Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.
PLoS One. 2023 Apr 4;18(4):e0282734. doi: 10.1371/journal.pone.0282734. eCollection 2023.
To investigate whether pain, sleep duration, insomnia, sleepiness, work-related factors, anxiety, and depression associate with excessive fatigue in nurses.
Fatigue among nurses is a problem in the context of ongoing nursing shortages. While myriad factors are associated with fatigue not all relationships are understood. Prior studies have not examined excessive fatigue in the context of pain, sleep, mental health, and work factors in a working population to determine if associations between excessive fatigue and each of these factors remain when adjusting for each other.
A cross-sectional questionnaire study among 1,335 Norwegian nurses. The questionnaire included measures for fatigue (Chalder Fatigue Questionnaire, score ≥4 categorized as excessive fatigue), pain, sleep duration, insomnia (Bergen Insomnia Scale), daytime sleepiness (Epworth Sleepiness Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and work-related factors. Associations between the exposure variables and excessive fatigue were analyzed using chi-square tests and logistic regression analyses.
In the fully adjusted model, significant associations were found between excessive fatigue and pain severity scores for arms/wrists/hands (adjusted OR (aOR) = 1.09, CI = 1.02-1.17), hips/legs/knees/feet (aOR = 1.11, CI = 1.05-1.18), and headaches/migraines (aOR = 1.16, CI = 1.07-1.27), sleep duration of <6 hours (aOR = 2.02, CI = 1.08-3.77), and total symptom scores for insomnia (aOR = 1.05, CI = 1.03-1.08), sleepiness (aOR = 1.11, CI = 1.06-1.17), anxiety (aOR = 1.09, CI = 1.03-1.16), and depression (aOR = 1.24, CI = 1.16-1.33). The musculoskeletal complaint-severity index score (aOR = 1.27, CI = 1.13-1.42) was associated with excessive fatigue in a separate model adjusted for all variables and demographics. Excessive fatigue was also associated with shift work disorder (OR = 2.25, CI = 1.76-2.89) in a model adjusted for demographics. We found no associations with shift work, number of night shifts and number of quick returns (<11 hours between shifts) in the fully adjusted model.
Excessive fatigue was associated with pain, sleep- and mental health-factors in a fully adjusted model.
探讨疼痛、睡眠时间、失眠、嗜睡、工作相关因素、焦虑和抑郁是否与护士的过度疲劳有关。
护士疲劳是护理人员持续短缺背景下的一个问题。尽管有许多因素与疲劳有关，但并非所有关系都已被了解。先前的研究并未在疼痛、睡眠、心理健康和工作因素的背景下检查过度疲劳，以确定在相互调整后，过度疲劳与这些因素中的每一个因素之间的关联是否仍然存在。
对 1335 名挪威护士进行横断面问卷调查研究。该问卷包括疲劳（Chalder 疲劳问卷，得分≥4 归类为过度疲劳）、疼痛、睡眠时间、失眠（卑尔根失眠量表）、白天嗜睡（Epworth 嗜睡量表）、焦虑和抑郁（医院焦虑和抑郁量表）以及工作相关因素的测量。使用卡方检验和逻辑回归分析对暴露变量与过度疲劳之间的关系进行分析。
在完全调整的模型中，过度疲劳与手臂/手腕/手的疼痛严重程度评分（调整后的比值比[aOR] = 1.09，95%置信区间[CI] = 1.02-1.17）、臀部/腿部/膝盖/脚部（aOR = 1.11，CI = 1.05-1.18）和头痛/偏头痛（aOR = 1.16，CI = 1.07-1.27）、睡眠时间<6 小时（aOR = 2.02，CI = 1.08-3.77）和失眠总症状评分（aOR = 1.05，CI = 1.03-1.08）、嗜睡（aOR = 1.11，CI = 1.06-1.17）、焦虑（aOR = 1.09，CI = 1.03-1.16）和抑郁（aOR = 1.24，CI = 1.16-1.33）显著相关。肌肉骨骼症状严重程度指数评分（aOR = 1.27，CI = 1.13-1.42）在单独调整所有变量和人口统计学因素的模型中与过度疲劳相关。在调整人口统计学因素的模型中，过度疲劳也与轮班工作障碍（OR = 2.25，CI = 1.76-2.89）相关。在完全调整的模型中，我们没有发现轮班工作、夜班数量和快速返回（班次之间间隔<11 小时）与过度疲劳之间的关联。
在完全调整的模型中，过度疲劳与疼痛、睡眠和心理健康因素有关。
