engleski

Some psychophysiological indicies of nurse's stress and fatigue

During night working shifts performance and safety are reduced due to inversion of the wake – sleep pattern, i.e. the upset of circadian rhythms. Normally, sympathetic part of the ANS system is dominant during day, and parasympathetic during night. Night working requires more sympathetic activity, which causes a discrepancy between general state of the organism, and the momentary work requirements. This discrepancy represents the source of stress, and greater efforts to overcome it generate fatigue much faster than during day working. The aim of this study was to compare levels and patterns of cardiac activity during working and non-working nights on a group of medical nurses, and to relate changes in the activity to the fatigue level at the beginning and the end of shifts. Ten shift working female nurses (average age 30 yr.) from the surgical and ten from infectious diseases department, of the local hospital, took part in this investigation. They were administered SOFI – the fatigue questionnaire - at the start and the end of shifts. The questionnaire measured five fatigue factors (lack of energy, physical exertion, physical discomfort, lack of motivation, sleepiness). Continuous R-R interval recordings of the nurses were made during working in night shifts and resting (sleeping) during night. Analyses of the results showed increased cardiac activity, lower HRV levels and relatively greater contribution of sympathetic modulation of cardiac activity during night shift. Similarity of changes of HRV pattern during working and non-working nights indicated the supremacy of circadian patterns of changes. Parasympathetic prevalence during night-shift working means maladjustment to work, which was particularly obvious between 03.00 and 06.00 hrs. Smaller sympathetic influence and parasympathetic dominance during night-shift are major sources of stress. Sleepiness and lack of energy were more pronounced at the end of shifts, particularly in the night shift. When comparing working stress in the two departments, all the parameters showed much higher working stress and fatgue levels in surgery nurses.

stress; fatigue; heart rate variability

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