Morning-evening type and burnout level as factors influencing sleep quality of shift nurses: a questionnaire study

Ayten Demir Zencirci, Sumeyye Arslan, Ayten Demir Zencirci, Sumeyye Arslan

Abstract

Aim: To assess the relationship between sleep quality and demographic variables, morning-evening type, and burnout in nurses who work shift.

Methods: We carried out a cross-sectional self-administered study with forced choice and open-ended structured questionnaires - Pittsburgh Sleep Quality Index, Morningness-eveningness Questionnaire, and Maslach Burnout Inventory. The study was carried out at Gazi University Medicine Faculty Hospital of Ankara on 524 invited nurses from July to September 2008, with a response rate of 89.94% (n=483). Descriptive and inferential statistics were applied to determine the risk factors of poor sleep quality.

Results: Most socio-demographic variables did not affect sleep quality. Participants with poor sleep quality had quite high burnout levels. Most nurses who belonged to a type that is neither morning nor evening had poor sleep quality. Nurses who experienced an incident worsening their sleep patterns (P<0.001) and needlestick or sharp object injuries (P=0.010) in the last month had poor sleep quality. The subjective sleep quality and sleep latency points of evening types within created models for the effect of burnout dimensions were high.

Conclusions: Nurses working consistently either in the morning or at night had better sleep quality than those working rotating shifts. Further studies are still needed to develop interventions that improve sleep quality and decrease burnout in nurses working shifts.

References

    1. International Council of Nurses. Nurses and shift work Avaliable from: . Accessed: July 23, 2011.
    1. Knauth P, Landau K, Droge C, Schwitteck M, Widynski M, Rutenfranz J. Duration of sleep depending on the type of shift work. Int Arch Occup Environ Health. 1980;46:167–77. doi: 10.1007/BF00378195.
    1. Edell-Gustafsson UM. Sleep quality and responses to insufficient sleep in women on different work shifts. J Clin Nurs. 2002;11:280–7. doi: 10.1046/j.1365-2702.2002.00574.x.
    1. Winwood PC, Lushington K. Disentangling the effects of psychological and physical work demands on sleep, recovery and maladaptive chronic stress outcomes within a large sample of Australian nurses. J Adv Nurs. 2006;56:679–89. doi: 10.1111/j.1365-2648.2006.04055.x.
    1. Samaha E, Lal S, Samaha N, Wyndham J. Psychological, lifestyle and coping contributors to chronic fatigue in shift-worker nurses. J Adv Nurs. 2007;59:221–32. doi: 10.1111/j.1365-2648.2007.04338.x.
    1. Bünning E. The physiological clock circadian rhythms and biological chronometry. Revised 3th ed. London: The English Universities Press Ltd; 1973.
    1. Moore-Ede MC, Richardson GS. Medical implications of shift-work. Annu Rev Med. 1985;36:607–17. doi: 10.1146/annurev.me.36.020185.003135.
    1. Gordon NP, Cleary PD, Parker CE, Czeisler CA. The prevalence and health impact of shiftwork. Am J Public Health. 1986;76:1225–8. doi: 10.2105/AJPH.76.10.1225.
    1. Akerstedt T, Kecklund G, Knutsson A. Spectral analysis of sleep electroencephalography in rotating three-shift work. Scand J Work Environ Health. 1991;17:330–6.
    1. Ohida T, Kamal A, Sone T, Ishii T, Uchiyama M, Minowa M, et al. Night-shift work related problems in young female nurses in Japan. J Occup Health. 2001;43:150–6. doi: 10.1539/joh.43.150.
    1. Chung MH, Chang FM, Yang CC, Kuo TB, Hsu N. Sleep quality and morningness-eveningness of shift nurses. J Clin Nurs. 2009;18:279–84. doi: 10.1111/j.1365-2702.2007.02160.x.
    1. Rogers AE, Hwang WT, Scott LD, Aiken LH, Dinges DF. The working hours of hospital staff nurses and patient safety. Health Aff (Millwood) 2004;23:202–12. doi: 10.1377/hlthaff.23.4.202.
    1. Ohida T, Osaki Y, Doi Y, Tanihata T, Minowa M, Suzuki K, et al. An epidemiologic study of self-reported sleep problems among Japanese adolescents. Sleep. 2004;27:978–85.
    1. Sukegawa M, Noda Aİ, Morishita Y, Ochi H, Miyata S, Honda K, et al. Sleep and lifestyle habits in morning and evening types of human circadian rhythm. Biol Rhythm Res. 2009;40:121–7. doi: 10.1080/09291010701794404.
    1. Taillard J, Philip P, Chastang JF, Bioulac B. Validation of Horne and Ostberg morningness-eveningness questionnaire in a middle-aged population of French workers. J Biol Rhythms. 2004;19:76–86. doi: 10.1177/0748730403259849.
    1. Paine SJ, Gander PH, Travier N. The epidemiology of morningness/eveningness: influence of age, gender, ethnicity, and socioeconomic factors in adults (30-49 years). J Biol Rhythms. 2006;21:68–76. doi: 10.1177/0748730405283154.
    1. Demir A, Ulusoy M, Ulusoy MF. Investigation of factors influencing burnout levels in the professional and private lives of nurses. Int J Nurs Stud. 2003;40:807–27.
    1. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397–422. doi: 10.1146/annurev.psych.52.1.397.
    1. Maslach C. Job burnout: new directions in research and intervention. Curr Dir Psychol Sci. 2003;12:189–92. doi: 10.1111/1467-8721.01258.
    1. Grossi G, Perski A, Evengard B, Blomkvist V, Orth-Gomer K. Physiological correlates of burnout among women. J Psychosom Res. 2003;55:309–16. doi: 10.1016/S0022-3999(02)00633-5.
    1. Buysse DJ, Reynolds CF, III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213. doi: 10.1016/0165-1781(89)90047-4.
    1. Ağargün MY, Kara H, Anlar Ö. The validity and reliability of Pittsburgh Sleep Quality Index. Turk Psikiyatri Derg. 1996;7:107–15. [in Turkish]
    1. Pündük Z, Gür H, Ercan İ. The reliability study on Turkish morningness-eveningness questionnary. Turk Psikiyatri Derg. 2005;16:40–5. [in Turkish]
    1. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981;2:99–113. doi: 10.1002/job.4030020205.
    1. Leiter MP, Maslach C. Banishing burnout: Six strategies for improving your relationship with work. San Francisco (CA): Jossey-Bass; 2005.
    1. Ergin C. Burnout in physicans and nurses and adjustment of Maslach Burnout Inventory [in Turkish]. Proceedings of the 7th Scientific Studies in the National Congress of Psychology; Ankara; 1992 Sep 22-25.
    1. Suzuki K, Ohida T, Kaneita Y, Yokoyama E, Miyake T, Harano S, et al. Mental health status, shift work, and occupational accidents among hospital nurses in Japan. J Occup Health. 2004;46:448–54. doi: 10.1539/joh.46.448.
    1. Dorrian J, Lamond N, van den Heuvel C, Pincombe J, Rogers AE, Dawson D. A pilot study of the safety implications of Australian nurses' sleep and work hours. Chronobiol Int. 2006;23:1149–63. doi: 10.1080/07420520601059615.
    1. Kunert K, King ML, Kolkhorst FW. Fatigue and sleep quality in nurses. J Psychosoc Nurs Ment Health Serv. 2007;45:30–7.
    1. Chan MF. Factors associated with perceived sleep quality of nurses working on rotating shifts. J Clin Nurs. 20082009;18:285–93. doi: 10.1111/j.1365-2702.2008.02583.x.
    1. Alimoglu MK, Donmez L. Daylight exposure and the other predictors of burnout among nurses in a University Hospital. Int J Nurs Stud. 2005;42:549–55. doi: 10.1016/j.ijnurstu.2004.09.001.
    1. Gold DR, Rogacz S, Bock N, Tosteson TD, Baum TM, Speizer FE, et al. Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses. Am J Public Health. 1992;82:1011–4. doi: 10.2105/AJPH.82.7.1011.
    1. Admi H, Tzischinsky O, Epstein R, Herer P, Lavie P. Shift work in nursing: is it really a risk factor for nurses' health and patients' safety? Nurs Econ. 2008;26:250–7.
    1. Dinges DF. An overview of sleepiness and accidents. J Sleep Res. 1995;4(suppl 2):4–14. doi: 10.1111/j.1365-2869.1995.tb00220.x.
    1. Efinger J, Nelson LC, Starr JM. Understanding circadian rhythms: a holistic approach to nurses and shift work. J Holist Nurs. 1995;13:306–22. doi: 10.1177/089801019501300403.
    1. Fitzpatrick JM, While AE, Roberts JD. Shift work and its impact upon nurse performance: current knowledge and research issues. J Adv Nurs. 1999;29:18–27. doi: 10.1046/j.1365-2648.1999.00861.x.
    1. Dembe AE, Delbos R, Erickson JB. Estimates of injury risks for healthcare personnel working night shifts and long hours. Qual Saf Health Care. 2009;18:336–40. doi: 10.1136/qshc.2008.029512.
    1. Scott LD, Rogers AE, Hwang WT, Zhang Y. Effects of critical care nurses' work hours on vigilance and patients' safety. Am J Crit Care. 2006;15:30–7.
    1. Winwood PC, Winfield AH, Lushington K. Work-related fatique and recovery: the contribution of age, domestic responsibilities and shift work. J Adv Nurs. 2006;56:438–49. doi: 10.1111/j.1365-2648.2006.04011.x.
    1. Rosen IM, Gimotty PA, Shea JA, Bellini LM. Evolution of sleep quantity, sleep deprivation, mood disturbances, empathy, and burnout among interns. Acad Med. 2006;81:82–5. doi: 10.1097/00001888-200601000-00020.
    1. Newey CA, Hood BM. Determinants of shift-work adjustment for nursing staff: the critical experience of partners. J Prof Nurs. 2004;20:187–95. doi: 10.1016/j.profnurs.2004.04.007.
    1. Jamal M, Baba VV. Shift work, burnout, and well-being: a study of Canadian Nurses. Int J Stress Manag. 1997;4:197–204.

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