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AIMS: To investigate the influence of fasting during the night shift on eating behavior, hunger, glucose and insulin levels the following day. METHODS: Study with 10 male police officers who have been working at night. Participants were tested under three different conditions separated by at least 6 days of washout in a randomized, crossover design: "Night Shift Fasting" (NSF)-two nights of fasting during the night shift; "Night Shift Eating" (NSE)-two nights with the consumption of a standardized meal during the night shift (678 ± 42 kcal consumed at ~ 0200 h); and "Nighttime Sleep" (NS)-two nights of sleep. The morning after, blood glucose and insulin and hunger ratings were assessed, and food intake was assessed with an ad libitum test meal. Food intake was also assessed throughout the remainder of the day using a food record. Generalized Estimating Equations were used to analyze the effect of experimental condition. RESULTS: Food intake during the test meal, especially of proteins and fats, was higher after fasting during the night shift compared to the other conditions (p < 0.05), whereas desire to eat scores were lower after the NSF compared to NSE condition (p = 0.043). Hunger levels were lower after the NSF compared to the NS condition (p = 0.012). Insulin and HOMA-IR were also lower in the morning after NSF (p < 0.001). CONCLUSION: Fasting during the night shift leads to not only a higher intake of energy and macronutrients both in the early morning after work and throughout the next day, but also lower insulin levels and HOMA-IR in the morning. REGISTRATION NUMBER OF CLINICAL TRIAL: NCT03800732. Initial release: 01/09/2019. Last release: 02/23/2022.

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ABSTRACT Objective: to analyze the association between sleep quality, health symptoms and the physical, psychological and social effects of work in Nursing professionals working the night shift. Method: a cross-sectional study conducted with Nursing professionals working the night shift of a hospital institution. The instruments used were a socio-occupational and health symptoms questionnaire, the Assessment Scale for Work-Related Harms, and the Pittsburgh Sleep Quality Index. Data were collected between September 2017 and April 2018.The analysis was performed by means of descriptive and analytical statistics. Results: a total of 139 workers took part in the study and a statistical difference was identified between poor sleep quality and the female gender and physical illness variables and health symptoms such as appetite disorder, sensation of indigestion, flatulence, insomnia, difficulty concentrating, unhappiness, sensation of decreased self-esteem and mood lability. Conclusion: it was verified that Nursing professionals working the night shift experienced poor sleep quality, and that this relationship exerts an impact on physical, psychological and social health. Interventions targeted at raising awareness about sleep hygiene can promote better outcomes in these individuals' health.

RESUMEN Objetivo: analizar la asociación entre la calidad del sueño, síntomas de salud y los efectos físicos, psicológicos y sociales del trabajo en profesionales de Enfermería que se desempeñaban en el turno nocturno. Método: estudio transversal, realizado con trabajadores de Enfermería que se desempeñaban en el turno nocturno de una institución hospitalaria. Se utilizaron los siguientes instrumentos: un cuestionario sociolaboral y de síntomas de salud, la Escala de Evaluación de los Daños Relacionados al Trabajo y el Índice de Calidad del Sueño de Pittsburgh. Los dados se recopilaron entre septiembre de 2017 y abril de 2018. El análisis se realizó por medio da estadística descriptiva y analítica. Resultados: se contó con la participación de 139 trabajadores y se identificó una diferencia estadística entre calidad de sueño deficiente y las variables sexo femenino y padecimiento físico, síntomas de salud como trastornos del apetito, sensación de indigestión, flatulencia, insomnio, dificultad para concentrarse, desdicha, sensación de disminución de la autoestima y labilidad en el estado de ánimo. Conclusión: se verificó que los trabajadores de Enfermería que se desempeñaban en el turno nocturno presentaron calidad de sueño deficiente, y esa relación afecta la salud física, psicológica y social. Intervenciones con el objetivo de generar conciencia sobre la higiene del sueño pueden promover mejores resultados en la salud de estas personas.

RESUMO Objetivo: analisar a associação entre a qualidade do sono, sintomas de saúde e os efeitos físicos, psicológicos e sociais do trabalho em trabalhadores de enfermagem que atuavam no turno noturno. Método: estudo transversal, realizado com trabalhadores de enfermagem que atuavam em instituição hospitalar no turno noturno. Utilizaram-se como instrumentos questionário sociolaboral e de sintomas de saúde, Escala de Avaliação dos Danos Relacionados ao Trabalho e o Índice de Qualidade do Sono de Pittsburgh. Os dados foram coletados entre setembro de 2017 e abril de 2018. A análise foi realizada por meio da estatística descritiva e analítica. Resultados: participaram 139 trabalhadores e identificou-se diferença estatística entre qualidade do sono ruim e as variáveis sexo feminino, adoecimento físico e sintomas de saúde como distúrbio de apetite, sensação de má digestão, flatulência, insônia, dificuldade de concentração, infelicidade, sensação de diminuição autoestima e labilidade de humor. Conclusão: constatou-se que os trabalhadores de enfermagem que atuavam no turno noturno experimentavam qualidade do sono ruim, e essa relação impacta na saúde física, psicológica e social. Intervenções visando à conscientização sobre a higiene do sono podem promover melhores resultados na saúde dessas pessoas.

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Night workers tend to eat irregularly, both in terms of meal times and composition. The disruption in energy metabolism caused by inappropriate eating habits can negatively affect the sleep quality of these individuals. The objectives of this study were to determine the interval between the last meal and bedtime and its relationship with both diurnal and nocturnal sleep parameters, as well as to evaluate the association of the adequacy of this meal with sleep parameters. The analyses were carried out for a usual sleep routine on a workday and a day off. This cross-sectional study was part of a controlled, randomized, double-blind, crossover clinical trial. The sample comprised 30 female nursing professionals who worked permanent night shifts of 12 × 36 h. Timing and composition of the last meal were obtained from food diaries, and sleep parameters were collected via actigraphy. On multiple linear regression analysis, every hour decrease in the interval between the last meal and sleep onset there was an increase of 0.39 h on diurnal sleep duration. Regarding food intake, every 1 g of fat and 1 g of carbohydrate consumed was associated with an increase in diurnal sleep onset latency of 0.13 h and 0.02 h, respectively. These findings suggest that both timing and composition of the last meal before bedtime may be potential key factors for good diurnal and nocturnal sleep among night-shift workers.

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Shift workers experience chronic circadian misalignment, which can manifest itself in reduced melatonin production, and has been associated with metabolic disorders. In addition, chronotype modulates the effect of night shift work, with early types presenting greater circadian misalignment when working night shift as compared to late types. Melatonin supplementation has shown positive results reducing weight gain in animal models, but the effect of exogenous melatonin in humans on body weight in the context of shift work remains inconsistent. The aim of this study was thus to evaluate the effects of exogenous melatonin on circadian misalignment and body weight among overweight night shift workers, according to chronotype, under real-life conditions. We conducted a double-blind, randomized, placebo-controlled, crossover trial where melatonin (3 mg) or placebo was administered on non-night shift nights for 12 weeks in 27 female nurses (37.1 yo, ±5.9 yo; BMI 29.9 kg/m2 , ±3.3 kg/m2 ). Melatonin (or placebo) was only taken on nights when the participants did not work night shifts, that is, on nights when they slept (between night shifts and on days off). Composite Phase Deviations (CPD) of actigraphy-based mid-sleep timing were calculated to measure circadian misalignment. The analyses were performed for the whole group and by chronotype. We found approximately 20% reduction in circadian misalignment after exogenous melatonin administration considering all chronotypes. Moreover, melatonin supplementation in those who presented high circadian misalignment, as observed in early chronotypes, reduced body weight, BMI, waist circumference, and hip circumference, without any change in the participants' calorie intake or physical activity levels.

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Night work has become necessary in our modern society. However, sleep deprivation induces a circadian misalignment that effectively contributes to the development of diseases associated with metabolic syndrome, such as obesity and diabetes. Here, we evaluated the pattern of circadian clock genes and endoplasmic reticulum stress (ERS) genes in addition to metabolic and anthropometric measures in subjects that work during a nocturnal period compared with day workers. We study 20 night workers (NW) and 20 day workers (DW) submitted to a work schedule of 12 h of work for 36 h of rest for at least 5 years in a hospital. The present report shows that NW have increased fasting blood glucose, glycated hemoglobin (HbA1c), triglycerides, and low-density lipoprotein (LDL)-cholesterol levels, and lower high-density lipoprotein (HDL)-cholesterol levels compared to DW. In addition, we observed that waist circumference (WC), waist-hip ratio (WHR), and systemic blood pressure are also increased in NW. Interestingly, gene expression analysis showed changes in CLOCK gene expression in peripheral blood mononuclear cells (PBMC) samples of NW compared to the DW, evidencing a peripheral circadian misalignment. This metabolic adaptation was accompanied by the up-regulation of many genes of ERS in NW. These findings support the hypothesis that night shift work results in disturbed glycemic and lipid control and affects the circadian cycle through the deregulation of peripheral CLOCK genes, which is possibly due to the activation of ERS. Thus, night work induces important metabolic changes that increase the risk of developing metabolic syndrome.

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OBJECTIVE: To explore the association between behavioural characteristics with the prevalence of abdominal obesity (AO) among a population of Southern Brazilian shift working women. DESIGN: A cross-sectional study was conducted. AO was estimated using waist circumference (WC), and it was used to classify women as having AO (WC ≥ 88 cm). Prevalence ratios were estimated using Poisson regression with robust variance. SETTING: A large plastic utensils company in Southern Brazil. PARTICIPANTS: 450 female shift workers. RESULTS: The prevalence of the AO in the women shift workers was 44·5 % (95 % CI 40·0, 49·2 %). In night shift workers, the prevalence of AO was 56·1 % compared with 40·9 % among hybrid shift workers. After adjustments for covariates, women who were current smokers had a decrease in the prevalence of AO compared with those who never smoked. Women who had three or fewer meals per day had a 46 % increase in the AO prevalence compared with those eating more frequent meals. Night shift work was associated with increase in AO prevalence compared with hybrid shift (PR 1·33; 95 % CI: 1·08, 1·64). CONCLUSIONS: Our findings indicate that behavioural characteristics are associated with a high prevalence of AO in female shift workers, thus suggesting that behavioural modifications among women working shifts, such as increase in meal frequency and physical activity, may reduce AO.

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The aim of this study was to compare the acute effect of a high-protein/moderate carbohydrate (HP-MCHO) versus low-protein/high-carbohydrate (LP-HCHO) meal served at night on the postprandial metabolic response of male night workers the following breakfast. A randomized crossover study was performed with 14 male night workers (40.9 ± 8.9 years old; 29.1 ± 5.3 kg/m2). Participants underwent two different isocaloric dietary conditions at 1:00 h of the night shift: HP-MCHO (45 en% carbohydrate, 35 en% protein and 20 en% fat) and LP-HCHO (65 en% carbohydrate, 15 en% protein and 20 en% fat). Postprandial capillary glucose levels were determined immediately before the intake of the test meal and 30, 60, 90 and 120 min after the end of the meal. At the end of the work shift (6:30 h), participants received a standard breakfast and postprandial levels of glucose, insulin and triglycerides were determined immediately before and then every 30 min for 2 h (30, 60, 90 and 120 min). Higher values of capillary glucose were found after the LP-HCHO condition compared to the HP-MCHO condition (area under the curve (AUC) = 119.46 ± 1.49 mg/dL × min and 102.95 ± 1.28 mg/dL × min, respectively; p < 0.001). For the metabolic response to standard breakfast as the following meal, no significant differences in glucose, insulin, triglyceride, and HOMA-IR levels were found between interventions. A night meal with a higher percentage of protein and a lower percentage of carbohydrate led to minor postprandial glucose levels during the night shift but exerted no effect on the metabolic response of the following meal. This trial was registered at ClinicalTrials.gov as NCT03456219.

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ABSTRACT Objective Different pathways may lead from night work to metabolic diseases, including type 2 diabetes. This study aimed to explore the direct and indirect pathways from night work to glycemic levels, considering the role of physical activity, waist circumference and snacking using data from ELSA-Brasil. Materials and methods A structural equation model was used to confirm the pathways from night work to glycemic levels. The latent variable, "glycemic levels", included fasting glucose, glycated hemoglobin and 2-hour plasma glucose. Results A total of 10.396 participants were included in the analyses. The final model showed that among women, night work was associated with increased glycemic levels. A statistical significant association between night work and glycemic levels mediated by waist circumference was observed among women and men. Conclusions The association between night shift and glycemic levels can be interpreted as an important step toward understanding the pathways that could explain night work as a risk factor for diabetes using epidemiological data.

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Resumo O objetivo foi identificar os principais padrões alimentares de trabalhadores em turnos e associá-los às variáveis socioeconômicas, demográficas e de estilo de vida. Foram estudado homens entre 20 a 60 anos, trabalhadores de uma metalúrgica do Ceará. Os padrões alimentares foram identificados por análise fatorial por componentes principais, seguida de rotação ortogonal varimax. Utilizou-se Regressão de Poisson para estimar as razões de prevalências (RP) das variáveis em relação aos padrões alimentares. Três padrões foram identificados: comum nordestino, popular e ocidental. Os funcionários do turno da noite e os que fumam ou já fumaram apresentaram menor adesão ao padrão comum nordestino, enquanto aqueles que consomem ou já consumiram bebidas alcoólicas mostraram maior adesão. Para o popular, a maior adesão foi de funcionários com maior escolaridade, residentes na cidade sede da empresa e que já consumiram bebidas alcoólicas apenas no passado, enquanto indivíduos com melhor classificação econômica brasileira mostraram menor adesão. Os homens com idade mais elevada e que fumam apresentaram menor adesão ao padrão ocidental. O conhecimento dessas variáveis associadas aos padrões alimentares identificados poderá orientar o planejamento das ações de práticas alimentares saudáveis no grupo estudado.

Abstract The scope of this paper was to identify the main eating patterns of shift workers and to associate them with socioeconomic, demographic and lifestyle variables. Men between 20 and 60 years of age, workers of a metallurgical company in the state of Ceará, were studied. Eating patterns were identified by factorial analysis by major components, followed by varimax orthogonal rotation. Poisson regression was used to estimate the prevalence ratios (PR) of the variables in relation to dietary patterns. Three patterns were identified: standard northeastern, popular and western. Employees of the night shift and those who smoke or have smoked showed less adherence to the common northeastern pattern, while those who consume or have consumed alcoholic beverages showed greater adherence. For the popular, the highest adherence was of employees with higher education, residents in the company's headquarter city and who only consumed alcoholic beverages in the past, while individuals with better Brazilian economic classification showed lower adherence. Older men and smokers had lower adherence to the western standard. Knowledge of these variables associated with the eating patterns identified may support the planning of healthy eating practices in the group studied.

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The medical career is considered highly stressful, especially during internships when academic and clinical demands, combined with changes in sleep patterns, increase students' likelihood to develop depression. Resilience, which is considered as opposite vulnerability to stress and, along with another protective factor, namely morningness, may cause a student to be less reactive to stimuli and, therefore, less prone to depression. The objective of this study was to evaluate the role of resilience and morningness facing to sleep quality and main risk factors, on the development of depression symptoms in a group of students with sleep pattern alterations. To this end, an observational and longitudinal study was performed with 30 undergraduate interns, with an average age of 22.63 years (SE ± 0.13), 33% men and 67% women. A survey was conducted in three different times during the year of internship: at the beginning (T1), in the middle (T2) and the end (T3). The instruments were the Brief Resilience Scale, Composite Scale of Morningness, Pittsburgh Sleep Quality Index and Patient Health Questionnaire. The path analysis examined the roles of morningness, sleep quality and resilience as potential mediators between family history of depression and depression symptoms at different times. The results showed that resilience had a protective effect on depression symptoms at T2 (ß = -0.18, p < 0.05) and with greater power at T3 (ß = -0.41, p < 0.05), as did morningness, although less strongly, on the symptoms at T3 (ß = -0.13, p < 0.05). A relationship between these two mediating variables was also observed (ß = 0.30, p < 0.05). The initial sleep quality had an effect on the increase of depression symptoms at T1 (ß = 0.61, p < 0.05) and T3 (ß = 0.21, p < 0.05), while family history of depression had a direct effect on the measures of depression at T2 (ß = 0.49, p < 0.05) and T3 (ß = 0.19, p < 0.05). Aside from personal risk factors, it is possible to conclude that the levels of resilience, morningness and sleep quality manifested by students at the beginning of their internship may explain the decrease in depression symptoms at the end of the course.

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Objective: Our goal herein has been to gain further insights regarding the life quality and its association with sociodemographic characteristics of nursing professionals working at night shift. Methods: It is an analytical research type with quantitative approach. The research was performed in a hospital of Montes Claros city, Minas Gerais State, Brazil, over the year of 2014 and had 145 workers participants. The survey has been done by applying a sociodemographic questionnaire and the Abbreviated Instrument for the Assessment of the Life Quality (WHOQOL-bref) in August 2014. The descriptive analysis and student's t-test was used in order to check for possible associations. Results: The majority of the workers were female, aged up to 35 years old, having intimate partner and children. The following dimensions had shown the worst scores: environment and physical. The comparison of average scores within the four dimensions has revealed that the most significant covariates were as follows: sex, physical activity, additional job, civil status and working time. Conclusion: In the present study was observed that the workers require greater attention to the environmental and physical dimensions, and also in the sociodemographic characteristics that interfered in their life quality

Objetivo: Avaliar a qualidade de vida e sua associação com as características sociodemográficas dos trabalhadores da enfermagem do período noturno. Métodos: Pesquisa do tipo analítico, com abordagem quantitativa, com 145 trabalhadores, realizada em 2014 em uma instituição hospitalar de Montes Claros, Minas Gerais-Brasil. Foram aplicados um questionário sociodemográfico e o Instrumento Abreviado de Avaliação da Qualidade de Vida, em agosto de 2014. Realizou-se a análise descritiva e o teste t student para verificação de associações. Resultados: Predominaram trabalhadores do sexo feminino, com idade de até 35 anos, com companheiro(a) e filhos. Os domínios meio ambiente e físico apresentaram piores escores. Na comparação dos escores médios nos quatro domínios, as covariáveis mais significativas foram: sexo, atividade física, outro vínculo, estado civil e tempo de trabalho. Conclusão: Os trabalhadores demandam maior atenção nas dimensões ambientais e físicas, e nas características sociodemográficas que interferiram na qualidade de vida

Objetivo: Evaluar la calidad de vida y su asociación con características sociodemográficas de los trabajadores de la enfermería durante la noche. Método: Un estudio de tipo analítico, con un enfoque cuantitativo, con 145 trabajadores, que se celebró en 2014 en un hospital de Montes Claros, Minas Gerais Gerais-Brasil. Se les aplicó un cuestionario sociodemográfico y el abreviado Instrumento de Evaluación de la Calidad de Vida (WHOQOLbref), en 2014 agosto. El análisis descriptivo y la prueba t de student para comprobar para las asociaciones. Resultados: La mayoría de los trabajadores era una mujer, a la edad de 35 años, con compañero(a) y los niños. Las esferas física y medio ambiente tuvo las peores puntuaciones. La comparación de puntuaciones medias en cuatro zonas, las covariables fueron: El sexo, la actividad física, otro bono, el estado civil y el tiempo de trabajo. Conclusión: Los trabajadores requieren una mayor atención en las zonas con menor puntuación y las características que interfieren con la calidad de vida

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PURPOSE: The study of cardiovascular diseases (CVD) associated with night work is difficult due to the long period required for conditions to manifest and the healthy-worker effect. Analyzing asymptomatic pre-clinical changes in the atherosclerotic process is a way to assess the pathways between exposure to night work and CVD. AIM: To evaluate the associations between night work and subclinical atherosclerosis measured by carotid intima-media thickness (CIMT) using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: We conducted cross-sectional analyses using baseline data (2008-2010) from 9785 civil servants, aged 35-74 years. The associations between time of exposure to night work and mean CIMT were examined using a structural equation model. RESULTS: The sample included 4259 men and 5526 women, mean age of 51.6 years. A total of 1778 (18.2%) individuals were exposed to night work (594 current and 1184 former night workers), and the mean years of night work exposed was 11.47 (SD = 9.45) years. On average, mean CIMT was 0.606 (SD = 0.130) mm. Among men, the increase in exposure to night work was significantly associated with an increase in BMI and CIMT. Among women, night work was not associated with increased CIMT. In relation to the indirect associations, results suggest a possible mediation by BMI, diabetes and hypertension on the association between the years of night work and mean CIMT only among men. CONCLUSION: Night work was associated with increased CIMT only among men. These findings add to the knowledge of the possible pathways that link night work and carotid atherosclerosis. Additionally, these results contribute to the recognition of work schedules as a public health problem that should be addressed by the medical community and policy makers.

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O propósito dessa pesquisa é estudar a influência do trabalho no turno noturno e sua relação com as variáveis sócio-demográficas e fisiológicas no contexto da saúde do trabalhador de enfermagem, considerando as necessidades biopsicossociais do ser humano. A pesquisa tem como objeto de estudo a adaptação do trabalhador de enfermagem ao trabalho noturno e suas repercussões na saúde destes profissionais, visando aprofundar a compreensão desta temática e subsidiar as discussões sobre a regulamentação do descanso noturno de modo adequado durante os plantões. O sono não é simplesmente um descanso, pois segundo Medeiros et al. (2009) dormir é um processo ativo em que algumas regiões do cérebro continuam com as mesmas atividades como durante o estado de alerta. Quando a privação do sono é excessiva e persistente, pode gerar fadiga, diminuição do nível de alerta, irritabilidade, dentre outros sintomas. Os objetivos dessa pesquisa são: Objetivo Geral Avaliar as influências do serviço noturno em relação aos problemas de saúde e bem-estar, dos trabalhadores de enfermagem no turno noturno auto-percebido por esses profissionais em um hospital de grande porte. Objetivos Específicos: Identificar os aspectos sócio-economico, fisiológico e legais dos profissionais de enfermagem que atuam no turno noturno por categoria profissional; Verificar as condições do descanso noturno dos trabalhadores de enfermagem; c) Discutir os sinais e sintomas percebidos pelos trabalhadores sobre os aspectos relacionados ao trabalho noturno. O Método utilizado para essa pesquisa, foi um estudo descritivo-exploratório com abordagem quantitativa composto de 89 profissionais de enfermagem do serviço noturno, distribuídos entre 36 enfermeiros, 19 técnicos de enfermagem e 34 auxiliares de enfermagem. Empregou-se um questionário semiestruturado, com a coleta de dados realizada entre agosto e setembro de 2016. Os Resultados revelam que os enfermeiros sentem-se exaustos após o plantão, pelo tempo dedicado ao serviço de enfermagem e a familiar e apresentaram maior ganho de peso durante o período de tempo de trabalho noturno. O local de repouso foi considerado adequado para a maioria dos participantes das três categorias, porque possibilitou um sono compensatório durante as horas permitidas de descanso pela Organização. Conclui-se que sendo o descanso noturno em local adequado, este é considerado uma das estratégias ergonomicamente eficaz, para adaptação cognitiva dos trabalhadores de enfermagem no turno noturno. Contudo, supõe-se ser insuficiente e inadaptado à outras estratégias de garantia de qualidade de vida essenciais ao trabalhador como a alimentação, lazer e convívio familiar saudável. Sugere-se que outras estratégias são impresisdíveis para enfrentar os efeitos do trabalho noturno, devendo envolver dois níveis básicos: individual e organizacional. Só assim o trabalho noturno será saudável para o trabalhador e proporcionar mais qualidade de assistência aos clientes, e evitar acidentes para o trabalhador e para os clientes, porque somente ceder tempo de descanso noturno não é suficiente.

The purpose of this research is to study the influence of night shift work and its relations with sociodemographic and physiological variables in the context of the health of a Nursing professional, considering a human being's biopsychosocial needs. The research has as a study object the adaptation of the nursing workers to nocturnal work and its repercussions in the health of said professionals, aiming to deepen the understanding of the theme and subsidize the discussions about regulamentation of nocturnal rest in an adequate fashion while on duty. Sleep is not simply rest, seeing as according to Medeiros et al. (2009) sleeping is an active process during which some parts of the brain display the same activities as when in an alert state. When sleep deprivation is excessive and persistent, it can cause fatigue, decrease in mental alertness, irritability, amongst other symptoms. The objectives of this research are: General Objetive: Assess the influences of night shit work in relation to health and well-being problems, of the night shift workers as noticed by said professionals in a large-scale hospital. Specific Objectives: Identify the socioeconomic, physiological and legal aspects of nursing professionals who are active in night shifts as professional categories; Verify the conditions of nocturnal rest of nursing workers; discuss the signals and symptoms perceived by said workers about the aspects of night shift work. The utilized method for this research was that of a descriptive exploratory study, with a quantitative approach made up of 89 night shift nursing professionals, distributed between 36 nurses, 19 nursing technicians and 34 nursing assistants. The results reveal that the nurses feel exhausted after the shift, because of the time dedicated to both nursing and family responsibilities, and they show a greater weight gain during periods of night shift work. The rest site was considered adequate by most of the participants of the three categories, for it made possible for them to compensate for the lost sleep during rest hours allowed by the Organization. In conclusion, being the nocturnal rest held in an adequate place, it is considered one of the most effective ergonomic strategies for cognitive adaptation of night shift nursing professionals. However, the nocturnal rest is assumed to be insufficient and inadaptive to other strategies of warranting essential quality of life for the professional such as nourishment, leisure (recreation) and healthy time with the family. It suggests that other strategies are essential to face the effects of nocturnal work, involving two basic levels: individual and organizational. Only then will nocturnal work be healthy for professionals, provide better quality assistance for clients and avoid accidents for both workers and patients, for the concession of nocturnal rest time during night shifts is not enough.

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Objective: recognizing the scientific productions that approach night shift work carried out by the nursing staff in hospitals. Method: this is a bibliographic, narrative, exploratory and descriptive research. The search was developed in the Virtual Health Library, from July to August 2012. Results: studies point to the fact that most workers are married women with spouses and/or children, who have to do housework and deal with their profession, in one or two jobs. Despite of the negative repercussion of the night shift work upon the health of the workers, they often do this shift because of their choice/personal need or professional and not by imposition of the institution. Conclusion: there is a growing interest in this topic, mainly in terms of repercussions of this work shift for the health of nursing professionals. It should be highlighted that it is fundamental to reduce these repercussions, as well as to diminish the hospitalization rates in a way to contribute for the promotion of health and satisfaction at work.

Objetivo: conhecer as produções científicas que abordam o trabalho noturno realizado pela enfermagem em instituições hospitalares. Método: trata-se de uma pesquisa bibliográfica, narrativa, exploratória e descritiva. A busca foi realizada na Biblioteca Virtual de Saúde nos meses de julho e agosto de 2012. Resultados: os estudos apontam que a maioria destes trabalhadores são mulheres casadas ou com companheiros e/ou filhos, que se dividem entre as tarefas do lar e profissionais em um ou dois empregos. Apesar de o trabalho noturno repercutir negativamente na saúde dos trabalhadores, estes frequentemente estão neste turno por escolha/necessidade pessoal ou profissional e não por imposição da instituição. Conclusão: há crescente interesse na temática, principalmente em relação às repercussões desse turno de trabalho para a saúde dos trabalhadores de enfermagem. Ressalta-se que minimizar estas repercussões é fundamental, assim como reduzir os índices de adoecimento, como forma de contribuir na promoção da saúde e satisfação no trabalho.

Objetivo: conocer las producciones científicas que enfocan en el trabajo nocturno realizado por las enfermeras en los hospitales. Método: se trata de una investigación bibliografica, narrativa, exploratoria y descriptiva. La busqueda se realizo em la Biblioteca Virtual de Salud em Julio y agosto de 2012. Resultados: estudios muestran que la mayoría de estos trabajadores son mujeres casadas o conparejas y/o niños, que están divididas entre las tareas de casa y profesionales en uno o dos puestos de trabajo. A pesar del trabajo nocturno reflejar negativamente en la salud de los trabajadores, a menudo están en este turno por elección/ necesidad personal o profesional y no por imposición de la institución. Conclusión: existe un creciente interés en el tema, sobre todo en relación con el impacto de este turno de trabajo para la salud de los trabajadores de enfermería. Es de destacar que minimicen estos efectos es essencial, así como reducir la incidencia de la enfermedad como una contribución en la promoción de la salud y la satisfacción en eltrabajo.

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Explorou-se as relações conjuntas entre o estado nutricional, as variáveis relacionadas às condições sociodemográficas, o trabalho e os comportamentos de saúde em profissionais de enfermagem, a partir da técnica de análise de correspondência. Trata-se de um estudo seccional realizado com 917 trabalhadores de enfermagem de um hospital público do Rio de Janeiro. Os resultados apontaram a formação de quatro grupos, sendo três agrupados segundo as categorias do índice de massa corporal. O grupo que conteve os obesos incluiu condição de saúde ruim, fatores socioeconômicos atuais e pregressos desfavoráveis e ex-trabalhadores noturnos. Por outro lado, o grupo de baixo/adequado agregou as condições mais favoráveis, enquanto o grupo com sobrepeso foi composto por tabagismo, consumo de álcool e trabalho noturno atual (até cinco noites/quinzena). Dentre as relações conjuntas de categorias associadas aos níveis de estado nutricional, destacaram-se aquelas relacionadas às condições socioeconômicas atuais e pregressas avaliadas, destacando a importância dos determinantes sociais ao longo da vida. .

The interrelationships between professional nursing workers’ state of nutrition, variables relating to their socio demographic relationships, their professional work, and health behavior, were examined based on a correspondence analysis technique. This is a sectional study carried out involving 917 nursing professionals in a public hospital in Rio de Janeiro. The results show the formation of four groups, three of them grouped under BMI (body mass index) categories. The obese individuals group included poor health, current socio economic conditions, unfavorable past conditions, and former night shift workers. The low/adequate group showed the most favorable conditions, while the group of overweight individuals also included smoking, alcohol consumption, and current night shift work (up to five nights per two-week period). Specifically, among the interrelationships between the states of nutrition levels, we highlight those relating to current and previously evaluated socio economic conditions, and underscore the life-long importance of social indicators.

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Depressão é uma doença com agravos pessoais e sociais. Objetivou-se avaliar indicadores clínicos e contextuais entre usuários de plantão noturno, com sintomas depressivos, em unidade de emergência. Estudo descritivo, exploratório, transversal, realizado em 2008, em Campinas/SP, com 62 adultos em atendimento noturno. Aplicou-se questionário de identificação, contextualização e informações clínicas, bem como o Inventário de Depressão de Beck. Realizou-se análise estatística. Os resultados mostraram 62 sujeitos entre 18 e 56 anos, 75,8% mulheres, 71,8% brancas, 53,2% solteiros, todos com ocupação, nenhum analfabeto, 21% com nível superior. Apresentavam queixas digestivas e cefaleia (32,2%) e referiam problemas no trabalho (12,9%) e álcool e drogas na família (17,7%). Registraram-se sinais de depressão em 21% dos sujeitos. Encontrou-se relação significativa com fumo (p=0,021), insônia (p=0,005) e problemas econômicos (p<0,000). Conclui-se que os sintomas depressivos estavam aumentados, se comparados à amostra insuspeita, mas em acordo com os dados de depressão associada a doenças clínicas.

Depression is a disease with personal and social losses. We aimed to know the clinical and contextual factors related to the presence of depression in users of night-shift services, in a emergence unit. Descriptive, exploratory, cross-sectionalstudy conducted in 2008, Campinas/SP, with 62 adults who searched for care. A questionnaire with personal, psychosocial and clinical information and the Beck’s Depression Inventory (BID) were applied. Statistics analyses were carried out. The results showed 62 subjects were between 18 and 56 years old, 75.8% women, 71,8% white and 53,2% single, all subjects worked and none of them were illiterate, 21% had university studies; they had digestive complaints and headache (32.2%) and reported problems at work (12.9%) and alcohol and drug abuse in the family (17.7%). According to BID, 21% of the subjects were depressed. The test showed correlations for smoking (p=0.021), insomnia (p=0.005), economic problems (p<0.000). We concluded that compared to unsuspected samples, symptoms were high, but in accordance to disease-related depression.

La depresión es una enfermedad con pérdidas personales y sociales. El objetivo fue evaluar indicadores clínicosy contextuales relacionados a la presencia de síntomas depresivos entre usuarios de servicios de turno nocturno, en una unidad de emergencia. Estudio descriptivo, exploratorio y transversal, realizado en 2008, Campinas/SP-Brasil, con 62 adultos en atendimiento nocturno. Se aplicó un cuestionario de identificación, contextualización e informaciones clínicas, asi como elInventario de Depresión de Beck. Se realizó análisis estadístico. Los resultados indicaron 62 sujetos entre 18 y 56 años, 75,8% mujeres, 71,8% blancas y 53,2% solteros, todos trabajando, ninguno analfabeto, 21% con educación superior; tenían problemas digestivos y dolor de cabeza (32,2%) y reportaron problemas en el trabajo (12,9%) y abuso de alcohol y drogas en la familia (17,7%). Se registró depresión en 21% de los sujetos. Se encontró relación significativa con el tabaquismo (p=0,021), insomnio (p=0,005) y problemas económicos (p<0,000). La conclusión es que, si comparados a muestras insospechadas, los síntomas estaban aumentados, pero en acuerdo con la depresión asociada a enfermedades clínicas.

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Este artigo de revisão teve como objeto o trabalho noturno e suas repercussões na saúde dos trabalhadores de enfermagem. Os objetivos foram identificar a produção científica de enfermagem sobre trabalho noturno e analisar as repercussões desse turno na saúde dos trabalhadores da área. Trata-se de uma pesquisa bibliográfica, sistemática, exploratória e descritiva. A busca bibliográfica ocorreu na Biblioteca Virtual em Saúde e na base de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, com um recorte temporal de 1988 a 2009. A partir da análise dos oito artigos encontrados, verificou-se que o trabalho noturno traz múltiplas repercussões para o processo saúde-doença dos trabalhadores como infecções, envelhecimento, alterações do humor, distúrbios de memória, alterações gastrointestinais, impotência, entre outras. Conclui-se que, apesar de o trabalho noturno impactar negativamente na saúde, os trabalhadores frequentemente optam pela jornada laboral noturna devido ao pagamento do adicional noturno e por facilitar o cumprimento de tarefas domésticas.

This article discusses the impact of the night shift on the health of nursing professionals. It reviews and analyzes scientific publications on the consequences of night shifts to the health of nursing workers. It is a bibliographic, systematic, exploratory, and descriptive piece of research. Bibliographic research was based both on the Health Virtual Library and on the LILACS database, comprehending the time span from 1988 to 2009. The analysis of the eight pieces of scientific production found showed multi-folded impacts of night shifts on the health of nursing workers, namely, infections, ageing, humor alterations, memory disorders, gastric-enteric alterations, sexual impotence, among others. Conclusions show that despite the negative impact of night shifts on their health, nursing workers frequently choose to work overnight on account of the resulting extra pay and extra time for their household care.

Este estudio tuvo como objeto el trabajo nocturno y su impacto en la salud de los trabajadores de enfermería. Los objetivos fueron identificar la producción científica de enfermería sobre trabajo nocturno y analizar las implicaciones de ese turno en la salud de los trabajadores en la noche. Se trata de una pesquisa bibliográfica, sistemática, exploratoria y descriptiva en la Biblioteca Virtual en Salud y en la base de datos Literatura Latinoamericana y del Caribe en Ciencias de la Salud, con una línea de tiempo desde 1988 a 2009. A partir del análisis de ocho producciones científicas, se constató que el trabajo nocturno conlleva múltiples consecuencias para la salud y la enfermedad de los trabajadores como infecciones, envejecimiento, cambios de humor, trastornos de memoria, alteraciones gastrointestinales, impotencia, entre otras. Se concluye que, a pesar del trabajo nocturno tener un impacto negativo en la salud a menudo los trabajadores optan por trabajar a la noche debido al adicional pago en los turnos de la noche y por facilitar la realización de las tareas domesticas.

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O presente estudo teve como objetivo, estudar a influência dos aspectos cronobiológicos individuais na tolerância dos profissionais de enfermagem ao serviço noturno hospitalar. Classificou os profissionais de enfermagem do serviço noturno de acordo com o perfil cronobiológico, quantificou a sonolência desses profissionais, relacionou o grau de sonolência dos mesmos com seus respectivos cronotipos e discutiu teoricamente a aplicação da cronobiologia na organização do trabalho de enfermagem. Caracterizou-se como pesquisa de natureza aplicada; quantitativa quanto à forma de abordagem do problema; descritiva, do ponto de vista de seus objetivos e de levantamento, quanto aos procedimentos técnicos. A instituição campo da pesquisa foi um hospital universitário situado no estado do Rio de Janeiro. Através da técnica de amostragem não probabilística intencional, 33 profissionais de enfermagem, foram selecionados como sujeitos da pesquisa. Os instrumentos utilizados foram o Questionário Matutinidade/Vespertinidade de Horne e Ostberg e a Escala de Sonolência de Epworth. A coleta de dados durou dez dias do mês de agosto de 2008, cobrindo os três plantões da escala 12X60h. Os dados foram analisados através de estatística descritiva e os resultados apresentados sob a forma de gráficos. Diante dos resultados apresentados, verifica-se que houve o predomínio de técnicos de enfermagem na amostra estudada; a maior parte foi do sexo feminino, com idade média de 46 anos. O cronotipo predominante foi o indiferente e não se encontraram os extremos definitivamente matutinos e definitivamente vespertinos. Quanto ao grau de sonolência, a maioria dos sujeitos apresentou resultados diferentes da normalidade nos mais diferentes níveis. Quando o grau de sonolência foi aplicado a cada cronotipo separadamente, observou-se que os sujeitos de cronotipo moderadamente vespertino apresentaram uma boa tolerância ao trabalho noturno...

The present study has as objective to study the influence of the individual chronobiological aspects in the tolerance of the nursing professionals to the hospital night shift. Classified the professionals of nursing of the hospital night shift in accordance with their chronobiological profile, quantified the sleepiness of these professionals, related the degree of sleepiness of the professionals of nursing of the night shift with its respective chronotips and argued, in theory, the application of the chronobiology in the organization of the nursing work. This research was characterized as applied nature; quantitative to the form of boarding of the problem; descriptive, of the point of view of its objectives and survey, according to technician procedures. The institution of the research was an university hospital located in the state of Rio de Janeiro. Through the intentional sampling, 33 professionals of nursing is selected as citizens of the research. The instruments used were the Eveningness/Morningness Questionnaire and the Epworth Sleepiness Scale. The collection of data lasted ten days of the month of August of 2008, covering the three shifts in a 12X60h scale. The data were analyzed through descriptive statistics and the results presented under the form of graphs. Ahead of the presented results, most was verified that it had the predominance of nursing technician in the studied sample; of female sex, with average age of 46 years. Predominant chronotip was the indifferent one and it does not meet the definitly morningness and definitly eveningness one extrems. About the sleepiness degree, the majority of the citizens presents resulted different of normality in the most different levels. When the sleepiness degree was applied to each chronotip separately, was observed that the citizens of moderately eveningness chronotip presented a good tolerance to the night shift work...

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Se compararon los factores de riesgo relacionados con la úlcera péptica gastroduodenal en una muestra de 76 trabajadores, divididos en dos grupos: expuestos y no a nocturnidad; así como entre los subgrupos del primero. El diseño de estudio fue tipo analítico de corte transversal con un muestreo no probabilístico. Se aplicó la prueba Chi cuadrado (alfa > o = 95%) para la significación de las diferencias entre los grupos. E l grupo expuesto a nocturnidad y el subgrupo: rotativo de cambios rápidos, presentaron mayor incidencia de los factores de riesgo de la UPGD. Los turnos de trabajo nocturnos y específicamente los trabajadores con rotación rápida, tuvieron condiciones más propicias para la génesis de la UPGD, por la frecuencia de aparición de los factores de riesgo y presuponen mayor interacción con los trastornos en los ritmos circadianos de sus trabajadores.

The risk factors related with the gastroduodenal peptic ulcer were compared in a sample of 76 workers divided in two groups: exposed and not to nigth shift work as well as among the subgrups of the first one. The study design was analytic type of traverse court with a not probabilistic sampling. The test chi-square was applied (alfa > or = 95%) for the significance of the differences among the groups. The exposed group to night shift work and the subgrup with rotative quick changes shift work they presented bigger incidence of the risk factors for that desease. The night shift work and specifically the workers with rotative quick chances had more appropriated conditions for happening of the gastroduodenal peptic ulcer because the frequency of appearance of the risk factors and they presuppose bigger interaction with circadian rhythm dysruptions.

RESUMEN

Se calculó un modelo matemático-estadístico por medio del análisis multivariado discriminante a una muestra de 76 trabajadores, para diferenciar los trabajadores expuestos y no expuestos a nocturnidad; nos basamos en la expresión de los factores de riesgo relacionados con la úlcera péptica gastroduodenal (p<0,05) y se determinó de forma comparativa entre los grupos la percepción subjetiva de adaptación al turno de trabajo . El diseño de estudio fue analítico de corte transversal. Los instrumentos aplicados para explorar los factores de riesgo fueron: Factores de individualidad, Personalidad, Escala Sintomática de Estrés, Exploración de Fatiga Laboral y Situación Laboral .Se aplicó la Escala Analógico-Visual como instrumento de evaluación de la percepción subjetiva de adaptación al turno de trabajo. La función discriminante calculada tuvo una capacidad de pronóstico de 86,8% y la percepción subjetiva de adaptación al turno de trabajo fue mala en 43,4 % de la muestra, sin diferencias significativas entre los grupos. La capacidad discriminante de este modelo puede constituir un primer paso en la estrategia de prevención de esta afección en nuestros trabajadores y alertarnos acerca del valor que pueden tener variables psicológicas como la percepción subjetiva de adaptación al turno de trabajo en la misma.

A mathematical-statistical model was calculated by means of the multivariade discriminant analysis (p <0,05) to a sample of 76 workers, to differentiate the exposed workers and not to night shift work, basing us on the expression of the risk factors related with the gastroduodenal peptic ulcer and the subjetive perception of adaptation to the type of shift work was determinated in comparative form betwen groups. The study design was analytic of traverse court. The instruments applied to explore the factors of risk were: Factors of Individuality, Personality, Symptomatic Scale of Stress, Exploration of Labor Fatigue and Labor Situation. The analogical-visual Scale was applied to evaluate the subjetive perception of adaptation to shift work. The calculated discriminant function had a capacity of prognostic of 86,8% and the subjetive perception of adaptation to shift work was bad in 43,4 % of the sample without any significant differencies betwen groups. This result can constitute a first step in the strategy of prevention of this affection in our workers and keep alert about impact of psicological variables as subjetive perception of adaptation to shift work in that desease.