MA (Social Work), Faculty of Humanities, University of the Witwatersrand, 1995

Evidence is accumulating that the imposed lifestyle associated with shift-work can adversely affect many aspects of nurses’ mental health. The 2005 National Survey of the Work and Health of Nurses stated depression is more common in nurses than in the general population. Minimal research has focused on depression as a direct outcome of shift-work for registered nurses. The purpose of this study was to examine the relationship between shift-work and depressive symptoms in female nurses. This study was a discrete analysis of data collected from 151 registered nurses enrolled in the primary study entitled “Work and health: Optimizing nurses’ physical health in hospital work environments” (Tranmer, McGillis-Hall, Katzmarzyk, Parry, et al, 2007). A descriptive correlational design was utilized to describe the relationships between shift-work and depressive symptoms. Shift work was categorized as participants working 8 hours, 12 hours, or a combination of both 8 and 12 hour shifts. Depressive symptoms were measured with the Centre for Epidemiological Studies Depression Scale (CES-D). Bivariate analysis showed no statistical significant correlations between CES-D scores and shift-work. However, correlational analysis between individual CES-D questions showed a positive association between shift-work and lack of concentration, decreased motivation to complete tasks, feeling depressed and difficulty sleeping as adverse effects. Fifty-two percent of these shift workers identified problems with keeping focus on the tasks they were performing, 40% described an alteration in motivation, 31% felt depressed and 69% reported sleep disturbances. This study found no direct association between shift-work and depression but found that individual symptoms of depression were related to the shift-work schedule. Studies addressing the effects of shift-work on mental health need to explore options to decrease depressive symptoms, such as impaired cognition and motivation, that were shown to impact upon the worker’s quality of life and quality of care provided. / Thesis (Master, Nursing) -- Queen's University, 2009-09-23 17:05:53.606

Shift work is a major feature of modern work practices. It involves individuals working at times considered unconventional for most workers, such as at night. Although the community often benefits from such work practices, shift work can be hazardous, for both the workers and the community. The thesis reviews the main problems of shift work, especially when involving night work. These are: an increased risk for accidents and errors; increased sleepiness and fatigue due to difficulties sleeping; increased health problems; and disruption to family and social life. Strategies to limit the risk associated with these hazards are also reviewed, and include using knowledge of circadian principles to plan shift schedules, sleeping schedules and meal times; planned napping; consideration of the work environment; and newer techniques such as using bright lights and melatonin. While this information is known to the research community, it has not filtered down to many shift work workplaces and thus has had little if any positive effect on actual shift work practices. For a change in shift work practices to occur, the research knowledge must become available to every shift work workplace, as must some incentive or motivation to ensure that workplaces make the necessary changes. The Occupational Health and Safety (OHS) laws provide such a framework. Considering shift work as an OHS hazard would ensure that all shift work workplaces identified the hazards of shift work, conducted a risk assessment to identify the risk associated with the hazards, and then implemented the appropriate strategies, from the hierarchy of shift work hazard control measures, for both employers and employees, to fulfil their duty of care to minimise the risks. Considering shift work as an OHS issue would ensure that the research information was used as intended – to improve the safety, performance, and quality of life of all shift workers. The present thesis reviews the shift work research and introduces an OHS perspective as a method to manage shift work effectively.

Background: Shift work is associated with increased risk of cardiovascular disease and cancer, where decreased melatonin has been proposed as an intermediate in the causal pathway. The influence of physical activity on melatonin has rarely been studied in an observational setting, and it may be important in mediating the effects of shift work. We aimed to assess the influence of energy expended during physical activity of different intensities on melatonin among rotating shift nurses. We hypothesized that physical activity before the night shift would lessen the decrease in melatonin production that occurs with exposure to light at night. Methods: 123 female rotating shift nurses working at Kingston General Hospital were recruited over a one-year period. Physical activity and sedentary behaviours for each participant were recorded during both a day and a night shift using activity diaries, and analysis was restricted to activities between 3 p.m. and 7 a.m. Concentrations of urinary 6-sulfatoxymelatonin, a melatonin metabolite, in morning void urine samples were analyzed for each shift. Results: The average age of participants was 41 years, and 60% were overweight or obese (body mass index ≥ 25 kg/m2). An average of 6.9 and 5.2 hours of sleep were reported after the day shift and night shift, respectively. Sedentary behaviours such as standing and television watching accounted for over half of the total reported energy expenditure. During the day shift, energy expended in moderate and vigorous intensity physical activity between 3 p.m. and 7 a.m. was negatively associated with melatonin levels (p=0.024, R2 = 0.09). During the night shift, energy expended in sedentary behaviours was negatively associated with melatonin levels (p=0.008, R2 = 0.03). Conclusions: Physical activity energy expenditure explains only a small amount of melatonin variation, suggesting that other factors are influencing melatonin production, or that melatonin production is minimally effected by these patterns of physical activity. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2010-09-01 11:22:35.915

Background: In 2007, the International Agency for Research on Cancer classified shift-work involving circadian disruption as a “probable carcinogen.” One proposed pathway for this relationship involves nighttime light exposure and subsequent decreases in melatonin production. It is postulated that melatonin, a cancer-protective hormone, may influence patterns of sex hormone production that in turn influence breast cancer risk. The purpose of this study was to investigate the relationships between night shift-work history, melatonin and sex hormone levels among shift-working women. Methods: 82 pre-menopausal nurses who work a rotating shift pattern of two days (7AM-7PM), two nights (7PM-7AM), followed by five days off participated in two study periods approximately six months apart (in summer and winter), each taking place during a day shift of the normal rotating shift pattern. Creatinine-adjusted melatonin metabolite concentrations were measured from morning void urine samples, and estradiol, estrone, progesterone and prolactin concentrations were measured from fasting blood samples taken at the same time. Other pertinent information was collected by measurement (weight, height) and by self-report via questionnaire. We examined melatonin-sex hormone relationships within each of two seasons, and across seasons, to investigate two hypothesized latency periods for influences of melatonin levels on sex hormones. Multivariate linear regression was used to explore relationships, with adjustment for confounders including age and body mass index. Results: An inverse relationship between melatonin and estradiol was suggested in winter (β = -0.13, p = 0.11), and a positive relationship was suggested for increasing estrone with increasing melatonin tertile in summer (p = 0.07), after multivariate adjustments. Melatonin was not associated with other hormones in either season. On investigation of a longer latency period, melatonin in the first season was not associated with sex hormones in the second season. While those working night shifts for 20 years or more had higher mean levels of estradiol, estrone and progesterone, results were not statistically different from those with a shorter history of night work. Conclusions: The results of this study do not provide evidence to support the proposed biological pathway involving altered melatonin and sex hormone levels as intermediates between shift-work and breast cancer risk. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2010-09-14 11:42:06.201

Substantial numbers of Canadians work shifts. The reasons individuals work shifts are varied and complex. Prior research regarding the relationship between work-family balance, gender, quality of life indicators and health has yielded mixed results. The goal of this research was to examine the association between work-family balance, quality of life indicators and Canadians' overall health status while controlling for socio-economic status, education, family structure and life satisfaction. The two objectives of this study were: 1) to explore how the relationship between work-related characteristics, quality of life and overall health status is different among Canadian male and Canadian female workers, controlling for age, education, socio-economic status, family structure, and life satisfaction and, 2) to examine the relationship between shift configuration and employees' overall health status, controlling for socio-economic status, gender, education, family structure and life satisfaction. This study involved analyses of cross-secional national data from the General Social Survey (GSS) 2006, Cycle 20. The sample for the study included employed men and women who were married or living in common-law relationships, ages 18 through 69. Bivariate and logistic regression analyses were conducted to address the stated research objectives. Appropriate survey weights were applied to estimate population characteristeics. To fully account for the survey's complex sample design, mean bootstrap weights were used for variance estimation and calculation of confidence intervals. Findings indicated that for women and shift workers, both work-to-family spillover and family-to-work spillover were predictve of poor self-rated health. Spillover was not a predictor of poor health for men or day workers. Shift configuration was not found to be significantly correlated with poor self-rated health. Analyses should be repeated to test for interaction between shift work and sleep quality as sleep quality was controlled for in this study.

Substantial numbers of Canadians work shifts. The reasons individuals work shifts are varied and complex. Prior research regarding the relationship between work-family balance, gender, quality of life indicators and health has yielded mixed results. The goal of this research was to examine the association between work-family balance, quality of life indicators and Canadians' overall health status while controlling for socio-economic status, education, family structure and life satisfaction. The two objectives of this study were: 1) to explore how the relationship between work-related characteristics, quality of life and overall health status is different among Canadian male and Canadian female workers, controlling for age, education, socio-economic status, family structure, and life satisfaction and, 2) to examine the relationship between shift configuration and employees' overall health status, controlling for socio-economic status, gender, education, family structure and life satisfaction. This study involved analyses of cross-secional national data from the General Social Survey (GSS) 2006, Cycle 20. The sample for the study included employed men and women who were married or living in common-law relationships, ages 18 through 69. Bivariate and logistic regression analyses were conducted to address the stated research objectives. Appropriate survey weights were applied to estimate population characteristeics. To fully account for the survey's complex sample design, mean bootstrap weights were used for variance estimation and calculation of confidence intervals. Findings indicated that for women and shift workers, both work-to-family spillover and family-to-work spillover were predictve of poor self-rated health. Spillover was not a predictor of poor health for men or day workers. Shift configuration was not found to be significantly correlated with poor self-rated health. Analyses should be repeated to test for interaction between shift work and sleep quality as sleep quality was controlled for in this study.

No description available.

Bakgrund: Eftersom sjukvård på sjukhus bedrivs 24 timmar om dygnet sju dagar i veckan behövs således bemanning för samtliga timmar, skiftarbete är den mest förekommande arbetsmodellen. Sjukvården är sedan tidigare ansträngd där personal slutar för att undgå att arbeta skift. Skiftarbete är associerat med störd dygnsrytm. Sömnbrist, bristande återhämtning, samt fysiska och psykiska åkommor är följder av dygnsrytmsrubbningar. Sjuksköterskans arbetsområde är varierat och den främsta uppgiften innebär att skapa en säker och trygg relation till patienten. För att sjuksköterskan ska kunna ge god omvårdnad krävs även att den egna hälsan är god. Syfte: Syftet med studien var att beskriva hur skiftarbete påverkar sjuksköterskans upplevelse av hälsa samt påverkan på arbetsförmågan. Metod: Designen som tillämpades var en allmän litteraturstudie. Litteraturstudien innehåller tolv artiklar som har granskats och beskrivits. Resultat: Fyra teman identifierades och huvudfynden var att treskiftssystem gav mest negativ hälsopåverkan men att även tvåskiftssystem medförde konsekvenser. Skiftsystem kunde medföra nedsatt livskvalitet och negativ hälsopåverkan och sjuksköterskorna upplevde en oro över att begå trötthetsrelaterade misstag. Konklusion: Skiftarbete kan leda till hälsopåverkan på flera nivåer. Mest problematiskt tycks den begränsade tiden med familj och vänner vara, samt den bristande fritiden. Sjuksköterskor upplever trötthet som följd av skiftarbete vilket ger konsekvenser på och utanför arbetet. Ett globalt problem kan urskiljas vilket tyder på att problematik med skiftarbete inte kan antas vara individ- eller kulturellt baserat. / Background: Since health care is provided 24 hours a day, seven days a week, it requires around the clock staffing, shift work is the most common system. The health care system is already highly strained where personnel quit due to the complexity of shift work. Shift work is associated with disturbed circadian rhythm, lack of sleep and recovery. There are both negative physical and physiological effects due to disturbed circadian rhythm. The nursing profession is a diverse area of work and the main task is to provide a secure and safe patient care. Maintaining a good personal health is of key importance in order to provide patients with good nursing. Aim: To describe nurses experience of shift work and its impact on their health and work performance. Methods: The design of the study was a literature review. The review used twelve articles, which have been examined and described. Results: Four themes were identified and the main findings included that three-shift rotation was associated with negative health impact, however two-shift rotation also gave negative health consequences. Shift systems reduce quality of life and cause negative physical and physiological health. Nurses experienced concern regarding committing fatigue related mistakes at work. Conclusion: Shiftwork can cause health consequences on several levels. Most problematic seems to be the lack of time spent with family and friend. Nurses experience fatigue caused by shift work, which generate consequences at and outside of work. Since this seems to be a global issue it indicates that no individual or cultural association can be made.

The aim of the present study was to investigate how dispositional resistance to change (RTC) and neuroticism could predict shift work tolerance (SWT) over a period of six months. Electronic questionnaire were completed by 74 shift workers employed in Trondheim municipality in January 2013 (T1) and in June 2013 (T2). The results showed that age, gender, neuroticism, and RTC were related to SWT. Age at T1 predicted better SWT at T2, while male gender predicted worse SWT at T2. RTC at T1 predicted better SWT at T2, while neuroticism at T1 predicted worse SWT at T2. The findings suggest that individual differences, especially neuroticism, can predict SWT over a period of six months.