Job Characteristic Profiles and Presenteeism Among Shift Nurses: A Latent Profile Analysis Based on the Job Demands-Resources Model.

AIM(S): To investigate job characteristic profiles based on the job demands-resources (JD-R) model and the association between job characteristic profiles and presenteeism. DESIGN: Cross-sectional study. METHODS: Data were collected from shift nurses in South Korea in January 2023 using an online survey. This study included 544 nurses working in tertiary and general hospitals in South Korea. The participants were classified into four job characteristic profiles based on the JD-R model using latent profile analysis. Multiple logistic and linear regression analyses were performed to examine the association between job characteristic profiles and presenteeism. RESULTS: Four profiles were derived from the latent profile analysis: low strain-low motivation, high strain-low motivation, low strain-high motivation and high strain-high motivation. The high strain-low motivation, low strain-high motivation and high strain-high motivation groups were 1.74, 1.37 and 3.51 times more likely to experience presenteeism than the low strain-low motivation group respectively. The number of days worked while sick and the level of reduced job productivity was also the highest in the high strain-high motivation group. In addition, general health, multimorbidities and insomnia were significant factors affecting presenteeism, number of days worked while sick and productivity loss among shift nurses. CONCLUSIONS: This study found that even with higher levels of job resources, work environments with high levels of job demands were associated with higher rates of presenteeism. IMPACT: Study findings suggest that various strategies are needed to improve the physical and mental health of shift nurses, and create a healthy organisational environment by reducing excessive job demands to reduce presenteeism and increase productivity. REPORTING METHOD: STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Psychometric properties of the Korean version of the Stanford Presenteeism Scale in a nurse population.

Presenteeism, which refers to going to work despite being ill, has been associated with loss of work productivity, decreased quality of care, and an increased risk of health problems. The prevalence of presenteeism is particularly high among nurses; therefore, a reliable and valid tool is needed to assess presenteeism. This study aimed to translate the Stanford Presenteeism Scale (SPS) and to examine its psychometric properties in a Korean nurse population. A methodological study was performed in January 2023. The original SPS-6 (English-language) was translated and adapted to the Korean language using a committee approach translation, cognitive interviews, and content validation with a review panel of experts. An online survey was completed by 608 Korean nurses. The internal consistency, item-to-total correlation, construct validity, concurrent validity, and discriminant validity were examined as psychometric properties of the Korean version of the SPS. The final version of the K-SPS consists of four items shortened from the original six items. Cronbach's alpha of the K-SPS-4 was 0.74, indicating adequate reliability. Confirmatory factor analysis showed a one-factor solution with a good fit. There was a positive correlation between the K-SPS-4 and the Work Limitations Questionnaire. Discriminant validity was evidenced by the positive correlation of the K-SPS-4 with job satisfaction and the negative correlation with job stress. The K-SPS-4 has acceptable psychometric properties, supporting the feasibility of its use in assessing the level of presenteeism among Korean nurses. The validated K-SPS-4 can provide a basis for developing intervention programs to enhance productivity and promote health among nurses in clinical settings.

A systematic review and pooled prevalence of symptoms among childhood and adolescent and young adult cancer survivors.

AIMS AND OBJECTIVES: To systematically review the existing literature reporting symptoms in childhood and adolescent and young adult cancer survivors and to meta-analyse the pooled prevalence of symptoms. BACKGROUND: Cancer survivors experience various symptoms caused by cancer treatments and their late effects. These symptoms are associated with adverse health outcomes. However, estimates of symptom prevalence vary largely, and no comprehensive review of symptoms has been conducted for childhood and adolescent and young adult cancer survivors. DESIGN: A systematic review. METHODS: This systematic review is registered in PROSPERO registry and was performed following the PRISMA guidelines. PubMed, EMBASE, Cochrane Library, Web of Science, Scopus and CINAHL were searched up to July 2021. Three investigators assessed the eligibility of studies, extracted data and performed quality assessment. The pooled prevalence of symptoms was calculated using a random-effect model. Subgroup analysis was conducted to identify heterogeneity. RESULTS: Sixty-one studies were used to synthesise symptom prevalence, involving 114,184 participants. There were 24 physical symptoms and 10 psychological symptoms reported in two or more studies. The most studied physical symptoms were fatigue and sleep disturbance, and the most studied psychological symptoms were anxiety and depression. Among physical symptoms, drowsiness had the highest prevalence, followed by dry mouth and fatigue. Among psychological symptoms, worry and nervousness had the highest prevalence, followed by difficulty concentrating. CONCLUSIONS: Physical and psychological symptoms are common in the target population. This review provides an up-to-date overview of symptom prevalence, identifying areas for future research. RELEVANCE TO CLINICAL PRACTICE: Education about possible symptoms related to cancer and its treatment should be given while in treatment. Symptoms should also be monitored throughout the survivorship period. Nurses have a critical role in identifying and making referrals for psychological symptoms as well as promoting preventative strategies that enhance well-being.

Overtime and alertness of rotating-shift nurses: An observational study using ecological momentary assessment.

AIMS AND OBJECTIVES: This study aimed to determine the effect of overtime on alertness at work among rotating-shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts. BACKGROUND: Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work. DESIGN: A prospective observational study was employed. The study followed STROBE checklist for observational studies. METHODS: Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real-time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed-effect models were employed to investigate the association between overtime and alertness. RESULTS: A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous-day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous-day overtime hours and consecutive overtime days in all shifts. CONCLUSIONS: The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty. RELEVANCE TO CLINICAL PRACTICE: Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime.

Alertness during working hours among eight-hour rotating-shift nurses: An observational study.

PURPOSE: The aim of this study was to identify the patterns of the decline in the alertness of rotating-shift nurses during working hours across different shift types (day, evening, and night) using an objective measure. DESIGN: An observational study using ReadiBand wrist actigraphs was conducted. METHODS: Data were collected from June 2019 to February 2020. Participants were rotating-shift nurses (N = 82) who provided direct nursing care for patients in acute care hospitals in South Korea. Nurses wore actigraphs continuously for 14 days on their non-dominant hand to identify sleep-wake cycles and predict their alertness scores hourly. All participants completed a sleep diary. FINDINGS: Nurses working during night shifts had lower average alertness scores (mean = 77.12) than nurses working during day (mean = 79.05) and evening (mean = 91.21). Overall, alertness showed a declining trend and the specific patterns of decline differed across shifts. Participants with alertness scores less than 70 or 80 demonstrated a significant decline in alertness across all shifts. CONCLUSIONS: Distinct patterns of decline in alertness per nursing shift were revealed. Each shift feature should be considered when developing interventions to increase nurses' alertness, promote high-quality care provision, and ensure patient safety. CLINICAL RELEVANCE: The implementation of interventions to increase alertness among shift nurses is needed at the organizational level, and the cooperation of nursing managers and administrators is required.

Factors influencing quality of life among childhood cancer survivors in Korea: A quantile regression approach.

Cancer treatment in childhood may negatively affect survivors' quality of life. In this study, we aimed to determine the contributing factors for health-related quality of life (HRQOL) in survivors of childhood cancer in Korea using quantile regression analysis. This study was a secondary analysis. Data were collected from 130 childhood cancer survivors (CCS) from November 2018 to July 2019. Participants completed the Memorial Symptom Assessment Scale, Depression Anxiety Stress Scale, Health-Promoting Lifestyle Profile-II, and 36-Item Short Form Health Survey (physical component summary [PCS] and mental component summary [MCS]). Quantile and multiple linear regressions were used to analyze the factors contributing to HRQOL. The quantile and linear regression models revealed different results on the contributing factors to HRQOL in CCS. Mean PCS and MCS scores were 78.55 (SD = 15.08) and 64.02 (SD = 18.00), respectively. Symptoms (e.g., difficulty concentrating, worrying, pain, and lack of energy), physical activity, spiritual growth, interpersonal relationships, stress management, depression, and anxiety were significant influencing factors in some PCS quantiles, while symptoms, spiritual growth, interpersonal relationships, depression, and stress were significant influencing factors in some MCS quantiles. The findings of this study showed specific contributing factors in CCS with different levels of HRQOL. There is a need for targeted interventions related to risk reduction and stratification for CCS with different HRQOL levels. Symptom management strategies, early detection programs for CCS with psychological distress, and clinical and counseling interventions for CCS with poor HRQOL need to be developed.

Work schedule characteristics associated with sleep disturbance among healthcare professionals in Europe and South Korea: a report from two cross-sectional surveys.

BACKGROUND: Healthcare professionals worldwide are prone to sleep disturbance. Such sleep disturbance is associated with lower patient safety and quality of care. Therefore, this study aimed to identify the prevalence of sleep disturbance and determine the effect of work schedule characteristics on sleep disturbance among healthcare professionals in Europe and South Korea. METHODS: We used the sixth European Working Conditions Survey and the fifth Korean Working Conditions Survey for analyses. The study included 2285 healthcare professionals aged 18-65 years. Work schedule characteristics included shift work, night work, working hours per week, long work hours (i.e., more than 10 hours per shift), quick return to work, having to come to work on short notice, and changes in work schedules. A multiple logistic regression analysis was performed. RESULTS: The overall prevalence of sleep disturbance was 37.7%. The multivariate logistic regression model indicated that long work hours, quick return to, having to come to work on short notice, and changes in work schedules were significant factors associated with sleep disturbance among healthcare professionals. CONCLUSION: The findings revealed that several work schedule-related factors were associated with sleep disturbances in healthcare professionals in Europe and Korea. Institutions and policymakers should implement strategies and policies to reduce the unpredictability of work schedules to ensure an adequate rest period between shifts and to reduce sleep disturbances.

Work schedule characteristics and occupational fatigue/recovery among rotating-shift nurses: A cross-sectional study.

AIMS: To determine the effects of work schedule characteristics on occupational fatigue and recovery among rotating-shift nurses in South Korea. BACKGROUND: Understanding the effects of work schedule characteristics on occupational fatigue is important to prevent adverse nurse outcomes and to ensure patient safety. METHODS: This study used secondary data analysis with a cross-sectional design. Data were collected on 436 rotating-shift nurses in 2018. Nurses' occupational fatigue and recovery were measured using the Occupational Fatigue Exhaustion/Recovery Scale. We used quantile regression models. RESULTS: The scores for acute and chronic fatigue and intershift recovery were 70.40, 73.39, and 29.82, respectively. Overtime hours, number of night shifts, number of consecutive days off, and breaks were significant influential factors in some quantiles of acute fatigue, chronic fatigue, and intershift recovery, while total working hours was only associated with chronic fatigue in the 25th quantile. CONCLUSIONS: The quantile and linear regression models revealed different results for work schedule factors that affect occupational fatigue and intershift recovery among rotating-shift nurses. IMPLICATION FOR NURSING MANAGEMENT: These findings have important implications for developing targeted strategies and policies to reduce occupational fatigue and improve intershift recovery for rotating-shift nurses with different levels of occupational fatigue and recovery.

Effects of Work Environments and Occupational Fatigue on Care Left Undone in Rotating Shift Nurses.

PURPOSE: This study aimed to examine the effects of work environments and occupational fatigue on care left undone in rotating shift nurses, and to identify the indirect (mediation) effect of work environments on care left undone through nurses' occupational fatigue in South Korean acute care hospitals. DESIGN: This study employed a cross-sectional design using an online survey to collect data from 488 rotating shift nurses of acute care hospitals in Korea between November and December 2018. METHODS: A mobile schedule management application for shift nurses was used to advertise the study and to send a link to the online survey. The survey included questions on the nurses' work environment characteristics, care left undone activities, and the Korean version of the Occupational Fatigue Exhaustion/Recovery scale. Poisson regression was used to explore the relationships among work environments, occupational fatigue, and care left undone. Hayes' Model 4 and a bootstrapping analysis were used to identify the mediating effect of occupational fatigue on the relationship between work environments and care left undone. FINDINGS: The average number of tasks left undone was 3.45 (SD = 2.19). The higher the acute and chronic fatigue levels noted among nurses, the higher were the occurrences of care left undone. Conversely, the higher the intershift recovery level, the lower were the occurrences of care left undone. The results showed a positive relationship between care left undone and overtime hours and the number of patients per nurse. Moreover, nurses' occupational fatigue mediated the relationship between work environments and care left undone. Night shifts per month and the number of consecutive days off had an indirect effect on care left undone through occupational fatigue. CONCLUSIONS: High levels of occupational fatigue and poor intershift recovery among nurses can lead to care left undone. Nurses' occupational fatigue mediates the effect of work environment on care left undone. CLINICAL RELEVANCE: It is crucial for healthcare administrators and leaders to develop policies and mandatory regulations to facilitate better working conditions for nurses, consequently reducing their occupational fatigue and decreasing the occurrence of care left undone in acute care hospitals.

The effectiveness of digital self-management interventions on health outcomes among childhood cancer survivors: A systematic review and meta-analysis.

AIMS: The study aimed to review the evidence about existing digital interventions for childhood cancer survivors and examine their effectiveness on health outcomes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PUBMED, EMBASE, Cochrane, CINAHL, Web of Science, PsycArticles, SCOPUS and PQDT Global databases were searched, and the date last searched was 16 September 2019. REVIEW METHODS: This systematic review followed PRISMA guidelines. Randomized and nonrandomized controlled trials, as well as before-and-after studies, were included. The main outcomes were health-related quality of life and moderate-to-vigorous physical activity. Two authors independently reviewed included studies and assessed methodological quality. Meta-analysis was conducted using statistical software STATA 16.0. RESULTS: Out of the eight eligible studies, four were included in the meta-analysis. The digital self-management interventions were not effective on health-related quality of life and moderate-to-vigorous physical activity. Additionally, the digital self-management interventions increased the moderate-to-vigorous physical activity over time but was not statistically significant. CONCLUSIONS: There is insufficient evidence on the effectiveness of digital self-management interventions in improving health outcomes among childhood cancer survivors. Future randomized controlled trials should be conducted from multiple locations and should include objective measures and means to encourage interaction with health care providers. IMPACT: Digital interventions are increasingly implemented to improve health outcomes among childhood cancer survivors, but their results are inconsistent. Well-designed digital interventions may be beneficial for this population over time. The recommendations proposed in the current review may be useful for developing digital interventions and designing related studies in the future, thereby reducing late effects and improving healthy behaviours among this population.

Sleep, fatigue and alertness during working hours among rotating-shift nurses in Korea: An observational study.

AIMS: To determine the effects of sleep parameters and fatigue on the decline in alertness of nurses across shifts. BACKGROUND: Shift work can lead to nurse fatigue owing to insufficient sleep and inadequate recovery time between shifts. Nurse fatigue has adverse effects on alertness and can affect provision of quality care. METHODS: An observational study using wrist actigraphs was conducted from 2019 to 2020. Participants were 82 rotating-shift nurses who provided direct nursing care in acute hospitals in South Korea. They wore actigraphs for 14 days to measure sleep parameters and predict hourly alertness and reported subjective fatigue before and after every shift. RESULTS: Nurses demonstrated shorter sleep hours, lower sleep efficiency and longer sleep latency before night shifts compared with other shifts. Fatigue was the highest before day shifts. Sleep parameters and fatigue significantly affected the steep decline in alertness in participants with alertness scores below 70. CONCLUSIONS: Sleep parameters and fatigue level contributed to the differences in decline in alertness across shifts. IMPLICATION FOR NURSING MANAGEMENT: Findings inform nurse managers, administrators to develop interventions to reduce fatigue, improve sleep quantity and quality and increase alertness among rotating-shift nurses. Management, institutional and individual factors should be considered when developing interventions.

Symptom clusters in childhood cancer survivors in Korea: A latent class analysis.

OBJECTIVE: To identify the occurrence of late symptom effects among childhood cancer survivors (CCS), generate subgroups using a latent class analysis and determine whether the subgroups differ in demographic and health-related characteristics and health-promoting lifestyle. METHODS: A cross-sectional survey was conducted on 130 adult CCS in Korea. The Memorial Symptom Assessment Scale was used to perform a latent class analysis based on symptom occurrence to generate subgroups. RESULTS: Difficulty in concentration, lack of energy, worrying, drowsiness, irritability, pain, difficulty in sleeping, nervousness, sadness and dry mouth appeared in more than 50% of the CCS. The three symptom subgroups identified were "all high" (46.2%), "high physical moderate psych" (26.9%) and "moderate physical low psych" (26.9%). The percentage of non-smokers was the highest in the moderate physical low psych subgroup (85.7%; p = .009), and the percentage of heavy alcohol consumption was the highest in the high physical moderate psych subgroup (31.4%; p = .013). Spiritual growth scores and interpersonal relationship scores were statistically different between subgroups (F = 3.35, p = .038; F = 7.55, p = .001 respectively). CONCLUSION: The results could guide the development of intervention programmes to strengthen spiritual growth and interpersonal relationships and facilitate further examination of the causal relationship between smoking and drinking and late symptoms of CCS.

Association between nurses' breaks, missed nursing care and patient safety in Korean hospitals.

AIMS: To examine the relationship between breaks and patient safety in Korean hospitals and determine the mediating effect of missed nursing care on this relationship. BACKGROUND: Breaks during working hours can affect patient safety; however, few studies have examined the relationship between breaks and patient safety in hospitals and their findings were conflicting. METHODS: A cross-sectional online survey was conducted with 399 nurses in Korean hospitals. Multiple linear regression was used to explore the association between breaks, missed nursing care and patient safety. Model 4 of Hayes's (2018) and bootstrapping analysis were employed to identify the mediating effect of missed nursing care. RESULTS: Average break time per shift was about 15 min; most participants had breaks of less than 30 min. Missed nursing care was a complete mediator of the relationship between breaks and patient safety. CONCLUSION: Break length has an indirect effect on patient safety, medication errors and falls with injury through missed nursing care. IMPLICATIONS FOR NURSING MANAGEMENT: More discussion is needed to develop policy and mandatory regulations to ensure sufficient breaks and adequate nurse staffing to reduce missed nursing care and enhance patient safety.

Cultural beliefs about breast cancer in Vietnamese women.

BACKGROUND: This study examined factors influencing cultural beliefs associated with later-stage detection of breast cancer and determined what factors influence those cultural beliefs in Vietnamese women residing in a rural Vietnamese community. METHODS: A cross-sectional survey was conducted with 289 women aged 20-64 years from 12 villages using a self-administered structured questionnaire. Cultural beliefs were measured with a 13-item cultural beliefs scale consisting of four domains-characteristics of breast lumps, self-help techniques, faith-based beliefs, and futility of treatment. Data were collected in February 2017 and analyzed using chi-square tests, nonparametric tests, Fisher's exact tests, and multiple linear regression analyses with SPSS/WIN 24.0 statistical software. RESULTS: Although the total score was relatively low (3.4 out of 13), cultural beliefs that could contribute to later-stage breast cancer were identified. Younger women (ß = .15, p = .016) and women with a lower income (ß = .21, p < .001) held more erroneous cultural beliefs as compared to their counterparts. Most women believed they would not get breast cancer if they took care of themselves. More than one-third held cultural beliefs about breast lumps, thinking they would need to be painful and/or actively growing to be breast cancer. CONCLUSIONS: The results support the urgent need for education concerning breast cancer health promotion, including breast cancer assessment as well as guidance on evidence-based and up-to-date detection measures to change rural Vietnamese women's cultural beliefs.

Effect of nurse staffing on rehospitalizations and emergency department visits among short-stay nursing home residents: A Cross-sectional study using the US Nursing Home Compare database.

The aim of this study was to examine the effect of nurse staffing on both rehospitalizations and emergency department emergency department visits among short-stay nursing home residents in the United States. Data for 11,132 US nursing homes were drawn from the 2016 Nursing Home Compare. We found that the Five-Star Quality Rating System's staffing rating is a significant predictor for the rates of rehospitalization and emergency department visit among short-stay nursing home residents. The results also showed the importance of registered nurse staffing in nursing home caring for short-stay residents. Administrators and policy-makers can employ the findings to formulate management strategies that will reduce rehospitalizations and emergency department visits among nursing home residents.

Work schedule characteristics and fatigue among rotating shift nurses in hospital setting: An integrative review.

AIM: To systematically evaluate the effect of work schedule characteristics on fatigue among shift nurses in hospital settings. BACKGROUND: The complexity and multidimensional nature of nursing work may lead to fatigue. This review mainly focused on work schedule characteristics that may mitigate the fatigue in nurses. EVALUATION: Six databases were searched, and eight relevant research articles published between 2000 and 2018 were identified. KEY ISSUES: The reviewed articles provided evidence supporting the association of work schedule characteristics such as total working hours, overtime, shift length and number of monthly night and evening shifts with fatigue. In addition, studies provided evidence for the positive association between insufficient rest period between shifts and fatigue among shift nurses in hospital settings. CONCLUSION: The reviewed studies provided mixed results regarding the associations between work schedule characteristics and nurse fatigue. However, quick returns and days called to work on days off were consistent factors contributing to nurse fatigue. More evidence is needed to arrive at a definitive conclusion about such relationships. IMPLICATION FOR NURSING MANAGEMENT: Nursing managers and administrators need to carefully review current rotating shift system and examine its impact on nurse fatigue as well as ensure enough resting time when developing nurse schedules.

Factors affecting trust in healthcare among middle-aged to older Korean American women.

BACKGROUND: Predictors of trust in healthcare providers and the healthcare system have never been studied in Korean Americans (KA) despite the fact that trust plays an important role in health behaviors. The purpose of this study is to examine factors influencing trust in the healthcare system and providers among KA women. METHODS: Data were collected in 196 KA women examining the effects of perceived discrimination and trust on breast cancer screening in the Chicago metropolitan area. Path analysis was used to identify factors influencing trust in the healthcare system and providers. RESULTS: Acculturation was positively related to trust in healthcare providers (ß = .15, p =. 002), and discrimination in the healthcare system was inversely related to trust in healthcare providers (ß = -.60, p <. 001). Length of stay in the US was inversely related to distrust in the healthcare system (ß = -.14, p <. 001), and discrimination in healthcare was positively related to distrust in the healthcare system (ß = .60, p <. 001). Trust in healthcare providers and distrust in the healthcare system were moderately correlated (r = .51, p < .001). CONCLUSION: Higher levels of acculturation and lower levels of perceived discrimination were identified as predictors of higher levels of trust in healthcare providers. A shorter stay in the US and higher levels of discrimination were identified as predictors of higher levels of distrust in the healthcare system. Perceived discrimination is a target for interventions to enhance trust in the healthcare system, and therefore reduce healthcare disparities in KAs.

Peer Victimization, Supportive Parenting, and Depression Among Adolescents in South Korea: A Longitudinal Study.

PURPOSE: The aims of this study were to examine relationships among peer victimization, supportive parenting, and depression in South Korean adolescents and the moderating effect of supportive parenting on the peer victimization-depression relationship. METHODS: Data were drawn from the Korean Children and Youth Panel Survey performed from 2010 to 2016. The first-year middle-school panel collected from the first year of middle school to the first year of university was used, and the final sample size was 1750. Generalized estimating equation models were employed to examine relationships among peer victimization, supportive parenting, and depression. RESULTS: About 6% of participants reported the experience of peer victimization at least once during the previous year. Females were more likely to report higher level of depression compared to males. Participants who were from lower family income, reported the past experience of peer victimization, and reported less supportive parenting were more likely to report higher level of depression compare to the counterpart. The moderating effect of supportive parenting on the association between peer victimization and depression was not statistically significant. CONCLUSIONS: Participants who had experienced of peer victimization and less supportive parenting showed higher levels of depression. The supportive parenting did not have significant moderating effect on the relationship between peer victimization and depression. PRACTICE IMPLICATIONS: Future research on adolescent depression should include development of interventions targeting both adolescent students' behaviors and their parents' styles of parenting aimed at the reducing the rate of peer victimization and the level of depression among adolescents in South Korea.

Multimorbidity and its Associated Factors in Korean Shift Workers: Population-Based Cross-Sectional Study.

BACKGROUND: Multimorbidity is a crucial factor that influences premature death rates, poor health, depression, quality of life, and use of health care. Approximately one-fifth of the global workforce is involved in shift work, which is associated with increased risk for several chronic diseases and multimorbidity. About 12% to 14% of wage workers in Korea are shift workers. However, the prevalence of multimorbidity and its associated factors in Korean shift workers are rarely reported. OBJECTIVE: This study aimed to assess multimorbidity prevalence, examine the factors associated with multimorbidity, and identify multimorbidity patterns among shift workers in Korea. METHODS: This study is a population-based cross-sectional study using Korea National Health and Nutrition Examination Survey data from 2016 to 2020. The study included 1704 (weighted n=2,697,228) Korean shift workers aged 19 years and older. Multimorbidity was defined as participants having 2 or more chronic diseases. Demographic and job-related variables, including regular work status, average working hours per week, and shift work type, as well as health behaviors, including BMI, smoking status, alcohol use, physical activity, and sleep duration, were included in the analysis. A survey-corrected logistic regression analysis was performed to identify factors influencing multimorbidity among the workers, and multimorbidity patterns were identified with a network analysis. RESULTS: The overall prevalence of multimorbidity was 13.7% (302/1704). Logistic regression indicated that age, income, regular work, and obesity were significant factors influencing multimorbidity. Network analysis results revealed that chronic diseases clustered into three groups: (1) cardiometabolic multimorbidity (hypertension, dyslipidemia, diabetes, coronary heart disease, and stroke), (2) musculoskeletal multimorbidity (arthritis and osteoporosis), and (3) unclassified diseases (depression, chronic liver disease, thyroid disease, asthma, cancer, and chronic kidney disease). CONCLUSIONS: The findings revealed that several socioeconomic and behavioral factors were associated with multimorbidity among shift workers, indicating the need for policy development related to work schedule modification. Further organization-level screening and intervention programs are needed to prevent and manage multimorbidity among shift workers. We also recommend longitudinal studies to confirm the effects of job-related factors and health behaviors on multimorbidity among shift workers in the future.

Sleep Deprivation and Fatigue among Nurses Working Consecutive Night Shifts: A Prospective Observational Study.

PURPOSE: This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work. METHODS: This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis. RESULTS: Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning. CONCLUSION: Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.