- 學位論文
輪值班別對護理人員睡眠品質及注意力之影響
The Effect of Shift Work Patterns on Nurses’ Sleep Quality and Attention
摘要
對於輪班或夜班工作的人員，可能因為內在晝夜節律與外在環境的要求的作息時間不一致，而造成晝夜節律紊亂，會影響睡眠時數與睡眠品質，造成疲倦、降低警覺性並負向影響工作安全。因此本研究進行探討輪值班別對護理人員注意力之狀況及輪值班別對護理人員睡眠品質改變之研究探討。 不同班別護理人員之注意力以d2 test測量選擇性注意力，輪班組大夜班錯誤率較固定白班組高，輪班組大夜班TN-E (整體操作正確題數)及CP (整體測驗之執行速度與準確性題數)較固定白班組差；輪班組於大夜班錯誤率較白班多0.45倍及較小夜班多0.62倍，於大夜班測得整體操作正確題數較白班少40.62題，整體之執行速度與準確性題數較白班少28.57題，顯示大夜班整體測驗之執行速度與準確性較白班差。 夜班與固定白班護理人員於上班及休假不同天數之睡眠品質，於大夜班組上班期間較固定白班組有較少之睡眠時數、較高之覺醒時數及較差之睡眠效率；大夜班組於休假第4天覺醒時數低於白班組、睡眠效率高於白班組、睡眠潛伏期小於白班組，顯示大夜班組休假至第4天之眠品質恢復。 綜合以上研究結果建議宜教育工作人員如何由晝夜節律週期、睡眠因素及環境因素來適應，連續上5天大夜班後若接著同一種班別，中間應安排至少4天之休假以提供足夠的休息，若由大夜班變換為白班則大夜班後宜安排5天之休假，以供足夠時間調整晝夜節律恢復睡眠品質。大夜班轉換不同班別之排班時至少需安排4天以上之休假，以提供足夠時間。
並列摘要
Thesis directed by: Kuei-Ru Chou PhD, Professor of Graduate Institution of Nursing, Taipei Medical University When work shifts are changed, the synchronous relationship between the body's biological clock and circadian rhythms, are disrupted, resulting in insufficient sleep. Because of poor sleep quality, night shift workers have higher probabilities of accidents, and are more prone to having negative impacts on their professional performance. The objectives of the study was to investigated selective attention levels of nursing staff on different shifts, and the effect of shift work patterns on nurses’ and sleep quality. A comparison of fixed- shift and rotating-shift schedules on nursing staff attention levels, selective attention was measured by the d2 test. The E% for night-shift workers in the rotating-shift group was higher than that of fixed day-shift workers. The TN-E and CP scores were higher for fixed day-shift workers. The error rate of night-shift workers in the experimental group was 0.45 times more than that of day-shift workers and 0.62 times more than that of evening-shift workers. The TN-E of night-shift workers was 40.62 items less than that of day-shift workers. CP was 28.57 items less than that of day-shift workers and indicated that performance speed and accuracy on the overall test of the staff on night shifts were poorer than that of the staff on day shifts. Sleep qualities in nurses on night shifts and days off, sleep diaries and sleep parameters collected by actigraphy. The study showed that on workdays, the night-shift group had fewer TST, more WASO, and lower SE than the day-shift group. On days off, TST of the two groups were higher than those on workdays. On the 4th day off, higher TST, a decrease in WASO, and an increase in SE indicated that the night-shift group had recovered their sleep quality after having taken 4 days off. The SE of the night-shift group exceeded the level of the day-shift group after the 4th days off. Staff education about sleep hygiene and knowledge of circadian rhythm functions can increase staff retention and improve workplace morale. It is recommended that night-shift workers arrange a rest period of at least 4 days off after 5 consecutive night shifts, and at least 5 days off if the staff who have previously worked night shifts are to being a set of day shifts.