Korean Journal of Psychosomatic Medicine (정신신체의학)

Korean Psychosomatic Society (한국정신신체의학회)
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Comparisons of Subjective and Actigraphic Measurements of Sleep between Shift-working and Daytime Psychiatric Nurses

정신과 교대근무와 주간근무 간호사에서 수면의 주관적 및 활동기록기 평가의 비교

  • Kwak, Jun (Department of Psychiatry, Naju National Hospital) ;
  • Yoon, Bo-Hyun (Department of Psychiatry, Naju National Hospital) ;
  • Jeon, Bong-Hee (Department of Psychiatry, Naju National Hospital) ;
  • Sea, Young-Hwa (Department of Psychiatry, Naju National Hospital) ;
  • Song, Jye-heon (Department of Psychiatry, Naju National Hospital) ;
  • Park, Su-hee (Department of Psychiatry, Naju National Hospital) ;
  • Kim, Kyung-Min (Department of Psychiatry, Naju National Hospital) ;
  • Jung, Ha-ran (Department of Psychiatry, Naju National Hospital) ;
  • Jeong, Yu-Ran (Department of Psychiatry, Naju National Hospital) ;
  • Park, Jinhyeong (Department of Psychiatry, Naju National Hospital)
  • 곽준 (국립나주병원 정신건강의학과) ;
  • 윤보현 (국립나주병원 정신건강의학과) ;
  • 전봉희 (국립나주병원 정신건강의학과) ;
  • 시영화 (국립나주병원 정신건강의학과) ;
  • 송제헌 (국립나주병원 정신건강의학과) ;
  • 박수희 (국립나주병원 정신건강의학과) ;
  • 김경민 (국립나주병원 정신건강의학과) ;
  • 정하란 (국립나주병원 정신건강의학과) ;
  • 정유란 (국립나주병원 정신건강의학과) ;
  • 박진형 (국립나주병원 정신건강의학과)
  • Received : 2017.10.12
  • Accepted : 2017.12.15
  • Published : 2017.12.31
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Abstract

Objectives: Shiftwork is known to be one of the common causes of sleep and health problems and finally causes the decreased quality of life. The purpose of this study was to investigate the sleep patterns of shift-working and daytime psychiatric nurses using actigraphy and compare it with subjective assessment for sleep. Methods : Twenty-three shift-working and 25 daytime nurses were enrolled. They rated their sleep quality using Pittsburgh Sleep Quality Index(PSQI) and other self-rating scales were measured for psychosocial aspects. Actigraphy was applied to the subjects for a total of 7 days to measure the sleep parameters. They also wrote sleep diaries during the period of wearing actigraphy. Sleep-related parameters of actigraphy, global score and components of PSQI, and the results of other self-rating scales were compared between shift-working and daytime nurses. Results : Although the global score of PSQI did not show significant difference, the PSQI components showed significant differences between two groups: the shift-working nurses showed lower sleep quality, more sleep disturbance and hypnotic medication use, and worsened daytime dysfunction than daytime nurses. The shift-working nurses showed significantly shorter total time in bed and total sleep time, lower sleep efficiency, and longer average awakening time than those of daytime nurses in actigraphy. Conclusions : The results showed that shift-working nurses experienced more sleep disturbances in both subjective and objective aspects of sleep than daytime nurses. This study also suggests that actigraphy may be useful to measure the objective aspects of sleep that are difficult to assess with subjective questionnaires alone.

연구목적 교대근무는 수면장애를 포함한 다양한 건강상의 문제와 연관이 있고 결국에는 삶의 질을 떨어뜨리는 것으로 알려져 있다. 그러나 임상현장에서는 주로 대상자의 주관적인 보고에 의하여 수면을 평가하고 있다. 본 연구는 정신과 교대근무 간호사의 수면을 주관적인 수면평가와 활동기록기를 이용한 수면평가를 통해 주간근무자와 비교해 보고자 하였다. 방 법 교대근무 간호사 23명과 주간근무 간호사 25명을 대상으로 하였다. PSQI를 이용하여 주관적인 수면의 질을 평가하였고 기타 자기보고척도를 이용하여 정신사회적 측면을 평가하였다. 객관적인 수면을 측정하기 위해 활동기록기를 총 7일간 착용하도록 하였고, 그 기간 동안 수면일지를 함께 작성하였다. 교대근무군과 주간근무군간에 활동기록기의 수면변수, PSQI 총점과 구성요소 그리고 자기보고척도로 평가한 결과를 비교하였다. 결 과 PSQI 총점은 양군 간 유의한 차이를 보이지는 않았으나 PSQI 구성요소 중에서 교대근무군이 유의하게 수면의 질(C1)이 나쁘고, 수면장애(C5)와 수면제 사용(C6)이 많으며, 주간기능장애(C7)가 심한 것으로 나타났다. 활동기록기로 측정한 수면변수에서 교대근무군이 주간근무군에 비해 유의하게 잠자리에 누워있는 시간과 총 수면시간이 짧으며, 수면효율이 떨어지고, 평균각성시간이 긴 것으로 나타났다. 결 론 교대근무 간호사가 주간근무 간호사에 비해 주관적 수면평가 및 활동기록기를 통한 객관적 지표 모두에서 수면에 문제를 보이는 것으로 나타났다. 본 연구는 활동기록기가 수면장애를 평가하는데 있어 주관적 설문만으로는 측정이 어려운 객관적 수면변수를 측정하는 데 유용한 도구일 가능성을 시사한다.

Keywords

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