Metodološki pristop ocenjevanja sindroma bolnih stavb pri zdravstvenih delavcih in zdravstvenih sodelavcih v opazovani bolnišnici

Kalender Smajlović, Sedina (author), Kukec, Andreja (mentor), Dovjak, Mateja (co-mentor)

Izhodišča Zdravstveni delavci, zdravstveni sodelavci/drugi zaposleni in pacienti so v bolnišničnem okolju izpostavljeni številnim dejavnikom tveganja. Epidemiološke presečne raziskave navajajo od 21 do 80 % pogostost sindroma bolnih stavb (SBS) v bolnišničnem okolju, medtem ko pogostost SBS v drugih notranjih okoljih znaša okoli 30 %. Namen Namen doktorske disertacije je bil razviti metodološki pristop za celovito oceno pogostosti SBS v povezavi z okoljskimi parametri pri zdravstvenih delavcih, zdravstvenih sodelavcih/drugih zaposlenih v opazovani bolnišnici. Metode Epidemiološka presečna raziskava je temeljila na različnih metodoloških pristopih. Uporabili smo mešano metodološko zasnovo, kombinacijo kvantitativne in kvalitativne raziskave. Podlaga za izvedbo raziskave je bil sistematični pregled znanstvene literature. Raziskava je potekala na vzorcu zdravstvenih delavcev (n = 258) in zdravstvenih sodelavcev/drugih zaposlenih (n = 78) v opazovani bolnišnici. Za samooceno pogostosti SBS med opazovanima populacijama smo uporabili standardizirana merska instrumenta za ocenjevanje kakovosti notranjega okolja (MM 040 NA Hospital in MM 040 NA Office). Kot orodje za analizo smo uporabili statistično programsko opremo SPSS za Windows (različica 21.0; IBM Corp; Armonk. NY. ZDA) (licenca: Univerza v Ljubljani, Slovenija). Uporabili smo metode opisne statistike, razlike smo testirali s Kruskal-Wallisovim testom ali ?2-kvadrat testom. Z metodo multiple regresijske analize smo ocenili vpliv neodvisnih spremenljivk (ocena prisotnih dejavnikov tveganja, dejavniki delovnega okolja, potencialno moteči dejavniki) na pojavnost simptomov SBS. Rezultate smo kot statistično značilne vrednotili pri vrednostih p ? 0,05. Rezultati Ugotovili smo, da so splošni simptomi SBS najpogostejši izmed vseh simptomov SBS pri zdravstvenih delavcih (51,9 %) in zdravstvenih sodelavcih/drugih zaposlenih (44,9 %). Zdravstveni delavci so izmed vseh okoljskih dejavnikov tveganja v najvišjem deležu samoocenili neprijeten vonj (39,1 %), zdravstveni sodelavci/drugi zaposleni pa zatohel zrak (34,6 %). Večje število zaznanih okoljskih dejavnikov tveganja zdravstvenih delavcev je pomenilo večje število navedenih simptomov SBS (ß = 0,205; p = 0,001). Manjša možnost vpliva na organizacijo dela je pomenila prisotnost večjega števila simptomov SBS (ß = 0,192; p = 0,001). Pri zdravstvenih delavcih, ki so redkeje ocenjevali prevelik obseg dela smo ugotovili pojavnost manjšega števila simptomov SBS (ß = –0,140; p = 0,021). Prisotnost nočnega dela je pozitivno vplivala na večjo prisotnost simptomov SBS (ß = 0,139; p = 0,012). Manjša zaskrbljenost s spremembami v delovni situaciji je pomenila pojavnost manjšega števila simptomov SBS (ß = –0,234; p = 0,000). Med izmerjenimi okoljskimi dejavniki tveganja ter obema skupinama opazovancev med ogrevalno in neogrevalno sezono smo ugotovili statistično značilno razliko v temperaturi zraka notranjih prostorov [°C] (p =

• Language: Slovenian
• Keywords: simptomi sindroma bolnih stavb, okoljski dejavniki, bolnišnični oddelki, metodološki pristop
• Work type: Doctoral dissertation
• Organization: MF - Faculty of Medicine
• Year: 2021
• PID: 20.500.12556/RUL-127032
• COBISS.SI-ID: 63731203
• Publication date in RUL: 14.05.2021

Secondary language

• Language: English
• Title: Methodological approach for assessment of sick building syndrome among health workers and co - workers in observed hospital

Abstract

Theoretical background Health workers, co-workers/other employees and patients are exposed to a number of risk factors in a hospital setting. Epidemiological cross-sectional studies report a 21 to 80 % incidence of sick building syndrome (SBS) in hospital settings, whereas the incidence of SBS in other indoor settings is about 30 %. Purpose The purpose of the doctoral dissertation was to develop a methodological approach for a comprehensive assessment of the frequency of SBS in relation to environmental parameters in health workers, co-workers/other employees in the observed hospital. Methods Epidemiological cross-sectional research was based on different methodological approaches. We used a mixed methodological design, a combination of quantitative and qualitative research. The basis for conducting the research was to conduct a systematic review of the scientific literature. The research was conducted on a sample of health workers (n = 258) and co-workers/other employees (n = 78) in the observed hospital. For self-assessment of the frequency of SBS among the observed populations, we used standardised measurement instruments to assess the quality of the internal environment (MM 040 NA Hospital and MM 040 NA Office). We used the statistical software SPSS for Windows (version 21.0; IBM Corp; Armonk. NY. USA) (license: University of Ljubljana, Slovenia). In our analysis we used descriptive statistics and the differences found were tested using the Kruskal - Wallis test or the chi-square test. Using the multiple regression analysis method, we assessed the influence of independent variables (assessment of present risk factors, work environment factors and potentially - disturbing factors) on the occurrence of SBS symptoms. The results were evaluated as statistically significant at p 䁤 0.05. Results We found that the general symptoms of SBS are the most common of all the symptoms of SBS experienced by health workers (51.9 %) and co-workers/other employees (44.9 %). Of all the environmental risk factors, health workers rated unpleasant odour the highest (39.1 %), while co-workers/other employees rated stale air (34.6 %) the highest. A higher number of perceived environmental risk factors by health workers meant a higher number of reported SBS symptoms (β = 0.205; p = 0.001). Due to a reduced capability of influencing the organisation of work meant there was a presence of a larger number of SBS symptoms (β = 0.192; p = 0.001). A lower number of SBS symptoms (β = -0.140; p = 0.021) were found in health workers who rarely considered their workload as excessive. The presence of night work had a positive effect on the increased incidence of SBS symptoms (β = 0.139; p = 0.012). Less concern about changes in the work situation meant the occurrence of fewer SBS symptoms (β = -0.234; p = 0.000). A statistically significant difference was found between the measured environmental risk factors and both groups of observed individuals dependent on seasons where heating was either used or not used/ with ambient indoor air temperature [°C] (p =

• Keywords: symptoms of sick building syndrome, environmental factors, hospital wards, methodological approach