• 간호행정학회지
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• 제21권5호
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• pp.519-529
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• 2015

Purpose: This study was performed to identify perceptions on fixed night shift system and turnover intention of general hospital nurses and to explore a desirable application plan for a fixed night shift system. Methods: This study was a cross-sectional survey. Participants were 300 nurses working at one general hospital in GyeongGi-Do, Korea. Data were collected from November 3 to 7, 2014, with a structured questionnaires and analyzed using SPSS/PC ver 20.0 programs. Results: Of the participants 73.5% had thought about turnover because of night shifts and the preconditions for desirable fixed night shift system were a payment plan differentiated according to work conditions and an adequate number of nursing staff. Economic and administrative supports like 'raising extra-pay for night shift' and 'increasing the number of paid holidays' were very important for a desirable fixed night shift system. Conclusion: The results indicate that the most important factor for a desirable fixed night shift system to decrease nurses' turnover intention is economic and administrative support according to the needs of the nurses. So nursing managers need to find a desirable fixed night shift system considering nurses' demographic characteristics and organizational characteristics.

• 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.

• 임상간호연구
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• 제27권2호
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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.

• 대한간호학회지
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• 제54권2호
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• pp.237-249
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• 2024

Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

• 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.

• 대한간호학회지
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• 제21권2호
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• pp.129-149
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• 1991

Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep - wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi -continuous shift schedule(sunday off) with a backward direction, that is, morning -evening - night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking tim, sleep - wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep- wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep -wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : λ＝0.121, p＜0.01, λ＝0.112, p＜0.01, biweekly shift group : λ＝0.116, p＜0.01, λ＝0.084, p＜0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t＝-2.28, p＜0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝5.79, p＜0.01, F＝4.56, p＜0.05). There was a significant difference between the shift groups and the control group(p＜0.05), Physical fatigue, neurosensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝12.65, p＜0.01, F＝7.77, p＜0.01, F＝9.68, p＜0.01). There was a significant difference between the shift groups and the control group(p＜0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmatic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝3.79, p＜0.05). There was a significant difference between the shift groups and the control group(p＜0.05) . The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F＝3.68, p＜0.05, F＝5.55, p＜0.01), and both showed a significant difference between the shift groups and the control group(p＜0.05). Accordingly, this study showed that during night duty, the waking time, sleep- wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the -first day, but the waking time, sleep- wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

• Journal of Acupuncture Research
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• 제24권4호
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• pp.13-23
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• 2007

Objectives : The aim of the present study was to assess the effects of Sa-am acupuncture (Damjeonggyeok) on autonomic nervous system in night nurses by heart rate variability. Methods : Five night nurses were divided into two groups. We checked their HRV once after sleeping for night and 5 times after working for night, 4 times after operation. We operate Sa-am acupuncture (Damjeonggyeok) and sham acupuncture twice by turns for group A and in reverse order for group B. We checked responses of HRV change after operations. Statistical analysis was performed by using the SPSS Win. Ver. 13.0 for analysis about correlation between data, and Baysian analysis using WinBUGS(Ver. 1.4) for comparison between Sa-am acupuncture (Damjeonggyeok) and sham acupuncture. Results : The median overall decrease for difference in responses of low-frequency power in normalized units (LF (NU)) was -16.56 (-28.88, -6.446), the median overall increase for difference in responses to high-frequency power in normalized units (HF (NU)) was 16.25 (8.104, 28.6) and for the median overall decrease for difference in responses to the ratio of low- to high-frequency power (LF/HF) was -1.846 (-3.922, -0.069), 95% credibility intervals being shown in brackets. VAS of stress was correlated with LF (NU) and HF (NU), LF/HF (p<0.0l). Conclusion : Sa-am acupuncture (Damjeonggyeok) might have sympatholytic and parasympathomimetic effects.

• 한국산업보건학회지
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• 제33권2호
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• pp.206-214
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• 2023

Objectives: To determine the effect of the various type and number of shift work on sociopsychological stress in the university hospital nurses in Seoul, South Korea. Methods: Data was collected through a self-administered questionnaire that included general characteristics, the type and number of shift work in the past 4 weeks and the an sociopsychological stress based on PWI-SF. Logistic regression analysis was conducted to analyze the effect of shift work by types on sociopsychological stress of university hospital nurses using SAS 9.4 and it adjusted general characteristics by the additional models. Results: When the number of night shift work 3 or 4 compared to 0, sociopsychological stress was significantly high(OR=2.16, 95% CI=1.29-3.65). When 5 or more, it was higher(OR=2.39, 95% CI=1.55-3.72). Two continuous night shift work compared to 0 increased sociopsychological stress(OR=2.37, 95% CI=1.49-3.81) and 3 or more even more(OR=2.70, 95% CI=1.72-4.27). If the shift work type changes 14 or 15 times compare to below 11, sociopsychological stress is increased and even higher when 15 or more times but it's not significant after adjusting for covariates. Conclusions: It suggests that workplace with nurse expose to shift work should be on lookout for more than three night shift work, more than two continuous night shift work and more than 14 shift work change which can lead to burnout, absenteeism, depression and decreased productivity.

• 한국간호교육학회지
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• 제13권2호
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• pp.169-176
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• 2007

Purpose: The purpose of this study was to verify the effect of aromatherapy hand massage on stress responses and serum Immunity of RN's before the night duty. Method: The data were collected during the period from Oct. 10 to Nov. 15, 2005 at S-Hospital in Seoul. There were forty-eight subjects, 24 for the experimental and 24 for the control group. A Pre & post test were conducted to measure pulse rate, perceived stress(level and score) and a blood sample for cortisol and IgA. In the experimental group, lavender and geranium were used. Data were analyzed by descriptive statistics, $x^2$-test and t-test with SPSS program. Result: The pulse rate was reduced but there were no significant differences between the two groups. Scores of subjective stress(VAS) decreased significantly after aromatherapy hand massage and the level of serum Cortisol was reduced significantly. The level of serum IgA was elevated significantly. Conclusion: Aromatherapy hand massage could be a useful intervention to reduce stress and elevate the immunity of nurses during the night duty.

• Journal of Korean Biological Nursing Science
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• 제1권1호
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• pp.86-99
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• 1999

The purpose of this study is to find out the difference in circadian rhythm and level of fatigue between ER and General Ward Nurse. This study was done through analyzing body temperature, heart rate and major electrolytes such as $Na^+$ and $K^+$ concentration on urinalysis, which are related to factors of circadian rhythm and level of fatigue. The subjects, 17 nurses from Emergency Room and 25 nurses from general ward, were selected from a General Hospital in Taegu City on August 8 to 23, 1998. And the data were analyzed by proportion, t-test, chi-square and Pearson's Correlation, ANCOVA, using SAS program. The results of this study were shown as follows: First, The difference of Maximal and minimal heart rate was significant between ER group and general ward group. However, body temperature difference wasn't notable. Second, Urine $Na^+$ concentration on urinalysis was lower and $K^+$ concentration on urinalysis was higher in ER group than general ward group significantly. Third, Fatigue level was higher in ER group than general ward group significantly. Fourth, through urine concentration, significant relations in circadian rhythm of ER nurse group and general ward group and their fatigue level were found. Urine $Na^+$ concentration on urinalysis of ER nurse was significant related with their fatigue level. In conclusion, the effect of fatigue on circadian rhythm is greater in ER group than general ward group during night shift. This study could be a help in improvement of nurse's health and understanding the effect of fatigue on health.