The Relationships Among Sleep Quality and Chronotype, Emotional Disturbance, and Insomnia Vulnerability in Shift Nurses

輪班護理人員睡眠品質與睡眠型態偏好、情緒困擾以及失眠易感性之相關研究

李靜怡(Ching-Yi Lee) ； 陳錫中(Hsi-Chung Chen) ； 曾美智(Meg Mei-Chih Tseng) ； 李信謙(Hsin-Chien Lee) ； 黃璉華(Lian-Hua Huang)

《The Journal of Nursing Research》 23卷3期 (2015/09) Pp. 225-235

https://doi.org/10.1097/jnr.0000000000000095

摘要

背景：輪班工作是護理人員重要的工作特性之一。雖然睡眠型態偏好、情緒困擾與失眠易感性為一般失眠患者已知的重要相關因素，他們在輪班護理人員間之角色仍未明。目的：本研究旨在探討輪班護理人員睡眠型態偏好、情緒困擾、失眠易感性與睡眠品質間之關係。方法：總計有398位在醫學中心任職的輪班護理人員參與本調查。本研究分別使用睡眠型態偏好量表、簡式症狀量表、失眠壓力反應量表與匹茲堡睡眠品質量表評估輪班護理人員之睡眠型態偏好、情緒困擾、失眠易感性與睡眠品質。結果：共計有70.1%的護理人員在匹茲堡睡眠品質量表得分超過5分。複迴歸分析發現夜班工作[b(se)=1.05 (0.35), ＂p＂=.003]、較高的情緒困擾[b(se)=0.30 (0.05), ＂p＂＜.001]與較高的失眠易感性[b(se)=0.18 (0.03), ＂p＂＜.001]是不良睡眠品質的預測因子，但是睡眠型態偏好則與睡眠品質無顯著相關。在複中介模型中發現黃昏型睡眠型態經由情緒困擾間接地影響主觀睡眠品質（匹茲堡睡眠品質量表之次量表）。結論／實務應用：除了輪班型態之外，情緒困擾與失眠易感性是輪班護理人員不良睡眠品質的重要相關因子，可作為其出現睡眠困擾的危險指標。黃昏型睡眠型態可能間接地透過情緒困擾而影響主觀睡眠品質，未來可針對相關路徑潛在的機轉進行研究。

關鍵字

睡眠型態偏好 ； 情緒困擾 ； 失眠易感性 ； 輪班護理人員 ； 睡眠品質

並列摘要

Background: Shift work is a prominent feature of most nursing jobs. Although chronotype, emotional disturbance, and insomnia vulnerability are important factors for patients with insomnia in general, their effects on shift nurses are unknown. Purpose: This study explores the relationships between the sleep quality of shift nurses and the variables of chronotype, emotional disturbance, and insomnia vulnerability. Methods: A survey was conducted with 398 shift nurses in a medical center. Chronotype, emotional disturbance, insomnia vulnerability, and sleep quality were evaluated using the Smith Morningness-Eveningness Questionnaire, the Brief Symptom Rating Scale, the Ford Insomnia Response to Stress Test, and the Pittsburgh Sleep Quality Index, respectively. Results: On the Pittsburgh Sleep Quality Index, 70.1% of the participants scored higher than 5. Multiple regression analysis revealed that, together with night shift work (＂b[SE]＂=1.05 [0.35], p=.003), higher levels of emotional disturbance (＂b[SE]＂=0.30[0.05], p＜.001) and higher insomnia vulnerability (＂b[SE]＂=0.18 [0.03], p＜.001) were predictors of poor sleep quality and that chronotype was not a predictor of poor sleep quality. The multiple mediator model indicated that emotional disturbance significantly mediated an indirect effect of evening chronotype preference on poor subjective sleep quality (one subscale of the Pittsburgh Sleep Quality Index). Conclusions/Implications for Practice: In addition to shift patterns, emotional disturbance and high insomnia vulnerability are factors that may be used to identify shift nurses who face a higher risk of sleep disturbance. Because evening chronotype may indirectly influence subjective sleep quality through the pathway of emotional disturbance, further research into the mechanism that underlies this pathway is warranted.

並列關鍵字

chronotype ； emotional disturbance ； insomnia vulnerability ； shift nurse ； sleep quality

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