How the lagged and accumulated effects of stress, coping, and tasks affect mood and fatigue during nurses' shifts

Nurses experience significant stress and emotional exhaustion, leading to burnout and fatigue. This study assessed how the nurses' mood and fatigue evolves during their shifts, and the temporal factors that influence these phenomena. Performing a two-level design with repeated measures with moments nested into a person level, a random sample of 96 nurses was recruited. The ecological momentary assessment of demand, control, effort, reward, coping, and nursing tasks were measured in order to predict mood and fatigue, studying their current, lagged, and accumulated effects. The results show that: (1) Mood appeared to be explained by effort, by the negative lagged effect of reward, and by the accumulated effort, each following a quadratic trend, and it was influenced by previously executing a direct care task. By contrast, fatigue was explained by the current and lagged effect of effort, by the lagged effect of reward, and by the accumulated effort, again following quadratic trends. (2) Mood was also explained by problem-focused and emotion-focused coping strategies, indicative of negative mood, and by support-seeking and refusal coping strategies. (3) Fatigue was also associated with direct care and the prior effect of documentation and communication tasks. We can conclude that mood and fatigue do not depend on a single factor, such as workload, but rather on the evolution and distribution of the nursing tasks, as well as on the stress during a shift and how it is handled. The evening and night shifts seem to provoke more fatigue than the other work shifts when approaching the last third of the shift. These data show the need to plan the tasks within a shift to avoid unfinished or delayed care during the shift, and to minimize accumulated negative effect

Effects Of Accumulating Work Shifts On Performance-Based Fatigue Using Multiple Strength Measurements In Day And Night Shift Nurses And Aides

Objective This study aimed to examine the effects of accumulating nursing work on maximal and rapid strength characteristics in female nurses and compare these effects in day versus night shift workers. Background Nurses exhibit among the highest nonfatal injury rates of all occupations, which may be a consequence of long, cumulative work shift schedules. Fatigue may accumulate across multiple shifts and lead to performance impairments, which in turn may be linked to injury risks. Method Thirty-seven nurses and aides performed isometric strength-based performance testing of three muscle groups, including the knee extensors, knee flexors, and wrist flexors (hand grip), as well as countermovement jumps, at baseline and following exposure to three 12-hour work shifts in a four-day period. Variables included peak torque (PT) and rate of torque development (RTD) from isometric strength testing and jump height and power output. Results The rigorous work period resulted in significant decreases (-\u277.2% to -\u2719.2%) in a large majority (8/9) of the isometric strength-based measurements. No differences were noted for the day versus night shift workers except for the RTD at 200 millisecond variable, for which the night shift had greater work-induced decreases than the day shift workers. No changes were observed for jump height or power output. Conclusions A compressed nursing work schedule resulted in decreases in strength-based performance abilities, being indicative of performance fatigue. Application Compressed work schedules involving long shifts lead to functional declines in nurse performance capacities that may pose risks for both the nurse and patient quality of care. Fatigue management plans are needed to monitor and regulate increased levels of fatigue

Effects of accumulating work shifts on performance-based fatigue using multiple strength measurements in day and night shift nurses and aides

Objective This study aimed to examine the effects of accumulating nursing work on maximal and rapid strength characteristics in female nurses and compare these effects in day versus night shift workers. Background Nurses exhibit among the highest nonfatal injury rates of all occupations, which may be a consequence of long, cumulative work shift schedules. Fatigue may accumulate across multiple shifts and lead to performance impairments, which in turn may be linked to injury risks. Method Thirty-seven nurses and aides performed isometric strength-based performance testing of three muscle groups, including the knee extensors, knee flexors, and wrist flexors (hand grip), as well as countermovement jumps, at baseline and following exposure to three 12-hour work shifts in a four-day period. Variables included peak torque (PT) and rate of torque development (RTD) from isometric strength testing and jump height and power output. Results The rigorous work period resulted in significant decreases (−7.2% to −19.2%) in a large majority (8/9) of the isometric strength-based measurements. No differences were noted for the day versus night shift workers except for the RTD at 200 millisecond variable, for which the night shift had greater work-induced decreases than the day shift workers. No changes were observed for jump height or power output. Conclusions A compressed nursing work schedule resulted in decreases in strength-based performance abilities, being indicative of performance fatigue. Application Compressed work schedules involving long shifts lead to functional declines in nurse performance capacities that may pose risks for both the nurse and patient quality of care. Fatigue management plans are needed to monitor and regulate increased levels of fatigue

Effects of accumulating work shifts on performance-based fatigue using multiple strength measurements in day and night shift nurses and aides

Objective This study aimed to examine the effects of accumulating nursing work on maximal and rapid strength characteristics in female nurses and compare these effects in day versus night shift workers. Background Nurses exhibit among the highest nonfatal injury rates of all occupations, which may be a consequence of long, cumulative work shift schedules. Fatigue may accumulate across multiple shifts and lead to performance impairments, which in turn may be linked to injury risks. Method Thirty-seven nurses and aides performed isometric strength-based performance testing of three muscle groups, including the knee extensors, knee flexors, and wrist flexors (hand grip), as well as countermovement jumps, at baseline and following exposure to three 12-hour work shifts in a four-day period. Variables included peak torque (PT) and rate of torque development (RTD) from isometric strength testing and jump height and power output. Results The rigorous work period resulted in significant decreases (−7.2% to −19.2%) in a large majority (8/9) of the isometric strength-based measurements. No differences were noted for the day versus night shift workers except for the RTD at 200 millisecond variable, for which the night shift had greater work-induced decreases than the day shift workers. No changes were observed for jump height or power output. Conclusions A compressed nursing work schedule resulted in decreases in strength-based performance abilities, being indicative of performance fatigue. Application Compressed work schedules involving long shifts lead to functional declines in nurse performance capacities that may pose risks for both the nurse and patient quality of care. Fatigue management plans are needed to monitor and regulate increased levels of fatigue

Feasibility of Workload Monitoring within Law Enforcement Officers and its Relationship to Injury Risk and Job Performance

Law enforcement officers (LEO) provide critical emergency services to the community yet experience a high rate of musculoskeletal (MSK) injuries. Previous research has suggested that shift work and perceived stress may contribute to poor health and occupational injury in LEO, however, a critical gap exists in determining the impact of job-related workload on work-related MSK injuries and job performance. Survey-based workload monitoring has shown promising results in athletics to improve injury prevention efforts. Due to the unique nature of workload within LEO, the multi-dimensional National Aeronautics and Space Administration-Task Load Index may be a feasible tool within this population. The purpose of this project was to examine the feasibility of workload monitoring among LEO and determine if alterations in workload can predict changes in MSK injury risk factors and predictors of job performance. Fifty local LEO (nine females; 37 ± 10 years; 29.6 ± 6.6 kg/m2) completed a workload survey after each shift for eight weeks (28-30 total shifts) and workload was examined as the acute-to-chronic workload ratio (ACWR) at week, shift cycle, and total study intervals. Pre- and post-testing of demographic and performance outcomes were completed prior to and following the eight-week period. There was 96% retention and 94.5% adherence to the workload survey. LEO reported high usability (88.3±11.2 out of 100) and a moderate willingness to continue to use (6.8±2.9 out of 10), while the administrative officials reported high utility (9.0±1.0 out of 10) and sustainability (8.9±0.9 out of 10). Balance improved (3.7%) and upper and lower strength decreased (-6.5 – -11.4%) over the eight weeks, while reaction time, movement quality and lower body power and fatigability showed no significant changes (P ≥ 0.065). A higher ACWRWEEK was associated with a greater decrease in percent body fat and rapid strength, indicating these may be sensitive measures to workload changes. Our findings suggest workload monitoring may be a feasible tool within this population to examine changes in key factors associated with injury risk and job performance. Our study also provides key recommendations for future research seeking to use workload monitoring as a means to investigate MSK injury risk within LEO.Doctor of Philosoph

The Influence of Age on the Recovery from Worksite Resistance Exercise

Worksite resistance exercise can reduce injuries and improve performance in the fire service. This study examined the influence of age on the recovery from a worksite exercise routine. Nineteen young and 19 older firefighters completed an acute bout of resistance exercise in addition to pre- and post-testing 24, 48, and 72 hours post-exercise. Upper- and lower-body strength, muscle activation, ultrasonography, countermovement jump, and muscle soreness were measured to assess recovery. Linear mixed model (controlling for work-related fatigue) results revealed no (group × time) interactions. Group effects indicated the young firefighters exhibited greater lower-body force, jump performance, and better muscle quality than the older firefighters (P≤0.047). Time effects indicated that upper-body force, lower-body rapid forces, early muscle activation, and jump performance decreased and muscle soreness and size increased (P≤0.044). These results suggest that age does not influence recovery from worksite resistance exercise in firefighters.Master of Art

Efectos adversos en salud asociados con el trabajo nocturno en trabajadores sanitarios, una revisión de literatura

Realizar una búsqueda de literatura que permita describir como el trabajo por turnos nocturnos representa un riesgo para padecer efectos adversos en salud en los trabajadores sanitarios.Por medio de esta revisión bibliográfica y luego de haber analizado 13 articulos se encontró que existen diversos efectos negativos en la salud del personal sanitario que realiza turnos nocturnos, estos artículos analizados usaron métodos cuantitaivos de investigacion y la mayoría de estos establecen relaciones significativas entre los efectos negativos y la realización de turnos nocturnos. Entre los efectos encontrados predominan el sobrepeso, la fatiga, el insomnio y los cambios del patrón del sueño, entre otros, alterando la actividad cotidiana del trabajador, su estado de salud y sus relaciones sociales. Como estrategias de intervención se recomienda que los turnos nocturnos y rotativos sean considerados como un peligro y se formalicen dentro del sistema de gestión de seguridad y salud en el trabajo, permitiendo que desde las medidas de intervención creadas para la fuente, el medio ambiente y el individuo estén encaminados a su gestión, mitigación y control

Timely Access to Maternal, Neonatal and Child Healthcare for rural communities in Rwanda: The Role of Community Health Workers

Abstract Introduction: In Rwanda, although there has been some progress in health care delivery as expressed in the reduction in maternal and child mortality, rates are still high and geographically variable. Improving equitable access to quality healthcare services for maternal, neonatal and child healthcare (MNCH), community-based maternal, neonatal and child healthcare (CBMNCH) depends upon using “community health workers” (CHWs). Yet CHWs program faces difficulties that upset delivery of the quality of the comprehensive package of services. Unfortunately, little is known about CHWs` performance and job satisfaction in the provision of CBMNCH. Goal: The study aimed to provide insight into the performance and job satisfaction of CHWs for timely access to maternal, neonatal, and child healthcare for rural communities in Rwanda Method: This quantitative cross-sectional study involved a survey of 500 sampled CHWs who are involved in CBMNCH in three selected rural districts of the southern province: Gisagara, Muhanga, and Ruhango district. The sample size in each district was calculated based on a district proportionate allocation sampling technique, probability proportional to size. The survey was conducted from June to September 2019. CHWs` job performance and job satisfaction were categorized as high, middle and low. Ordinal regression analysis was used to examine the correlates of CHWs` job performance and the determinants of their job satisfaction. Results: CHWs who were more likely to report high performance on the job had more years of experience (2.51, pConclusion: The findings indicated that the managers of community health program and other stakeholders need to find on how to reduce CHWs heavy the workloads and how to improve the severe working conditions of CHWs when considering the assignment of their responsibilities to enable effective CBMNCH with good quality. Keywords: Maternal, Health, Child, Access, Healthcare, Community, Worker, Rwand

Exploring how Long Shifts Impact upon Nursing in Inpatient Mental Health Settings

Background: Research into the effect of working long shifts in mental health care had not been carried out before. Research into long shifts in other settings had mixed findings regarding fatigue and job satisfaction for nursing staff and quality of care for patients; evidence indicated that safety is reduced when long shifts are used. Aim: This research explored the experience of nurses, student nurses and support workers working long shifts in mental health settings and the factors they perceived influenced their wellbeing and patient care when working long shifts. Method: Semi-structured interviews were carried out with 17 nursing staff who worked in inpatient mental health settings. Nursing staff were recruited through social media. Under a pragmatic paradigm framework analysis was used to explore the data. Results: Five categories emerged: ‘being present and being absent’; ‘using up personal resources’; ‘getting rest and why it can be difficult’; ‘being part of a team’ and ‘getting the most out of time off’. Conclusion: The duration of emotional labour and restricted time to recover between long shifts created high levels of job demand, impacting nursing staff and patients. Job demand was buffered by job control factors, such as sufficient: breaks, handover, staff mix and regular shift pattern. Social support buffered job demand with cohesive teams providing practical and emotional support for nursing staff working long shifts