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| ORIGINAL ARTICLE |
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| Year : 2018 | Volume
: 15
| Issue : 1 | Page : 10-12 |
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The prevalence of shift work sleep disorder and the quality of sleep among nurses working in selected Hospitals, Hyderabad
Anumol Joseph1, Sister Mary Brooke2, Jelby3, Pushpalatha3, Sharon3, Sunitha3
1 Assistant Professor, Vijaymarie College of Nursing, Hyderabad, India
2 Associate Professor, Vijaymarie College of Nursing, Hyderabad, India
3 Staff nurses, Vijaymarie Hospital, Hyderabad, India
| Date of Web Publication | 10-Jul-2019 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None  | 2 |
DOI: 10.4103/2231-1505.262498
Now a days the shift work is one of the most important cause for sleeping disorders among nurses. In almost every occupation round the clock performance is expected and the census data shows that there is a large segment of the work force is employed on nonstandard work schedule which may include shift work. A study was conducted with the aim to assess the occurrence of shift work disorder (SWD )and quality of sleep among staff nurses in a selected hospital of Hyderabad. Methods: The study was conducted in a private hospital of Hyderabad, Telangana.The sample size was 60 staff nurses of a selected multispecialty hospital of Hyderabad.The tools selected for the study was Pittsburgh’s sleep quality index and a questionnaire was developed for assessing shift work disorder prepared by reviewing the literature, Bergen’s shift work disorder and global sleep disorder scale. Result: The result of the study revealed that 83.3% had mild Shift Work Disorder followed by moderatemild SWD16.6% and surprisingly no mild SWDand severe mild SWD were reported by the staff nurses .In regards to sleep quality, majority of the nurses that is 70% reported to have poor quality of sleep whereas only 30% of the nurses reported to have good quality of sleep. There was no association found between prevalence of shift work sleep disorders and age, marital status and duration of sleep. In conclusion, reducing night work exposure appears to be the best intervention strategy for preventing SWD. A high prevalence of SWDsymptoms may call for a focus on the systemic antecedents of work related sleep problems.
Keywords: Shift work sleep disorders, quality of sleep, sleep quality index
How to cite this article:
Joseph A, Brooke SM, Jelby, Pushpalatha, Sharon, Sunitha. The prevalence of shift work sleep disorder and the quality of sleep among nurses working in selected Hospitals, Hyderabad. Indian J Psy Nsg 2018;15:10-2 |
How to cite this URL:
Joseph A, Brooke SM, Jelby, Pushpalatha, Sharon, Sunitha. The prevalence of shift work sleep disorder and the quality of sleep among nurses working in selected Hospitals, Hyderabad. Indian J Psy Nsg [serial online] 2018 [cited 2023 Jun 3];15:10-2. Available from: https://www.ijpn.in/text.asp?2018/15/1/10/262498 |
| Introduction | |  |
Shift work disorder (SWD) is a sleep disorder characterized by sleepiness and insomnia, which can be attributed to the person’s work schedule. The diagnostic criteria for SWD, as defined by the American Academy of Sleep Medicine (AASM)‘s International Classification of Sleep Disorders-2 (ICSD-2) include: (i) complaints of insomnia or excessive sleepiness temporally associated with a recurring work schedule in which work hours overlap with the usual time for sleep, (ii) symptoms must be associated with the shift work schedule over the course of at least one month, (iii) sleep log or actigraphic monitoring for ≥ 7 days demonstrates circadian and sleep-time misalignment; (iv) sleep disturbance is not better explained by another sleep disorder, mental disorder, a medical or neurological disorder, medication use or substance use disorder[1]’ .
A study done in southern India on Shift Work Disorders revealed that the prevalence of Shift Work Disorder was found to be 43.07%. Headache, back pain, gastritis, and menstrual disorders were the most common complaints, which are found in 78 (60.0%), 75 (57.6%), 42 (32.3%), and 39 (30.0%) cases, respectively. Anxiety and depression was found in 23 (17.6%) and 31 (23.8%) individuals, respectively. There was significant association of Shift work disorder with increasing age, more number of nights worked in a year, and longer duration of working hours reported by the nurses[2].
Approximately 16% of Australian employees are employed on some form of work schedule that includes working during the night[3]. A consistent finding is that working night shift is associated with shorter sleep duration and increased sleepiness[4],[5]. Compared to day workers, night workers have been reported to sleep from 15 minutes[6] to two hours less per day[7]. Objective indicators of sleepiness show that sleepiness increases across the night shift and falling asleep during night work is not uncommon®. In addition, there is an increasing recognition that night work may play a role in the development of metabolic syndrome (MetS)[9] MetS may be considered as a cluster of risk factors (e.g. obesity, hypertension, hypercholesterolemia) that contribute to poor health[10]. The objective of this study was to assess the occurrence of Shift Work Disorder and quality of sleep among staff nurses in a multi-specialty hospital.
| Need for the study | | |
Studies have highlighted thatoccurrence of SWD among health workers has deleterious effects on health. Nurses are vulnerable to many diseases due to inadequate sleep which often goes unreported and unnoticed. Theearly detection of SWD can prevent health problems among nurses. Henceforth, the investigators felt the need to conduct a study on nurses, as they work in multiple shifts and are often deprived of quality sleep. Furthermore,the nurses can also be trained accordingly to prevent SWD and spare time in catering to their own needs.The objective of this study was to assess the occurrence of SWD and quality of sleep among staff nurses in a multi-specialty hospital.
| Materials and methods | | |
A quantitative approach was adopted for the study. The research design selected was descriptive research design. The study was conducted on 60 staff nurses working in three different shifts in Yashoda Hospital, Secunderabad was chosen by Purposive sampling technique.
| Sample and Sampling | | |
The criteria for subject selection included the following based on International Classification of Sleep Disorders are; i) complaints of insomnia or excessive sleepiness temporally associated with a recurring work schedule in which work hours overlap with the usual time for sleep, ii) symptoms must be associated with the shift work schedule over the course of at least one month, iii) sleep log or actigraphic monitoring for ≥7 days demonstrates circadian and sleep-time misalignment; iv) sleep disturbance is not better explained by another sleep disorder, mental disorder, a medical or neurological disorder, medication use or substance use disorder[0]’ .
| Tools | | |
Structured subject data sheet consisting of age, qualification, marital status etc. and hours of sleep .
Tool 1: Shift work disorder scale(SWD): A structured questionnaire to assess the occurrence of Shift work disorder among staff nurses with 30 questions. The interpretation scores was 0-20: Mild SWD, 21-40: Moderate SWD and 41-60: Severe SWD developed for assessing shift work disorder prepared by researcher for assessing sleep disorder, used only by confirmed symptoms indicative of SWD.
Tool 2: Pittsburgh’s sleep quality index with 10 questions a standardized structured questionnaire(r=0.70) was interpreted as good and poor quality of sleep. A score less than 5 was indicative of poor quality of sleep and a score of above 6 indicated good quality of sleep.
A formal administrative approval was taken from the Medical Director of the Yashoda Hospital, Hyderabad. The study was carried for three days in November 2017. Descriptive and inferential statistics were used to accomplish the study objectives.
| Results | | |
As given in [Table 1] majority of nurses were under the age group 20-25 years 32 (53.3%), there were 70% unmarried and 30% married nurses and majority of the nurses slept for 7-8 hours. The shift pattern changed on weekly basis that is for all the staffs that is 60 (100%).
As seen in [Figure 1] that majority of the nurses have mild SWD 50(83.3%) followed by moderate 10 (16.6%) and surprisingly no SWD and severe SWD are 0% were reported
As given in [Figure 2] shows that majority of the nurses that is 70%(18)reported poor quality of nurses whereas 30%(18) nurses reported good quality of sleep. | Table 5: Association between occurrence of SWD and selected demographic variables of Subjects
Click here to view |
There was no association found between prevalence of shift work sleep disorders and age, marital status and duration of sleep of subjects.
| Discussion | | |
As per a study done by Elizabeth Florence and Stale[11].regarding the assessment, prevalence and related health problems of shift work sleep disorders among nurses. They investigated three shift work disorder assessment procedures all based on current diagnostic criteria and employing symptom based questions , crude and adjusted logistic regression analysis where performed with symptoms of shift work disorder . 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 ,age , gender , circadian rhythm , number of shifts.The present study shows that majority of nurses 83.3% had mild Shift Work Disorder followed by moderatemild Shift Work Disorder contributing to 16.6% and surprisingly no mild Shift Work Disorderand severe mild Shift Work Disorder were reported by the staff nurses and also the majority of nurses were found with poor quality42(70%) of sleep. The investigators did not diagnose the study subjects with sleep disorders[11].
As per a study conducted by Christopher L Drake shifts[12] and Timothy Rohers based on the prevalence and consequences of shift work sleep disorder beyond that of symptomatic day workers the present study was designed to determine the relative prevalence and negative consequences associated with shift work sleep disorder in a representative sample drawn from the working population of the metropolitan Detroit. Individuals were assessed for the presence of insomnia and excessive sleepiness, based on DSM-14. Those individuals with either insomnia or excessive sleepiness and who were currently working rotating or the right schedule were classified as SWD. Individuals who met criteria for SWD had significantly higher rates of ulcers, sleepiness, related accidents, absenteeism and depression and missed family and social activities more frequently compared to those shift workers who did not meet. The present study shows that majority of nurses 83.3% had mild level of Shift Work Disorder followed by moderate mild Shift Work Disorder 16.6% and surprisingly no mild SWD and severe mild SWD were reported by the staff nurses and also the majority of nurses were found to have poor quality 42(70%) of sleep. In the present study the researcher was not interested exploring about the consequences of the SWD and its impact on health[11].
| Conclusion | | |
In conclusion, reducing night work exposure appears to be the best intervention strategy for preventing SWD. A high prevalence of SWD symptoms may call for a focus on the systemic antecedents of work related sleep problems. It is important that nurses being frontline providers of care should have good mental and physical health in order to cater to the needs of the patients.
| References | | |
| 1. | American Academy of Sleep Medicine (AASM).International classification of sleep disorders, revised: Diagnostic and coding manual (ICSD-2) Westchester, IL: AASM; 2005.  |
| 2. | Surekha Anbazhagan, Naveen Ramesh, Catherine Nisha, and Bobby Joseph.Shift work disorder and related health problems among nurses working in a tertiary care hospital, Bangalore, South India.Indian Journal of Occupational and environmental medicine.2016;20(1):35-38 |
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| 4. | A ‘Kerstedt T, Fredlund P, Gillberg M, Jansson B .Work load and work hours in relation to disturbed sleep and fatigue in a large representative sample. J Psychosom .2002;53(0): 585 –588. |
| 5. | Sallinen M, KecklundG.Shift work, sleep and sleepiness –differences between shift schedules and systems. Scand J Work Health Environ.2010;36(0): 121 –133 |
| 6. | Ursin R, Baste V, Moen BE .Sleep duration and sleep-related problems in different occupations in the Hordaland Health Study. Scand J Work Health Environ .2009;35(1): 193 –202. |
| 7. | Pilcher JJ, Lambert BJ, Huffcutt AI . Differential effects of permanent and rotating shifts on self-report sleep length: a meta-analytic review. Sleep .2000;23(1): 155 –163. |
| 8. | Bjorvatn B, Stangenes K, Øyane N, Forberg K, Lowden A, et al.Subjective and objective measures of adaptation and readaptation to night work. Sleep .2006;29(3): 821-829. |
| 9. | Wang X-S, Armstrong MEG, Cairns BJ, Key TJ, Travis RC Shift work and chronic disease: the epidemiological evidence. Occup Med (Lond).2011; 61(3): 78 –89 |
| 10. | Puttonen S, Viitasalo K, Ha’rma” M .The relationship between current and former shift work and the metabolic syndrome. Scand J Work Health Environ.2012;38(1): 343 –348 |
| 11. | |
| 12. | Christopher . L . Drake and Timothy Rohers , Shift work sleep disorder : prevalence and consequences beyond that of symptomatic workers .Sleep journal .2004;27 (8) :1483 - 1462. |
[Figure 1], [Figure 2]
[Table 1], [Table 2]
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