Not only a Problem of Fatigue and Sleepiness: Changes in Psychomotor Performance in Italian Nurses across 8-h Rapidly Rotating Shifts.

Marco Di Muzio,Emanuele Di Simone,Giulia Diella,Luana Novelli,Aurora D’Atri,Luigi De Gennaro,Flaminia Reda,Annamaria Giannini

doi:10.3390/jcm8010047

Marco Di Muzio, Emanuele Di Simone + Show 6 more

Open Access

https://doi.org/10.3390/jcm8010047

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Abstract

Although many studies have detailed the consequences of shift work in nurses concerning health, fatigue, sleepiness, or medical errors, no study has been carried out trying to disentangle the contribution of sleepiness and fatigue associated to shift work from the attentional performance. The aim of this pilot study is (A) to investigate the effects of an 8-h rapidly rotating shift on fatigue and sleepiness among staff nurses and (B) how these factors affect their psychomotor performance. Fourteen nurses were selected for a within-subject cross-sectional study according to this sequence of shifts: morning–afternoon–night, which were compared as function of tiredness, sleepiness, and performance at the Psychomotor Vigilance Task (PVT). Subsequently, a within-subject Analysis of Covariance (ANCOVA) evaluated if the observed differences between shifts persist when the contribution of sleepiness is controlled. Our results clearly indicate that night shifts are associated with significant greater sleepiness and tiredness, and worsened performance at the PVT. As hypothesized, ANCOVA showed that these differences disappear when the contribution of sleepiness is controlled. Results point to a lower psychomotor performance in night compared to day shifts that depends on sleepiness. Hence, interventions to minimize the consequences of the night shift should consider a reduction of sleepiness.

Highlights

The night shift, with its overnight duty hours, is a prominent feature of health care providers and a necessary part of a 24-h healthcare institution [1,2]
Since tiredness and sleepiness may covary with performance at the Psychomotor Vigilance Task (PVT), we evaluated if differences in the attentional performance will be still present when partialling the contribution of correlated variables
Our data confirm an increased sleepiness and a greater sense of fatigue at the end of the night shift compared to daytime shifts

Summary

Introduction

The night shift, with its overnight duty hours, is a prominent feature of health care providers and a necessary part of a 24-h healthcare institution [1,2]. As a consequence of insufficient or poor sleep quality over a prolonged period, can lead to difficulty in attention and concentration, reduced motivation, irritability, misperception, memory lapses, decreased reaction times, loss of empathy, and errors of judgment. The aim of our pilot study will be to assess the levels of psychomotor vigilance fatigue and sleepiness across nursing 8-h rapidly rotating work shifts, in order to highlight a potential level of risk associated with a specific work shift. This evaluation will be performed using a within-subject design. The differences between different shifts will be not present when the contribution of sleepiness has been taken into account

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