Avaliação das alterações eletrocardiograficas entre enfermeiros que trabalham em turnos alternados e fixos
Arquivos
Data
2011
Autores
Lima, Josemir de Almeida 
Tipo
Tese de doutorado
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Introdução: O trabalho em turnos esta associado a varios problemas de Saúde nos trabalhadores submetidos a esse sistema de jornada de atividade laboral. Entre os mais antigos grupos profissionais que trabalham em sistemas de turnos, encontram-se os dos servicos de Saúde, dentre os quais os enfermeiros. Diversos estudos sugerem uma relacao entre trabalho em turnos e disturbios cardiovasculares. A natureza de tal nexo nao esta bem esclarecida. As doencas cardiovasculares (DCV) sao responsaveis pela maior taxa de morbidade e mortalidade na maioria dos paises, alem de representar elevados custos sociais e economicos. Objetivo: Avaliar as alteracoes eletrocardiograficas entre enfermeiros que trabalham em turnos alternados e fixos. Metodos: Estudo tipo observacional transversal com amostra populacional de 114 enfermeiros de 3 hospitais publicos na cidade de Maceio (AL), sendo 70 trabalhadores em turno alternado e 44 em turno fixo. A tecnica de coleta de dados aplicada foi mediante um instrumento tipo formulario, dividido em seis partes, cada qual com a sua especificidade, sendo a primeira na busca das caracteristicas sociodemograficas; a segunda, os aspectos funcionais; a terceira, estilo de vida; a quarta, avaliacao do estado nutricional; a quinta, a avaliacao da PA; e ultima, as variaveis eletrocardiograficas. Exames complementares foram utilizados, como: afericao de peso, altura, medida da pressao arterial e realizacao de ECG. Para a base estatistica utilizou-se o programa Excel 2003 - ambiente Window® relacionado ao programa BioEstat versao 5.0. A comparacao das variaveis quantitativas entre os grupos trabalhadores de enfermagem do turno alternado e turno fixo foram realizadas utilizando o teste t de Student ou de Mann-Withney de acordo com os pressupostos de normalidade. A presenca de associacao entre as variaveis qualitativas e os grupos de trabalhadores em turnos alternados e turno fixo foi avaliada utilizando-se o teste estatistico Qui-quadrado. Em todos os testes estatisticos considerou-se um nivel de significancia de 0,05. Resultados: A maioria dos trabalhadores (96,5%) foi do sexo feminino, casado e com filhos (71,05%), nunca ou raramente consomem bebida alcoolica ( 70,17% ), nao fumam ( 96,49%) e tem jornada dupla de trabalho (77,19%). A media de idade constatada foi de 38 anos (DP= 6,71) sendo o valor minimo de 27 anos e maximo de 55 anos. Mostrou ainda que 100% dos individuos do sexo masculino e maioria dos individuos separados e viuvos e com idade acima de 50 anos sao trabalhadores em turno alternado. Este grupo apresentou ainda maior percentual de individuos com sobrepeso (40%), baixo peso (2,9%), fumantes (4,3%), hipertensos(20%) em relacao ao turno fixo, sendo os percentuais de (22,7%), (0,0%), (2,3%) e (9,1%), respectivamente. Houve, quanto a obesidade, maior percentual nos trabalhadores do turno fixo (25,7%) quando comparados ao turno alternado (11,4%). Houve diferencas significantes em relacao as variaveis eletrocardiograficas duracao das ondas S (V2) e T e a posicao do eixo P (anteroposterior), todavia, nao houve diferencas significantes quanto as demais variaveis. Conclusoes: A analise dos resultados obtidos no presente estudo confirmou alguns dos disturbios ja descritos na literatura cientifica relacionados ao sistema de jornada de trabalho em turnos, tais como os gastrintestinais e interferencia na vida familiar e com o conjuge. Tambem identificou os seguintes fatores de riscos para DCV: hipertensao, sobrepeso,obesidade e excesso de trabalho. No entanto, estes nao confirmaram a hipotese estatistica proposta para este estudo, de que na populacao pesquisada a frequencia de alteracoes eletrocardiograficas seria maior nos enfermeiros que trabalham em turno alternado quando comparados aos que trabalham em turno fixo. Entretanto, em razao desses resultados terem ocorrido numa populacao predominantemente jovem e do sexo feminino, nao podemos afirmar com certeza absoluta se existe ou nao um nexo entre o trabalho em turnos e alteracoes eletrocardiograficas. Havendo, portanto, a necessidade de mais estudos abordando essa problematica. Face ao exposto, e fundamental intervir na prevencao, incentivando os trabalhadores por turnos realizarem exames medicos anuais, diminuir a carga de trabalho, dedicando mais tempo a familia, ao lazer e ao autocuidado
Introduction: Shift work is associated with several health problems in workers subjected to this system of daily work activity. Among the oldest professional groups working in shift systems, we find the professionals that work in a health service as the nurses. Several studies suggest a relationship between shift work and cardiovascular disorders. The nature of such a link remains unclear. Cardiovascular diseases (CVD) are responsible for most morbidity and mortality in most countries, and represents high social and economic costs. Objective: To evaluate electrocardiographic alterations among nurses working in alternating shifts and fixed. Methods: This observational cross-sectional study with sample of 114 nurses from three hospitals in the city of Maceió (AL), 70 alternate shift workers and 44 in fixed shift. The data collection technique was applied by an instrument in such form, divided into six parts, being the first in the pursuit of socio-demographic characteristics, the second the functional aspects, the third life style; the fourth nutritional status, the fifth the evaluation of the PA, and last, the electrocardiographic variables. Investigations were used as measuring weight, height, blood pressure measurement and ECG. For the statistical basis was used the program Excel 2003 - Window environment-related BioEstat ® version 5.0. The comparison of quantitative variables between groups of nursing workers fixed shift and alternate shifts were performed using the Student t test or Mann-Whitney test according to the assumptions of normality. The presence of association between qualitative variables and groups of workers on alternate shifts and fixed shift was evaluated using the chi-square statistical test. In all statistical tests were considered a significance level of 0.05. Results: Most workers (96.5%) were female, married with children (71.05%), rarely or never consume alcohol (70.17%), do not smoke (96.49%) and have a double shift work (77.19%). The average age was found 38 years (SD = 6.71) with minimum of 27 years and a maximum of 55 years. It showed that 100% of males and most individuals were separated and widowed and aged above 50 years are working in alternate shifts. This group also presented the highest percentage of overweight individuals (40%), lightweight (2.9%), smoking (4.3%), hypertension (20%) compared to fixed shift, and the percentages (22, 7%) (0.0%) (2.3%) and (9.1%), respectively. There was obesity, the highest percentage of fixed shift workers (25.7%) when compared to alternate shifts (11.4%). There were significant differences in relation to electrocardiographic duration of S-waves (V2) and T and P axis position (anteroposterior), however, no significant differences concerning the other variables. Conclusion: The results obtained in this study has confirmed some of the disorders described in the scientific literature related to the system of working hours in shifts, such as gastrointestinal and interference in family life and the spouse. It also identified the following risk factors for CVD: hypertension, overweight, obesity and overwork. However, these statistics do not confirm the hypothesis proposed in this study, that the population studied in the frequency of ECG abnormalities was higher in nurses who work alternate shifts when compared to those working in fixed shift. However, because these results have occurred in a predominantly young and female, we can not say with absolute certainty whether there is or not a link between shift work and electrocardiographic changes. Thus, there is a need for more studies addressing this problem. Given the above, it is essential to intervene in the prevention, encouraging shift workers conduct annual medical examinations, reduce the workload, dedicating more time to family, leisure and self-care.
Introduction: Shift work is associated with several health problems in workers subjected to this system of daily work activity. Among the oldest professional groups working in shift systems, we find the professionals that work in a health service as the nurses. Several studies suggest a relationship between shift work and cardiovascular disorders. The nature of such a link remains unclear. Cardiovascular diseases (CVD) are responsible for most morbidity and mortality in most countries, and represents high social and economic costs. Objective: To evaluate electrocardiographic alterations among nurses working in alternating shifts and fixed. Methods: This observational cross-sectional study with sample of 114 nurses from three hospitals in the city of Maceió (AL), 70 alternate shift workers and 44 in fixed shift. The data collection technique was applied by an instrument in such form, divided into six parts, being the first in the pursuit of socio-demographic characteristics, the second the functional aspects, the third life style; the fourth nutritional status, the fifth the evaluation of the PA, and last, the electrocardiographic variables. Investigations were used as measuring weight, height, blood pressure measurement and ECG. For the statistical basis was used the program Excel 2003 - Window environment-related BioEstat ® version 5.0. The comparison of quantitative variables between groups of nursing workers fixed shift and alternate shifts were performed using the Student t test or Mann-Whitney test according to the assumptions of normality. The presence of association between qualitative variables and groups of workers on alternate shifts and fixed shift was evaluated using the chi-square statistical test. In all statistical tests were considered a significance level of 0.05. Results: Most workers (96.5%) were female, married with children (71.05%), rarely or never consume alcohol (70.17%), do not smoke (96.49%) and have a double shift work (77.19%). The average age was found 38 years (SD = 6.71) with minimum of 27 years and a maximum of 55 years. It showed that 100% of males and most individuals were separated and widowed and aged above 50 years are working in alternate shifts. This group also presented the highest percentage of overweight individuals (40%), lightweight (2.9%), smoking (4.3%), hypertension (20%) compared to fixed shift, and the percentages (22, 7%) (0.0%) (2.3%) and (9.1%), respectively. There was obesity, the highest percentage of fixed shift workers (25.7%) when compared to alternate shifts (11.4%). There were significant differences in relation to electrocardiographic duration of S-waves (V2) and T and P axis position (anteroposterior), however, no significant differences concerning the other variables. Conclusion: The results obtained in this study has confirmed some of the disorders described in the scientific literature related to the system of working hours in shifts, such as gastrointestinal and interference in family life and the spouse. It also identified the following risk factors for CVD: hypertension, overweight, obesity and overwork. However, these statistics do not confirm the hypothesis proposed in this study, that the population studied in the frequency of ECG abnormalities was higher in nurses who work alternate shifts when compared to those working in fixed shift. However, because these results have occurred in a predominantly young and female, we can not say with absolute certainty whether there is or not a link between shift work and electrocardiographic changes. Thus, there is a need for more studies addressing this problem. Given the above, it is essential to intervene in the prevention, encouraging shift workers conduct annual medical examinations, reduce the workload, dedicating more time to family, leisure and self-care.
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Citação
LIMA, Josemir de Almeida. Avaliação das alterações eletrocardiográficas entre enfermeiros que trabalham em turnos alternados e fixos. 2010. 82 f. Dissertação (Mestrado em Enfermagem) - Departamento de Enfermagem, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010.