Efetividade do extrato seco de Rosmarinus officinalis L. sobre sono, parâmetros metabólicos e estresse de trabalhadores de enfermagem: estudo quase-experimental

Abstract

Introduction: the work of emergency nursing professionals has been associated with stress, poor sleep quality and cardiovascular risk factors. The complexity of aspects involved in wellbeing and illness has increased the demand for alternative or complementary therapies, including the use of medicinal plants. Rosemary has therapeutic potential for these conditions and research into new evidence is needed. Objectives: to evaluate the effectiveness of oral administration of capsules with 500 mg of dry extract of Rosmarinus officinalis L. on the risk of cardiovascular events, sleep quality, stress and metabolic parameters of nursing professionals in emergency services. Method: this is an intervention study, of a quasi-experimental type, carried out with nursing professionals from emergency services, in the State of Rio Grande do Sul, Brazil. Participants received capsules with 500 mg of dry extract of Rosmarinus officinalis L. (Rosemary) for oral use (1g/day). Prior to the intervention, participants completed a sociodemographic and clinical questionnaire, the Pittsburgh Sleep Quality Index, the Depression, Anxiety and Stress Scale and underwent blood collection to analyze the glucose and lipid profile, and hair, for cortisol analysis. Cardiovascular risk was estimated using the Framingham Global Risk Score. During the intervention period, in the first 4 weeks, fasting blood glucose and triglycerides were analyzed. After the intervention, participants were reassessed with instruments used in the first stage. The risk for cardiovascular events was considered as the primary outcome and other variables as the secondary outcome. Data analysis with descriptive and inferential statistics. All ethical assumptions regarding research with people were respected. Research registered in the Brazilian Clinical Trials Registry nº RBR 88hrnnw. Results: the systematic review, carried out to support the quasi-experimental study, showed that 2-3 g/day of Rosmarinus reduced fasting blood glucose, as well as 10g. There was a decrease in other blood lipids with doses of 3 – 10 g of Rosmarinus powder. However, the risk of bias in the studies was high and the certainty of the evidence was low. The quasiexperimental study had a sample composed of 36 professionals, 61.1% aged < 40 years, 83.3% with a workload > 44 hours per week, 69.4% with central obesity, 61.1% with high cholesterol, 63.9% had poor quality sleep, 50.0% high to very high stress and 44.4% hair cortisol above 600pg/mg. Number of risk factors > 5 was associated with age. Hair cortisol < 600 pg/mg was associated with desirable high-density lipoprotein cholesterol values and > 600 pg/mg with increased triglycerides. The Framigham Score estimated a low risk for cardiovascular events. A direct correlation was identified between cardiovascular risk and age and a direct correlation between waist circumference and the Framingham risk score. With the intervention: there were few adverse effects, particularly sleep, anxiety, headache and stomach pain; a reduction in weight and systolic and diastolic blood pressure was identified, with a small to medium effect size; there was a reduction in the time to fall asleep, an improvement in subjective sleep quality and a reduction in stress symptoms (this with a large effect), which was not accompanied by a reduction in cortisol, which increased after the intervention; there was a decrease in serum triglycerides, with a small to moderate effect, even after 4 weeks of intervention, and in total cholesterol; the reduction of high-density lipoprotein cholesterol, with a large size effect, ensured that the average remained within normal parameters; there was a significant reduction in cardiovascular risk in male (9.16±6.85; 8.17±5.19) and female (2.31±4.00; 1.45±3.65) professionals. ) with a small intervention effect (n2G=0.018). Conclusion: the ingestion of capsules with dry Rosemary extract, with few adverse events, reduced the risk of cardiovascular events in nursing professionals in emergency services, improved sleep quality, reduced stress symptoms, improved metabolic parameters and, therefore, we confirmed the thesis that the ingestion of capsules with 500 mg of dry Rosemary extract is effective for these outcomes. However, the intervention time and/or dose used may not have been sufficient to improve the glycemic and cortisol levels of these workers. Contributions to nursing and health: consolidation of nursing science; stimulation of the role of nursing in research using phytotherapics; collaboration with the Política Nacional de Práticas Integrativas e Complementares and with the Política Nacional de Saúde do Trabalhador e da Trabalhadora; innovation with phytotherapics to reduce cardiovascular morbidity and mortality.