SAĞLIK ÇALIŞANLARINDA ALGILANAN STRES İLE FİZİKSEL VE BİLİŞSEL YORGUNLUK ARASINDAKİ İLİŞKİNİN DEĞERLENDİRİLMESİ: KESİTSEL ANALİTİK BİR ÇALIŞMA

Abstract

Amaç: İzmir’de kamu hastanelerinde çalışan sağlık profesyonellerinde algılanan stres ile fiziksel ve bilişsel yorgunluk arasındaki ilişkiyi belirlemek ve sosyodemografik/işe ilişkin etmenlerle farklılıkları incelemek. Gereç ve Yöntemler: Kesitsel-analitik tasarımda yürütülen araştırmada n=995 gönüllü sağlık çalışanı çevrim içi anketle değerlendirilmiştir. Ölçümler için Algılanan Stres Ölçeği (PSS- 10) ve Chalder Yorgunluk Ölçeği (CFS-11) kullanılmıştır. Tanımlayıcı istatistiklerin ardından iki grup için bağımsız t-testi, çoklu gruplar için ANOVA (gerekli yerlerde post-hoc), ilişkiler için Pearson korelasyon, etkileyen faktörler için doğrusal regresyon uygulanmıştır (α=0,05). Bulgular: Örneklemin %75,7’si kadın, %67,4’ü 20-40 yaş aralığındadır. Ortalama puanlar: PSS-toplam 2,07/4, olumsuz duygulanım 2,14, pozitif kontrol 1,88; CFS-toplam 1,44/3, fiziksel 1,33, bilişsel 1,30. Kadınlarda PSS-toplam ve CFS (fiziksel/bilişsel/toplam) daha yüksektir (tümü p≤0,001). 20-30 yaş, 1-5 yıl kıdem, nöbet/karma vardiya ve ≤4 saat uyku gruplarında stres ve yorgunluk anlamlı biçimde yüksektir (çoğu p≤0,001). Kronik hastalık ve alkol kullanımı daha yüksek stres/yorgunlukla ilişkilidir; sigara özellikle fiziksel yorgunluğu artırır. PSS-toplam ile CFS-toplam arasında orta düzey pozitif ilişki vardır (r=0,542; p<0,001); PSS toplam ile fiziksel ve bilişsel yorgunluk güçlü biçimde ilişkilidir (r=0,784; p<0,001). Regresyonda olumsuz duygulanım, pozitif kontrol, fiziksel/bilişsel yorgunluk ve CFS-toplam, algılanan stresi anlamlı yordar (tümü p<0,001). Sonuç: Sağlık çalışanlarında yüksek algılanan stres, fiziksel ve bilişsel yorgunluğu artırmaktadır. Genç yaş, düşük kıdem, nöbet/karma vardiya ve yetersiz uyku başlıca risk alanlarıdır. Kurumsal düzeyde vardiya optimizasyonu, dinlenme-uyku olanaklarının güçlendirilmesi ve psikososyal destek/baş etme programları önerilir.

Keywords

• Algılanan stres
• fiziksel yorgunluk
• bilişsel yorgunluk
• sağlık çalışanları

Evaluation of the Relationship Between Perceived Stress and Physical and Cognitive Fatigue Among Healthcare Professionals: A Cross-Sectional Analytical Study

Abstract

Objective: To determine the relationship between perceived stress and physical and cognitive fatigue among healthcare professionals working in public hospitals in İzmir, and to examine the differences based on sociodemographic and workrelated factors. Material and Methods: In this cross-sectional analytical study, a total of 995 voluntary healthcare professionals were evaluated using an online questionnaire. The Perceived Stress Scale (PSS- 10) and the Chalder Fatigue Questionnaire (CFS-11) were employed as measurement tools. Following descriptive statistics, an independent t-test was performed for two groups, ANOVA for multiple groups (with post-hoc tests where necessary), Pearson correlation for relationships, and linear regression for influencing factors (α=0.05). Results: Of the sample, 75.7% were female and 67.4% were aged between 20 and 40 years. The mean scores were as follows: PSS total 2.07/4, negative affect 2.14, positive control 1.88; CFS total 1.44/3, physical fatigue 1.33, cognitive fatigue 1.30. Female participants reported significantly higher scores for PSS total and CFS (physical, cognitive, and total) (all p≤0.001). Stress and fatigue were significantly higher among participants aged 20-30 years, those with 1-5 years of experience, those working night or rotating shifts, and those sleeping ≤4 hours per night (most p≤0.001). Chronic illness and alcohol use were associated with higher stress and fatigue, while smoking particularly increased physical fatigue. There was a moderate positive correlation between total PSS and total CFS scores (r=0.542; p<0.001), and a strong correlation between physical and cognitive fatigue (r=0.784; p<0.001). In regression analysis, negative affect, positive control, physical and cognitive fatigue, and CFS total were significant predictors of perceived stress (all p<0.001). Conclusion: High perceived stress among healthcare professionals increases both physical and cognitive fatigue. Younger age, lower seniority, shift or rotating work schedules, and insufficient sleep are the primary risk factors. Institutional strategies such as shift optimization, enhancement of rest and sleep opportunities, and the implementation of psychosocial support and coping programs are recommended.

Keywords

• Perceived stress
• physical fatigue
• cognitive fatigue
• healthcare professionals

References

1. West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529.
2. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians. Arch Intern Med. 2012;172(18):1377-1385.
3. Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol. 2005;1:607-628.
4. Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-111.
5. Hockey GRJ. The psychology of fatigue: Work, effort and control. Cambridge: Cambridge University Press; 2013.
6. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-396.
7. Taylor SE. Health Psychology. 9th ed. New York: McGraw-Hill Education; 2015.
8. Maunder RG, Heeney ND, Strudwick G, Shin HD, O’Neill B. Burnout in hospital-based healthcare workers during COVID-19. BMJ Open. 2021;11(9):e053808.

9. Mealer M, Jones J, Newman J, McFann KK, Rothbaum B, Moss M. The presence of resilience is associated with a healthier psychological profile in intensive care unit nurses: results of a national survey. Int J Nurs Stud. 2012;49(3):292-299.
10. Aaronson LS, Teel CS, Cassmeyer V, Neuberger GB, Pallikkathayil L, Pierce J, Wingate A. Defining and measuring fatigue. Image J Nurs Scholarsh. 1999;31(1):45-50.
11. Van Dongen HP, Dinges DF. Sleep, circadian rhythms, and psychomotor vigilance. Clin Sports Med. 2005;24(2):237-249.
12. Öktem Özgür A, Demirbilek T. Fiziksel ve zihinsel yorgunluk ile algılanan stresin işe tutkunluk üzerine etkisi. Uluslararası İktisadi ve İdari İncelemeler Dergisi. 2024;(42):37-60.
13. Dorrian J, Baulk SD, Dawson D. Work hours, workload, sleep and fatigue in Australian rail industry employees. Appl Ergon. 2011;42(2):202-209.
14. Baş T. Anket Nasıl Hazırlanır, Uygulanır, Değerlendirilir. 4. Baskı. Ankara: Seçkin Yayınları; 2006.
15. Cohen S, Williamson GM. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, eds. The Social Psychology of Health. Newbury Park, CA: Sage; 1988:31-67.
16. Eskin M, Harlak H, Demirkıran F, Dereboy Ç. The adaptation of the perceived stress scale into turkish: A reliability and validity analysis. New Symposium J. 2013;51(3):132-140.
17. Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, Wallace EP. Development of a fatigue scale. J Psychosom Res. 1993;37(2):147-153.
18. Adın RM. Chalder Yorgunluk Ölçeği’nin Türkçe’ye Uyarlanması ve Genç Yetişkin Bireylerde Psikometrik Özelliklerinin İncelenmesi [Yüksek Lisans Tezi]. Ankara: Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü; 2019.
19. Bakker AB, Demerouti E. Job demands–resources theory: taking stock and looking forward. J Occup Health Psychol. 2017;22(3):273-285.
20. Alarcon GM. A meta-analysis of burnout with job demands, resources, and attitudes. J Vocat Behav. 2011;79:549-562.
21. Van Dongen HPA, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose–response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep. 2003;26(2):117-126.
22. Lim J, Dinges DF. A meta-analysis of the impact of short-term sleep deprivation on cognitive variables. Psychol Bull. 2010;136(3):375-389.
23. Goel N, Basner M, Rao H, Dinges DF. Circadian rhythms, sleep deprivation, and human performance. Prog Mol Biol Transl Sci. 2013;119:155-190.
24. Killgore WDS. Effects of sleep deprivation on cognition. Prog Brain Res. 2010;185:105-129.
25. Barker LM, Nussbaum MA. Fatigue, performance and the work environment: a survey of registered nurses. J Adv Nurs. 2011;67(6):1370-1382.
26. Schaufeli WB, Taris TW. A critical review of the Job Demands–Resources model: implications for improving work and health. In: Bauer G, Hämmig O, eds. Bridging Occupational, Organizational and Public Health. Dordrecht: Springer; 2014:43-68.
27. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288(16):1987-1993.
28. Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PLoS One. 2016;11(7):e0159015.
29. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388(10057):2272-2281.