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http://dx.doi.org/10.4040/jkan.2018.48.5.622

Structural Equation Model for Sleep Quality of Female Shift Work Nurses  

Jeong, Ji Yeong (Department of Nursing, Samsung Changwon Hospital, Sungkyunkwan University)
Gu, Mee Ock (College of Nursing.Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University)
Publication Information
Journal of Korean Academy of Nursing / v.48, no.5, 2018 , pp. 622-635 More about this Journal
Abstract
Purpose: This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses. Methods: This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data. Results: The final model showed good fit to the empirical data: ${\chi}^2/df=2.19$, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (${\beta}=.32$), perceived shift work status (${\beta}=-.16$), stress response (${\beta}=.16$), shift work experience (${\beta}=.15$), perceived health status (${\beta}=-.14)$, and circadian rhythm (${\beta}=-.13$) explaining 36.0% of the variance. Conclusion: The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.
Keywords
Nurses; Shift Work Schedule; Sleep; Psychological stress; Sleep Hygiene;
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Times Cited By KSCI : 4  (Citation Analysis)
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1 Korea Occupational Safety & Health Agency. Health care guidelines for shift workers [Internet]. Ulsan: Korea Occupational Safety & Health Agency; c2008 [cited 2016 Dec 1]. Available from: https://www.kosha.or.kr/cms/board/Download.jsp?fileId=63207.
2 Kim HJ. Domestic an international night worker health care case [Internet]. Ulsan: Korea Occupational Safety & Health agency; c2012 [cited 2016 Dec 1]. Available from: https://oshri.kosha.or.kr/cms/board/Download.jsp?fileId=72530.
3 Moul DE, Nofzinger EA, Pilkonis PA, Houck PR, Miewald JM, Buysse DJ. Symptom report in severe chronic insomnia. Sleep. 2002;25(5):548-558. https://doi.org/10.1093/sleep/25.5.548   DOI
4 Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep. 2007;30(2):213-218. https://doi.org/10.1093/sleep/30.2.213   DOI
5 No OJ, Song MS, Kim KM, Eom OB, Han OH, Kim MJ, Hong JH. 2013 Survey on the status of hospital nursing staffing [Internet]. Seoul: Korea Hospital Nurses Association; c2013[cited 2016 Dec 1]. Available from: http://khna.or.kr/web/notice/news.php.
6 Liu X, Uchiyama M, Kim K, Okawa M, Shibui K, Kudo Y, et al. Sleep loss and daytime sleepiness in the general adult population of Japan. Psychiatry Research. 2000;93(1):1-11. https://doi.org/10.1016/S0165-1781(99)00119-5   DOI
7 Pilcher JJ, Ginter DR, Sadowsky B. Sleep quality versus sleep quantity: Relationships between sleep and measures of health, well-being and sleepiness in college students. Journal of Psychosomatic Reseach. 1997;42(6):583-596. https://doi.org/10.1016/S0022-3999(97)00004-4   DOI
8 Kwon GJ. A study on shift work nurses' sleeping pattern according to their fatigue level and working type [master's thesis]. Seoul: Ewha Womans University; 2005. p. 1-56.
9 Kim HS, Choi KS, Eom M, Joo EJ. Role of circadian types and depressive mood on sleep quality of shift work nurses. The Korean Journal of Psychopharmacology. 2011;22(2):96-104.
10 Han KS, Park EY, Park YH, Lim HS, Lee EM, Kim L, et al. Factors influencing sleep quality in clinical nurses. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2011;20(2):121-131. https://doi.org/10.12934/jkpmhn.2011.20.2.121   DOI
11 Shin SW, Kim SH. Influence of health-promoting behaviors on quality of sleep in rotating-shift nurses. Journal of Korean Academy Fundamentals of Nursing. 2014;21(2):123-130. https://doi.org/10.7739/jkafn.2014.21.2.123   DOI
12 Chien PL, Su HF, Hsieh PC, Siao RY, Ling PY, Jou HJ. Sleep quality among female hospital staff nurses. Sleep Disorders. 2013;2013:283490. https://doi.org/10.1155/2013/283490   DOI
13 Hong KS. A Study on daytime sleepiness, insomnia, and the quality of sleep in clinical nurses [master's thesis]. Jeju: Jeju National University; 2015. p. 1-74.
14 Jeong JY, Gu MO. The influence of stress response, physical activity, an sleep hygiene on sleep quality of shift work nurses. Journal of the Korea Academia-Industrial Cooperation Society. 2016;17(6):546-559. http://doi.org/10.5762/KAIS.2016.17.6.546   DOI
15 Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kuper DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research. 1989; 28(2):193-213. https://doi.org/10.1016/0165-1781(89)90047-4   DOI
16 Jang CH, Kim SH, Oh DH. Cognitive behavioral therapy of insomnia. Hanyang Medicine Reviews. 2013;33(4):210-215. https://doi.org/10.7599/hmr2013.33.4.210   DOI
17 Edell-Gustafsson UM, Kritz EIK, Bogren IK. Self-reported sleep quality, strain and health in relation to perceived working conditions in females. Scandinavian Journal of Caring Sciences. 2002;16(2):179-187. https://doi.org/10.1046/j.1471-6712.2002.00078.x   DOI
18 Yang EO, Choi IR, Kim SM. The impact of sleep disorder and job stress on turnover intention of shift working nurses. The Korean Journal of Stress Research. 2017;25(4):255-264. https://doi.org/10.17547/kjsr.2017.25.4.255   DOI
19 Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America. 1987;10(4):541-553. https://doi.org/10.1016/S0193-953X(18)30532-X   DOI
20 Kim MY, Choi HJ. Factors influencing sleep patterns during clinical practice weeks among nursing students: Based on Spielman's Model. Journal of Korean Biological Nursing Science. 2016;18(4):203-21. https://doi.org/10.7586/jkbns.2016.18.3.203   DOI
21 Kim BY. Job stress and related factors of nurses in a general hospital [master's thesis]. Gangneung: Kwandong University; 2010. p. 1-67.
22 Jeong MS. The relationship between, job stress, quality of sleep and stress response among shift nurses [master's thesis]. Busan: Kosin University; 2012. p. 1-72.
23 Chung MH, Liu WI, Lee HL, Hsu N. Selected neurophysiological. psychological, and behavioral influences on subjective sleep quality in nurses: A structure equation model. PLOS ONE. 2013;8(11):e79529. https://doi.org/10.1371/journal.pone.0079529   DOI
24 Park JH. Health promoting behaviors and sleep quality of shift working nurses [master's thesis]. Gochang: Chonbuk National University; 2013. p. 1-47.
25 Yu JP. The concept and understanding of structual equation modeling. Seoul: Hannare Publishing Co.; 2012. p. 1-391.
26 Yeun EJ, Kim HJ, Jeon MS. Factors influencing health promoting behavior among hospital registered nurses: Mood states, resourcefulness, and health perception. Journal of Korean Academy of Nursing Administration. 2011;17(2):198-208.   DOI
27 Kim JS, Kim CJ. Association of job stress with health-promoting behaviors and health status in clinical nurses. Korean Journal of Occupational Health Nursing. 2016;25(4):311-319. https://doi.org/10.5807/kjohn.2016.25.4.311   DOI
28 Kim SJ, Gu MO. A study on the relationship among circadian types, sleep quality and adaptation to night shifts among nurses working on two or three day night duties. Journal of Korean Clinical Nursing Research. 2013;19(3):309-320. https://doi.org/10.22650/JKCNR.2013.19.3.309   DOI
29 Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the sleep hygiene index. Journal of Behavioral Medicine. 2006;29(3):223-227. https://doi.org/10.1007/s10865-006-9047-6   DOI
30 Cho YW. Measures of sleep and sleep hygiene. Journal of Korean Sleep Research Society. 2004;1(1):12-23.   DOI
31 Kim JK. Circadian rhythm and psychological adjustment. The Korean Journal of Health Psychology. 1998;3(1):129-140.
32 Smith CS, Reilly C, Midikiff K. Evaluation of three circadian rhythm questionnaires with suggestions for an improved measure of morningness. Journal of Applied Psychology. 1989; 74(5):728-738. https://doi.org/10.1037//0021-9010.74.5.728   DOI
33 Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. International Journal of Chronobiology. 1976;4(2):97-110.
34 Torsvall L, Akerstedt T. A diurnal type scale. Construction, consistency and validation in shift work. Scandinavian Journal of Work, Environment & Health. 1980;6(4):283-290. https://doi.org/10.5271/sjweh.2608   DOI
35 Kook SH, Yoon JS, Lee HY. Cross validation of the Korean translation of composite Scale(KtCS) to measure morningness-eveningness. Journal of Korean Neuropsychiatric Association. 1999;38(2):297-305.
36 Speake DL, Cowart ME, Pellet K. Health perceptions and lifestyles of the elderly. Research in Nursing and Health. 1989;12(2):93-100. https://doi.org/10.1002/nur.4770120206   DOI
37 Koh KB, Park JK, Kim CH. Development of the stress response inventory. Journal of Korean Neuropsychiatric Association. 2000;39(4):707-719.
38 Kweon YR, Jeon HO. Effects of perceived health status, self-esteem and family function on expectations regarding aging among middle-aged women. Journal of Korean Academy of Nursing. 2013;43(2):176-184. https://doi.org/10.4040/jkan.2013.43.2.176   DOI
39 Kim MJ, Gu MO. The development of the stress measurement tool for staff nurses working in the hospital. The Journal of Nurses Academic Society. 1984;14(2):28-37. https://doi.org/10.4040/jnas.1984.14.2.28   DOI
40 Yun CG, Lee HN. A study on the job stress of nurses in hospital. Journal of Health Informatics and Statistics. 2003;28(2): 95-110.
41 Yang CM, Lin SC, Hsu SC, Cheng CP. Maladaptive sleep hygiene practices in good sleepers and patients with insomnia. Journal of Health Psychology. 2010;15(1):147-155. https://doi.org/10.1177/1359105309346342   DOI
42 Choi SM, Kang TY, Woo JM. Development and validation of a modified form of the stress response inventory for workers. Journal of Korean Neuropsychiatric Association. 2006;45(6):541-553.
43 Walker SN, Sechrist KR, Pender NJ. The health-promoting life style profile: Development and psychometric characteristics. Nursing Research. 1987;36(2):76-81. https://doi.org/10.1097/00006199-198703000-00002
44 Seo HM, Hah YS. A study of factors influencing on health promoting lifestyle in the elderly: Application of Pender's health promotion model. Journal of Korean Academy of Nursing. 2004;34(7):1288-1297. https://doi.org/10.4040/jkan.2004.34.7.1288   DOI
45 Kline RB. Principles and practice of structural equation modeling. 2nd ed. New York: Guilford Press; 2004. p. 1-366.
46 Koran Occupational Safety a Health agency. Night work and Shift work Occupational Health guidelines [Internet]. Ulsan: Koran Occupational Safety a Health agency; c2013 [cited 2016 Dec 25]. Available from: http://www.kosha.or.kr/www/board-View.do?contentId=354389&menuId=5405&boardType=A.
47 Lee EO, Im NY, Park HA, Lee IS, Kim JI, Bae JI, et al. Nursing research and statistical analysis. Seoul: Soomoonsa; 2009. p. 1-733.
48 Kim GS. Analysis structural equation modeling. Seoul: Hannarae Publishing Co.; 2010. p. 1-663.
49 Hong SH. The criteria for selecting appropriate fit indices in structural equation modeling and their rationales. Korean Journal of Clinical Psychology. 2000;19(1):161-177.
50 Pronitis-Ruotolo D. Surviving the night shift. The American Journal of Nursing. 2001;101(7):63-65, 67-68.