• 임상간호연구
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• 제19권3호
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• pp.309-320
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• 2013

Purpose: This study was conducted to identify relationships among circadian types, sleep quality, and adaptation to night shifts among nurses working on two or three day night duties. Methods: The participants were 199 ward nurses from two university hospitals in Gyeongnam province. Each nurse worked on two or three day night duties. Data were collected between September 24 and October 14, 2012 and analyzed using t-test, ANOVA, $Scheff{\grave{e}}$ test, Pearson correlation, and multiple regression with SPSS/WIN 14.0 program. Results: Mean scores for sleep quality and adaptation to night shifts was $4.92{\pm}1.46$ on a 10-point scale and $2.66{\pm}0.47$ on a 5-point scale respectively. There were no significant differences in sleep quality and adaptation to night shifts according to circadian types of nurses. There were significant correlation between sleep quality and adaptation to night shifts (r=.25, p<.001). Factors affecting adaptation to night shifts were preference for night shifts, and subjective health status, which together explained about 35% of the total variance. Conclusions: Nurses working on two or three day night duties had low level of sleep quality and adaptation to night shifts. It is necessary to improve preference for night shifts and subjective health status for improving adaptation to night shifts of nurse.

• 대한간호학회지
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• 제50권4호
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• pp.631-640
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• 2020

Purpose: This study aimed to examine premenstrual symptoms (PMS) of shift nurses and identify the association between PMS, sleep, and occupational stress. Methods: This study was conducted with a secondary data analysis that used data from the Shift Work Nurse's Health and Turnover study. The participants were 258 nurses who were working in shifts including night shifts. PMS, sleep patterns (sleep time and sleep time variability), sleep quality, and the occupational stress of each participant were measured using the Moos Menstrual Distress Questionnaire, a sleep diary, an actigraph, the Insomnia Severity Index, and the Korean Occupational Stress Scale, respectively. Data were analyzed using SPSS 23 and STATA 15.1 to obtain descriptive statistics, Pearson's correlation coefficients, multiple linear regression with generalized estimating equations (GEE) and Baron and Kenny's mediating analysis. Results: The average PMS score, average sleep time, average sleep time variability, average sleep quality score, and average occupational stress score of the participants was 53.95 ± 40.45, 7.52 ± 0.89 hours, 32.84 ± 8.43%, 12.34 ± 5.95, and 49.89 ± 8.98, respectively. A multiple linear regression analysis with GEE indicated that sleep time variability (B = 0.86, p = .001), and sleep quality (B = 2.36, p < .001) had negative effects on nurses' PMS. We also found that sleep quality had a complete mediating effect in the relationship between occupational stress and PMS. Conclusion: These findings indicate that both sleep time variability and sleep quality are important factors associated with PMS among shift work nurses. To improve shift nurses' PMS status, strategies are urgently needed to decrease sleep time variability and increase sleep quality.

• 임상간호연구
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• 제18권1호
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• pp.63-73
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• 2012

Purpose: The purpose of this study was to compare job satisfaction and nursing performance of nurses on fixed night shifts (FNS) and nurses working three shifts (W3S), to identify the environment of night work and recognition of the viability of the FNS system. Methods: The research was conducted with 106 nurses on FNS and 257 on W3S. The nurses had worked for 1 to 11 years at A hospital, Seoul. Results: Job satisfaction was significantly higher (t=-3.51, p< .001) for nurses on FNS. However, no significant difference was found for nursing performance (t=-1.019, p=.309) between the two groups. Both groups of nurses were mostly satisfied. Subjective fatigue scores (0 to 10 points) during the night for nurses on FNS (6.02) were lower than for W3S nurses (7.28) A high percentage (88.7%) of nurses on FNS indicated a willingness to further participate in FNS. Conclusion: Results indicate that the demonstration FNS system showed its effectiveness. Therefore, efforts are needed to enhance and revitalize FNS and to upgrade the system to control patient transfer time from emergency departments to wards, and to provide nurses needed resources for emergency or intensive care.

• Safety and Health at Work
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• 제7권2호
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• pp.111-119
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• 2016

Background: Shift work and/or sleep quality may affect health. We investigated whether shift work and sleep quality, separately and jointly, were associated with abnormal levels of triglycerides, total cholesterol (TC), and low-and high-density lipoprotein cholesterol in 360 police officers (27.5% women). Methods: Triglycerides, TC, and high-density lipoprotein were analyzed on the Abbott Architect; low-density lipoprotein was calculated. Shift work was assessed using City of Buffalo payroll work history records. Sleep quality (good, ${\leq}5$; intermediate, 6-8; poor, ${\geq}9$) was assessed using the Pittsburgh Sleep Quality Index questionnaire. A shift work + sleep quality variable was created: day plus good sleep; day plus poor sleep; afternoon/night plus good; and poor sleep quality. Mean values of lipid biomarkers were compared across categories of the exposures using analysis of variance/analysis of covariance. Results: Shift work was not significantly associated with lipids. However, as sleep quality worsened, mean levels of triglycerides and TC gradually increased but only among female officers (age- and race-adjusted p = 0.013 and 0.030, respectively). Age significantly modified the association between sleep quality and TC. Among officers ${\geq}40$ years old, those reporting poor sleep quality had a significantly higher mean level of TC ($202.9{\pm}3.7mg/dL$) compared with those reporting good sleep quality ($190.6{\pm}4.0mg/dL$) (gender- and race-adjusted p = 0.010). Female officers who worked the day shift and also reported good sleep quality had the lowest mean level of TC compared with women in the other three categories (p = 0.014). Conclusion: Sleep quality and its combined influence with shift work may play a role in the alteration of some lipid measures.

• 여성건강간호학회지
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• 제27권2호
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• pp.113-127
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• 2021

Purpose: This study examined health behaviors, use of health services, and depression among women who perform daytime and shift work in Korea, as well as factors related to depression. Methods: We conducted a secondary analysis using data from the 2018 data of the 7th Korea National Health and Nutrition Examination Survey. Data on women, 1,493 regular daytime workers and 322 shift workers, were analyzed. Results: Women shift workers (χ²=43.97, p<.001), had a lower education level (χ²=45.56, p<.001), and lower personal income (χ²=16.85, p=.030) than their daytime counterparts. A higher proportion of shift workers were unmarried (χ²=37.47, p<.001) and they typically worked fewer than 40 hours per week (χ²=69.94, p<.001). The depression score of shift workers was higher than that of daytime workers (t=2.85, p=.005). A higher proportion of shift workers also drank alcohol (χ²=6.49, p=.032) and smoked (χ²=30.79, p<.001). Over 8% of shift workers typically slept fewer than 5 hours per night (χ²=14.17, p=.024). It was confirmed that depression in women shift workers was affected by age, personal income, marital status, health status, and smoking status, in addition to cancer screening participation, unmet medical care needs, and unmet dental care needs. Conclusion: More attention should be given to the health needs of women working shifts. Health promotion programs specific for women shift workers are needed to improve their physical and mental health, encourage use of medical care services, and improve public health policies and systems.

• 한국산업보건학회지
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• 제27권3호
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• pp.210-220
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• 2017

Objectives: This study was conducted to prepare fundamental data and prevention measures on health promotion and occupational disease, and to assess the effects of the working environment on subjective health status and absenteeism among workers using data from the third working environment survey in Korea. Methods: This study's subjects were composed of 29,711 wage workers from the 3rd working environment survey data. The dependent variables were several diseases, subjective health status and absences, and the independent variable was the working environment. The collected data were analyzed by One-Way ANOVA, Pearson's correlation and stepwise multiple analysis using the IBM SPSS(ver. 20.0) statistical package program. Results: The effecting factors for cardiovascular disease were age, working shift and emotional state. The effecting factors for anxiety and depression were years of education, working condition, duties, and emotional state. The effecting factors of insomnia were duty and emotional state. The positive effecting factors for absent days were work standing, working shift, number of night shifts, autonomy, and duties. The positive effecting factors of subjective health status were age, work standing, working years, working shift, appropriateness of working hours, leadership of superiors, duties and emotional state. Conclusions: Based on the above results, the author considers that it is necessary to improve the working environment to reduce absent days, such as by reducing of number of night shifts and giving autonomy regarding duties, and to improve the working environment for subjective health status such as by controlling the appropriateness of working hours and stability of the emotional state. In addition, this study provides fundamental data on health promotion and occupational disease among workers.

• 한국식생활문화학회지
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• 제35권2호
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• pp.156-166
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• 2020

In this study, 594 questionnaires administered to men and women residing in the capital metropolitan area who work night shifts were analyzed in order to study the effect of health information cognition on healing needs in accordance with the type of food selection criteria of the night worker. The results of confirmatory factor analysis in deriving food selection type identified four categories, a safety seeking type, a food exploratory type, a habitual seeking type, and a rational type, and the cognition types on health information were classified into physical cognition and psychological cognition. The need for healing, which was the investigated factor, was found to have a high correlation between questionnaire items with high reliable consistency. The results of this study were as follows. First, the food selection types of safety seeking type and habitual food seeking type had significant positive effects on the cognitive level of physical health information, and food exploratory type and habitual seeking type had significant positive effects on the cognitive level of psychological health information. In addition, it was shown that food exploratory type and rational type had significant positive effects on healing needs. As a result of this study, it was found that the cognition level of physical and psychological information was different according to food selection type, and the higher the cognitive level, the higher the healing needs. In particular, the result that the level of psychological health information significantly affected healing needs signifies that there is a demand to develop programs and menus that satisfy various needs related to healing and recovery from fatigue. In addition, further interest and study on the health and healing of night workers are required.

• 근관절건강학회지
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• 제25권3호
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• pp.196-204
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• 2018

Purpose: The purpose of this study was to contribute to the activation of comprehensive nursing care services by comparing and analyzing the working environment and operational status of comprehensive nursing care wards with general wards. Methods: A questionnaire survey was conducted at hospitals operating comprehensive nursing care services. We collected data on patient characteristics, workforce, working environment, and work support facilities of 40 hospitals voluntarily participating in the survey. The collected data were analyzed by dividing it into an comprehensive nursing care ward and a general ward. Results: Compared with the general ward, the comprehensive nursing care ward had fewer hospitalized patients, but the severity of the patients and the need for nursing were high. The number of nurses, assistant nurses, and ward support workers per patient was higher in the comprehensive nursing care ward than in the general ward, and the implementation rate of night shift fixed system, the fixed shift system, and the preceptor system were higher. In terms of structural environment, comprehensive nursing care wards had more room for interviews. Conclusion: The comprehensive nursing care ward had more nursing staff and provided a better working environment than the general ward, but required additional support for the structural environment.

• 대한간호
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• 제36권1호
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• pp.77-96
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• 1997

The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

• 항공우주의학회지
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• 제30권2호
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• pp.51-53
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• 2020

In commemoration of Vol. 30, Issue 2, our journal prepared three review articles, two original papers, and a case report. The first review analyzed aircraft accidents caused by pilots' fatigue and presented a protocol to measure their fatigue, such as primary background survey, subjective drowsiness/arousal evaluation, sleep and activity log, sleep data, and performance measurement. The second review analyzed shift work patterns and work characteristics that may affect the fatigue of aviation mechanics. Also, desirable work principles for aviation mechanics (restrictions on working hours, appropriate rest hours, and night shift restrictions) were presented. The third review discussed the effects that allergic rhinitis can have on pilots (drowsiness and decreased arousal) and introduced a safe treatment method that can prevent these adverse effects. In the first original article, the ratio of 'incompatible (non-fit)' result in aerospace medical examination among Korean aircraft pilots for the past five years was investigated by age group and the common causes of nonconformity were analyzed. In the second original article, the prevalence, mortality, prevalence according to age groups, and regional characteristics of severe febrile thrombocytopenia syndrome were compared and analyzed in Korea and Japan for the past five years. Finally, in the case report, the cases of a patient diagnosed as gastrointestinal stromal tumors who received surgical treatment and chemotherapy were discussed, and the results of the judgment were presented.