Objetivo: identificar posibles asociaciones entre la calidad de sueño, las variables personales y laborales y los estilo de vida de los enfermeros de hospital. Método: estudio transversal, exploratorio, correlacional, cuantitativo, realizado de octubre a diciembre de 2019. Los datos fueron recolectados mediante un cuestionario que abordó las características personales, estilo de vida y condiciones de trabajo de los encuestados. Para evaluar la calidad de sueño, se utilizó el Pittsburgh Sleep Quality Index (PCSI), versión en portugués de Brasil. Resultados: participaron 42 profesionales, 31 (73,8%) mujeres, con edad entre 26 y 66 años (media 40,2); el 61,9% trabajaba horas extras; el 26,2% tenía dos vínculos laborales y el 40,5% faltó al trabajo. La calidad de sueño fue considerada buena por el 9,5% de los participantes, mala por el 64,3% y con trastornos del sueño por el 26,2%. El 26,2% de la población que hacía turnos rotativos, calificó la calidad como mala. Los peores resultados se encontraron en la franja etaria de 30 a 39 años y hubo significación estadística en la variable "vive en pareja". Conclusión: la calidad de sueño de los enfermeros se vio afectada; es necesario monitorear a estos trabajadores, en particular a los que trabajan por turnos, a fin de implementar medidas preventivas que reduzcan los daños a su salud.

Repercussions of night shift work on nursing professionals' health and sleep quality / Repercusiones del trabajo nocturno en la calidad del sueño y la salud de profesionales de enfermería / Repercussões do trabalho noturno na qualidade do sono e saúde de trabalhadores de enfermagem

ABSTRACT Objective: to analyze the association between sleep quality, health symptoms and the physical, psychological and social effects of work in Nursing professionals working the night shift. Method: a cross-sectional study conducted with Nursing professionals working the night shift of a hospital institution. The instruments used were a socio-occupational and health symptoms questionnaire, the Assessment Scale for Work-Related Harms, and the Pittsburgh Sleep Quality Index. Data were collected between September 2017 and April 2018.The analysis was performed by means of descriptive and analytical statistics. Results: a total of 139 workers took part in the study and a statistical difference was identified between poor sleep quality and the female gender and physical illness variables and health symptoms such as appetite disorder, sensation of indigestion, flatulence, insomnia, difficulty concentrating, unhappiness, sensation of decreased self-esteem and mood lability. Conclusion: it was verified that Nursing professionals working the night shift experienced poor sleep quality, and that this relationship exerts an impact on physical, psychological and social health. Interventions targeted at raising awareness about sleep hygiene can promote better outcomes in these individuals' health.

RESUMEN Objetivo: analizar la asociación entre la calidad del sueño, síntomas de salud y los efectos físicos, psicológicos y sociales del trabajo en profesionales de Enfermería que se desempeñaban en el turno nocturno. Método: estudio transversal, realizado con trabajadores de Enfermería que se desempeñaban en el turno nocturno de una institución hospitalaria. Se utilizaron los siguientes instrumentos: un cuestionario sociolaboral y de síntomas de salud, la Escala de Evaluación de los Daños Relacionados al Trabajo y el Índice de Calidad del Sueño de Pittsburgh. Los dados se recopilaron entre septiembre de 2017 y abril de 2018. El análisis se realizó por medio da estadística descriptiva y analítica. Resultados: se contó con la participación de 139 trabajadores y se identificó una diferencia estadística entre calidad de sueño deficiente y las variables sexo femenino y padecimiento físico, síntomas de salud como trastornos del apetito, sensación de indigestión, flatulencia, insomnio, dificultad para concentrarse, desdicha, sensación de disminución de la autoestima y labilidad en el estado de ánimo. Conclusión: se verificó que los trabajadores de Enfermería que se desempeñaban en el turno nocturno presentaron calidad de sueño deficiente, y esa relación afecta la salud física, psicológica y social. Intervenciones con el objetivo de generar conciencia sobre la higiene del sueño pueden promover mejores resultados en la salud de estas personas.

RESUMO Objetivo: analisar a associação entre a qualidade do sono, sintomas de saúde e os efeitos físicos, psicológicos e sociais do trabalho em trabalhadores de enfermagem que atuavam no turno noturno. Método: estudo transversal, realizado com trabalhadores de enfermagem que atuavam em instituição hospitalar no turno noturno. Utilizaram-se como instrumentos questionário sociolaboral e de sintomas de saúde, Escala de Avaliação dos Danos Relacionados ao Trabalho e o Índice de Qualidade do Sono de Pittsburgh. Os dados foram coletados entre setembro de 2017 e abril de 2018. A análise foi realizada por meio da estatística descritiva e analítica. Resultados: participaram 139 trabalhadores e identificou-se diferença estatística entre qualidade do sono ruim e as variáveis sexo feminino, adoecimento físico e sintomas de saúde como distúrbio de apetite, sensação de má digestão, flatulência, insônia, dificuldade de concentração, infelicidade, sensação de diminuição autoestima e labilidade de humor. Conclusão: constatou-se que os trabalhadores de enfermagem que atuavam no turno noturno experimentavam qualidade do sono ruim, e essa relação impacta na saúde física, psicológica e social. Intervenções visando à conscientização sobre a higiene do sono podem promover melhores resultados na saúde dessas pessoas.

Processo de passagem de plantão: o olhar de enfermeiras nas unidades de terapia intensiva / Procedimiento de paso de guardia: la mirada de las enfermeras en las unidades de cuidados intensivos / Procedure for the handover: nurses' perspective in intensive care units

Objetivo: compreender o processo de passagem de plantão das enfermeiras nas Unidades de Terapia Intensiva Adulto. Método: estudo com abordagem qualitativa, cuja coleta de dados foi realizada entre outubro e dezembro de 2020, por meio de observação não participativa e entrevista semiestruturada realizada em cinco unidades intensivas de hospital público do estado da Bahia, Brasil. Resultados: emergiram duas categorias principais: Práxis da passagem de plantão para melhoria do cuidado e Barreiras que prejudicam a comunicação durante a passagem de plantão. Foi possível compreender o processo de passagem de plantão, com base nos olhares das enfermeiras intensivistas, as quais dispõem de elementos estruturais para comunicação efetiva que reverberam na continuidade da assistência. Considerações finais: no processo de passagem de plantão das enfermeiras, condições estruturais e ambientais, tais como conversas paralelas, dispersão, falta de atenção, interrupções, saídas antecipadas e ruídos foram caracterizadas como barreiras que causavam falhas e interferiam no processo de comunicação.

Objetivo: comprender el proceso de paso de guardia de las enfermeras en las Unidades de Terapia Intensiva Adulto. Método: estudio con enfoque cualitativo, cuya recopilación de datos fue realizada entre octubre y diciembre de 2020, por medio de observación no participativa y entrevista semiestructurada realizada en cinco unidades intensivas de hospital público del estado de Bahía, Brasil. Resultados: surgieron dos categorías principales: Praxis del paso de guardia para mejora del cuidado y Barreras que perjudican la comunicación durante el paso de guardia. Fue posible comprender el proceso de paso de guardia, con base en las miradas de las enfermeras intensivistas, las cuales disponen de elementos estructurales para comunicación efectiva que reverberan en la continuidad de la asistencia. Consideraciones finales: en el proceso de paso de guardia de las enfermeras, condiciones estructurales y ambientales, tales como conversaciones paralelas, dispersión, falta de atención, Las interrupciones, salidas anticipadas y ruidos fueron caracterizadas como barreras que causaban fallas e interferían en el proceso de comunicación.

Objective: to understand the process of handover of nurses in Adult Intensive Care Units. Method: study with a qualitative approach, whose data collection was performed between October and December 2020, through non-participant observation and semi-structured interview conducted in five intensive care units of a public hospital in the state of Bahia, Brazil. Results: two main categories emerged: Praxis of the handover to improve care and barriers that impair communication during the handover. It was possible to understand the process of shift, based on the looks of intensive nurses, which have structural elements for effective communication that reverberate in the continuity of care. Final considerations: in the process of handover of nurses, structural and environmental conditions, such as parallel conversations, dispersion, lack of attention, interruptions, anticipated egress and noise were characterized as barriers that caused failures and interfered in the communication process.