晨晚间唾液褪黑素、困倦感与昼夜类型：固定日班与轮班夜班护士的对比研究。

Morning and evening salivary melatonin, sleepiness and chronotype: A comparative study of nurses on fixed day and rotating night shifts.

机构信息

Department of Nursing, College of Health Sciences, Sharjah Institute for Medical and Health Sciences Research, University of Sharjah, Sharjah, United Arab Emirates.

Health Promotion Research Group, Sharjah Institute for Medical and Health Sciences Research, Sharjah, United Arab Emirates.

出版信息

J Adv Nurs. 2020 Dec;76(12):3372-3384. doi: 10.1111/jan.14530. Epub 2020 Sep 23.

DOI:10.1111/jan.14530

PMID:32969092

Abstract

AIMS

To compare morning and evening salivary melatonin levels, sleep quality and chronotype between nurses working fixed day shifts and those working rotating night shifts.

BACKGROUND

Rotating night shift work is an inevitable part of nursing and is a major reason for disrupted sleep.

DESIGN

Cross-sectional comparative design.

PARTICIPANTS AND SETTINGS

We used cluster sampling to recruit 520 female nurses working fixed day and rotating night shifts in the United Arab Emirates.

METHODS

Morning and evening melatonin were measured from corresponding saliva samples. The Pittsburgh Sleep Quality Index used to evaluate sleep quality and self-assessment of preferred circadian times was used to assess participants' chronotypes. Data were collected between October 2017-December 2018.

RESULTS

Rotating night shift nurses had significantly lower evening melatonin compared with the fixed day shift group. No significant difference was found in sleep quality between the groups, although more participants in the rotating night shift group (N = 110, 42.31%) expressed better sleep quality than those in the fixed day group (N = 90, 36.00). Participants in the rotating night shift group expressed better subjective sleep, longer sleep duration, less disturbed sleep and better daily function (p > .05) than the fixed day group. Rotating night shift participants were more likely to have evening or intermediate chronotypes and more likely to report alignment of shift work to their chronotype compared with fixed day shift participants (p = .001). Longer shift duration, marital status and city location were associated with reduced evening melatonin among nurses on rotating night shifts.

CONCLUSION

Rotating night shift nurses showed evidence of better sleep than those from the fixed day shift. Proper shift assignment, chronotype and alignment with shift work appeared to produce better sleep quality.

IMPACT

Organizational policy must consider a novel model for work schedules that allow adequate off-duty days for sleep recovery among nurses.

摘要

目的

比较固定白班和轮班夜班护士的晨、晚间唾液褪黑素水平、睡眠质量和昼夜型。

背景

轮班夜班工作是护理工作不可避免的一部分，也是睡眠紊乱的主要原因。

设计

横断面比较设计。

参与者和设置

我们使用聚类抽样方法招募了 520 名在阿拉伯联合酋长国从事固定白班和轮班夜班的女性护士。

方法

从相应的唾液样本中测量晨、晚间褪黑素。使用匹兹堡睡眠质量指数评估睡眠质量，使用自我评估的偏好昼夜时评估参与者的昼夜型。数据收集于 2017 年 10 月至 2018 年 12 月期间。

结果

轮班夜班护士的晚间褪黑素明显低于固定白班组。两组间睡眠质量无显著差异，尽管轮班夜班组（N=110，42.31%）有更多的参与者表示睡眠质量较好，而固定白班组（N=90，36.00%）表示睡眠质量较差。轮班夜班组的参与者主观睡眠质量更好、睡眠时间更长、睡眠干扰更少、日常功能更好（p>.05）。与固定白班组相比，轮班夜班组的参与者更有可能表现出夜间或中间型昼夜型，并且更有可能报告轮班工作与昼夜型相符（p=.001）。轮班夜班护士的夜间褪黑素水平与轮班时间较长、婚姻状况和城市地点有关。