護理人員輪班工作情形與自覺壓力及心率變異數的相關性

Relationships between Shift Work, Perceived Stress, and Heart Rate Variability in Nurses

孫于珊(Yu-Shan Sun) ； 張耀文(Yaw-Wen Chang) ； 王映權(Ying-Chuan Wang) ； 陳韋良(Wei-Liang Chen) ； 高東煒(Tung-Wei Kao) ； 廖芳藝(Fang-Yih Liaw)

《中華職業醫學雜誌》 22巻1期 (2015/01) Pp. 21-30

摘要

目的：護理人員需輪班照護病患，而輪班工作已證實會造成身體及心理的影響。特別是女性輪班更加容易造成生理及心理問題，也造成壓力。心率變異分析是目前常用來進行自律神經調控、身心壓力評估的工具。本研究藉由壓力問卷以及心率變異分析了解護理人員輪班情形與壓力及心律變異的相關性。方法：本研究為橫斷性研究，對象為台北市某醫學中心護理人員，由研究人員利用員工健康檢查時進行問卷調查及測量。問卷內容包括：護理人員基本人口學資料、工作場所、工作性質、輪班狀況及PSS-10壓力知覺量表。心率變異分析以SA-3000P身心能量分析儀進行五分鐘測量並分析心率變異參數。統計方式以無母數分析護理人員輪班情形與基本資料、工作場所、工作性質、PSS-10壓力指數、心律變異相關參數（包含SDNN、TP、LF、HF及LF/HF）平均值差異。以皮爾森相關分析PSS-10壓力指數與心率變異參數的相關性。結果：本研究分析50位護理人員，平均31.9±5.8歲。在工作情形與壓力關係分析中，需輪班的護理人員有較高的PSS-10壓力指數(17.96±5.08 v.s. 15.30±4.40，p=0.06)；但工作場所、工作性質與壓力指數並無顯著相關。在輪班情形及壓力指數與心律變異參數分析中，護理人員輪班工作與心率變異各項參數均無明顯相關。結論：本研究發現需輪班工作的護理人員有較高的自覺壓力且統計呈邊緣性顯著，但是輪班工作情形並未影響心率變異度。因本研究人數有限，且收案時仍有部分限制，未來仍需進一步研究來探討護理人員輪班工作對健康的影響。

關鍵字

護理人員 ； 輪班工作 ； 自覺壓力 ； 心率變異數

並列摘要

Background: The aims of our study to determine the relationships between shift work, perceived stress, and cardiac autonomic activity of nurses. Method: The study is conducted in a Northern Medical Center in Taiwan from January 1, 2012 to December 31, 2012. which surveyed nurses with different types of work shift schedules. We use the PSS-10 stress questionnaire to evaluate stress condition, and collected demographic data, shift work condition, job type during the same interview. The electrocardiographic (ECG) R-R interval variability, total power, LF and HF( proportions of sympathetic and parasympathetic activities, respectively), and LF/HF ratio were computed by means of autoregressive spectral and component analyses. Nonparametric statistics was used to investigate the correlation between the perceived stress and heart rate variability in the shift work nurses. Results: A total of 50 nurses aged 31.9±5.8 years were included in our study. Twenty-six nurses with shift work worked under a rotating three shift system, while twenty-four nurses without shift work worked during the daytime for sixth months or more years prior to this study. The presence of shift work had borderline correlation with stress (p=0.06). There was no significant correlation neither between shift work and heart rate variability, nor stress and heart rate variability. Conclusion: The shift work may be associated with work stress in the nursing units. The effects of stress and burnout on the nurses possibly had poor patient care, patient outcomes, patient safety, and quality care. Better understanding of shift work in the workplace was helpful to improve health and safety. A further prospective study was necessary to examine the effect of the shift work on the nurses.

並列關鍵字

nurse ； shift work ； perceived stress ； heart rate variability