Abstract
Background: Nurses have a high incidence of shift work sleep disorder, which places their health and patient safety in danger. Thus, exploring the factors associated with shift work sleep disorder in nurses is of great significance in improving their sleep health, nursing personnel staffing, and scheduling during the COVID-19 pandemic.Objectives: The purpose of this study was to investigate the incidence of shift work sleep disorder during the COVID-19 pandemic and explore the factors associated with shift work sleep disorder in Chinese nurses.Methods: This was a multicenter cross-sectional study using an online survey. Stratified cluster sampling was used to include 4,275 nurses from 14 hospitals in Shandong, China from December 2020 to June 2021. Stepwise multivariate logistic regression analysis and random forest were used to identify the factors associated with shift work sleep disorder.Results: The prevalence of shift work sleep disorder in the sampled shift nurses was 48.5% during the COVID-19 pandemic. Physical fatigue, psychological stress, shift work more than 6 months per year, busyness during night shift, working more than 40 h per week, working more than four night shifts per month, sleeping more than 8 h before night shift, using sleep medication, irregular meals, and high-intensity physical activity were associated with increased odds of shift work sleep disorder. Good social support, good work-family balance, napping two or three times per week, resting more than one day after shifts, intervals of 8 days or more between shifts, and taking turns to rest during the night shift were associated with decreased odds of shift work sleep disorder.Conclusions: Shift work sleep disorder may be associated with scheduling strategies and personal behavior during the COVID-19 pandemic. To reduce the incidence of shift work sleep disorders in nurses, nursing managers should increase night shift staffing, extend rest days after shift, increase night shift spacing, and reduce overtime, and nurses need to seek more family and social support and control their sleep schedules and diet.
Highlights
The National Sleep Foundation defines shift work as a work that takes place outside the traditional daily schedule of 09:00– 17:00 [1]
Nursing managers and nurses themselves should improve their awareness of the incidence and harm of shift work sleep disorder (SWSD) during the COVID-19 pandemic, and pay more attention to the possible factors associated with SWSD in the physical, psychological, environmental, occupational, social, and behavioral aspects, so as to improve professional identity and happiness and ensure the health and safety of nurses on duty
The participants (n = 4,655) of the present study were recruited from nurses participating in shift work in 14 hospitals across six cities in Shandong, China
Summary
The National Sleep Foundation defines shift work as a work that takes place outside the traditional daily schedule of 09:00– 17:00 [1]. Shift work is very common in the healthcare sector, in which nurses are usually involved. A previous longitudinal study showed that shift work schedules had no effect on lifestyle [2]. Shift work sleep disorder (SWSD) is considered a chronic condition that is directly related to work schedule [4]. Previous studies have shown that nurses are taking more frequent shifts, with heavier workloads and a sharp increase in fatigue and mental stress during the COVID-19 pandemic [5]. Nurses have a high incidence of shift work sleep disorder, which places their health and patient safety in danger. Exploring the factors associated with shift work sleep disorder in nurses is of great significance in improving their sleep health, nursing personnel staffing, and scheduling during the COVID-19 pandemic
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