Shift work sleep disorder and job stress in shift nurses: implications for preventive interventions

Background:A growing literature has revealed a relationship between shift-work, including night-shift, and the disturbance of sleep-wake cycle, leading to insomnia and/or increased daytime sleepiness in shift nurses; recent findings showed an association between shift work sleep disorders and distress, work accidents, decreased job performance and, consequently, lower quality of health service provision and lower standards of care.Objectives:To analyze across the gender how shift nurses experience shift work sleep disorders and job stress.Methods:A cross-sectional study was performed following the STROBE Statement. The Italian version of the Job Content Questionnaire, the Bergen Insomnia Scale and the Epworth Sleepiness Scale were administered to the registered nurses employed in three Departments of General Practice and Elderly Care Medicine.Results:No significant association was found between high job strain and insomnia and daytime sleepiness. Significantly more women than men experienced high job strain, insomnia and daytime sleepiness; among women the level of social support was significantly and negatively associated with insomnia and daytime sleepiness.Conclusions:The findings of this study suggest that interventions aimed to prevent shift work sleep disorder and job stress in shift-nurses should incorporate the assessment of social support across the gender. Moreover, longitudinal studies are required to evaluate the effectiveness of interventions targeted on social support to minimize the occurrence of insomnia and daytime sleepiness in shift nurses.Key words: Shift work, work related stress, insomnia, sleepiness, interventions     

Two alternative job stress models and the risk of coronary heart disease.

OBJECTIVES: This study examined the association between two alternative job stress models-the effort-reward imbalance model and the job strain model-and the risk of coronary heart disease among male and female British civil servants. METHODS: The logistic regression analyses were based on a prospective cohort study (Whitehall II study) comprising 6895 men and 3413 women aged 35 to 55 years. Baseline measures of both job stress models were related to new reports of coronary heart disease over a mean 5.3 years of follow-up. RESULTS: The imbalance between personal efforts (competitiveness, work-related overcommitment, and hostility) and rewards (poor promotion prospects and a blocked career') was associated with a 2.15-fold higher risk of new coronary heart disease. Job strain and high job demands were not related to coronary heart disease; however, low job control was strongly associated with new disease. The odds ratios for low job control were 2.38 and 1.56 for self-reported and externally assessed job control, respectively. Work characteristics were simultaneously adjusted and controlled for employment grade level, negative affectivity, and coronary risk factors. CONCLUSIONS: This is apparently the first report showing independent effects of components of two alternative job stress models-the effort-reward imbalance model and the job strain model (job control only)-on coronary heart disease.     

Sociodemographic and cultural determinants of sleep deficiency: Implications for cardiometabolic disease risk

Sleep is a biological imperative associated with cardiometabolic disease risk. As such, a thorough discussion of the sociocultural and demographic determinants of sleep is warranted, if not overdue. This paper begins with a brief review of the laboratory and epidemiologic evidence linking sleep deficiency, which includes insufficient sleep and poor sleep quality, with increased risk of chronic cardiometabolic diseases such as obesity, diabetes and hypertension. Identification of the determinants of sleep deficiency is the critical next step to understanding the role sleep plays in human variation in health and disease. Therefore, the majority of this paper describes the different biopsychosocial determinants of sleep, including age, gender, psychosocial factors (depression, stress and loneliness), socioeconomic position and race/ethnicity. In addition, because sleep duration is partly determined by behavior, it will be shaped by cultural values, beliefs and practices. Therefore, possible cultural differences that may impact sleep are discussed. If certain cultural, ethnic or social groups are more likely to experience sleep deficiency, then these differences in sleep could increase their risk of cardiometabolic diseases. Furthermore, if the mechanisms underlying the increased risk of sleep deficiency in certain populations can be identified, interventions could be developed to target these mechanisms, reduce sleep differences and potentially reduce cardiometabolic disease risk.     

职业应激与稳态应变负荷关系的研究

目的探讨职业应激与稳态应变负荷(AL)之间的关系。方法采用工作内容量表(JCQ-22)对4家企业963名职工进行职业应激状况调查和健康体检,选择13个生理生化项目为AL,包括体重指数(BMI)、腰围/臀围(WHR);收缩压(SBP)、舒张压(DBP);血C-反应蛋白(CRP)、高密度脂蛋白(HDL)、总胆固醇(TC)/HDL、三酰甘油(TG)、糖化血红蛋白(HbAC1)、空腹胰岛素/空腹血糖、12h尿皮质醇(Col)、12h尿肾上腺素。根据各项指标的四分位数的方法对AL赋分,总计0~13分。采用α系数、协方差分析、多元逐步回归对数据进行分析(SPSS13.0)。结果问卷全部回收,合格率100%;在调整了年龄因素后AL的职业应激组(4.78±3.30)与非职业应激组(3.85±2.10)间比较,差异有显著性(F=8.38,P<0.01),并且两组间的BMI[(25.45±4.84)和(23.40±3.61)kg/m2]、SBP[(122.20±21.00)和(113.5±13.87)mmHg]、DBP[(78.67±10.81)和(75.18±9.52)mmHg]、TG[(2.04±1.00)和(1.36±0.97)mmol/L]、TC/HDL[(3.51±0.54)和(3.22±0.59)]、Col[(23.06±4.70)和(19.62±9.15)μg/g]比较差异均有显著性(P<0.05,P<0.01或P<0.001)。多元逐步回归结果显示工作控制和工作需求是AL的独立危险因素。结论职业应激与AL存在相关关系。     

供电企业运检人员职业紧张的危险因素研究

目的明确供电运检人员职业紧张的现状,探索职业紧张的相关危险因素。方法采用横断面研究方法对329名大型供电企业运检人员进行问卷调查,对相关数据进行χ~2检验、t检验、方差分析、非条件Logistic回归分析。结果各组间不同婚姻状况、频繁不良工作姿势作业和加班对职业紧张影响存在差异(P0.05); Logistic回归表明,年龄(OR=1.068)、体育锻炼(OR=0.658)、加班(OR=5.641)和工作后疲劳程度(OR=1.461)最终进入方程,是职业紧张的相关因素。结论体育锻炼是职业紧张的保护性因素,年龄、加班和工作后疲劳程度是职业紧张的危险因素,建议从生活习惯和作业制度两方面对职业紧张进行干预。     

Psychosocial stress and impaired sleep

This review demonstrates that stress is closely related to impaired sleep in cross-sectional studies. In particular, the anticipation of high demands or effort the next day seems important. Sleep recordings show that stress is associated with shortened sleep, fragmentation, and possibly a reduction in sleep stages 3 and 4. Shortened or disturbed sleep causes increases in levels of traditional stress markers (eg, cortisol) and may thus exacerbate the effects of stress. Much knowledge is still lacking, however, particularly about the effects of real-life work stress. The latter requires longitudinal studies in real-life situations.     

Change in job satisfaction,and its association with self-reported stress,cardiovascular risk factors and mortality

Many studies have suggested that occupational stress may be related to the development of cardiovascular disease (CVD), independently of other known risk factors. Despite the recognition of job satisfaction as a particular form of stress, however, few studies have examined its association with CVD. Those studies that have explored the associations between job satisfaction and CVD risk factors, or job satisfaction and CVD mortality, have been largely cross-sectional in approach and report contradictory findings. This study revisits the associations between job satisfaction, self-reported stress. CVD risk factors and CVD mortality using longitudinal data from a cohort of working Scottish men and women recruited between 1970 and 1973. Approximately half of the cohort was screened for a second time, 4-7yr after the baseline examination. Job satisfaction at baseline was strongly associated with low or moderate perceived stress at 2nd screening. Men and women reporting decreased satisfaction in their jobs between baseline and 2nd screening tended to report moderate or high perceived stress at 2nd screening. Job satisfaction was associated with own occupational class in different directions for men and women. Men in the manual social classes reported more satisfaction with their jobs than their peers, whilst it was women in the non-manual social classes who reported more satisfaction with their jobs than their peers. There was limited evidence of an association between job satisfaction and age-adjusted CVD risk factors (diastolic blood pressure; blood cholesterol; body mass index; forced expiratory volume in 1st amount of recreational exercise undertaken; cigarette smoking and alcohol consumption) for men, after adjustment for occupational class, but there was no evidence of any association for women. There was also no evidence to suggest that men or women reporting job dissatisfaction on one occasion or on two occasions several years apart, had a significantly greater risk of mortality from CVD.     

Psychosocial work environment and myocardial infarction: improving risk estimation by combining two complementary job stress models in the SHEEP Study

OBJECTIVES: Associations between two alternative formulations of job stress derived from the effort-reward imbalance and the job strain model and first non-fatal acute myocardial infarction were studied. Whereas the job strain model concentrates on situational (extrinsic) characteristics the effort-reward imbalance model analyses distinct person (intrinsic) characteristics in addition to situational ones. In view of these conceptual differences the hypothesis was tested that combining information from the two models improves the risk estimation of acute myocardial infarction. METHODS: 951 male and female myocardial infarction cases and 1147 referents aged 45-64 years of The Stockholm Heart Epidemiology (SHEEP) case-control study underwent a clinical examination. Information on job stress and health adverse behaviours was derived from standardised questionnaires. RESULTS: Multivariate analysis showed moderately increased odds ratios for either model. Yet, with respect to the effort-reward imbalance model gender specific effects were found: in men the extrinsic component contributed to risk estimation, whereas this was the case with the intrinsic component in women. Controlling each job stress model for the other in order to test the independent effect of either approach did not show systematically increased odds ratios. An improved estimation of acute myocardial infarction risk resulted from combining information from the two models by defining groups characterised by simultaneous exposure to effort-reward imbalance and job strain (men: odds ratio 2.02 (95% confidence intervals (CI) 1.34 to 3.07); women odds ratio 2.19 (95% CI 1.11 to 4.28)). CONCLUSIONS: Findings show an improved risk estimation of acute myocardial infarction by combining information from the two job stress models under study. Moreover, gender specific effects of the two components of the effort-reward imbalance model were observed.     

Impact of a participatory organizational intervention on job characteristics and job stress.

Increased employee control and participation are recommended to achieve both "flexible organization" and improvements in health, as outlined in occupational stress intervention models. This study evaluates the impact of a participatory organizational intervention on job stress and job characteristics. The intervention was carried out in two post offices in the Norwegian Postal Service. "Local theories" were seen as the key drivers for organizational improvement and increased control. The underlying dynamics of the intervention were to manipulate employees' learning opportunity and decision authority so as to improve work environment and health. Work groups, in dialogue with a steering committee, conducted diagnosis, action planning, and action taking. Work conditions deteriorated during the observation period in the control groups. In one of the intervention groups, this negative trend was reduced by the intervention. Lack of positive results in the other intervention group may have been due to organizational restructuring and turbulence.     

农民工职业紧张与工作满意度关系

目的 初步探讨农民工职业紧张与工作满意度关系:心理资本的中介作用。方法 整群随机抽取安徽建筑工地、民营企业899名农民工,运用付出-回报失衡问卷、工作满意度问卷和心理资本问卷进行测量。结果 889名农民工工作满意度平均得分为(65.04±10.91)分,心理资本4个维度平均得分自我效能为(22.1±5.34)分,希望(23.7±4.67)分,韧性(23.5±3.61)分,乐观(22.6±2.69)分;外在付出与工作满意度呈负相关(r=-0.150,P<0.001),回报、内在投入和心理资本均与工作满意度呈正相关(均P<0.001),职业紧张在工作满意度的解释增量为30.6%,心理资本的中介作用对工作满意度解释增量为22.5%。结论 农民工工作满意度一般,外在付出、回报、内在投入对于工作满意度有良好的预测作用,心理资本在回报、内在投入与工作满意度的关系中起中介作用。     

Downsizing, role demands, and job stress

This is a cross-sectional study consisting of self-administered survey instruments to measure psychological distress and stress-inducing work demands after 6 months of rumors about an upcoming corporate downsizing event. The workforce consisted predominantly of white males who were married, college-educated, and nonsmokers. Higher stress levels were seen among older, more educated workers, who had longer company tenure. Role boundary problems, noxious physical environments, and company tenure were retained in the final multivariable model predicting distress level. The ongoing time delay for management to implement the threatened layoff and peer rankings for a new job performance appraisal contributed to a decline in worker solidarity because of concerns about career and job security. These uncertainties reduced worker productivity and effective teamwork.     

职业应激对工作疲竭感影响的层次回归分析

目的探讨职业人群中工作疲竭感的影响因素。方法以456名教师与外企员工为研究对象,问卷评估工作疲竭感,同时运用工作要求-自主模式与付出-回报失衡模式问卷评估职业应激程度。运用层次多元回归分析工作疲竭感与个体拓征和职业应激程度之间的关系。结果工作疲竭感3个维度情感耗竭得分为19．70±8．92,人格解体得分为11．95±4．45,个体成就感降低得分为28．10±10．08。职业应激对工作疲竭感的3个维度影响不同。工作要求、工作付出、内在驱动均对情感耗竭呈正向作用,而工作自主性对情感耗竭呈负向作用。人格解体受个体的年龄、性别和受教育程度的明显影响；同时工作自主程度、工作回报及内在驱动影响人格解体得分。个人成就感得分与受教育程度及社会支持关系密切。结论工作疲竭感的预防需要降低职业应激程度,同时关注个体特征。     

Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment

Background  

The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. Despite the fact that there have been plenty of studies on job satisfaction, none was specifically addressed to integrate the relational model of job rotation, role stress, job satisfaction, and organizational commitment among nurses.