A1 Refereed original research article in a scientific journal
Job Strain, Sleep and Alertness in Shift Working Health Care Professionals – A Field Study
Subtitle: A Field Study
Authors: Karhula K, Härmä M, Sallinen M, Hublin C, Virkkala J, Kivimäki M, Vahtera J, Puttonen S
Publication year: 2013
Journal: Industrial Health
Number in series: 4
Volume: 51
Issue: 4
First page : 406
Last page: 416
Number of pages: 11
ISSN: 0019-8366
DOI: https://doi.org/10.2486/indhealth.2013-0015(external)
Abstract
We explored the associations of job strain with sleep and alertness of shift working female
nurses and nursing assistants. Participants (n=95) were recruited from the Finnish Public Sector
Study, from hospital wards that belonged to the top or bottom quartiles on job strain. Participants’
own job strain was at least as high in high-strain group or low in low-strain group as the ward’s average.
The study included three-week measurements with sleep diary and actigraphy. Psychomotor
Vigilance Test (PVT) was performed during one pre-selected morning and night shift and a day off.
Sleep efficiency before morning shifts was lower in the high-strain than low-strain group (p=0.03).
Low-strain group took more often (72 vs. 45%; p<0.01) and longer naps (62 vs. 35 min; p=0.01)
before the first night shift than high-strain group. Difficulties initiating sleep were more common in
high-strain group, especially after evening shifts (p<0.01). High-strain group had more often at least
one lapse in PVT during the night shift (p=0.02). Average sleep duration (06:49h) and efficiency
(89%) did not differ between these groups. In conclusion, high job strain is associated with difficulties
initiating sleep and reduced psychomotor vigilance in night shifts. Shift working contributed
to impaired sleep in both high and low job strain group. Individual and organization-based actions
are needed to promote sufficient sleep in shift working nurses, especially with high job strain.
We explored the associations of job strain with sleep and alertness of shift working female
nurses and nursing assistants. Participants (n=95) were recruited from the Finnish Public Sector
Study, from hospital wards that belonged to the top or bottom quartiles on job strain. Participants’
own job strain was at least as high in high-strain group or low in low-strain group as the ward’s average.
The study included three-week measurements with sleep diary and actigraphy. Psychomotor
Vigilance Test (PVT) was performed during one pre-selected morning and night shift and a day off.
Sleep efficiency before morning shifts was lower in the high-strain than low-strain group (p=0.03).
Low-strain group took more often (72 vs. 45%; p<0.01) and longer naps (62 vs. 35 min; p=0.01)
before the first night shift than high-strain group. Difficulties initiating sleep were more common in
high-strain group, especially after evening shifts (p<0.01). High-strain group had more often at least
one lapse in PVT during the night shift (p=0.02). Average sleep duration (06:49h) and efficiency
(89%) did not differ between these groups. In conclusion, high job strain is associated with difficulties
initiating sleep and reduced psychomotor vigilance in night shifts. Shift working contributed
to impaired sleep in both high and low job strain group. Individual and organization-based actions
are needed to promote sufficient sleep in shift working nurses, especially with high job strain.
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