Turner Institute for Brain and Mental Health, School of Psychological Sciences Monash University, Clayton, Victoria, Australia.
Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Australia.
J Clin Sleep Med. 2022 Apr 1;18(4):1035-1045. doi: 10.5664/jcsm.9782.
While insomnia and sleepiness symptoms are common in shift workers, 20%-30% experience more severe symptoms and meet the criteria for shift work disorder (SWD). SWD can lead to impairments in cognitive function, physical and mental health, and reduced productivity and increased risk of workplace injury. The aim of this study was to deliver and evaluate a shift work individual management coaching program, focusing on sleep education, promoting good sleep hygiene, and providing individualized behavioral strategies to cope with shift schedules.
A clustered randomized controlled trial of sleep education and sleep disorders screening was undertaken, based on hospital wards at a tertiary hospital in Melbourne, Australia. Participants identified as high risk for SWD underwent one of two 8-week programs, a shift work individualized management program, or an active control. The primary outcome was ward-based sick leave. Secondary outcomes were SWD risk, sleep hygiene, insomnia, depression, and anxiety. A total of 149 nurses, across 16 wards (96% female, 34.66 ± 11.99 years) completed both baseline and follow-up questionnaires (23.9% were high risk SWD).
There was no significant reduction in sick leave between intervention and control wards (mean difference = 1.2 days, = .063). Improvements were seen in insomnia ( < .0001) and depression (intervention, ≤ .0001, control, = .023) in both groups, but were not significantly different between programs. Anxiety ( = .001. control = .079) and Functional Outcomes of Sleep Questionnaire 10 ( = .001 control = .056) improved only for the intervention.
This SWD intervention trial did not reduce sick leave compared to the active control but there was an improvement. Improvements in sleep hygiene, insomnia, depression, and anxiety severity were seen for both groups. Future intervention trials should consider including both sleep and mental health interventions, strategies to avoid between group contamination and the duration of programs for optimal behavioral modification.
Registry: Australian New Zealand Clinical Trials Registry; Name: Sleep Health Management for Healthcare Workers; URL: https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12616000369426; Identifier: ACTRN12616000369426.
Booker LA, Sletten TL, Barnes M, et al. The effectiveness of an individualized sleep and shift work education and coaching program to manage shift work disorder in nurses: a randomized controlled trial. . 2022;18(4):1035-1045.
虽然失眠和困倦症状在轮班工人中很常见，但仍有 20%-30%的轮班工人出现更严重的症状，并符合轮班工作障碍（SWD）的标准。SWD 可导致认知功能、身心健康受损，生产力降低，工作场所受伤风险增加。本研究的目的是提供并评估一项针对轮班工作的个体管理辅导计划，重点是睡眠教育、促进良好的睡眠卫生，并提供应对轮班时间表的个体化行为策略。
这是一项在澳大利亚墨尔本一家三级医院的病房中进行的基于睡眠教育和睡眠障碍筛查的聚类随机对照试验。被确定为 SWD 高风险的参与者接受了为期 8 周的两种方案之一，即轮班工作个体化管理方案或积极对照。主要结局是病房内的病假。次要结局是 SWD 风险、睡眠卫生、失眠、抑郁和焦虑。共有 149 名护士（96%为女性，34.66±11.99 岁）完成了基线和随访问卷（23.9%为高风险 SWD）。
干预病房和对照病房之间的病假天数没有显著减少（平均差异=1.2 天， =.063）。两组的失眠（ <.0001）和抑郁（干预， <.0001，对照， =.023）均有所改善，但方案之间无显著差异。焦虑（ =.001，对照=.079）和睡眠功能问卷 10（ =.001，对照=.056）仅在干预组中得到改善。
与积极对照相比，这项 SWD 干预试验并没有减少病假，但有一定程度的改善。两组的睡眠卫生、失眠、抑郁和焦虑严重程度都有所改善。未来的干预试验应考虑同时包括睡眠和心理健康干预，避免组间污染的策略以及为实现最佳行为改变而延长方案的持续时间。
注册机构：澳大利亚和新西兰临床试验注册中心；名称：医护人员的睡眠健康管理；网址：https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12616000369426；标识符：ACTRN12616000369426。
Booker LA, Sletten TL, Barnes M, et al. The effectiveness of an individualized sleep and shift work education and coaching program to manage shift work disorder in nurses: a randomized controlled trial.. 2022;18(4):1035-1045.
