Tesis

Hubungan antara pola kerja gilir dengan gangguan fungsi kognitif pada tenaga kesehatan di RS X = A Relationship between shift work and cognitive function impairment among healthcare workers at Hospital X.

Latar belakang: Pekerjaan dengan pola kerja gilir, khususnya yang irregular, dapat mengganggu irama sirkadian dan kualitas tidur yang kemudian berdampak pada fungsi kognitif. Meskipun penting, penelitian tentang kerentanan domain kognitif terkait pola kerja gilir masih terbatas. Kualitas tidur dan fungsi kognitif menjadi kritis dalam konteks pelayanan kesehatan di rumah sakit, di mana keputusan dan tindakan harus dilakukan dengan cepat dan tepat dalam menunjang keselamatan pasien. Metode: Penelitian ini merupakan penelitian analitik observasional dengan potong lintang untuk mengetahui hubungan pola kerja gilir dengan gangguan fungsi kognitif. Untuk mengukur kualitas tidur, digunakan Pittsburgh Sleep Quality Index bahasa Indonesia (PSQI-Ina), sementara fungsi kognitif dan domain kognitif diukur menggunakan Oxford Cognitive Screen (OCS) bahasa Indonesia (OCS-Ina), sebuah instrument kognitif untuk pasien stroke, yang sudah tervalidasi. Besar sampel minimal pada penelitian ini dihitung dengan rumus Slovin berjumlah 72 sampel. Korelasi,analisis komponen utama,analisis demografi dan regresi digunakan untuk mengkarakterisasi hubungan antara PSQI-Ina,OCS-Ina dan variabel penelitian lainnya. Hasil: Sebanyak 83 tenaga kesehatan masuk ke dalam kriteria inklusi dan diikutsertakan dalam penelitian. Hasil memperlihatkan sebanyak 16 responden (19,3%) mengalami gangguan fungsi kognitif pada domain Atensi serta 2 responden (2,4%) mengalami gangguan di 2 domain kognitif (Atensi dan Pengelolaan Angka). Hasil analisis statistik mendapatkan hubungan bermakna dengan tenaga kesehatan yang memiliki pekerjaan sampingan berisiko 12,8 kali lipat (OR 12,8; IK 95% 1,7-91; p = 0,011) mengalami gangguan kognitif. Lalu tenaga kesehatan yang mengalami kualitas tidur yang buruk (dengan nilai PSQI > 5) memiliki risiko 40,3 kali lipat (OR 40,3; IK 95% 2,2-708,1; p = 0,011) mengalami gangguan kognitif. Begitu juga tenaga kesehatan dengan pola kerja gilir irregular memiliki resiko mengalami gangguan kognitif sebesar 5,4 kali (OR 5,4; IK 95% 0,1-26,6; p = 0,036) Kesimpulan: Terdapat hubungan pola kerja gilir terhadap gangguan fungsi kognitif di tempat kerja. Rumah sakit sebaiknya memberikan prioritas pada jadwal kerja shift ergonomis, dengan menekankan kecepatan dan rotasi searah jarum jam, untuk mendukung kesejahteraan para pekerja kesehatannya.
Kata Kunci: Pola kerja gilir; tenaga kesehatan; gangguan fungsi kognitif; domain kognitif; PSQI; Oxford Cognitive Screen.


Background: Irregularities in shift work, especially those marked by unpredictability, can disrupt circadian rhythms and compromise sleep quality, consequently adversely affecting cognitive function. Despite its pivotal significance, there is a shortage of research on the susceptibility ofcognitive domains associated with irregular shift work. The connection between sleep quality and cognitive function becomes especially crucial in the healthcare service domain, particularly within the confines ofhospitals. In such environments, where decisions and actions require swift and accurate execution, the interplay between sleep quality and cognitive function is critical to ensuring the safety and well-being of patients. Methods: The objective of this research is to conduct an analytical observational study with a cross-sectional design, aiming to examine the correlation between shift work patterns and cognitive function impairment. The study utilizes the Pittsburgh Sleep Quality Index in Bahasa Indonesia (PSQI-Ina) to measure sleep quality. Cognitive function and cognitive domains are assessed using the Indonesian Oxford Cognitive Screen (OCS-Ina), a validated cognitive instrument for stroke patients. The minimum sample size for the research was determined, resulting in a calculated sample size of72 participants. Correlation analysis, principal component analysis, demographic analysis, and regression analysis are employed to characterize the relationships between PSQI-Ina, OCS-Ina, and other relevant research variables. Results: A total of 83 healthcare workers meeting the inclusion criteria were included in the study. Results indicated that 16 respondents (19.3%) experienced cognitive function impairment in the Attention domain, and 2 respondents (2.4%) experienced impairment in two cognitive domains (Attention and Number). Healthcare workers engaged in secondary employment were found to have a 12.8 times higher risk of experiencing cognitive impairment (OR 12.8; CI 95% 1.7-91; p = 0.011). Similarly, healthcare workers with poor sleep quality (PSQI score > 5) faced a 40.3 times higher risk of cognitive impairment (OR 40.3; CI 95% 2.2-708.1; p = 0.011). Likewise, healthcare workers working in irregular shift patterns had a 5.4 times higher risk of experiencing cognitive impairment (OR 5.4; CI 95% 0.1-26.6; p = 0.036). Conclusions: There is a correlation between shift work patterns and cognitive function impairment in the workplace. Hospitals should prioritize ergonomic shift work schedules, emphasizing speed and clockwise rotations, to support the well-being oftheir healthcare workers.
Keywords: Shift work; healthcare workers; cognitive impairment; cognitive domains; PSQI; Oxford Cognitive Screen