• Journal of Korean Critical Care Nursing
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• v.13 no.2
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• pp.1-11
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• 2020

Purpose : The aim of this study was to compare shift satisfaction, sleep, fatigue, quality of life (QOL), and patient safety incidents between a newly implemented two-shift system and a traditional three-shift system. Methods : A total of 127 intensive care unit nurses (48 two-shift nurses and 79 three-shift nurses) working in a tertiary hospital in Seoul were recruited from January 1, 2017, to March 31, 2017. They completed a self-reported questionnaire about their work hours, shift satisfaction, sleep patterns, sleep quality, fatigue, QOL, and patient safety incidents in the past 2 weeks. Data were analyzed using SPSS version 23.0. Results : The two-shift group showed higher shift satisfaction scores compared with the three-shift group (6.93 vs. 4.37, p<.001). Sleep latency was shorter and sleep quality was better in the two-shift group compared with the three-shift group. There were no significant differences in other sleep parameters, fatigue, QOL, and patient safety incidents between the two groups. Conclusion : Although a two-shift system did not improve nurses' fatigue or QOL in this study, it may effectively serve as an alternative shift-work system that can increase sleep quality and shift satisfaction without increasing patient safety incidents.

• Journal of Korean Academy of Nursing Administration
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• v.11 no.1
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• pp.79-88
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• 2005

Purpose: This study was conducted to assess the effects of shift-work on psychological factors in university hospital's nurses. Method: The subjects were 276 nurses who have worked in a university hospital and the nurses were questioned with self-reported questionnaire forms. We investigated psychological factors(anxiety, depression, stress and self-esteem), nurses' general characteristics and shift-work. The data was analyzed by using SAS for Windows 9.13. Results: The frequency of nurses with anxiety, depression and high stress were 56.5%, 44.9% and 19.6%, respectively. The mean score of self-esteem was 30.03. Stress was higher in cases of having shift-work. Immediately after doing shift-work, nurses had higher depression and stress, and lower self-esteem scores. After controlling confounding variables, psychological factors affected by shift-work was stress. An upward tendency in anxiety, depression and stress were found in cases of doing shift-work for more than 5 years. Conclusions: It is necessary to develope a program for reducing psychological disturbance at the early times of shift-work and to plan adequate shift-work intervals.

• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.46-54
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• 2021

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.

• Journal of Korean Biological Nursing Science
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• v.19 no.4
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• pp.252-257
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• 2017

Purpose: This study aimed to investigate the associations of sleep, dietary behaviors and physical activity with quality of life among shift-work nurses. Methods: For this cross-sectional descriptive study, data were collected from 191 shift-work nurses in a tertiary hospital. Multiple linear regression analysis was used to identify the relationships among variables. Results: The levels of sleep quality, dietary behaviors and physical activity were low. Factors associated with quality of life among shift-work nurses included sleep disturbance (B=-0.16, ${\beta}=-0.26$, p<.001), dietary behaviors (B=0.28, ${\beta}=0.24$, p<.001), and physical activity (B=0.05, ${\beta}=0.19$, p<.001). The strongest factor was sleep disturbance. Conclusion: In order to improve quality of life among shift-work nurses, it is significant to encourage and maintain health behaviors such as sleep, dietary behaviors and physical activity. Under the circumstances where shift-work cannot be avoided, personal efforts made by nurses to establish their own living standards for positive health behaviors will benefit their quality of life.

• Journal of Korean Biological Nursing Science
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• v.24 no.3
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• pp.141-149
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• 2022

Purpose: This study aimed to investigate the effects of grit and body composition on fatigue and burnout in shift-working nurses. Methods: A descriptive cross-sectional design using self-report questionnaires was employed. Data were collected between February and April 2021 from 192 shift-working nurses in 22 units of C tertiary hospitals. Of the 192, 175 nurses returned their completed questionnaires (return rate: 91.1%). The participants objectively measured their body composition for three consecutive days using a home body composition measurement scale. Results: Nurses with higher consistency of interest were more likely to have lower chronic fatigue (B = -5.23, p= .013), lower emotional exhaustion (B = -2.75, p< .001), and decreased depersonalization (B = -1.08, p= .014). Perseverance of effort was not statistically significant for fatigue; however, it was statistically significant for higher personal accomplishment among the subdomains of burnout (B= 2.50, p< .001). Skeletal muscle mass and body mass index had no significant effect on fatigue and burnout. Conclusion: To reduce fatigue and burnout in shift-working nurses, comprehensive efforts at the organizational and individual levels should be implemented to increase their grit. Further research is needed to determine whether body composition affects fatigue and burnout in shift-working nurses.

• Journal of Nutrition and Health
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• v.47 no.6
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• pp.416-425
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• 2014

Purpose: The purpose of this study was to investigate the stress, dietary habits, dietary behaviors, and health-related behavior of nurses. Method: The subjects of this study were 161 nurses studying at a cyber university. The general characteristics, stress, dietary habits, dietary behaviors, and health-related behavior of the subjects were surveyed using a self-administered questionnaire in October, 2010. The subjects were divided into two groups according to the working pattern: shift workers (n = 110) and non-shift workers (n = 51). Results: In the general characteristics, there were significant differences in marriage, monthly income, employment type, and job satisfaction between the two groups. Total stress score did not differ significantly between the two groups. In dietary habits, significant differences in meal regularity, skipping meals, skipping reasons, having regular mealtimes, frequency of snack and the snack time between shift workers and non-shift workers (p<0.05). Total score of dietary behaviors in shift workers was significantly lower than that in non-shift workers (p<0.05). Score of shift workers in taking three meals per day regularly was significantly lower than that of non-shift workers. In health-related behavior, a significant difference in sleeping time was observed between shift workers and non-shift workers. Dietary behavior showed negative correlation with shift work (r = 0.176) and positive correlation with health consciousness (r = 0.210) and perceived health status (r = 0.198) in subjects after adjustment for age, marriage, monthly income, and employment type (p < 0.05). Multiple regression analysis revealed that shift work, health consciousness, and perceived health status affected dietary behavior in subjects. Conclusion: These results indicate that shift working nurses had poor dietary habits and dietary behaviors, and these dietary behaviors are affected by their shift work, health consciousness, and perceive health status.

• Safety and Health at Work
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• v.12 no.2
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• pp.255-260
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• 2021

Background: A well-designed shift schedule has been reported to have a positive effect on improving health problems associated with shift work. This study aimed to identify compliance with the 17 recommendations on work schedule (WSRs) for shift nurses and related factors. Methods: The descriptive study was conducted with 182 nurses who worked in three shifts for more than 1 year at superior general and general hospitals in three regions. Data were collected with selfadministered questionnaire and 13-week work schedule tables, and analyzed with both person- and cycle-based compliance. Results: Person-based compliance was 11.77 among 17 items in total. However, no one completely complied with WSRs of "no work on weekends" and which showed the lowest cycle-based compliance (22.3%). Compliance with some WSRs was related to hospital type, proportion of nurses in school and having standards on work schedule at institutional level. Conclusion: Compliance with WSRs of shift nurses in Korea is still unsatisfactory, and one day off after night shift and work on weekend are quite common. Hospitals should keep the standards on work schedule, monitor compliance with standards, and try to introduce modified shift systems to improve the current problems.

• 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.

• 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 Clinical Nursing Research
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• v.24 no.2
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• pp.170-177
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• 2018

Purpose: The aim of this study was to examine effectiveness of 12-hour shifts for nurses compared to 8-hour shifts for the variables: Work-Life Balance, fatigue and work errors. Methods: In 2014, an opportunity to choose a 12-hour shift duty was given to a group of 8-hour shift nurses. In 2016, two years after this change, this study was done to compare the two groups. Data were collected using questionnaires. Data were sampled by a matching method with propensity score matching (PSM). The participants were 128 nurses: 64 nurses on 12-hour shifts and 64 nurses on 8-hour shifts. The comparison was analyzed using $x^2$ test, t-test. Results: The nurses on 12-hour shifts showed higher scores for Work-Life Balance (3.37) than the groups on 8-hour shifts (2.99)(p=.018) whereas were no statistical differences between the groups for fatigue (p=.132) or work errors (p=.703). Conclusion: The Work-Life Balance scores for nurses who chose the 12-hour shift shows an enhancement without an increase in fatigue or work errors.