The Quality of Sleep of Intensive Care Unit Nurses Working in Different Shift-work Systems

不同輪班制度加護病房護理人員之睡眠品質

林志鴻(Chih-Hung Lin) ； 林慧泠(Huei-Ling Lin) ； 石磊玉(Lei-Yu Shi) ； 張文靜(Wen-Ching Chanq) ； 張坤權(Kun-Chuan Chanq) ； 李興中(Henry Hsin-Chung Lee)

《醫務管理期刊》 14卷2期 (2013/06) Pp. 128-146

https://doi.org/10.6174/JHM2013.14(2).107

摘要

目的：本研究目的在探討不同輪班制度加護病房護理人員睡眠品質之異同。方法：本研究採橫斷性研究，選取台灣北部兩家不同輪班制度醫院加護病房之護理人員，以立意取樣方式招募個案，共收案60位護理人：公立醫院規則輪班（固定班）30名與私立醫院不規則輪班（花花班）30名，兩組人員皆接受匹茲睡眠品質量表（PSQI）一份，與居家睡眠檢測儀連續測量三天，收案日期自2011年01月01日起至5 月31 日止，共完成60 人，回收率100%。資料分析以SPSS18.0統計軟體，進行描述性統計、比較兩制度下之不同：連續變項以獨立樣本t檢定、類別變項以Chi-Square 檢定（卡方檢定），並且進行多變異迴歸分析及三種模式的邏輯迴歸分析。結果：睡眠品質不良之比例在規則輪班與不規則輪班兩組之間無差異（PSQI大於等於五分）（26/30對28/30, χ^2＝0.19, p＝0.667）。自我感受之入睡潛伏時間長度在規則輪班者有顯著較長，即使在用三種模式的邏輯迴歸分析（校正年齡、婚姻及喝咖啡三因子）也有顯著差異（p＜0.01）。其他並無明顯統計差異。結論：此研究顯示輪班制度中的輪替速率之不同與自我感受之入睡潛伏期長短有關，而自我感受之入睡潛伏時間長度在學理上與疲勞程度（fatigue level）有密切相關，所以如果我們把輪班制中的輪替速率調整適當，必能在醫務管理中設計出更好的輪班制度來降低工作人員之疲勞程度。

關鍵字

輪班工作 ； 護理人員 ； 睡眠品質 ； 疲勞程度

並列摘要

Objective: to compare the quality of sleep of intensive care unit nurses in different shift-work systemsMethod: This cross-sectional survey was designed for intensive care unit nurses in hospitals utilizing two different shift-work systems. A total of 60 nurses in intensive care units were enrolled between Jan 1st and May 31st 2011; 30 were from a public hospital on a fixed shift schedule, and the other 30 from a private hospital on an irregular shift schedule. Participants were each given a Pittsburg Sleep Quality Index (PSQI) questionnaire and a machine for cardiopulmonary coupling analysis for three days to record both subjective and objective sleep quality. The response rate for data collection was 100%. Data were analyzed with SPSS 18.0 software: Chi-square tests for categorical measures and T-tests for continuous measures. Multivariate regression and three models of logistic regression were used to determine correlations.Results: The poor sleep quality ratio (global score of PSQI not less than 5) was not significantly different between regular shift and irregular shift nurses (26/30 versus 28/30, χ^2 = 0.19, P = 0.667). Self-perceived sleep latency was significantly longer in the regular shift group even in the three models of logistic regression adjusted for age, marriage and coffee consumption (p ＜ 0.01). There were no other differences.Conclusions: The rate of shift rotation was significantly associated with self assessed sleep latency, which is closely related to the level of fatigue in the literature. If we adjust the rotation schedule, then we can reduce the level of fatigue of our colleagues in the healthcare system.

並列關鍵字

Shift-work ； Nurse ； Sleep Quality ； Fatigue Level

參考文獻

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