Chair of Family Nursing and Community Care, Department of Nursing Science, Witten/Herdecke University, Stockumer Str, 12, D-58285 Witten, Germany.
BMC Public Health. 2013 Dec 5;13:1137. doi: 10.1186/1471-2458-13-1137.
Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule.
Longitudinal data from the NEXT Study was used. In total 11,102 nurses from Belgium, Germany, Finland, the Netherlands, Poland, Slovakia, France and Italy completed both the 'basic questionnaire' (t1) and the '12 month follow-up questionnaire' (t2). To examine the time-effect (repeated measures) and the group-effect of five defined groups of nurses on the Work Ability Index (WAI) and general health (SF36), an adjusted 2-way analysis of covariance (ANCOVA) was performed.
The nurses who wanted to, but could not change their shifts during the 12 month follow-up had the lowest initial and follow-up scores for WAI (t1: 37.6, t2: 36.6, p <0.001), lowest general health (t1: 63.9, t2: 59.2, p <0.001) and showed the highest decrease in both outcomes. Shift pattern change in line with the nurses' wishes was associated with improved work ability and to a lesser comparatively low extent with increased decline in health scores. A forced change of shift against the nurses' will was significantly associated with a deteriorating work ability and health.
The findings would suggest that nurses' desire to change their shift patterns may be an indicator for perceived low work ability and/or low health. The results also indicate that fulfilling nurses' wishes with respect to their shift work pattern may improve their personal resources such as work ability and - to somewhat lesser extent - health. Disregarding nurses' preferences, however, bears the risk for further resource deterioration. The findings imply that shift schedule organization may constitute a valuable preventive tool to promote nurses' work ability and - to lesser extent - their perceived health, not least in aging nursing work forces.
欧洲护士提前离职研究（NEXT）的先前横断面研究结果表明，对工作安排不满意的护士往往会考虑离开护理行业。这一决策过程中的中介因素可能是由于自我感知的较差的工作能力和/或健康状况。本文旨在研究护士的工作能力和一般健康状况变化与请求、强制和拒绝改变轮班时间表之间的关系。
使用 NEXT 研究的纵向数据。来自比利时、德国、芬兰、荷兰、波兰、斯洛伐克、法国和意大利的 11102 名护士完成了“基本问卷”（t1）和“12 个月随访问卷”（t2）。为了检验五种不同护士群体的时间效应（重复测量）和群体效应对工作能力指数（WAI）和一般健康状况（SF36）的影响，采用了调整后的 2 向方差分析（ANCOVA）。
在 12 个月的随访期间，希望但无法改变轮班的护士初始和随访时的 WAI 得分最低（t1：37.6，t2：36.6，p<0.001），一般健康状况最低（t1：63.9，t2：59.2，p<0.001），且这两个结果的下降幅度最大。符合护士意愿的轮班模式变化与工作能力的提高有关，而与健康评分的相对较低的下降有关。违背护士意愿的强制性轮班变化与工作能力的恶化显著相关。
研究结果表明，护士改变轮班模式的愿望可能是工作能力和/或健康状况较差的一个指标。研究结果还表明，满足护士对轮班工作模式的意愿可能会提高他们的个人资源，如工作能力，并且在一定程度上提高他们的健康状况。然而，忽视护士的偏好会增加资源恶化的风险。研究结果表明，轮班时间表的组织可能是促进护士工作能力和在一定程度上提高他们感知健康的一个有价值的预防工具，尤其是在老龄化的护理劳动力中。
