Sleepiness and Fatigue among Night - Shift Nurses with Three - Hour Nap and Day - Shift Nurses
DOI:
https://doi.org/10.22100/ijhs.v2i4.193Keywords:
Nap, Night shift, Nurse, Fatigue, Sleepiness.Abstract
Background: Deficiency of sleep among nurses working in shifts, results in sleepiness, fatigue, health, and safety problem, and it also can deteriorate the quality of care provision. The present study aimed to compare sleepiness and fatigue between night-shift nurses who have a 3-h nap and day-shift nurses.
Methods: A prospective cohort study was done on 23 night-shift nurses with a 3-h nap and 24 day-shift nurses in Sina Hospital in Tehran (Iran) during 2015–2016. Subjective sleepiness and fatigue before and after their shifts were measured by Stanford Sleepiness Scale (SSS) and Swedish Occupational Fatigue Inventory (SOFI-20), respectively. Statistical analysis including independent t-test, Mann–Whitney test, multivariate analysis of variance, and discriminant analysis were performed to compare the two groups.
Results: The difference in means of subjective sleepiness before and after the shifts was significantly greater among night-shift nurses having a 3-h nap (1.43±1.50) than the day-shift nurses (0.37±0.92) (P=0.007). Although after their working shifts, the night-shift nurses (1.40±2.30) were more fatigued than the day-shift ones (0.96±1.46), this was not statistically significant (P=0.81). Moreover, day or night shift working with a 3-h nap was an effective factor (P=0.015) while considering the interrelationship between sleepiness and fatigue in multivariate analysis. Discriminant analysis revealed the dominant role of subjective sleepiness in differentiating the two groups.
Conclusions: Despite the 3-h nap, subjective sleepiness was seen more among the night-shift nurses than the day-shift ones; however, the mean difference scores of fatigue did not differ between the two groups. Presumably, getting a 3-h nap during night shift and a heavy work load for day-shift nurses might result in insignificant fatigue between the groups. Furthermore, studies with new strategies for napping among nurses are recommended.
References
Richter K, Acker J, Adam S, Niklewski G. Prevention of fatigue and insomnia in shift workers—a review of non-pharmacological measures. EPMA J 2016;7:1-11. doi:10.1186/s13167-016-0064-4
Åkerstedt T, Kecklund G.. Shift work, severe sleepiness and safety. Ind Health 2011;49:141-2.
Scott LD, Hwang WT, Rogers AE, Nysse T, Dean GE, Dinges DF. The relationship between nurse work schedules, sleep duration, and drowsy driving. Sleep 2007;30:1801-7.
Fuller TP, Bain EI. Health & Safety: Shift Workers Give Sleep Short Shrift. Am J Nurs 2010;110:28-30. doi:10.1097/01.NAJ.0000368048.49858.69
Caldwell JA. The impact of fatigue in air medical and other types of operations: a review of fatigue facts and potential countermeasures. Air Med J 2001;20:25-32. doi:10.1016/S1067-991X(01)70076-4
Yong LC, Li J, Calvert GM. Sleep-related problems in the US working population: prevalence and association with shiftwork status. Occupational and environmental medicine. 2016;0:1-12. doi:10.1136/oemed-2016
WB & A Market Research. 2002 Sleep in America Poll. Washington, DC: National Sleep Foundation 2002.
Verster JC, Veldhuijzen DS, Volkerts ER. Residual effects of sleep medication on driving ability. Sleep Med Rev 2004;8:309-25. doi:10.1016/j.smrv.2004.02.001
Philibert I. Sleep loss and performance in residents and nonphysicians: a meta-analytic examination. Sleep 2005;28:1392-402. doi:10.1093/sleep/28.11.1392
Rogers A, Scott L, Hwang W, Dinges D, editors. Sleep duration affects the amount of fatigue, stress, physical exhaustion and mental exhaustion reported by hospital staff nurses. Annual Meeting of the Associated Professional Sleep Societies; 2004 June; Pennsylvania.
Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, et al. Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med 2004;351:1838-48. doi:10.1056/NEJMoa041406
Kohn LT, Corrigan JM, Donaldson MS. To Err is Human. Building a Safer Health System. 1st ed. Washington: National Academies Press;2000.312 p.
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.
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.
Geiger-Brown J, Rogers VE, Trinkoff AM, Kane RL, Bausell RB, Scharf SM. Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiol Int 2012;29:211-9. doi:10.3109/07420528.2011.645752
Kazemi R, Haidarimoghadam R, Motamedzadeh M, Golmohammadi R, Soltanian A, Zoghipaydar MR. Effects of Shift Work on Cognitive Performance, Sleep quality, and sleepiness among petrochemical control room operators. J Circadian Rhythms 2016;14:1-8. doi:10.5334/jcr.134
Sussman D, Coplen M. Fatigue and alertness in the United States railroad industry part I: the nature of the problem. Transportation research part F: traffic psychology and behaviour 2000;3:211-20. doi:10.1016/S1369-8478(01)00005-5
Comperatore C, Kingsley L. Undated. The commercial mariner endurance management system. Groton, CT: Crew Endurance Management Team, United States Coast Guard, Research and Development Center.11 p.
Saadat et al
International Journal of Health Studies (Undergoing change to Shahroud Journal of Medical Sciences) 2016;2(4) | 4
Diño J, Soukhovitskaya V. NASA’s interactive training tool makes general aviation safer. Moffett Field, Calif: NASA Ames Research Center; 2002 July 22. Report No.: 02-84AR.
Rogers AE. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. The effects of fatigue and sleepiness on nurse performance and patient safety. 2008.
Davy J, Göbel M. The effects of a self-selected nap opportunity on the psychophysiological, performance and subjective measures during a simulated industrial night shift regimen. Ergonomics 2013;56:220-34. doi:10.1080/00140139.2012.751459
Palermo TAdC, Rotenberg L, Zeitoune RCG, Silva-Costa A, Souto EP, Griep RH. Napping during the night shift and recovery after work among hospital nurses. Rev Lat Am Enfermagem 2015;23:114-21. doi:10.1590/0104-1169.0147.2532
Ruggiero JS, Redeker NS. Effects of napping on sleepiness and sleep-related performance deficits in night-shift workers: a systematic review. Biol Res Nurs 2014;16:134-42. doi:10.1177/1099800413476571
Howard ME, Radford L, Jackson ML, Swann P, Kennedy GA. The effects of a 30-minute napping opportunity during an actual night shift on performance and sleepiness in shift workers. Biological Rhythm Research 2010;41:137-48.
Oriyama S, Miyakoshi Y, Kobayashi T. Effects of two 15-min naps on the subjective sleepiness, fatigue and heart rate variability of night shift nurses. Ind Health 2014;52:25-35. doi:10.2486/indhealth.2013-0043
Hoddes E, Zarcone V, Dement W, editors. Development and use of Stanford Sleepiness scale (SSS). Psychophysiology; 1972: Cambridge Univ Press 40 West 20TH Street, New York, NY 10011-4211.
Farvaresh E, Monazam MR, Abbassinia M, Asghari M, Sadeghi A, Mohammadian F. Investigation the relationship between sleepiness and general health of shift workers in the automobile industry 2012;4:221-7.
Åhsberg E, Garnberale F, Kjellberg A. Perceived quality of fatigue during different occupational tasks development of a questionnaire. International Journal of Industrial Ergonomics 1997;20:121-35. doi:10.1016/S0169-8141(96)00044-3
Leung AW, Chan CC, He J. Structural stability and reliability of the Swedish occupational fatigue inventory among Chinese VDT workers. Appl Ergon 2004;35:233-41. doi:10.1016/j.apergo.2004.02.004
Gutiérrez JLG, Jiménez BM, Hernández EG, López AL. Spanish version of the Swedish Occupational Fatigue Inventory (SOFI): Factorial replication, reliability and validity. International Journal of Industrial Ergonomics 2005;35:737-46. doi:10.1016/j.ergon.2005.02.007
Javadpour F, Keshavarzi S, Choobineh A, Aghabaigi M. Validity and reliability of the Swedish Occupational Fatigue Inventory (SOFI-20) among Iranian working population. Journal of Ergonomics 2015;3:50-8.Persian.
Sultanian AR, Motamedzade Torghabe M, Shafii Motlagh M, Garkaz A, Mahdavi N. Persian version of Swedish Occupational Fatigue Inventory) P-SOFI): validity and reliability. Iran Occupational Health Journal 2014;11:34-43.Persian.
Borges FNS, Fischer FM, Rotenberg L, Soares NS, Fonseca MB, Smolensky MH, et al. Effects of naps at work on the sleepiness of 12-hour night shift nursing personnel. Sleep Science 2009;2:24-9.
Geiger-Brown J, Sagherian K, Zhu S, Wieroniey MA, Blair L, Warren J, et al. Napping on the Night Shift: A Two-Hospital Implementation Project. AJN The American Journal of Nursing. 2016;116(5):26-33.
Smith-Coggins R, Howard SK, Mac DT, Wang C, Kwan S, Rosekind MR, et al. Improving Alertness and Performance in Emergency Department Physicians and Nurses: The Use of Planned Naps. Ann Emerg Med 2006;48:596-604. doi:10.1016/j.annemergmed.2006.02.005
Volpp KG, Shea JA, Small DS, Basner M, Zhu J, Norton L, et al. Effect of a protected sleep period on hours slept during extended overnight in-hospital duty hours among medical interns: a randomized trial. JAMA 2012;308:2208-17. doi:10.1001/jama.2012.34490
Takeyama H, Matsumoto S, Murata K, Ebara T, Kubo T, Tachi N, et al. Effects of the length and timing of nighttime naps on task performance and physiological function. Rev Saude Publica 2004;38:32-7. doi:10.1590/S0034-89102004000700006
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