The association between rotating shift work and increased occupational stress in nurses.

PURPOSE: The aim of this study was to investigate whether rotating shift work increases occupational stress in nurses. METHODS: This study measured shift work scheduling and occupational stress by using the Effort-Reward Imbalance model with self-reported questionnaires in a sample of 654 female nurses. RESULTS: Overcommitment risk was higher in nurses who worked rotating shifts than in those who worked day/non-night shifts (OR, 2.16; 95% CI, 1.03-4.66). However, an effort/reward imbalance was not directly associated with work schedules (OR, 1.88; 95% CI, 0.87-4.35). Among nurses working rotation rotating shifts, those who had 2 days off after their most recent night shifts showed an alleviated risk of overcommitment (OR, 0.52; 95% CI, 0.32-0.82), but those who had worked for at least one series of 7 consecutive work days per month had an increased risk of effort/reward imbalance (OR, 2.75; 95% CI, 1.69-4.48). Additionally, those who had little or no participation in planning working hours and shift scheduling and worked overtime at least three times per week during the preceding 2 months tended to have high stress. CONCLUSIONS: The nurses who worked rotating shifts tended to experience work-related stress, but their stress levels improved if they had at least 2 days off after their most recent night shift and if they were not scheduled to work 7 consecutive days. These empirical data can be used to optimize work schedules for nurses to alleviate work stress.

Effects of marital status and shift work on family function among registered nurses.

This study aims to assess the interactive effect of marital status and shift work on family function. A population-based sample of 1,438 nurses between the ages of 20-45 yr was recruited from Taiwan during the period from July 2005 to April 2006 using a mailed questionnaire. The self-administered questionnaire contained information about demographic data, work status, shift work schedule, and the Family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve) Scale, to evaluate family function. Compared to day shift nurses, non-night and rotation shift nurses had 1.53- and 1.38-fold (95% CI=1.09-2.14 and 1.01-1.88) risk to have poor family function after adjusting for other covariates. Married nurses, by contrast, had a 0.44-fold (95% CI=0.29-0.66) risk to have poor family function compared to single nurses. In addition, married nurses who worked non-night or rotation shifts had a significantly higher percent of poor family function than those married nurses working day shifts; however, similar results were not replicated in single nurses. We concluded that shift work and marital status could influence family function.

Atypical work schedules are associated with poor sleep quality and mental health in Taiwan female nurses.

PURPOSE: To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan. METHODS: This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6-10 months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12). RESULTS: Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.26; 95% CI, 1.57-3.28; and OR, 1.91; 95% CI, 1.39-2.63, respectively). Additionally, rotation shift nurses who had ≥2 days off after their most recent night shifts showed significantly improved sleep quality and mental health (PSQI decreased of 1.23 and CHQ-12 decreased of 0.86, respectively). Comparison of sleep quality between the first and second surveys showed aggravated sleep quality only in nurses who had an increased frequency of night shifts. CONCLUSION: Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses.

Adherence to management after occupational exposure to bloodborne pathogen among health care workers in Taiwan.

The study purpose was to investigate the adherence to postexposure management of health care workers (HCWs) in Taiwan. A total of 685 HCWs of 1164 HCWs who had reported exposure incidents during 2003-2005 completed questionnaires. Only 33% of the 567 exposed HCWs adhered to the postexposure management. Adherence was associated with percutaneous injury and knowledge of the seropositive status of source patients. Regular follow-ups for seroconversion testing are essential to improving the quality of postexposure management.

Evaluating work ability and quality of life for clinical nurses in Taiwan.

This study investigated the work ability and its relationship with quality of life for the clinical nurses in Taiwan. The survey was of 1534 nursing professionals from 8 different hospitals. Work ability of nursing professionals varied by age, work experience, working departments and hospital types. Work ability of nurses increased with age until after the age of 45. Personal health condition and physical workload were the main factors contributing to the decline of the perceived work ability for senior nurses. For young nurses, the mental demands of work were a critical influence on their work ability. Moreover, work ability of nurses varied among hospital type and department. The work ability of nurses was strongly associated with the quality and safety of the work environment and leisure time management. For improving and maintaining the work ability of nurses, countermeasures such as enhancing the ability to cope with the job's mental demands for young nurses, and improving the job design to reduce physical workload for senior nurses are recommended.

Attitudes toward gay men and lesbians and related factors among nurses in Southern Taiwan.

OBJECTIVES: The aims of this study were to explore different dimensions of the attitudes toward gay men and lesbians among nurses in southern Taiwan and to examine the association between attitudes and intention to provide care to homosexual individuals. The factors related to attitudes towards gay men and lesbians by nurses were also examined. METHODS: In total, 1824 nurses from a medical centre and two regional teaching hospitals in southern Taiwan were recruited into this study. We used the Attitudes Toward Homosexuality Questionnaire (ATHQ) to examine four-dimensional concepts toward homosexuality among nurses. The association of attitudes with the intention of taking care of homosexual patients was examined. Correlations of attitudes toward homosexuality with demographic and occupational data, sexual orientation, knowledge about homosexuality, and experiences of having contact with gay men and lesbians were examined using a stepwise multiple linear regression. RESULTS: Participants had the most negative attitude toward homosexuality in the 'contact' and 'stereotypes' dimensions, followed by the 'morality' dimension and then the 'condemnation/tolerance' dimension. Nurses with more negative attitudes toward homosexuality had lower intentions of taking care of patients with a homosexual orientation. Nurses who had friends or relatives with a homosexual orientation, had a higher educational degree, and had provided care to homosexual patients were more likely to have positive attitudes toward homosexuality. In contrast, nurses who had worked for a longer period, labelled themselves as being absolutely heterosexual, and were religious were more likely to have negative attitudes toward homosexuality. CONCLUSIONS: The factors related to attitudes toward homosexuality identified in this study have to be taken into consideration when intervening for nurses' attitudes toward gay men and lesbians.

Correlates of attitudes toward homosexuality and intention to care for homosexual people among psychiatric nurses in southern Taiwan.

This study examined the association between attitudes toward homosexual individuals and intention to provide care and demographic and occupational factors, sexual orientation, knowledge about homosexuality, and experiences of contact with homosexual people among psychiatric nurses in southern Taiwan. In total, 133 psychiatric nurses from a medical center, three regional teaching hospitals, and one psychiatric hospital in southern Taiwan were recruited into this study. Their attitudes toward homosexual people as recorded on the Attitudes Toward Homosexuality Questionnaire, intention to provide care to homosexual individuals, and related factors were examined. The results revealed that psychiatric nurses who had a bachelor's or master's degree, higher level of knowledge about homosexuality, and friends or relatives with a homosexual orientation had a more positive attitude toward homosexuality. These psychiatric nurses, with more positive attitudes, and who worked in the medical center or regional teaching hospitals had a higher intention to care for homosexual people. The factors related to attitudes toward homosexuality and intention to care for homosexual people identified in this study should be taken into consideration when intervening in psychiatric nurses' attitudes toward homosexuality and intention to care for homosexual people.

Job strain and minor psychiatric morbidity among hospital nurses in southern Taiwan.

Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. The purpose of this study was to identify the degree of job strain and to investigate the association between job strain and the minor psychiatric disorder in hospital nurses. A total of 907 registered nurses were recruited for this study via stratified random sampling from hospitals in Kaohsiung, Taiwan. Each participant was requested to answer a structured questionnaire anonymously and a 98.1% response rate was achieved. The Job Strain Questionnaire was used to measure job strain. The minor psychiatric disorder was measured by the Chinese Health Questionnaire, and a cut-off score of 4 or more was used to identify which subjects had minor psychiatric disorder. Results indicated that 24.5% of the nurses were in the high strain group and that those who were unmarried, had a lack of social support, and those with shift work were the most susceptible to high job strain. A total of 443 (48.8%) respondents were identified as having minor psychiatric disorder. Multiple logistic regression revealed that high job strain, poor social support, and poor self-perceived health were the significant factors for nurses to have minor psychiatric disorder. These findings suggested that the best way to decrease the prevalence of psychological distress of nurses might focus on organizational attempts to reduce work stress and to develop effective health promotion programs and give more assistance to nurses who have a managerial role.

Applying theory of planned behavior to predict nurses' intention and volunteering to care for SARS patients in southern Taiwan.

Severe acute respiratory syndrome (SARS) spread worldwide after an outbreak in Guangdong Province, China, in mid-November 2002. Health care workers were at highest risk of infection. The purpose of this study, which was based on Ajzen's theory of planned behavior (TPB), was to determine the extent to which personal attitudes, subjective norms, and perceived control influence nurses' intention and volunteering to care for SARS patients. After the SARS outbreak, a total of 750 staff nurses (response rate 90%) at one hospital completed a questionnaire assessing their intention to provide care to SARS patients. Overall, 42.7% of nurses had a positive intention to provide care to SARS patients, and 25.4% of nurses would volunteer to care for SARS patients. Four factors explaining 35% of the variance in nurses' intention to care for SARS patients were self-efficacy (beta = 0.39, p < 0.001), attitude (beta = 0.25, p < 0.001), years of working in the study hospital (beta = -0.15, p < 0.001), and receiving resources from the hospital (beta = 0.13, p < 0.001). Two factors explaining 15% of the variance in nurses' volunteering to care for SARS patients were intention (beta = 0.31, p < 0.001) and attitude (beta = 0.15, p < 0.001). The final model shows that the variables of the TPB contributed significantly to the explanation of a portion of variance in nurses' intention and volunteering to care for SARS patients. The results are helpful for human resources managers facing a new contagious disease.