Dirbantieji naktinį darbą pirmiausia susiduria su šoko sukėlimu organizmui. Kadangi kūnas yra įpratęs „gyventi“ pagal tam tikrą ritmą, kitaip vadinamą cirkadiniu ritmu, nuolatiniai ar dažnai pasikartojantys nukrypimai nuo jo gali sukelti sveikatos sutrikimų, kurie ilgainiui gali pereiti į rimtas ligas ar sutrikimus. Darbo tikslas ir yra ištirti ir įvertinti slaugytojų sveikatos problemų sąsajas su naktiniu darbu. Baigiamajame magistro darbe atliekamas sveikatos nusiskundimų palyginimas tarp slaugytojų dirbančiųjų naktinį darbą ir nedirbančiųjų naktinio darbo. Gauti rezultatai parodo reikšmingus skirtumus tarp šių grupių subjektyvaus savo sveikatos bei psichologinės sveikatos vertinimų. Naktinį darbą dirbančioms slaugytojoms padidėja rizika susirgti tam tikromis ligomis. / Night workers first encounters with a shock inducing body. Since the body is accustomed to live according to a certain rhythm, known as the circadian rhythm, persistent or frequently recurring deviations from it can cause health problems, which may eventually move on to serious diseases or disorders. The aim is to explore and evaluate nursing and health issues with night work. The master thesis is performed in health complaints comparison between nurses who works at night and and the ones who doesn't work at night. The obtained results show significant differences between the groups in their subjective health and psychological health assessments. Nurses working night work has increased risk of developing certain diseases.

Thesis (Ph. D.)--University of Texas at Austin, 2008. / Vita. Includes bibliographical references.

O trabalho por turnos é definido como aquele realizado fora dos horários considerados “convencionais”, por exemplo: pelo trabalho no turno noturno ou o trabalho de forma contínua, através do revezamento de equipes. Durante as últimas décadas, a proporção de trabalhadores que executam as atividades em escalas de turnos vem aumentando e, com as mudanças nas condições de trabalho, a organização do ambiente social, familiar, dos hábitos de vida e das necessidades básicas desses trabalhadores passou por significativas transformações, que podem causar danos saúde. O desenvolvimento de doenças crônicas não transmissíveis e distúrbios metabólicos em trabalhadores de turnos já é bastante evidenciado na literatura, e os estudos epidemiológicos demonstram associações consistentes entre o trabalho por turnos e a ocorrência de doenças, como obesidade, diabetes e síndrome metabólica. Além da relação entre alterações dos ritmos biológicos, disruptura do sistema circadiano e alterações metabólicas, mudanças comportamentais experienciadas pelos trabalhadores de turnos são apontadas como potenciais fatores de risco adicionais ao desenvolimento de doenças. Dentre as alterações nos hábitos de vida, a alimentação parece ser alterada em decorrência do trabalho por turno. Mudanças nos horários de sono, vigília, da atividade laboral, bem como na disponibilidade de alimentos e tempo para realização das refeiçoes em locais adequados, são fatores determinantes nas escolhas alimentares desses indivíduos. Ainda que estudos voltados à avaliaçao da alimentação de trabalhadores de turnos tenham sido propostos e bastante discutidos na literatura, a real influência do turno de trabalho nos hábitos alimentares é pouco elucidada. Assim, o objetivo desse trabalho foi revisar sistematicamente os resultados de estudos que avaliaram os hábitos alimentares de trabalhadores de turnos, de forma a esclarecer como o turno de trabalho influencia, positiva ou negativamente na alimentação. A sumarização de evidências permite a elaboração de condutas e estratégias nutricionais específicas a esse grupo de risco. Além disso, destaca aspectos importantes a serem considerados no desenvolvimento de futuros estudos, visando contribuir com a qualidade das informações obtidas. / Shift work is defined as the one performed outside the "conventional" hours, for example by working the night shift or working continuously through the team relay. Over the last few decades, the proportion of workers performing turn-based activities has been increasing and, with changes in working conditions, the organization of the social, family, living, and basic needs of these workers has changed significantly which can cause health damage. The development of chronic noncommunicable diseases and metabolic disorders in shift workers is already well documented in the literature, and epidemiological studies demonstrate consistent associations between shift work and the occurrence of diseases such as obesity, diabetes and metabolic syndrome. In addition to the relationship between changes in biological rhythms, disruption of the circadian system and metabolic alterations, behavioral changes experienced by shift workers are indicated as potential additional risk factors for the development of diseases. Among the changes in life habits, food habits seems to be altered as a result of shift work. Changes in sleep schedules, wakefulness, labor activity, as well as food availability and time to make meals in appropriate places, are determining factors in the food choices of these individuals. Although studies aimed at evaluating the feeding of shift workers have been proposed and discussed in the literature, the real influence of work shift on eating habits is little elucidated. Thus, the objective of this study was to systematically review the results of studies that evaluated the eating habits of shift workers, in order to clarify how the work shift influences, positively or negatively in the diet. Summarizing evidence allows the elaboration of specific nutritional strategies and strategies for this risk group. In addition, it highlights important aspects to be considered in the development of future studies, aiming to contribute to the quality of the information obtained.

Nursing is a very demanding profession requiring not only expertise and erudition, but also a good mental and physical condition. Nurses are not only professionals with their rights and duties, but also persons with their needs (6). Health professionals must be able to communicate not only among themselves, but mainly with clients, family members, medical and nursing officials and departments and clinic management. After working some years in health care facilities, professional burnout and fatigue can appear as a result of experienced stress (24). The objective of this thesis was to determine total cholesterol levels and BMI values in the medical staff working shift and night work in the wards, and in the staff working in a single-shift in out-patient departments in České Budějovice hospital, Inc. Another objective was to ??compare these values in relation with the regime of workers, their food and biorhythms. To meet these objectives, quantitative research was chosen which was conducted through questionnaires. Qualitative research was also carried out by determination of total cholesterol levels in the blood, by measuring height and weight of the medical staff members who filled out questionnaires, and calculating their BMI. The research has concluded that the hypothesis 1: Irregular work regime has an effect on cholesterol levels and weight, was not confirmed. Hypothesis 2: Irregular eating has an effect on cholesterol levels and weight, was confirmed, and Hypothesis 3: Biorhythm of an individual, disturbed by irregular work regime, has an effect on cholesterol levels and BMI, was neither confirm or refuted. I would like to provide the results of my research to the České Budějovice hospital management, to individual wards and departments officials as well as nursing staff members.

Esta pesquisa tem como objetivo geral avaliar as situações que envolvem o trabalho noturno em unidades fechadas, sob a percepção dos profissionais de enfermagem de um hospital público. Trata-se de um estudo descritivo com abordagem quantitativa, utilizando um questionário semiestruturado com perguntas fechadas. O instrumento abrange as condições de trabalho, as condições de saúde, o ambiente de trabalho, as relações com os colegas e com a chefia, a motivação e a percepção do profissional de enfermagem no que se refere à valorização profissional que a sociedade e os outros profissionais atribuem ao seu trabalho. Foi utilizada uma população amostral de noventa sujeitos distribuídos em quatro clínicas fechadas. Os dados foram analisados através do programa Statistical Package for the Social Sciences (SPSS). Os resultados permitiram estabelecer uma relação desses dados com a atuação dos profissionais no que se refere à satisfação na execução dos procedimentos. Os trabalhadores de enfermagem do serviço noturno em unidades fechadas são representados, majoritariamente, por mulheres entre 41 e 50 anos de idade, casadas e com filhos sob sua guarda, 60% apresentam dois vínculos empregatícios com carga horária de trabalho superior a 60 horas semanais, encontram-se satisfeitas por atuarem em unidades fechadas e insatisfeitas com o serviço noturno, apresentando-se, portanto, estressadas e desmotivadas, com ganho de peso e índice elevado de afastamento por motivo de saúde. Os resultados apontam, ainda, que 90% dos participantes nunca receberam incentivos para a realização de cursos de atualização, 63,3% expressaram insatisfação com o dimensionamento de pessoal, o que se traduz em sobrecarga de atividades para os profissionais. Mais de 50% dos participantes da pesquisa sentem-se desvalorizados profissionalmente perante a sociedade e encontram-se insatisfeitos com os salários e benefícios oferecidos pela instituição. No que se refere à exposição a riscos, 86,6% dos profissionais se declararam insatisfeitos e muito insatisfeitos com os riscos ergonômicos. Já os riscos químicos, biológicos, psicossociais e mecânicos apresentaram 50% de índice de insatisfação, seguido pelos riscos físicos com 40%. Os dados desse estudo levam a concluir que existe uma grande complexidade de fatores, cuja interação interfere direta e indiretamente na qualidade do desempenho profissional de enfermagem e contribui para a falta de segurança e insatisfação no trabalho noturno. / This research aims to evaluate situations involving night work in closed units, under the perception of nursing workers in a public hospital. This is a descriptive study, using a semi-structured questionnaire with closed questions. This instrument is mainly about the working conditions, mental health conditions, working environment, relationships with colleagues and with the leadership, motivation and perception of nursing staff in relation to the valuation that society and others professionals attach to their work. There was used a population sample of ninety subjects divided into four closed clinics. Data were analyzed using Statistical Package for the Social Sciences (SPSS). The results allowed to establish a relation between such data and the satisfaction of professional sin the execution of procedures.The nursing workers night service on closed units are represented mostly by women, between 41and 50years old, married with children under their care, 60% have two employment contracts with work hours exceeding 60 hours per week, are satisfied by acting in closed units and dissatisfied with the night service, presenting there for stressed and unmotivated, with weight gain and high rate of absence due to health reasons. The results also indicate that 90% of participants never receive incentives for conducting refresher courses, 63.3% expressed dissatisfaction with the dimension in staff, which consequently means over load of activities for professionals. Over 50%of respondents feel professionally devalued by the society and are dissatisfied with the wages and benefits offered by the institution. With regard to risk exposure, 86.6% of professionals said they were "dissatisfied" or "very dissatisfied" with the ergonomic risks; the chemical, biological, psychosocial and mechanical risks presented 50% of dissatisfaction, followed by physical risks with 40%. The data from this research lead to the conclusion that there is an extraordinary complexity of aspects, whose interaction, affect directly and indirectly the quality of professional nursing performance and contributes to a lack of safety and dissatisfaction at nursing night work.

Esta pesquisa tem como objetivo geral avaliar as situações que envolvem o trabalho noturno em unidades fechadas, sob a percepção dos profissionais de enfermagem de um hospital público. Trata-se de um estudo descritivo com abordagem quantitativa, utilizando um questionário semiestruturado com perguntas fechadas. O instrumento abrange as condições de trabalho, as condições de saúde, o ambiente de trabalho, as relações com os colegas e com a chefia, a motivação e a percepção do profissional de enfermagem no que se refere à valorização profissional que a sociedade e os outros profissionais atribuem ao seu trabalho. Foi utilizada uma população amostral de noventa sujeitos distribuídos em quatro clínicas fechadas. Os dados foram analisados através do programa Statistical Package for the Social Sciences (SPSS). Os resultados permitiram estabelecer uma relação desses dados com a atuação dos profissionais no que se refere à satisfação na execução dos procedimentos. Os trabalhadores de enfermagem do serviço noturno em unidades fechadas são representados, majoritariamente, por mulheres entre 41 e 50 anos de idade, casadas e com filhos sob sua guarda, 60% apresentam dois vínculos empregatícios com carga horária de trabalho superior a 60 horas semanais, encontram-se satisfeitas por atuarem em unidades fechadas e insatisfeitas com o serviço noturno, apresentando-se, portanto, estressadas e desmotivadas, com ganho de peso e índice elevado de afastamento por motivo de saúde. Os resultados apontam, ainda, que 90% dos participantes nunca receberam incentivos para a realização de cursos de atualização, 63,3% expressaram insatisfação com o dimensionamento de pessoal, o que se traduz em sobrecarga de atividades para os profissionais. Mais de 50% dos participantes da pesquisa sentem-se desvalorizados profissionalmente perante a sociedade e encontram-se insatisfeitos com os salários e benefícios oferecidos pela instituição. No que se refere à exposição a riscos, 86,6% dos profissionais se declararam insatisfeitos e muito insatisfeitos com os riscos ergonômicos. Já os riscos químicos, biológicos, psicossociais e mecânicos apresentaram 50% de índice de insatisfação, seguido pelos riscos físicos com 40%. Os dados desse estudo levam a concluir que existe uma grande complexidade de fatores, cuja interação interfere direta e indiretamente na qualidade do desempenho profissional de enfermagem e contribui para a falta de segurança e insatisfação no trabalho noturno. / This research aims to evaluate situations involving night work in closed units, under the perception of nursing workers in a public hospital. This is a descriptive study, using a semi-structured questionnaire with closed questions. This instrument is mainly about the working conditions, mental health conditions, working environment, relationships with colleagues and with the leadership, motivation and perception of nursing staff in relation to the valuation that society and others professionals attach to their work. There was used a population sample of ninety subjects divided into four closed clinics. Data were analyzed using Statistical Package for the Social Sciences (SPSS). The results allowed to establish a relation between such data and the satisfaction of professional sin the execution of procedures.The nursing workers night service on closed units are represented mostly by women, between 41and 50years old, married with children under their care, 60% have two employment contracts with work hours exceeding 60 hours per week, are satisfied by acting in closed units and dissatisfied with the night service, presenting there for stressed and unmotivated, with weight gain and high rate of absence due to health reasons. The results also indicate that 90% of participants never receive incentives for conducting refresher courses, 63.3% expressed dissatisfaction with the dimension in staff, which consequently means over load of activities for professionals. Over 50%of respondents feel professionally devalued by the society and are dissatisfied with the wages and benefits offered by the institution. With regard to risk exposure, 86.6% of professionals said they were "dissatisfied" or "very dissatisfied" with the ergonomic risks; the chemical, biological, psychosocial and mechanical risks presented 50% of dissatisfaction, followed by physical risks with 40%. The data from this research lead to the conclusion that there is an extraordinary complexity of aspects, whose interaction, affect directly and indirectly the quality of professional nursing performance and contributes to a lack of safety and dissatisfaction at nursing night work.

O trabalho por turnos é definido como aquele realizado fora dos horários considerados “convencionais”, por exemplo: pelo trabalho no turno noturno ou o trabalho de forma contínua, através do revezamento de equipes. Durante as últimas décadas, a proporção de trabalhadores que executam as atividades em escalas de turnos vem aumentando e, com as mudanças nas condições de trabalho, a organização do ambiente social, familiar, dos hábitos de vida e das necessidades básicas desses trabalhadores passou por significativas transformações, que podem causar danos saúde. O desenvolvimento de doenças crônicas não transmissíveis e distúrbios metabólicos em trabalhadores de turnos já é bastante evidenciado na literatura, e os estudos epidemiológicos demonstram associações consistentes entre o trabalho por turnos e a ocorrência de doenças, como obesidade, diabetes e síndrome metabólica. Além da relação entre alterações dos ritmos biológicos, disruptura do sistema circadiano e alterações metabólicas, mudanças comportamentais experienciadas pelos trabalhadores de turnos são apontadas como potenciais fatores de risco adicionais ao desenvolimento de doenças. Dentre as alterações nos hábitos de vida, a alimentação parece ser alterada em decorrência do trabalho por turno. Mudanças nos horários de sono, vigília, da atividade laboral, bem como na disponibilidade de alimentos e tempo para realização das refeiçoes em locais adequados, são fatores determinantes nas escolhas alimentares desses indivíduos. Ainda que estudos voltados à avaliaçao da alimentação de trabalhadores de turnos tenham sido propostos e bastante discutidos na literatura, a real influência do turno de trabalho nos hábitos alimentares é pouco elucidada. Assim, o objetivo desse trabalho foi revisar sistematicamente os resultados de estudos que avaliaram os hábitos alimentares de trabalhadores de turnos, de forma a esclarecer como o turno de trabalho influencia, positiva ou negativamente na alimentação. A sumarização de evidências permite a elaboração de condutas e estratégias nutricionais específicas a esse grupo de risco. Além disso, destaca aspectos importantes a serem considerados no desenvolvimento de futuros estudos, visando contribuir com a qualidade das informações obtidas. / Shift work is defined as the one performed outside the "conventional" hours, for example by working the night shift or working continuously through the team relay. Over the last few decades, the proportion of workers performing turn-based activities has been increasing and, with changes in working conditions, the organization of the social, family, living, and basic needs of these workers has changed significantly which can cause health damage. The development of chronic noncommunicable diseases and metabolic disorders in shift workers is already well documented in the literature, and epidemiological studies demonstrate consistent associations between shift work and the occurrence of diseases such as obesity, diabetes and metabolic syndrome. In addition to the relationship between changes in biological rhythms, disruption of the circadian system and metabolic alterations, behavioral changes experienced by shift workers are indicated as potential additional risk factors for the development of diseases. Among the changes in life habits, food habits seems to be altered as a result of shift work. Changes in sleep schedules, wakefulness, labor activity, as well as food availability and time to make meals in appropriate places, are determining factors in the food choices of these individuals. Although studies aimed at evaluating the feeding of shift workers have been proposed and discussed in the literature, the real influence of work shift on eating habits is little elucidated. Thus, the objective of this study was to systematically review the results of studies that evaluated the eating habits of shift workers, in order to clarify how the work shift influences, positively or negatively in the diet. Summarizing evidence allows the elaboration of specific nutritional strategies and strategies for this risk group. In addition, it highlights important aspects to be considered in the development of future studies, aiming to contribute to the quality of the information obtained.

Magister Curationis / This study focused on nurses who work the night shift, and on some of the aspects of their lives. The objectives of the study were to identify and describe these experiences with specific reference to the physical, social and work-related effects. / South Africa

Napping has been explored extensively as a means of counteracting the negative effects associated with shift work. A significant amount of this research has focused on the implementation of scheduled naps, with few studies considering flexible nap schemes. The current study therefore aimed to assess the effects of a flexible nap opportunity on the physiological, cognitive, performance, neurophysiological and subjective responses of a group of non shift workers over the course of a three-day simulated night shift regime. Additional foci were the effects of the nap condition on the extent of the circadian adaptation of the subjects to the irregular work schedule and the circadian-related influences associated with being awake during the night. 36 subjects – 18 males and 18 females – were recruited to participate in the current study. The data collection spanned twelve days, during which four, three-day long shift cycles were set up: three night shift cycles and one day shift cycle. During each night shift cycle, three separate experimental conditions were staggered, namely the nap condition, the no nap condition and a booster break condition (a collaborative study that completed the setup). The day shift served as a further comparison. Each cycle comprised of 12 subjects, which meant there were four subjects per condition during each cycle. The shifts were 8 hours in duration, with the no nap group following a standard break schedule evinced in industry. The three breaks taken during the shifts amounted to a total time of 1 hour. The nap group was afforded a 1 hour flexible nap opportunity between 00h00 and 03h00 with no other breaks. Therefore, both conditions had the same amount of work time. During the shifts, subjects performed two simple, low arousal tasks (beading and packing) and completed a test battery roughly every two hours which was comprised of physiological, performance, neurophysiological and subjective measures. It was found that the inclusion of the nap opportunity significantly improved output performance and response time during a low precision, modified Fitts tapping task over the course of three night shifts, relative to no napping. Physiologically, napping resulted in higher heart rate frequency measures by the end of the shifts, which were also accompanied by significant reductions in subjective sleepiness ratings during all iii the night shifts. The nap group’s responses in this case, did not differ significantly from those of the day shift. Both simple reaction time and memory performances improved as a result of the nap inclusion, but only during the third night shift. The majority of the measures included in the research also depicted the effects of the circadian rhythm, which was indicative of the pronounced effect that this natural biological down regulation has on performance during the night. Napping reduced the severity of these effects during beading performance and measures of subjective sleepiness. With regard to habituation, the nap opportunity also resulted in positive changes in the responses of beading performance, high precision response time, simple reaction time and both subjective sleepiness measures, relative to no napping. Sleep diary responses indicated that although sleep length and quality during the day were significantly reduced for both night-time conditions, recovery sleep (length and quality) for the nap group did not differ significantly from the no nap group. The findings of this research indicate that the inclusion of a flexible napping opportunity during the night shift had positive effects on some physiological, performance and subjective responses, and that this intervention is as beneficial as scheduled napping. Specifically, napping resulted in a significantly higher output during the beading task, relative to the no nap group despite the duration of work time being the same. As such the introduction of a flexible, self-selected nap opportunity is a practical, effective and individual-specific means of alleviating the negative effects of shift work, while improving certain performance parameters. Therefore, industries should consider its inclusion in their fatigue management programs. However, contextspecific considerations must be made, with regard work scheduling, individual differences and task demands when implementing such an intervention. This will ensure that its introduction will be well received and in time, lessen the health and work-related decrements associated with shift work.

Orientador: Maria Ines Monteiro Cocco / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-04T01:16:20Z (GMT). No. of bitstreams: 1 Chillida_ManueladeSantanaPi_M.pdf: 3501546 bytes, checksum: 1bb7fb7d4753ee441aab2fa36d79b08c (MD5) Previous issue date: 2003 / Resumo: Às vésperas de discussões do sistema previdenciário de nosso país, que apontam para o aumento do tempo de trabalho necessário à aposentadoria e concomitante ao envelhecimento da população brasileira faz-se extremamente oportuno discutirmos a necessidade de medidas que visem a avaliação, manutenção, restauração e promoção da capacidade para o trabalho destes trabalhadores. Esta pesquisa teve por objetivo avaliar a capacidade para o trabalho dos trabalhadores de enfermagem do período noturno de um hospital universitário, bem como descrever a prevalência de doenças auto-referidas e com diagnóstico médico. Foram utilizados para este estudo o Índice de Capacidade para o Trabalho (ICT), instrumento desenvolvido por pesquisadores da Finlândia, questionário semi-estruturado desenvolvido por COCCO (1996) e um roteiro para observação. A população estudada era composta por 425 trabalhadores de enfermagem do período noturno de um hospital universitário do interior de São Paulo, foram entrevistados 312 trabalhadores, tota1izando a amostra. A idade da população variou entre 24 e 59 anos, sendo composta em sua maioria por mulheres, 82,6% tinha escolaridade igual ou superior a 11 anos. Os resultados mostraram um número considerável de trabalhadores com necessidade de melhora ou restauração da capacidade para o trabalho, uma vez que 28,2% da população apresentava ICT moderado ou baixo. Observando-se a análise univariada pode-se observar associação entre as variáveis: idade, sexo, escolaridade, idade em que começou a trabalhar, tempo de trabalho noturno, tempo de trabalho no hospital, índice de massa corpórea, todos os grupos de doenças e o índice de capacidade para o trabalho / Abstract: On the eve of discussions of the system pension of our country, that appear for the increase of the time of necessary work to the retirement and concomitant to the ageing of the Brazilian population it is done extremely opportune we discuss the need of measures that you/they seek the evaluation, maintenance, restoration and promotion of the capacity for these workers' work. This research aimed to evaluate work ability of nursing of health care nurses the night period of an university hospital work, a to describe the prevalence of solemnity-referred diseases and with medical diagnosis. They were used for this study the Work Ability Index (ICT), instrument developed by researchers of Finland, semi-structured questionnaire developed by COCCO (1996) and of observation itinerary. The studied population was composed by 425 workers ofnursing ofthe night period ofan university hospital of the interior of São Paulo, 312 workers were interviewed, totaling 73,4% ofthe popuJation. The age of the population varied between 24 and 59 years, being this composed population in hislher majority for women, 82,6% ofthe population bave education same or superior to 11 years. The resuhs showed a considerable number of workers with improvement need or restoration of the work ability once 28,2% of the population presented moderate ICT or Iow. Being observed the analysis univariada association can be observed among the variables: age, sex, education, age in tbat helshe began to work, time of night work, time of work in the hospital, index of corporal mass, all of the groups of diseases and the work Ability index / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem