Luciana Fernandes Portela

Self-Reported Health and Sleep Complaints Among Nursing Personnel Working Under 12 h Night and Day Shifts

This cross-sectional exploratory study involved health care workers of various skill types and levels. We tested the hypothesis that the prevalence of diseases, sleep complaints, and insufficient time for nonprofessional activities (family, leisure, and rest) are higher among night than day workers. Data collection was carried out in two public hospitals using questionnaires and other forms. Night work was explored as a risk factor, considering a night worker as one who had at least one night job on the occasion of the research. Data were assessed by a univariate analysis. The association between work schedule and the dependent variables—health conditions, sleep complaints, and insufficient time for nonprofessional activities—was evaluated through the estimation of the prevalence ratio, with a confidence interval of 95%. Two hundred and fifty-eight female nursing personnel participated; 41.5% were moonlighters, and only 20 worked a shift of less than 12 h in length. Reports of migraine and need of medical care the 2 weeks before the survey were more prevalent among day than night workers (PR = 0.71; CI = 0.55–0.92 and PR = 0.71; CI = 0.52–0.95, respectively). Migraine headaches occurred less frequently among night than day workers as confirmed by comparing the reports of the night workers and day workers whose work history was always day shifts (PR = 0.74; CI = 0.57–0.96). Reports of mild emotional disorders (mild depression, tension, anxiety, or insomnia) were less frequent among night (PR = 0.76; CI = 0.59–0.98) and ex-night workers (PR = 0.68; CI = 0.50–0.91) than day workers who never had worked a night job. The healthy worker effect does not seem to explain the results of the comparisons between day and night workers. The possible role of exposure by day workers to some risk factors, such as stress, was suggested as an explanation for these results. No significant difference was observed between night and day workers as to sleep complaints, a result that may have been influenced by the nature of the shift-work schedule (no successive night shifts) and possibly nap taking during the night shift. Moreover, the long work hours and moonlighting of the healthcare workers, which is common in Brazil, may have masked other possible differences between the day and night workers. Among night workers, a significant relation was found between years working nights (more than 10 yrs) and high cholesterol values (PR = 2.58; CI = 1.07–6.27), a result that deserves additional study. Working nights more than four times per 2-week span was related to complaints about insufficient time for children (PR = 1.96; CI = 1.38–2.78) and rest/leisure (PR = 1.54; CI = 1.20–1.99). These results can be related to the “social value of time,” as evenings and nights are when families usually spend time together. The complexity of the professional life and the consequent heterogeneity of the group of workers under shift-work schemes confound the results. More in-depth study of the questions raised here demands a more sophisticated epidemiological treatment and larger sample size.

A gender approach to work ability and its relationship to professional and domestic work hours among nursing personnel

The association between working hours and work ability was examined in a cross-sectional study of male (N=156) and female (N=1092) nurses in three public hospitals. Working hours were considered in terms of their professional and domestic hours per week and their combined impact; total work load. Logistic regression analysis showed a significant association between total work load and inadequate work ability index (WAI) for females only. Females reported a higher proportion of inadequate WAI, fewer professional work hours but longer domestic work hours. There were no significant differences in total work load by gender. The combination of professional and domestic work hours in females seemed to best explain their lower work ability. The findings suggest that investigations into female well-being need to consider their total work load. Our male sample may have lacked sufficient power to detect a relationship between working hours and work ability.

Enfermeiros dos grandes hospitais públicos no Rio de Janeiro: características sociodemográficas e relacionadas ao trabalho

O objetivo do estudo foi analisar caracteristicas sociodemograficas e de trabalho de enfermeiros que atuam em hospitais publicos. Realizou-se estudo epidemiologico, seccionais, envolvendo 3.229 enfermeiros dos dezoito maiores hospitais publicos no municipio do Rio de Janeiro. Observou-se predominância feminina (87,3%) e idade media de 39,9±10 anos. Cerca de 7% referiram ter titulo de mestrado e/ou doutorado, 58,5% formaram-se em instituicoes publicas e 24,5% trabalhavam no setor saude antes de serem enfermeiros. Metade pensou em abandonar a Enfermagem e quase um quarto se considera insatisfeito com a profissao. Cerca de 10% esteve procurando emprego fora e 30% na propria Enfermagem. Entre os homens foi mais frequente o trabalho noturno, mais de um emprego e carga semanal de trabalho mais elevada. O estudo apontou aspectos desafiadores para os enfermeiros/as. Em funcao de sua abrangencia, os resultados podem subsidiar estrategias de melhoria das condicoes de trabalho nos hospitais publicos.

Working hours and health behaviour among nurses at public hospitals

OBJECTIVE To analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. METHODS This is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279). RESULTS Men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. CONCLUSION Both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.OBJETIVOS: analizar diferencias entre los sexos en la descripcion en las jornadas profesional, domestica y total y evaluar su asociacion con comportamientos relacionados a la salud entre enfermeros. METODOS: se trata de un estudio transversal realizado en 18 hospitales publicos en el municipio de Rio de Janeiro. La obtencion de datos se baso en cuestionarios. Fueron considerados elegibles todos los enfermeros que trabajaban en la asistencia (n=2279). RESULTADOS: hombres y mujeres difieren significativamente en cuanto a las horas de trabajo. El grupo femenino presento las jornadas domestica y total mas extensas, comparadas al grupo masculino. En cambio, la jornada profesional fue mas larga entre los hombres. Para las mujeres, tanto la jornada profesional como la total se asociaron al consumo excesivo de alimentos fritos y de cafe, a la ausencia de ejercicio fisico y a la mayor prevalencia de sobrepeso/obesidad. CONCLUSION: tanto la jornada profesional como la domestica deben ser consideradas en los estudios sobre salud, el cuidado de si y el cuidado prestado en el contexto de trabajadores de enfermeria, en especial, entre las mujeres. Los resultados resaltan la necesidad de acciones de promocion de la salud en este grupo ocupacional y la importancia de evaluar el impacto de las largas jornadas en la salud de los trabajadores

Job Strain and Self-Reported Insomnia Symptoms among Nurses: What about the Influence of Emotional Demands and Social Support?

Job strain, derived from high psychological demands and low job control, is associated with insomnia, but information on the role of emotional demands and social support in this relationship is scarce. The aims of this study were (i) to test the association between job strain and self-reported insomnia symptoms, (ii) to evaluate the combination of emotional demands and job control regarding insomnia symptoms, and (iii) to analyze the influence of social support in these relationships. This cross-sectional study refers to a sample of nurses (N = 3,013 and N = 3,035 for Job Strain and Emotional demand-control model, resp.) working at public hospitals in Rio de Janeiro, Brazil. Data were collected through a self-report questionnaire. The prevalence of insomnia symptoms was 34.3%. Job strain was associated with increased odds for insomnia symptoms (OR: 2.20); the same result was observed with the combination of emotional demands and low job control (OR: 1.99). In both models, the inclusion of low social support combined with high demands and low job control led to increased odds for insomnia symptoms, compared to groups with high social support from coworkers and supervisors. Besides job strain, the study of emotional demands and social support are promising with regards to insomnia symptoms, particularly among nurses.

Housework and recovery from work among nursing teams: a gender perspective.

The impact on health of work carried out within the household is recognized by several authors in the occupational health field. The purpose of this article is to verify whether and to what extent the need for recovery is related to professional work hours and to housework duties in female nursing workers. Workers (N = 1122) completed a questionnaire with data on household chores and professional work, as well as the Need for Recovery from Work scale. Regression analysis showed that the odds for reporting poor recovery were significantly higher for workers showing long domestic work hours, high total work load (professional plus domestic work hours), and housework overload. No association was found for professional work hours per se. Findings highlight the potential detrimental effects of housework, either by itself or in combination with professional work for the group studied, and can generate discussion on gender equality in both the public and private domains.

The Influence of Domestic Overload on the Association between Job Strain and Ambulatory Blood Pressure among Female Nursing Workers

Evidence suggests that the workplace plays an important etiologic role in blood pressure (BP) alterations. Associations in female samples are controversial, and the domestic environment is hypothesized to be an important factor in this relationship. This study assessed the association between job strain and BP within a sample of female nursing workers, considering the potential role of domestic overload. A cross-sectional study was conducted in a group of 175 daytime workers who wore an ambulatory BP monitor for 24 h during a working day. Mean systolic and diastolic BP were calculated. Job strain was evaluated using the Demand-Control Model. Domestic overload was based on the level of responsibility in relation to four household tasks and on the number of beneficiaries. After adjustments no significant association between high job strain and BP was detected. Stratified analyses revealed that women exposed to both domestic overload and high job strain had higher systolic BP at home. These results indicate a possible interaction between domestic overload and job strain on BP levels and revealed the importance of domestic work, which is rarely considered in studies of female workers.

Intention to leave profession, psychosocial environment and self-rated health among registered nurses from large hospitals in Brazil: a cross-sectional study

BackgroundNurses’ intention to leave their profession is a worldwide concern. Studies have shown that it can take the form of a chain reaction: many nurses first leave the unit, then the hospital, and finally the profession. Organisation and other labour factors, personal and conjunctural, have been associated with the intention to quit nursing. This study aimed to examine the factors associated with the intention to leave the profession among registered nurses (RNs) at large public hospitals in Brazil.MethodsThis was a cross-sectional study, conducted from 2010 to 2011: all RNs at Rio de Janeiro’s 18 largest public hospitals (>150 beds) were invited to participate. The study sample comprised 3,229 RNs (82.7% of those eligible), who answered a self-completed, multidimensional paper questionnaire. The outcome was defined as thoughts of leaving the profession sometimes a month or more. We based the analyses on hierarchical logistic regression models, considering three blocks of determinants: socio-demographic data (block I), occupational factors (block II), and health conditions (block III).ResultsOf the study population, 22.1% indicated the intention to leave the profession. In the final model after adjustment, the variables associated with the intention to leave were as follows: male sex (odds ratio [OR] = 1.65), not holding a leadership position (OR = 1.28), highly demanding work (OR = 2.49), passive work (OR = 2.10), effort-reward imbalance (OR = 2.00), poor self-rated health (OR = 1.92), over-commitment to the job (OR = 1.87), and poor supervisor support (OR = 1.33). The likelihood of expressing the intention to leave increased with age (OR = 0.98 for the oldest).ConclusionsSelf-rated health and factors connected with the work environment, particularly those that generate psychosocial strain, were most strongly associated with the intention to leave the profession. From the profiles of nurses who wished to leave the profession, we found that for many people who go into nursing—especially men and younger entrants—their prospects of remaining in the profession are poor. The potential role of psychosocial job characteristics and self-rated health indicates the need for long-term action involving all stakeholders, i.e. managers, employers, and workers.

[Nurses of large public hospitals in Rio de Janeiro: socio demographic and work related characteristics].

O objetivo do estudo foi analisar caracteristicas sociodemograficas e de trabalho de enfermeiros que atuam em hospitais publicos. Realizou-se estudo epidemiologico, seccionais, envolvendo 3.229 enfermeiros dos dezoito maiores hospitais publicos no municipio do Rio de Janeiro. Observou-se predominância feminina (87,3%) e idade media de 39,9±10 anos. Cerca de 7% referiram ter titulo de mestrado e/ou doutorado, 58,5% formaram-se em instituicoes publicas e 24,5% trabalhavam no setor saude antes de serem enfermeiros. Metade pensou em abandonar a Enfermagem e quase um quarto se considera insatisfeito com a profissao. Cerca de 10% esteve procurando emprego fora e 30% na propria Enfermagem. Entre os homens foi mais frequente o trabalho noturno, mais de um emprego e carga semanal de trabalho mais elevada. O estudo apontou aspectos desafiadores para os enfermeiros/as. Em funcao de sua abrangencia, os resultados podem subsidiar estrategias de melhoria das condicoes de trabalho nos hospitais publicos.

Avaliação e diagnóstico das condições de trabalho em duas indústrias de baterias chumbo-ácidas no Estado do Rio de Janeiro

A analise do processo produtivo e das condicoes de trabalho em fabricas de baterias chumbo-acidas apresenta uma gama de informacoes mais completas do que as que tem sido discutidas ate entao. O presente estudo analisa o processo produtivo de duas industrias de baterias no Rio de Janeiro. A metodologia utilizada aborda o assunto de uma forma qualitativa, utilizando como ferramentas entrevistas estruturadas com os trabalhadores e analise do ambiente de trabalho. O principal objetivo deste artigo e mostrar uma metodologia de analise com visao ambiental ressaltando os riscos inerentes a estas atividades com uso de mapas de riscos, atraves de sua construcao nos ambientes estudados. Os resultados sugerem um conjunto de recomendacoes, baseadas na literatura cientifica e nas normas de seguranca e medicina do trabalho explicitadas pela legislacao brasileira.