Shift nurses’ social jetlag,anxiety, and premenstrual symptoms: A cross-sectional study

BackgroundAlthough rotating shifts are essential for nurses to ensure optimal patient care, rotating shifts expose them to an imbalanced circadian rhythm. Shift work leads to nurses experiencing diminished sleep quality, which affects their wakefulness and judgment, curtails work performance, and affects care quality.AimTo investigate the relationship among social jetlag, anxiety, and premenstrual symptoms in nurses working in 8-hour rotating shiftsMethodsParticipants were 194 shift-working nurses in three South Korean university hospitals from March 21 to April 2 in 2021. Chronotype and social jetlag were assessed using the Munich Chronotype Questionnaire for Shift Workers. Anxiety was measured with the State-Trait Anxiety Inventory X-1. Premenstrual symptoms were measured using the Shortened Premenstrual Assessment Form. This cross-sectional study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.FindingsAmong participants, the mean overall social jetlag was 3 hours 45 minutes. Hierarchical regression analysis revealed that social jetlag (on evening shift) and anxiety significantly influenced nurses’ premenstrual symptoms. Moreover, individuals’ chronotype and preference to work the night shift were identified as predictors of premenstrual symptoms.DiscussionNurses working on shifts are bound to experience greater social jetlag compared with the general population and are at an elevated risk of deteriorated quality of life. Nursing managers should consider individuals’ chronotypes and social jetlag when establishing shift schedules and identify strategies that relieve anxiety in nurses working in rotating shifts.ConclusionSocial jetlag and anxiety adversely affect premenstrual symptoms in female nurses working in 8-hour rotating shifts.     

Self-assessed quality of sleep, occupational health, working environment, illness experience and job satisfaction of female nurses working different combination of shifts

AIM: The aim of this study was to describe and compare the self-assessed quality of sleep, occupational health, working environment, illness experience and job satisfaction among female nurses working different combinations of shifts. BACKGROUND: Evidence from several studies indicates that there is an association between the disruption of the circadian cycle caused by shift work and adverse health effects. METHODS: A cross-sectional design was used with a sample of 348 nurses drawn from the registry of the Icelandic Nurses' Association, representing 17% of the workforce of Icelandic nurses. A self-administered questionnaire, measuring occupational health, quality of sleep, the illness experience, job satisfaction and working environment was used. Data were analysed according to type of shift (days only, rotating days/evenings, rotating days/evenings/nights) by use of analysis of variance and chi-square. RESULTS: No difference was found between participants based on type of shift with regard to the illness experience, job satisfaction and quality of sleep. Nurses working rotating day/evening/night shifts reported a longer working day, more stressful environmental risk factors, more strenuous work and that they were less able to control their work-pace. In general, the nurses reported low severity of symptoms; however, nurses working rotating days/evenings shifts experienced more severe gastrointestinal and musculoskeletal symptoms when compared with others. This was explained by the short rest period provided for between evening and morning shifts. CONCLUSIONS: In general Icelandic nurses are satisfied with their work and their shift assignment does not seem to pathologically disrupt their circadian cycle. Nevertheless, nursing directors are advised to look more closely at the organization of nurses' work during night shifts, as well as the rest period for nurses changing from evening to day shifts.     

The mediating and moderating effects of sleep hygiene practice on anxiety and insomnia in hospital nurses

This study aimed to test the mediating and moderating effects of sleep hygiene practice on the relationship between anxiety and insomnia severity in hospital nurses. A cross‐sectional survey was employed, and a convenience sample was recruited from one regional hospital in Taiwan. Participants completed the following self‐report questionnaires over a 3‐month period in 2009: the Insomnia Severity Index, the Beck Anxiety Inventory, and Sleep Hygiene Awareness and Practice Scale. The results indicated that nurses with more anxiety tended to have higher insomnia severity. Further, nurses with poor sleep hygiene practice had more insomnia. Sleep hygiene practice partially mediated the effects of anxiety on insomnia severity. Also, sleep hygiene practice was a moderator in the relationship between anxiety and insomnia severity with age and work units as covariates. Sleep hygiene practice mediated and moderated the relationship between anxiety and insomnia severity after controlling the variables of age and work units. Continuing to learn and train sleep hygiene practice might promote nurses' sleep hygiene, and thereby ameliorate anxiety and reduce the risk of insomnia.     

Nurses and shift work: effects on job performance and job-related stress

The purpose of this research was to examine the influence of day, afternoon, night and rotating shift schedules on the job performance and job-related stress of nurses. Registered nurses from five hospitals (n = 463) were surveyed using a structured questionnaire which measured both job performance and job-related stress. Analysis of data indicated that both the nurses' job performance and their job-related stress were related to the type of shift they worked. Overall job performance was highest for the nurses on the day shift, followed by the night, afternoon, and rotating shifts. Rotating shift nurses experienced the most job-related stress, followed in turn by the afternoon, day, and night shift nurses. The findings are interpreted within a conceptual framework which examines the social organization of work in the hospital by shift and the effects of shift work on biological rhythm synchronization.     

2种排班模式护理人员满意度分析

目的 探讨护理人员对2种排班模式的满意度。方法 在同一病区对30名护理人员不同时期分别实施AN(A指日班,N指夜班)连续性排班结合周夜班(周夜班组)和AN连续性排班结合轮夜班(轮夜班组)各8个月。比较2组护理人员满意度。 结果 护理人员满意度得分均低于最低标准。周夜班组工作被称赞和认可、福利待遇得分高于轮夜班组,轮夜班组家庭和工作的平衡、排班得分高于周夜班组。 结论 AN连续性排班结合周夜班与AN连续性排班结合轮夜班的排班模式护理人员满意度均低,2种排班模式各有优势。     

ICU护士工作反应时间现况及影响因素分析

目的 :比较可反映工作执行力的客观指标反应时间在ICU护士白、夜班上班前和下班后之间的差异及其影响因素。方法 :采用便利抽样法选取2家医院6个ICU的118名护士,通过自设一般资料问卷进行调查,使用精神运动警觉测试仪器实施测量。结果 :护士下班后(白班后为296.75 ms,夜班后为310.25 ms)反应时间均长于上班前(白班前为290.64 ms,夜班前为288.44 ms),夜班后(310.25 ms)长于白班后(296.75 ms),差异有统计学意义(P<0.05)。存在睡眠障碍的护士,夜班前(299.64 ms)及夜班后(363.33 ms)的反应时间均长于无睡眠障碍组(夜班前为285.56 ms,夜班后为306.40 ms)(P<0.05)。性别、孩子个数、医院工作年限、日工作时长、摄入咖啡因饮料、摄入甜品会对ICU护士上班前后反应时间产生不同程度的影响。结论 :建议护理管理者合理运用反应时间指标改善排班方法,识别其保护因素和危险因素,提高ICU护士工作执行能力。     

Sleep disorder in Taiwanese nurses: a random sample survey

This study determined the prevalence of and factors associated with insomnia in rotating-shift nurses. A two-stage, cross-sectional, hospital-based study was conducted in eastern Taiwan. Participants were randomly-sampled, rotating-shift nurses (n=661), ranging in age from 21 to 62 years, with a mean age of 31.86 (standard deviation=8.09). Insomnia disorder was identified using the Pittsburgh Sleep Quality Index. Nurses completed the self-reported Index, together with other questionnaires designed by the researchers for the purpose of the study. The prevalence of insomnia disorder was 59% (n=390). Multivariate logistic regression analyses revealed that poor sleepers are more likely to have higher anxiety, feelings of depression, and a poor working atmosphere. Anxiety, depression, and working atmosphere are independent predictors of insomnia. These results suggest that it is crucial to implement a more appropriate shift system and to develop prevention programs for nurses with insomnia to improve their occupational health.     

Effect of working consecutive night shifts on sleep time,prior wakefulness,perceived levels of fatigue and performance on a psychometric test in emergency registrars

Objective: To evaluate the effect of working consecutive night shifts on sleep time, prior wakefulness, perceived levels of fatigue and psychomotor performance in a group of Australian emergency registrars. Methods: A prospective observational study with a repeated within‐subjects component was conducted. Sleep time was determined using sleep diaries and activity monitors. Subjective fatigue levels and reciprocal reaction times were evaluated before and after day and night shifts. Results: A total of 11 registrars participated in the study with 120 shifts analysed. Sleep time was found to be similar during consecutive night and day shifts. The mean number of hours spent awake before the end of a night shift was 14.33. Subjective fatigue scores were worst at the end of a night shift. There was no difference in reciprocal reaction time between the end of night shift and the start of day shift. Conclusions: Registrars sleep a similar amount of time surrounding night and day shifts. Despite reporting the highest levels of fatigue at the end of a night shift, there is no significant difference in reaction times at the end of night shift compared with the beginning of day shift. This correlates with the finding that at the end of night shift the registrars have been awake for less than 16 h, which is the point at which psychomotor performance is expected to decline.     

轮班制对ICU女护士昼夜活动节律与疲倦的影响

目的 比较ICU女护士不同工作时长（8 h和12 h）昼夜活动节律相关指标与工作前后疲倦的差异,并分析疲倦程度的影响因素。 方法 采用便利抽样法选取北京市3所三级甲等综合医院228名ICU女护士,通过一般资料问卷、李氏疲倦量表（Lee's Fatigue Scale）进行调查,使用活动记录仪实施客观测量。 结果 护士昼夜活动节律相关指数中静息-活动周期（r24）和昼夜节律整体偏低,8 h轮班制护士总睡眠时间明显低于12 h轮班制护士,差异有统计学意义（P<0.001）。8 h轮班制护士在值夜班前的疲倦程度比12 h轮班制护士高,但12 h轮班制护士在值夜班后的疲倦程度比8 h轮班制护士高,差异有统计学意义（P<0.001）。多元线性回归分析显示,昼夜活动节律指标中的工作时活动水平、总睡眠时间、静息-活动周期（r24）是工作后疲倦度的显著预测因子,尤其是ICU12 h轮班制护士。 结论 通过昼夜活动节律相关指标与工作前后疲倦度相关性探讨,有助于护理管理者了解护士工作状态,为改善ICU护士轮班方式、限定夜班数量及量化工作负荷提供依据。     

Chronobiologic aspects of sleep-wake cycle and anxiety levels of nurses working on different shifts

This research had as objectives: to identify the chronotypes of nurses on different shifts, to study the sleep patterns and to identify the levels of anxiety trace-state, correlating the chronotypes with the variables trace-anxiety and state-anxiety. It was conducted at the Clinics Hospital of the State University of Campinas (UNICAMP), with 40 subjects. The preponderant chronotype of the morning shift nurses was the morning moderate and the ones from the afternoon and night shifts were the indifferent type. Regarding to the sleep patterns, the morning shift nurses sleep less, wake up earlier with help of the alarm clock in relation to the other shifts. As for the levels of trace-state anxiety, they were located in the levels I (low) and II (moderate) of trace-state anxiety. This study allowed us to conclude that the nurses are satisfied and motivated with the work conditions of the institution.     

Rituals,ghosts and glorified babysitters: A narrative analysis of stories nurses shared about working the night shift

Working the night shift can be fraught and experienced as demanding and, yet, is often dismissed as babysitting. Few researchers have explored the social and cultural meanings of night nursing, including storytelling rituals. In 2019, a narrative study was undertaken. The aim was to explore the stories recalled by nurses about working night shifts. Thirteen Australian nurses participated. Data were gathered using the Biographical Narrative Interview Method, and narrative analysis produced forty stories and three themes: strange and challenging experiences; colleagues can be mentors (or not); and textbook knowledge is only part of what is needed on night shift. Nursing students who engage with these stories may come to understand the challenges of the night shift, and the valuable work that nurses engage in throughout a 24‐hr period, work that involves adept psychosocial and interpersonal skills alongside technical and physical competence.     

护理人员睡眠状况调查以及夜班工作对睡眠的影响

目的调查护理人员的睡眠状况,以及夜班工作对睡眠的影响.方法对348名护理人员、50名通讯值班员,100名夜勤人员进行匹兹堡睡眠质量指数测查和睡眠特征分析,采用DSM-Ⅳ标准进行失眠症诊断.结果护理人员中睡眠状况差者占71.86%,符合DSM-Ⅳ中原发性失眠诊断者占38.22%;通讯值班员该两项比例分别为74%和48%;夜勤人员分别为26.76%和7%.护理人员睡眠状况差与年龄、从事夜班年限有关;护理人员与通讯值班员的睡眠状况相似（ P〉0.05）,与夜勤人员的睡眠状况有非常显著性差异（ P＜0.01）.结论轮班工作方式对护理人员的睡眠状况影响较大,使其在入睡时间、睡眠时间、睡眠效率、日间功能等方面普遍存在一定障碍,但对此不倾向于使用药物治疗,可采用非药物疗法如穴位按摩、自我保健等.     

A comparison of rotating-shift and permanent night nurses

This study tests the hypothesis that permanent night nurses would be no better off than rotating shift nurses on the first night of a run of duty. duty. Thirty permanent and 30 rotating shift female nurses from the same hospital participated in a study involving sleep diaries, oral temperature measurement as well as subjective ratings of well-being and the effort needed to complete their work. Although the permanent nurses fared significantly better than rotating shift nurses in subjective ratings, this did not appear to be due to the maintenance of a nocturnal orientation in the permanent group. Significant differences between the groups only emerged in the amount of night sleep before the shift. Day sleep amounts were similar between groups, as was the size of the temperature drop (0.5 degree F) between midnight and 4 a.m. Thus, lifestyle and social differences between the groups appeared to be more likely than biological rhythm adjustment ones to account for the permanent group's better subjective ratings.     

Psychometric properties of the Korean version of the Occupational Fatigue Exhaustion Recovery Scale in a nurse population

Most nurses in Korea work rotating shifts, an important contributor to fatigue. The Occupational Fatigue Exhaustion Recovery (OFER) Scale assesses work‐related fatigue among nurses. In this study, we aimed to translate and culturally adapt the Korean version of this scale (OFER‐K) with nurses working rotating shifts in Korea. Instrument adaptation was performed using committee‐based translation, cognitive interviewing, and expert panel interviewing. Criterion validity, convergent validity, construct validity, internal consistency, and test–retest reliability were examined as psychometric properties of the OFER‐K. An online survey was completed by 331 nurses; 107 of these nurses completed a second survey after 1 month to assess test–retest reliability. The overall Cronbach's alpha was 0.88. The correlation between participants’ initial and retest responses for the total scale was 0.64 (p < .001). The chronic fatigue subscale was stable over time, t(106) = ?1.76, p = .08. Criterion and convergent validity were supported by correlations between the OFER‐K scale and the Chalder Fatigue Questionnaire, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. Confirmatory factor analysis showed a good fit using a three‐factor model. The findings of this study showed that the OFER‐K scale is a reliable and valid instrument for assessing chronic fatigue, acute fatigue, and inter‐shift recovery in Korean nurses. Future research using this scale may lead to a better understanding of the antecedents and consequences of nurse fatigue and could provide important information to nurse researchers, administrators, and policymakers for developing interventions to reduce nurse fatigue.     

三级中医医院护士留职意愿调查及影响因素分析

目的调查三级中医医院护士留职意愿现状并分析其影响因素,为制订留职策略提供参考。方法采用整群抽样法,于2017年5—9月对我国西、中、东部的3所三级中医医院的1080名护士进行调查。选取人口学资料问卷、护士留职意愿问卷、工作满意度量表、工作控制量表和变革型领导问卷对其进行调查。采用多重分层回归分析进行护士留职意愿影响因素的分析。本研究共发放问卷1080份,回收有效问卷918份,有效回收率为85.00%。结果918名中医护士的护士留职意愿问卷均分为(3.45±0.63)分;不同职务、职称、聘用形式、每月夜班数、月收入护士的护士留职意愿问卷得分比较,差异有统计学意义(P<0.05)。多重分层回归分析结果显示,职务、每月夜班数、工作满意度、工作效率控制、愿景激励是影响护士留职意愿的主要因素(P<0.05),共解释总变异的28.0%。结论中医医院护士留职意愿处于中等水平,医院管理者应适当调整夜班班次,给予护士适当激励,加强护士工作自主性,以提升护士工作满意度,稳定其留职意愿。     

Analysis of the evidence of related factors,associated conditions and at-risk populations of the NANDA-I nursing diagnosis insomnia

ObjectivesTo summarize evidence in the literature on the predictors of insomnia in adults and to determine correspondences with diagnostic indicators of the NANDA-I diagnosis Insomnia.MethodsAn integrative review performed in Pubmed, Virtual Health Library and CINAHL. Forty-eight articles published in Portuguese, English or Spanish from 2011 to 2018 were included. An analysis of correspondence between the predictors and the NANDA-I related factors and associated conditions for Insomnia was performed.ResultsThere was a correspondence of the predictors found in this review with NANDA-I related factors and associated conditions, except for grieving and frequent naps during the day. Smoking, caffeine intake, dysfunctional sleep beliefs, obesity and caregiver role strain are possible new related factors; chronic illness is a possible new associated condition and individuals going through changes in marital status, economically disadvantaged, female gender, increasing age and night shift worker are possible new at-risk populations.ConclusionThe predictors of insomnia that had a correspondence with the NANDA-I elements can support the evidence base of the nursing diagnosis. The predictors found without a correspondence with the diagnosis can be considered for inclusion in the NANDA-I classification, thereby supporting the clinical reasoning of nurses and students.     

聘用护士的专业自我概念现状及影响因素分析

目的：了解聘用护士的专业自我概念水平并分析其影响因素,尝试以新视角为提高聘用护士专业自我概念干预措施提供依据。方法：采用一般资料调查表、专业自我概念量表（PSCNI）、自我压弹量表（ER89）、家庭适应性和家庭亲密度量表（FACEⅡ-CV）对福建省福州市某三级甲等综合性医院239名聘用护士进行调查。结果：聘用护士的专业自我概念总分为（84.30±9.45）分,条目均分为（2.81±0.31）分。多元逐步回归分析显示,家庭亲密度、心理弹性、家庭发展阶段、每周夜班数为聘用护士专业自我概念的主要影响因素,共解释了40%的变异量。结论：医院管理者应该注重聘用护士的夜班数、家庭情况和心理弹性问题,通过给予积极的心理支持,倡导家庭和谐关系,以期提高聘用护士的整体专业自我概念,提高工作满意度,降低离职率。     

门诊失眠患者焦虑、抑郁情况及影响因素分析

目的分析医院门诊失眠患者焦虑、抑郁情况及其影响因素。方法采用一般资料及匹兹堡睡眠指数、焦虑与抑郁自评量表的调查问卷,对2010年1月至2012年4月235例精神科及心理咨询门诊失眠患者进行调查分析。结果失眠平均得分(12.63±4.03)分,失眠得分16分以下者占85.9%。失眠合并焦虑或抑郁者分别为40.0%和36.6%。失眠合并焦虑及抑郁者占30.6%,失眠与焦虑、抑郁呈正相关性(P<0.01)。受教育程度为失眠的影响因素,体质量指数、生活习惯为焦虑的影响因素,体质量指数为抑郁的影响因素。结论失眠与焦虑、抑郁相互影响,受教育程度低者失眠得分较高,低体质量指数为焦虑、抑郁的影响因素,不规律的生活习惯是焦虑的影响因素。     

Night shift work experiences among Iranian nurses: a qualitative study

Aim:  To describe the perceptions held by Iranian registered nurses (IRNs) concerning their night shift work experiences.
Background:  Due to the nature of nursing work and the need for 24-h coverage every day, the majority of nurses work night shifts in their professional practice. Evidence from several studies indicates that night working is a challenge for most nurses. This situation can cause many forms of physical and emotional stress.
Methods:  A qualitative design was used with purposeful sampling. Eighteen IRNs from four different general educational hospitals in Iran took part in the study. Data were collected via semi-structured interviews and analysed according to qualitative content analysis.
Findings:  Three main themes were identified from the data: (a) socio-cultural impacts of night work, (b) health-related impacts of night work, and (c) night work as an opportunity for gaining more clinical experiences and learning more.
Conclusion:  The impact of shift work on nurses' daily professional behaviour and adverse health outcomes related to shift work should be well understood and considered when organizing healthcare systems. We need to identify ways to support nurses who work nights and also give attention to the caregiver's needs.