Rīgas Austrumu klīniskās universitātes slimnīcas intensīvās terapijas nodaļas personāla diennakts dežūras un to ilgtermiņa veselības riski
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Date
2023
Authors
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads
Ilgstošs stress var izraisīt trauksmi un depresīvas epizodes, kā arī fiziskas veselības problēmas, piemēram, koronāro sirds slimību. Ir zināms, ka liela darba slodze un ar darbu saistīts stress palielina alkohola un narkotisko vielu lietošanas risku, sociālo attiecību problēmu, depresijas un trauksmes biežumu. Liela darba slodze un stress var negatīvi ietekmēt darba rezultātus un palielināt arodveselības apdraudējumu risku. Eiropas Darba laika direktīva (EWTD), kas attiecas uz visām profesijām visā Eiropas Savienībā (ES), nosaka maksimālo darba nedēļu (48 stundas) un atpūtas periodus. Kopš 2009. gada, kad tas stājās spēkā veselības aprūpē, tas ir saistīts ar bažām par veselības pakalpojumu sniegšanu. Ārstu darba laika lielās atšķirības dažādās valstīs, kā arī obligātā darba laika kontrole dažādās profesijās rada papildu jautājumus par šo ierobežojumu izvēli un noteikšanu. Pēdējo gadu laikā arī Latvijas lielākās slimnīcas izvērtē jautājumu par darbinieku grafiku un stundu plānojumu attiecībā uz pacientu drošību un veselības aprūpes kvalitāti.
Mērķis
Noskaidrot, kādi ir medicīnas personāla ilgtermiņa veselības riski, strādājot diennakts dežūras.
Hipotēze
Palielinoties visbiežāk strādātajam darba stundu skaitam, palielinās ilgtermiņa veselības problēmas darbiniekiem.
Izmantotie materiāli un metodes
Pētījums tika plānots kā analītisks šķērsgriezuma pētījuma modelis, kurā tika aptaujāti Rīgas Austrumu klīniskās universitātes Intensīvās terapijas nodaļas darbinieki, kas atbilda ieslēgšanas kritērijiem: darbinieks ir sertificēts ārsts, rezidents vai medicīnas māsa, kas vismaz vienu reizi mēnesī strādā 24 stundu dežūru. Datu statistiskā apstrāde tika veikta ar IBM SPSS v22. Tika izmantotas aprakstošās statistikas metodes, kā arī sekojošās analītiskās statistikas metodes: Korelāciju analīze, Hī-kvadrāta tests, Binārā loģistiskā regresija. Statistiskā nozīmība tika pieņemta, ja p<0,05.
Rezultāti
Pētījumā tika iekļauti dati no 100 darbiniekiem. Pētījumā piedalījās 50 medicīnas māsas, 28 sertificēti ārsti un 22 rezidenti. Visbiežāk tika strādātas 24 stundu dežūras (63%), tad 8 stundu dežūras (24%) , 16 stundu dežūras (12%) un 12 stundu dežūras tika strādātas visretāk (1%). Korelāciju analīzes rezultātā tika atrastas statistiski nozīmīgas saistības starp strādāto stundu skaitu un ilgtermiņa veselības problēmām. Darbinieki, kas visbiežāk strādāja 8 stundu dežūras daudz laika veltīja saviem hobijiem (p=<0.001), reti bija slikts vai nomākts garastāvoklis (p=<0,001), retāk pieļāva darbā kļūdas (p=<0,001), jutās novērtēti darba vietā (p=0,006), bija labas attiecības ar kolēģiem (p=<0,001), turklāt tiem nebija pārmērīgs stress palielinātas darba slodzes dēļ (p=<0,001). Šai grupai arī bija mazāk kaitīgu ieradumu – ēda regulāras ēdienreizes (p=0,05), ikdienā mazāk lietoja alkoholu (p=<0,001) un smēķēja (p=0,028).
24 stundu dežūru grupa mazāk laika veltīja saviem hobijiem (p=<0,001), biežāk bija slikts vai nomākts garastāvoklis (p=0,002), nespēja pilnvē
Introduction Persistent stress can result in anxiety and depression episodes, in addition to physical health issues such as coronary heart disease. Workload and work-related stress are known to increase the incidence of substance addiction, social relationship difficulties, depression, and anxiety. Stress and a heavy workload can significantly impact work performance and increase the probability of occupational health hazards. The European Working Time Directive (EWTD), which applies to all professions in the European Union (EU), establishes the maximum workweek (48 hours) and vacation days. Since its implementation in 2009, the healthcare law has been linked to issues regarding the provision of healthcare. The substantial discrepancies in the working hours of doctors in various countries, as well as the mandatory control of working hours in multiple fields, raise additional problems about the selection and determination of these restrictions. In the past few years, the main hospitals in Latvia have evaluated the issue of staff scheduling in relation to patient safety and healthcare quality. Aim To determine the long-term health risks of medical staff on 24-hour shifts. Hypothesis Long-term health problems for workers increase as their work hours rise. Materials and methods The study was planned as an analytical cross-sectional study. Employees of the Intensive Care Department of Riga Eastern Clinical University who met the inclusion criteria were surveyed. To meet the inclusion criteria, an employee must be a certified doctor, resident, or nurse who works 24-hour duty at least once a month. Statistical data processing was done with IBM SPSS v22. In addition to descriptive statistical methods, the following analytical statistical techniques were used: correlation analysis, Chi-square test, and binary logistic regression. Statistical significance was considered at p<0.05. Results The research collected data from 100 employees. 50 nurses, 28 certified physicians, and 22 residents took part in the study. 24-hour shifts were the most common (63%), followed by 8-hour shifts (24%), 16-hour shifts (12%), and 12-hour shifts (1%). Analysis of correlations revealed statistically significant links between the amount of hours worked and longterm health issues. Employees who frequently worked 8-hour shifts invested a great deal of time in their hobbies (p= 0.001), rarely had a bad mood (p=0.00), made fewer errors at work (p=0.001), felt appreciated at work (p=0.006), had good relationships with coworkers (p=0.001), and didn’t experience excessive stress due to an increased workload (p=0.001). This group had less hazardous habits - they ate regular meals (p=0.05), consumed less alcohol (p0.001), and smoked less (p=0.028). The 24-hour duty group spent less time on hobbies (p=0.001), had a more depressed mood (p=0.002), was unable to completely evaluate and care for the patient during the night (p=0.047), and made more errors at work (p=0.001). Similarly, 2
Introduction Persistent stress can result in anxiety and depression episodes, in addition to physical health issues such as coronary heart disease. Workload and work-related stress are known to increase the incidence of substance addiction, social relationship difficulties, depression, and anxiety. Stress and a heavy workload can significantly impact work performance and increase the probability of occupational health hazards. The European Working Time Directive (EWTD), which applies to all professions in the European Union (EU), establishes the maximum workweek (48 hours) and vacation days. Since its implementation in 2009, the healthcare law has been linked to issues regarding the provision of healthcare. The substantial discrepancies in the working hours of doctors in various countries, as well as the mandatory control of working hours in multiple fields, raise additional problems about the selection and determination of these restrictions. In the past few years, the main hospitals in Latvia have evaluated the issue of staff scheduling in relation to patient safety and healthcare quality. Aim To determine the long-term health risks of medical staff on 24-hour shifts. Hypothesis Long-term health problems for workers increase as their work hours rise. Materials and methods The study was planned as an analytical cross-sectional study. Employees of the Intensive Care Department of Riga Eastern Clinical University who met the inclusion criteria were surveyed. To meet the inclusion criteria, an employee must be a certified doctor, resident, or nurse who works 24-hour duty at least once a month. Statistical data processing was done with IBM SPSS v22. In addition to descriptive statistical methods, the following analytical statistical techniques were used: correlation analysis, Chi-square test, and binary logistic regression. Statistical significance was considered at p<0.05. Results The research collected data from 100 employees. 50 nurses, 28 certified physicians, and 22 residents took part in the study. 24-hour shifts were the most common (63%), followed by 8-hour shifts (24%), 16-hour shifts (12%), and 12-hour shifts (1%). Analysis of correlations revealed statistically significant links between the amount of hours worked and longterm health issues. Employees who frequently worked 8-hour shifts invested a great deal of time in their hobbies (p= 0.001), rarely had a bad mood (p=0.00), made fewer errors at work (p=0.001), felt appreciated at work (p=0.006), had good relationships with coworkers (p=0.001), and didn’t experience excessive stress due to an increased workload (p=0.001). This group had less hazardous habits - they ate regular meals (p=0.05), consumed less alcohol (p0.001), and smoked less (p=0.028). The 24-hour duty group spent less time on hobbies (p=0.001), had a more depressed mood (p=0.002), was unable to completely evaluate and care for the patient during the night (p=0.047), and made more errors at work (p=0.001). Similarly, 2
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Medicīnas nozarē strādājošie, maiņu darbs, pārslodze, darba slodze, darba vides riska faktori, Medical staff, shift work, overload, workload, environmental risk factors.