輪班工作對護理人員健康的影響

背景：輪班工作是護理人員不可避免的工作型態，過去文獻指出工作時間及作息不固定，易造成日夜節律失調，間接影響體內荷爾蒙分泌與調節、造成睡眠型態改變、增加罹患心血管疾病、糖尿病、代謝症候群、胃腸疾病及肥胖的風險，然而關於護理人員輪班工作對健康影響之研究卻仍欠缺一致性結果及整合。目的：本文目的為藉由文獻回顧與統整，深入了解輪班對護理人員健康的影響。方法：以系統性文獻回顧，歸納輪班對護理人員健康影響的證據，蒐集Cochrane Library、Pubmed、Medline、CINAHL及CEPS等資料庫，刊登自1985年迄2016年9月的英文或中文為主之研究性文章都納入評讀。結果：部分研究指出護理人員輪班工作可能增加心血管疾病、代謝性疾病、腸胃道不適症狀、癌症、肥胖及睡眠障礙風險，然而不僅實證資料仍偏少，且結果亦不盡一致；相關健康議題均和生活型態（如飲食習慣、身體活動）有關，但部分研究卻未控制相關因子。結論／實務應用：輪班對護理人員健康影響的研究仍過少，未來需要更多嚴謹的研究探討輪班對護理人員健康的影響。建議護理人員應定期接受健檢，以期早期發現早期治療；此外，本文期望藉此拋磚引玉，提供醫療機構主管、衛政人員思考規劃護理人員合理排班、及介入輪班護理人員健康促進策略之參考。

關鍵字

輪班工作；護理人員；健康

並列摘要

Background: Rotating night-shift is an unavoidable work condition for nurses. Literature review revealed the negative health consequences caused by irregular working shifts, including impairments in circadian rhythm, hormone secretion and regulation, increased risk for cardiovascular disease, diabetes, metabolic syndrome, gastrointestinal diseases, and obesity. However, the evidence was inconsistent and fragmented. Purpose: To provide a systematic review and assess literature on the impact of rotating night-shift work on nurses' physical health. Methods: This study used a systematic review to integrate evidence on the health impact from rotating night-shift among nurses. Literature search was conducted on publications from 1985 to September 2016 using five databases, including Cochrane Library, Pubmed, Medline, CINAHL and CEPS. Results: Current evidence remains rare and inconsistent. Few studies showed that nurses who worked rotating night-shift had increased risk for cardiovascular, metabolic, gastrointestinal, cancer, obesity, and sleep-related conditions. Some research did not have controls for health-related lifestyle covariates (i.e., dietary patterns, physical activity). Conclusions/Implications for Practice: Research exploring the health impact of nurses working rotating night-shift remains insufficient and further quality research is required. Nurses should receive regular checkups to early detect any health problems. This study may serve as reference and recommendations for nursing leaders and hospital administrations to consider in future plans for reasonable and best health promotion work shifts.