Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia.
Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia; Health Data and Clinical Trials, Flinders University, Bedford Park, SA, Australia.
Sleep Med. 2024 Jan;113:131-141. doi: 10.1016/j.sleep.2023.11.027. Epub 2023 Nov 20.
The combination of shift work and an unmanaged sleep disorder carries health and safety risks. Yet, diagnosis rates for sleep disorders are low in shift workers. The aim of this study was to understand the experience of sleep disorder diagnosis and treatment in shift workers, and consider patient informed solutions to improve access to health services.
Semi-structured interviews were conducted with 16 Australian shift workers with a diagnosed sleep disorder. Patient journey mapping and reflexive thematic analysis were used to understand diagnosis and management experiences.
There were highly variable experiences with diagnosis and management, often taking >5 years to seek help from a health care provider (HCP) after noticing symptoms of a sleep disorder. Three themes were constructed, including 'the cause of the problem', 'prioritising work', and '(dis)satisfaction and (dis)connection'. Extent of patient and HCP awareness of sleep disorders, and a prevailing attitude of shift work being 'the problem' impacted diagnosis, as did organisational needs (including rostering, which had both positive and negative influences on help seeking). Relationships with HCPs were important, and living on non-standard time was both a barrier and an enabler to sleep disorder care. Participants identified the need for education and awareness, prompts and easy access to screening and referral pathways, and tailored models of care.
Education and awareness initiatives for shift workers, their employers and HCPs, together with development of a model of care for shift workers with sleep disorders may address some of the unique barriers to diagnosis and management.
轮班工作和未得到管理的睡眠障碍的结合会带来健康和安全风险。然而，轮班工人的睡眠障碍诊断率很低。本研究旨在了解轮班工人的睡眠障碍诊断和治疗体验，并考虑患者知情的解决方案，以改善获得卫生服务的机会。
对 16 名澳大利亚轮班工人进行了半结构式访谈，他们患有已确诊的睡眠障碍。采用患者旅程图和反思性主题分析来了解诊断和管理的经验。
诊断和管理的体验差异很大，通常在注意到睡眠障碍症状后 >5 年才向医疗保健提供者（HCP）寻求帮助。构建了三个主题，包括“问题的原因”、“优先考虑工作”和“（不满）和（脱节）”。患者和 HCP 对睡眠障碍的认识程度，以及轮班工作被视为“问题”的普遍态度，都影响了诊断，组织需求（包括对排班的影响，这对寻求帮助既有积极影响，也有消极影响）也是如此。与 HCP 的关系很重要，非标准时间的生活既是睡眠障碍护理的障碍，也是促进因素。参与者确定了对轮班工人、他们的雇主和 HCP 进行教育和提高认识的必要性，以及制定针对轮班工人睡眠障碍的护理模式的必要性。
针对轮班工人、他们的雇主和 HCP 的教育和意识提升举措，以及针对轮班工人睡眠障碍的护理模式的发展，可能有助于解决一些独特的诊断和管理障碍。
