Shift work of nursing professionals and blood pressure, burnout and common mental disorders

Nascimento, Jaqueline Oliveira Valdeviño; Santos, Juliano dos; Meira, Karina Cardoso; Pierin, Angela Maria Geraldo; Souza-Talarico, Juliana Nery

doi:10.1590/S1980-220X2018002103443

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018002103443 copy

Shift work of nursing professionals and blood pressure, burnout and common mental disorders^* * Extracted from the thesis: “Risco cardiovascular e carga alostática em profissionais de enfermagem que atuam em oncologia: variáveis biopsicoemocionais e relacionadas ao trabalho”, Escola de Enfermagem, Universidade de São Paulo, 2016.

Trabajo en turnos de profesionales de enfermería y la presión arterial, burnout y trastornos mentales comunes

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the influence of shift work on blood pressure, the presence of burnout and common mental disorders in nursing professionals.

Method:

A cross-sectional study. Burnout was assessed by the Maslach Burnout Inventory, and Common Mental Disorders by the Self-Reporting Questionnaire. Casual blood pressure measurement and Ambulatory Blood Pressure Monitoring (ABPM) were performed.

Results:

231 professionals participated. The majority (59.7%) worked in shifts, and this condition was associated (p≤0.05) with: higher weekly workload; doing the night shift; shorter training and work time at the institution; alcoholism; leisure activity; and alteration in ambulatory blood pressure monitoring of the sleep period. The professionals with common mental disorders and who worked in shifts had lower casual diastolic pressure levels (p = 0.039) and higher hypertension prevalence (p = 0.045). The presence of emotional exhaustion was associated with normal waking blood pressure and depersonalization with altered sleep blood pressure.

Conclusion:

Shift work was associated with a higher prevalence of work-related negative factors, inadequate habits and lifestyles, and change in sleep blood pressure.

DESCRIPTORS:
Nursing; Shift Work Schedule; Burnout, Profissional; Mental Disorders; Life Style; Hypertension

Characteristics related to work	Shift work						P-Value
	Yes		No		Total
	n	%	n	%	N	%
Professional Category
Nurse	61	44.2	23	24.7	84	36.4	0.003
Nursing Assistant/Technician	77	55.8	70	75.3	147	63.6	0.003
Work unit
Surgical Oncology	54	39.1	30	32.3	84	36.4	0.632†
Clinical Oncology	40	29.0	30	32.3	70	30.3
Clinical and Surgical Oncology	17	12.3	10	10.8	27	11.7
Intensive Care Unit	27	19.6	23	24.7	50	21.6
Work schedule/shift
Day shift	75	54.3	51	54.8	126	54.5	0.041†
Night shift	57	41.3	30	32.3	87	37.7
Part-time work	6	4.3	12	12.9	18	7.8
Weekly working hours
Mean (SD)	54.2 (17.0)		48.7 (12.4)		51.9(15.5)		0.016*
Number of employment contracts
Mean (SD)	1.53 (0.60)		1.39 (0.51)		1.48 (0.57)		0.079*
1	72	52.2	58	62.4	130	56.3
≥ 2	66	47.8	35	37.6	101	43.7
Time since graduation (in years)
Mean (SD)	15.4 (7.9)		17.6 (7.6)		16.3 (7.8)		0.019*
Institutional working time
Mean (SD)	7.9 (7.2)		9.6 (7.8)		8.6 (7.5)		0.039
Working tired
Frequently	53	38.4	35	37.6	88	38.1	0.480†
Sometimes	72	52.2	53	57.0	125	54.1
Rarely/Never	13	9.4	5	5.4	18	7.8
Concentration is decreased during the shift
Frequently	18	13.0	11	11.8	29	12.6	0.293†
Sometimes	63	45.7	52	55.9	115	49.8
Rarely/Never	57	41.3	30	32.3	87	37.7

Habits and lifestyle	Shift work						P-Value
	Yes		No		Total
	n	%	n	%	n	%
Smoker	9	6.5	5	5.4	14	6.1	0.720
Alcoholism	51	37.0	18	19.4	69	29.8	0.004
Physical inactivity	93	67.4	58	62.4	151	65.4	0.431
Stress	62	44.9	41	44.1	103	44.6	0.900
Burnout	56	40.6	34	36.6	90	39.0	0.539
Emotional exhaustion: Mean (SD)	28.8 (7.8)		28.3 (7.8)		28.6 (7.8)		0.617
Depersonalization: Mean (SD)	11.4 (4.4)		11.3 (4.0)		11.4 (4.3)		0.986
Low professional achievement: Mean (SD)	29.6 (5.4)		29.9 (5.6)		29.7 (5.5)		0.429
Common Mental Disorders	84	60.9	49	52.7	133	57.6	0.217
Does leisure activity	104	75.4	57	61.3	161	69.7	0.022
Sleep hours Mean (SD)	6.3 (1.5)		6.2 (1.6)		6.3 (1.5)		0.669*
Comorbidities
Dyslipidemias	33	23.9	32	34.4	65	28.1	0.082
Arterial Hypertension	34	24.6	25	26.9	59	25.5	0.701
Angina pectoris	13	9.4	5	5.4	18	7.8	0.261
Diabetes mellitus	7	5.1	7	7.5	14	6.1	0.443
Acute myocardial infarction	2	1.4	0	0.0	2	0.9	0.517‡
Stroke	0	0.0	1	1.1	1	0.4	0.403‡

Blood pressure	Shift work						P-Value
	Yes		No		Total
	n	%	n	%	n	%
Casual
Altered casual blood pressure	15	10.9	15	16.1	30	13.0	0.244
Systolic: Mean (SD)	118.8(15.1)		121.4(17.2)		119.4(16.0)		0.275*
Diastolic: Mean (SD)	76.6 (11.0)		82.4 (44.1)		78.9 (29.3)		0.323*
ABPM 24 hous
Altered blood pressure	43	31.9	24	27.3	67	30.0	0.466
Systolic: Mean (SD)	119.2(12.1)		116.3(11.0)		118.1(11.7)		0.123*
Diastolic: Mean (SD)	75.4 (8.8)		73.9 (8.8)		74.8 (8.8)		0.206*
Awake ABPM
Altered blood pressure	39	28.9	19	21.6	58	26	0.225
Systolic: Mean (SD)	122.5(12.4)		120.1(11.2)		121.5(12.0)		0.206*
Diastolic: Mean (SD)	78.9 (9.1)		77.8 (8.2)		78.5 (8.8)		0.426*
Sleep ABPM
Altered blood pressure	62	45.9	28	31.8	90	40.4	0.036
Systolic: Mean (SD)	111.7(13.7)		108.6(13.0)		110.5(13.5)		0.072*
Diastolic: Mean (SD)	68.1(10.9)		66.1 (11.2)		67.3 (11.0)		0.108*

Blood Pressure	Shift work (n=138)									P-Value
	Burnout				P-Value	Common mental disorders
	Yes		No			Yes		No
	n	%	n	%		n	%	n	%
Casual measurement
Altered casual blood pressure	7	12.5	8	9.8	0.611	10	11.9	5	9.3	0.626
Systolic: Mean (SD)	119.9 (15.5)		118.0 (14.9)		0.557*	117.4 (15.8)		121.0 (13.9)		0.062*
Diastolic: Mean (SD)	76.1 (10.9)		76.9 (11.1)		0.671*	75.2 (11.4)		78.7 (10.1)		0.039*
Hypertension	16	28.6	29	35.4	0.403	22	26.2	23	42.6	0.045
ABPM 24 hours
Altered blood pressure	16	29.6	27	33.3	0.651	25	30.9	18	33.3	0.763
Systolic: Mean (SD)	119.1 (11.7)		119.2 (12.4)		0.984*	119.1 (11.6)		119.4 (12.9)		0.793*
Diastolic: Mean (SD)	75.5 (8.4)		75.4 (9.0)		0.943*	75.1 (8.2)		75.9 (9.6)		0.829*
Awake ABPM
Altered blood pressure	15	27.8	24	29.6	0.816	22	27.2	17	31.5	0.587
Systolic: Mean (SD)	122.2 (12.7)		122.6 (12.3)		0.902*	122.6 (12.4)		122.3 (12.5)		0.678*
Diastolic: Mean (SD)	79.0 (9.9)		78.8 (8.6)		0.986*	78.9 (8.9)		78.9 (9.4)		0.886*
Sleep ABPM
Altered blood pressure	27	50.0	35	43.2	0.438	37	45.7	25	46.3	0.944
Systolic: Mean (SD)	112.5 (12.6)		111.2 (14.4)		0.487*	112.0 (12.6)		111.4 (15.3)		0.770*
Diastolic: Mean (SD)	69.3 (10.3)		67.3 (11.2)		0.270*	68.1 (9.9)		68.2 (12.3)		0.914*

	Emotional exhaustion		Depersonalization		Low professional achievement
	Mean (SD)	P-Value	Mean (SD)	P-Value	Mean (SD)	P-Value*
Arterial Hypertension
Yes	28.1 (6.8)	0.530	11.1 (4.0)	0.670	30.1 (6.0)	0.515
No	29.2 (8.2)	0.530	11.6 (4.7)	0.670	29.3 (5.1)	0.515
ABPM 24 hours
Altered	27.1 (8.4)	0.085	12.3 (4.2)	0.073	29.7 (5.7)	0.979
Normal	29.5 (7.4)	0.085	11.0 (4.6)	0.073	29.5 (5.3)	0.979
Awake
Altered	26.0 (7.6)	0.012	12.2 (4.0)	0.113	29.5 (5.7)	0.754
Normal	29.9 (7.6)	0.012	11.1 (4.7)	0.113	29.6 (5.3)	0.754
Sleep
Altered	28.1 (8.2)	0.414	12.2 (4.6)	0.036	29.2 (6.2)	0.439
Normal	29.3 (7.4)	0.414	10.7 (4.3)	0.036	29.9 (4.7)	0.439

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Juliano dos Santos Av. Nove de Julho, 611 CEP 01313-000 - São Paulo, SP, Brazil jlnsantos@yahoo.com.br