Journal of Preventive Medicine and Public Health

  • 제54권1호
  • /
  • Pages.46-54
  • /
  • 2021
  • /
  • 1975-8375(pISSN)
  • /
  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
권호 표지
DOI QR코드

DOI QR Code

Relationship Between Shift Intensity and Insomnia Among Hospital Nurses in Korea: A Cross-sectional Study

  • Chung, Yuhjin (Department of Preventive Medicine, Graduate School of Public Health, Seoul National University) ;
  • Kim, Hyunjoo (Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital) ;
  • Koh, Dong-Hee (Department of Occupational and Environmental Medicine, International St. Mary's Hospital) ;
  • Park, Ju-Hyun (Department of Statistics, Dongguk University) ;
  • Yoon, Seohyun (Ewha Medical Research Institute, Ewha Womans University School of Medicine)
  • 투고 : 2020.11.12
  • 심사 : 2020.11.26
  • 발행 : 2021.01.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objectives: This study explored the relationship between shift intensity and insomnia among hospital nurses. Methods: The participants were 386 female hospital nurses who underwent a special health examination for night workers in 2015. The Korean Insomnia Severity Index (ISI), indices of shift work intensity, and other covariates such as amount of exercise, level of alcohol consumption, employment duration, and hours worked were extracted from the health examination data. The indices for shift intensity were (1) number of 3 consecutive night shifts and (2) number of short recovery periods after a previous shift, both assessed over the prior 3 months. Multiple logistic regression analysis adjusted for the aforementioned covariates was performed to evaluate the association of shift intensity with insomnia, defined as an ISI score of ≥8. Results: The nurses with insomnia tended to be younger (p=0.029), to have worked 3 consecutive night shifts more frequently (p<0.001), to have experienced a greater number of short recovery periods after the previous shift (p=0.021), and to have worked for more hours (p=0.006) than the nurses without insomnia. Among the other variables, no statistically significant differences between groups were observed. Experiences of 3 or more consecutive night shifts (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.29 to 4.20) and 3 or more short recovery periods (OR, 2.01; 95% CI, 1.08 to 3.73) were associated with increased odds of insomnia. Conclusions: The results suggest that decreasing the shift intensity may reduce insomnia among hospital nurses working rotating shifts.

키워드

참고문헌

  1. Qiao H, Beibei Z, Chong T, Tieying Z, Yuzhi G, Jing M, et al. Both frequency and duration of rotating night shifts are associated with metabolic parameters: a cross-sectional study. Sleep Med 2020;71:89-96. https://doi.org/10.1016/j.sleep.2020.02.016
  2. Kervezee L, Kosmadopoulos A, Boivin DB. Metabolic and cardiovascular consequences of shift work: the role of circadian disruption and sleep disturbances. Eur J Neurosci 2020;51(1): 396-412. https://doi.org/10.1111/ejn.14216
  3. Eldevik MF, Flo E, Moen BE, Pallesen S, Bjorvatn B. Insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder in nurses having less than 11 hours inbetween shifts. PLoS One 2013;8(8):e70882. https://doi.org/10.1371/journal.pone.0070882
  4. Hu Y, Niu Z, Dai L, Maguire R, Zong Z, Hu Y, et al. The relationship between sleep pattern and depression in Chinese shift workers: a mediating role of emotional exhaustion. Aust J Psychol 2020;72(1):68-81. https://doi.org/10.1111/ajpy.12253
  5. Shen SH, Yen M, Yang SL, Lee CY. Insomnia, anxiety, and heart rate variability among nurses working different shift systems in Taiwan. Nurs Health Sci 2016;18(2):223-229. https://doi.org/10.1111/nhs.12257
  6. Gold DR, Rogacz S, Bock N, Tosteson TD, Baum TM, Speizer FE, et al. Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses. Am J Public Health 1992;82(7):1011-1014. https://doi.org/10.2105/AJPH.82.7.1011
  7. Johnson AL, Jung L, Song Y, Brown KC, Weaver MT, Richards KC. Sleep deprivation and error in nurses who work the night shift. J Nurs Adm 2014;44(1):17-22. https://doi.org/10.1097/NNA.0000000000000016
  8. Booker LA, Magee M, Rajaratnam SM, Sletten TL, Howard ME. Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review. Sleep Med Rev 2018;41:220-233. https://doi.org/10.1016/j.smrv.2018.03.005
  9. Flo E, Pallesen S, Mageroy N, Moen BE, Gronli J, Hilde Nordhus I, et al. Shift work disorder in nurses--assessment, prevalence and related health problems. PLoS One 2012;7(4):e33981. https://doi.org/10.1371/journal.pone.0033981
  10. Lin Y, Shan PY, Jiang WJ, Sheng C, Ma L. Subjective cognitive decline: preclinical manifestation of Alzheimer's disease. Neurol Sci 2019;40(1):41-49. https://doi.org/10.1007/s10072-018-3620-y
  11. Min A, Min H, Hong HC. Work schedule characteristics and fatigue among rotating shift nurses in hospital setting: an integrative review. J Nurs Manag 2019;27(5):884-895. https://doi.org/10.1111/jonm.12756
  12. Storemark SS, Fossum IN, Bjorvatn B, Moen BE, Flo E, Pallesen S. Personality factors predict sleep-related shift work tolerance in different shifts at 2-year follow-up: a prospective study. BMJ Open 2013;3(11):e003696. https://doi.org/10.1136/bmjopen-2013-003696
  13. Vedaa O, Krossbakken E, Grimsrud ID, Bjorvatn B, Sivertsen B, Mageroy N, et al. Prospective study of predictors and consequences of insomnia: personality, lifestyle, mental health, and work-related stressors. Sleep Med 2016;20:51-58. https://doi.org/10.1016/j.sleep.2015.12.002
  14. Lim S, Han K, Cho H, Baek H. Shift-work nurses' work environments and health-promoting behaviours in relation to sleep disturbance: a cross-sectional secondary data analysis. J Clin Nurs 2019;28(9-10):1538-1545. https://doi.org/10.1111/jocn.14769
  15. Sun Q, Ji X, Zhou W, Liu J. Sleep problems in shift nurses: a brief review and recommendations at both individual and institutional levels. J Nurs Manag 2019;27(1):10-18. https://doi.org/10.1111/jonm.12656
  16. Byeon YS. The effects of 2 or 3 shift rotation on the fatigue and sleep. J Korean Biol Nurs Sci 2005;7(2):5-15 (Korean).
  17. Chae MJ, Choi SJ. Comparison of shift satisfaction, sleep, fatigue, quality of life, and patient safety incidents between two-shift and three-shift intensive care unit nurses. J Korean Crit Care Nurs 2020;13(2):1-11 (Korean). https://doi.org/10.34250/jkccn.2020.13.2.1
  18. Yoon S, Kang CW, Kee D, Kim H. Working time patterns and health among Korean nurses: a literature review. J Korean Soc Occup Environ Hyg 2018;28(4):331-345 (Korean). https://doi.org/10.15269/JKSOEH.2018.28.4.331
  19. Chaiard J, Deeluea J, Suksatit B, Songkham W, Inta N, Stone TE. Sleep disturbances and related factors among nurses. Nurs Health Sci 2019;21(4):470-478. https://doi.org/10.1111/nhs.12626
  20. Harma M, Ropponen A, Hakola T, Koskinen A, Vanttola P, Puttonen S, et al. Developing register-based measures for assessment of working time patterns for epidemiologic studies. Scand J Work Environ Health 2015;41(3):268-279. https://doi.org/10.5271/sjweh.3492
  21. Yoon S, Park JH, Kee D, Koh TK, Kang CW, Koh DH, et al. Assessment of working time pattern for hospital nurses. J Ergon Soc Korea 2018;37(6):759-769 (Korean). https://doi.org/10.5143/jesk.2018.37.6.759
  22. Shin S, Kim SH. Influence of consecutive night-shift work and working time on insomnia among hospital nurses. Korean J Occup Health Nurs 2020;29(2):133-139 (Korean). https://doi.org/10.5807/KJOHN.2020.29.2.133
  23. Cho YW, Song ML, Morin CM. Validation of a Korean version of the insomnia severity index. J Clin Neurol 2014;10(3):210-215. https://doi.org/10.3988/jcn.2014.10.3.210
  24. Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001;2(4):297-307. https://doi.org/10.1016/S1389-9457(00)00065-4
  25. Korea Centers for Disease Control and Prevention. 2018 Counseling manual of national health screening program; 2017 [cited 2020 Nov 1]. Available from: https://www.cdc.go.kr/board/board.es?mid=&bid=0019&act=view&list_no=138041&tag=&nPage=20 (Korean).
  26. National Institute on Alcohol Abuse and Alcoholism. Helping patients who drink too much: a clinician's guide; 2005 [cited 2020 Nov 1]. Available from: https://pubs.niaaa.nih.gov/publications/practitioner/cliniciansguide2005/guide.pdf.
  27. Lee S, Kim JS, Jung JG, Oh MK, Chung TH, Kim J. Korean alcohol guidelines for moderate drinking based on facial flushing. Korean J Fam Med 2019;40(4):204-211. https://doi.org/10.4082/kjfm.19.0059
  28. U.S. Department of Health and Human Services. 2008 Physical activity guidelines for Americans: fact sheet for health professionals on physical activity guidelines for adults [cited 2020 Nov 1]. Available from: https://www.cdc.gov/physicalactivity/downloads/PA_Fact_Sheet_Adults.pdf.
  29. Kim Y, Yang Y, Park H, Kim H. Development of guideline for physical activity and self-help for Koreans. Seoul: Ministry of Health and Welfare; 2012, p. 38-51 (Korean).
  30. Portela LF, Kroning Luna C, Rotenberg L, Silva-Costa A, Toivanen S, Araujo T, et al. Job strain and self-reported insomnia symptoms among nurses: what about the influence of emotional demands and social support? Biomed Res Int 2015;2015: 820610.
  31. Yazdi Z, Sadeghniiat-Haghighi K, Javadi AR, Rikhtegar G. Sleep quality and insomnia in nurses with different circadian chronotypes: morningness and eveningness orientation. Work 2014; 47(4):561-567. https://doi.org/10.3233/WOR-131664
  32. Oyane NM, Pallesen S, Moen BE, Akerstedt T, Bjorvatn B. Associations between night work and anxiety, depression, insomnia, sleepiness and fatigue in a sample of Norwegian nurses. PLoS One 2013;8(8):e70228. https://doi.org/10.1371/journal.pone.0070228
  33. Thun E, Bjorvatn B, Akerstedt T, Moen BE, Waage S, Molde H, et al. Trajectories of sleepiness and insomnia symptoms in Norwegian nurses with and without night work and rotational work. Chronobiol Int 2016;33(5):480-489. https://doi.org/10.3109/07420528.2016.1148045
  34. Harma M, Karhula K, Ropponen A, Puttonen S, Koskinen A, Ojajarvi A, et al. Association of changes in work shifts and shift intensity with change in fatigue and disturbed sleep: a within-subject study. Scand J Work Environ Health 2018;44(4): 394-402. https://doi.org/10.5271/sjweh.3730
  35. Knauth P, Rutenfranz J. Experimental shift work studies of permanent night, and rapidly rotating, shift systems. I. Circadian rhythm of body temperature and re-entrainment at shift change. Int Arch Occup Environ Health 1976;37(2):125-137. https://doi.org/10.1007/BF00378059
  36. International Labor Organization. R178 - night work recommendation, 1990 (No. 178) [cited 2020 Nov 11]. Available from: https://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_INSTRUMENT_ID:312516.
  37. Choi BN . The working conditions of night shift nurses in general wards and issuess related to nursing policy [dissertation]. Seoul: Ewha Womans University; 2018 (Korean).
  38. Ropponen A, Koskinen A, Puttonen S, Harma M. Exposure to working-hour characteristics and short sickness absence in hospital workers: a case-crossover study using objective data. Int J Nurs Stud 2019;91:14-21. https://doi.org/10.1016/j.ijnurstu.2018.11.002
  39. Thun E, Le Hellard S, Osland TM, Bjorvatn B, Moen BE, Mageroy N, et al. Circadian clock gene variants and insomnia, sleepiness, and shift work disorder. Sleep Biol Rhythms 2016;14(1):55-62. https://doi.org/10.1007/s41105-015-0023-9

피인용 문헌

  1. The Association Between the Number of Consecutive Night Shifts and Insomnia Among Shift Workers: A Multi-Center Study vol.9, 2021, https://doi.org/10.3389/fpubh.2021.761279
  2. Alcohol Abuse and Insomnia Disorder: Focus on a Group of Night and Day Workers vol.18, pp.24, 2021, https://doi.org/10.3390/ijerph182413196