Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University School of Public Health, Taipei, Taiwan.
Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University School of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan.
Int J Nurs Stud. 2015 Jan;52(1):297-306. doi: 10.1016/j.ijnurstu.2014.09.003. Epub 2014 Oct 11.
Lack of sleep is a common problem amongst nurses. Short sleep duration has been related to stress and burnout. However, in nurses, the effects of short sleep duration on job strain and burnout are controversial and a clear relationship has been lacking. This study aims to assess whether short sleep duration is related to job strain and burnout statue, and whether such relationship is in a dose-dependent manner.
A cross-sectional survey among female nurses in secondary referral health centers in Taiwan, using a self-administered structured questionnaire. Stratified sampling by region and patient bed number category was done to select representative centers for this survey. Approximately 10% of all secondary referral centers were randomly selected from each stratum. Non-linear dose-response relationship between sleep duration and job strain and burnout scores was assessed by general additive models (GAM), adjusting for personal characteristics, work condition, and family situation.
Among the 2268 full-time nurses in 39 hospitals invited to participate in this study, 1384 (61%) satisfactorily completed the questionnaire. There were 169 nurses (12.2%) who slept less than 6 h per working day. Among the participants, 37% (n=512) were classified into high strain group. The mean scores of personal, work-related, and client-related burnout were 59.4 (SD=22.0), 54.6 (SD=21.7), and 42.3 (SD=18.6). Compared to those slept longer than 7 h, nurse who slept less than 6 h per working day had higher risk for job strain (adjusted odds ratio, AOR=1.8, 95% confidence interval, CI=1.2-2.7), personal burnout (AOR=3.0, CI=1.7-5.2), work-related burnout (AOR=3.4, CI=2.0-6.0), and client-related burnout (AOR=2.0, CI=1.2-3.6). GAM analysis found a linear relationship between sleep duration and job strain, and client-related burnout. For personal and work-related burnout, a linear increase in burnout score between 7 h and 5 h of sleep was observed, followed by a leveling off for durations of less than 5 h.
Our study found sleep duration at working days was inversely associated with female nurses' job strain and burnout in a dose-dependent manner. Further studies on work factors which affecting sleep duration are warranted.
睡眠不足是护士中常见的问题。睡眠时间短与压力和倦怠有关。然而，在护士中，睡眠时间短与工作压力和倦怠状态之间的关系尚存在争议，并且缺乏明确的关系。本研究旨在评估睡眠时间短是否与工作压力和倦怠状态有关，以及这种关系是否呈剂量依赖性。
使用自我管理的结构化问卷对台湾二级转诊保健中心的女性护士进行横断面调查。通过区域和病床数量类别进行分层抽样，以选择具有代表性的中心进行此项调查。从每个层次中随机选择约 10％的所有二级转诊中心。通过广义加性模型（GAM）评估睡眠时间与工作压力和倦怠评分之间的非线性剂量反应关系，调整个人特征，工作条件和家庭状况。
在邀请参加这项研究的 39 家医院的 2268 名全职护士中，有 1384 名（61％）满意地完成了问卷。有 169 名护士（12.2％）每天的工作睡眠时间少于 6 小时。在参与者中，有 37％（n=512）被归入高压力组。个人，工作相关和客户相关倦怠的平均得分为 59.4（SD=22.0），54.6（SD=21.7）和 42.3（SD=18.6）。与睡眠时间超过 7 小时的护士相比，每天工作时间少于 6 小时的护士工作压力（调整后的优势比，AOR=1.8，95％置信区间，CI=1.2-2.7），个人倦怠（AOR=3.0，CI=1.7-5.2），工作相关倦怠（AOR=3.4，CI=2.0-6.0）和客户相关倦怠（AOR=2.0，CI=1.2-3.6）的风险更高。 GAM 分析发现睡眠时间与工作压力和客户相关倦怠之间存在线性关系。对于个人和工作相关的倦怠，在睡眠时间为 7 小时至 5 小时之间，倦怠评分呈线性增加，然后在睡眠时间少于 5 小时时趋于平稳。
我们的研究发现，工作日的睡眠时间与女性护士的工作压力和倦怠呈剂量依赖性负相关。需要进一步研究影响睡眠时间的工作因素。
