Workload of community health nurses during the covid-19 epidemic

Uvod: Epidemija covida-19 je korenito posegla v javno življenje in obremenila nekatere sisteme. S posebno stopnjo obremenitve se srečuje zdravstveno osebje, ki je neposredno in posredno v stiku s pacienti, ki so pozitivni na covid-19. Za medicinske sestre v patronažnem varstvu, ki dnevno vstopajo v stanovanja pacientov, situacija po marcu 2020 predstavlja večjo izpostavljenost možnosti okužbe ter s tem povezano večjo obremenjenost pri delu. Namen: Namen raziskave je raziskati stopnjo doživljanja obremenjenosti medicinskih sester v patronažnem zdravstvenem varstvu, povezano s spremembo načina dela v obdobju epidemije in ukrepov za zajezitev prvega vala nove koronavirusne bolezni covid-19 v Sloveniji. Odgovoriti smo želeli na naslednja raziskovalna vprašanja: Kakšno je bilo psihofizično zdravje medicinskih sester v patronažnem zdravstvenem varstvu, ki so delale v spremenjenih okoliščinah zaradi epidemije covid-19?Okužbe koga (sebe, svojih družinskih članov ali pacientov) je bilo medicinskih sester v patronažnem zdravstvenem varstvu v času epidemije covid-19 najbolj strah?Ključno raziskovalno vprašanje je bilo: Kako obremenjene so se medicinske sestre v patronažnem zdravstvenem varstvu počutile med epidemijo covid-19? Metode dela: V anketni vprašalnik je bil vključen vzorec patronažnih medicinskih sester, katerih starost se je gibala med 23 in 63 let in katerih povprečna delovna doba je znašala 25,4 let. Med anketiranci je bilo 96 % zaposlenih za polni delovni čas in 4 % za skrajšan delovni čas. V anketni vprašalnik so bile vključene lestvice za oceno počutja in strahu pred okužbo s covid-19, oceno stopnje zahtevnosti dela, oceno števila nadur, ki so jih anketirani opravljali med in pred epidemijo, in oceno sprememb organizacije dela, pri čemer smo sodelujoče vprašali, ali je do sprememb prišlo in ali so se jim zdele ustrezne. Raziskava je vsebovala tudi oceno zdravstvenih problemov sodelujočih v zadnjih dveh tednih pred izpolnjevanjem vprašalnika in vprašanje, ali je bilo zdravstveno stanje pred epidemijo slabše, enako ali boljše. Rezultati: Zaposlenim v patronažnem zdravstvenem varstvu nadure niso predstavljale problema, saj so pred epidemijo v povprečju delali več ur tedensko (xŻ = 39,7) kot med epidemijo (xŻ = 38,3). Razpon obsega dela se je povečal iz 20–48 ur na teden pred epidemijo na 18–60 ur dela na teden med epidemijo. Največjo stisko je sodelujočim predstavljal strah, da bi s koronavirusom okužili svoje družinske člane ali paciente, kar jih je skrbelo bolj, kot to, da bi se okužili sami. Med zdravstvenimi težavami so anketiranci najbolj izpostavili slabše spanje, glavobole ter prisotnost bolečin po telesu. Razprava in zaključek: V raziskavi nismo zaznali preobremenjenosti zaposlenih v patronažnem zdravstvenem varstvu zaradi povprečnega obsega delovnih ur. S trditvijo »V službi preveč delam.« se je za obdobje med epidemijo v primerjavi z obdobjem pred epidemijo strinjalo ali popolnoma strinjalo 6 % več anketiranih. Iz tega lahko sklepamo, da so se medicinske sestre v patronažnem zdravstvenem varstvu v času epidemije covid-19 počutile bolj obremenjene. Nekatere medicinske sestre v patronažnem zdravstvenem varstvu v času epidemije na delovnem mestu niso bile deležne nobenega načina za olajšanja dela, kot je psihološka podpora. Čeprav so se nekatere zdravstvene institucije zaprle ali zmanjšale obseg dela, so zaposleni v patronažnem zdravstvenem varstvu morali nadaljevati z delom. Potrebe pacientov namreč niso izginile ali se zmanjšale zaradi pojava epidemije.Introduction: The Covid-19 epidemic has radically interfered with public life and strained some public systems. Health workers who are in direct or indirect contact with patients positive for Covid-19 deal with a special type of work-overload. Community health nurses visit their patients’ homes every day. After March 2020, they are exposed to the possibility of contracting the disease daily and part of their work-overload is also connected to that. Purpose: The aim of this research is to find out the level of overload of community health nurses, related to work changes during epidemic and measures to contain the first wave of the new coronavirus disease Covid-19 in Slovenia. We wanted to answer the following research questions: What was the psychophysical health of community health nurses in changed circumstances due to the Covid-19 epidemic?Infection of whom (themselves, their family members or patients) were the community health nurses most afraid during the covid-19 epidemic? The main research question was: How burdened did community health nurses feel during the covid-19 epidemic? Methods: The sample included community health nurses aged between 23 and 63 years old with 25.4 years of work experience on average. The majority, 96 % of the sample, were employed full time and 4 % were working part-time. We used scales to assess the community health nurses’ well-being and fear of contracting Covid-19, different types of complexity of their work, changes in overtime before and during the Covid-19 epidemic, the change of work organization the community health nurses’ satisfaction with the implemented changes. We also asked them to assess their health and well-being in the 14 days before answering the questionnaire, and whether their symptoms were worse, the same or better before the epidemic. Results: Most of the community health nurses didn\u27t have a problem with working overtime and most of them worked less hours during the epidemic (x̄ = 38.3) than before (x̄ = 39.7). Working hours increased from 20-48 hours per week before the epidemic, to 18-60 hours per week during the epidemic. They were most distressed by the fear that they would infect their families and patients with Covid-19, not that they would contract it themselves. Some of them reported trouble sleeping, headaches and body pain. Discussion and conclusion: In our study, we did not detect work-overload of community health nurses due to the average number of working hours. Compared to the period before epidemic, 6 % more respondents agreed or completely agreed with the statement »I work too much at work.« From this we can conclude that the community health nurses were more overloaded with work during the Covid-19 epidemic. Some of them did not have access to any kind of support at work, for example psychological support. Even though almost every medical institution closed or reduced their working hours during the epidemics, community health nurses could not stop working. Their patients’ needs did not disappear or became reduced just because of an epidemic