Effect of shift work on excessive daytime sleepiness in female nurses: results from the Japan Nurses' Health Study.

We investigated the relationship between shift work and excessive daytime sleepiness (EDS) among participants in the Japan Nurses' Health Study (JNHS). Responses of 9,728 female nurses to the 6th follow-up questionnaire were cross-sectionally analyzed. EDS was defined as an Epworth Sleepiness Scale score ≥11. EDS-associated factors were evaluated using Poisson regression analysis after adjustment for multiple confounders. Of the participants (mean age, 52.2 ± 8.0 yr), 28.7% were engaged in shift work, and the overall prevalence of EDS was 24.6%. EDS-associated factors were investigated separately in women aged <40 yr (n=250), 40-59 yr (n=7,467), and ≥60 yr (n=2,011). Current engagement in shift work (prevalence ratio: 1.92 [95% confidence interval: 1.20-3.06], compared with no experience of shift work) and obesity (2.08 [1.11-3.88] for BMI ≥30 and 1.39 [1.02-1.90] for BMI of 25.0-30.0, compared with BMI of 18.5-25.0) showed an independent association with EDS in women aged ≥60 yr. The effect of shift work on EDS in female nurses differed by age, as shift work and obesity contributed to EDS only in older participants. Shift work should be assigned after full consideration of age, sleep, and health status to minimize medical errors.

Workplace gender discrimination in the nursing workforce-An integrative review.

AIM: To critically synthesise the literature that explores the experiences of workplace gender discrimination from the perspective of registered nurses. DESIGN: Integrative review. REVIEW METHODS: Primary research articles reporting on the experience of workplace gender discrimination towards registered nurses in any setting were eligible for inclusion. Studies were critically appraised for methodological quality using a modified Critical Appraisal Skills Program list. The six phases of thematic analysis proposed by Braun and Clarke (2006) were used to guide the analysis. Data were extracted and coded, and themes were identified according to the review aims and significant findings of each study. DATA SOURCES: CINAHL, MEDLINE, SCOPUS, Cochrane Library, published between January 2012 and June 2022. RESULTS: Twenty studies met the inclusion criteria. Major themes identified were (1) career progression, (2) career interruption, (3) positioning of men in nursing and (4) positioning of women in nursing. CONCLUSION: This review shows that both men and women in nursing experience workplace gender discrimination; however, the forms and consequences of this discrimination differ substantially by gender. IMPLICATIONS FOR THE PROFESSION: It is important that the pursuit of greater numerical representation of men in nursing does not result in further reinforcing patriarchal advantage. Professional development for nurse leaders in managing gender issues is recommended. IMPACT: This integrative review presents current issues on workplace gender discrimination for men and women in nursing. The findings suggest gender roles and norms have an effect on the careers of both men and women in nursing. The time has come to alter restrictive gender norms and to challenge notions of hegemonic masculinity and femininity. REPORTING METHOD: We have adhered to relevant EQUATOR guidelines-PRISMA. NO PATIENT OR PUBLIC CONTRIBUTION: For this literature review on workplace gender discrimination for registered nurses, we did not engage members of the patient population, nor the general public.

Mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China.

Objective: To investigate mental health status and its associated factors among female nurses in the normalization of COVID-19 epidemic prevention and control in China. Methods: Random cluster sampling was applied to recruit 740 female nurses in China. The respondents completed the survey with mobile devices. Demographic questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, and The Impact of Event Scale-Revised were used to assess demographic Information, anxiety, depression, insomnia and PTSD symptoms, respectively. The associated factors of mental health status were identified by binary logistic regression analysis. Results: The prevalence of anxiety and depression was 7.9 and 17.8%, respectively. Insomnia was an associated factor of anxiety (OR = 6.237, 95%CI = 6.055-23.761, P < 0.001) and depression (OR = 9.651, 95%CI = 5.699-22.370, P < 0.001), while PTSD was an associated factor of anxiety (OR = 11.995, 95%CI = 2.946-13.205, P < 0.001) and depression (OR = 11.291, 95%CI = 6.056-15.380, P < 0.001), Being married was a protective factor of depression (OR = 0.811, 95%CI = 1.309-6.039, P < 0.01). Conclusion: Female nurses showed problems in mental health. Insomnia, PTSD and marital status were associated with mental health. The hospital management should pay more attention to the unmarried groups, and strive to improve the sleep quality of female nurses and reduce their stress caused by traumatic events.

Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts.

AIMS AND OBJECTIVES: To investigate whether the sleep quality and fatigue of female nurses working rotating shifts could be used to predict future turnover status. BACKGROUND: Female nurses working rotating shifts often suffer from sleep problems and fatigue, and the turnover rates of nurses are generally higher than those of other hospital personnel. DESIGN: A prospective study. METHODS: We recruited a total of 198 female nurses working rotating shifts from December 2017 to March 2019. The nurses completed the Checklist Individual Strength (CIS) scale and wore an actigraph for seven consecutive days in order to collect their sleep parameters. Their turnover status was tracked until 31 May 2021 at which time 55 participants (27.8%) had resigned. The Cox proportional hazard model was used to analyse the factors influencing turnover. In addition, the study adhered to the STROBE checklist. RESULTS: The results revealed significant differences between the nurses in the still-working group and the resigned group in terms of the sleep quality parameters sleep efficiency (SE) and wake after sleep onset (WASO) as well as CIS scores. WASO was significantly correlated with intensity of fatigue, and fatigue was common among all of the nurses working rotating shifts. As time progressed, the sleep quality parameter WASO and CIS scores could be used to predict turnover status after 2.4 years. CONCLUSION: The results of this study indicated more sleep fragmentation and poor sleep efficiency in the resigned group. Sleep fragmentation was highly correlated with fatigue, and sleep fragmentation and fatigue could be used to predict turnover status. RELEVANCE TO CLINICAL PRACTICE: We suggest that relevant hospital management pay more attention to the sleep conditions and fatigue of female nurses working rotating shifts when arranging personnel and schedules and offer them more understanding.

Influence of shift work on rest-activity rhythms, sleep quality, and fatigue of female nurses.

Female nurses working rotating shifts must change their daily routines often, which affects their biological circadian rhythms and could cause sleep disorders and fatigue. The objective of this study was to compare the sleep-wake rhythms, sleep quality, and fatigue of female nurses working rotating shifts and fixed day shifts and to analyze the factors that influence their fatigue. Participants comprised a shift worker group of 101 nurses and a day worker group of 76 nurses. Following the collection of basic information of the nurses and their scores in the various constructs of the Pittsburg Sleep Quality Index (PSQI) and the Checklist Individual Strength (CIS) questionnaire, each nurse wore an actigraph for seven consecutive days to collect for analysis the sleep-wake rhythm parameter dichotomy index (I < O) and durations of continuous sleep and wake. Multivariable linear regression was then used to determine whether the influence of various variables on fatigue differed between the two groups. Results revealed that the sleep-wake rhythm parameter I < O of the day worker group was significantly higher than that of the shift worker group (t = 5.08, p < .001). The shift worker group exhibited significantly higher PSQI global scores (t = -2.00, p = .047), longer total sleep time (t = 2.07, p = .040), poorer habitual sleep efficiency (t = -3.06, p = .003), and greater use of sleeping medication (t = -2.90, p = .004) than did the day worker group. Multivariable linear regression was performed to analyze the important predictors of the CIS score in the two groups with body mass index, age, work experience, marital status, educational background, department of employment, shift type at the time of recruitment, sleep-wake rhythm parameter I < O, and quality of sleep as independent variables. Results indicated that in the shift worker group, the overall explanatory power (R2) of the multivariable linear regression model was 22.9% (F = 3.01, p = .003), and only the PSQI global score (ß = 0.33, p = .003) influenced the CIS score. In the day worker group, the various variables did not influence the CIS score in the multivariable linear regression model. Although the female nurses working rotating shifts spent more time in bed, their sleep-wake rhythms and sleep quality were poorer than those of the day worker group. Furthermore, the sleep quality of female nurses in the shift worker group had a significant impact on their fatigue. In other words, for female nurses who must work rotating shifts, sleep quality determines whether fatigue can be reduced. The shift-working nurses themselves should implement sleep management, such as avoiding disruptions to their sleep-wake rhythm and improving sleep quality, which should be effective strategies to reduce fatigue.

The perception of queen bee phenomenon in nurses; qualitative study in health sector.

OBJECTIVE: The aim of this study was to investigate how Queen bee syndrome, which is known as the mobbing behaviors of female employees from other female employees or managers, as perceived by nurses who are predominantly female workers. MATERIALS AND METHODS: The universe of the qualitative type patterned research was formed by 12 nurses between the ages of 20 and 40 who worked for at least one year in different parts of a private hospital on the Anatolian side of Istanbul province. Maximum diversity sampling method for purposes was used for sample selection. The research data were collected in the form of written recording and voice recording with an unstructured interview form, which includes the structure, gender, competence, support, conflict, and competition themes created by the researchers to evaluate the characteristics of Queen bee syndrome. Focus group interviews were held on 30 April 2018. The results were evaluated using descriptive analysis and indicator methods. RESULTS: In the study, the nurses' responses to interview questions were examined and women managers felt more emotional than men managers, and therefore they were less successful in problem-solving than men managers, but they were more successful in communication among women. The majority of nurses stated that women managers are more suitable for management in healthcare, that they are open to change, but they are not enough for men to solve the problem due to the fact that they are more concerned with the details. In addition, a significant part of the nurses, more than one female managers can cause competition and conflict in the workplace, especially women managers with similar status, said that this situation is seen more. CONCLUSIONS: The results of this study indicate that the woman is adapting to the Queen bee syndrome because of her ambition, competition, and emotional approaches, but that she has not been able to produce enough of it due to the environment.

Influence of shift type on sleep quality of female nurses working monthly rotating shifts with cortisol awakening response as mediating variable.

When shift nurses change shifts, it is likely to affect the cortisol patterns of their bodies and sleep quality. The objectives of this study was to verify the influence of monthly rotating day, evening and night shifts on the sleep quality of female nurses and determine whether the cortisol awakening response (CAR) mediates this relationship. A total of 132 female shift nurses were recruited, and ultimately 128 complete questionnaires and samples were obtained (subject loss rate = 3.0%) from 45 day-shift nurses, 44 evening-shift nurses and 39 night-shift nurses at a teaching hospital in Northern Taiwan. The Pittsburgh sleep quality index served as the research instrument that nurses used to collect saliva samples at home every day after waking and 30 min after waking so as to calculate the net increases in cortisol levels (CARi). Hierarchical multiple regression was employed to examine the influence of shift type on the sleep quality of the female nurses and the mediating effect of CARi. The results of this study indicate that shift type significantly influenced CARi (F = 19.66, p < 0.001) and that the regression coefficients of evening versus day shifts and night versus day shifts are both negative. Shift type also significantly influenced sleep quality (F = 15.13, p < 0.001), and the regression coefficients of evening versus day shifts and night versus day shifts are both positive. After controlling for the influence of shift type, CARi remained significantly correlated with sleep quality (ΔF = 5.17, p = 0.025). The results show that female evening-shift or night-shift nurses display significantly lower CARi and experience significantly poorer sleep quality than day-shift nurses. A greater CARi in the female shift nurses represents better sleep quality. Furthermore, the results prove that CARi is a mediating variable influencing the sleep quality of female shiftwork nurses.

Gender segregation as a benefit - a qualitative study from Pakistan.

AIM: To explore the possibility of exploiting gender segregation as a benefit for registered female nurses. BACKGROUND: Nursing is a highly gendered profession in Pakistan with 95% of nurses comprising females who suffer from low professional status, negative identity and unfavourable work environments. METHODS: A qualitative research design was used to interview 12 nurses in management positions through purposive sampling. Face-to-face in-depth interviews were conducted to explore the views of female nurses on the benefits, if any, of gender segregation in the nursing profession. RESULTS: Content analysis identified three major categories of benefits of gender segregation for female nurses including: (1) demand for female nurses compared with demand for males, (2) resilience of female nurses in the face of difficult work environments and (3) comfort and safety of female co-workers in a male-dominated setting. CONCLUSION: Realising the benefits of gender segregation could mobilise nurse teamwork and union efforts in order to improve nurse identity, professional status and work environments. IMPLICATIONS FOR NURSE MANAGEMENT: The present study highlights the nurse manager role in advancing knowledge of gender segregation benefits, team-building for gender solidarity, control of nurse supply, union mobilization and raising community awareness for women's health development.

Percepción del paciente hospitalizado sobre el trato digno proporcionado por una enfermera-un enfermero / Perception of hospitalized patients about the proper treatment given by nurses", "_i": "

Introducción: Durante muchos años las mujeres han predominadoen enfermería, acentuándose con la división sexual deltrabajo; en la actualidad los hombres han incursionado en laprofesión, por lo que el paciente puede percibir la atención enforma distinta dependiendo del sexo del cuidador; el objetivo delestudio fue conocer la percepción del paciente hospitalizado sobreel trato digno proporcionado por una enfermera o enfermeroen un hospital de tercer nivel. Metodología: Se realizó unestudio comparativo, transversal y prolectivo tomándose unamuestra no probabilística de 48 pacientes hospitalizados que recibieronatención del personal de enfermería de ambos sexos, seaplicaron dos instrumentos acorde al indicador de calidad tratodigno modificado a escala tipo Likert para determinar si la percepcióndel paciente es buena, regular o mala con una Alfa deCronbach de 0.86. Se utilizó una prueba de c2 para la comparaciónde variables cualitativas, percepción del paciente y el sexode enfermería. Resultados: La percepción del paciente sobre eltrato digno proporcionado por las enfermeras se reportó comobuena 47 (98%) y regular 1 (2%) y por los enfermeros buena 46(96%) y regular 2 (4%). No existe diferencia en la percepción delpaciente con el sexo del personal de enfermería. Conclusión:De acuerdo a los resultados, la percepción del paciente sobre eltrato digno que proporciona el personal de enfermería es buenasin influir el sexo de éste.

Introduction: During a number of years there has been femaleprevalence in nursing, with the stress of this fact because of sexualdivision of labor. Nowadays, men have entered this profession.So patients may receive distinctive attention depending onthe sex of the caretaker. Objective: The objective of this studywas to know the perception of hospitalized patients about dignifiedtreatment provided by female or male nurses at a thirdlevelhospital. Methodology: A comparative, transversal andprolective study was performed on forty-eight patients, obtaininga non-probabilistic sample of those hospitalized patients whoreceived attention from nursing staff from both sexes. Two elementswere applied according to the quality indicator. Humanetreatment modified into Linker-type scale in order to determineif patient’s perception is good, normal/medium, or bad with aCronbach’s a (alpha) of 0.86. A c2 test was used for the comparisonof qualitative variables: patient’s perception, and nurse sex.Results: Patient’s perception about humane treatment provided by female nurses was reported as good in 47 cases (98%) andnormal/medium in 1 case (2%), and by male nurse as good in46 cases (96%) and normal/medium in 2 cases (4%). There isno difference in patient’s perception with regard to both sexesof infirmary staff. Conclusion: According to the results, patient’sperception about humane treatment provided by infirmary(nursing) staff is good, stating no difference between nursesexes.