تأثير نور درخشان بر خستگي و خواب آلودگي پرستاران نوبت كار

The effect of bright light on fatigue and sleepiness of shift work nurses

ﻣﻘﺪﻣﻪ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﺄﺛﯿﺮ ﻧﻮر درﺧﺸﺎن را ﺑﺮ ﺧﺴﺘﮕﯽ و ﺧﻮاب آﻟﻮدﮔﯽ ﭘﺮﺳﺘﺎران ﺑﺮرﺳﯽ ﮐﺮديم. روش ﺑﺮرﺳﯽ: 44 ﭘﺮﺳﺘﺎر ﺧﺎﻧﻢ ﺳﺎﻟﻢ از ﺑﯿﻦ ﭘﺮﺳﺘﺎران ﻧﻮﺑﺖ ﮐﺎر در دو ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﺷﺎﻫﺪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ ﮐﻪ در ﻣﺮﺣﻠﻪ اول ﺑ ﮔﺮوه ﻣﺪاﺧﻠﻪ ﻧﻮر درﺧﺸﺎن از ﻃﺮﯾﻖ ﺟﻌﺒﻪ ﻧﻮر ﺗﺎﺑﯿﺪه ﺷﺪ و ﺑﻪ ﮔﺮوه ﺷﺎﻫﺪ ﻧﻮري ﺗﺎﺑﯿﺪه ﻧﺸﺪ. در ﻣﺮﺣﻠﻪ ﺑﻌﺪ (ﯾﮏ ﻣﺎه ﺑﻌﺪ) ﺟﺎي دو ﮔﺮوه ﻋﻮض ﺷﺪ و اﯾﻦ ﺑﺎر ﺑﻪ ﮔﺮوﻫﯽ ﮐﻪ در ﻣﺮﺣﻠﻪ ﻗﺒﻞ ﻧﻮر درﺧﺸﺎن ﻧﺪاده ﺑﻮدﯾﻢ ﻧﻮر دادﯾﻢ و ﺑﺮﻋﮑﺲ. ﭘﯿﺎﻣﺪي ﮐﻪ ﭘﺲ از اﻧﺠﺎم ﻣﺪاﺧﻠﻪ ﺑﺮرﺳﯽ ﮐﺮدﯾﻢ، روﻧﺪ ﺗﻐﯿﯿﺮات ﺧﺴﺘﮕﯽ (ﻣﻘﯿﺎس آﻧﺎﻟﻮگ ﺑﺼﺮي) و ﻣﻘﯿﺎس ﺧﻮاب آﻟﻮدﮔﯽ ﮐﺎروﻟﯿﻨﺴﮑﺎ ﺑﻮدﻧﺪ. ﺧﺴﺘﮕﯽ و ﺧﻮاب آﻟﻮدﮔﯽ ﻃﯽ 24 ﺳﺎﻋﺖ ﻫﺮ ﺳﺎﻋﺖ اﻧﺪازه ﮔﯿﺮي ﺷﺪ. ﻧﺘﺎﯾﺞ: در ﻣﻮرد ﻣﻘﯿﺎس آﻧﺎﻟﻮگ ﺑﺼﺮي ﺧﺴﺘﮕﯽ، روﻧﺪ ﺗﻐﯿﯿﺮات ﭘﺎﺳﺦ در دو ﮔﺮوه ﺧﻼف ﻫﻢ ﺑﻮد و در اﮐﺜﺮ ﻃﻮل دوره ﻣﻘﺪار ﻣﯿﺎﻧﮕﯿﻦ در ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﮐﻨﺘﺮل ﺗﻔﺎوت ﻣﻌﻨﯽ داري داﺷﺖ. در ﻣﻮرد ﻣﻘﯿﺎس ﺧﻮاب آﻟﻮدﮔﯽ ﮐﺎروﻟﯿﻨﺴﮑﺎ ﻧﯿﺰ اﺛﺮ ﻣﺪاﺧﻠﻪ ﺑﺮ ﭘﺎﺳﺦ در ﻫﻤﻪ دوره زﻣﺎﻧﯽ ﻣﻌﻨﯽ دار ﺑﻮد، ﯾﻌﻨﯽ ﻣﯿﺎﻧﮕﯿﻦ ﻣﻘﯿﺎس ﮐﺎروﻟﯿﻨﺴﮑﺎ در ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﮐﻨﺘﺮل ﺗﻔﺎوت ﻣﻌﻨﯽ داري داﺷﺖ و روﻧﺪ ﺗﻐﯿﯿﺮات ﮔﺮوه ﮐﻨﺘﺮل و ﻣﺪاﺧﻠﻪ، در ﺟﻬﺖ ﺧﻼف ﻫﻢ ﺑﻮدﻧﺪ. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﺑﺎ ﺗﺎﺑﺶ ﻧﻮر درﺧﺸﺎن در ﭘﺮﺳﺘﺎران ﻧﺘﯿﺠﻪ ﮔﺮﻓﺘﯿﻢ ﮐﻪ روﻧﺪ ﺧﺴﺘﮕﯽ و ﺧﻮاب آﻟﻮدﮔﯽ در اﯾﺸﺎن ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل، ﮐﺎﻣﻼ ﺑﺮﻋﮑﺲ ﺷﺪ. ﺣﺪاﻗﻞ ﺧﺴﺘﮕﯽ در ﮔﺮوه ﻣﺪاﺧﻠﻪ در ﺳﺎﻋﺖ 4 ﺻﺒﺢ رخ داد ﮐﻪ در ﮔﺮوه ﮐﻨﺘﺮل زﻣﺎن ﺣﺪاﮐﺜﺮي ﺧﺴﺘﮕﯽ ﺑﻮد. در ﻣﻮرد ﺧﻮاب آﻟﻮدﮔﯽ ﮐﺎروﻟﯿﻨﺴﮑﺎ ﻧﯿﺰ در ﮔﺮوه ﻣﺪاﺧﻠﻪ ﮐﻪ ﻣﻮاﺟﻬﻪ ﺑﺎ ﻧﻮر درﺧﺸﺎن داﺷﺘﻨﺪ، ﺣﺪاﻗﻞ ﺧﻮاب آﻟﻮدﮔﯽ در ﺳﺎﻋﺖ 4 ﺻﺒﺢ ﺑﻮد.

Introduction: In this study, we assessed the effect of bright light emitted by light box on fatigue, and sleepiness of nurses. Methods: Forty four healthy female shift work nurses were allocated into two groups of intervention and control. In the first stage, bright light was emitted to the nurses in the intervention group by the light box, and bright light was not emitted to the control group. In the next stage (one month later), we emitted bright light to the control group in the first stage (cross- over design). Main outcome measures assessed were fatigue and sleepiness. We used Visual Analogue Scale (VAS) of fatigue, and, Karolinska Sleepiness Scale (KSS). Fatigue and sleepiness were assessed every hour, during next 24 hours. Results: During 24 hours of the assessment of fatigue (VAS), the trend of changes in two groups were in opposite direction and almost all the time of 24 hours, the mean value of two groups were significantly different. In addition, the effect of intervention on the mean values of KSS during 24 hours was significant and the mean values in two groups were significantly different and the trend of changes in two groups were in opposite direction. Conclusion: The bright light exposure in nurses resulted in changing the trend of fatigue and sleepiness in opposite directions compared to the controls. The minimum of fatigue occurred at 4 am which was time of maximum fatigue in the controls. Also, minimum sleepiness in the cases who were exposed to the bright light was at 4 am.