護理人員輪班造成工作時間不規則,使得護理人員日夜節律混亂,導致睡眠障礙、生理、心理等健康問題。而個人的日夜作息型態可能是影響輪班適應與否的重要因子,但迄今相關研究仍闕如。因此本研究主要探討護理人員的日夜作息型態對其睡眠品質、疲倦及警覺的影響,研究採立意取樣,調查北部、中部各一家醫學中心,共收案固定白班(n=37)、固定小夜班(n=37)、固定大夜班(n=35)。收案時間為單月班別的中第二至三週中間的連續6天,收集的資料包括:個案基本資料、作息型態(日夜作息模式量表)、睡眠品質(24小時配戴Actiwatch並紀錄睡眠日誌共6天)、慢性疲勞標準測量表、警覺視覺類比量表。收集資料根據研究目的以卡方檢定、單因子變異數、一般線性模式分析(GLM)分析。 結果顯示三班護理人員的睡眠時數、睡眠潛伏期、睡眠效率、入睡後醒來時間並沒有顯著差異。三班分別以不同的日夜作息型態比較其睡眠品質,發現輪值白班夜晚型的睡眠潛伏期較長於清晨型與中間型(p=.026)。另外在輪值班別、日夜作息型態、睡眠品質、疲倦及警覺之間不會有交互影響。 大夜班的睡眠時數少於其他班別,且低於正常成人睡眠8小時,建議輪值大夜班者能調節其作息時間,深入瞭解自身的睡眠狀態,以獲得足夠睡眠時間以達到充分休息。在固定班別護理人員、日夜作息型態對睡眠品質、疲倦及警覺並未有顯著影響,因此建議盡量以固定班別的方式排班,護理人員招募亦可以班別為招募條件,讓人員可選擇其個人較適應的班別,以減少對健康的負面影響。
Introduction:Shift-working causes the irregular working period and confusing of liferhythm of nurse leading to sleep disorder, physiological and psychological health problems. The individual Morning-Evening patterns could be one of important factors which affect the adaptation of shift-working conditions, but so far related studies are still lacking. Methods:The subjects are divided into three groups of day-shifting (n = 37), night-shifting (n = 37) and overnight-shifting (n = 35) from two medical center (Northern and Central of Taiwan). The collecting periods are 6 continuing days from 2nd to 3rd week in one-month fixed shifts. Data including personal characteristics, Morning-Evening patterns (Morningness-Eveningness questionnaire), sleeping quality(wear Actiwatch 24 hourscontinuously and sleep diary for 6 days) and fatigue (SSICFS) and alert (VAS). Data were analyzed by Chi-Square Test,one-way ANOVA and Generalized Linear Model. Result:There are no significant differences between shift-working groups in sleep duration, sleep latency, sleep efficiency and wake-up time. Comparing Morning-Evening patterns tosleep quality in each groups, the sleep latency is longest in night-shift group (p=.026). Nointeraction between three groups, Morning-Evening patterns, sleep quality, fatigue and alerthas found. The sleep duration in overnight-group is shortest, less than 8 hours in average. In each group,Morning-Evening patterns had no interferes to sleep quality, fatigue and alert. In future, consider Morning-Evening patterns effect, when recruiting new staffs individual can select fit Morning-Evening patterns shift-work may be applied.