1
|
Dolu İ, Açıkgöz S, Rıza Demirbaş A, Karabulut E. Circadian Rhythms Characteristics of Nurses Providing Direct Patient Care: An Observational Study. Saf Health Work 2024; 15:102-109. [PMID: 38496283 PMCID: PMC10944160 DOI: 10.1016/j.shaw.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 03/19/2024] Open
Abstract
Background In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. Methods This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. Results The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. Conclusion Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.
Collapse
Affiliation(s)
- İlknur Dolu
- Department of Nursing, Faculty of Health Science, 74100 Bartın University, Bartın, Turkey
| | - Serap Açıkgöz
- Department of Nursing, Faculty of Health Science, Çankırı Karatekin University, Çankırı, Turkey
| | - Ali Rıza Demirbaş
- Governors State University, Department of Health Administration and Informatics, United States
| | - Erdem Karabulut
- Hacettepe University, Faculty of Medicine, Basic Medical Sciences, Department of Biostatistics, Turkey
| |
Collapse
|
2
|
Chen HM, Cheung DST, Huang CS, Wu YC, Hsu PK. Mediation and Dose-Response Relationship Among Physical Activity, Daylight Exposure, and Rest-Activity Circadian Rhythm in Patients With Esophageal and Gastric Cancer. Cancer Nurs 2023:00002820-990000000-00195. [PMID: 38011048 DOI: 10.1097/ncc.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Physical activity and daylight exposure predict rest-activity circadian rhythm (RACR) in patients with cancer. However, whether daylight exposure mediates the relationship between physical activity and RACR and the optimal amounts of physical activity and daylight that benefit RACR remain unclear. OBJECTIVES This study investigated the mediating role of daylight exposure and determined the dose-response relationship among daylight exposure, physical activity, and RACR in patients with cancer. METHODS This cross-sectional exploratory study recruited 319 patients with esophageal and gastric cancer from 2 surgery outpatient departments in Taiwan. Daylight exposure (>500 lux), physical activity (up activity mean), and RACR (midline estimating statistic of rhythm) were measured through actigraphy. Regression was performed, and the receiver operating characteristic curve was plotted. RESULTS Daylight exposure (>500 lux) partially mediated the relationship between physical activity (up activity mean) and RACR (midline estimating statistic of rhythm). The optimal cutoffs for discriminating between satisfactory and poor RACR were 187.43 counts/min for physical activity (sensitivity, 90.3%; specificity, 84.4%) and 35.71 min/d for daylight exposure (sensitivity, 55.9%; specificity, 78.2%). CONCLUSIONS Participants who engaged in physical activity were more likely to receive daylight exposure and experience improved RACR. The optimal level of daylight exposure and frequency of physical activity that can improve RACR in patients with esophageal and gastric cancer are 36 min/d and 187 counts/min, respectively. IMPLICATIONS FOR PRACTICE Healthcare professionals should encourage patients to engage in exercise or physical activity during the daytime to improve their circadian rhythm.
Collapse
Affiliation(s)
- Hui-Mei Chen
- Author Affiliations: School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences (Dr Chen), Taiwan; School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong (Dr Cheung), China; and Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital (Drs Huang and Hsu); and Division of Thoracic Surgery, Department of Surgery, Taipei Medical University Hospital (Dr Wu), Taiwan
| | | | | | | | | |
Collapse
|
3
|
Yang L, Feng H, Ai S, Liu Y, Lei B, Chen J, Tan X, Benedict C, Wang N, Wing YK, Qi L, Zhang J. Association of accelerometer-derived circadian abnormalities and genetic risk with incidence of atrial fibrillation. NPJ Digit Med 2023; 6:31. [PMID: 36869222 PMCID: PMC9984286 DOI: 10.1038/s41746-023-00781-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/17/2023] [Indexed: 03/05/2023] Open
Abstract
Evidence suggests potential links between circadian rhythm and atrial fibrillation (AF). However, whether circadian disruption can predict the onset of AF in the general population remains largely unknown. We aim to investigate the association of accelerometer-measured circadian rest-activity rhythm (CRAR, the most prominent circadian rhythm in humans) with the risk of AF, and examine joint associations and potential interactions of CRAR and genetic susceptibility with AF incidence. We include 62,927 white British participants of UK Biobank without AF at baseline. CRAR characteristics, including amplitude (strength), acrophase (timing of peak activity), pseudo-F (robustness), and mesor (height), are derived by applying an extended cosine model. Genetic risk is assessed with polygenic risk scores. The outcome is the incidence of AF. During a median follow-up of 6.16 years, 1920 participants developed AF. Low amplitude [hazard ratio (HR): 1.41, 95% confidence interval (CI): 1.25-1.58], delayed acrophase (HR: 1.24, 95% CI: 1.10-1.39), and low mesor (HR: 1.36, 95% CI: 1.21-1.52), but not low pseudo-F, are significantly associated with a higher risk of AF. No significant interactions between CRAR characteristics and genetic risk are observed. Joint association analyses reveal that participants with unfavourable CRAR characteristics and high genetic risk yield the highest risk of incident AF. These associations are robust after controlling for multiple testing and in a series of sensitivity analyses. Accelerometer-measured CRAR abnormalities, characterized by decreased strength and height, and later timing of peak activity of circadian rhythm, are associated with a higher risk of AF in the general population.
Collapse
Affiliation(s)
- Lulu Yang
- grid.410643.4Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong China
| | - Hongliang Feng
- grid.410643.4Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong China ,grid.10784.3a0000 0004 1937 0482Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sizhi Ai
- grid.410737.60000 0000 8653 1072Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong China ,grid.493088.e0000 0004 1757 7279Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan China ,grid.10784.3a0000 0004 1937 0482Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yue Liu
- grid.410643.4Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong China
| | - Binbin Lei
- grid.410643.4Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong China
| | - Jie Chen
- grid.10784.3a0000 0004 1937 0482Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiao Tan
- grid.13402.340000 0004 1759 700XDepartment of Big Data in Health Science, Zhejiang University School of Public Health and Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China ,grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Christian Benedict
- grid.8993.b0000 0004 1936 9457Molecular Neuropharmacology (Sleep Science Laboratory), Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Ningjian Wang
- grid.16821.3c0000 0004 0368 8293Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yun Kwok Wing
- grid.10784.3a0000 0004 1937 0482Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. .,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China. .,Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| |
Collapse
|
5
|
Kim Y, Kim HY. Retention Rates and the Associated Risk Factors of Turnover among Newly Hired Nurses at South Korean Hospitals: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910013. [PMID: 34639317 PMCID: PMC8507922 DOI: 10.3390/ijerph181910013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 11/25/2022]
Abstract
This retrospective cohort study analyzed the turnover rate and the risk factors of turnover among newly hired nurses at tertiary and secondary hospitals in South Korea. Using National Health Insurance Service data, this study created a cohort of 21,050 newly hired nurses across 304 hospitals in 2018, with a follow-up period of 18 months. Retention and turnover risk factors were analyzed at 6-month intervals. Differences in retention period according to hospitals’ organizational characteristics and nurses’ individual characteristics were analyzed using the chi-squared test. The likelihood of staying at work was analyzed using Kaplan–Meier survival curves with the log-rank test, and the hazard ratios of turnover at each retention period were analyzed using multilevel Cox proportional hazards analysis. The turnover rate of newly hired nurses within 1 year of employment was 26.4%, with 20.1% resigning within 6 months, and 6.3% resigning between 7 and 12 months. For all retention periods, turnover risk was associated with a higher bed-to-nurse ratio and older age. Higher standardized monthly income was associated with lower turnover between 13 and 18 months. Hospitals should develop nurse-retention strategies that consider risk factors for turnover. To reduce turnover, adequate nursing personnel should be maintained and fair compensation should be offered.
Collapse
Affiliation(s)
- Yunmi Kim
- Department of Nursing, College of Nursing, Eulji University, Seongnam-si 13135, Korea;
| | - Hyun-Young Kim
- Department of Nursing, College of Medical Sciences, Jeonju University, Jeonju-si 55069, Korea
- Correspondence:
| |
Collapse
|