輪班工作是大部分護理從業人員必須面對的工作特質。近期的研究發現「約日型態」與「失眠易感性」是一般失眠患者重要的身心特質,但是目前「約日型態」與「失眠易感性」對於輪班護理人員睡眠品質之影響並不清楚。因此本研究旨在調查影響輪班護理人員睡眠品質之相關因素,並進一步探討「約日型態」與「失眠易感性」在輪班護理人員睡眠品質中所扮演之角色。 本研究設計為橫斷式研究,並以紙筆測驗的方式於綜合醫院收集相關輪班護理人員資料。「約日型態偏好」、「失眠易感性」、「情緒障礙」、「睡眠品質」的等資料分別以「睡眠型態偏好量表」、「失眠壓力反應量表」、「簡式症狀量表」以及「匹茲堡睡眠品質量表」評估測量。本研究共計回收398位輪班護理人員之問卷資料進行分析。 研究結果顯示研究個案中,女性護理人員占97.5%,年齡分佈則以25歲至34歲間最多。「匹茲堡睡眠品質量表」平均得分為7.3分,70.1% (n=279)之護理人員近一個月睡眠品質不良。相關分析顯示,「失眠壓力反應量表」以及「簡式症狀量表四題版」得分與「匹茲堡睡眠品質量表」總分呈現顯著正相關。相對地,「睡眠型態量表」雖然沒有直接和「匹茲堡睡眠品質量表」總分呈現顯著相關性,但卻和「失眠壓力反應量表」以及「簡式症狀量表四題版(不包含睡眠題項之版本)」得分呈現顯著負相關。在「匹茲堡睡眠品質量表」總得分相關因素之複迴歸分析中,「失眠壓力反應量表」與「簡式症狀量表四題版」為「匹茲堡睡眠品質量表」總得分之重要預測因子。同樣地,「睡眠型態量表」得分仍然對睡眠品質無顯著的影響力。調控因子之分析方面則沒有發現任何一個「睡眠型態偏好量表」得分與「失眠壓力反應量表」得分交互作用項在「匹茲堡睡眠品質量表」總得分或次量表得分之迴歸模型中達到統計顯著。 本研究結果顯示影響護理人員之睡眠品質因素,除了輪值夜班外,較高的「失眠易感性」與情緒障礙都是重要的相關因子。此外,本研究並未發現顯著的證據支持「約日型態」與「失眠易感性」在睡眠品質上之交互作用。經由本研究我們除了瞭解護理人員睡眠品質不佳之危險指標外,對於「約日型態」影響睡眠品質之機轉也有進一步之瞭解。這些發現可提供在失眠演進為慢性化前,協助輪班護理人員改善睡眠品質之早期篩檢、介入與研究計畫之參考。
Shift work characterizes the occupational property of most nursing staff. Chronotype and insomnia vulnerability are the important psychophysiological traits of general insomniacs; however, to what extent these traits influence sleep quality of nursing staff is unknown. This study aims to investigate correlates of sleep quality among nursing staff. Besides, the roles that chronotype and insomnia vulnerability play in the sleep quality of shifting nurses are also examined. This is a cross-sectional study. All data was collected from shift nurses at a general hospital with paper-pencil questionnaire. Chronotype preference, insomnia vulnerability and sleep quality were measured with Morning-evening questionnaire (MEQ), Ford Insomnia Response to Stress Test (FIRST), Brief Symptoms Rating Scale (BSRS-5) and Pittsburgh Sleep Quality Index (PSQI), respectively. A total of 398 questionnaires from shift nurses were collected and analyzed. A total of 97.5% participants were female who aged from 25 to 34 years in majority. The total scores of PSQI is 7.3 in average and 70.1% (n=279) subjects had poor sleep quality in the past one month. Scores of FIRST, BSRS-4 (BSRS-5 without the item of sleep disturbance) and PSQI correlated positively. In contrast, scores of MEQ did not correlated with scores of PSQI but negatively associated with scores of FIRST and BSRS-4 instead. In the multiple regression analyses, the most important predictive variables for the total scores of PSQI were the scores of FIRST and BSRS-4 . No significant interaction effects from FIRST on the relationship between MEQ with total or sub-scale of PSQI were found. The results suggested that in addition to night shift, higher insomnia vulnerability and emotional disturbance were crucial factors affecting sleep quality of shift nurses. Besides, no evidence indicates that insomnia vulnerability moderates the relationship between chronotype and sleep quality among shift nurses. In this study, not only the risk indicators for poor sleep quality in shift nurses were explored, but also the mechanism that chronotype influences sleep quality was examined. These findings may be applied as references for the screen, intervention or research projects that aim to prevent sleep disturbance from chronicity.