| Abstract | Uvod: Rad u hitnoj i intenzivnoj medicinskoj skrbi spada među najčešće profesije koje se susreću s visokom razinom profesionalnog stresa za koji je pokazano da ima veliki utjecaj na razvoj rane kardiovaskularne bolesti. Aktivacija autonomnog živčanog sustava uključena je u odgovore na stres, a njegova produljena kronična aktivacija povezana je s povećanim kardiovaskularnim rizikom. -----
Cilj: Cilj ovoga istraživanja je mjerenjem vitalnih parametara utvrditi postoji li određeni utjecaj profesionalnih stresora na povišenje arterijskog tlaka i pulsa te na patološke varijacije u EKG zapisu zdravstvenog osoblja zaposlenog u jedinicama intenzivne kardiološke skrbi. -----
Ispitanici i metode: Prospektivna, klinička, opservacijska studija parova provedena na odraslim zdravstvenim djelatnicima dobi 18 – 65 godina, oba spola, koji rade u Zavodu za intenzivnu kardiološku skrb Kliničkog bolničkog centra (KBC) Sestre milosrdnice.
Trajanje istraživanja bilo je 4 mjeseca, u razdoblju od siječnja do lipnja 2022.godine. -----
Rezultati: U ukupnom uzorku od 17 ispitanika su predominirale osobe ženskog spola s udjelom od 70,6%, a osobe muškog spola su činile 29,4%. Većina ispitanika je spadalo u radnu skupinu medicinskih sestara/tehničara (94,12%). Prosječan sistolički tlak bio je 128,47 mmHg (SD 8,70), dok je prosječan dijastolički tlak bio 82,65 mmHg (SD 7,31). Zabilježen je trend rasta tlaka tijekom radne noći (prosječna promjena bila je 2,57%, SD 6,01), a trend pada tijekom neradne noći (prosječna promjena -12,42%, SD 4,55). Usporedbom uparenih opažanja dokazane su statistički značajne razlike u nekoliko parametara. Usporedbom dijastoličkog tlaka tijekom radnih i neradnih 24h pronađena statistički značajna razlika uz povišenje tijekom rada za prosječnu vrijednost od 8,18 mmHg (p<0,001). Usporedbom sistoličkog tlaka tijekom radnih i neradnih 24h pronađena statistički značajna razlika uz povišenje tijekom rada za prosječnu vrijednost od 7,18 mmHg (p<0,001). Uz to je pronađena i statistička značajnost u prosječnoj razlici broja QRS-ova, minimalne frekvencije te promjene tlaka tijekom noći usporedbom radnih i neradnih sati uz povišenje tijekom rada. Obradom podataka, McNemarov test nije pokazao statističku značajnost u razlici učestalosti i morfologiji VESa i SVESa ili drugih poremećaja ritma tijekom radnih 24h u odnosu na neradnih 24h. -----
Zaključak: Analiza podataka u ovom istraživanju pokazala je da postoji statistički značajna razlika u dijastoličkom krvnom tlaku usporedbom radnog i neradnog dana, radne i neradne noći te radnih i neradnih 24 sata uz povišenje tijekom rada.
Isto tako, postoji i statistička značajnost u prosječnoj razlici sistoličkog tlaka usporedbom radne i neradne noći te radnih i neradnih 24 sata uz povišenje tijekom rada.
Uz to, primijećen je veći broj QRS kompleksa tijekom radnih u odnosu na neradnih 24h.
Postoji značajna razlika u promjeni tlaka usporedbom radne i neradne noći. Tijekom radne noći dolazi do povišenja prosječnog srednjeg krvnog tlaka za otprilike 3%, a tijekom neradne noći dolazi do pada za otprilike 12%.
Praćenjem varijabilnosti srčanog ritma i aritmija nisu pronađene značajne razlike u usporedbi radnih i neradnih sati. |
| Abstract (english) | Background: Working in emergency and intensive care is one of the most common occupations that face high levels of occupational stress, which has been shown to have a major impact on the development of early cardiovascular disease. Activation of the autonomic nervous system is involved in stress responses, and its prolonged chronic activation is associated with increased cardiovascular risk. -----
Objective: The aim of this research is to determine, by measuring vital parameters, whether there is a certain influence of professional stressors on the increase in arterial pressure and pulse and on pathological variations in the ECG record of health personnel working in intensive cardiac care units. -----
Participants and methods: Observational case control study conducted on adult health professionals aged 18-65 years, both sexes, working in the intensive cardiac care units of the Clinical Hospital Center (KBC) Sestre milosrdnice.
Duration of the research was 4 months, in the period from January to June 2022. ------
Results: In the total sample of 17 respondents, the female gender predominated with a share of 70.6%, and the male gender accounted for 29.4%. Most of the respondents belonged to the working group of nurses/technicians (94.12%). The average systolic pressure was 128.47 mmHg (SD 8.70), while the average diastolic pressure was 82.65 mmHg (SD 7.31). There was a trend of increasing pressure during the working night (average change was 2.57%, SD 6.01), and a decreasing trend during non-working nights (average change -12.42%, SD 4.55). By comparing pared observations, statistically significant differences in several parameters were proven. By comparing diastolic pressure during working and non-working 24 hours, a statistically significant difference was observed with an average value of 8.18 mmHg (p<0.001) increasing during work. By comparing systolic pressure during working and non-working 24 hours, a statistically significant difference was observed with an average value of 7.18 mmHg (p<0.001) increasing during work. In addition, statistical significance was observed in the average difference in the number of QRS, minimum frequency and pressure changes during the night by comparing working and non-working hours all increasing during work. Through data processing, McNemar's test did not show statistical significance in the difference in the frequency and morphology of VES and SVES or other rhythm disturbances during the working 24 hours compared to the non-working 24 hours. -----
Conclusions: Data analysis in this research showed that there is a statistically significant difference in diastolic blood pressure comparing working and non-working days, working and non-working nights, and working and non-working 24 hours all increasing during work.
Likewise, there is statistical significance in the average difference in systolic pressure comparing working and non-working nights and working and non-working 24 hours all increasing during work.
In addition, a higher number of QRS complexes was observed during working compared to non-working 24 hours.
There is a significant difference in the pressure change comparing working and non-working nights. During a working night, the average mean blood pressure increases by approximately 3%, and during a non-working night, it decreases by approximately 12%.
By monitoring heart rate variability and arrhythmias, no significant differences were found in the comparison of working and non-working hours. |
