School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Chronobiol Int. 2021 Oct;38(10):1384-1396. doi: 10.1080/07420528.2021.1931273. Epub 2021 May 31.
The objective of this study was to understand the influence of rotating shifts and fixed night shifts on the sleep quality of nurses using a systematic literature review and meta-analysis and to determine whether the sleep quality of nurses working rotating shifts or fixed night shifts differs from that of nurses working fixed day shifts. We conducted a meta-analysis on literature that had used the Pittsburgh Sleep Quality Index (PSQI) to gauge sleep quality and had been published between 2000 and 2020 in the Cochrane Library, CINAHL, MEDLINE, and PubMed databases. This study was conducted in accordance with PRISMA, and the quality of the literature was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross Sectional Studies. CMA 3.0 was employed for data analysis, and meta-regression analysis was conducted to examine the differences between the PSQI scores of nurses working fixed day shifts and those working rotating shifts or fixed night shifts. Following assessment, a total of 29 papers (34 items of data) were analyzed. The papers included a total of 3,935 nurses who worked fixed day shifts, 3,777 nurses who worked rotating shifts, and 1,559 nurses who worked fixed night shifts. Our subgroup analysis indicated that the sleep quality of nurses working rotating shifts was poorer than the sleep quality of nurses working fixed day shifts; the standardized mean difference (SMD) was 0.38 (95% CI: 0.24-0.52, < .001), and the meta-regression analysis found that the difference in sleep quality between nurses over 40 years old working rotating shifts and those working fixed day shifts was significantly smaller than the difference in sleep quality between nurses 40 years old or younger working rotating shifts and those working fixed day shifts (β = -0.368, = .011). The sleep quality of nurses working fixed night shifts was also poorer than the sleep quality of nurses working fixed day shifts; the SMD was 0.58 (95% CI: 0.38-0.78, < .001), and the meta-regression analysis revealed that the difference in sleep quality between nurses over 40 years old working fixed night shifts and those working fixed day shifts was not significantly different from the difference in sleep quality between nurses 40 years old or younger working fixed night shifts and those working fixed day shifts (β = -0.118, = .608). This meta-analysis found that both nurses working rotating shifts and those working fixed night shifts had poorer sleep quality than those working fixed day shifts and that age influenced the difference in sleep quality only between nurses working rotating shifts and those working fixed day shifts; the difference in sleep quality between nurses 40 years old or younger working rotating shifts and those working fixed day shifts was greater than the difference in sleep quality between nurses over 40 years old working rotating shifts and those working fixed day shifts.
本研究旨在通过系统文献回顾和荟萃分析了解轮班和固定夜班对护士睡眠质量的影响，并确定轮班和固定夜班护士的睡眠质量是否与固定白班护士的睡眠质量不同。我们对 2000 年至 2020 年间在 Cochrane 图书馆、CINAHL、MEDLINE 和 PubMed 数据库中使用匹兹堡睡眠质量指数（PSQI）评估睡眠质量的文献进行了荟萃分析。本研究遵循 PRISMA 进行，使用 Joanna Briggs 研究所分析性横断面研究的批判性评价清单评估文献质量。使用 CMA 3.0 进行数据分析，并进行元回归分析以检查固定白班护士与轮班或固定夜班护士 PSQI 评分之间的差异。评估后，共分析了 29 篇论文（34 项数据）。这些论文共包括 3935 名固定白班护士、3777 名轮班护士和 1559 名固定夜班护士。我们的亚组分析表明，轮班护士的睡眠质量比固定白班护士差；标准化均数差（SMD）为 0.38（95%CI：0.24-0.52，<0.001），元回归分析发现，40 岁以上轮班护士与固定白班护士的睡眠质量差异小于 40 岁轮班护士与固定白班护士的睡眠质量差异（β=-0.368，=0.011）。固定夜班护士的睡眠质量也比固定白班护士差；SMD 为 0.58（95%CI：0.38-0.78，<0.001），元回归分析表明，40 岁以上固定夜班护士与固定白班护士的睡眠质量差异与 40 岁以下固定夜班护士与固定白班护士的睡眠质量差异无统计学意义（β=-0.118，=0.608）。这项荟萃分析发现，轮班和固定夜班护士的睡眠质量均比固定白班护士差，年龄仅影响轮班和固定白班护士之间的睡眠质量差异；40 岁以下轮班护士与固定白班护士的睡眠质量差异大于 40 岁轮班护士与固定白班护士的睡眠质量差异。
