An Ran, Li Cheng, Ai Shaolong, Wu Yuan, Wang Sha, Luo Xi, Li Xin, Xu Yanming, He Hongchen, He Chengqi
Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China.
BMC Nurs. 2025 Jul 1;24(1):696. doi: 10.1186/s12912-025-03383-4.
BACKGROUND: Working in shifts can disrupt circadian rhythm and reduce sleep duration, which have a detrimental effect on cognitive function. Shift work is often a special requirement for nurses to provide continuous service for patients. The Stroop task is a classic method of executive function (EF) applied in neuroimaging researches. Functional near-infrared spectroscopy (fNIRS) has created new opportunities for investigating the hemodynamics of cerebral activated regions during executive function. However, there has been no study exploring cerebral hemodynamics changes related to shift work by fNIRS in nurses during performing a Stroop paradigm. The purpose of our study was to investigate the effects of shift work on fNIRS-based cerebral functions during the Stroop task among nurses in a real clinical environment. METHODS: Nurses registered in the Department of Neurology were eligible and consecutively included if they were simultaneously responsible for the day, evening and night shifts on the shift work schedule. A multi-channel fNIRS imaging system (NirScan, Danyang Huichuang Medical Equipment Co. Ltd, China) was used to acquire each participant's cerebral hemodynamic activities during performance of the Stroop task, which was performed for each subject separately before and after three working shifts. RESULTS: Eighteen nurses with certification were included in our study. Cerebral cortical activation and functional connectivity were significantly changed during Stroop test after day-shift (all p < 0.05, FDR corrected), indicating a leading role of left PFC. Further, we identified the reaction time under incongruent task before day shift, was positively correlated with LPFC (r = 0.507, p = 0.038), RPFC (r = 0.547, p = 0.023) and BPFC activation (r = 0.512, p = 0.036). CONCLUSIONS: Our study further supported fNIRS as a useful functional imaging technique for monitoring brain activity in healthcare providers. Also, brain activation and functional connectivity during Stroop task consistently showed that working in day shift was related to decreased brain hemodynamic activities in nurses. Further, our findings would be helpful for leadership in clinical management on decision-making about arrangements for shift work.
背景:轮班工作会扰乱昼夜节律并缩短睡眠时间,对认知功能产生不利影响。轮班工作通常是护士为患者提供持续服务的一项特殊要求。斯特鲁普任务是神经影像学研究中应用的一种经典的执行功能(EF)测试方法。功能近红外光谱技术(fNIRS)为研究执行功能期间大脑激活区域的血流动力学创造了新机会。然而,尚无研究通过fNIRS探讨护士在执行斯特鲁普范式时与轮班工作相关的脑血流动力学变化。本研究的目的是在真实临床环境中调查轮班工作对护士在斯特鲁普任务期间基于fNIRS的脑功能的影响。 方法:在神经内科登记注册的护士符合条件,若其在排班表上同时负责日班、中班和夜班,则连续纳入研究。使用多通道fNIRS成像系统(NirScan,中国丹阳慧创医疗设备有限公司)在执行斯特鲁普任务期间采集每位参与者的脑血流动力学活动,该任务在每个受试者三个轮班前后分别进行。 结果:18名有资质的护士纳入本研究。日班后斯特鲁普测试期间,大脑皮质激活和功能连接发生显著变化(所有p < 0.05,经FDR校正),表明左前额叶皮质起主导作用。此外,我们发现日班前不一致任务下的反应时间与左前额叶皮质激活(r = 0.507,p = 0.038)、右前额叶皮质激活(r = 0.547,p = 0.023)和双侧前额叶皮质激活(r = 0.512,p = 0.036)呈正相关。 结论:我们的研究进一步支持fNIRS作为一种有用的功能成像技术用于监测医护人员的大脑活动。此外,斯特鲁普任务期间的大脑激活和功能连接一致表明,日班工作与护士脑血流动力学活动降低有关。此外,我们的研究结果将有助于临床管理人员在轮班工作安排决策方面提供参考。
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