עבודת משמרות עם חזרות מהירות ומצב הרוח - הילכו יחדיו? הקשר המתווך של עייפות ואיכות השינה בקרב אחים ואחיות: [מאמר מחקר]

Background: Nurses are required to work different kinds of shifts to provide ongoing services that are available 24/7. Working in shifts may increase fatigue and impair sleep and mood, with consequences on the quality and safety of treatment. One factor that has recently been of interest refers to short intervals between successive shifts,coined as "quick returns". Mood has been shown to affect performance at work and is associated with sleep disturbance and fatigue.Purpose: To investigate whether sleep quality and fatigue mediate the association between quick returns and mood in nurses working on shifts with quick returns.Method: By cluster sampling, 98 nurses were sampled, aged 20-65, working in units with quick return shifts, at a central hospital. An online questionnaire was sent viaa Facebook group of hospital nurses and departmental WhatsApp groups within the hospital. The questionnaire included the Pittsburgh Sleep Quality Index (PSQI), the fatigue questionnaire, the Center for Epidemiologic Studies Depression Scale short form (CES-D10), the NASA Task Load Index, the Composite Scale of Morningness (CSM), and self-report of the number of quick returns in the past month. To test the mediation of sleep quality and fatigue in the association between frequency of quick returns and mood, Model 4 of PROCESS macro analysis was performed (Hayes, 2012)while monitoring control variables (workload, age and chronotype).Results: Number of quick return shifts was associated with fatigue (b=0.282, se=0.129,95% CI=0.026, 0.537), but not with sleep quality. A significant relationship was found between mood and fatigue (b=0.277, se=0.039, 95% CI=0.199, 0.355) and between mood and sleep quality (b=0.252, se=0.057, 95% CI=0.139, 0.364). No significant relation was found between quick returns and mood. Fatigue, but not sleep quality,mediated the relation between quick returns and mood (b = 0.078, Boot95%CI = 0.004,0.170).Conclusions: Fatigue (but not sleep quality) explains the relationship between the frequency of quick returns and mood in shift working nurses. Further investigation is warranted to understand individual differences as well as consequences of fatigue and mood on functioning, in order to develop interventions tailored to both the organization and the individual.