Reinke Laurens, Özbay Yusuf, Dieperink Willem, Tulleken Jaap E
Department of Critical Care, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands,
Intensive Care Med. 2015 Apr;41(4):657-66. doi: 10.1007/s00134-015-3667-7. Epub 2015 Feb 12.
In general, sleeping and activity patterns vary between individuals. This attribute, known as chronotype, may affect night shift performance. In the intensive care unit (ICR), night shift performance may impact patient safety. We have investigated the effect of chronotype and social demographics on sleepiness, fatigue, and night shift on the performance of nurses.
This was a prospective observational cohort study which assessed the performance of 96 ICU night shift nurses during the day and night shifts in a mixed medical-surgical ICU in the Netherlands. We determined chronotype and assessed sleeping behaviour for each nurse prior to starting shift work and before free days. The level of sleepiness and fatigue of nurses during the day and night shifts was determined, as was the effect of these conditions on psychomotor vigilance and mathematical problem-solving.
The majority of ICU nurses had a preference for early activity (morning chronotype). Compared to their counterparts (i.e. evening chronotypes), they were more likely to nap before commencing night shifts and more likely to have young children living at home. Despite increased sleepiness and fatigue during night shifts, no effect on psychomotor vigilance was observed during night shifts. Problem-solving accuracy remained high during night shifts, at the cost of productivity.
Most of the ICU night shift nurses assessed here appeared to have adapted well to night shift work, despite the high percentage of morning chronotypes, possibly due to their 8-h shift duration. Parental responsibilities may, however, influence shift work tolerance.
一般来说，个体之间的睡眠和活动模式存在差异。这种被称为昼夜节律类型的属性可能会影响夜班工作表现。在重症监护病房（ICU），夜班工作表现可能会影响患者安全。我们研究了昼夜节律类型和社会人口统计学因素对护士嗜睡、疲劳及夜班工作表现的影响。
这是一项前瞻性观察队列研究，评估了荷兰一家综合内科-外科ICU的96名ICU夜班护士在白班和夜班期间的工作表现。我们在每位护士开始轮班工作前及休息日之前确定其昼夜节律类型并评估睡眠行为。测定了护士在白班和夜班期间的嗜睡和疲劳程度，以及这些状况对心理运动警觉性和数学问题解决能力的影响。
大多数ICU护士偏好早起活动（晨型昼夜节律）。与其他护士（即夜型昼夜节律）相比，她们在开始上夜班前更有可能小睡，且家中更有可能有年幼子女。尽管夜班期间嗜睡和疲劳有所增加，但未观察到对夜班期间心理运动警觉性有影响。夜班期间解决问题的准确率仍然很高，但以工作效率为代价。
尽管在此评估的大多数ICU夜班护士为晨型昼夜节律，但他们似乎已很好地适应了夜班工作，这可能得益于其8小时的轮班时长。然而，父母的责任可能会影响对轮班工作的耐受性。
