Purpose: This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses. Methods: This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data. Results: The final model showed good fit to the empirical data: ${\chi}^2/df=2.19$, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (${\beta}=.32$), perceived shift work status (${\beta}=-.16$), stress response (${\beta}=.16$), shift work experience (${\beta}=.15$), perceived health status (${\beta}=-.14)$, and circadian rhythm (${\beta}=-.13$) explaining 36.0% of the variance. Conclusion: The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.
Choi, Jin Yi;Park, Young Mi;Choi, Dug Ja;Ha, Young Ok
Journal of East-West Nursing Research
/
v.25
no.1
/
pp.17-25
/
2019
Purpose: This study investigated the factors influencing sleep quality in adults according to age groups. The escriptive study was conducted in metropolitan areas of South Korea to control for possible sleep differences between adults living in rural areas and those living in cities. Participants were 450 adults between 19 and 65 years old. Methods: Self-administered questionnaires consisting of including the Korean Modified Sleep Leeds Evaluation Questionnaire, the International Physical Activity Questionnaire and the Perceived Stress Scale were used to assess the quality of adults' sleep. Results: Sleep quality was poor across the all age groups Stress and subjective health status were influencing factors of sleep quality among participants in their 20s; subjective health status and circadian rhythm (evening-type) were influencing factors of those in their 30s; subjective health status, alcohol consumption, and work days of less than 8 hours were influencing factors among participants in their 40s; and stress, circadian rhythm (evening-type), subjective health status, work days of over 11 hours, past smoking habit, and light physical activity were influencing factors of those aged 50 years and over. Conclusion: The quality of sleep was low across the all adult age groups in South Korea. Although the factors influencing quality of sleep differed by age groups, they in general indicate the need to focus on maintaining and controlling health status in sleep interventions.
Choi, Su Jung;Kim, Mi Soon;Jeon, Mi-Kyeong;Choi, Jin Ju;Son, Sook Yeon;Kim, Eun Hye
Journal of Korean Clinical Nursing Research
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v.29
no.3
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pp.223-237
/
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.
Eunseun Han;Yongho Lee;Sanghyuk Lee;Shinhyeong Kim;Seunghon Ham;Wanhyung Lee;Won-Jun Choi;Seong-Kyu Kang
Safety and Health at Work
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v.15
no.1
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pp.53-58
/
2024
Background: As social distancing persists and interest in work-life balance grows, more companies are adopting flexible work policies. While there have been studies on sleep disorders associated with different types of work, such as shift work, research exploring the relationship between flexible work schedules and sleep disorders is still limited, particularly among Korean workers. Methods: We performed a secondary analysis of the 6th Korean Working Conditions Survey, focusing on 31,243 paid workers out of a total of 50,538 participants. We defined flexible workers as those who set their own working hours. Sleep disorders were divided into three categories: 'difficulty falling asleep,' 'frequent waking during sleep,' and 'waking up feeling exhausted and fatigued.' Using scores derived from three specific symptoms, the Minimal Insomnia Symptoms Scale (MISS) was calculated to assess the prevalence of insomnia. We used chi-square tests to analyze demographic and job-related differences. A multivariate logistic regression analysis was employed to identify any relationship between flexible work schedules and sleep disorders. Results: Significant differences were found between flexible and non-flexible workers regarding age, income level, education level, and job type. Flexible workers reported sleep-related symptoms significantly more often. The odds ratio for insomnia was 1.40 (95% CI 1.21-1.61). For males, the odds ratio was 1.68 (1.36-2.08). Conclusion: This study establishes a correlation between flexible work schedules and sleep disorders among Korean salaried workers. Potential causes could include changes in circadian rhythm, increased work demands, and extended working hours. To precisely determine causality and associated diseases, further research is required.
Background: E-waste workers in Hong Kong are handling an unprecedented amount of e-waste, which contains various neurotoxic chemicals. However, no study has been conducted to evaluate the neurological health status of e-waste workers in Hong Kong. This study aimed to evaluate the prevalence of neurobehavioral alterations and to identify the vulnerable groups among Hong Kong e-waste workers. Methods: We recruited 109 Hong Kong e-waste workers from June 2021 to September 2022. Participants completed standard questionnaires and wore a GENEActiv accelerometer for seven days. Pittsburgh Sleep Quality Index and Questionnaire 16/18 (Q16/18) were used to assess subjective neurobehavioral alterations. The GENEActiv data generated objective sleep and circadian rhythm variables. Workers were grouped based on job designation and entity type according to the presumed hazardous level. Unconditional logistic regression models measured the associations of occupational characteristics with neurobehavioral alterations after adjusting for confounders. Results: While dismantlers/repairers and the workers in entities not funded by the government were more likely to suffer from neurotoxic symptoms in Q18 (adjusted odds ratio: 3.18 [1.18-9.39] and 2.77 [1.10-7.46], respectively), the workers from self-sustained recycling facilities also have poor performances in circadian rhythm. Results also showed that the dismantlers/repairers working in entities not funded by the government had the highest risk of neurotoxic symptoms compared to the lowest-risk group (i.e., workers in government-funded companies with other job designations). Conclusion: This timely and valuable study emphasizes the importance of improving the working conditions for high-risk e-waste workers, especially the dismantlers or repairers working in facilities not funded by the government.
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation that is able to alter neuronal activity in particular brain regions. Many studies have researched how tDCS modulates neuronal activity and reorganizes neural networks. However it is difficult to conclude the effect of brain stimulation because the studies are heterogeneous with respect to the stimulation parameter as well as individual difference. It is not fully in agreement with the effects of brain stimulation. In particular few studies have researched the reason of variability of brain stimulation in response to time so far. The study investigated individual variability of brain stimulation based on circadian rhythm and chronotype. Participants were divided into two groups which are morning type and evening type. The experiment was conducted by Zoom meeting which is video meeting programs. Participants were sent experiment tool which are Muse(EEG device), tdcs device, cell phone and cell phone holder after manuals for experimental equipment were explained. Participants were required to make a phone in frount of a camera so that experimenter can monitor online EEG data. Two participants who was difficult to use experimental devices experimented in a laboratory setting where experimenter set up devices. For all participants the accuracy of 98% was achieved by SVM using leave one out cross validation in classification in the the effects of morning stimulation and the evening stimulation. For morning type, the accuracy of 92% and 96% was achieved in classification in the morning stimulation and the evening stimulation. For evening type, it was 94% accuracy in classification for the effect of brain stimulation in the morning and the evening. Feature importance was different both in classification in the morning stimulation and the evening stimulation for morning type and evening type. Results indicated that the effect of brain stimulation can be explained with brain state and trait. Our study results noted that the tDCS protocol for target state is manipulated by individual differences as well as target state.
In order to know the characteristics of circadian rhythms in core temperature in tropical inhabitants, we measured rectal temperatures every 10 min for 24 hrs in 6 Vietnamese, 20 - 22 yrs (5 males and I females) under natural conditions. Average light intensity was 16000 lx. Ambient temperatures ranged from 33 to 36 oC. These data obtained were compared with those in Japanese setters and the Polish inhabitants. The participants were sitting mostly during wakefulness and lying in bed during sleep. The results obtained are summarized as follows: I) The average maximum value was 37.7 oC, which was significantly higher than in the Japanese and Polish as well. 2) The average minimum value was 36.4 oC, which was also lower. 3) A range of oscillation was 1.3 oC, which was clearly greater than in the people living in the temperate areas. The higher maximum value of core temperature, which was actively regulated under warm temperature, seemed of adaptive significance in order to reduce water consumption. A greater rage of oscillation in tropical Vietnamese people might have ecological significance for efficient acclimatization in the environment with strong light intensity and high ambient temperature, suggesting that the setpoint of core temperature could show a greater range of oscillation.
Many mammals in temperate zones are affected by the distinctive changes of the four seasons in these zones. Their reproductive status is active in the summer climate and inactive during severe winter weather. The golden hamster (Mesocricetus auratus) is seasonal breeding animal whose sexual activities are regulated by photoperoidism. The reproduction and metabolism are activated by long summer days (LD) and inhibited by short winter days (SD). After several months of SD, animals become refractory to this inhibitory photoperiod and spontaneously revert to LD-like physiology. The suprachiasmatic nuclei (SCN) house the primary circadian oscillator in mammals. Seasonal changes in the photic input to this structure control many annual physiological rhythms via SCN-regulated pineal melatonin secretion, which provides an internal endocrine signal representing photoperiod. The aim of this study was to assess the variation in the morphology of the testis in relation to the natural photoperiod in male golden hamsters. The hamsters were castrated at different weeks (2, 5, 8, and 15). The cell numbers of tubules with spermatogonia (SG), spermatocyte (SC), spermatids (ST), and spermatozoa (SZ) were recorded in each sample. The results showed that testicular regression of golden hamsters occurred in the SD-treated animals. The present investigation determines that the effects of the photoperiod on the reproduction of male golden hamsters. It was also found that the circadian period increases the rate of reproductive inhibition in animals exposed to inhibitory photoperiods.
This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( $^2$) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.
Circadian rhythmicity (e.g. secretory pattern of hormones) plays an important role in the control of reproductive function. We hypothesized that the alteration of feeding pattern via meal time shift/restriction might disrupt circadian rhythms in energy balance, and induce changes in reproductive activities. To test this hypothesis, we employed simple animal model that not allowing $ad$$libitum$ feeding but daytime only feeding. The animals of $ad$$libitum$ feeding group (Control) have free access to food for 4 weeks. The day feeding (=reverse feeding, RF) animals (RF group) have restricted access to food during daytime (0900-1800) for 4 weeks. After completing the feeding schedules, body weights, testis and epididymis weights of animals from both group were not significantly different. However, the weights of seminal vesicle (control : RF group = $0.233{\pm}0.014g$ : $0.188{\pm}0.009g$, $p$<0.01) and prostate (control : RF group = $0.358{\pm}0.015g$ : $0.259{\pm}0.015g$, $p$<0.001) were significantly lower in RF group animals. The mRNA levels of pituitary common alpha subunit ($C{\alpha}$; control : RF group = $1.0{\pm}0.0699$ AU : $0.1923{\pm}0.0270$ AU, $p$<0.001) and $FSH{\beta}$ (control : RF group = $1.0{\pm}0.1489$ AU : $0.5237{\pm}0.1088$ AU, $p$<0.05) were significantly decreased in RF group. The mRNA levels of ACTH were not significantly different. We were unable to find any prominent difference in the microstructures of epididymis, and there were slight alterations in those of seminal vesicles after 4 weeks of reversed feeding when compared to control samples. The present study demonstrates that the shift and/or restriction of feeding time could alter the pituitary gonadotropin expression and the weights of seminal vesicle and prostate in rats. These data suggest the lowered gonadotropin inputs may decrease androgen secretion form testis, and consequently results in poor response of androgen-dependent tissues such as seminal vesicle and prostate.
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