Sažetak | Uvod: Postupak kardiopulmonalne reanimacije (CPR) predstavlja jedan od najzahtjevnijih i najstresnijih postupaka vezanih uz bolničku, kao i izvanbolničku djelatnost. Sestrinstvo je, kao neizostavna sastavnica medicinskog tima u bazičnom i naprednom postupku oživljavanja, izloženo jačini popratnoga stresa reanimacije. Odgovor pojedinca na stres je subjektivan i individualan. Najčešće je praćen nizom emotivnih i somatskih reakcija koje proizlaze iz kompleksnosti samog događaja te dužini i učestalosti izloženosti CPR-u.
Cilj istraživanja: Utvrditi učestalost izloženosti studenata sestrinstva kardiopulmonalnoj reanimaciji, kao i jačinu doživljenoga stresa te faktore koji doprinose njegovom nastanku.
Ispitanici i metode istraživanja: Istraživanje je provedeno među 104 zdravstvena djelatnika (medicinske sestre i tehničari iz bolničkih i izvanbolničkih djelatnosti) koji su bili podijeljeni u dvije skupine: Skupinu I = sa višebrojnim iskustvom u CPR-u (CPR≥1) i Skupinu BI = sa prvim iskustvom u CPR-u (CPR=1). Anketni upitnik proveden je preko internetskog sučelja „Google Forms“, a rezultati statističke analize izraženi su numerički u obliku apsolutnih brojeva (n) i učestalosti (%) te prikazani u tablicama medijanom i interkvartilnim rasponom. Prisutnost razlika ispitana je Hi-kvadrat testom ili Fisherovim egzaktnim testom te Mann-Whitney U testom ili Kruskal-Wallis testom.
Rezultati istraživanja: Nakon provedenog istraživanja dobiveni rezultati mogu se podijeliti u pet skupina, a to su rezultati vezani uz sociodemografska obilježja ispitanika, opće parametre ocjene intenziteta stresa, objektivne čimbenike tijekom izvođenja CPR-a, subjektivne čimbenike tijekom izvođenja CPR-a te utjecaj edukacije iz CPR-a na smanjenje stresa. Ispitanici iz Skupine BI bili su mlađi (70% njih do 30 godina starosti, P<0.0001) te su imali većinom do 5 godina radnog iskustva (34%) za razliku od Skupine I u kojoj je bilo podjednako ispitanika mlađe (40%) te srednje životne dobi (40%) i gdje je čak 30% ispitanika imalo radno iskustvo duže od 16 godina. Također, ispitanici sa iskustvom su u značajno većem broju smatrali da stres ne utječe na njihove postupke tijekom reanimacije (83%) za razliku od ispitanika bez iskustva koji su bili uvjereni da stres bitno utječe na njihov rad (77%) (χ2=0.57; P=0.0001). Ispitanici iz obje skupine smatrali su da povećanju stresa tijekom izvođenja CPR-a najviše pridonosi kombinacija vanjskih i unutrašnjih (tj. osobnih) čimbenika te su reanimaciju mlade osobe ili djeteta naveli kao najjači osobni čimbenik koji pridonosi povećanju intenziteta stresa. Također, ispitanici sa iskustvom u značajno većem postotku osjećaju smirenost, bez promjena u svome radu tijekom sudjelovanja u CPR-u (57% Skupina I; P=0.035), dok ispitanici
sa jednim iskustvom u reanimaciji osjećaju i ubrzano lupanje srca, znojenje i glavobolju (32% Skupina BI; P=0.4457) koji se javljaju kao posljedica njihove nesigurnosti te manjka samopouzdanja. Obje ispitivane skupine smatrale su da bi organizacija dodatnih edukacija o kardiopulmonalnoj reanimaciji doprinijela smanjenju stresa tijekom njihovog sudjelovanja u samom postupku, kao i stalna dostupnost stručne osobe s kojom bi mogli otvoreno razgovarati.
Zaključak: Kardiopulmonalna reanimacija (CPR) predstavlja jedan od najstresnijih događaja za zdravstveno osoblje. Medicinske sestre i tehničari s višegodišnjim radnim iskustvom na radilištima gdje se učestalo susreću s postupkom kardiopulmonalne reanimacije mnogo bolje snalaze se u zadacima i izazovima koje izvođenje CPR-a stavlja pred njih zbog stečenog znanja i godina iskustva u kliničkoj praksi, a samim time, bolje se nose i sa stresom te njegovim posljedicama za razliku od zdravstvenog osoblja koje nema dovoljno iskustva u kliničkoj praksi. |
Sažetak (engleski) | Introduction: The cardiopulmonary resuscitation (CPR) is one of the most demanding and stressful procedures inside and outside the hospital. Nursing, as an indispensable component of the medical team in basic and advanced resuscitation procedures, is exposed to the severity of the accompanying stress of resuscitation. An individual's response to stress is subjective and individual. It is most often accompanied by a series of emotional and somatic reactions resulting from the complexity of the event itself and the length and frequency of exposure to CPR.
Aim of the research: To determine the frequency of exposure of nursing students to cardiopulmonary resuscitation, as well as the intensity of the experienced stress and the factors that contribute to its occurrence.
Subjects and research methods: The study was conducted among 104 healthcare professionals (nurses and technicians from inside and outside the hospital) who were divided into two groups: Group I = with multiple experience in CPR (CPR≥1) and Group BI = with first experience in CPR (CPR=1). The survey questionnaire was administered via the online interface "Google Forms", and the results of the statistical analysis were expressed numerically in the form of absolute numbers (n) and frequencies (%) and presented in tables with median and interquartile range. The presence of differences was examined using the Chi-square test or Fisher's exact test and the Mann-Whitney U test or Kruskal-Wallis test.
Results: After conducting the research, the results can be divided into five groups, namely results related to the sociodemographic characteristics of the respondents, general parameters of stress intensity assessment, objective factors during CPR performance, subjective factors during CPR performance, and the impact of CPR education on stress reduction. The respondents from Group BI were younger (70% of them under 30 years of age, P<0.0001) and had mostly up to 5 years of work experience (34%), unlike Group I, which had an equal number of respondents of young age (40%) and middle age (40%) and where as many as 30% of the respondents had work experience longer than 16 years. Also, significantly more respondents with experience believed that stress did not affect their actions during resuscitation (83%) compared to respondents without experience who were convinced that stress significantly affected their work (77%) (χ2=0.57; P=0.0001). Respondents from both groups believed that the combination of external and internal (i.e. personal) factors contributed most to the increase in stress during CPR, and they cited resuscitation of a young person or child as the strongest personal factor contributing to the increase in stress intensity. Also, respondents with
experience were significantly more likely to feel calm, without changes in their work during participation in CPR (57% Group I; P=0.035), while respondents with one experience in resuscitation also felt a rapid heartbeat, sweating, and headache (32% Group BI; P=0.4457), which occurred as a result of their insecurity and lack of self-confidence. Both groups considered that the organization of additional education on cardiopulmonary resuscitation would contribute to the reduction of stress during their participation in the procedure itself, as well as the constant availability of a professional with whom they could talk openly.
Conclusion: Cardiopulmonary resuscitation (CPR) represents one of the most stressful events for healthcare personnel. Nurses and technicians with many years of work experience at workplaces where they often encounter the procedure of cardiopulmonary resuscitation are much better at handling the tasks and challenges that performing CPR puts before them due to the acquired knowledge and years of experience in clinical practice, and thus, they are better they also deal with stress and its consequences, unlike health personnel who do not have enough experience in clinical practice. |