• 수면정신생리
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• 제7권2호
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• pp.96-101
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• 2000

목 적 : 본 연구는, 교대근무자에 있어 세 교대근무간의 수면양상과 자율신경계활동성을 비교함으로써, 근무자들은 어떤 근무시에 가장 적합하다고 느끼는지 그리고 교대근무자의 심리적, 신체적 문제점의 특성은 무엇인지를 알아보고자 하였다. 또한 본 연구는 근무자들이 교대근무에 좀 더 효과적으로 적응하는데 도움을 주고자 기획되었다. 방 법 : 3일 정도 연속적으로 한 교대근무를 한 후 1일 휴무, 그 다음에 다른 교대로 넘어가는 빠른 순환주기의 교대근무자 51명이 연구에 참여하였다. 각 대상은 수면일기를 작성하였으며 수면잠복기, 수면기간시간, 수면 중 깨어난 횟수를 세 교대근무간에 비교하였다. Epworth 졸음척도와 시각아날로그척도를 사용하여 졸음을 평가하였으며 기분상태는 기분상태척도로 평가하였다. 심박수변동성과, 스트레스 호르몬(아드레날린, 노르아드레날린) 및 그 대사산물을 측정하여 자율신경계 활동성을 살펴보았다. 심박수변동성에는 저주파영역의 스펙트럼 파워, 고주파영역의 스펙트럼 파워, 저주파영역의 파워와 고주파영역의 파워간의 비가 포함되었다. 결 과 : 수면기간시간은 오후근무시 가장 길었고 수면잠복기는 밤근무시 가장 짧았다. 깨어났을 때의 각성도는 오전근무시 가장 저하되었고 작업 중의 각성도는 밤근무 중 가장 떨어지는 것으로 나타났다. 밤근무시 근무자들은 신체적인 피곤감과 인지기능의 저하를 호소하였다. 심박수변동성의 비교를 통해 오후근무시 부교감신경계가 가장 활성화된다는 것을 알 수 있었으며 아드레날린 및 노르아드레날린 분비도 통계적인 의미는 없었지만 오후근무시 가장 감소하였다. 결 론 : 본 연구결과 오후근무가 교대근무자에게 가장 적합한 것으로 나타났다. 오전근무시에는 빛을 아침에 투여하고 밤근무시에는 근무 중에 빛을 투여하면 교대근무에의 적응이 촉진될 것으로 생각된다.

• 대한간호학회지
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• 제28권4호
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• pp.869-880
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• 1998

In order to investigate of the effects of rapid rotating shift work on physiological stress, the activities of urinary Na$^{+}$, $K^{+}$, Cl$^{[-10]}$ were measured in 14 rotational shift nurses, during day shifts(8AM-4PM, n=4), evening shifts(4PM-l2MN, n=5), and night shifts(12MN-8AM, n=5) in hospital twenty students attending nursing college a used as a control group. Urine specimens were collected in 30 minutes before and after work on the second day of shift work. In day shift nurses, Na$^{+}$ activity was 137mM at 8AM and increased to 206mM at 4PM, whereas $K^{+}$ activity was 42mM at 8AM and no significant change at 4PM. Cl$^{[-10]}$ activity was changed from 234mM to 344mM at 4PM at 8AM. In the evening shift, Na$^{+}$ activity was 117mM at 4PM and 140mM at 12MN, $K^{+}$ activity was 22mM and 32mM, respectively. Cl$^{[-10]}$ activity was 169mM and changed to 270mM. During the night shift, Na$^{+}$ activity was 128mM at 12MN and changed to 161mM at 8AM, $K^{+}$ activity was 42mM at 12MN and 8AM, and Cl$^{[-10]}$ activity was from 303mM and changed to 355mM. In general, the urinary ion activities seemed to increase after work, however there were no significant changes in ion activities except the Na$^{+}$ increase in day shift. The mean of the activities of $K^{+}$ and Cl$^{[-10]}$ before and after work during the day and night shift were significantly higher than those in control group (P＜0.05). $K^{+}$ activities were also higher than that of evening shift(P＜0.05). However, there was no difference in Na$^{+}$ activity among the control group and three shifts. There was a significant relationship among urinary Na$^{+}$, Cl$^{[-10]}$ and $K^{+}$ in the control group and rotating shift nurses except between Na$^{+}$ and $K^{+}$ in shift. The relationship between Na$^{+}$ and Cl$^{[-10]}$ was low in shift work and there was no significant relationship between Na$^{+}$ and $K^{+}$ in shift, suggesting that the active regulation $K^{+}$ and/or Na$^{+}$ in response to stress upon the shift work disruped the ratio of urinary Na$^{+}$ to $K^{+}$ and also lowered the relationship between $K^{+}$ and Cl$^{[-10]}$ . These results suggest that nurses working the day shift were overloaded and under stress, and the night shift interfered with the physiological rhythm of the nurses.red with the physiological rhythm of the nurses.

• Journal of Korean Biological Nursing Science
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• 제1권1호
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• pp.100-114
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• 1999

This study was done to investigate the effects of rapidly-rotating shift work of two-day interval on fatigue level and the concentration of urinary 17-KS, $Na^+,\;Cl^-$. The subjects were 20 nursing college students(control group) and 15 nurses in a university hospital and the study was done from Apr. 21 to May 4th, 1999. In the test group, each 5 nurses were allocated to day shift(8 AM-4 PM), evening shift(4 PM-12 MN) and night shift(12 MN-8 AM) respectively. The fatigue level were measured 30 minutes after work start on the 2nd day of work shift. Urine specimens were collected at 8 AM, 4 PM and 12 MN on the 2nd day of work shift in the control group and 30 minutes before and after work on the 2nd day of work shift in the test group. The data were analyzed with SPSS(for Window, ver 7.5). Statistical analysis was performed by using t-test, paired t-test and ANOVA. The results were as follows. 1. The perceived fatigue level in shift work 1) The physical and mental fatigue level were significantly higher in night shift than that in day or evening shift(p<0.05). In the neuro-sensory fatigue level, night shift showed higher tendency than that in day or evening shift, but there were no significant differences between each shifts. 2) Comparison between the control group and the test group: Physical fatigue level was significantly higher in night shift than that in day or evening shift of the control group(P<.001). Mental fatigue level was significantly higher in day or night shift than that in evening shift of the control group(P<.05). In the neuro-sensory fatigue level, test group showed higher tendency than that in the control group, but there were no significant differences between two groups. 3) The total fatigue level was higher in night shift than that in day shift or evening shift(P<.05). In comparing with the control group, night shift and day shift showed higher total fatigue level than that in the control group(p<0.05). 2. The concentration of urinary 17-KS, $Na^+$ and $Cl^-$ In the control group, urinary 17-KS, $Na^+$ and $Cl^-$ showed higher level in afternoon that in morning and night. In the test group, cr in day and evening shift and $Na^+$ in evening shift showed higher level at the end of work. The 17-KS concentration at the begining and the end of work in three shift groups were lower than those in control group(p<0.05), however, $Cl^-$ concentration at the begining of work in day shift, and the end of work in day and evening shift were higher than those in control group(p<0.05). $Cl^-$ concentration at the begining and end of work in night shift were considerably higher than those in control group repectively(p<0.1, p<001). $Na^+$ concentration showed a higher tendency in three shift groups except at the begining of work in night shift, but there were no statistical difference. In comparing concentration of the 17-KS, $Na^+$ and $Cl^-$ among the shift groups, 17-KS concentration showed a lower tendency and $Na^+,\;Cl^-$ showed a higher tendency in night shift: The result of this study showes that biorhythm of shift work nurse was irregular. Fatigue level as the subjective index for evaluating the health problem concerning shift work was higher in night shift and proved to be in accordance with the concentration of urinary 17-KS, $Na^+$ and $Cl^-$ used as objective indices. Disturbation of biorhythm and work stress due to night shift seems to cause the health problem of nurses and decrease of work efficiency. It is considered that work regualtion is necessary for the rational management of the nursing administration.