护士六分钟步行试验期间夜班工作对心脏自主神经调节的影响

The impact of working night shifts on cardiac autonomic nervous regulation during the six-minute walk test in nurses.

作者信息

Zhan Taihe, Wei Xiumei, Zhang Ziying, Shi Zhimin, Xie Hongyan, Ma Xiaotao, Pan Suyue, Zha Daogang

机构信息

Department of General Practice, Nanfang Hospital, Southern Medical University, 1838 Northern Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.

Department of Neurology, Nanfang Hospital, Southern Medical University, 1838 Northern Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.

出版信息

BMC Nurs. 2024 Dec 18;23(1):907. doi: 10.1186/s12912-024-02563-y.

DOI:10.1186/s12912-024-02563-y

PMID:39696211

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11658303/

Abstract

BACKGROUND

Clinical nurses frequently face the necessity of working night shifts, often with insufficient opportunities for timely sleep recovery, which may negatively impact autonomic nervous system regulation. The aim of this study was to evaluate changes in heart rate variability (HRV) after the six-minute walk test (6MWT) in nurses post-night shift and to explore the impact of night shift work on cardiac autonomic regulation.

METHODS

Thirty-five female nurses, with a mean age of 28.7 years (range 21.0-37.0 years), participated in this study. On the first and second mornings after a night shift, the nurses performed the 6MWT. During the test, electrocardiogram (ECG) signals, blood pressure, and walking distance were recorded simultaneously.

RESULTS

Compared with the second postshift morning, on the first postshift morning, nurses presented higher ratings of perceived exertion (RPE), higher Borg scale scores, and a slower pulse rate before and after the 6MWT but covered a shorter walking distance. Additionally, HRV indicators such as the SDNN, RMSSD, pNN50, TP, VLF, LF, and HF were all higher on the first postshift morning. Regarding the amplitude of cardiac autonomic nervous regulation, variations in the RMSSD and pNN50 were both greater during the 6MWT on the first postshift morning, although there was no significant difference in post-6MWT recovery.

CONCLUSIONS

Night shifts appear to increase the activity of the autonomic nervous system in nurses on the first postshift morning and exert a greater inhibitory effect on parasympathetic activity during the 6MWT. Therefore, it is important to ensure timely recovery sleep and improve autonomic regulation after working night shifts.

KEYWORDS

Heart rate variability; Night shift; Autonomic nervous system; Six-minute walk test; Nurses.

TRIAL REGISTRATION

This study was retrospectively registered in the Clinicaltrials.gov. Registration Date: August 1, 2024.

CLINICALTRIALS

gov ID: NCT06542510.

摘要

背景

临床护士经常面临值夜班的情况，且往往没有足够的机会及时恢复睡眠，这可能会对自主神经系统调节产生负面影响。本研究的目的是评估夜班后护士在六分钟步行试验（6MWT）后心率变异性（HRV）的变化，并探讨夜班工作对心脏自主调节的影响。

方法

35名平均年龄为28.7岁（范围21.0 - 37.0岁）的女性护士参与了本研究。在夜班后的第一个和第二个早晨，护士们进行了6MWT。测试期间，同步记录心电图（ECG）信号、血压和步行距离。

结果

与夜班后第二个早晨相比，在夜班后第一个早晨，护士们在6MWT前后的自觉用力程度（RPE）评分更高、Borg量表得分更高、脉搏率更慢，但步行距离更短。此外，夜班后第一个早晨的HRV指标，如SDNN、RMSSD、pNN50、TP、VLF、LF和HF均更高。关于心脏自主神经调节的幅度，尽管6MWT后恢复无显著差异，但在夜班后第一个早晨的6MWT期间，RMSSD和pNN50的变化均更大。