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Relationship Between Shift Intensity and Insomnia Among Hospital Nurses in Korea: A Cross-sectional Study
Yuhjin Chung, Hyunjoo Kim, Dong-Hee Koh, Ju-Hyun Park, Seohyun Yoon
J Prev Med Public Health. 2021;54(1):46-54.   Published online December 22, 2020
DOI: https://doi.org/10.3961/jpmph.20.555
  • 5,117 View
  • 221 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
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.
Summary
Korean summary
불면증상의 척도로서 ‘한국판 불면증 심각도 평가척도’를, 교대근무강도의 지표로서 지난 3개월 간의 ‘3회 연속 야간근무 횟수’와 ‘교대근무 이후 짧은 휴식기간’을 사용하여, 대학병원 야간 근무 간호사 386명의 불면증상과 교대근무강도 간의 연관성을 탐색하고자 하였다. 로지스틱 회귀분석 결과, ‘3회 연속 야간근무 횟수’와 ‘교대근무 이후 짧은 휴식기간’은 불면증상의 오즈비 증가와 관련이 있었다. 이 결과는 교대근무강도를 저하시켜야 순환 교대근무 병원 간호사들의 불면증상을 줄일 수 있음을 시사한다.

Citations

Citations to this article as recorded by  
  • The interaction between mental resilience and insomnia disorder on negative emotions in nurses in Guangdong Province, China
    Ningjing Zhan, Yixuan Xu, Jiangfeng Pu, Waner Wang, Zhanghao Xie, Huigen Huang
    Frontiers in Psychiatry.2024;[Epub]     CrossRef
  • Qualidade de vida e engajamento no trabalho em profissionais de enfermagem no início da pandemia de COVID-19
    Taisa Moitinho de Carvalho, Luciano Garcia Lourenção, Maria Helena Pinto, Renata Andrea Pietro Pereira Viana, Ana Maria Batista da Silva Gonçalves Moreira, Leticia Pepineli de Mello, Gilney Guerra de Medeiros, Antonio Marcos Freire Gomes
    Ciência & Saúde Coletiva.2023; 28(10): 2903.     CrossRef
  • Quality of life and work engagement among nursing staff at the start of the COVID-19 pandemic
    Taisa Moitinho de Carvalho, Luciano Garcia Lourenção, Maria Helena Pinto, Renata Andrea Pietro Pereira Viana, Ana Maria Batista da Silva Gonçalves Moreira, Leticia Pepineli de Mello, Gilney Guerra de Medeiros, Antonio Marcos Freire Gomes
    Ciência & Saúde Coletiva.2023; 28(10): 2903.     CrossRef
  • Prevalence of Insomnia among Medical Staff during the Epidemic Prevention and Control: A Perspective on Health Behavior
    Jinhua Sun, Xiaoqing Wang, Liman Jian, Bo Dong
    American Journal of Health Behavior.2023; 47(4): 714.     CrossRef
  • Insomnia among Intensive Care Unit Nurses in the United Arab Emirates and its Association to Work Productivity and Quality of Life
    Hassnaa Shaban Mobarak, Fatma Refaat Ahmed, Nabeel Al-Yateem, Wegdan Bani-Issa, Muna Ibrahim Alhosani, Mohannad Eid AbuRuz
    The Open Nursing Journal.2023;[Epub]     CrossRef
  • Personality Traits and Insomnia Symptoms in Shift Workers
    Brigitte Holzinger, Lucille Mayer, Gerhard Klösch
    Frontiers in Psychology.2021;[Epub]     CrossRef
  • The Association Between the Number of Consecutive Night Shifts and Insomnia Among Shift Workers: A Multi-Center Study
    Juho Sim, Byung-Yoon Yun, Jiho Lee, Sung Kyung Kim, Seunghyun Lee, Ara Cho, Seunghan Kim, Chang-young Kim, Yeon Suh Oh, Jin-Ha Yoon
    Frontiers in Public Health.2021;[Epub]     CrossRef
  • Alcohol Abuse and Insomnia Disorder: Focus on a Group of Night and Day Workers
    Fulvio Plescia, Luigi Cirrincione, Daniela Martorana, Caterina Ledda, Venerando Rapisarda, Valentina Castelli, Francesco Martines, Denis Vinnikov, Emanuele Cannizzaro
    International Journal of Environmental Research and Public Health.2021; 18(24): 13196.     CrossRef
Health Assessment of Shift Workers in a Automobile Manufacturing Plant.
Jung Jeung Lee, Jong Hak Chung
Korean J Prev Med. 1995;28(1):103-122.
  • 2,047 View
  • 23 Download
AbstractAbstract PDF
An investigation on psychophysiological health and social well-being of shift workers been carried out on workers of a automobile manufacturing plant in Ulsan. for 1 month from April, 1993. This cross-sectional survey compared shift workers(n=544) with day workers(n=l15). Each subject completed a questionnaire about his personal habit background. shift schedule. sleep and eating patterns. subjective digestive symptom and psychological well-being and distress using the General Well-Being schedule(GWB) by self administrated questionnaire that was developed for the U. S. Health and Nutrition Examination surveys (HANES I). chi-square analysis was used for discontinuous data and the t-test was used for continous data to determine whether differences noted between the two groups. In terms of sleep quality, a greater percentage of shift workers frequently had trouble getting back to sleep once awakend(p<0.01) and a greater percentage of shift workers awakend tired or sleepy frequently more often than day workers(p<0.05). In rating the quality of their sleep, more shift workers rated their sleep fair to poor than day workers, and greater percentage of shift workers felt tired or sleepy at work two or more times per week(p<0.01) and a much higher percentage of shift workers felt tired or sleepy after work every days(p<0.01). In terms of sleep patterns, a much higher percentage of day workers reported uninterrupted sleep per 24hours than shift workers. The shift workers reported different eating patterns from day workers but there were no statistically significant and rate of their appetite. Thirteen percent of day workers reported the best appetite but only 6.6% of shift workers had the best appetite. The gastric complaints is more frequent in shift workers than day workers(p<0.01). Among subscores in General Well-Being Schedule, anxiety, depression, positive well-being and vitality subscale of shift workers were lower than those of day workers(p<0.05) and general health and self control subscale of shift workers were lower than those of day workers but there were no statistical significant difference. Based on these study result, it could be concluded that the shift work has significant effects on some psychophysiological conditions of the workers.
Summary
Comparison of Subjective Symptoms of Workers in Rapidly and Weekly Rotating Shift Systems.
Young Yeon Jung, Gwang Seo Choi, Kuck Hyeun Woo, Gu Wung Han
Korean J Prev Med. 1992;25(4):374-385.
  • 2,144 View
  • 19 Download
AbstractAbstract PDF
Some circadian rhythms can become disorganized due to rotating shift work. This lack of organization, termed desynchronization, can produce a group of symptoms such as insomnia, GI disturbance and fatigue among many rotating shift workers. The magnitude of these symptoms are influenced by personal and environmental factors and the patterns of shift work. This study was carried out to investigate the subjective symptoms related to rotational schedules of shift work after personal and environmental factors adjusted. 182 male workers in rapidly rotating shift system and 86 male workers in weekly rotating shift system were conducted the questionnaire on personal factors and subjective sleep, GI and fatigue symptoms. Major findings obtained from this study are as follows: 1. The symptoms of 'feeling tired at work' and 'being irritable' were more frequent in weekly rotating shift workers(P<0.05), and the mean of symptom score was significantly higher in weekly rotating shift workers(P<0.01). 2. According to 6 hours of sleeping which is a definite elevation point of fatigue, there was not a significant difference between two groups in sleeping hours. Among workers in rapidly rotating shift system, the mean of symptom score was significantly higher in workers of less than 6 hours of sleeping(P<0.05), but it was not different among weekly rotating shift workers. 3. The symptoms of GI disturbance were more frequent in weekly rotating shift workers but statistically mot significant. 4. The positive rate of mental and physical fatigue symptoms were significantly higher in weekly rotating shift workers(P<0.01) and mental and physical fatigue symptoms were more frequent in them(P<0.01). 5. After the effect of the factors that were significantly different between two groups by X2-test were controlled, the mean score of sleep disturbance was significantly higher in weekly rotating shift workers(P<0.01) and mental physical fatigue symptoms were more frequent in them(P<0.01). Based on these study results, subjective symptoms were more common in the weekly rotating shift workers. In future, medical examination and laboratory test will be also administered to evaluate a more accurate health outcomes and the review of current shift schedules will be required.
Summary
Health risks related to shift work among female workers of major manufacturing industries in Korea.
Euichul Shin, Kwang Ho Meng
Korean J Prev Med. 1991;24(3):279-286.
  • 2,134 View
  • 23 Download
AbstractAbstract PDF
Much of the working population in developing countries are engaged in shift work now and the number of shift workers is not expected to decrease in the future mostly because the need for continuity of production is increasing. Therefore, the possible effects of shift work on health are of particular interest, and in fact, there have been many epidemiological studies on shift work since the first world war. However, no studies on health effects of shift work have been reported in Korea, and the existing studies in western world have arrived at quite different conclusions mainly because the conditions of work other than shift work, such as age and selection of workers, work environment, and labor conditions also influence the health of workers. This study was firstly carried out in Korea to investigate the health risks related to shift work with 2,093 female workers randomly selected from three major manufacturing industries in proportion to total number of female workers in those industries. Differences of work conditions other than shift work in this study were adjusted by multivariate analysis. Major findings obtained from this study are as follows: 1. There were significant differences between shift and day workers in the distribution of age, type of industry, condition of noise and dust, regularity of mealtime, working position, and working duration. Shift workers tended to be younger, to have shorter working duration, to have more irregular mealtime, to work in standing position, and to work under more noisy and dusty environment than day workers. 2. Univariate analysis showed that shift work increased the Todai Health Index (THI) scores of digestive tract, respiratory tract, and mental instability symptom categories. Shift work also increased days of sickness absence and number of industrial accident per 100 workers per month. 3. Multivariate analysis that adjusted the differences of demographic, occupational and non-occupational health-related working conditions showed that digestive tract symptoms and mental instability symptom scores were significantly higher in shift workers than those in day workers. Based on those study results, it is concluded that the shift work has significant effects on some psychophysiological conditions of the workers and the effects are also influenced by several other personal and working conditions.
Summary

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