Baek Jihyun, Han Kihye, Choi-Kwon Smi
The Research Institute of Nursing Science, Seoul National University College of Nursing, Seoul, Republic of Korea.
Chung-Ang University College of Nursing, 84 Heukseok-ro, Bldg 102 Rm 712, Dongjak-gu 06974 Seoul, Republic of Korea.
Int J Nurs Stud. 2020 Dec;112:103719. doi: 10.1016/j.ijnurstu.2020.103719. Epub 2020 Jul 27.
Given the harmful effects of night shifts and rotating schedules on nurses' sleep and work performance, shift nurses' sleep patterns have been a research concern. Actigraphy involves acquisition of data using a movement sensor worn continuously on the nondominant wrist, typically for a week or more. Although actigraphy provides objective and accurate sleep data, sleep diaries have been a practical alternative. However, there is a lack of research on the agreement and consistency between the two methods of measuring sleep for shift work nurses. In addition, differences in sleep patterns by shift types among 8-hour fast-rotating shift work nurses has not yet been examined.
To evaluate the agreement between the sleep diary and actigraphy methods for sleep assessment, and to compare sleep parameters of 8-hour fast-rotating shift work nurses according to shift type.
Descriptive and prospective study design.
Two tertiary hospitals in Seoul, South Korea.
A total of 94 shift work nurses who wore actigraphy along with completing a sleep diary.
Subjective and objective sleep parameters were recorded during a two-week period in a sleep diary and actigraphy, respectively. Bland-Altman plots and intraclass correlation coefficients were used to analyze the agreement between the two methods. Sleep parameters according to shift type were compared using the Kruskal-Wallis and Mann-Whitney U tests.
Good agreement was observed between the sleep diary and the actigraphy data for total sleep time (intraclass correlation coefficients = 0.765 or 0.858) and variability in sleep time (intraclass correlation coefficients = 0.838). When compared to the actigraphy data, diary-derived data were overestimated by 41-45 min for total sleep time and 0.4% for variability in sleep time. There was a difference of 2-3 h of sleep quantity by shift type: 5.3-5.8 h for day shifts and 7.1-8.4 h for night shifts.
A sleep diary can function as an acceptable alternative to actigraphy for measuring shift work nurses' sleep patterns, specifically total sleep time and variability in sleep time. Given the high variability in sleep among shift work nurses, both personal and organizational efforts are required. Nurses should monitor their sleep quantity and develop their own regular sleep schedules to fit their work schedules. Hospitals should establish healthy schedules for nurses to guarantee sufficient sleep hours before work. Future research on shift work nurses' sleep should examine fluctuations in sleep duration.
鉴于夜班和轮班制对护士睡眠及工作表现的有害影响，轮班护士的睡眠模式一直是研究关注的焦点。活动记录仪通过佩戴在非优势手腕上的运动传感器持续采集数据，通常持续一周或更长时间。虽然活动记录仪能提供客观准确的睡眠数据，但睡眠日记也是一种实用的替代方法。然而，对于轮班工作护士的两种睡眠测量方法之间的一致性和可靠性，缺乏相关研究。此外，8小时快速轮班制护士不同班次类型的睡眠模式差异尚未得到研究。
评估睡眠日记和活动记录仪方法在睡眠评估方面的一致性，并根据班次类型比较8小时快速轮班制护士的睡眠参数。
描述性前瞻性研究设计。
韩国首尔的两家三级医院。
共有94名轮班护士，她们在佩戴活动记录仪的同时完成睡眠日记。
在两周时间内，分别通过睡眠日记和活动记录仪记录主观和客观睡眠参数。采用Bland-Altman图和组内相关系数分析两种方法之间的一致性。使用Kruskal-Wallis检验和Mann-Whitney U检验比较不同班次类型的睡眠参数。
睡眠日记和活动记录仪数据在总睡眠时间（组内相关系数 = 0.765或0.858）和睡眠时间变异性（组内相关系数 = 0.838）方面具有良好的一致性。与活动记录仪数据相比，睡眠日记得出的数据在总睡眠时间上高估了41 - 45分钟，在睡眠时间变异性上高估了0.4%。不同班次类型的睡眠量相差2 - 3小时：日班为5.3 - 5.8小时，夜班为7.1 - 8.4小时。
睡眠日记可作为测量轮班护士睡眠模式（特别是总睡眠时间和睡眠时间变异性）的一种可接受的替代活动记录仪的方法。鉴于轮班护士睡眠的高度变异性，个人和组织都需要做出努力。护士应监测自己的睡眠量，并制定适合工作时间表的规律睡眠计划。医院应为护士制定健康的时间表，以保证工作前有足够的睡眠时间。未来关于轮班护士睡眠的研究应考察睡眠时间的波动情况。
