Shift Work Disorder in Nurses – Assessment, Prevalence and Related Health Problems

BACKGROUND: This study investigates the prevalence of symptoms of shift work disorder in a sample of nurses, and its association to individual, health and work variables. METHODOLOGY/PRINCIPAL FINDINGS: We investigated three different shift work disorder assessment procedures all based on current diagnostic criteria and employing symptom based questions. Crude and adjusted logistic regression analyses were performed with symptoms of shift work disorder as the dependent variable. Participants (n = 1968) reported age, gender, work schedule, commuting time, weekly work hours, children in household, number of nights and number of shifts separated by less than 11 hours worked the last year, use of bright light therapy, melatonin and sleep medication, and completed the Bergen Insomnia Scale, Epworth Sleepiness Scale, Global Sleep Assessment Questionnaire, Diurnal Scale, Revised Circadian Type Inventory, Dispositional Resilience (Hardiness) Scale--Revised, Fatigue Questionnaire, questions about alcohol and caffeine consumption, as well as the Hospital Anxiety and Depression Scale. CONCLUSIONS/SIGNIFICANCE: Prevalence rates of symptoms of shift work disorder varied from 32.4-37.6% depending on the assessment method and from 4.8-44.3% depending on the work schedule. Associations were found between symptoms of shift work disorder and age, gender, circadian type, night work, number of shifts separated by less than 11 hours and number of nights worked the last year, insomnia and anxiety. The different assessment procedures yielded similar results (prevalence and logistic regression analyses). The prevalence of symptoms indicative of shift work disorder was high. We argue that three symptom-based questions used in the present study adequately assess shift work disorder in epidemiological studies

Prioritizing sleep for healthy work schedules

Good sleep is advantageous to the quality of life. Sleep-related benefits are particularly helpful for the working class, since poor or inadequate amounts of sleep degrade work productivity and overall health. This review paper explores the essential role of sleep in healthy work schedules and primarily focuses on the timing of sleep in relation to the work period (that is, before, during and after work). Data from laboratory, field and modeling studies indicate that consistent amounts of sleep prior to work are fundamental to improved performance and alertness in the workplace. In addition, planned naps taken during work maintain appropriate levels of waking function for both daytime and night-time work. Clearly, sufficient sleep after work is vital in promoting recovery from fatigue. Recent data also suggest that the time interval between shifts should be adjusted according to the biological timing of sleep. Although sleep is more likely to be replaced by job and other activities in the real life, research shows that it is worthwhile to revise the work schedules in order to optimize sleep before, sometime during and after the work period. Therefore, we suggest establishing work-sleep balance, similar to work-life balance, as a principle for designing and improving work schedules

Sleep hygiene

Sleep hygiene refers to the general rules of behavioral practices and environmental factors that are consistent with good quality sleep. Several studies reported that a program combining sleep hygiene education with cognitive behavioral exercises is an effective method of non-pharmacological intervention for patients with insomnia, but there is insufficient evidence to support that sleep hygiene alone is an effective treatment. Shift work often has a negative impact on health, safety, quality of life, and work performance. Sleep hygiene practices can be helpful in shift workers. A prophylactic nap before night work can be beneficial in attenuating alertness and performance deterioration and decreasing the risk of accidents

Le paradoxe de la fiction: le retour

Tullmann et Buckwalter (2014) ont récemment soutenu que le paradoxe de la fiction tenait plus de l'illusion que de la réalité. D'après eux, les théories contemporaines des émotions ne fourniraient aucune raison d'adopter une interprétation du terme « existence » qui rende les prémisses du paradoxe incompatibles entre elles. Notre discussion a pour but de contester cette manière de dissoudre le paradoxe de la fiction en montrant qu'il ne prend pas sa source dans les théories contemporaines des émotions. Bien plutôt, son origine se situe dans ce que Radford (1975) décrit comme une incohérence dans nos réactions émotionnelles aux évènements fictionnels et non fictionnels. Malgré ce désaccord, nous concédons à Tullmann et Buckwalter qu'une solution satisfaisante au paradoxe de la fiction doit s'appuyer sur les théories des émotions. Ainsi, en guise de conclusion, nous expliquons comment il convient de comprendre l'incohérence en question et comment les théories des émotions pourraient contribuer à la résolution du paradoxe de la fiction