Shift Work Schedules Research Articles

Short sleep duration and high exposure to quick returns are associated with impaired everyday memory in shift workers

PurposeTo investigate the relationship between self-reported everyday memory problems the last month, and: (a) shift work schedule, (b) night shifts and quick returns worked the last year, and (c) sleep duration the last month. MethodsIn all, 1,275 nurses completed the Everyday Memory Questionnaire – revised, and answered questions about shift work exposure and sleep duration. We performed multiple linear regression analyses with memory score as dependent variable, and the shift work exposure variables as well as sleep duration as predictors, while adjusting for potential confounders. FindingsHigh exposure to quick returns (β = .10, p < .05) and short sleep duration (β = .10, p < .05) were both positively associated with memory problems, whereas shift work schedule, long sleep duration, night shift exposure, and low and moderate exposure to quick returns were not. DiscussionFrequent insufficient time for rest between shifts as well as short sleep was associated with poorer everyday memory.

Night shift work is associated with an increased risk of asthma

IntroductionShift work causes misalignment between internal circadian time and the external light/dark cycle and is associated with metabolic disorders and cancer. Approximately 20% of the working population in industrialised countries...

Efficient shift scheduling with multiple breaks for full-time employees: A retail industry case

A work shift scheduling methodology is presented that can assign shifts incorporating multiple breaks, providing the flexibility vital to service sector firms for reducing staff surpluses and shortages and thereby improve staff demand coverage. The proposed approach differs from previous works in the literature because it attempts to minimize the levels of overstaffing and understaffing, but also the possible negative impacts associated to a strategy of multiple breaks. The approach is built around four modules that implement a sequential iterative process to solve the scheduling problem. The first two modules use novel heuristic procedures to construct efficient break profiles that define the distribution of multiple breaks across a shift. The third module consists of a mixed-integer programming model that assigns shifts to full-time employees over a one-day planning horizon. The model uses the best break profiles constructed by the first two modules to minimize over/understaffing arising from demand seasonality. The fourth module compares the level of over/understaffing minimized by the model to the minimum possible level of over/understaffing, and if the former is not within a percentage considered to be satisfactory the entire procedure is iterated until a satisfactory solution is found. A test case using different daily demand profiles generated results showing that the level of over/understaffing obtained by the methodology under each profile was within 1 percentage point of the minimum possible despite assigning only one break additional to the mandatory meal break.

Features of modern approaches to the diagnosis and treatment of insomnia

Currently, insomnia is not only a medical, but also a social as well as an economic problem. Sleep disorders increase the risk of somatic, neurological and mental illnesses. The shift schedule has a significant impact on the employee’s health, increasing the risk of developing such disorders as metabolic syndrome, arterial hypertension and other. As a result of sleep disturbances, lipid peroxidation processes may intensify, which can lead to the disorders described above. Therefore, the prevention and treatment of sleep disorders is an important aspect of chronic diseases diagnostics. In our opinion, it is crucial to study possible sleep disorders for their timely correction. The article discusses the features of drug and non-drug treatment of sleep disorders, as well as approaches to the primary and secondary prevention of insomnia. It is recommended to begin the treatment of sleep disorders with cognitive-behavioral therapy. Cognitive-behavioral therapy for insomnia typically includes psycho-education, training in relaxation techniques, stimulation limitation method, sleep limitation therapy, and cognitive therapy. When developing recreational activities for employees with a shift work schedule, attention should be paid to work and rest regimes, prevention of fatigue and obesity, and the sleep disorders treatment. Training in sleep hygiene and improving its compliance in the target groups is regarded as a method of non-pharmacological treatment of sleep disorders and a means of primary and secondary prevention of insomnia. In our opinion, further research on the features of the prevention and treatment of insomnia in various population groups is needed. Effective primary and secondary prevention of sleep disorders will reduce the risks of developing neurological, somatic and mental diseases and significantly improve the quality of life.

Nurses' experiences regarding shift patterns in isolation wards during the COVID-19 pandemic in China: A qualitative study.

Aim and objectiveTo explore nurses’ experiences regarding shift patterns while providing front‐line care for COVID‐19 patients in isolation wards of hospitals in Shanghai and Wuhan during the novel coronavirus pandemic. Our findings will help to optimise shift work scheduling, use the existing nursing workforce more efficiently and improve nursing quality.BackgroundNurses are one of the main professionals fighting against COVID‐19. Providing care for COVID‐19 patients is challenging. In isolation wards, the workload has increased, and the workflow and shift patterns are completely different from the usual. More importantly, there is a shortage of nurses. Therefore, it is essential and urgent to arrange nurses’ shifts correctly and use the existing workforce resources efficiently.DesignA qualitative descriptive study of 14 nurses in Chinese hospitals was conducted.MethodsSemi‐structured interviews were used based on the phenomenological research method; data were analysed using Colaizzi's method of data analysis. This study aligns with the COREQ checklist.ResultsFour themes were extracted: assess the competency of nurses to assign nursing work scientifically and reasonably, reorganise nursing workflow to optimise shift patterns, communicate between managers and front‐line nurses to humanise shift patterns, and nurses’ various feelings and views on shift patterns.ConclusionIt is necessary to arrange shift patterns scientifically and allocate workforce rationally to optimise nursing workforce allocation, reduce nurses’ workload, improve nursing quality and promote physical and mental health among nurses during the COVID‐19 pandemic.Relevance to clinical practiceThis study emphasised nurses’ experiences on shift patterns in isolation wards, providing useful information to manage shift patterns. Nursing managers should arrange shifts scientifically, allocate nursing workforce rationally, formulate emergency plans and establish emergency response rosters during the COVID‐19 pandemic.

The Associations of Shift Work, Sleep Quality, and Incidence of Hypertension in Ontario Adults: A Population-Based Study

BackgroundRelatively few population-based studies have explored the relationship and potential mechanisms between exposure to shift work and hypertension. The study objectives for this study were to determine 1) if history of shift work was associated with increased rates of hypertension among working adults, and 2) if sleep quality mediated this relationship. MethodsWe conducted a population-based cohort study using data from Ontario respondents (aged 35-69 y) in the 2000-2001 Canadian Community Health Survey, which was linked to administrative health data housed at the Institute for Clinical Evaluative Sciences. Our sample included survey participants who were employed with no previous diagnosis of hypertension (n = 7420). During a 12-year follow-up window, we determined the time of hypertension diagnosis based on a previously validated algorithm; and explored the mediating effect of sleep quality using marginal structural effect models. ResultsThe study sample included 2079 shift workers and 5341 day workers. Shift workers reported less refreshing sleep, more trouble sleeping, and poorer sleep quality overall compared with day workers. In 12 years of follow-up, 31.3% of workers developed hypertension. History of shift work was associated with higher hypertension rates in both men (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.02-1.44) and women (HR 1.26, 95% CI 1.03-1.55). There was no evidence that these associations were mediated by past sleep quality. ConclusionsHistory of shift work schedules is associated with increased rates of hypertension. Shift work disrupts sleep, but further longitudinal studies are needed to determine if sleep quality mediates the association between shift work and hypertension.

The Future of Shift Work: Circadian Biology Meets Personalised Medicine and Behavioural Science.

Shift work is commonplace in modern societies, and shift workers are predisposed to the development of numerous chronic diseases. Disruptions to the circadian systems of shift workers are considered important contributors to the biological dysfunction these people frequently experience. Because of this, understanding how to alter shift work and zeitgeber (time cue) schedules to enhance circadian system function is likely to be key to improving the health of shift workers. While light exposure is the most important zeitgeber for the central clock in the circadian system, diet and exercise are plausible zeitgebers for circadian clocks in many tissues. We know little about how different zeitgebers interact and how to tailor zeitgeber schedules to the needs of individuals; however, in this review we share some guidelines to help shift workers adapt to their work schedules based on our current understanding of circadian biology. We focus in particular on the importance of diet timing and composition. Going forward, developments in phenotyping and “envirotyping” methods may be important to understanding how to optimise shift work. Non-invasive, multimodal, comprehensive phenotyping using multiple sources of time-stamped data may yield insights that are critical to the care of shift workers. Finally, the impact of these advances will be reduced without modifications to work environments to make it easier for shift workers to engage in behaviours conducive to their health. Integrating findings from behavioural science and ergonomics may help shift workers make healthier choices, thereby amplifying the beneficial effects of improved lifestyle prescriptions for these people.

Individual Circadian Preference, Shift Work, and Risk of Medication Errors: A Cross-Sectional Web Survey among Italian Midwives

Background: In order to explore the possible association between chronotype and risk of medication errors and chronotype in Italian midwives, we conducted a web-based survey. The questionnaire comprised three main components: (1) demographic information, previous working experience, actual working schedule; (2) individual chronotype, either calculated by Morningness–Eveningness Questionnaire (MEQ); (3) self-perception of risk of medication error. Results: Midwives (n = 401) responded “yes, at least once” to the question dealing with self-perception of risk of medication error in 48.1% of cases. Cluster analysis showed that perception of risk of medication errors was associated with class of age 31–35 years, shift work schedule, working experience 6–10 years, and Intermediate-type MEQ score. Conclusions: Perception of the risk of medication errors is present in near one out of two midwives in Italy. In particular, younger midwives with lower working experience, engaged in shift work, and belonging to an Intermediate chronotype, seem to be at higher risk of potential medication error. Since early morning hours seem to represent highest risk frame for female healthcare workers, shift work is not always aligned with individual circadian preference. Assessment of chronotype could represent a method to identify healthcare personnel at higher risk of circadian disruption.

Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function

ObjectivesHere we examine the association between shift work sleep disorder (SWSD) and erectile dysfunction (ED) in shift workers. MethodsMen presenting to a single andrology clinic between January 2014 and July 2017 completed validated questionnaires: International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and the nonvalidated SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, phosphodiesterase 5 (PDE5) inhibitor use, and testosterone use. Serum total testosterone values were determined for each visit. Linear regression was performed controlling for testosterone use, testosterone levels, PDE5 inhibitor use, age, and comorbidities to determine the effect of SWSD on ED as assessed using the IIEF. ResultsOf the 754 men completing questionnaires, 204 reported nonstandard shift work (begins before 7 am or after 6 pm, regularly extends out of that frame, or rotates frequently) and 48 were found to have SWSD using a screening questionnaire. Nonstandard shift work alone did not result in worse IIEF-EF scores (P = .31), but those who worked nonstandard shifts and had SWSD demonstrated IIEF-EF scores 2.8 points lower than men without SWSD (P < .01). When assessing for the type of shift work performed, men who worked night shifts had IIEF-EF scores 7.6 points lower than men who worked during the day or evening (P < .01). Testosterone use improved IIEF-EF scores for men with SWSD by 2.9 points, ameliorating the effect of SWSD on ED. However, baseline testosterone levels were not associated with worse erectile function in this cohort. ConclusionMen with SWSD have worse erectile function, with men who work night shifts having even poorer erectile function. These findings suggest that circadian rhythm disturbance may significantly impact erectile function. While testosterone therapy may partly reverse the effects of SWSD, shift work is a potential risk factor for ED and should be assessed for as part of the evaluation of men with ED.Rodriguez KM, Kohn TP, Kohn JR, et al. Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function. J Sex Med 2020;17:1687–1693.

Fatigue and recovery in shiftworking nurses: A scoping literature review

ObjectivesTo identify factors impeding or enhancing recovery from fatigue in shiftworking nurses. DesignScoping literature review methodology was implemented to identify key concepts around recovery from fatigue in shiftworking nurses to provide a narrative around these paradigms. Data sourcesFive electronic data bases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO to identify primary studies on fatigue and recovery in shiftworking nurses from 2000 to 2019 inclusive. Review methodsPreliminary searches were completed between September and December 2017 and finalised in January 2020. Research was drawn from nursing only samples employed under shiftwork scheduling. Results31 studies were included in this scoping review. Factors impeding and enhancing recovery at work and home are identified as impacting on fatigue outcomes. Findings indicate recovery from fatigue in shiftworking nurses are most significantly affected by high work and job demands and the 'when' and 'how' of shiftwork scheduling; all reported to impede recovery from shiftwork related fatigue. The most noteworthy facilitators of recovery were work control and control over shiftwork scheduling, break opportunities at work, age and being part of a family structure. There was a dearth of research identified around the time frames of the progression from acute to chronic fatigue and the in-depth role of recovery in this transition. As chronic or long-term fatigue can develop from an acute or recoverable fatigue this may significantly impact on shiftworking nurses' health and wellbeing. ConclusionsThis scoping review highlights the complicated nature of shiftwork scheduling and the impact it can have on recovery from fatigue in shiftworking nurses. Multiple methods and ways of measuring fatigue, recovery and shiftwork were identified in the studies. The results describe factors impeding and enhancing recovery from fatigue as occurring within both the workplace and during time away from work. Thus, this review provides improved understanding of the barriers and facilitators in recovery from fatigue and the potential accumulation of fatigue over time. These findings are important for shiftworking nurses, nursing managers and hospital administrators, and society, who are dependant on nurses' care.

Reduced Neuromuscular Performance in Night Shift Orthopedic Nurses: New Insights From a Combined Electromyographic and Force Signals Approach.

The effect of sleep–wake rhythm disruption on neuromuscular control and muscle fatigue has received little attention. Because nurse shift work is so varied, including overnight duty, rotating shift schedules, early awakening, and interrupted nocturnal sleep, it offers an interesting model to study this paradigm. It has been investigated so far using only subjective markers. A combined approach based on the simultaneous analysis of surface electromyographic (sEMG) and force signals can objectively detect possible deficits in neuromuscular control and muscle fatigue. With this study we investigated neuromuscular activation and muscle contraction capacity at submaximum and maximum level in nurses working two night-shift schedules and compared them to levels in nurses working entirely in day shifts. Sleep quality and activity levels were also assessed. The study sample was 71 nurses grouped by their shift work schedule: night shift for 5 days (NS5, n = 46), night shift for 10 days (NS10, n = 9), and only day/swing shift (DS, n = 16). Before and after the shift-work cycle, maximum voluntary contraction (MVC) force and muscle activation, neuromuscular control, and muscle fatigability were measured in the finger flexor muscles. Activity level and sleep quality during the shift-work cycle were recorded with a wrist actigraph. After the shift-work cycles, MVC force and muscle activation were decreased (−11 ± 3% and −33 ± 3%, p < 0.001) as was neuromuscular control (−36 ± 8%, p = 0.007), whereas muscle fatigability was increased (+ 19 ± 9%, p = 0.006) in the NS5 and the NS10 group. Sleep quality was lower in the NS5 and the NS10 group (−8 ± 1.8% and −15%3, respectively, p < 0.001), while the activity level for the three groups was similar. There was a clear reduction in neuromuscular control and an increase in muscle fatigue in the nurses working the night shift. These findings may inform of work schedule planning or recommendations for devising new recovery strategies to counteract neuromuscular alterations in night shift nurses.

Employee Work Life Balance and Organizational Performance of the County Governments in Kenya

There is growing need to investigate the effects of work-life on organization performance. The study intended to examine the effect of Work Life Balance (WLB) organizational performance (OP) in the County Government of Busia. The unit of study was the County Government of Busia which is one of the 47 Counties in Kenya. The study was guided by Exchange and Spill over Theories. The researcher used census survey research design. The study population targeted 91 respondents of the County Government of Busia. Questionnaires were the main data collection instruments. Results of the study were: There was a positive, linear and significant association between flexible work schedule, telecommuting, compressed work weeks and organizational culture on OP. It was recommended that organizations must strive to fully operationalize flexi time, compressed work schedule, shift schedule and job sharing in their organizations. Organizations should make provisions of more platforms that would encourage employees to away from their places so that organization reduces the cost of hiring offices, space and increasing profitability. It encourages managers to ensure results expected and to push further for WLB culture in the organization, setting a pace of effective and accountable management practice.

Association between Shift Work and Neurocognitive Function among Firefighters in South Korea: A Prospective Before-After Study.

Background: Recent research indicates that shift work is associated with neurocognitive function. However, studies that examine the association between shift work and neurocognitive function in firefighters have not yet been performed. We examined the effect of shift work on neurocognitive function in firefighters by measuring and comparing neurocognitive function before and after night shift. Methods: 352 firefighters from eight fire stations in South Korea were included in this study. We performed neurocognitive function test using central nervous system vital signs (CNSVS) during daytime work and on the next day after night work. We performed paired t-tests to assess differences between neurocognitive function before and after night work. We also compared neurocognitive function in insomnia and depression. We used a general linear model to analyze the associations between shiftwork schedule and the changes in neurocognitive function. Results: The neurocognitive function significantly decreased in six domains (composite memory, verbal memory, visual memory, complex attention, psychomotor speed, and motor speed) as did the neurocognitive index on the next day after night work compared with during day work. These decreased domains were the same following night work regardless of the type of shift work. Conclusion: Night work in firefighters may cause neurocognitive decline.

ORGANIZATION OF COMPLEX MANAGEMENT MODEL-BASED PRODUCTION OPERATIONAL-CALENDAR AND NETWORK PLANNING

The paper considers a methodological approach to the system coordination of operational-calendar, network and tactical planning in the conditions of individual and serial production of complex high-tech products. It is proposed to organize an operational management system with this type of production based on the use of optimization tasks for volume-calendar, operational-calendar and network planning.&#x0D; Planning in such productions is usually organized on the basis of network planning, determining the critical path. However, this does not solve the main problem — resource usage restrictions are not taken into account, and an effective algorithm for solving it is not developed. Here you can create a set of options for leading operations to perform them over time, which allows you to shift work schedules in one direction or another, and take into account the use of resources over time. It is also important that the problem of setting the duration of work (operations) is not approximately solved in integers.&#x0D; The optimization criterion is a minimum of work completion time and a minimum of work in progress. In General, the problem of network production planning, taking into account resource constraints, is reduced to the problem of linear integer programming.&#x0D; Operational production management is organized as an iterative, rolling process (reducing production risks), implemented by a single task with tactical management. In General, the developed system of models is undoubtedly of interest for the theory and practice of industrial enterprise management.

Assessing the Management of Excessive Daytime Sleepiness by Napping Benefits

Demanding lifestyle characterized by extended working hours, shift work schedules as well as excessive use of mobile gadgets leads to the disruption of the circadian and homeostatic factors affecting the sleep quality of individuals. As consequence, subjects complain of suffering several sleep disorders some of them characterized by inducing excessive daytime sleepiness (EDS). Currently, the therapeutic approaches for managing EDS include medication, promotion of sleep hygiene, cognitive and behavioral therapy or using of continuous positive airway pressure machine. In this review, we propose the posology of the personalized sleep medicine by the prescription of naps for treating EDS. This review included the online search in PubMed and manual review of articles (basic and clinical trials) of a range of personalized medicine potentially associated to factors of dosage in areas such as nutrition, sports and sleep. Articles in English were identified and subsequently analyzed for consideration for this review. Current evidence has demonstrated that naps exert positive outcomes for individuals complaining with EDS. The dosage of naps might follow similar procedures as reported for personalized interventions in diets or exercise programs (by taking the right dose, at the proper time, with a recommended frequency) which have demonstrated successfully results. The management of EDS may include the personalized sleep medicine considering the prescription of dosage of naps.

Environmental Circadian Disruption Increases Stroke Severity and Dysregulates Immune Response.

Understanding the health consequences of chronic disruption of circadian rhythms can contribute to improving prevention strategies for shift workers. Chronic circadian disruption in shift work has been linked to a higher risk of stroke. Dysregulated immune responses are also linked to circadian disruption and may be a factor in stroke outcomes in shift workers. In this study, we test the hypotheses that specific schedules of circadian disruption exacerbate inflammatory responses in the brain, causing an increase in infarct size after experimentally induced ischemic stroke. Mice were exposed to 1 of 5 different lighting schedules followed by a 30-min middle cerebral artery occlusion, then reperfusion and 3-day recovery. A history of weekly phase advances resulted in an increased infarct volume versus the control lighting schedule. These effects were shift-direction specific, nonpermanent, and required multiple shifts to occur. In a separate cohort, stereotaxic injections of lipopolysaccharide were given bilaterally after exposure to 1 of 3 different lighting schedules. Ratios of pro- to anti-inflammatory cytokine expression show dysregulated responses after a history of phase advances. We conclude that chronic circadian disruption leads to worsened stroke outcome in a direction- and schedule-specific manner likely because of priming of the inflammatory response in the brain. These pieces of evidence suggest that the health impacts of shift work may be improved by targeting shift work scheduling, inflammatory mediators, or both.

0284 The Effects of a Circadian-Aligned Watchbill Shift Work Schedule on Sleep Quality and Quantity in U.S. Navy Submarine Personnel

Abstract Introduction Prior to 2014, the U.S. Navy Submarine Force operated on a non-circadian-aligned watchbill shift work schedule (18-hour day-length) that resulted in insufficient sleep. For instance, prior research reported that submariners received insufficient sleep on this schedule, and modest sleep restrictions can adversely affect performance, alertness, and, ultimately, negatively impact mission outcomes. Thus, the present study characterized sleep patterns of submariners operating on a newer, circadian-aligned 24-hour day-length watchbill. Methods Submariners (n=58; 27.8±5.9 years) of various ranks volunteered from a U.S. Navy submarine. Submariners wore a research-grade actigraphy watch over a 30-day underway mission, for objective sleep measurement of time in bed (TIB), total sleep time (TST), and sleep efficiency (SE). Subjective sleep was measured from questionnaires (Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], Profile of Mood States [POMS-fatigue subscale]) that were taken pre- and post-underway. Results Compared with pre-underway, at post-underway submariners reported significantly higher scores on the ISI, PSQI global sleep quality, and POMS-fatigue (all p&amp;lt;0.05, indicating worse sleep and fatigue ratings). According to actigraphy, submariners acquired on average 6.7±1.0 hours TST, 7.5±1.1 hours TIB, and 88.9±3.9 % SE per day throughout the underway mission. Actigraphy-determined TIB and TST were variable compared with PSQI self-reported TIB and TST. Conclusion Study results indicate that submariners experience modest sleep restriction on a newly implemented 24-hour watchbill, which is an improvement in sleep relative to prior assessments of the former standard 18-hour watchbill. However, submariners endorsed lower sleep quality and higher fatigue levels from a month-long underway mission. This study is one of the first examinations of sleep under the 24-hour watchbill mandate that was instated in 2014. Future studies should further evaluate sleep and test fatigue mitigation strategies in different shift configurations of the 24-hour watchbill. Support Joint Program Committee-5 Fatigue Mechanisms and Countermeasures Working Group

0409 The Efficacy of Afternoon-Evening Sleep Following Night Shifts on Sleep and Alertness in Nurses with Rotating Shift Work Schedule: Real World Data

Abstract Introduction The aim of this study was to investigate the efficacy of changing sleep timing to afternoon-evening following nightshifts in hospital nurses with three rapid rotating shift schedules. Methods Hospital nurses with three rotating shift schedules were enrolled for a 1-month pre-intervention and a 1-month intervention study. During the Intervention, sleep timing following nightshifts was directed to afternoon-evening sleep for 8h time-in-bed (TIB) after 1 PM, and ad-lib sleep schedule for other shifts. Baseline and follow-up evaluation included sleep schedule, sleep duration, Epworth sleepiness scale (ESS), insomnia severity index (ISI) for each shift, Beck depression inventory (BDI), and Beck anxiety inventory (BAI). Sleep was assessed by sleep diary and actigraphy. Alertness during the night shift was evaluated using the Karolinska sleepiness scale (KSS) in the beginning and at the end of the shift by texts sent to their cell phones. The participants were asked to give feedback and a willingness to continue this intervention. Results A total of 26 subjects (30.7±8.5years, 25 female) finished the study among 29 nurses who participated in the study. The shift work was 6.5±8.0years. The mean morningness-eveningness scale was 42.1±8.0(31-62). TIB following nightshifts were 379.9±91.2 and 478.4±48.7 min for preintervention and intervention, respectively (p=0.001). Total sleep time (TST) was 328.0±91.0 vs. 361.0±70.4min, respectively following nightshifts (p=0.187, Cohen’s drm = 0.467). BDI, BAI, ESS, and ISI were significantly improved after the intervention. 60.7% and 49% of the participants reported improved alertness, and work efficiency during the nightshift. 17.9% and 42.9% of the participants reported increased sleep duration, and improved sleep quality after nightshift, respectively. Only eight participants were willing to continue the afternoon-evening sleep schedule following night shifts. KSS was not different between pre-intervention and intervention. Conclusion The afternoon-evening sleep schedule modestly increased total sleep time following nightshift. The overall mood, sleepiness and insomnia scale improved after the intervention although the alertness assessed by KSS failed to show the difference. The individual difference should be considered for applying afternoon-evening sleep for rapid rotating shift schedules. Support 2018 Research award grants from the Korean sleep research society and NRF-2019R1A2C1090643 funded by the Korean national research foundation

Work-Family Conflict among Iranian Emergency Medical Technicians and Its Relationship with Time Management Skills: A Descriptive Study.

Background Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. The EMTs experience high level of job stress, which may affect their ability to perform their family roles, and, on the other hand, actively performing their family responsibilities may interfere with the effective delivery of the already stressful activities at workplace. Objective The aim of this study was to determine the prevalence of WFC among Emergency Medical Technicians in Iran and its relationship with time management skills. Methods This was a descriptive study. In this study, 271 EMTs from the western part of Iran completed the questionnaire for the assessment of WFC. The Carlson Family-Conflict Questionnaire and the “Time Management Behaviors Scale” developed by Macan were used as evaluation instruments. The data were analyzed by SPSS software version 16. Appropriate statistical analysis such as mean and standard deviation, Pearson correlation, and Spearman rank correlation was applied for analyzing the data in SPSS. Results The majority of the participants reported some degrees of WFC. Statistical analysis showed a significant inverse correlation between total WFC score and total “Time Management Behaviors scale” score (r = −0/381، p < 0/0001). In the present study, there was no significant correlation between total WFC score and demographic factors such as educational level, age, sex, marital status, number of family members, need for family member care, and work experience (p > 0.05). Conclusions The findings of this study indicate that time management behaviors and skills can reduce WFC among Emergency Medical Technicians. Therefore, it is recommended that prehospital emergency authorities and policymakers plan and implement measures such as reducing the duration of shift-work schedules, decreasing shift-change restrictions, and organizing regular time management courses. Also, employment of local inhabitants is preferred to geographically distant individuals with similar qualification as this will reduce the distance between home and workplace.

Sleep disorder among shift work nurses and its impact on their quality of life at Al Ahrar Governmental Hospital, Zagazig City, Egypt

Background Shift work sleep disorder is a crucial occupational health problem for nurses that not only causes health problems for them but also affects patient’s safety and job performance. Objective The aim was to assess the magnitude of sleep disorders among shift working nurses at Al Ahrar Governmental Hospital and to determine the associations between sleep disorders and work characteristics and their impact on quality of life. Materials and methods A comparative cross-sectional study was conducted among 180 nurses. Data collection was done by using Pittsburgh Sleep Quality Index to measure the quality of sleep, insomnia severity index to measure self-perception of insomnia symptoms, Epworth sleepiness scale to measure daytime sleepiness symptoms, and functional outcome of sleep questionnaire to measure the quality of life. Results It has been estimated that 73% of shift work nurses are suffering from poor subjective sleep quality compared with the morning shift group (20%) and 60% of shift work nurses had sleep disturbances compared with 36.7% among the morning shift group with a significant difference ( Conclusion Shift work sleep disorders are prevalent and important health concerns among nurses. Nurses’ sleep disorders can affect the patient’s safety by affecting the nurse’s performance and care quality. Therefore, planning for improving work shift schedules by hospital administration can be helpful and the use of day rest after night shift work can improve the sleep quality of nurses.