HEMŞİRELERİN VARDİYA İLE ÇALIŞMALARININ ANKSİYETE VE ARTERYEL KAN BASINCINA ETKİSİNİN İRDELENMESİ

Abstract

Bu çalışma, hemşirelerin vardiya ile çalışmalarının anksiyete ve arteryel kan basıncına etkisini irdelemek amacıyla tanımlayıcı nitelikte yapılmıştır. Araştırmanın örneklemini Türkiye’nin büyük şehirlerinden birinin il merkezinde bulunan bir hastanede çalışan ve tabakalı rasgele örnekleme yöntemiyle seçilen 167 hemşire oluşturmuştur. Veri toplama aracı olarak; “Tanıtıcı Bilgiler Formu”, “Kan Basıncı Ölçüm Formu” ve “Durumluk-Sürekli Anksiyete Envanteri” kullanılmıştır. Araştırmadan elde edilen sonuçlara göre hemşirelerin kan basıncını vardiya ile çalışma etkilemiştir. Sürekli gündüz vardiyasında çalışan hemşirelerin gündüz diastolik kan basıncı değerleri gündüz+gece vardiyalarında çalışanlardan daha yüksek bulunmuştur. Hemşirelerin ‘sürekli anksiyete’ düzeyi vardiya ile çalışmadan etkilenmezken, ikinci ‘durumluk anksiyete’ düzeyi sürekli gündüz vardiyasında çalışanlarda, gündüz+gece vardiyasında çalışanlara göre daha yüksek bulunmuştur. Literatüre ters düşen bu bulgular; sürekli gündüz vardiyası’nda (8 saat) çalışan hemşirelerin yaş ortalamalarının yüksek oluşu, gece vardiyası’nda (16 saat) çalışan hemşirelerin extra ücret almaları ve bu vardiyada en az 3-4 saat uyumaları ile açıklanmıştır.

Keywords

• Hemşirelik, vardiya, kan basıncı, anksiyete, Türkiye

References

1. Baltas A, Baltas Z (1987). Stres ve Basacikma Yollari, 5. Basim, Evrim Matbaacilik Ltd. Sti, İstanbul.
2. Baumgart P, Walger P, Fuchs G et al. (1989). Twenty-four-hour blood pressure is not dependent on endogenous circadian rhythm. Journal of Hypertension 7, 331-334.
3. Bünning E (1973). The Physiological Clock Circadian Rhythms and Biological Chronometry. Reveised third edition: The English Universities Press Ltd. London. Chau NP, Mallion JM, Gaudemaris R et al. (1989). Twenty-four-hour ambulatory blood pressure in shift workers. Circulation. 80: 341-347.
4. Evans O, Steptoe A (2002). The contribution of gender-role orientation, work factors and home stressors to psychological well-being and sickness absence in male and female-dominated occupational groups. Social Ssience & Medicine 54: 481-492.
5. Fishel AH (1998). Nursing Management of Anxiety and Panic. Nursing Clinics of North America 33: 135-151.
6. Goldstein IB, Shapiro D, DeMet AC et al. (1999). Ambulatory blood pressure, heart rate, and neuroendocrine pesponses in women nurses during work and off work days. Psychosomatic Medicine 61, 387-396.
7. Gorgulu SR (1988). Hemsirelerin anksiyete duzeylerinin saptanmasi ve hemsireleri is ortaminda etkileyen stresörlerin tanimlanmasi. Yayinlanmamıs Doktora Tezi. Hacettepe Universitesi Saglik Bilimleri Enstitusu.
8. Guyton AC, Hall JE (2001). Tibbi Fizyoloji (Textbook of Medical Physiology). Cev: Cavusoglu H, Yegen BC, Aydin Z, & Alican I, editor. Turkce 1. baski: Yüce yayimlari A.S. & Nobel Tip Kitapevleri Ltd. Sti.

9. Harbert K (2002). Acute traumatic stress. Clinician Reviews. 12: 50-57. Available from: http://www.medscape.com/viewarticle/4245 01_print
10. Heim E (1991). Job Stressors and Coping in Health Professions. Psychother Psychosom 55: 90-99.
11. International Council of Nurses. “Nurses and Overtime”. (online) Available from: http://www.icn.ch/matters_overtime.htm., (reached: 28.12.2002)
12. International Labour Organization. “What is workplace stress?”. (online) Available from: http://www.ilo.org/public/english/protection/ safework/stress/whatis.htm (Last update: 23.7.2002), (reached: 06.11.2002a). International Labour Organization. “Workrelated stress in nursing”. Available from:http://www.ilo.org/public/english/prote ction/safework/stress/nursing.htm (Last update: 10.11.2000), (reached: 06.11.2002b).
13. Kario K, Schwartz JE, Davidson KW et al. (2001). Gender differences in associations of diurnal blood pressure variation, awake physical activity, and sleep quality with negative affect. Hypertension 38: 997-1002.
14. Lercher P, Hörtnagl J, Kofler WW (1993). Work noise annoyance and blood pressure: combined effects with stressful working conditions. Int Arch Occup Environ Health. 65: 23-28.
15. Light KC, Turner JR, Hinderliter AL (1992). Job strain and ambulatory work blood pressure in healthy young men and women. Hypertension 20: 214-218.
16. Matthews KA, Cottington EM, Talbott E et al. (1987). Stressful work conditions and diastolic blood pressure among blue collar factory workers. American Journal of Epidemology 126: 280-291.
17. Motowidlo SJ, Packard JS, Manning MR (1986). Occupational stress: its causes and consequences for job performance. Journal of Applied Psychology 71: 618-629.
18. Oner N, LeCompte A (1985). DurumlukSürekli Kaygı Envanteri El Kitabi (StateTrait Anxiety Handbook). 2. basim: Istanbul; Bogazici Universitesi Yayinlari. No: 333.
19. Robinson L (1990). Stress and Anxiety. Nursing Clinics of North America 25: 935943.
20. Schnall PL, Landsbergis PA, Pieper CF et al. (1992a). The impact of anticipation of job loss on psychological distress and worksite blood pressure. American Journal of Industrial Medicine 21: 417-432.
21. Schnall PL, Schwartz JE, Landsbergis PA et al. (1992b). Relation Between Job Strain, Alcohol, and Ambulatory Blood Pressure. Hypertension 19: 488-494.
22. Steptoe A, Cropley M, Griffith J et al. (2000). Job strain and anger expression predict early morning in salivary cortisol. Psychosomatic Medicine 62: 286-292.
23. Taylor C, Lillis C, LeMone P (1997). Fundamentals of Nursing-The Art, Science of Nursing Care. Third edition: Philadelphia: PA: Lippincott.
24. Theorell T, Ahlberg-Hulten G, Jodko M et al. (1993). Influence of job strain and emotion on blood pressure in female hospital personnel during workhours. Scand J Environ Health. 19: 313-8.
25. Van Egeren LF (1992). The relationship between job strain and blood pressure at work, at home, and during sleep. Psychosomatic Medicine 54: 337-343. Vrijkotte TGM, Van Doornen JP, Gues EJC (2000). Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension 35: 880886.
26. World Health Organization Expert Committee on Hypertension Control. Geneva, 24-31 October 1994. Last update: 03 Jul 2001. Available from: http://www.who.int/ncd/cvd/trs862.html#s22 (reached 01.11.2001).
27. Yamasaki F, Schwartz JE, Gerber LM et al. (1998). Impact of shift work and race/ethnicity on the diurnal rhythm of blood pressure and catecholamines. Hypertension 32: 417-423.