Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
COVID-19 Salgınının Sağlık Çalışanlarında İkincil Travmatik Strese ve Uyku Kalitesi Üzerine Etkisi
The Effect of COVID-19 Outbreak on Secondary Traumatic Stress and Sleep Quality in Healthcare Workers
Ezgi DEMİRTÜRK SELÇUKa, Birsel Canan DEMİRBAĞb
aErzincan Binali Yıldırım Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Erzincan, TÜRKİYE
bKaradeniz Teknik Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Halk Sağlığı Hemşireliği ABD, Trabzon, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2021;13(3):533-43
doi: 10.5336/nurses.2020-79415
Article Language: TR
ÖZET
Amaç: Bu araştırmanın amacı, sağlık çalışanlarında koronavirüs salgınının ikincil travmatik stres ve uyku kalitesiyle ilişkisini incelemektir. Gereç ve Yöntemler: Tanımlayıcı olarak planlanan bu araştırmanın evrenini, Türkiye'deki 1, 2 ve 3. basamak sağlık hizmetlerinde görev yapan sağlık çalışanları oluşturmuştur. Araştırmada, kartopu örneklem seçim yöntemi kullanılmış ve araştırmaya katılmayı gönüllü olarak kabul eden sağlık çalışanları araştırma kapsamına alınmıştır. Veriler, kişisel bilgi formu, İkincil Travmatik Stres Ölçeği ve Pittsburgh Uyku Kalitesi İndeksi kullanılarak toplanmıştır. Verilerin tanımlayıcı istatistikleri frekans, yüzde, ortalama, standart sapma, medyan, minimum, maksimum olarak verilmiştir. İstatistiksel karşılaştırmalar için ANOVA, Kruskal-Wallis, Mann-Whitney U testi ve Spearman korelasyon analizi kullanılmıştır. Araştırmadan elde edilen veriler, SPSS (Statistical Package for Social Science) 22.0 istatistik programıyla analiz edilmiştir. Bulgular: Çalışmaya katılan sağlık çalışanların %45,2'si 31-40 yaşında, %77,6'sı kadın, %61,1'i lisans mezunu, %76,2'si hemşire/ebe, %64,4'ü evli, %43,9'unun çocuğu yok, %65'i eşi ve çocuklarıyla birlikte yaşamaktadır. Sağlık çalışanlarının %39,6'sı koronavirüs hastalığı-2019 [coronavirus disease-2019] (COVID-19)] testi pozitif çıkan hastaya bakım vermiş ve %9,2'sine COVID-19 tanısı konulmuştur. Sağlık çalışanlarının Pittsburgh Uyku Kalitesi İndeksi toplam puan ortalamalarının 8,84±3,58 olduğu saptanmıştır. Araştırmada çalışanların ikincil travmatik stres ölçeği puan ortalaması 45,01±15,51 olarak bulunmuştur. Sonuç: Bu çalışmayla bu grubun, uykusuzluk ve ikincil travmatik streslerinin yüksek olduğu tespit edilmiştir. Çalışmanın sonuçları doğrultusunda pandemi döneminde sağlık çalışanlarının çalışma saatlerinin planlanmasının çok dikkatli yapılması ve sirkülasyon yöntemiyle COVID-19 hastalarına bakmaları önerilebilinir.

Anahtar Kelimeler: COVID-19; uyku; stres bozuklukları; post travmatik
ABSTRACT
Objective: The aim of this study is to examine the relationship between the coronavirus epidemic and secondary traumatic stress and sleep quality in healthcare workers. Material and Methods: The universe of this descriptive and cross-sectional study; in Turkey the primary care, health care workers who were working in secondary and tertiary health care services has joined. The snowball sampling method was used in the study, and healthcare workers who voluntarily accepted to participate in the study were included in the study. The data were collected using a personal information form, Secondary Traumatic Stress Scale, and Pittsburgh Sleep Quality Index (PSQI). Descriptive statistics of the data are given as frequency, percentage, mean, standard deviation, median, minimum, maximum. ANOVA, Kruskal-Wallis, Mann-Whitney U test and Spearman correlation analysis were used for statistical comparisons. The data obtained from the research were analyzed with SPSS (Statistical Package for Social Science) 22.0 statistics program. Results: Health workers participating in the study was 45.2% are 31-40 years old, 77.6% are women, 61.1% are undergraduate, 76.2% are nurses/midwives, 64.4% are married, 43.9% have no children, 65% are with their spouses and children live together. 39.6% of the healthcare professionals provided care to the patient who had a positive coronavirus disease-2019 (COVID-19) test, and 9.2% were diagnosed with COVID-19. It was determined that the PSQI total score mean of healthcare workers was 8.84±3.58. The secondary traumatic stress scale mean score of the employees in the study was found to be 45.01±15.51. Conclusion: The pandemic period causes psychological and physical disorders in healthcare workers. This study found that this group had high levels of insomnia and secondary traumatic stress. Considering that employees with this condition may make much more mistakes and experience burnout, it may be recommended to plan their working hours very carefully in line with the results of this study and to take care of COVID-19 patients with the circulation method.

Keywords: COVID-19; sleep; stress disorders; post-traumatic
REFERENCES:
  1. Lai CC, Wang CY, Wang YH, Hsueh SC, Ko WC, Hsueh PR. Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status. Int J Antimicrob Agents. 2020;55(4):105946. [Crossref] [PubMed] [PMC] 
  2. Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome -coronavirus-2 (SARS-CoV-2; coronavirus disease-19). Clin Exp Pediatr. 2020;63(4):119-24. [Crossref] [PubMed] [PMC] 
  3. Özlü A, Öztaş D. Yeni corona pandemisi (COVID-19) ile mücadelede geçmişten ders çıkarmak. [Learning lessons from the past in combating the novel coronavirus (COVID-19) pandemic]. Ankara Med J. 2020;20(2):468-81. [Crossref] 
  4. Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic. JAMA. 2020;21;323(15):1439-40. [Crossref] [PubMed] 
  5. Wu KK, Chan SK, Ma TM. Posttraumatic stress, anxiety, and depression in survivors of severe acute respiratory syndrome (SARS). J Trauma Stress. 2005;18(1):39-42. [Crossref] [PubMed] [PMC] 
  6. Atkinson P, French J, Lang E, McColl T, Mazurik L. Just the facts: protecting frontline clinicians during the COVID-19 pandemic. CJEM. 2020;22(4):435-9. [Crossref] [PubMed] [PMC] 
  7. Wu KK, Chan SK, Ma TM. Posttraumatic stress after SARS. Emerg Infect Dis. 2005;11(8):1297-300. [Crossref] [PubMed] [PMC] 
  8. Aysan E, Karaköse S, Zaybak A, Günay İsmailoğlu E. Üniversite öğrencilerinde uyku kalitesini etkileyen faktörler. [Sleep quality among undregraduate students and influencing factors]. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi. 2014;7(3):193-8. [Link] 
  9. Lange T, Dimitrov S, Born J. Effects of sleep and circadian rhythm on the human immune system. Ann N Y Acad Sci. 2010;1193:48-59. [Crossref] [PubMed] 
  10. Akdemir N, Özdemir L. Dinlenme-Uyku ve Düzensizliklerinde Hemşirelik Bakımı. Akdemir N, Birol L, editör. İç Hastalıkları ve Hemşirelik Bakımı. 4. Baskı. Ankara: Akademisyen Kitabevi; 2018. p.129-39.
  11. Çetinol T, Özvurmaz S. Hemşirelerde uyku kalitesi ve ilişkili faktörler. [Sleep quality and related factors in nurses]. Medical Sciences. 2018;13(4):80-9. [Link] 
  12. Benbir G, Karadeniz D. Uyku ile ilişkili solunum bozuklukları: obstrüktif uyku apne sendromu. [Sleep related breathing disorders: obstructive sleep apnea syndrome]. Turkiye Klinikleri J Neurol-Special Topics. 2010;3(3):27-40. [Link] 
  13. Kara N. Gazete kuryelerinde uyku kalitesinin ruhsal belirtiler ve yaşam kalitesi üzerine etkisi. [Effect of sleep quality on psychiatric symptoms and life quality in newspaper couriers]. Arch Neuropsychiatr. 2016;53:102-7. [Crossref] [PubMed] [PMC] 
  14. Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease-2019 (COVID-19) in january and february 2020 in China. Med Sci Monit. 2020;5;26:e923549. [Crossref] [PubMed] [PMC] 
  15. Çolak B, Şişmanlar ŞG, Karakaya I, Etiler N, Biçer Ü. Çocuk cinsel istismarı olgularını değerlendiren meslek gruplarında dolaylı travmatizasyon. [Vicarious traumatization in professionals working with sexually abused children]. Anadolu Psikiyatri Dergisi. 2012;13(1):51-8.
  16. Beck CT. Secondary traumatic stress in nurses: a systematic review. Arch Psychiatr Nurs. 2011;25(1):1-10. [Crossref] [PubMed] 
  17. Karakaş SA, Gönültaş N, Okanlı A. Vardiyalı çalışan hemşirelerde uyku kalitesi. [The quality of sleep of nurses who works shift workers]. Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2017;4(1):17-26. [Link] 
  18. Günaydın N. Bir devlet hastanesinde çalışan hemşirelerin uyku kalitesi ve genel ruhsal durumlarına etkisi. [The quality of sleep and effects on general mental health nurses who works in a state hospital]. Journal of Psychiatric Nursing. 2014;5(1):33-40. [Crossref] 
  19. Şentürk S. Yoğun bakım hemşirelerinin tükenmişlik düzeyleri ile uyku kalitesi arasındaki ilişkinin incelenmesi. [Evaluation of the relationship between burnout levels and sleep quality in the intensive care unit nurses]. Bozok Med J. 2014;4(3):48-56. [Link] 
  20. Bride BE, Robinson MM, Yegidis BL, Figley CR. Development and validation of the secondary traumatic stress scale. Research on Social Work Practice. 2004;14(1):27-35. [Crossref] 
  21. Yıldırım G, Kıdak LB, Yurdabakan İ. İkincil travmatik stres ölçeği: bir uyarlama çalışması. [Secondary traumatic stress scale: an adaptation study]. Anadolu Psikiyatri Dergisi. 2018;19(1):45-51. [Crossref] 
  22. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. [Crossref] [PubMed] 
  23. Yücel Ağargün M, Kara H, Anlar Ö. Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. [The validity and reliability of the Pittsburgh sleep quality index]. Türk Psikiyatri Dergisi. 1996;7(2):107-15. [Link] 
  24. Alpar R. Uzaklık ve benzerlik ölçüleri. Uygulamalı Çok Değişkenli İstatistiksel Yöntemler. 5. baskı. Ankara: Detay Yayıncılık; 2017. p.153-73. [Link] 
  25. Özdemir C. Erciyes üniversitesi tıp fakültesi hastanelerinde çalışan hekim dışı sağlık personelindeuyku kalitesi ve ilişkili faktörler. [Sleep quality and associated factors among non-physician health personnel working in Erciyes university medical faculty hospitals]. Journal of Health Sciences. 2014;23(2):66. [Link] 
  26. Dong H, Zhang Q, Sun Z, Sang F, Xu Y. Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors. BMC Psychiatry. 2017;3;17(1):241. [Crossref] [PubMed] [PMC] 
  27. Kara B, Tenekeci EG. Sleep quality and associated factors in older Turkish adults with hypertension: a pilot study. J Transcult Nurs. 2017;28(3):296-305. [Crossref] [PubMed] 
  28. Shim J, Kang SW. Behavioral factors related to sleep quality and duration in adults. J Lifestyle Med. 2017;7(1):18-26. [Crossref] [PubMed] [PMC] 
  29. Arslan M. Aydemir İ. Sağlık çalışanlarının uyku kalitesi ve fiziksel aktivite durumlarının beden kitle [The relationship between sleep quality and physical activity status of health personnel with their body mass index]. Turkiye Klinikleri J Health Sci. 2020;5(1):1-9. [Crossref] 
  30. Restauri N, Sheridan AD. Burnout and posttraumatic stress disorder in the coronavirus disease-2019 (COVID-19) pandemic: intersection, impact, and interventions. J Am Coll Radiol. 2020;17(7):921-6. [Crossref] [PubMed] [PMC] 
  31. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;2;3(3):e203976. [Crossref] [PubMed] [PMC] 
  32. Lerias D, Byrne MK. Vicarious traumatization: symptoms and predictors. Stress Health. 2003:19(3):129-38. [Crossref] 
  33. Zara A, İçöz JF. Türkiye'de ruh sağlığı alanında travma mağdurlarıyla çalışanlarda ikincil travmatik stres. [Secondary traumatic stress in mental health workers in Turkey]. Klinik Psikiyatri Dergisi. 2015;18(1):15-23. [Link] 
  34. Arslan S, Özer N. Yoğun bakım hastalarının duyusal girdi sorunlarında tamamlayıcı istatistikler. [Complementary treatments for the sensory input problems of ıntensive care patients]. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2010;13(2):68-75. [Link] 

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