• 임상간호연구
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• 제29권3호
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• pp.223-237
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• 2023

Purpose: This study aimed to investigate the impact of a nurse shift improvement pilot project on nurses' shift adjustment, work-life balance, and turnover intention, as well as nurses' experiences of participating in the pilot project. Methods: An explanatory sequential mixed-methods study was performed. Survey data was collected from a total of 1,051 nurses both in participant and non-participant groups. For the qualitative study, focus group interviews were conducted with 22 nurses who participated in the shift improvement pilot, including 12 staff nurses, 7 nurse managers, and 3 substitute nurses. Results: There were significant positive effects on the key variables of nurses' shift adjustment, work-life balance, and turnover intention in the group that participated in the nurse shift improvement pilot project. Based on the qualitative study, participants in the shift improvement pilot project indicated that it enabled nurses to recover their circadian rhythm, and achieve a better work-life balance, and they wanted to continue working as a nurse, and hoped expanded application of the pilot project. Conclusion: In order for expanded implementation of the pilot project and continued improvement in the shift system, we recommend establishing compensation standard, systematizing the use of substitute nurses, developing guidelines for shift schedules, and expanding the shift improvement pilot project to other departments such as the emergency room.

• 한국산업보건학회지
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• 제28권4호
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• pp.331-345
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• 2018

Objective: Shift work including night work is known to be harmful to the health of nurses. This study was conducted in order to systematically review the academic literature on the health effects of working time patterns, including shift work or night work, among Korean nurses and propose a research direction for the future. Methods: We searched online academic databases to find relevant papers in domestic and international journals using the keyword terms 'shift work', 'night work', 'night shift', 'work shift', 'nurse', and 'Korea', and reviewed a total of 36 articles. Results: As a result of this literature review, more than half of the articles were found to investigate the health effects between shiftwork and non-shiftwork nurses. A few studies considered the shift type(n=6), frequency of night shift(n=4), and shiftwork duration(n=3) as working time patterns. These studies focused mainly on mental health(n=18) or sleep(n=15). Conclusions: Based on the review results obtained from this study, it is necessary to assess working time patterns of Korean nurses using a variety of variables including night-work-related factors, and various health outcomes should be examined considering the confounder.

• 기본간호학회지
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• 제1권1호
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• pp.77-97
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• 1994

The circadian system represents a temporal order which is mediated by the mutual coupling of oscillators and by the synchronizing effects of zeitgebers. It is known that well-being of man depends partly on the maintenance of this order, and that repeated or long lasting disturbances to it such as shift work will Cause harmful effects. This study was a quasi-experimental study to test the effect of shift directions for the clinical nurses on the circadian rhythm. Fourteen nurses working at the general units of Y hospital were selected according to the established criteria. Fourteen subjects were assigned to a weekly shift but the directions of shift work were phase delay first and then phase advance or vice versa. Oral temperature, total sleeping time, frequency of sleep-wake cycle, fatigue, mental performance, and physical symptom were measured during these days except holidays. The data collection period was from April 26, 1993 to July 3, 1993. MANOVA and Wilcoxon signed rank test were used for statistical analysis. The results are summarized as follows. 1. Having worked on evening and night shifts in either phase delay or phase advance schedules, temperature rhythms of shift workers were gradually adapted to the new sleep-wake cycles. A complete adaptation to work on the night shift was achieved the sixth day of the night shift in the phase delay schedule compared to the partial adaptation to the work on the night shift in the phase advance schedule. Accordingly, by putting evening shift between day and night shifts, it will be possible for circadian rhythm to adapt easily to the night shift. 2. There were differences in the total sleeping time, frequency of steep-wake cycle, fatigue, and physical symptom except for mental performance between night shift and day, evening shift. This indicates further that shift workers working on the night shift have a hard time adapting to the shift work compared to the other shifts. 3. Evaluating all the acrophases of temperature rhythm either in phase delay or phase ad-vance schedules, it was shown that night to evening shift in the phase ad-vance schedule revealed the smallest phase move. Also phase advance schedule showed poorer adaptation to shift work than phase delay schedule in connection with total sleeping time, frequency of sleep-wake cycle, fatigue, mental performance, and physical symptom. It is suggested, taken together, these findings reflect that phase delay schedule facilitated the degree of adjustment to the shift work compared to the phase advance schedule.

• Journal of Korean Biological Nursing Science
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• 제13권3호
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• pp.229-237
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• 2011

Purpose: The objective of this study was to investigate the relationships between sleep quality, fatigue, depression and health promoting behavior by shift-work patterns in university hospital nurses. Methods: A cross-sectional, descriptive survey was conducted using a convenient sample. The self-administered questionnaires were given to 165 nurses (shift workers 91, non-shift workers 74) employed in two university hospital located in Seoul and Gyeunggi-do. Data were collected from February to March, 2010. Results: The shift workers showed significantly lower sleep quality and health promoting behavior, and higher fatigue than non-shift workers. There were significant correlations between fatigue, depression and health promoting behavior in shift workers. There were significant correlations between sleep quality, fatigue, depression and health promoting behavior in non-shift workers. In multiple linear regression analysis, after controlling for total work experiences, predictor of health promoting behavior in shift workers was only fatigue (${\beta}$=-.29, p<.001). Predictors of health promotion behavior in non-shift workers were depression (${\beta}$=-.37, p=.002) and fatigue (${\beta}$=-.27, p=.023). Conclusion: This study failed to provide a clear explanation why sleep quality does not have a comparable effect on health promotion behaviors of shift-workers as well as non-shift workers. However, future research is needed to determine the various risk factors influencing on health promotion behaviors by which shift-work pattern exacerbates fatigue.

• Safety and Health at Work
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• 제13권1호
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• pp.17-22
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• 2022

Background: This study aimed to identify work-related risk factors, including long working hours and night/shift work, for unmet health care need using data of a representative panel of Korean adults. Methods: Associations between work-related factors and unmet health care need were analyzed using data of 3,440 participants (10,320 observations) from the 2011-2013 Korean Health Panel Study. A generalized estimating equation was used for the analysis of repeated measures. Results: The prevalence of unmet health care was 16.6%. After adjusting sex, age, socioeconomic status, work characteristics, and working more than 60 hours per week (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.23-1.65) or 50-59 hours per week (OR: 1.26, 95% CI: 1.08-1.46) instead of 40-49 hours per week and night/shift work (OR: 1.27, 95% CI: 1.06-1.51) were associated with unmet health care need. Conclusion: Long working hours and night/shift work are risk factors for unmet health care need among the Korean working population.

• 생물정신의학
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• 제24권2호
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• pp.59-67
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• 2017

Shift workers experience a disruption in the circadian sleep-wake rhythm, which brings upon adverse health effects such as fatigue, insomnia and decreased sleep quality. Moreover, shift work has deleterious effects on both work productivity and safety. In this review, we present a brief overview of the current literature on the consequences of shift work, especially focusing on attention-associated cognitive decline and related behavioral changes. We searched two electronic databases, PubMed and RISS, using key search terms related to cognitive domains, deleterious effects, and shift work. Twenty studies were eligible for the final review. The consequences of shift work can be classified into the following three categories extracted from the literature review : 1) work accidents ; 2) commuting accidents such as car accidents that occur on the way to and from work ; and 3) attendance management at work (i.e., absenteeism, tardiness, and unscheduled early departure). These cognitive and behavioral consequences of shift work were also found to be associated with sleep disorders in shift workers. Thus, improvements in the shift work system are necessary in order to enhance workers' health conditions, work productivity, and safety.

• 대한지역사회영양학회지
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• 제7권5호
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• pp.615-627
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• 2002

The purpose of this study was to examine the eating habits and nutrient intake of industrial workers who work day and night shifts. In the area of percentage of skipped meals, the day shift workers responded that they usually skipped breakfast and the night shift workers often skipped lunch and dinner. The day shift workers answered that they skipped meals because of lack of time. The night shift workers cited poor appetite as their main reason for skipping meals. The intake of calories, Vitamin $B_2$ and calcium of the industrial workers who worked day and night shift was lower than the Korean RDA. The intake of iron of the male night shift workers was lower than the Korean RDA The intake of calories, protein, calcium, iron, Vitamin $B_2$and niacin, vitamin C of the female night shift workers was lower than the Korean RDA. In the area of nutrient intake, the night shift workers both male and female got lower scales than the day shift workers. The nutrient intake of the female night shift workers was the worst. Because they cook for themselves and live alone, their nutrient intake and eating habits were bad. The night shift workers were worse than the day shift workers and the female night shift workers were the worst. Considering the above results, night shift workers should correct their poor eating habits, their nutrient intake and have a well-balanced diet.

• 성인간호학회지
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• 제29권2호
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• pp.190-199
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• 2017

Purpose: The purpose of this study was to investigate the differences in sleep, fatigue, and neurocognitive function between shift nurses and non-shift nurses. Methods: A cross-sectional descriptive study design was used. A total of 100 nurses participated in the study. 50 were shift nurses and the remaining 50 were non-shift nurses. The Pittsburgh Sleep Quality Index, Fatigue Severity Scale, and a computerized neurocognitive function test (CNS Vital Signs-VS4) were administered to the subjects to assess verbal and visual memory, processing speed, reaction time, and simple attention. After the last night shift, the shift nurse conducted the study at around 8:00 am and the non-shift nurse participated after work. Results: Compared to non-shift nurses, shift nurses had a significantly lower sleep quality (p=.002) and higher fatigue (p=.001) and achieved significantly lower scores on verbal memory (p=.001), processing speed (p=.003), and reaction time (p=.018). There were significant correlations between sleep quality and processing speed (p=.042), and reaction time (p=.015) of shift nurses who were bad sleepers. Conclusion: This study findings suggest shift work could interfere with cognitive function. Personal and organizational programs should be developed to support their sleep and neurocognitive function.

• Journal of Korean Biological Nursing Science
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• 제20권3호
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• pp.187-195
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• 2018

Purpose: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. Methods: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. Results: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance ($ISI{\geq}15$), fatigue (FSS $score{\geq}4$), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS $score{\geq}4$). Conclusion: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.

• 한국직업건강간호학회지
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• 제18권1호
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• pp.14-21
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• 2009

Purpose: This study was performed to investigate the effect of shift work on diurnal blood pressure (BP) pattern in nurses. Method: We studied 20 healthy nurses engaged in 3 shift work. 24-hour ambulatory BP monitoring was performed to each nurse two times during the day and night shift. Five nurses were excluded because of inadequate BP measurement. Results: All subjects were female. The mean age was 27.4 years (range: 23-33 years) and mean body mass index was 19.7 Kg/$m^2$ (range: 18.0-21.2 Kg/$m^2$). The changes of systolic BP ($17.8{\pm}9.1$ vs. $13.2{\pm}4.7%$, p=0.031), diastolic BP ($22.3{\pm}8.7$ vs. $17.3{\pm}9.0%$, p=0.061), and heart rate ($25.2{\pm}5.2$ vs. $12.5{\pm}8.7%$, p=0.001) during the sleeping period were decreased after a night shift compared with day shift. The non-dipper group significantly increased from 20% to 40% after a night shift (p=0.018). Conclusion: Working night shift is significantly associated with non-dipper status in nurses.