• Journal of Korean Clinical Nursing Research
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• v.27 no.2
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• pp.165-178
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• 2021

Purpose: To analyze nurses' shift work according to the government guidelines for night work and their perceptions of their work schedules. Methods: The study sample included 487 nurses who provided information on their schedules, including the normal working hours of each shift, and overtime per shift during September 2020. Nurses' perceptions were measured in terms of satisfaction, appropriateness for work-life balance, and fairness to their work schedule. Results: One-third of the respondents worked more than 40 hours per week. The average overtime hour was 1.14 hours per shift. Unsocial hours (8 pm to 6 am on weekdays, midnight to midnight on weekends and public holidays) accounted for 56.4% of all working hours. During their last night shift, on average, nurses worked 9.62 hours and had a break of 39 minutes, although 20.5% reported no break. Sixty-eight percent of nurses had at least one between-shift break shorter than 48 hours after a consecutive night shifts. Fifty-seven percent were satisfied with their schedule. One-third perceived their schedule as appropriate for work-life balance, and two-thirds perceived that days off on weekends and nights were fairly distributed within the unit. Working and overtime hours had an inverse relationship with all three aspects of nurses' perceptions. A higher proportion of unsocial hours and having no breaks during the night shift were associated with lower perceptions of fairness. Conclusion: Reducing working hours, ensuring breaks during night shifts, and increasing rewards for unsocial hours are required to improve nurses' perceptions and reduce turnover due to shift work.

• Journal of Korean Biological Nursing Science
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• v.22 no.4
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• pp.308-316
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• 2020

Purpose: This study aimed to explore the knowledge and performance of sleep hygiene among nurses with shift work schedules and examine the influence on sleep disturbance. Methods: A total of 199 shift-work nurses from a tertiary hospital were included in the study. To examine the knowledge and performance of sleep hygiene, the participants were asked to respond to a self-reported survey. To assess sleep disturbance, the General Sleep Disturbance Scale was used. Descriptive statistics and multiple linear regression were applied using the SPSS/WIN 21.0 program to analyze the data. Results: Both the knowledge and performance of sleep hygiene among nurses with shift work schedules were measured at a moderate level. Nurses' knowledge and the performance of sleep hygiene was not significantly associated with sleep disturbance, whereas age, experience with shift-working, and perceived health status were significantly associated. Conclusion: Strategies for providing more accurate information and motivating better sleep hygiene would help to enhance sleep hygiene in nurses with shift work schedules. Further studies examining the association of knowledge and the performance of sleep hygiene with sleep disturbances in nurses with shift work schedules are needed.

• 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 Biological Nursing Science
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• v.2 no.2
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• pp.81-89
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• 2000

To determine the optimal rotational shift system, the effect of the direction of the rotational work shifting on the nocturnal rhythm of plasma melatonin were investigated in nursing students. Two groups of nine volunteers participated as experimental subjects, and two nursing students participated as a control group. The directions of the rotational work shift were as follows: CW(clockwise)-shift were rotated in the direction of day shift(3 days), evening shift(3 days), off duty(1 day) and night shift(5 days), and CCW(conuterclockwise)-shift were done in the reverse direction. Plasma melatonin concentrations was measured by radioimmunoassay. The results were as follows : The plasma melatonin levels were kept low at night and in the following morning in the CW night shift workers, whereas the level started to increase at 05 : 00 hr in two workers of four CCW shift workers. These result suggests that the shift rotation in the CW direction is more acceptable in terms of the adaptation of hormonal rhythms. These results indicate that the CCW rotation of shift work is somewhat better than CCW rotation for the adaptation to shift work on hormonal aspects in nurses.

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.54-63
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• 2017

Purpose: The purpose of this study was to compare the working status and Standard Shiftwork Index (SSI) between night shift-fixed nurses and rotating shift nurses. Methods: Participants were 367 nurses working as registered nurses at 7 different medical institutions. The data were collected from August 8, 2016 to September 30, 2016. Results: Night shift fixed nurses were more satisfied with work schedule than rotating shift nurses. Rotating shift nurses reported higher SSI scores, such as chronic fatigue, musculoskeletal problems, than night shift fixed nurses. In SSI's sub-items, rotating shift nurses reported higher scores, such as the amount of sleep, feeling well after sleep, heartburn or stomach-ache and heartbeat irregularities, than night shift fixed nurses. Conclusion: The results indicated that night shift fixed system might be an effective method to improve nurses' work satisfaction. It is necessary to figure out any suitable night shift fixed system based on the characteristics of each nursing organization. The SSI might be an useful tool to measure the nurses' satisfaction in reference to their work shift.

• Journal of Nutrition and Health
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• v.40 no.6
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• pp.576-583
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• 2007

The purpose of this study was to assess the daily steps, physical activities and activity coefficient of policemen (average age: 31.5 ${\pm}$ 5.1 years) who do shift work. Body weight, height and daily steps were measured and one-day activity diary was collected by interviewing with policemen. Average height, body weight, BMI, body fat (%) and muscles (%) of subjects were 173.1 ${\pm}$ 5.2 cm, 73.7 ${\pm}$ 9.7 kg, 24,6 $kg/m^{2}$, 15.5 ${\pm}$ 1.9% and 37.3 ${\pm}$ 5.8%, respectively. The average daily numbers of steps were found to be 9,812 steps/day on day shift duty and 10,888 steps/day on night shift duty and 6,551 steps/day on holiday duty. Hourly step rates on day shift, night shift and holiday came to 1946 steps/hr, 2,130 steps/hr and 1,318 steps/hr, respectively. Activity coefficient (1.75) in night shift of the subjects was the highest and activity coefficient (1.52) in day shift was significantly higher than that (1.31) in holiday (p < 0.05). The rate of expending time for very light activity in holiday (91.5%) was significantly higher than that (70.0%) in night shift. The muscle mass (kg, %) had significantly positive relationship with daily steps in day shift (r = 0.592, r = 0.632) and night shift (r = 0.550, r = 0.503). Triceps skinfold thickness was negatively correlated with daily steps in day shift (r = -0.366, p < 0.05). There were remarkable differences in physical activities and sleeping hours depending on shift works of policemen. In the case of night shift work, sleeping hours was the lowest and activity coefficient was the highest among day shift, night shift and holiday. These results suggest that energy requirements of policemen should be differentiated according to shift work duty.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.111-120
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• 2021

Objectives : Shift work has been known to cause various health problems by making it difficult for humans to adapt to their natural circadian rhythms. In particular, shift workers tend to complain of sleep difficulties associated with work schedules, and sometimes use alcohol as a self-medication to induce sleep. To date, no clear mechanism has been identified regarding the link between shift work and sleep, between shift work and drinking. This study aims to confirm the relationship between shift work and sleep, and to analyze whether the change in sleep caused by shift work causes drinking. Methods : This study included 11360 people (5704 men and 5656 women) among the Korean National Health and Nutrition Survey data in 2014, 2016 and 2018. The work type between 6am-6pm was defined as day work, and other work types were defined as shift work. Using logistic regression analysis, the relationship between shift work and sleep quality, shift work and high risk drinking, drinking amount at 1 time, drinking frequency were analyzed. In addition, we analyzed whether sleep mediates the relationship between shift work and drinking using mediated analysis. Results : Shift work showed a significant negative relationship with sleep quality in men and women (male OR=1.37, 95% CI 1.11-1.70, female OR=1.26, 95% CI=1.05-1.50). There was no significant relationship between shift work and alcohol in the case of men, but in the case of women, there was a significant positive relationship between shift work and the number of alcohol consumption (OR=1.34, 95% CI=1.04-1.72). When mediation analysis was conducted, it was found that women's sleep quality partially mediated the relationship between shift work and the frequency of drinking. Conclusions : The results of this study suggest that shift work causes sleep difficulties, and in the case of women, drinking can be induced through the partial mediating effect of sleep. Considering that women are more likely to choose drinking as a coping method for sleep problems, more active interventions for female shift workers are needed.

• Safety and Health at Work
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• v.10 no.4
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• pp.512-517
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• 2019

Background: Rest breaks at work are reported to reduce fatigue and job stress. Apartment janitors in Korea who perform night shift work and work long hours can be exposed to various health problems (HPs). However, few studies have evaluated relationships between their rest breaks and HPs. This study was conducted to examine the relationships between long working hours, shift work, and insufficient rest breaks and HPs among Korean apartment janitors. Methods: Data on 1,212 selected male apartment janitors were obtained from the 3rd and 4th Korean Working Conditions Surveys. Demographic and occupational characteristics were collected using self-reported questionnaires. Rest breaks at work were classified as "sufficient" or "insufficient." Long working hours were considered as working more than 60 hours per week. Zero-inflated negative binomial (ZINB) regression was performed to investigate the effects of shift work and long working hours on HPs and the effects of rest breaks on relationships between HPs and long working hours and shift work. Results: Among those with insufficient rest breaks at work, significant associations were found between long working hours and the risk of HPs [odds ratio (OR) = 1.489; 95% confidence interval (CI) = 1.038-2.136] and work-related HPs (WRHPs) [OR 1.621; 95% CI = 1.156-2.272], and between shift work and HPs [OR = 1.603; 95% CI = 1.084-2.372]. These relationships became nonsignificant when sufficient rest breaks were provided. Conclusion: It is important to provide breaks at work to reduce HPs because of long working hours and shift work among aged workers such as apartment janitors.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.550-561
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• 2019

Objectives: The purpose of this study is to provide basic data for the improvement of the working environment for health prevention and related countermeasures for shift workers. This study was conducted based on the Fifth Korean Working Conditions Survey (KWCS), which analyzed the health effects of shift work forces and compared them with preceding studies. Methods: By analyzing secondary rates using raw data from the 5th KWCS, 4,870 (9.7%) of the 50,184 total study subjects were divided into shift work and 45,314 (90.3%) non-shift work groups based on the response to shift status. Variables that could affect work health issues were identified and corrected. A cross-analysis was conducted to examine demographic characteristics (gender, age, and education level) of the workers and occupation characteristics (monthly net earnings, employment type, occupation, working period up to now, workplace scale, type of work system, and weekly working hours). In order to find the work health issue ratio between the shift and non-shift work groups, logistic regression was analyzed and the association with health problems according to shift type by gender was looked at through cross-analysis. Results: According to the surveys conducted from the 1st KWCS (2006) to the 5th KWCS (2017), the proportion of shift workers continued to increase. Also, muscular pains in the lower limbs (hips, legs, knees, feet, etc.) (OR=1.135, 95%CI 1.031-1.251), headaches, eyestrain (OR=1.580, 95% CI 1.428-1.748), anxiety (OR=1.715, 95% CI 1.402-2.099), difficulty falling asleep (OR=1.391), and other problems (OR=7.392) were reported. In addition, back pain, muscular pains in shoulders, neck and/or upper limbs, muscular pains in lower limbs (hips, legs, knees, feet, etc.), headaches, eyestrain, depression, anxiety, overall fatigue resulted in significant results for both male and female shift workers. Depression and anxiety were higher in female shift/circulation compared to males. Conclusions: The social nets for the health and safety of shift workers should be explored in a variety of ways, including management and supervision of shift sites, attempts to reorganize and improve the shift system, development of workers' health recovery programs, promotion, systematic treatment, and compensation systems.

• 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.