• Safety and Health at Work
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• v.9 no.2
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• pp.203-209
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• 2018

Background: Night shift work is associated with many problems such as sleep deprivation, sleepiness, decreased cognitive performance, increased human errors, and fatigue. This study set out to measure cognitive performance, melatonin rhythms, and sleep after different consecutive night shifts (7 vs. 4) among control room operators (CORs). Methods: The participants included 60 CORs with a mean age of 30.2 years (standard deviation, 2.0) from a petrochemical complex located in Southern Iran. Cognitive performance was assessed using the n-back task and continuous performance test. To evaluate melatonin, saliva was collected and tested by enzyme-linked immunosorbent assay. To assess sleep and sleepiness, the Pittsburgh Sleep Quality Index and Karolinska Sleepiness Scale were used, respectively. Results: Individuals who worked 7 consecutive night shifts had a significantly better cognitive performance and sleep quality than those who worked 4 consecutive night shifts. However, salivary melatonin profile and sleepiness trend were not affected by shift type. Conclusion: The main duty of CORs working night shifts at the studied industry included managing safety-critical processes through complex displays; a responsibility that demands good cognitive performance and alertness. It is suggested that an appropriate number of consecutive night shifts in a rotating shift system should be planned with the ultimate aim of improving CROs performance/alertness and enhancing safety.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.1
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• pp.527-535
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• 2015

This study was conducted to compare and analyse work-related injuries, physical and mental health status of nurses according to working environment. The subjects were 192 nurses working at a university hospital in Seoul. After analyzing each categories of health status by working environment and work-related injuries, meaningful differences were found physical and mental health status. And shift work was significantly related to work-related injuries compared to non-shift work. In addition, it was confirmed that nurses have negative influences from night work in physical and mental health compared to other work pattern. Thus, it would be necessary to improve working system with considering their health problems caused by working environment and work-related injuries. And we will have to be a study for effective night work and additional support for night workers.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.333-344
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• 2013

Purpose: This study was conducted to provide baseline data to develop work patterns for nurses that are suitable to Korean hospitals. Shift work patterns and nurses' preferences for working condition were examined. Methods: Questionnaires for nurse departments and nurses were mailed to 478 hospitals from June 1 to July 30, 2012. Nurse departments of 174 hospitals and 1,409 nurses responded to the questionnaire. Data were analyzed using SPSS statistical program. Results: Of the nurses, 89.4% were working three shifts. Of the hospitals, 17.3% had implemented fixed night work. Although 80% of nurses preferred fixed time work, only 24.9% of hospitals had fixed working hours. Of the nurses, 57% agreed with night work as fixed but potential night nurses accounted for only 17% of the respondents. Sixty-three percent of the nurses agreed on short time work during busy hours. There were preference differences according to age, marital status and clinical career. Conclusion: As many nurses reported a preference for various flexible working patterns rather than three shift work, there is a need for new decisions on hospital policy to ensure improved working conditions for nurses and enhanced job security. Legal requirements also need to be considered for various work patterns.

• Korean Journal of Occupational Health Nursing
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• v.9 no.2
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• pp.86-93
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• 2000

This study was conducted to find out the degree of tiredness, accumulated tendencies of fatigues in accordance with 3 types of circadian rhythms and 3 types of perceived fatigue signs such as physical, psychological and neurosensory aspects in before and after work at night. Samples were chosen from the 217 intensive care units nurses working in 13 general hospitals which had 3 shift rotating systems, Data were collected from November to December in 1999. Two hundreds seventeen respondents were classified by 3 circadian types such as 59 morning, 110 middle and 48 evening. Circadian type was measured by the circadian type scale which was designed by ${\ddot{O}}stberg$ and Home (1976). in order to estimate the level of tiredness, the investigator used the fatigue checklist designed by the Labor and Health Institute of Japan(1970). Analysis was done by frequency a percentages, ${\chi}^2$ test and repeated measures ANOVA test. The result of this study were as follow: 1. In the general characteristics of the subjects circadian types, moderate type had the large proportion at 50.7% and morning type had 27.2% and evening type had 22.1%. 2. According to the 3 types of fatigue signs, the highest general tendency was 'General weakness' and 'Feeling of headsore' for physically perceived sign, 'Drowsiness' for psychological sign, and 'Uncomfortableness in sight seeing' for neurosensory sign. 3. The most frequently complained fatigue were observed in physical symptoms among physical, mental, and neurosensual symptoms. The percentage of complained was higher after night work than before the work started. 4. There was not any statistical significant difference between the circadian type and the degree of physical, mental, neurosensory fatigue. 5. There was not any statistical significant difference in regarding to each date of night shift except difference between 1st and 2nd days of fatigue perceived physically. Therefore, the study concluded that the fatigue perceived by night shift nurses might be related with shift working condition rather than circadian types.

• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.46-54
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• 2021

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.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.309-320
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• 2013

Purpose: This study was conducted to identify relationships among circadian types, sleep quality, and adaptation to night shifts among nurses working on two or three day night duties. Methods: The participants were 199 ward nurses from two university hospitals in Gyeongnam province. Each nurse worked on two or three day night duties. Data were collected between September 24 and October 14, 2012 and analyzed using t-test, ANOVA, $Scheff{\grave{e}}$ test, Pearson correlation, and multiple regression with SPSS/WIN 14.0 program. Results: Mean scores for sleep quality and adaptation to night shifts was $4.92{\pm}1.46$ on a 10-point scale and $2.66{\pm}0.47$ on a 5-point scale respectively. There were no significant differences in sleep quality and adaptation to night shifts according to circadian types of nurses. There were significant correlation between sleep quality and adaptation to night shifts (r=.25, p<.001). Factors affecting adaptation to night shifts were preference for night shifts, and subjective health status, which together explained about 35% of the total variance. Conclusions: Nurses working on two or three day night duties had low level of sleep quality and adaptation to night shifts. It is necessary to improve preference for night shifts and subjective health status for improving adaptation to night shifts of nurse.

• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.139-150
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• 2024

Purpose: This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work. Methods: This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis. Results: Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning. Conclusion: Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.

• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.240-248
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• 2018

Objective Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Methods Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Results Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. Conclusion Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.

• Journal of Korean Academy of Nursing
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• v.28 no.4
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• pp.869-880
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• 1998

In order to investigate of the effects of rapid rotating shift work on physiological stress, the activities of urinary Na$^{+}$, $K^{+}$, Cl$^{[-10]}$ were measured in 14 rotational shift nurses, during day shifts(8AM-4PM, n=4), evening shifts(4PM-l2MN, n=5), and night shifts(12MN-8AM, n=5) in hospital twenty students attending nursing college a used as a control group. Urine specimens were collected in 30 minutes before and after work on the second day of shift work. In day shift nurses, Na$^{+}$ activity was 137mM at 8AM and increased to 206mM at 4PM, whereas $K^{+}$ activity was 42mM at 8AM and no significant change at 4PM. Cl$^{[-10]}$ activity was changed from 234mM to 344mM at 4PM at 8AM. In the evening shift, Na$^{+}$ activity was 117mM at 4PM and 140mM at 12MN, $K^{+}$ activity was 22mM and 32mM, respectively. Cl$^{[-10]}$ activity was 169mM and changed to 270mM. During the night shift, Na$^{+}$ activity was 128mM at 12MN and changed to 161mM at 8AM, $K^{+}$ activity was 42mM at 12MN and 8AM, and Cl$^{[-10]}$ activity was from 303mM and changed to 355mM. In general, the urinary ion activities seemed to increase after work, however there were no significant changes in ion activities except the Na$^{+}$ increase in day shift. The mean of the activities of $K^{+}$ and Cl$^{[-10]}$ before and after work during the day and night shift were significantly higher than those in control group (P＜0.05). $K^{+}$ activities were also higher than that of evening shift(P＜0.05). However, there was no difference in Na$^{+}$ activity among the control group and three shifts. There was a significant relationship among urinary Na$^{+}$, Cl$^{[-10]}$ and $K^{+}$ in the control group and rotating shift nurses except between Na$^{+}$ and $K^{+}$ in shift. The relationship between Na$^{+}$ and Cl$^{[-10]}$ was low in shift work and there was no significant relationship between Na$^{+}$ and $K^{+}$ in shift, suggesting that the active regulation $K^{+}$ and/or Na$^{+}$ in response to stress upon the shift work disruped the ratio of urinary Na$^{+}$ to $K^{+}$ and also lowered the relationship between $K^{+}$ and Cl$^{[-10]}$ . These results suggest that nurses working the day shift were overloaded and under stress, and the night shift interfered with the physiological rhythm of the nurses.red with the physiological rhythm of the nurses.

• Journal of Preventive Medicine and Public Health
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• v.37 no.2
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• pp.182-189
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• 2004

Objectives : The objective of this study is to compare the circadian patterns of heart rate variability assessed by 24-hour ambulatory electrocardiographic (ECG) recordings during day shift and night shift among the workers in the 5 days-concecutive-12-hour shift in an automobile factory in Korea. Methods : The study population consisted 300 workers, who were randomly selected among the 8700 total workers in one car factory. To analyse circadian variation, the 24-hour ECG recordings (Marquette) were measured during day shift (08:00-20:00 h) and night shift (20:00-08:00 h). Analysis was performed for all time and frequency domain measures of HRV. 233 workers completed taking 24-hour ECG recordings. Results : This study shows that the 24 hourcircadian variation mainly follows work/sleep cycle rather than day/night cycle among shift workers. This study also shows that among the night shift, the circadian variation between work and sleep cycle decreased compared to the work/sleep cycle among day shift workers. All time and frequency domain parameters (except LF/HF ratio) show significantly different between work and sleep in the day shift and night shift. Conclusion : These changes in heart rate variability circadian rhythms reflect significant reductions in cardiac parasympathetic activity with the most marked reduction in normal vagal activity among the shift workers. Especially, it suggests the circadian rhytm has blunted among the night workers. The quantification of the circadian variation in HRV can be a surrogates of workers' potential health risk, as well as suggests possible mechanisms through which the shift works compromise workers' health.