Shift Work, Work-Related Stress, and Hypertension among Healthcare Workers at the 37 Military Hospital, Accra Ghana

Abstract

Background of study: Hypertension is well documented as one of the major cause of morbidity and mortality in the developed world, the significance of hypertension in low-income countries is less well established. In Ghana, however, very little is being done about the disease and its associated risk factors, particularly among healthcare workers. There are several reports of hypertension and other chronic diseases among health care workers in medical facilities in Ghana. However, no study has been conducted to determine the association between shift work, work-related stress, and hypertension among healthcare workers at the 37 Military Hospital. Objective: The general objective of the study was to assess shift work and work-related stress and their association with hypertension among healthcare workers at 37 Military Hospital. Methods: Participants of this cross-sectional study included 300 healthcare workers who were randomly selected from 7 professions (Doctors, Nurses, Laboratory professionals, Public Health staff, Dental staff, Radiology staff and Ward Assistants) at 37 Military hospital. Data were collected between March and June 2018 using four-part Questionnaire and an OMRON digital sphygmomanometer was also used to measure the blood pressure of participants three times with 5 minutes resting period. Hypertension was defined according to the guideline of the National Institute for Health and Care Excellence (Systolic of ≥ 140 and a diastolic of ≥ 90) . Data management: Collected data were coded before being entered into Statistical Package for Social Sciences (SPSS) version 24 before importing into STATA version 15. Descriptive statistics including frequency tables, pie charts and bar charts were used to display data. Frequency tables for socio-demographic, determinant of interest and outcome of interest were generated. Continuous data were reported as the mean and standard deviation (or median and interquartile range where the data was not normally distributed), while categorical data were reported as proportions. Ethics: A written consent was sought from all respondents before including them as participants in the study. Privacy and confidentiality were maintained at all times. To ensure confidentiality, the questionnaires were coded prior to dissemination and names were not required in filling out questionnaires. Participation in this study was entirely voluntary. Results: The median age of the study was 30 years (IQR =. 10). The prevalence of hypertension among the selected healthcare workers at the 37 Military hospital, Accra was 7% , while about 48% of the healthcare workers were on shift work schedule. High job strain (work-related stress) among healthcare workers was found to be 41.7% which was observed to be significantly related to hypertension (IQR = 18.3, P = <0.0001) with about 86.4% of healthcare workers with hypertension having high job strain (χ 2 = 19.514, p < 0.0001). 89.6% of health care workers had adequate knowledge of the risk factors for hypertension. Conclusion: A significant number of healthcare workers reported experiencing high job strain and apparently work-related stress was found to be significantly associated with hypertension. It was also observed that the joint association of shift work and high job strain was significantly associated with hypertension. It is therefore explicitly possible that work-related stress and the joint association of shift work and high job strain are contributing factor to the presence of hypertension among healthcare workers at the 37 Military hospital, Accra.