Relationship between sleeping on the night shift and recovery from work among nursing workers - the influence of domestic work

P>Aim. This paper is a report of a study on the association between sleep patterns during work nights and recovery from work among nursing workers, considering domestic work hours. Background. Several hospitals allow nursing workers to sleep during the night shift, but this is rarely evaluated from the workers` health perspective. The need for recovery from work concept can be useful for testing the impact of night work on sleep. Recovery is not a problem if workers have enough time to recover between periods of work. Therefore, domestic work would be likely to interfere in the recovery process. Methods. This cross-sectional study was carried out at three hospitals in 2005-2006, through a comprehensive questionnaire. All nursing teams engaged in assistance to patients were invited to participate. Analyses included female night workers with no incidence of insomnia. Participants (n = 396) were classified into those who did not sleep during night shifts, those who slept for up to 2 hours and those who slept for 2-3 hours. Results. Binomial logistic regression analysis showed that sleeping on the job for 2-3 hours during night shifts is related to a better recovery from work provided the workers do not undergo long domestic work hours. Conclusions. Being allowed to sleep at work during night shifts seemed to contribute to, but was not enough to guarantee, a good recovery from work in the studied population. Recommendations to deal with sleep-deprivation among night workers should consider the complexity of gender roles on the recovery process.

Spontaneous Abortions and Shift Work in a Cohort of Nurses in Norway

Background: An association between spontaneous abortions and shift work has been suggested, but present research results are conflicting. The aim of the study is to evaluate the relationship between spontaneous abortions among nurses, shift schedules, and nights worked. Methods: This is a longitudinal study where we identified 914 females from a cohort of nurses in Norway who had worked the same type of shift schedule 2008-2010; either permanent day shift, three-shift rotation or permanent night shift. Information on age, work and life-style factors, as well as spontaneous abortions during lifetime and the past three years (2008-2010) was obtained by annual questionnaires. Results: A higher prevalence of experienced spontaneous abortions before study start (2008) was found among nurses working permanent night shift compared to other nurses. In a linear regression analysis, a risk of 1.3 was found for experienced spontaneous abortions before study start among permanent night shift nurses, with day shift as reference, when adjusting for age, smoking, caffeine and job strain, but the finding was not statistical significant (95 per cent confidence interval 0.8-2.1). Permanent night shift workers had a risk of 1.5 experiencing spontaneous abortions in 2008-2010 compared to day shift nurses, although not statistical significant (95 per cent confidence interval 0.7-3.5). The number of night shifts the past three years was not associated with experiencing spontaneous abortions 2008-2010, but associated with a reduced risk of experiencing spontaneous abortions during lifetime. The results must be interpreted in the light of a possible selection bias; both selections into the occupation of nursing and into the different shift types of the more healthy persons may have occurred in this population. Conclusion: No significant increased risk of spontaneous abortion among permanent night shift nurses compared to day-time nurses was found in this study, and no association was found between spontaneous abortions and the number of worked night shifts.

Enhanced preference for high-fat foods following a simulated night shift

Objectives Shift workers are prone to obesity and associated co-morbidities such as diabetes and cardiovascular disease. Sleep restriction associated with shift work results in dramatic endocrine and metabolic effects that predispose shift workers to these adverse health consequences. While sleep restriction has been associated with increased caloric intake, food preference may also play a key role in weight gain associated with shift work. This study examined the impact of an overnight simulated night shift on food preference. Methods Sixteen participants [mean 20.1, standard deviation (SD) 1.4 years; 8 women] underwent a simulated night shift and control condition in a counterbalanced order. On the following morning, participants were provided an opportunity for breakfast that included high- and low-fat food options (mean 64.8% and 6.4% fat, respectively). Results Participants ate significantly more high-fat breakfast items after the simulated night shift than after the control condition [167.3, standard error of the mean (SEM 28.7) g versus 211.4 (SEM 35.6) g; P=0.012]. The preference for high-fat food was apparent among the majority of individuals following the simulated night shift (81%), but not for the control condition (31%). Shift work and control conditions did not differ, however, in the total amount of food or calories consumed. Conclusions A simulated night shift leads to preference for high-fat food during a subsequent breakfast opportunity. These results suggest that food choice may contribute to weight-related chronic health problems commonly seen among night shift workers.

Do Circadian Preferences Influence the Sleep Patterns of Night Shift Drivers?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of fixed night shift work on 24 hour blood pressure regulation, state anxiety levels and total sleep time

Nearly 22 million Americans operate as shift workers, and shift work has been linked to the development of cardiovascular disease (CVD). This study is aimed at identifying pivotal risk factors of CVD by assessing 24 hour ambulatory blood pressure, state anxiety levels and sleep patterns in 12 hour fixed shift workers. We hypothesized that night shift work would negatively affect blood pressure regulation, anxiety levels and sleep patterns. A total of 28 subjects (ages 22-60) were divided into two groups: 12 hour fixed night shift workers (n=15) and 12 hour fixed day shift workers (n=13). 24 hour ambulatory blood pressure measurements (Space Labs 90207) were taken twice: once during a regular work day and once on a non-work day. State anxiety levels were assessed on both test days using the Speilberger’s State Trait Anxiety Inventory. Total sleep time (TST) was determined using self recorded sleep diary. Night shift workers demonstrated increases in 24 hour systolic (122 ± 2 to 126 ± 2 mmHg, P=0.012); diastolic (75 ± 1 to 79 ± 2 mmHg, P=0.001); and mean arterial pressures (90 ± 2 to 94 ± 2mmHg, P<0.001) during work days compared to off days. In contrast, 24 hour blood pressures were similar during work and off days in day shift workers. Night shift workers reported less TST on work days versus off days (345 ± 16 vs. 552 ± 30 min; P<0.001), whereas day shift workers reported similar TST during work and off days (475 ± 16 minutes to 437 ± 20 minutes; P=0.231). State anxiety scores did not differ between the groups or testing days (time*group interaction P=0.248), suggesting increased 24 hour blood pressure during night shift work is related to decreased TST, not short term anxiety. Our findings suggest that fixed night shift work causes disruption of the normal sleep-wake cycle negatively affecting acute blood pressure regulation, which may increase the long-term risk for CVD.

The impact of shift-work and organizational climate on health outcomes in nurses

Shift workers have a higher rate of negative health outcomes than day shift workers. Few studies however, have examined the role of difference in workplace environment between shifts itself on such health measures. This study investigated variation in organizational climate across different types of shift work and health outcomes in nurses. Participants (n = 142) were nursing staff from a metropolitan Melbourne hospital. Demographic items elicited the type of shift worked, while the Work Environment Scale and the General Health Questionnaire measured organizational climate and health respectively. Analysis supported the hypotheses that different organizational climates occurred across different shifts, and that different organizational climate factors predicted poor health outcomes. Shift work alone was not found to predict health outcomes. Specifically, permanent night shift workers had significantly lower coworker cohesion scores compared with rotating day and evening shift workers and significantly higher managerial control scores compared with day shift workers. Further, coworker cohesion and involvement were found to be significant predictors of somatic problems. These findings suggest that differences in organizational climate between shifts accounts for the variation in health outcomes associated with shift work. Therefore, increased workplace cohesion and involvement, and decreased work pressure, may mitigate the negative health outcomes of shift workers.

Les stratégies de soutien des infirmières novices travaillant le soir et la nuit en centre hospitalier

Travail dirigé présenté à la Faculté des sciences infirmières en vue de l’obtention du grade de Maître ès sciences (M.Sc.) en sciences infirmières option administration des services infirmiers

Turno de trabalho, cronotipo e desempenho de memória e atenção de profissionais da área da saúde de dois serviços de emergência da cidade de Porto Alegre/RS/BRASIL

Trabalhadores forçados a alterar o ciclo sono/repouso em função do turno de trabalho tendem a dessincronizar seus ritmos fisiológicos (endógenos) em relação aos do meio ambiente (exógenos) acarretando transtornos na organização dos sistemas fisiológicos. Os objetivos deste estudo foram avaliar a relação do turno de trabalho (manhã, noite e rotativo) e perfil cronobiológico e seus efeitos sobre desempenho em testes de atenção e memória de profissionais (médicos, enfermeiros e técnicos/auxiliares de enfermagem) dos serviços de emergência de dois hospitais de Porto Alegre (RS/Brasil). Uma amostra aleatória de 140 profissionais, de ambos os sexos e idade entre 25 e 60 anos, foi avaliada num estudo transversal. Os sujeitos que relataram presença de doença (clínica, neurológica ou psiquiátrica), transtornos do sono prévios ao emprego atual, e uso de benzodiazepínicos nas 6 horas anteriores à testagem foram excluídos. Padrão cronobiológico (matutinidade/vespertinidade) foi definido pelo questionário de Hidalgo-Chaves (2002). Os testes de atenção e memória foram span de dígitos, span palavras, stroop, memória lógica, e Wisconsin Card Sorting Test (versão computadorizada). Déficit de atenção foi definido pela combinação de testes positivos (50%+1). Não se observou associação significativa entre cronotipo e turnos de trabalho. A freqüência de desempenho abaixo do ponto de corte em diversos testes foi maior no turno da noite. Déficit de atenção/memória foi observado em 51% dos profissionais do turno da noite, 21% do turno da manhã, e 22% do rotativo. O desempenho nos testes de atenção/memória entre os sujeitos distribuídos por cronotipo (tanto no total, como entre coincidentes com o turno de trabalho) não mostrou diferença estatisticamente significativa. Em conclusão, a discordância entre turno de trabalho e cronotipo pode ser explicada por diferentes motivos como a falta de opção para escolher o turno, questões financeiras, e desconhecimento quanto às características relacionadas ao perfil cronobiológico. Os déficits observados podem expressar efeitos de longo prazo do trabalho em turnos e especialmente no noturno.

Violência ocupacional contra profissionais de saúde em um hospital de urgência. natal/rn, 2009

Descriptive exploratory study, with quantitative approach, with data collected from April to May 2009, aiming to identify the types of occupational violence affecting professionals on the nursing and medical staff in an emergency hospital service in Natal/RN, over the last 12 months; to identify emergency sectors where occupational violence episodes took place; to characterize aggressors on each type of occupational violence; to know the procedures adopted after each violent act targeting nursing and medical staff professionals; and to know the consequences of violence suffered by the nursing and medical staff professionals. The sample consisted of 26 nurses, 95 nursing assistants/technicians and 124 physicians, for a total of 245 professionals. The results showed that 50.61% of the professionals were women, aged 41 to 45 (22.45%), with post-graduate studies (51.43%), married (60.82%); 21.22% had 16 to 20 years of experience in the profession and in emergency practice; working 40 weekly hours (86.12%); and working both the day shift and the night shift (70.21%); 27.35% consider violence to be a part of their profession and the patient s companions as an important risk factor (86.53%); couldn t inform whether there was a specific established procedure for reporting occupational violence (45.71%); 73.06% suffered occupational violence in the 12 months; 70.20% verbal assault, 24.08% moral harassment, 6.12% physical assault, and 3.67% sexual harassment; 66.67% of the patients took part in the physical assault; the companions, in verbal assault (58.14%); and the health staff in moral harassment (69.49%); facing episodes violence, 37.65% of the professionals reported the fact to their co-workers; 57.25% uffered from stress as a consequence; on 4.71% of the episodes the professionals had to be bsent from work, resulting in 75 days of occupational violence-related absence. We conclude here was a high rate of occupational violence in the researched population, with verbal ssault and moral harassment as the most frequent violence types. Because factors related to ccupational violence were very diverse, actions seeking to confront this problem shouldn t be limited to the work environment itself. Education ought to be one of the most effective ctions for avoiding or minimizing these events occurrence

Satisfação da equipe de enfermagem do serviço de atendimento móvel às urgências (SAMU) no ambiente de trabalho

Descriptive exploratory study, prospective with quantitative approach, performed on the Medical Regulation Central of SAMU/Natal, aiming to identify the level of professional satisfaction of the members of the nursing team working at SAMU/Natal; and verify the degree of importance attributed by the professionals to each of the components Professional Satisfaction: autonomy, interaction, professional status , work requirements, organizational rules and remuneration. The population was of 60 professionals, with data collected from january to february 2005. We used an instrument translated and validated by Lino (1999) to the portuguese language, the Professional Satisfaction Rate (PSR). The results demonstrate that there was a slight predominance of the female gender (54,9%); aged between 36 and 45 years old (60,8%); married (58,8%), 82,4% with children, 30,8% aged between 05 and 09. Regarding formation, we observed that 78,4% were nursing technicians and 21,6% nurses, formed for 11 to 15 years (17,5%). From the 11 nurses, 09 (81,8%) informed they have specialization, 29,4% of the team has been working for 11 to 15 years on the urgency area, 58.8% works for more than 02 years on SAMU, 72,6% of the team members have fixed work schedules. There was homogeneity on the work shifts: 41,2% on the day shift and 53% on the night shift. Regarding the reason to be working on SAMU, 64% chose to work in the service, and among these 76,3% predominantly perform direct care to the patients, 96,1% like and are satisfied to work in the service. Regarding the remuneration, 90,9% informed they receive 05 to 10 minimum wages; 70% of the technicians informed they receive -2 to 05 minumum wages, 50,1% informed they receive no additional benefit. The analysis of PSR through Cronbach s Alpha Coeficient resulted on the value of 0,94 and through Kendall s Tau Coeficient on 0,87, demonstrating to be a trustworthy instrument to measure the level of professional satisfaction of the SAMU nursing team, in our environment. As for the level of importance attributed to the components of professional satisfaction, we indentified that the nursing team considered the Autonomy component as the most important, followed by the component Remuneration, Interaction, Work Requirements, Work Requirements, Organizational Rules and Professional Status . Regarding the current level of professional satisfaction, we identified they were most satisfied with the Professional Status , Autonomy, Interaction, Remuneration, Work Requirements and Organizational Rules. The real professional satisfaction level, calculated through statistics, however, tells these professionals are more satisfied with Autonomy, Remuneration, Interaction, Work Requirements, professional Status and Organizational Rules. The PSR in our work was of 8,6, indicating the SAMU Natal nursing team has little satisfaction on their work environment

No caleidoscópio o estresse da equipe de enfermagem da UTI de um Hospital Universitário em Natal-RN

This study aimed to analyze stress on nursing staff of intensive care at the Teaching Hospital Onofre Lopes. The study sample consisted of thirty-eight (38) nursing professionals, including technicians and nurses working in the ICU of the hospital Data were collected between September to November 2011 in two stages.The first was the application of the Lipp Stress Symptoms Inventory (LSSI), which allowed us to measure the stress phase in which each team member was. After that, data were tabulated in Microsoft Excel spreadsheets and analyzed according to the 2010 inventory guidelines proposed by the author. After this analysis it was possible to complete the second phase of the research, which consisted of a semi-structured interview designed for those workers who were in the second phase of stress, resistance. Data analysis was based on Bardin 2004 content analysis, enabling the creation of categories based on grouping the ideas present in the interviewees' statements. It was found that the study population was mostly female (78.9%) aged from 30 to 39 years (50%), married (52.3%) and with dual-employment (65.7%). The most predominant phase, according to the Lipp inventory, was the stress resistance, present in 44.7% of the team and having as most predominant physical symptoms the constant feeling of physical exhaustion, verified in 16.8% of the participants, and psychological, the excessive irritability and emotional sensitivity in 26.3%. Regarding the qualitative data it was possible to establish three categories and four subcategories, with the following categories: the stressors of the workplace, overwork and the interpersonal relationships of the nursing staff in the ICU. And as subcategories: Routine care in the ICU; Pressures and Individual Charges; double journey: professional reflections on daily life, the night shift nursing staff and the body suffers, the manifestations of stress; deficient communication between team members. Thus, this study allowed the visualization of the stress phenomenon on nursing staff of the Teaching Hospital Onofre Lopes as a kaleidoscope of thoughts, feelings and experiences perceived by these professionals in different areas of their lives. It was also verified that the strengthening of the stress theme among nursing professionals need to be exploited and stimulated in several nursing areas of discussion so these workers are encouraged to take better care of themselves so they can take care of others health

Sleep, ageing and night work

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Quality of performance of the operation of sugarcane mechanized planting in day and night shifts

The sugarcane mechanized planting is becoming increasingly widespread in Brazil due to a higher operability and better working conditions offered to workers compared to other types of planting. Studies related to this topic are insufficient or scarce in Brazil. In this context, the aim of this study was to evaluate the operation quality of sugarcane mechanized planting in two operation shifts, by means of statistical process control. The mechanized planting was held on March 2012 and statistical design was completely randomized with two treatments, totaling 40 replications for the day shift and 40 replications for the night shift. The variables evaluated were: speed, engine rotation, engine oil pressure, water temperature of the engine, effective field capacity and the time consumption hourly and effective fuel. The use of statistical control charts showed that random intrinsic do not cause this process. The tractor alignment error showed outliers in the day and night shifts operations, indicating a possible delay in receiving the signal. The water temperature of the engine and the effective fuel consumption showed lower variability in nighttime operation with average values of 81°C and 22.66 L ha-1, respectively. The hourly fuel consumption had greater variability and consequently lower quality during the night of the operation, with an average consumption of 25.46 L h-1 while the day shift showed 26.86 L h-1.

Eventos adversos em terapia medicamentosa em Unidade de Terapia Intensiva - UTI

Due to the complexity and instability of clinical conditions of ICU patients, the drug therapy applied in this type of environment requires a combination of several prescribed drugs, which is a favorable condition for drug interaction, toxic synergism and possible iatrogenia. In the possible universe of ICU occurrences, this study aimed at identifying and evaluating the incidence of adverse events in drug therapy at the Intensive Care Therapy Service (SETI) in wards I and II. It is a cross-sectional, descriptive, prospective and quantitative study conducted from August to September, 2011 in the Intensive Care Service of the Botucatu School of Medicine University Hospital - UNESP. The population consisted of fifteen clinical nurses, including those in the Improvement and Volunteer Internship Programs, who contributed to the investigation after signing an informed consent form and according to approval by the Research Ethics Committee number 10711/CE - FMB. The data were entered on a form and analyzed. Results showed that, on average, 8.9% of events/day occurred, and the highest frequency was observed on August 04, 2011. 63% and 22% were respectively observed in the morning and afternoon shifts, and 15% in the night shift. 48% of these were due to administration time errors, followed by drug prescription and dispensation errors, with percentages of 22% and 18%, respectively. Antibiotics showed the highest frequency of adverse events - 18%, which was followed by 13% for anticoagulant, 11% for antiemetic and 10% for antiulcerative drugs. As regards the occurrence of adverse events related to hospitalization time, the highest frequency occurred in patients who were hospitalized for 10 days. Concerning the ratio between reported events and the number of items in the prescription, the highest frequency of events was related to prescriptions with 20 items... (Complete abstract click electronic access below)

Job satisfaction and discrepancies between social and biological timing

The discrepancies between social and biological timing are reflected in shift workers' well-being. The aim of this study was to verify the association between job satisfaction and chronotype among day and night nursing personnel. Several variables, including seniority at the hospital and, in the same shift, sleep duration, quality of sleep, sleepiness and willingness to change sleep timing were also analyzed. Chronotype was calculated by using the morningness-eveningness questionnaire. We studied 514 nursing professionals from a public university hospital. Among the day workers, the higher the morningness, the more the workers were satisfied with their job. In contrast, among night workers, job satisfaction was associated with sleep quality and seniority at the hospital but not with chronotype. Our results suggest that an agreement between work schedule and chronotype may help to increase job satisfaction among diurnal workers.