Shift work (Shift Work-SW) is common in Westernized societies representing a high percentage of the workforce worldwide (Farias, 2020; Costa 2010). Recent studies have demonstrated the negative health effects of shift work, disturbing circadian rhythms and the sleep-wake cycle and increasing the risk of chronic non-communicable diseases (Ramin, 2015). Others have reported that shift workers possess an altered dietary structure and how shift work is positively associated with the risk of obesity (Farias, 2020; Shaw, 2019). In Italy, approximately 25% of healthcare and private companies provide shift work. In this thesis work, the role of nutrition in chronobiological alterations and psychosocial well-being was evaluated in a population of adult healthcare workers from a public hospital in central Italy. With the aim of implementing strategies that include nutritional interventions in workplace health programs. The study was conducted on a cohort of 59 healthcare workers (mainly nurses) involved in shift work. Among the 59 operators initially selected, 33 were suitable for the study, who had to have been employed in night work for at least 3 years with rapidly rotating shifts, i.e. regularly alternating morning, evening and night shifts. The following were collected: demographic data, body composition (BMI), physical activity, sleep quality, perceived stress, diet characteristics (diet composition, timing of meals, dietary intake and diet quality). To study the relationship between shift work, eating habits, BMI, chronobiological alterations, chi-square tests, t-tests and logistic regressions were used. In the work of the health workers involved in night work interviewed, situations considered stressful by a large part of them were encountered, especially in the 3 areas of clinical emergency, personal attack and relationships with patients and family members. Furthermore, it emerged that the symptoms most associated with "distress" were those of depression and anxiety. No relationship was found between high work stress and sleep disturbances due to night work; in fact, the 33 subjects interviewed had obtained a score lower than 5, defining themselves as "good sleepers". Subjects with higher levels of stress they were more predisposed to a higher caloric intake and to take in more lipids and potassium in the diet, although the difference in total energy intake between shift workers and day workers was not statistically significant in the present study. To prevent psychological distress and job dissatisfaction from translating into errors in clinical practice, healthcare facilities should systematically monitor the phenomenon and provide valid psychological support when needed, furthermore since night workers run a greater risk of developing obesity these results They provide important data to inform workplace health policy to support improving the health of at-risk and vulnerable employees. Therefore, appropriate dietary intervention for shift workers needs to be emphasized in terms of the type of food to be consumed during shifts, meal times to be consumed, and how to follow a healthy diet.
Il lavoro a turni (Shift Work-SW) è comune nelle società occidentalizzate rappresentando un’elevata percentuale della forza lavoro in tutto il mondo (Farias, 2020; Costa 2010). Recenti studi hanno dimostrato gli effetti negativi sulla salute del lavoro a turni, disturbando i ritmi circadiani e il ciclo sonno-veglia e aumentando il rischio di malattie croniche non trasmissibili (Ramin, 2015). Altri, hanno segnalato che i lavoratori a turni possiedono una struttura alimentare alterata e come il lavoro su turni sia positivamente associato al rischio di obesità (Farias, 2020; Shaw, 2019). In Italia, circa il 25% delle aziende sanitarie e private prevede il lavoro a turni. In questo lavoro di tesi è stata valutato il ruolo dell’alimentazione nell’alterazioni cronobiologiche e nel benessere psicosociale in una popolazione di operatori sanitari adulti provenienti da un ospedale pubblico del centro Italia. Con lo scopo di implementare strategie che prevedono interventi nutrizionali nei programmi di salute sul posto di lavoro. Lo studio è stato condotto su una coorte di 59 operatori sanitari (prevalentemente infermieri) coinvolti nel lavoro a turni. Tra i 59 operatori inizialmente selezionati, 33 erano idonei per lo studio, i quali dovevano essere impiegati in lavoro notturno da almeno 3 anni con turni a rotazione rapida, ovvero alternando regolarmente turni mattutini, serali e notturni. Sono stati raccolti: dati demografici, composizione corporea (BMI), attività fisica, qualità del sonno, stress percepito, caratteristiche della dieta (composizione della dieta, tempistica dei pasti, intake dietetico e qualità della dieta). Per studiare la relazione tra lavoro su turni, abitudini alimentari, BMI, alterazioni cronobiologiche sono stati utilizzati test del chi quadrato, t-test e regressioni logistiche. Nell’attività lavorativa degli operatori sanitari coinvolti nel lavoro notturno intervistati si sono riscontrate situazioni ritenute stressanti da una gran parte di essi, soprattutto nelle 3 aree dell’emergenza clinica, dell’attacco personale e delle relazioni con pazienti e familiari. Inoltre, è emerso che i sintomi maggiormente associati a “distress” erano quelli della depressione e dell’ansietà. Non è stata trovata alcuna relazione tra stress lavorativo elevato e disturbi del sonno dovuti al lavoro notturno; infatti, i 33 soggetti intervistati avevano ottenuto un punteggio inferiore a 5 autodefinendosi “buoni dormitori”. I soggetti con più alti livelli di stress erano più predisposti ad un apporto calorico maggiore e ad assumere più lipidi e potassio con la dieta, sebbene la differenza di apporto energetico totale tra i lavoratori a turni e quelli diurni non era statisticamente significativa nel presente studio. Per evitare che il disagio psicologico e l’insoddisfazione del lavoro si traduca in errori nella pratica clinica, le strutture sanitarie dovrebbero sistematicamente monitorare il fenomeno e fornire un valido supporto psicologico al bisogno inoltre poiché i lavoratori notturni corrono un rischio maggiore di sviluppare obesità questi risultati forniscono dati importanti per informare la politica sanitaria sul posto di lavoro come sostegno per migliorare la salute dei dipendenti a rischio e vulnerabili. Pertanto, l'adeguato intervento alimentare per i lavoratori a turni deve essere enfatizzato in termini di tipo di cibo da consumare durante i turni, orari dei pasti da consumare e come seguire una dieta sana.
Benessere psicosociale e livelli di stress in operatori sanitari coinvolti nel lavoro a turni: il ruolo dell’alimentazione
MANCINI, ELISA
2022/2023
Abstract
Shift work (Shift Work-SW) is common in Westernized societies representing a high percentage of the workforce worldwide (Farias, 2020; Costa 2010). Recent studies have demonstrated the negative health effects of shift work, disturbing circadian rhythms and the sleep-wake cycle and increasing the risk of chronic non-communicable diseases (Ramin, 2015). Others have reported that shift workers possess an altered dietary structure and how shift work is positively associated with the risk of obesity (Farias, 2020; Shaw, 2019). In Italy, approximately 25% of healthcare and private companies provide shift work. In this thesis work, the role of nutrition in chronobiological alterations and psychosocial well-being was evaluated in a population of adult healthcare workers from a public hospital in central Italy. With the aim of implementing strategies that include nutritional interventions in workplace health programs. The study was conducted on a cohort of 59 healthcare workers (mainly nurses) involved in shift work. Among the 59 operators initially selected, 33 were suitable for the study, who had to have been employed in night work for at least 3 years with rapidly rotating shifts, i.e. regularly alternating morning, evening and night shifts. The following were collected: demographic data, body composition (BMI), physical activity, sleep quality, perceived stress, diet characteristics (diet composition, timing of meals, dietary intake and diet quality). To study the relationship between shift work, eating habits, BMI, chronobiological alterations, chi-square tests, t-tests and logistic regressions were used. In the work of the health workers involved in night work interviewed, situations considered stressful by a large part of them were encountered, especially in the 3 areas of clinical emergency, personal attack and relationships with patients and family members. Furthermore, it emerged that the symptoms most associated with "distress" were those of depression and anxiety. No relationship was found between high work stress and sleep disturbances due to night work; in fact, the 33 subjects interviewed had obtained a score lower than 5, defining themselves as "good sleepers". Subjects with higher levels of stress they were more predisposed to a higher caloric intake and to take in more lipids and potassium in the diet, although the difference in total energy intake between shift workers and day workers was not statistically significant in the present study. To prevent psychological distress and job dissatisfaction from translating into errors in clinical practice, healthcare facilities should systematically monitor the phenomenon and provide valid psychological support when needed, furthermore since night workers run a greater risk of developing obesity these results They provide important data to inform workplace health policy to support improving the health of at-risk and vulnerable employees. Therefore, appropriate dietary intervention for shift workers needs to be emphasized in terms of the type of food to be consumed during shifts, meal times to be consumed, and how to follow a healthy diet.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/15645