Benton Jack S, Lee Charlotte L, Long Hannah A, Sugavanam Thavapriya, Holmes Leah, Keane Annie, Thurley Neal, Kyle Simon, Ray David, French David P
Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Scand J Work Environ Health. 2025 Jul 1;51(4):282-297. doi: 10.5271/sjweh.4223. Epub 2025 Mar 30.
Shift work is common across most societies but poses significant risks to the health of shift workers. In part, this risk is due to the disruption of healthy sleep-wake schedules. This systematic review identified qualitative research on shift workers' experiences of sleep disturbance, fatigue and healthy behaviors.
We conducted a systematic search of four databases (CINAHL, EMBASE, MEDLINE, PsycINFO) and identified 28 eligible studies involving 1519 participants. We appraised the studies using an adapted Critical Appraisal Skills Programme (CASP) checklist, and confidence in the review findings was formally assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach. Data were thematically synthesized.
Three analytical themes were generated. 'Inevitability of fatigue and tiredness' outlines how shift workers experience a culture where they feel "peer pressure to soldier through" their shifts regardless of fatigue. 'Balancing sleep needs with competing responsibilities' highlights how shift workers struggle to balance the need for daytime sleep with family, leisure, and work responsibilities, often prioritizing family needs over their own sleep. 'Obstacles to engaging in healthy behaviors' describes how shift workers often know which actions would benefit their health and reduce fatigue but find it challenging to translate this knowledge into behavior due to fatiguing and stressful work environments. For the purposes of the GRADE-CERQual assessment, short summary statements were developed to describe 22 review findings: there was moderate or high confidence in all but one of these findings.
This review suggests that sleep education alone is unlikely to be effective. Interventions should focus on helping shift workers self-regulate their behaviors, thoughts, and emotions to better manage sleep and fatigue.
轮班工作在大多数社会中都很常见，但对轮班工人的健康构成重大风险。部分风险归因于健康的睡眠-清醒时间表被打乱。本系统评价确定了关于轮班工人睡眠障碍、疲劳和健康行为体验的定性研究。
我们对四个数据库（CINAHL、EMBASE、MEDLINE、PsycINFO）进行了系统检索，确定了28项符合条件的研究，涉及1519名参与者。我们使用经过改编的批判性评价技能计划（CASP）清单对这些研究进行评价，并使用推荐分级评估、制定和评价-定性研究综述证据的可信度（GRADE-CERQual）方法正式评估对综述结果的信心。对数据进行了主题综合分析。
生成了三个分析主题。“疲劳和疲倦的不可避免性”概述了轮班工人如何体验一种文化，即无论疲劳程度如何，他们都感到“有来自同事的压力要坚持完成”轮班工作。“平衡睡眠需求与其他责任”强调了轮班工人如何努力在白天睡眠需求与家庭、休闲和工作职责之间取得平衡，他们常常将家庭需求置于自身睡眠需求之上。“参与健康行为的障碍”描述了轮班工人通常知道哪些行为对他们的健康有益并能减轻疲劳，但由于工作环境疲劳且压力大，将这些知识转化为实际行为具有挑战性。为了进行GRADE-CERQual评估，编写了简短的总结陈述来描述22项综述结果：除其中一项结果外，对所有其他结果的信心为中等或高。
本综述表明，仅靠睡眠教育不太可能有效。干预措施应侧重于帮助轮班工人自我调节其行为、思想和情绪，以更好地管理睡眠和疲劳。
