Job Strain, Sleep and Alertness in Shift Working Health Care Professionals —A Field Study

Abstract

Abstract:We explored the associations of job strain with sleep and alertness of shift working female nurses and nursing assistants. Participants (n=95) were recruited from the Finnish Public Sector Study, from hospital wards that belonged to the top or bottom quartiles on job strain. Participants' own job strain was at least as high in high-strain group or low in low-strain group as the ward's average. The study included three-week measurements with sleep diary and actigraphy. Psychomotor Vigilance Test (PVT) was performed during one pre-selected morning and night shift and a day off. Sleep efficiency before morning shifts was lower in the high-strain than low-strain group (p=0.03). Low-strain group took more often (72 vs. 45%; p<0.01) and longer naps (62 vs. 35 min; p=0.01) before the first night shift than high-strain group. Difficulties initiating sleep were more common in high-strain group, especially after evening shifts (p<0.01). High-strain group had more often at least one lapse in PVT during the night shift (p=0.02). Average sleep duration (06:49h) and efficiency (89%) did not differ between these groups. In conclusion, high job strain is associated with difficulties initiating sleep and reduced psychomotor vigilance in night shifts. Shift working contributed to impaired sleep in both high and low job strain group. Individual and organization-based actions are needed to promote sufficient sleep in shift working nurses, especially with high job strain.

Association of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery

“…Davy and Göbel 2013;Ruggiero and Redeker 2013;Bonnefond et al 2001). Very few (4%) nurses in these data (Karhula et al 2013) napped during the night shift. The sleepiness values during the pre-selected, circadian rhythm standardised shifts were similar among the two different work stress groups, indicating that severe sleepiness was not fully congruent with the subjective workload during these shifts.…”

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“…1 17-21 Physicians working under acute care conditions, for example, in Emergency Departments (EDs), face a combination of cognitive load, interruptions, communication challenges and time-urgency conditions that are reported to increase the risk of adverse medical events. [22][23][24][25][26][27][28][29][30][31] Of special interest is whether stressor-induced biological processes, such as activation of the hypothalamic-pituitary-adrenal axis and inflammation, contribute to cognitive deficits in physicians. 16 32 33 Consistent with this hypothesis, Rauchenzauner et al demonstrated a positive association between provider on-call duties and inflammatory and cardiac autonomic processes implicated in cardiovascular disease processes, although the impact of professional performance was not determined.…”

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