1
|
Ji Y, Min A, Kang M, Park C. How Shift Nurses' Presenteeism is Related to Insomnia and Care Left Undone: A Cross-Sectional Study Using Generalised Structural Equation Modelling. J Adv Nurs 2024. [PMID: 39315744 DOI: 10.1111/jan.16483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/08/2024] [Accepted: 09/10/2024] [Indexed: 09/25/2024]
Abstract
AIM To examine the association between nurses' insomnia, presenteeism and care left undone and explore the mediating effect of presenteeism on the relationship between insomnia and care left undone among nurses in acute care hospitals, applying a dynamic model of presenteeism and absenteeism. DESIGN A cross-sectional design. METHODS A secondary data analysis was conducted using online survey data collected in January 2023. Participants were 1154 registered nurses who provided direct nursing care to patients in tertiary or general hospitals (hospitals with 300 or more beds) in South Korea. Poisson regression analysis was used to examine the association between nurses' insomnia, presenteeism and care left undone. Generalised structural equation modelling was performed to examine the mediating effect of presenteeism on the relationship between insomnia and care left undone. RESULTS The prevalence of insomnia was 15.3%. More than half of the participants (63.7%) reported experiencing presenteeism in the past 4 weeks. All reported at least one nursing care left undone during their last shift. Insomnia and presenteeism were positively associated with care left undone, and presenteeism mediated the relationship between insomnia and care left undone among nurses in acute care hospitals. CONCLUSION Nurses experienced insomnia and presenteeism, related to higher rates of care left undone. Nurses' insomnia had a direct effect on care left undone and an indirect effect through presenteeism. IMPLICATIONS FOR THE PROFESSION Nurse managers and administrators need to make greater efforts to reduce insomnia and presenteeism among nurses, thereby reducing care left undone and improving patient safety in acute care settings. IMPACT Nurse managers and administrators should consider proactive interventions to address nurses' insomnia and foster a workplace with healthy systems and culture to reduce sleep disturbance and presenteeism, which can effectively decrease care left undone. REPORTING METHOD STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Yoonjung Ji
- College of Nursing, CHA University, Pocheon-si, Gyeonggi-do, South Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Minkyung Kang
- Research Institute of Nursing Science, College of Nursing, Ajou University, Suwon, South Korea
| | - Chang Park
- College of Nursing, University of Illinois, Chicago, Illinois, USA
| |
Collapse
|
2
|
Kim JH, Kim O, Cho M, Jeong H, Dan H. Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study. Int J Nurs Pract 2024; 30:e13232. [PMID: 38273459 DOI: 10.1111/ijn.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/15/2023] [Accepted: 12/05/2023] [Indexed: 01/27/2024]
Abstract
AIM To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.
Collapse
Affiliation(s)
- Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Mijung Cho
- Department of Nursing, Hallym Polytechnic University, Chuncheon, Republic of Korea
| | - Hyunseon Jeong
- College of Nursing, Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Hyunju Dan
- Department of Nursing, Hwasung Medi-Science University, Hwasung-si, Kyunggi-do, Republic of Korea
| |
Collapse
|
3
|
Keshavarzi A, Delavari S, Lotfi F, Goudarzi Z, Bashiri F, Bayati M. Nursing labor supply in Iran: a survey in Shiraz public hospitals in 2022. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:31. [PMID: 38650021 PMCID: PMC11034066 DOI: 10.1186/s12962-024-00542-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/13/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The labor supply of nurses, as one of the main healthcare workers, is an important issue in health human resources planning in all health systems. Finding the factors affecting it, could help policymakers to solve the shortage of nursing work supply. The present study aimed to investigating the quantity and factors affecting the nurses' labor supply in Iran. METHOD In this cross-sectional study, a sample of 598 nurses working in public hospitals of Shiraz (Iran) were selected via proportionate stratified random sampling method. The required data was collected using a structured questionnaire which asked working hours and other related factors. To analyze the data, descriptive statistics, univariate analysis and multivariate linear regression were performed using STATA 15. The multivariate labor supply model was estimated separately for married and single nurses. RESULTS: The average weekly working hours of nurses was 54.65 h in all medical centers and 50.28 h in the main hospital. The regression results showed that the labor supply of nurses with work experience (β = - 0.368, P = 0.014), satisfaction with work shift arrangement (β = - 2.473, P = 0.001), income between 60-89 million rial (β = - 14.046, P = 0.002), income between 90-119 million rial(β = - 12.073, P = 0.012), and working in the emergency department (β = - 5.043, P = 0.017) had negative and significant relationship; But there was a positive and significant relationship with satisfaction of the work environment (β = 1.86, P = 0.011), workload at work (β = 1.951, P = 0.023) and employment status (contractual employees) (β = 4.704, P = 0.004). CONCLUSION The labor supply function of nurses is affected by demographic, economic and non-economic factors. The most contributing factors were related to non-economic variables. It seems that the non-financial cost and benefits related to the job as well as internal factors have more important role on the nurses' labor supply.
Collapse
Affiliation(s)
- Ali Keshavarzi
- Student Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, Shiraz, 71336-54361, Iran
| | - Farhad Lotfi
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, Shiraz, 71336-54361, Iran
| | - Zahra Goudarzi
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, Shiraz, 71336-54361, Iran
| | - Faezeh Bashiri
- Student Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Almas Building, Alley 29, Qasrodasht Ave, Shiraz, 71336-54361, Iran.
| |
Collapse
|
4
|
Shin SH, Lee EH. Development and validation of a quality of healthy work environment instrument for shift nurses. BMC Nurs 2024; 23:37. [PMID: 38212736 PMCID: PMC10785413 DOI: 10.1186/s12912-023-01672-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND As the importance of a healthy work environment for nurses' good practice and patient safety has been recognized, there is a need to assess nurses' perceptions of the quality of a healthy work environment. METHODS A conceptual framework and construct components were extracted through a literature review and in-depth interviews with shift nurses. The initial items of the instrument were developed according to the conceptual attributes, and the items were selected through content validity by ten experts. Two hundred and forty-seven shift nurses participated in this study through face-to-face surveys to test the reliability and validity of the instrument. The evaluation was used for item and confirmatory factor analyses to assess the criterion-related validity and internal consistency of the instrument. Test-retest reliability was analyzed using data from thirty-two nurses. RESULTS The final instrument consisted of 23 items with five components identified through confirmatory factor analysis. Criterion-related validity was established using the K-PES-NWI (r = .54). Cronbach's alpha for the total items was 0.85, and test-retest reliability was 0.73. CONCLUSION The quality of the healthy work environment instrument developed in this study was considered reliable and valid. The instrument developed in this study can be used to measure the quality of a healthy work environment as perceived by shift nurses and to identify preventive measures needed to improve the quality of the work environment.
Collapse
Affiliation(s)
- Sun-Hwa Shin
- College of Nursing, Sahmyook University, 815, Hwarang-ro, Nowon-gu, 01795, Seoul, Republic of Korea
| | - Eun-Hye Lee
- College of Nursing, Sahmyook University, 815, Hwarang-ro, Nowon-gu, 01795, Seoul, Republic of Korea.
| |
Collapse
|
5
|
Min A, Hong HC, Son S, Scott LD. Overtime and alertness of rotating-shift nurses: An observational study using ecological momentary assessment. J Clin Nurs 2023; 32:199-207. [PMID: 35034393 DOI: 10.1111/jocn.16218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/04/2021] [Accepted: 01/02/2022] [Indexed: 02/06/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to determine the effect of overtime on alertness at work among rotating-shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts. BACKGROUND Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work. DESIGN A prospective observational study was employed. The study followed STROBE checklist for observational studies. METHODS Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real-time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed-effect models were employed to investigate the association between overtime and alertness. RESULTS A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous-day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous-day overtime hours and consecutive overtime days in all shifts. CONCLUSIONS The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty. RELEVANCE TO CLINICAL PRACTICE Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime.
Collapse
Affiliation(s)
- Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Sungtaek Son
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Linda D Scott
- School of Nursing, University of Wisconsin - Madison, Madison, Wisconsin, USA
| |
Collapse
|
6
|
Kim O, Kim S, Jeon HO, Kim A, Cha C, Kim B. Depressive symptoms and menstrual distress according to the menstrual phase in nurses: the Korea Nurses' Health Study. J Psychosom Obstet Gynaecol 2022; 43:541-549. [PMID: 35811498 DOI: 10.1080/0167482x.2022.2095999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE This study aimed to identify the level of menstrual distress among nurses during the premenstrual and menstrual phases and to investigate associations between depressive symptoms and menstrual distress. METHODS This was a cross-sectional study conducted using data from the Korea Nurses' Health Study. We used data from December 2018 to September 2019. A total of 6878 nurses was selected for final analysis. Data on demographic characteristics, women's health-related variables, shift work, sleep quality, depressive symptoms and menstrual distress were collected. Descriptive statistics, and hierarchical multiple regression analysis were used. RESULTS Depressive symptoms were significantly correlated with menstrual distress in both premenstrual and menstrual phases (premenstrual phase B = 1.60, 95% CI = 1.49-1.71; menstrual phase B = 1.65, 95% CI = 1.54-1.76) after controlling for demographic characteristics, women's health-related variables, shift work and sleep quality. CONCLUSION The results of this study indicate the importance of tailored care for menstrual distress based on the menstrual phase and the significance of depressive symptoms in the management of menstrual distress.
Collapse
Affiliation(s)
- Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Sue Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Hae Ok Jeon
- Department of Nursing, Cheongju University, Cheongju, Republic of Korea
| | - Ahrin Kim
- Department of Nursing, Cheongju University, Cheongju, Republic of Korea
| | - Chiyoung Cha
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Bohye Kim
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| |
Collapse
|
7
|
The Importance of Monitoring the Psychological Wellbeing and Mental Health of Nursing Staff for Sustainable Management. SUSTAINABILITY 2022. [DOI: 10.3390/su14148300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study examines the psychological wellbeing and mental health of nursing staff and determines workplace factors that affect them. Wellbeing and sustainable workload are important for the quality of work life. A cross-sectional study of employees in nursing was conducted at Slovenian hospitals. The response was 35%. The main findings were that more than half of employees are satisfied or very satisfied with their job and with their leaders’ support, but they are often exposed to stress. Quality of work life, work–life balance, and managing stress at the workplace affect the psychological wellbeing and mental health of nursing staff. Management should identify the importance of monitoring and improving workplace factors that can affect the employees. At the same time, they should also be aware of the importance of sustainable development of nursing employees at the local and national levels to improve the working conditions and quality of work life for better psychological wellbeing and mental health for employees.
Collapse
|
8
|
Kim S, Chae SM. Missed nursing care and its influencing factors among neonatal intensive care unit nurses in South Korea: a descriptive study. CHILD HEALTH NURSING RESEARCH 2022; 28:142-153. [PMID: 35538726 PMCID: PMC9091770 DOI: 10.4094/chnr.2022.28.2.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/04/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Preventing missed care is important in neonatal intensive care units (NICUs) due to neonates’ vulnerabilities. This study examined missed care and its influencing factors among NICU nurses. Methods Missed care among 120 Korean NICU nurses was measured using a cross-culturally adapted online questionnaire. The frequency of missed care for 32 nursing activities and the significance of 23 reasons for missed care were collected. Results All participants had missed at least 1 activity, missing on average 19.35 activities during a typical work-day. The most common missed item was “provide developmental care for the baby”. The most common reason for missed care was “emergency within the unit or deterioration of one of the assigned patients”. The final regression model explained 9.6% of variance in missed care. The average daily number of assigned patients receiving inotropes or sedation over the last month influenced the total number of missed care items. Conclusion Missed care was affected by nurses’ workload related to the number of patients taking medication. Frequently missed activities, especially those related to developmental care, require patience and time, conflicting with safety prioritization and inadequate working conditions. NICU nurses’ working conditions should be improved to ensure adequate time for nursing activities.
Collapse
Affiliation(s)
- Soohyun Kim
- Registered Nurse, Seoul National University Hospital, Seoul, Korea
| | - Sun-Mi Chae
- Professor, College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea
- Corresponding author Sun-Mi Chae College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea TEL: +82-2-740-8816 FAX: +82-2-766-1852 E-MAIL:
| |
Collapse
|
9
|
McCurley JL, Levy DE, Dashti HS, Gelsomin E, Anderson E, Sonnenblick R, Rimm EB, Thorndike AN. Association of Employees' Meal Skipping Patterns with Workplace Food Purchases, Dietary Quality, and Cardiometabolic Risk: A Secondary Analysis from the ChooseWell 365 Trial. J Acad Nutr Diet 2022; 122:110-120.e2. [PMID: 34478879 PMCID: PMC9115715 DOI: 10.1016/j.jand.2021.08.109] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/14/2021] [Accepted: 08/26/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Employed adults may skip meals due to time or financial constraints, challenging work schedules, or limited workplace food choices. Little is known about the relationship between employees' meal skipping patterns and workplace dietary choices and health. OBJECTIVE To examine whether hospital employees' meal skipping patterns were associated with workplace food purchases, dietary quality, and cardiometabolic risk factors (ie, obesity, hypertension, and prediabetes/diabetes). DESIGN This is a secondary cross-sectional analysis of baseline data from the ChooseWell 365 randomized controlled trial. Employees reported meal-skipping frequency in a baseline survey. The healthfulness of workplace food purchases was determined with a validated Healthy Purchasing Score (HPS) (range = 0 to 100 where higher scores = healthier purchases) calculated using sales data for participants' purchases in the 3 months before study enrollment. Dietary quality was measured with the 2015 Healthy Eating Index (range = 0 to 100 where higher score = healthier diet) from two 24-hour recalls. Cardiometabolic risk factors were ascertained from clinic measurements. PARTICIPANTS/SETTING Participants were 602 hospital employees who regularly visited workplace cafeterias and enrolled in ChooseWell 365, a workplace health promotion study in Boston, MA, during 2016-2018. MAIN OUTCOME MEASURES Primary outcomes were HPS, 2015 Healthy Eating Index, and cardiometabolic risk factors. STATISTICAL ANALYSES Regression analyses examined differences in HPS, 2015 Healthy Eating Index, and cardiometabolic variables by meal skipping frequency, adjusting for demographic characteristics. RESULTS Participants' mean (standard deviation) age was 43.6 (12.2) years and 478 (79%) were women. Overall, 45.8% skipped breakfast, 36.2% skipped lunch, and 24.9% skipped dinner ≥ 1 day/week. Employees who skipped breakfast ≥ 3 days/week (n = 102) had lower HPS (65.1 vs 70.4; P < 0.01) and 2015 Healthy Eating Index score (55.9 vs 62.8; P < 0.001) compared with those who never skipped. Skipping lunch ≥ 3 days/week and dinner ≥ 1 day/week were associated with significantly lower HPS compared with never skipping. Employees who worked nonstandard shifts skipped more meals than those who worked standard shifts. Meal skipping was not associated with obesity or other cardiometabolic variables. CONCLUSIONS Skipping meals was associated with less healthy food purchases at work, and skipping breakfast was associated with lower dietary quality. Future research to understand employees' reasons for skipping meals may inform how employers could support healthier dietary intake at work.
Collapse
Affiliation(s)
- Jessica L McCurley
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Douglas E Levy
- Mongan Institute Health Policy Research Center, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Hassan S Dashti
- Center for Genomic Medicine and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Emily Gelsomin
- Department of Nutrition and Food Services, Massachusetts General Hospital, Boston, Massachusetts
| | - Emma Anderson
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Ross Sonnenblick
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Channing Division of Network Medicine, Department of Medicine, Brigham and Woman's Hospital, Boston, Massachusetts
| | - Anne N Thorndike
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
| |
Collapse
|
10
|
Min A, Hong HC, Kim YM. Work schedule characteristics and occupational fatigue/recovery among rotating-shift nurses: A cross-sectional study. J Nurs Manag 2021; 30:463-472. [PMID: 34783087 DOI: 10.1111/jonm.13511] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/23/2021] [Accepted: 11/03/2021] [Indexed: 01/30/2023]
Abstract
AIMS To determine the effects of work schedule characteristics on occupational fatigue and recovery among rotating-shift nurses in South Korea. BACKGROUND Understanding the effects of work schedule characteristics on occupational fatigue is important to prevent adverse nurse outcomes and to ensure patient safety. METHODS This study used secondary data analysis with a cross-sectional design. Data were collected on 436 rotating-shift nurses in 2018. Nurses' occupational fatigue and recovery were measured using the Occupational Fatigue Exhaustion/Recovery Scale. We used quantile regression models. RESULTS The scores for acute and chronic fatigue and intershift recovery were 70.40, 73.39, and 29.82, respectively. Overtime hours, number of night shifts, number of consecutive days off, and breaks were significant influential factors in some quantiles of acute fatigue, chronic fatigue, and intershift recovery, while total working hours was only associated with chronic fatigue in the 25th quantile. CONCLUSIONS The quantile and linear regression models revealed different results for work schedule factors that affect occupational fatigue and intershift recovery among rotating-shift nurses. IMPLICATION FOR NURSING MANAGEMENT These findings have important implications for developing targeted strategies and policies to reduce occupational fatigue and improve intershift recovery for rotating-shift nurses with different levels of occupational fatigue and recovery.
Collapse
Affiliation(s)
- Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Young Man Kim
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
| |
Collapse
|
11
|
Bae SH, Pen M, Sinn C, Kol S, An B, Yang SJ, Rhee HY, Ha J, Bae S. Work hours and overtime of nurses working in Cambodian hospitals. Int Nurs Rev 2021; 69:150-158. [PMID: 34599766 PMCID: PMC9293033 DOI: 10.1111/inr.12720] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/07/2021] [Indexed: 11/28/2022]
Abstract
Aim To examine the nature and prevalence of Cambodian nurses’ work hours and overtime and related factors Background The chronic shortage of nursing workforce is a major cause of overtime among nurses. Introduction Nursing shortage and working overtime among nurses negatively affect nurse and patient outcomes, but nurses’ work hours and overtime in Cambodia have not been comprehensively examined. Methods A multicenter cross‐sectional study was conducted in four Cambodian hospitals. Data were collected from 253 nurses providing direct nursing care using a questionnaire. The STROBE checklist was used for reporting this study. Results More than a fifth of staff nurses worked more than 48 h, which is the legal work hour limit in Cambodia. Two major reasons for working mandatory or voluntary overtime, on‐call or 24‐h on‐call were (a) not wanting to let down colleagues and (b) able to get all work done. The number of patients cared for was related to whether or not nurses worked 48 h or more. Conclusion Overtime work and adverse nurse scheduling are common in Cambodia. Implications for nursing and health policy Nurse managers and healthcare institutes in Cambodia need to monitor Cambodian nurses’ work hours, which are often beyond the legal work hour limit. Moreover, it is important to understand why nurses work overtime and develop health policies, strategies, and programs that can help promote patient and nurse safety and retain qualified nursing staff. The 24‐h on‐call practice needs to be regulated according to the labor policy in healthcare institutes to prevent adverse nurse and patient outcomes.
Collapse
Affiliation(s)
- Sung-Heui Bae
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Mom Pen
- Technical School of Medical Care, University of Health Sciences, Phnom Penh, Cambodia
| | | | - Sokry Kol
- Angkor Hospital for Children, Siem Reap, Cambodia
| | - Bomi An
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Sook Ja Yang
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Hyang-Yon Rhee
- Ewha Education Research Institute, Ewha Womans University, Seoul, Republic of Korea
| | - Jaeyoung Ha
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| | - Suhyun Bae
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| |
Collapse
|
12
|
Min A, Hong HC, Son S, Lee T. Sleep, fatigue and alertness during working hours among rotating-shift nurses in Korea: An observational study. J Nurs Manag 2021; 29:2647-2657. [PMID: 34351017 DOI: 10.1111/jonm.13446] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/22/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
AIMS To determine the effects of sleep parameters and fatigue on the decline in alertness of nurses across shifts. BACKGROUND Shift work can lead to nurse fatigue owing to insufficient sleep and inadequate recovery time between shifts. Nurse fatigue has adverse effects on alertness and can affect provision of quality care. METHODS An observational study using wrist actigraphs was conducted from 2019 to 2020. Participants were 82 rotating-shift nurses who provided direct nursing care in acute hospitals in South Korea. They wore actigraphs for 14 days to measure sleep parameters and predict hourly alertness and reported subjective fatigue before and after every shift. RESULTS Nurses demonstrated shorter sleep hours, lower sleep efficiency and longer sleep latency before night shifts compared with other shifts. Fatigue was the highest before day shifts. Sleep parameters and fatigue significantly affected the steep decline in alertness in participants with alertness scores below 70. CONCLUSIONS Sleep parameters and fatigue level contributed to the differences in decline in alertness across shifts. IMPLICATION FOR NURSING MANAGEMENT Findings inform nurse managers, administrators to develop interventions to reduce fatigue, improve sleep quantity and quality and increase alertness among rotating-shift nurses. Management, institutional and individual factors should be considered when developing interventions.
Collapse
Affiliation(s)
- Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Sungtaek Son
- Clinical Development Division, Celltrion Inc., Incheon, South Korea
| | - Taehee Lee
- Department of Applied Statistics, Yonsei University, Seoul, South Korea
| |
Collapse
|
13
|
Min A, Kang M, Hong HC. Sickness Presenteeism in Shift and Non-Shift Nurses: Using the Fifth Korean Working Conditions Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063236. [PMID: 33800982 PMCID: PMC8004057 DOI: 10.3390/ijerph18063236] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023]
Abstract
Nurses have reported higher rates of sickness presenteeism than other workers, which is particularly problematic because this problem is linked to care quality and patient safety. This secondary data analysis study aimed to identify the prevalence of sickness presenteeism and explore related factors among shift and non-shift nurses using the Fifth Korean Working Conditions Survey. A total of 272 nurses in Korean hospitals were included. The survey included questions on working conditions, health status, and sickness presenteeism. A multivariate logistic regression was used to identify associated factors of sickness presenteeism. Overall, 21.8% of the participants reported experiencing sickness presenteeism; shift nurses experienced more sickness presenteeism than non-shift nurses. Sickness presenteeism was greater in shift nurses who did not have rest breaks during work and in nurses who experienced quick return. Additionally, the odds of sickness presenteeism were approximately four times greater in shift nurses who experienced sleep disturbance and about four times higher in shift nurses who experienced health problems. Among non-shift nurses, the odds of sickness presenteeism were about 15 times greater in those who worked ≥53 h per week. Nurse managers and administrators should prevent sickness presenteeism in hospital nurses to provide quality care and enhance productivity.
Collapse
Affiliation(s)
- Ari Min
- Department of Nursing, Chung-Ang University, Seoul 06974, Korea; (A.M.); (H.C.H.)
| | - Minkyung Kang
- College of Nursing, Keimyung University, Daegu 42601, Korea
- Correspondence: ; Tel.: +82-53-258-7657
| | - Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul 06974, Korea; (A.M.); (H.C.H.)
| |
Collapse
|
14
|
Bae SH. Relationships between comprehensive characteristics of nurse work schedules and adverse patient outcomes: A systematic literature review. J Clin Nurs 2021; 30:2202-2221. [PMID: 33616252 DOI: 10.1111/jocn.15728] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 11/29/2022]
Abstract
AIMS To review the comprehensive characteristics of adverse nurse work schedules and to synthesise the evidence of their relationships with adverse patient outcomes. BACKGROUND To manage nurse shortages and fluctuations in patient censuses, nurses often work overtime. This increases nurses' work hours and causes them to have fewer breaks. Such extended work schedules, long shift length, long weekly work hours and insufficient beaks can be considered as adverse nurse work schedules. Understanding how these adverse nurse work schedules affect patient outcomes is important to ensure patient safety. DESIGN A systematic review of nursing and healthcare literature was conducted in this study. METHODS Eight electronic bibliographic databases (CINAHL, Cochrane Library, DBpia, EBSCO, PubMed, PsycINFO, RISS and Web of Science) were used to search research articles published from 2000 to 2019. The study selection process followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). RESULTS From the search, 2,366 articles were identified, 22 of which were included in this review. Working more than 12 hours in a day had an adverse effect on patient outcomes, as was working more than 40 hours per week. There were mixed findings in the relationship between nurse overtime and adverse patient outcomes. CONCLUSIONS This study found a conclusive relationship between excessive nurse work hours and adverse patient outcomes. This review highlights the importance of managing adverse nurse schedules such as long daily and weekly work hours to improve patient safety and prevent adverse patient outcomes. RELEVANCE TO CLINICAL PRACTICE Study findings support the importance of monitoring and regulating nurse work schedules and adverse scheduling practices to improve nurse well-being and health and to prevent adverse patient outcomes.
Collapse
Affiliation(s)
- Sung-Heui Bae
- College of Nursing, Graduate Program in System Health Science and Engineering (BK 21), Ewha Womans University, Seoul, Republic of Korea
| |
Collapse
|
15
|
Bae SH. Intensive care nurse staffing and nurse outcomes: A systematic review. Nurs Crit Care 2021; 26:457-466. [PMID: 33403791 DOI: 10.1111/nicc.12588] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/04/2020] [Accepted: 12/21/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Intensive care units (ICU) are associated with significant work stress and exert continuous physical and emotional demand upon health care providers. The health and well-being of care providers, including ICU nurses, is a matter of great concern. However, to the researcher's knowledge, there have been no reviews synthesizing the evidence about the relationship between nurse staffing and nurse outcomes in the ICU. PURPOSE The purpose of this systematic review was to examine nurse staffing in the ICU and synthesize literature to examine the relationship with nurse outcomes such as job satisfaction, burnout, fatigue, and intent to leave. METHODS This review was reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed articles published between January 2000 and September 2019 were identified via eight electronic bibliographic databases. Articles were included and reviewed if they were correlational studies examining the relationships between nurse staffing and nurse outcomes in the ICU, and were published in peer-reviewed journals written in either English or Korean. The Quality Assessment and Validity Tool for Correlation Studies was used for quality appraisal. RESULTS From 5086 articles, eight published between 2006 and 2019 were included in this review. Three studies found expected relationships between worse nurse staffing and adverse nurse outcomes (high burnout, fatigue state, emotional exhaustion, depersonalization, and stress). However, the relationships between nurse staffing and other adverse nurse outcomes were not significant. Perceived adequate staffing was negatively related to adverse nurse outcomes. However, a non-significant relationship also was found. CONCLUSION This study found limited evidence on relationships between nurse staffing and nurse outcomes in the ICU. More studies are needed to conduct to find a conclusive relationship. RELEVANCE TO CLINICAL PRACTICE Given high demands and workload in the ICU, nurse staffing levels should be closely monitored to prevent adverse nurse outcomes.
Collapse
Affiliation(s)
- Sung-Heui Bae
- College of Nursing, System Health & Engineering Major in Graduate School (BK21), Ewha Womans University, Seoul, South Korea
| |
Collapse
|
16
|
Cho H, Han K, Ryu E, Choi E. Work Schedule Characteristics, Missed Nursing Care, and Organizational Commitment Among Hospital Nurses in Korea. J Nurs Scholarsh 2020; 53:106-114. [PMID: 33249723 DOI: 10.1111/jnu.12612] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE This study describes Korean nurses' work schedule characteristics and identifies their components to investigate associations of work schedule components with missed nursing care and organizational commitment. DESIGN This cross-sectional secondary analysis used survey data of 1,057 nurses in 111 units at six hospitals in South Korea. Data were collected between April 2017 and March 2018. METHODS A self-administered survey, including seven work schedule characteristic items, the Korean version of the MISSCARE Survey, and the Korean version of the Organizational Commitment Questionnaire, was employed. To construct independent components of work schedule characteristics, a principal component analysis was performed. The associations of work schedule components with missed nursing care and organizational commitment were analyzed using multiple linear regression models with generalized estimating equation methods. FINDINGS The average number of daily work hours was 9.7. Nearly half of the study population worked while sick once or more per month. The two components of nurses' work schedule characteristics were "long work hours" and "lack of rest," and these components showed variations between units. Unhealthy work schedule components were linked to frequently missed nursing care and decreased organizational commitment. CONCLUSIONS This study showed that proper work hours and adequate rest are important to reduce missed nursing care tasks and enhance organizational commitment, both of which are critical for better patient care and organizational outcomes. CLINICAL RELEVANCE Healthcare organizations should provide adequate nursing staff and assign reasonable workloads. Furthermore, hospitals should periodically monitor the work schedule characteristics of nurses and actively intervene in cases of scheduling issues to resolve them.
Collapse
Affiliation(s)
- Hyeonmi Cho
- Beta Eta-at-Large, PhD Student, University of Wisconsin-Madison, School of Nursing, WI, USA
| | - Kihye Han
- Lambda Alpha-at-Large, Associate Professor, Chung-Ang University College of Nursing, Seoul, Republic of Korea
| | - Eunjung Ryu
- Professor, Chung-Ang University College of Nursing, Seoul, Republic of Korea
| | - Eunsook Choi
- Unit Manager, National Cancer Center Department of Nursing, Gyeonggi-do, Republic of Korea
| |
Collapse
|
17
|
Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214083. [PMID: 31652889 PMCID: PMC6862320 DOI: 10.3390/ijerph16214083] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 11/17/2022]
Abstract
The environment of health organizations can determine healthcare quality and patient safety. Longer working hours can be associated with nurses’ health status and care quality, as well as work-related hazards. However, little is known about the association of hospital nurses’ working hours and patient safety competencies with adverse nurse outcomes. In this cross-sectional descriptive study, convenience sampling was employed to recruit 380 nurses from three tertiary care hospitals in South Korea. Data were collected using structured questionnaires from May to June 2016. Hierarchical linear regression analysis was used to identify the association of working hours and patient competencies with adverse nurse outcomes among 364 participants selected for analysis. Most nurses worked over 40 h/week. Working hours (β = 0.202, p < 0.001) had the strongest association with adverse nurse outcomes. Low perceived patient safety competencies (β = −0.179, p = 0.001) and frequently reporting patient safety accidents (β = 0.146, p = 0.018) were also correlated with adverse nurse outcomes. Nursing leaders should encourage work cultures where working overtime is discouraged and patient safety competencies are prioritized. Further, healthcare managers must formulate policies that secure nurses’ rights. The potential association of overtime with nurse and patient outcomes needs further exploration.
Collapse
|
18
|
Min A, Yoon YS, Hong HC, Kim YM. Association between nurses' breaks, missed nursing care and patient safety in Korean hospitals. J Nurs Manag 2019; 28:2266-2274. [DOI: 10.1111/jonm.12831] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/04/2019] [Accepted: 07/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Ari Min
- Red Cross College of Nursing Chung‐Ang University Seoul Korea
| | - Yea Seul Yoon
- Department of Nursing, Graduate School Yonsei University Seoul Korea
| | - Hye Chong Hong
- Red Cross College of Nursing Chung‐Ang University Seoul Korea
| | - Young Man Kim
- Department of Nursing, Graduate School Yonsei University Seoul Korea
| |
Collapse
|
19
|
Min A, Min H, Hong HC. Psychometric properties of the Korean version of the Occupational Fatigue Exhaustion Recovery Scale in a nurse population. Res Nurs Health 2019; 42:358-368. [PMID: 31410868 DOI: 10.1002/nur.21980] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/02/2019] [Indexed: 11/11/2022]
Abstract
Most nurses in Korea work rotating shifts, an important contributor to fatigue. The Occupational Fatigue Exhaustion Recovery (OFER) Scale assesses work-related fatigue among nurses. In this study, we aimed to translate and culturally adapt the Korean version of this scale (OFER-K) with nurses working rotating shifts in Korea. Instrument adaptation was performed using committee-based translation, cognitive interviewing, and expert panel interviewing. Criterion validity, convergent validity, construct validity, internal consistency, and test-retest reliability were examined as psychometric properties of the OFER-K. An online survey was completed by 331 nurses; 107 of these nurses completed a second survey after 1 month to assess test-retest reliability. The overall Cronbach's alpha was 0.88. The correlation between participants' initial and retest responses for the total scale was 0.64 (p < .001). The chronic fatigue subscale was stable over time, t(106) = -1.76, p = .08. Criterion and convergent validity were supported by correlations between the OFER-K scale and the Chalder Fatigue Questionnaire, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. Confirmatory factor analysis showed a good fit using a three-factor model. The findings of this study showed that the OFER-K scale is a reliable and valid instrument for assessing chronic fatigue, acute fatigue, and inter-shift recovery in Korean nurses. Future research using this scale may lead to a better understanding of the antecedents and consequences of nurse fatigue and could provide important information to nurse researchers, administrators, and policymakers for developing interventions to reduce nurse fatigue.
Collapse
Affiliation(s)
- Ari Min
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Haeyoung Min
- College of Nursing, Gyeongsang National University, Jinju, South Korea
| | - Hye C Hong
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| |
Collapse
|