Occupational Medicine Advance Access published online on March 6, 2009
Occupational Medicine, doi:10.1093/occmed/kqp015
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Shiftwork impacts and adaptation among health care workers
1 Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, Center for Colon Cancer Research, University of South Carolina, Columbia, SC 29208, USA
2 Dorn Department of Veteran's Affairs Medical Center, Columbia, SC 29208, USA
3 Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
Background Shiftwork among health care workers impacts upon the safety and health of both employees and patients.
Aim To characterize shiftwork-related attitudes, behaviours, symptoms and coping strategies among health care workers, two validated questionnaires (the Standard Shiftwork Index and the Pressure Management Indicator) were used to identify factors predicting shiftwork adaptation.
Methods Participants (n = 376, response rate 25%) were grouped according to their work schedule (days, permanent evenings, rotating days plus evenings, permanent nights or relief and combined shifts). Indicators of lifestyle, work organization, sleep disruption, health and pressure management among workers on irregular shifts were compared with participants on day shifts, after adjustment for gender, age and marital status. Principal components analysis and ordinal logistic regression were used among irregular shiftworkers to identify factors predicting schedule adaptation.
Results Night and relief/combined shiftworkers reported a greater ability to accommodate irregular schedules and disrupted sleep, but were also more likely to report work-related impacts than day workers. Permanent night workers generally reported poorer health, more absenteeism and less job satisfaction than day workers. Factors associated with optimal work performance or schedule contentment among shiftworkers included adequate sleep, evening circadian preference, increased age and organizational satisfaction. Reduced work performance or schedule discontent was associated with sleep/wake difficulties and poor health.
Conclusions This study confirmed previous research and identified factors that can be targeted for the development of more effective shiftwork adaptation programmes in a health care setting (sleep timing and duration, exercise and optimal health and organizational satisfaction).
Keywords Circadian rhythm; medical care; nursing; shiftwork
Correspondence to: James B. Burch, Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, Center for Colon Cancer Research, University of South Carolina, 915 Green Street, Room 228, Columbia, SC 29208, USA. Tel: +1 803 576 5659; fax: +1 803 576 5624; e-mail: burch{at}mailbox.sc.edu