Night work and symptoms of anxiety and depression among nurses: A longitudinal study

Over the last few decades, night work has been found to be associated with negative somatic consequences; however, there is less knowledge about its impact on mental health. In a sample of 633 Norwegian nurses, we investigated by means of latent growth curve modelling whether different work schedules predicted differences in baseline values of anxiety and depressive symptoms, and trajectories of these over a two-year span. All participants completed the Hospital Anxiety and Depression Scale as part of a larger survey conducted during the winters of 2009, 2010 and 2011. The results revealed that night workers and nurses who changed from day work to night work during the study period did not differ from day workers either in terms of baseline symptoms of anxiety or depression, or in terms of trajectories of these symptoms. However, nurses who changed from night work to day work reported a significant decrease in symptoms of both anxiety and depression over time compared to day workers. Furthermore, supporting previous work, languidity was related to higher anxiety and depression and hardiness to lower levels of those symptoms. Possible mechanisms underlying the results are discussed.     

Health, well-being and burnout of ICU nurses on 12- and 8-h shifts

It is generally agreed that some features of shift systems can influence the extent of well-being and health problems experienced by the workers involved. Extended working days (9-12 h) have been found to aggravate some problems associated with shiftwork, especially when the work is mentally and emotionally demanding. The aim of the study was to compare measures of health, sleep, psychological and social well-being, job satisfaction and burnout of ICU nurses on 12- and 8-h shifts. The groups of subjects were matced for age, length of shiftwork experience, marital status and number of hours worked. the 12-h shift nurses, when compared to their 8-h shift colleagues, experienced more chronic fatigue, cognitive anxiety, sleep disturbance and emotional exhaustion. Job satisfaction seems to be independent of the shift duration. The nurses on 12-h shifts reported less social and domestic disruption than those on 8-h shifts. The 12-h shift nurses showed worse indices of health, well-being and burnout tan the 8-h shift nurses. It is suggested that this may be associated with their longer daily exposure to the stress of work. The increased number of rest days of 12-h shift nurses seems tobe insufficient to dissipate the adverse health and well-being effects that built up over their longer shifts.     

Hassles, hardiness and absenteeism: Results of a 3-year longitudinal study

In this 3-year longitudinal study of 229 full-time employees, the authors investigated the association between hassles, two measures of personality hardiness, and absenteeism verified from medical personnel records and self-reported hospitalization owing to injury and illness. Using stepwise multiple regression analysis, hassles, but neither of the hardiness measures, significantly predicted absenteeism when controlling for psychological well-being and relevent demographic variables over the 3-year period. The alternative measure of hardiness, but not any of the original Kobasa personality hardiness scales, predicted self-reported hospitalization for injury and illness. Little evidence for the predicitve validity of the Kobasa personality hardiness components, or composite hardiness score, existed for either absenteeism or self-reported hospitalization in this study. These findings support the concept that the current conceptualization, measurement and use of the original Kobasa hardiness scales should be re-evaluated.     

Hassles,hardiness and absenteeism: Results of a 3-year longitudinal study

Abstract

In this 3-year longitudinal study of 229 full-time employees, the authors investigated the association between hassles, two measures of personality hardiness, and absenteeism verified from medical personnel records and self-reported hospitalization owing to injury and illness. Using stepwise multiple regression analysis, hassles, but neither of the hardiness measures, significantly predicted absenteeism when controlling for psychological well-being and relevent demographic variables over the 3-year period. The alternative measure of hardiness, but not any of the original Kobasa personality hardiness scales, predicted self-reported hospitalization for injury and illness. Little evidence for the predicitve validity of the Kobasa personality hardiness components, or composite hardiness score, existed for either absenteeism or self-reported hospitalization in this study. These findings support the concept that the current conceptualization, measurement and use of the original Kobasa hardiness scales should be re-evaluated.     

Does 'hardiness' predict adaptation to shiftwork?

This longitudinal study examined whether the dimensions of hardiness (commitment, control and challenge) predicted psychological symptoms and dissatisfaction with shiftwork, and whether or not the relationships identified were confounded with neuroticism and extraversion. Female nurses were studied during their first 15 months of shiftwork. Thirty-six nurses worked on a 2-shift (day and evening) schedule throughout and 66 transferred from the 2-shift schedule to a 3-shift (day, evening and night) schedule after 6 months. Hardiness, neuroticism, extraversion and symptoms were measured before the respondents began shiftwork (Stage 1). Symptoms and dissatisfaction were measured after 6 months (Stage 2) and 15 months (Stage 3). Multiple regressions indicated that the hardiness dimensions did not predict dissatisfaction at Stages 2 or 3, or symptoms at Stage 3. They also failed to buffer the effect of night-work on symptoms. However, commitment did predict symptoms at Stages 1 and 2 and challenge predicted symptoms at Stage 2. Although these effects were confounded with neuroticism, commitment showed weak evidence of independent prediction. In general, hardiness was a very poor predictor of shiftwork tolerance.     

Stress at work and psychological and immunological parameters in a group of Norwegian female bank employees

This study concerned the immunological correlates of stress and work. Self reported stress, emotional state, ego-strength, and defensiveness were examined in relation to measures of cellular immunity (T-cell response to Con A and number of T4 and T8 cells) and humoral immunity (concentrations of immunoglobulins and complement components in plasma) in a group of 96 Norwegian female bank employees. The analyses showed that workload, the stress factor with the highest group mean, was associated with number of T-cells, while strain due to body posture during work was related to concentrations of IgM and C3. Further, depression was significantly correlated with IgM concentration and T-cell number, and anxiety with C3 concentration. T-cell activity was the immunological parameter most consistently associated with psychological well-being, showing positive correlations with defensiveness and ego-strength and negative correlations with anxiety and depression. In conclusion, T-cell number and concentrations of IgM and C3 were sensitive to both work-related stress experience and emotional distress. Coping abilities, indicated by the MMPI Ego-strength scale and emotional distress, were reflected in T-cell activity; insufficient coping was associated with low T-cell activity.     

Hardiness and the relationship between stressors and outcomes

Using a sample of 468 participants, from two organizations, this study examined direct and moderating relationships between hardiness (a composite of challenge, control, and commitment), life and work stressors, and a variety of health-related outcomes. The results indicated that hardiness did not moderate the relationship between stressors and outcomes as reported by others (e.g. Kobasa 1982a). However, hardiness did have significant direct effects on emotional and psychological factors thought to be related to personal well-being and work performance. Hardy individuals reported higher levels of job satisfaction and fewer tensions at work dun did the less hardy. In general, hardy individuals experienced a higher quality of life and a more positive affect while being more energized and less negative about life. Hardy individuals also reported fewer somatic complaints and tended to be less depressed and anxious than individuals low in hardiness. In addition, hardiness was negatively related to all four measures of life and work stress implying that hardiness may not be independent of life demands.     

Impact of shift work and department type upon strain and attitudinal measures of hospital nurses

The effects of shift work (fixed versus rotating), type of hospital department (intensive care unit versus non-ICU), and job scope on stress and attitudes have been reported previously. The goal of the present study was to examine the interactive, as well as individual, impact of these variables on measures of perceived work stress, strain, work satisfaction and withdrawal intentions. Respondents in the study were nurses in a large general hospital in Israel. None of the two- or three-way interactions received empirical support. However, significant multivariate main effects for each of the three independent measures were found. The negative influence of rotating work shift compared to fixed work shift was supported. Nurses who thought that their job was more enriching were more satisfied and perceived their workload as being lower. Department type affected only burnout level; nurses in non-ICUs were lower in burnout. Several theoretical and practical possible interpretations and possible implications are presented.     

Is workplace bullying related to the personality traits of victims? A two-year prospective study

The main aims of this two-wave prospective study were to (1) present different theoretical mechanisms for relationships between bullying and personality characteristics, (2) determine forward and reverse long-term associations between victimization from bullying and personality traits included in the five-factor model and (3) establish whether these personality traits contribute to the variance in bullying, beyond work environment factors in the form of role conflict and role ambiguity. The prospective sample comprised 3066 Norwegian employees. The time lag between the two measurement points was two years. Neuroticism significantly predicted subsequent bullying in analyses of direct associations between personality traits and victimization. When adjusting for role conflict and role ambiguity, conscientiousness emerged as the only significant predictor of later victimization from bullying. In tests of reverse associations, victimization from bullying at baseline was significantly related to agreeableness, conscientiousness and openness at follow-up. Taken together, the study findings indicate that personality traits may function as both predictors and outcomes of workplace bullying.     

The relationship of subjective distress and emergency response experience to the effective use of protective equipment

A total of 11 1 chernical emergency response team members were evaluated on the effective use ofpersonal protective equipment (PPE) and self-contained breathing apparatus (SCBA) whde participating in a series of simulated hazardous material accidents. Performance ratings of PPE and SCBA use were conducted via behaviourally anchored rating scales (BARS), self-estimates of effectiveness, and cohort ratings. Subjective distress was assessed via the Subjective State Change Measure (SSCM), State-Trait Anxiety Inventory, and the Framingham Type A Behaviour Scale. Results indicated that effective use ofprotective breathing apparatus was correlated with prior emergency response experience and state anxiety. BARS scores were negatively related to state anxiety when controlling for experience. Self-ratings for effectiveness was positively related to both type A behaviour pattern and state anxiety.     

Psychophysiological coherence training to moderate air traffic controllers’ fatigue on rotating roster

The nature of the current rotating roster, providing 24-h air traffic services over five irregular shifts, leads to accumulated fatigue which impairs air traffic controllers’ cognitive function and task performance. It is imperative to develop an effective fatigue risk management system to improve aviation safety based upon scientific approaches. Two empirical studies were conducted to address this issue. Study 1 investigated the mixed effect of circadian rhythm disorders and resource depletion on controllers’ accumulated fatigue. Then, study 2 proposed a potential biofeedback solution of quick coherence technique which can mitigate air traffic controllers’ (ATCOs’) fatigue while on controller working position and improve ATCOs’ mental/physical health. The current two-studies demonstrated a scientific approach to fatigue analysis and fatigue risk mitigation in the air traffic services domain. This research offers insights into the fluctuation of ATCO fatigue levels and the influence of a numbers of factors related to circadian rhythm and resource depletion impact on fatigue levels on study 1; and provides psychophysiological coherence training to increase ATCOs’ fatigue resilience to mitigate negative impacts of fatigue on study 2. Based on these two studies, the authors recommended that an extra short break for air traffic controllers to permit practicing the quick coherence breathing technique for 5 min at the sixth working hour could substantially recharge cognitive resources and increase fatigue resilience. Application: Present studies highlight an effective fatigue intervention based on objective biofeedback to moderate controllers’ accumulated fatigue as a result of rotating shift work. Accordingly, air navigation services providers and regulators can develop fatigue risk management systems based on scientific approaches to improve aviation safety and air traffic controller's wellbeing.     

Effects of short-term role overload on marital interactions

This paper examines the effect of role overload on marital interactions using a within-person, time series approach. It is proposed that role overload is indirectly related to marital interactions most strongly via anxiety but also via depression. Twenty-three couples completed daily reports of overload, depression and anxiety and weekly reports of their own and their spouse's marital behaviour over 4 months. After controlling for autocorrelation, role overload was found to affect directly both depression and anxiety, but its effect on anxiety was much stronger than that on depression. Anxiety predicted withdrawal from marital interactions, but not anger, and depression predicted anger, but not withdrawal. Also, spouses' perceptions of their partners' behaviour reflected the partners' self-reported behaviour, and spouses' perceptions predicted their own behaviour.     

Is there an optimum number of night shifts? Relationship between sleep, health and well-being

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health: i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

Is there an optimum number of night shifts? Relationship between sleep, health and well-being

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

The moderating role of personality characteristics on the relationship between job insecurity and strain

The experience of job insecurity has been linked to several different outcomes, such as negative attitudes towards work and the organization, turnover intention, as well as health complaints. However, since the strength of these effects have been found to vary across studies, it is vital to identify factors that could influence the relationships. The present study examines the moderating role of three personality characteristics (negative affectivity, positive affectivity, and external locus of control) on the relation between job insecurity and outcomes (mental health complaints, job dissatisfaction, and job-induced tension). Data from 400 nurses at a Swedish acute care hospital (response rate 71%; 91% women, aged 20-68 years) showed that both job insecurity and personality were related to strain. Also, the data indicated some buffering effect of personality. Despite the gender bias of the sample, the study provides additional support for the notion that job insecurity affects strain even after controlling for individual characteristics. The study also expands the literature on job insecurity by pointing out the influence of personality characteristics on the relationship between stressors and strain.     

Is there an optimum number of night shifts? Relationship between sleep,health and well-being

Abstract

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health: i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

On-shift and daily variations in self-report and performance measures in rotating-shift and permanent night nurses

An intensive study was conducted of the influence of type of shift system, type of shift, and time-into-shift on a battery of on-shift and daily measures obtained from 61 female nurses over a 28-day period. Thirty-two rotating-shift nurses and 28 permanent night nurses recorded data on a hand-held computer at the start and end of each day, and every 2-h during their shifts. The measures included a sleep diary, self-ratings of mood, workload, and personal disruption, and two cognitive performance tasks. These results suggest that the permanent night nurses were no worse off and for some measures were actually better off than the rotating-shift nurses after controlling for differences in age and shiftwork experience; the night-shift was problematic for the rotating-shift nurses but so was the early shift; mood deteriorated and reaction time got slower over the course of the night-shift but extra long responses (which may correspond to lapses of attention) and rated workload were lower on the night-shift. The relatively large number of consecutive night-shifts worked by the rotating-shift nurses, the uneven distribution of workload between shifts, and the long night-shift may have contributed to these results.     

结构式团体在临床护士心理压力调解中的应用

目的探讨应用结构式团体在临床护士心理压力调解中的改善效果。方法选择临床护士60例,均为2020年06月~2020年12月间我院在册在岗内科病区护士,依据护士入科先后顺序采取分组,即前期入科护理人员30例采取自我调节方式应用心理压力,观察组为后期入科护理人员30例,采取结构式团体干预模式进行心理压力调节,对比护士不同调节方式下,情绪分值变化及对自我职业的倦怠评分、心理健康状态评分,并采取科室设计的满意度问卷展开评估。结果由自评量表结果所示,观察组护理人员在干预前焦虑、抑郁分值均无明显变化(P>0.05),干预后观察组护理人员焦虑、抑郁分值有所下降,与对照组呈鲜明对比(P<0.05)。职业倦怠量表测评结果所示,观察组护理人员情绪衰竭、工作态度、个人成就感三个维度的分值均低于对照组,差异显著(P<0.05)。由科室自我设计满意度问卷所示,观察组对自我工作满意度较高,与对照组比值差异明显(P<0.05)。两组在SCL-90量表测评下,观察组护理人员各项指标得分低于对照组(P<0.05)。结论结构式团体在临床护士心理压力的调解中的应用效果值得肯定,可改善职业倦怠感,提高工作效率。     

Attitudes of nurses towards 8-h and 12-h shift systems

Twelve-hour shift schedules are becoming increasingly popular. The present study was designed to investigate the attitudes of nurses, their priorities with respect to working time and other aspects of the working conditions, and to analyse the conditions leading to a diminished satisfaction with the shift schedule and to aspirations for a change of schedule. Questionnaires were returned by 880 nurses (78% return rate) from 12 hospitals. A total of 65% worked 12-h shifts and 35% worked 8-h shifts. A considerable proportion of both groups showed a low satisfaction with their schedule and a desire to change the schedule (44% of those working 12-h shifts, 47% of those working 8-h shifts). Concerning effects of the shift schedule on work strain, continuity of service, health, family and leisure time, 8-h shifts were rated more favourably, especially by those working these shifts, but also by nurses working 12-h systems, with the exception of effects on leisure time and to some extent also on continuity of service and on family. Effects of the shift schedule on social responsibilities and leisure time activities turned out to be a major moderating variable in both groups with respect to schedule satisfaction and attitudes towards a change of schedule. Apparently neither type of shift system, traditional 12-h shift rosters or rotating 8-h shifts, is very appealing to the nurses. A stronger relationship between social consequences and health state in nurses working 12-h shifts indicates that in this group negative effects on family and leisure time might be due to an increased need for recuperation, which reduces effective leisure time.     

Stress states in nuclear operators under conditions of shiftwork

This study examined the stress states experienced by nuclear power operators at work under an existing shift system, time-on-shift effects and the manner in which these states may be moderated by achievement motivation and a sense of coherence. The results show an incidence of stress states during evening shifts and night-shifts in the operators, which are primarily characterized by increased distraction as well as by enhanced sleepiness and low irritability. The night-shift was found to be the most problematic one in terms of increased sleepiness and distractibility, and reduced alertness. An abrupt fall in alertness during the evening shift and a considerably increased distractibility at its end was observed. These facts, as well as the lack of recuperation from daily domestic activities and caring for children at the start of the shift, suggest that besides the night duty, the evening one also constitutes a serious challenge to operational safety at this nuclear facility. Correlations found between personality characteristics and sleepiness, distractibility and irritability, indicate personal resources as important modifiers of stress states. A narrowing in the effects of motivation and sense of coherence was found in the evening shifts and night-shifts. The results have practical implications for intentional modifications of personal resources at nuclear facilities.