• Journal of Korean Academy of Nursing
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• v.28 no.4
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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 Clinical Nursing Research
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• v.25 no.2
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• pp.107-119
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• 2019

Purpose: The purpose of this study was to investigate the welfare status of nurses and the status of fixed night shifts and flexible work arrangements in both general hospitals and advanced general hospitals in Korea. Methods: A total of 167 hospitals participated in this study, done from April to October 2018. Results: There were 103 hospitals utilizing the fixed night shift system, 22 in the two-shift system, 3 in the fixed holiday shift, 79 in the fixed shift system, and 39 in the short-time working system. The average welfare benefits for nurses increased to 33.02 million won on average. However, welfare services for the nurses were poor: 41.8% of the respondents had a nurses' lounge, 81.7% were given dormitory space at their place of employment, 41.8% had access to welfare facilities, and 56.4% were provided with welfare support countermeasures. Conclusion: The results show an increasing trend of hospitals to utilize fixed night shift and flexible work arrangements. An institutional strategy at the national policy level should be established to implement flexible work arrangements including the fixed night shift system, which has a poor level of welfare.

• Journal of the Korean Dietetic Association
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• v.29 no.1
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• pp.13-30
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• 2023

This study investigates the effect of working hours on the dietary behaviors and dietary quality of male industrial workers employed in rotating shifts. The survey was conducted from February to March 2022, enrolling 209 male workers operating in rotational shifts at industries in the Chungcheongnam-do region. Eating behavior and health awareness were investigated during the morning shift, afternoon shift, and night shift for the same subjects. The shift timings were found to be associated with dietary behavior, which had an impact on the dietary quality of workers. Negative effects of shift timings on diet and health were also perceived by the shift workers. The frequency of alcohol consumption was high during the morning shift, and the frequency of night time snack intake was high during the afternoon shift. During the night shift, there was decreased vegetable intake and increased ramyeon intake. Compared to the morning shift, a significant decrease in dietary quality scores was found during the night shift. The workers recognized that rotating shift work negatively affected health, eating habits and sleep. There was a high demand for providing a variety of menus and healthy night snacks in the company cafeteria. When nutritional counseling and educational health services were provided, the willingness to participate was high. Therefore, to improve the health and dietary quality of shift workers, there is a need to provide diets suitable for the working environment and the characteristics, and to provide nutrition management services.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.182-189
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• 2004

Objectives : The objective of this study is to compare the circadian patterns of heart rate variability assessed by 24-hour ambulatory electrocardiographic (ECG) recordings during day shift and night shift among the workers in the 5 days-concecutive-12-hour shift in an automobile factory in Korea. Methods : The study population consisted 300 workers, who were randomly selected among the 8700 total workers in one car factory. To analyse circadian variation, the 24-hour ECG recordings (Marquette) were measured during day shift (08:00-20:00 h) and night shift (20:00-08:00 h). Analysis was performed for all time and frequency domain measures of HRV. 233 workers completed taking 24-hour ECG recordings. Results : This study shows that the 24 hourcircadian variation mainly follows work/sleep cycle rather than day/night cycle among shift workers. This study also shows that among the night shift, the circadian variation between work and sleep cycle decreased compared to the work/sleep cycle among day shift workers. All time and frequency domain parameters (except LF/HF ratio) show significantly different between work and sleep in the day shift and night shift. Conclusion : These changes in heart rate variability circadian rhythms reflect significant reductions in cardiac parasympathetic activity with the most marked reduction in normal vagal activity among the shift workers. Especially, it suggests the circadian rhytm has blunted among the night workers. The quantification of the circadian variation in HRV can be a surrogates of workers' potential health risk, as well as suggests possible mechanisms through which the shift works compromise workers' health.

• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.139-150
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• 2024

Purpose: This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work. Methods: This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis. Results: Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning. Conclusion: Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.4
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• pp.403-412
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• 2014

Purpose: Shift work disrupts the synchronization between the human biological clock and the environment. Sleep disturbances are common for shift work nurses, and may threaten patient safety. This study was done to investigate the sleep characteristics and medication errors (ME) of intensive care unit (ICU) nurses who work shifts, and ascertain if there is an association between these factors. Methods: Data were collected using a self-report questionnaire from 126 ICU nurses on three shifts. Collected data included their sleep characteristics including sleep patterns and sleep disturbances, and ME for the past 2 weeks. Results: There were significant differences in sleep duration and sleep latency according to shift. Day shift nurses had the shortest sleep duration, and their sleep latency was the longest (about 49 minutes) compared to nurses on evening and night shifts; 54% reported sleep disturbances, 16% experienced ME, and among these nurses 50% were on the night shift. Logistic regression analysis revealed significant associations between nurses' sleep duration and ME (adjusted OR 0.52 [95% CI 0.32-0.85]). Conclusions: The results confirmed that shift work nurses in the ICUs experience sleep disturbance, and that less sleep is associated with ME.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.5
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• pp.519-529
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• 2015

Purpose: This study was performed to identify perceptions on fixed night shift system and turnover intention of general hospital nurses and to explore a desirable application plan for a fixed night shift system. Methods: This study was a cross-sectional survey. Participants were 300 nurses working at one general hospital in GyeongGi-Do, Korea. Data were collected from November 3 to 7, 2014, with a structured questionnaires and analyzed using SPSS/PC ver 20.0 programs. Results: Of the participants 73.5% had thought about turnover because of night shifts and the preconditions for desirable fixed night shift system were a payment plan differentiated according to work conditions and an adequate number of nursing staff. Economic and administrative supports like 'raising extra-pay for night shift' and 'increasing the number of paid holidays' were very important for a desirable fixed night shift system. Conclusion: The results indicate that the most important factor for a desirable fixed night shift system to decrease nurses' turnover intention is economic and administrative support according to the needs of the nurses. So nursing managers need to find a desirable fixed night shift system considering nurses' demographic characteristics and organizational characteristics.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.74-83
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• 1994

To investigate the sleeping patterns and gastrointestinal disorders of shift workers, the author studied 434 female workers who worked at textile industry ill Taejon city from September 1,1992 to September 31,1992. Shift pattern were divided into 3 categories ; 3 shift(shifts per 8 hours), 2 shift(day and night shift) and day work. The results obtained were as follows : 1 The average sleeping hours when adjusted for the education level of the total study subjects was 6.1 hours. That of 3 shift workers was 6.1 hours, 2 shift workers was 6.0 hours, but that of day workers was 6.5 hours. There were no significant difference among the shift workers. 2. For the 3 shift workers, the average physiologic adjusted duration in day shift (2.2 days) was shorter than that of night shift(2.7 days) and there were significant difference among the rotating shift works (p<0.001). The sleeping problems in day shift was less than those of night shift (p<0.001). 3. 44.9% of 3 shift workers, 39.3% of 2 shift workers and 33.1% of day workers complained gastrointestinal symptoms when adjusted for the age, education level, job tenure, work post. And the rates of gastrointestinal symptoms complained increase with job tenures (p<0.001). 4. The most frequent gastrointestinal diseases were gastitis and gastric ulcer with 14.2% , Irritable bowel syndrome with 3.1 %, duodenitis and duodenal ulcer with 2.1% and combined gastrointestinal disease with 2.1%. Age, eating habit, amount of coffee per day, job tenure, work post and shift pattern showed no significant difference with the gastrointestinal diseases when adjusted for the age. According to the above results, the author suggested that the shift pattern and job tenure can affect to the sleeping problem and gastrointestinal symptoms.

• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.240-248
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• 2018

Objective Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Methods Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Results Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. Conclusion Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.

• Korean Journal of Occupational Health Nursing
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• v.9 no.2
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• pp.86-93
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• 2000

This study was conducted to find out the degree of tiredness, accumulated tendencies of fatigues in accordance with 3 types of circadian rhythms and 3 types of perceived fatigue signs such as physical, psychological and neurosensory aspects in before and after work at night. Samples were chosen from the 217 intensive care units nurses working in 13 general hospitals which had 3 shift rotating systems, Data were collected from November to December in 1999. Two hundreds seventeen respondents were classified by 3 circadian types such as 59 morning, 110 middle and 48 evening. Circadian type was measured by the circadian type scale which was designed by ${\ddot{O}}stberg$ and Home (1976). in order to estimate the level of tiredness, the investigator used the fatigue checklist designed by the Labor and Health Institute of Japan(1970). Analysis was done by frequency a percentages, ${\chi}^2$ test and repeated measures ANOVA test. The result of this study were as follow: 1. In the general characteristics of the subjects circadian types, moderate type had the large proportion at 50.7% and morning type had 27.2% and evening type had 22.1%. 2. According to the 3 types of fatigue signs, the highest general tendency was 'General weakness' and 'Feeling of headsore' for physically perceived sign, 'Drowsiness' for psychological sign, and 'Uncomfortableness in sight seeing' for neurosensory sign. 3. The most frequently complained fatigue were observed in physical symptoms among physical, mental, and neurosensual symptoms. The percentage of complained was higher after night work than before the work started. 4. There was not any statistical significant difference between the circadian type and the degree of physical, mental, neurosensory fatigue. 5. There was not any statistical significant difference in regarding to each date of night shift except difference between 1st and 2nd days of fatigue perceived physically. Therefore, the study concluded that the fatigue perceived by night shift nurses might be related with shift working condition rather than circadian types.