輪班工作對護理人員之生心理健康與其自律神經調節功能之影響

護理人員於每天二十四小時以2－3班無縫接軌輪替上班，以使病人獲得持續性且高品質的照護。由於護理人員輪班工作中包含了夜間臨床照護任務，使得其生理時鐘、晝夜節律被打亂。有越來越多的文獻顯示，輪班工作者生理時鐘混亂，易導致自律神經系統調節失衡，而使得其有較高的生理及心理健康問題。為關心護理人員的健康，筆者以文獻回顧的方式，統整護理人員在輪班體制中常見的生、心理健康問題與自律神經系統調節功能失衡之議題。結果顯示，以輪值夜班天數較多的護理師而言，可能會有較高癌症、心血管疾病或代謝症候群之風險，以及產生憂鬱、焦慮等心理健康問題；而這與輪班者即使在睡眠休息時刻，自律神經中交感神經仍處於活躍的狀態有關。研究亦指出若越長時間從事輪班工作，自律神經調節功能將越來越差甚至受損，將使得生、心理健康問題益發嚴重。期望本文章的綜整結果，能讓護理人員及其直屬主管能更進一步瞭解輪班工作帶來的影響，並提供後續發展適當的評估與促進生心理健康策略之依據，以降低因輪班工作所引發自律神經失調而導致的身心疾病之機率。

關鍵字

輪班工作；護理人員；生心理健康；自律神經調節功能

並列摘要

For providing continuing and high-quality care for patients, nursing staff work in two to three seamlessly rotating shifts 24 hours a day. Rotating shift work may include night shifts or overnight shifts, which might disturb the nursing staff’s biological clock or regard as circadian rhythm. A growing literature has been showing that rotating shift workers with circadian rhythm disturbance might easily have autonomic dysregulation and further lead to physiological and psychological health problems. Taking good consideration, this work was using the literature review to identify and discuss the physiological and psychological health problems and their associations with autonomic dysregulation caused by rotating shift work in nursing staff. In summary, evidence has shown that more night or overnight shifts of nursing staff could lead to a higher risk of cancer, cardiovascular diseases, and metabolic syndrome, in addition, to more psychological problems with anxiety and depression. These health problems might be related to the overactive sympathetic function of the autonomic system during the sleep-rest period after rotating shift work. The longer history of rotating shift work, the more impact or potential damage to the autonomic regulative function, further, leading to more physiological and psychological health problems. With anticipation, this work might provide more understanding about the impact of rotating shift work in nursing for nursing staff and nursing managers. Based on this review, the prompt evaluation and related health promotive intervention should be considered to develop for diminishing the risk of autonomic dysregulation and its related physiological and psychological diseases.

並列關鍵字

shift work ； nursing staff ； physiological and psychological health ； autonomic nervous regulation function

主題瀏覽