| Abstract | UVOD: Zdravstvena zaštita u Republici Hrvatskoj organizirana je na primarnoj
sekundarnoj, tercijarnoj te razini zdravstvenih zavoda. Većina medicinskih sestara i tehničara
radi na sekundarnoj i tercijarnoj razini koja uključuje kontinuiranu 24satnu skrb te iz tog
razloga je i najveći broj medicinskih sestara i tehničara izloženo utjecaju noćnog rada. Noćni
rad utječe na zdravlje na način da dovodi do deprivacije sna, umora, rizika za psihičke i
fizičke smetnje i bolesti, ali i poremećaje u socijalnom i obiteljskom životu. METODE:
Pretražene su 3 baze podataka,: Pubmed, Google scholar i Proquest, kriterij za odabir bio je
sustavni pregled literature i meta analiza, a u obzir su dolazili samo članci na engleskom
jeziku. Pregled literature rađen je prema PRISMA smjernicama, kvaliteta članaka ocjenjena je
AMSTAR-R instrumentom za ocjenjivanje, pouzdanost između ocjenjivača napravljena je
Cohenovim kappa koeficijentom, a kako bi se utvrdilo preklapanje korištene literature
korištena je metoda ispravljenog pokrivenog područja (eng. Corrected Covered Area (CCA)).
REZULTATI: Pregledom sustavnih pregleda i meta analiza, rezultati prikazani u ovom radu
dobiveni su iz 8 istraživanja od kojih su 3 sistematski pregled, a 5 meta analize, objavljivani
su između 2013. i 2021. godine iz različitih dijelova svijeta (Europa, Azija, Amerika,
Australija,Afrika). Istraživanja su pokazala da noćni rad utječe na san medicinskih sestara u
smislu smanjenja njegove kvalitete, te na samo zdravlje u smislu povećanja rizika od
povećane težine, razvoja metaboličkog sindroma, dijabetesa tipa 2, kardiovaskularnih bolesti,
karcinoma dojke, bolova u leđima te povećanja unosa alkohola. RASPRAVA: Osim utjecaja
na san i zdravlje medicinskih sestara, noćni rad može dovesti i do drugih rizika kako za
medicinske sestre poput rizika od ubodnih incidenata, ozljeda i bolova, psihičkih i
emocionalnih smetnji, željom za odlaskom te automobilskih nesreća, tako i za krajnje
korisnike zdravstvene zaštite, a to su pacijenti, a odnose se na rizik od pogrešne administracije
lijekova, dekubitusa, hipoglikemije, urinarne infekcije te bolničke infekcije . ZAKLJUČAK:
Potrebna su dodatna istraživanja vezana za problematiku noćnog rada kako za same rizike
koje on donosi tako i za utjecaj potencijalnih rješenja na iste. Potrebna je trajna edukacija
medicinskih sestara o ovom problemu kako bi se na vrijeme prepoznale posljedice, na njih
pravovremeno reagiralo te na taj način smanjile dugoročne posljedice na zdravlje. Nužno je i
kontinuirano praćenje zdravstvenog stanja te poboljšanje radnih uvjeta sukladno procjeni
rizika pojedinog radilišta. |
| Abstract (english) | INTRODUCTION: Health care in the Republic of Croatia is organized at the primary,
secondary, tertiary and health care institutions. Most nurses and technicians work at the
secondary and tertiary levels, which includes continuous 24-hour care, and for this reason
most nurses and technicians are exposed to night work. Night work affects health in a way
that leads to sleep deprivation, fatigue, risk of mental and physical disorders and illnesses, but
also disturbances in social and family life. METHODS: 3 databases were searched: Pubmed,
Google scholar and Proquest, the selection criteria were a systematic review of the literature
and meta-analyzes, and only articles in English were considered. The literature review was
performed according to PRISMA guidelines, the quality of the articles was evaluated by the
AMSTAR-R evaluation instrument, the reliability between evaluators was made by the Cohen
kappa coefficient, and the Corrected Covered Area (CCA) method was used to determine the
overlap of the used literature. )). RESULTS: A review of systematic reviews and metaanalyzes, the results presented in this paper were obtained from 8 studies, 3 of which are
systematic reviews, and 5 meta-analyzes, were published between 2013 and 2021 from
different parts of the world (Europe, Asia, America) , Australia, Africa). Research has shown
that night work affects nurses' sleep in terms of reducing its quality, and health itself in terms
of increasing the risk of weight gain, developing metabolic syndrome, type 2 diabetes,
cardiovascular disease, breast cancer, back pain and increasing alcohol intake.
DISCUSSION: In addition to the impact on nurses' sleep and health, night work can lead to
other risks for nurses, such as the risk of needlestick incidents, injuries and pain, mental and
emotional disturbances, the desire to leave and car accidents, and for end users of health care,
which are patients, risk of mismanagement of drugs, pressure ulcers, hypoglycemia, urinary
tract infections and nosocomial infections. CONCLUSION: Additional research is needed
related to the issue of night work, both with the risks it brings and the impact of potential
solutions on them. Continuous education of nurses on this problem is needed in order to
timely recognize the consequences of responding to them in a timely manner and thus reduce
long-term health consequences. It is also necessary to continuously monitor the health
condition and improve working conditions in accordance with the risk assessment of each
site. |
