Shift Work Disorder and Associated Health Problems Among Nursing Staffs Working in A Tertiary Health Centre, Chennai, South India
Shift Work Disorder and Associated Health Problems Among Nursing Staffs Working in A Tertiary Health Centre, Chennai, South India
Shift Work Disorder and Associated Health Problems Among Nursing Staffs Working in A Tertiary Health Centre, Chennai, South India
ISSN No:-2456-2165
Abstract:- Nurses are healthcare workers who don’t care There is evidence to suggest that SWD can lead to
about their health but their patient. There are evidences headaches, Cardiovascular Diseases (CVD), hypertension,
that nurses are engaged into improper shift system gastrointestinal tract problems (GIT), type II diabetes
(mainly night shifts)- such work schedules have been mellitus, obesity, Metabolic Syndrome, stroke, acute
related to numerous health problems, which include respiratory infections, back pain, anxiety, mood disorders,
gastrointestinal problems, cardiovascular problems, and depression. [2-5]
metabolic syndrome, migraine, anxiety, and depression
.The diagnostic criteria for SWD, as defined by the Individuals vary on how they tolerate shift work, and
American Academy of Sleep Medicine (AASM)'s how their body reacts. The diagnostic criteria for SWD, as
International Classification of Sleep Disorders-2 (ICSD- defined by the American Academy of Sleep Medicine
20). Here in this study we assess the prevalence of Shift (AASM)'s International Classification of Sleep Disorders-2
Work Disorder and related health problems among (ICSD-2), are as follows: (i) Complaints of insomnia or
nurses in a tertiary care hospital, Chennai, South India. excessive sleepiness temporally associated with repeated
A cross sectional Hospital based study on nurses of shift schedules affecting their sleep pattern, (ii) symptoms
tertiary hospital in Chennai for a duration of 2 months associated with the shift work schedule over least 1 month,
on sample size (N):127 using Standard Shift work Index (iii) sleep disturbance not better explained by another sleep
questionnaire. The results will be tabulated and analysed disorder, mental disorder, a medical or neurological
statistically with appropriate parametric and non- disorder, medication use, or substance use disorder.[6]
parametric tests such as student’s t-test and chi-Square
test. The prevalence of SWD will be assessed and related Need for the study
health problems among the health care nurses will be Healthcare professionals, such doctors, and nurses are
assessed using the questionnaire as the tool. Shift work at a greater risk of getting SWD and its related health
and related health problems are important topics in the problems. Anxiety and depression are found to be more
health-care sector due to their possible negative impact among shift workers compared to day shift workers due to
on the workers’ health and safety. Health education, their altered sleep pattern.
awareness among workers regarding their work
schedules, shifts, holidays, and treatment plays a major Here in this study, we assess the prevalence of Shift
role in treating SWD. Till now only few studies haves Work Disorder and related health problems among nurses in
been done to assess the shift work disorder hence, this a tertiary care hospital, Chennai, South India.
study will be useful in assessing the prevalence of shift
work disorder and to create awareness among the health II. METHODOLOGY
care individuals whose primary job is taking care of
other people’s health. Study Design: Cross-Sectional Hospital-based study
Study Population: Nurses of a tertiary care hospital in
Keywords:- Shift Work Disorder, Health Problems, Night Chennai
Shifts. Study Duration: March 2019- May 2019
Sample Size(N) : 127 (P=43.07, L=20%) using the
I. INTRODUCTION formula (4*P*Q)/L^2) using the article [7]as the
reference article
Nurses are healthcare workers who don’t care about Study Tool: Basic demographic details along with brief
their health but their patient’s. No hospital can function details about their shift working time and A pretested and
effectively if there is a high incidence of health problems validated questionnaire- Standard Shift Work Index
among nurses. The healthy work environment is very Questionnaire.
important for the function of hospitals. Circadian rhythm,
mediated by hypothalamus, is essential for the normal body Nurses working in shifts and those who agree to
function of a person. This circadian rhythm is disrupted in a participate in the study. Clearance from the Institutional
shift worker and can affect a person's health [1]. Poor sleep Ethics Committee was obtained. All the eligible participants
significantly affects a person’s performance. were identified and were invited to take part in the study. All
Table 3:- health problems due to SWD As of today, only a few studies have systematically
assessed the Prevalence of SWD and its related health
Based on the P-value we found that there is a problems. Thus, it’s difficult for an epidemiological
statistically significant association between the presence of researcher to properly assess the symptoms of SWD as the
SWD and age (higher chance in younger age), number of questionnaire used is also under development. Hence, such
hours worked in a week (more the shifts), experience in researches are needed to further understand the dimensions
years (lesser the experience more the chance of getting of SWD and its related health problems.
SWD), it also associated with travel (more the travel hour)
higher the chance of getting SWD. No significant relation V. IMPLICATIONS
was seen between marital status, and gender was seen with
SWD. Shift work and related health problems are important
topics in the health-care sector due to their possible negative
IV. DISCUSSION impact on the workers’ health and safety. Health education,
awareness among workers regarding their work schedules,
Mental and physical illnesses are more among Swift- shifts, holidays, and treatment plays a major role in treating
workers compared to non shift-workers [8]. Night shift work SWD.
is associated with poor sleep, and disturbed sleep is a major
risk factor for Type II Diabetes Mellitus, obesity, and Till now only a few studies have been done to assess
Metabolic Syndrome which is related with poor health and the shift work disorder hence, this study will be useful in
can affect the person’s performance [9]. The prevalence of assessing the prevalence of shift work disorder and to create
SWD among nurses in the present study was found to be awareness among the health care individuals whose primary
36.43%. We found that young nurses who were aged 20-24 job is taking care of other people’s health.
and who have less experience are at a higher risk of getting
SWD. REFERENCES
We need further studies to identify the precise reason [1]. Ball LJ, Palesh O, Kriegsfeld LJ. The
for this phenomenon. This study finds that headache(46%), Pathophysiologic Role of Disrupted Circadian and
gastrointestinal and digestive problems, such as indigestion, Neuroendocrine Rhythms in Breast
heartburn, stomach ache and loss of appetite, were(43%) Carcinogenesis. Endocr Rev. 2016;37(5):450–
and mild cardiovascular problems such as palpitation, tight 466. [PMC free article][PubMed] [Google Scholar]
chest were found to be (38%) and sleep problems were [2]. Anbazhagan S, Ramesh N, Nisha C, Joseph B. Shift
found more common during their morning shifts. It is also work disorder and related health problems among
found that older individuals tend to have a higher chance of nurses working in a tertiary care hospital, Bangalore,
SWD due to increased workload. The health problems occur South India. Indian J Occup Environ
due to altered biological clock or circadian rhythm [10]. The Med. 2016;20(1):35. [PMC free
limitations to this study are that we didn’t account for the article] [PubMed] [Google Scholar]
possible confounding factors such as increased workload, [3]. Figueiro MG, White RD. Health consequences of shift
exact shift changes for the past 1 year, their work ambiance, work and implications for structural design. Journal of
environmental factors, and their illness. J Perinatol. 2013;33(Suppl 1):S17
S23. [PubMed] [Google Scholar]
Shift work and related health problems pose a negative [4]. Sonati J, De Martino M, Vilarta R, Maciel É, Moreira
impact on the health of the health care individual and E, et al. Quality of life, health, and sleep of air traffic
society. Awareness against SWD is very much important as controllers with different shift systems. Aerosp Med
most of the health care individual wok in shift basis, hence Hum Perform. 2015;86(10):895–
health education, awareness among workers regarding their 900.[PubMed] [Google Scholar]
work schedules, shifts, holidays, and treatment plays a major [5]. Togo F, Yoshizaki T, Komatsu T. Association between
role in treating SWD. depressive symptoms and morningness-eveningness,
sleep duration and rotating shift work in Japanese
Insomnia can be best treated by using non- nurses. Chronobiol Int. 2017;34(3):349–
pharmacological techniques, such as cognitive behavioural 359. [PubMed] [Google Scholar]
therapies or reviewing sleep hygiene or stress management
techniques. Healthy work environment among nurses,