Sickness Presenteeism in Shift and Non-Shift Nurses: Using the Fifth Korean Working Conditions Survey

How Shift Nurses' Presenteeism is Related to Insomnia and Care Left Undone: A Cross-Sectional Study Using Generalised Structural Equation Modelling

AIM

To examine the association between nurses' insomnia, presenteeism and care left undone and explore the mediating effect of presenteeism on the relationship between insomnia and care left undone among nurses in acute care hospitals, applying a dynamic model of presenteeism and absenteeism.

DESIGN

A cross-sectional design.

METHODS

A secondary data analysis was conducted using online survey data collected in January 2023. Participants were 1154 registered nurses who provided direct nursing care to patients in tertiary or general hospitals (hospitals with 300 or more beds) in South Korea. Poisson regression analysis was used to examine the association between nurses' insomnia, presenteeism and care left undone. Generalised structural equation modelling was performed to examine the mediating effect of presenteeism on the relationship between insomnia and care left undone.

RESULTS

The prevalence of insomnia was 15.3%. More than half of the participants (63.7%) reported experiencing presenteeism in the past 4 weeks. All reported at least one nursing care left undone during their last shift. Insomnia and presenteeism were positively associated with care left undone, and presenteeism mediated the relationship between insomnia and care left undone among nurses in acute care hospitals.

CONCLUSION

Nurses experienced insomnia and presenteeism, related to higher rates of care left undone. Nurses' insomnia had a direct effect on care left undone and an indirect effect through presenteeism.

IMPLICATIONS FOR THE PROFESSION

Nurse managers and administrators need to make greater efforts to reduce insomnia and presenteeism among nurses, thereby reducing care left undone and improving patient safety in acute care settings.

IMPACT

Nurse managers and administrators should consider proactive interventions to address nurses' insomnia and foster a workplace with healthy systems and culture to reduce sleep disturbance and presenteeism, which can effectively decrease care left undone.

REPORTING METHOD

STROBE guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Presenteeism and missed nursing care: a descriptive, correlational and observational study

BACKGROUND

Missed nursing care poses a significant challenge for healthcare staff in terms of patient safety and care quality.

OBJECTIVE

To evaluate presenteeism and missed care attitudes of nurses and to determine the correlation between presenteeism and missed care.

METHODS

This descriptive, correlational, and observational study was conducted between February and August 2023. The Stanford Presenteeism Scale-Short Form and the MISSCARE Survey were used to collect the data among nurses at two public hospitals in a city in Turkey. The study was completed with 229 nurses representing 27.4% of the total number of nurses who met the inclusion criteria. The data was analyzed using a comprehensive analytical approach, including Cronbach's alpha analysis, frequency and percentage distribution, the Shapiro-Wilk test of normality, correlation coefficient analysis, Pearson correlation coefficient, and the Bonferroni test.

RESULTS

The participants' mean age was 30.22 ± 7.14 years, and 74.2% of them were female. 53.3% of the participants reported difficulty providing patient care due to material shortages, and 62.9% experienced challenges delivering care due to the intensity of paperwork in the clinic. Nurses who felt that paperwork intensity affected patient care and were not confident in their care provision had higher levels of presenteeism (p = 0.041) and a significantly higher frequency of missed care instances (p < 0.001).

CONCLUSIONS

Material shortages and high paperwork intensity are contributing factors to the difficulties experienced by nurses in their practice. These difficulties may lead to an increase in presenteeism and instances of missed nursing care. It is important to address these challenges to ensure adequate care provision and reduce the likelihood of presenteeism among nurses. The correlation between presenteeism and instances of missed nursing care highlights the impact of presenteeism behaviors on the quality of patient care.

Examining presenteeism and productivity losses among nursing workers: a cross-sectional study

Objective

To characterize presenteeism and productivity losses among nursing professionals in public and private health services.

Method

A cross-sectional study was conducted with 123 participants from a public hospital and 159 from a private hospital in Manaus, Brazil. The Sociodemographic Health Questionnaire was utilized to assess presenteeism, while the Work Limitations Questionnaire measured productivity losses. Data were analyzed using non-parametric methods.

Results

Health-related work loss and presenteeism were reported by 50.41% of public sector professionals and 39.62% of private sector professionals. Despite this, presenteeism was more prevalent in the private sector (93.65%) compared to the public sector. Common health issues included musculoskeletal (26.49%), mental/behavioral (19.21%), respiratory (17.22%), neurological (16.56%), and gastrointestinal (5.96%) conditions. Additionally, 54.24% of private sector professionals and 44.23% of public sector professionals did not seek treatment. The private sector exhibited greater limitations in receiving care due to time management (40.34%), mental-interpersonal tasks (49.95%), production tasks (52.54%), and physical tasks (61.30%), resulting in higher productivity losses among nurses (13.46%) and nursing technicians (15.82%). High-complexity sectors demonstrated the greatest productivity losses.

Conclusion

The study identified significant differences in the characteristics of presenteeism and productivity losses between nursing professionals in the public and private health sectors. These results point to the need to improve management and occupational safety and regulatory measures to solve workers' health problems and mitigate presenteeism and productivity losses in the public and private health sectors.

Presenteeism and sleep duration on workdays and days off

BACKGROUND

Presenteeism refers to being present at work but experiencing reduced productivity due to health problems, and has been known to be related to sleep loss. Workers commonly sleep longer on days off than on workdays, and presenteeism may be reduced with extended sleep on days off.

AIMS

This study aimed to determine the association between sleep duration both on workdays and days off and presenteeism.

METHODS

The participants were 1967 workers who engaged in work for 5 days and rested for 2 days weekly. Sleep duration was classified into less than 6 hours (short; S), 6-8 hours (medium; M), and 9 hours or longer (long; L), for workdays and days off, respectively. Presenteeism was assessed using the World Health Organization Health and Work Performance Questionnaire.

RESULTS

On both workdays and days off, compared to medium sleep duration, short sleep duration was significantly associated with increased odds of presenteeism. The odds of presenteeism were significantly increased for S-S (odds ratio [OR] 2.17, 95% confidence interval [CI]1.40-3.37), S-M (OR 1.59, 95% CI 1.14-2.22), S-L (OR 2.71, 95% CI 1.05-7.00), and M-S (OR 6.82, 95% CI 2.71-17.17) combined sleep duration for workdays and days off, respectively, compared to an M-M (reference).

CONCLUSIONS

Sleep loss on workdays cannot be compensated for with longer sleep on days off. This study suggests that sufficient sleep duration on both workdays and days off is important for reducing presenteeism.

Relationships among meal time, break time and workplace characteristics of nurses who work day, evening and night shifts: a cross-sectional study

Objectives. This study aimed to examine the relationships among shift-working nurses' meal time, break time and workplace characteristics. Methods. The cross-sectional study analyzed 351 questionnaires from 117 nurses who worked three shifts, drawn from eight nursing units in two tertiary hospitals located in South Korea. Meal time and break time during work were investigated through a questionnaire that participants completed immediately after the end of each shift. Regression analysis was conducted to investigate the associations between nurses' work characteristics and meal time and break time. Results. Meal time and break time were less than 30 min on all shifts and significantly longer on the night shift than on the other shifts. As patients' average length of stay increased, meal time increased on day and night shifts, while break time decreased on evening shifts. Overall, a higher nursing staff-to-patient ratio was associated with shorter meal and break times. Conclusions. It was found that nurses were not able to take proper time for meals and breaks while working. A realistic and specific strategy should be prepared to address this issue, with appropriate consideration of the specific characteristics of nurse staffing, patients' conditions and shifts.

Evaluation of absenteeism and presenteeism status of factory employees

BACKGROUND

While absenteeism refers to not attending work, presenteeism is defined as not being present at work. These two conditions, which negatively affect employee health, can be indicators of work efficiency, work peace, work safety and work engagement.

OBJECTIVE

Several factors were evaluated in this study concerning absenteeism and presenteeism among factory workers.

METHODS

This cross-sectional study was conducted among workers in a factory operating in a heavy industry in southern Turkey in 2021. A survey consisting of 57 questions was applied to 152 factory workers by face-to-face interview method. The participants' behaviour over the last month was evaluated regarding absenteeism and presenteeism.

RESULTS

It was reported that 24 (15.8%) of all employees were absent from work in the last month (absenteeism), excluding holidays and sick leave, and that 20 (13.2%) employees engaged in presenteeism, working when they should not have been at the workplace. There was a high absenteeism rate among employees who had an acute illness and were dissatisfied with their jobs. Several factors have been associated with presenteeism, including poor economic conditions, family health problems, previous unemployment, working overtime, job dissatisfaction, poor relationships with colleagues and difficulty finding a replacement, acute illness, sleep problems and fatigue.

CONCLUSIONS

To increase the productivity and commitment of employees, it may be useful to identify the reasons for absenteeism and present behaviours, to facilitate effective interpersonal communication skills by examining the organisational climate of employees, and to regulate workload based on a comprehensive assessment of the health status of employees.

Factors related to career interruption and Re-employment of women in human health and social work activities sector: Comparison with other industry sectors

AIMS

This study aims to examine the factors related to career interruption and re-employment of women who had worked or were working in the human health sector and to compare them with those in other industrial sectors.

DESIGN

Secondary data analysis study.

METHODS

Data from the 2019 economic activities survey of career-interrupted women of South Korea was used, and 2570 participants were included in the analysis.

RESULTS

Women who had majored in health care and had worked, or were working, in the human health and social work activities sector showed a higher tendency to work more than 40 h per week, compared to the mean of all participants. Moreover, parental leave and flexible working time were related to career interruption and re-employment.

PATIENT OR PUBLIC CONTRIBUTION

Policies that encourage the use of parental leave and flexible shift work systems should be developed and implemented to prevent career interruption of women in the health sector.

The Effects of Job Demand-control-support Profiles on Presenteeism: Evidence from the Sixth Korean Working Condition Survey

Background

Presenteeism is closely related to work performance, work quality and quantity, and productivity at work. According to the job demand-control-support model, job demand, job control, and support play important roles in presenteeism. The present study investigated job characteristics profiles based on the job demand-control-support model and identify the association between job characteristics profiles and presenteeism.

Methods

This secondary data analysis used the Sixth Korean Working Condition Survey, a nationwide cross-sectional dataset. The study included 25,361 Korean wage workers employed in the workplace with two or more workers. Participants were classified into four job characteristics profiles based on the job demand-control-support model, using latent profile analysis, and logistic regression was performed to examine the association between study variables.

Results

Overall, 11.0 % of study participants reported experience of presenteeism in the past 12 months. Age, sex, location, monthly income, shift work, work hours, health problems, and sleep disturbances were significantly associated with presenteeism. The rate of presenteeism was the highest in the passive isolate group. The passive collective, active collective, and low-stain collective groups had a 23.0%, 21.0%, and 29.0% lower likelihood of experiencing presenteeism, respectively, than the passive isolate group.

Conclusions

The job demand-control-support profiles and the risk of presenteeism were significantly associated. The most significant group that lowered the experience of presenteeism was the low-strain collective group, which had a low level of demand and high levels of control and support. Therefore, we need a policy to reduce job demand and increase job control and support at the organizational and national levels.

Association between sickness presenteeism and depressive symptoms in Korean workers during the COVID-19 pandemic: A cross-sectional study

BACKGROUND

During the COVID-19 pandemic, Korean workers have reported various types of sickness presenteeism (SP: continuing to attend work during illness). Understanding SP through mental health perspectives will help to make practical strategy for better working conditions. We examined the association between SP and depression among Korean workers during the COVID-19 pandemic in relation with the socioeconomic and lifestyle factors.

METHODS

Data from the 2020 Korean Community Health Survey were used as a representative nationwide sample dataset. We surveyed the experience of depression in the last two weeks from individuals who worked more than a week recently. We investigated the associations between SP and depressive symptoms. Depressive symptoms were scored using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression analysis was performed to examine the significance of the associations.

RESULTS

Analysis of the data obtained from 84,514 participants revealed that 1700 (2.2 %) participants reported experiencing depressive symptoms in 2020. Employees with SP showed higher association with depressive symptoms than employers or self-employed individuals (OR = 2.18, 95 % CI: 1.85, 2.56 among employees vs. OR = 1.76, 95 % CI: 1.29, 2.40 among employers or self-employed individuals).

CONCLUSION

SP has become more prominent during the COVID-19 pandemic. A protective strategy against SP among vulnerable workers is necessary for a healthier and safer society.

A comparative analysis of the work environments for registered nurses, nurse aides, and caregivers using the 5th Korean Working Conditions Survey

BACKGROUND

Since the quality of work life of healthcare workers is affected by various factors, an improvement in their work environment can reduce the burden on them, increasing their performance. This study aimed to identify the current problems in working environments for registered nurses (RNs), nurse aides (NAs), and caregivers using the 5th Korean Working Conditions Survey (KWCS), presenting measures to improve working conditions by analyzing their predictors: 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working patterns, 3) work-family balance, 4) work situations, and 5) self-rated health.

METHODS

The sampling frame was a list of apartment and general survey zones, excluding islands, dormitories, special social facilities, tourist hotels, and foreigner zones, among the total survey zones of the 2010 Population and Housing Census. The KWCS was given to 50,205 participants of various occupations, and responses from 494 RNs, 201 NAs, and 505 caregivers were extracted to compare their 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working pattern, 3) work-family balance, 4) work situations, and 5) self-rated health.

RESULTS

The response rate was 0.449. There were significant differences in all the variables (exposure to musculoskeletal and mental work-related risk factors, working pattern, work-family balance, work situations, self-rated health, and satisfaction with working conditions) among RNs, NAs, and caregivers (p < 0.001). The degree of work-related musculoskeletal and mental risk exposure was higher among caregivers and RNs than among NAs; irregular working patterns, challenges with work-family balance, and work environment satisfaction were higher among caregivers than among NAs. In addition, work situations were poorer among caregivers and NAs than among RNs. Self-rated health was the highest among caregivers, followed by RNs and NAs. The most potent predictor of self-rated health was occupation, followed by work environment satisfaction and work-family balance; the most potent predictor of work environment satisfaction was self-rated health, followed by degree of exposure to work-related musculoskeletal and mental risk factors, occupation, work-family balance, work situation, and working patterns.

CONCLUSION

This study confirmed that a variety of factors influence work environment satisfaction. Thus, practical and realistic measures to improve work environments tailored to each healthcare occupation should be developed at the national and community levels. Further qualitative studies are needed to analyze the work environments of nurses and other care workers in depth.

How Psychosocial Safety Climate Helped Alleviate Work Intensification Effects on Presenteeism during the COVID-19 Crisis? A Moderated Mediation Model

Healthcare sector organizations have long been facing the issue of productivity loss due to presenteeism which is affected by psychosocial safety climate (PSC) and work intensification. Presenteeism has visibly increased among nurses during COVID-19 pandemic period. Grounded in COR theory and sensemaking theory, the current study aimed to examine the role PSC plays as driver or moderator to reduce presenteeism by lessening work intensification over time and the impact of work intensification over time on presenteeism during the COVID-19 pandemic. Adopting a time-lagged research design, this study gathered data from randomly selected registered nurses, practicing in Québec, Canada in two phases, i.e., 800 at Time 1 and 344 at Time 2 through email surveys. The study results showed that (1) PSC reduces presenteeism over time by reducing work intensification at time 1; (2) PSC moderates the relationship between work intensification at time 1 and work intensification at time 2; and (3) PSC as moderator also lessens the detrimental effect of work intensification at time 2 on presenteeism at time 2. Presenteeism among nurses affects their health and psychological well-being. We find that PSC is likely an effective organizational tool particularly in crises situations, by providing an organizational mechanism to assist nurses cope (through a resource caravan, management support) with managing intensified work.

Nurses' steps, distance traveled, and perceived physical demands in a three-shift schedule

BACKGROUND

The physical job demands of hospital nurses are known to be very high. Although many studies have measured the physical activities of nurses subjectively using questionnaires, it remains necessary to quantify and measure nurses' physical activity at work using objective indicators. This study was conducted to address this gap in the literature by analyzing nurses' physical activity using both objective measurements and subjective perceptions. The number of steps, distance traveled, and actual work hours were measured during work, and the influence of related factors was analyzed.

METHODS

Using a cross-sectional design, survey and activity tracking data were collected from nurses who worked in three shifts in two tertiary hospitals located in the capital region of South Korea. The participants comprised 117 nurses working in four different units (medical ward, surgical ward, intensive care unit, emergency room), and data from 351 shifts were used in the final analysis. Between-group differences in the main variables were analyzed using the t-test, the Mann-Whitney test, analysis of variance, or the Kruskal-Wallis test, as appropriate. The relationships were examined through multiple linear regression analysis.

RESULTS

The average number of steps and distance traveled were greatest for nurses working in the emergency room, followed by the intensive care unit, surgical ward, and medical ward (in descending order). Younger nurses and those with shorter unit experience tended to have the greatest number of steps and distance traveled.

CONCLUSION

Using activity trackers, this study derived physical activity measures such as number of steps and distance traveled, enabling an objective examination of physical activity during shifts. Nurses' level of physical activity differed depending on the type of nursing unit, nurses' age, and unit experience. These results suggest the need for support programs that are specific to the job demands of specific nursing units.

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.

Working conditions in essential occupations and the role of migrants

Following a national lockdown in response to the Covid-19 pandemic, state governments in Germany published lists of "essential" occupations that were considered necessary to maintain basic services such as health care, social care, food production and transport. This paper examines working conditions in these essential occupations and identifies clusters of similar jobs. Differences across clusters are highlighted using detailed data on job characteristics including working conditions, tasks and educational requirements. Two clusters with favourable or average working conditions account for more than three-quarters of jobs in essential occupations. Another two clusters, comprising 20% of jobs in essential occupations, are associated with unfavourable working conditions such as low pay, job insecurity, poor prospects for advancement and low autonomy. These latter clusters exhibit high shares of migrants. An Oaxaca-Blinder decomposition is used to investigate which individual characteristics explain why migrants are more likely to have unfavourable working conditions. The results suggest that lacking proficiency in the host-country language is the main barrier to improving migrants' working conditions.

Relationship between insomnia and rest time between shifts among shift workers: A multicenter cross‐sectional study

Objectives

A rest time of less than 11 h taken by a shift worker between shifts is defined as quick return (QR). QR is shown to decrease sleep time by virtue of decreasing rest time, diminishing sleepiness and exhaustion, and increasing the number of sick days taken by employees. Therefore, in this multicenter retrospective study, the association between QR and the incidence of insomnia was established using the night‐shift questionnaire from the Korean Workers Health Examination‐Common Data Model.

Methods

Three hospitals collected the night‐shift profiles and baseline demographic data of 33 669 workers between January 2015 and December 2017. The most recent date of examination was used for participants who had been examined multiple times at the same institution. We used multiple logistic regression to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). The pooled ORs were estimated using combined results from the three institutions.

Results

The proportion of men was higher than that of women in the QR group at each institution. The pooled ORs were computed using combined data from the three institutions. Workers who reported a QR had the highest risk of sleeplessness (OR, 1.21; 95% CI, 1.12–1.31) compared to those workers who reported a slow return, after adjusting for possible confounders.

Conclusions

A substantial correlation was established between QR and insomnia using the CDM approach and data from multiple centers. This study may serve as a foundation for developing guidelines to enhance the health of shift workers and prevent occupational accidents.

Global prevalence of presenteeism in the nursing workforce: A meta-analysis of 28 studies from 14 countries

AIMS

This study aimed to estimate the overall presenteeism prevalence in the nursing workforce.

BACKGROUND

Nurses are more prone to presenteeism, which is associated with adverse outcomes for both nurses and patients. However, comprehensive information on the global prevalence of presenteeism in nursing workforce is lacking. Evaluation Seven databases were systematically searched without year or language restrictions in July 2021. Studies that reported the prevalence rate of presenteeism among nurses were included. A meta-analysis was performed using a random-effects model. Key issues A total of 28 studies from 14 countries were included. The overall pooled estimate of presenteeism prevalence among nursing workforce was 49.2% (95% CI: 0.411, 0.574). Subgroup analyses showed that the prevalence of presenteeism was higher when the reporting time frame was > 1 month and < 1 year compared with ≤ 1 month or ≥ 1 year.

CONCLUSION

The results of this meta-analysis showed the substantial prevalence of presenteeism in the nursing workforce with variations across different reporting time frames.

IMPLICATION FOR NURSING MANAGEMENT

The findings can be used to support nurse managers, administrators, and policymakers in recognizing the prevalence of presenteeism and developing relevant prevention strategies against presenteeism among global nursing workforce.

Serial-Multiple Mediation of Job Burnout and Fatigue in the Relationship Between Sickness Presenteeism and Productivity Loss in Nurses: A Multicenter Cross-Sectional Study

Background:

In China, sickness presenteeism, job burnout, and fatigue are common among nurses during the COVID-19 pandemic. We propose the prevalence of sickness presenteeism can adversely affect nurses' physical and mental health, negatively impact their work productivity and quality, and pose a threat to patients' safety. Therefore, this study examines the mechanism of productivity loss caused by sickness presenteeism, fatigue, and job burnout.

Objectives:

To investigate the serial-multiple mediating effect of job burnout and fatigue in the relationship between sickness presenteeism and productivity loss among nurses.

Methods:

A multicenter cross-sectional survey was undertaken by administering an online questionnaire from December 2020 to May 2021. Stratified cluster sampling was used to include 3,491 nurses from 14 hospitals in Shandong Province, China. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Chalder Fatigue Scale, and Maslach Burnout Inventory. Data analyses were carried out using descriptive statistics, one-way analysis of variance, independent-samples t-test, Pearson correlation analysis, hierarchical regression, and bootstrapping method.

Results:

From the 3,491 nurses who volunteered in this online survey, only 2,968 valid questionnaires were returned. Sickness presenteeism exhibited a prevalence of 70.6% during the COVID-19 pandemic. The average score of health-related productivity loss was 15.05 ± 4.52, fatigue was 8.48 ± 3.40, and job burnout was 39.14 ± 19.64. Sickness presenteeism was positively associated with fatigue and job burnout while job burnout was positively associated with nurse fatigue. Sickness presenteeism, fatigue, and job burnout were also positively correlated with health-related productivity loss. Statistically significant paths via the single mediation of fatigue and job burnout were established. A statistically significant serial-multiple mediating effect of fatigue and job burnout on the association between sickness presenteeism and productivity loss accounted for 35.12% of the total effect size.

Conclusions:

There was a high incidence of sickness presenteeism and job burnout among Chinese nurses. High-frequency sickness presenteeism may result in increased productivity loss through the two mediating effects of fatigue and job burnout. Sickness presenteeism may increase fatigue, promote job burnout, and result in increased productivity loss among Chinese nurses during the COVID-19 pandemic.

Emotional Labor, Burnout, Medical Error, and Turnover Intention among South Korean Nursing Staff in a University Hospital Setting

Nurses are vulnerable to mental health challenges, including burnout, as they are exposed to adverse job conditions such as high workload. The mental health of this population can relate not only to individual well-being but also to patient safety outcomes. Therefore, there is a need for a mental health improvement strategy that targets this population. This cross-sectional survey study investigates emotional labor, burnout, turnover intention, and medical error levels among 117 nursing staff members in a South Korean university hospital; it also analyzes correlations among outcomes and conduct correlation analysis and multiple regression analysis to determine relationships among these factors. The participants had moderate to high levels of emotional labor and burnout, and 23% had experienced medical errors within the last six months. Save for medical errors, all outcomes significantly and positively correlated with each other. These results can be used to improve the mental health outcomes of nurses working in the hospital and their consequences. Specifically, the job positions of nursing personnel may be a major consideration in such a strategy, and job-focused emotional labor and employee-focused emotional labor may be promising targets in ameliorating turnover intention and client-related burnout, respectively.

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.

Exploring the Association between Sleep Quality and Heart Rate Variability among Female Nurses

The quality of nurses' work has a direct effect on patient health, and poor sleep has been positively associated with nurses' medical errors. The aim of this study was to investigate the relationship between quality of sleep and heart rate variability (HRV) among female nurses. A descriptive cross-sectional correlational study design was used in January 2014 to study female nurses (n = 393) employed in a medical center in Taiwan. Data were obtained from several questionnaires. HRV was analyzed with five-minute recordings of heart rate signals obtained using a Heart Rater SA-3000P. Approximately 96% of the participants self-reported a poor quality of sleep. Compared to non-shift nurses, significant decreases were found in total power (TP) and low-frequency HRV among shift-work nurses. However, negative correlations were found between sleep quality and HRV, including total power, low frequency, and the low frequency/high frequency ratio (r = -0.425, p < 0.05; r = -0.269, -0.266, p < 0.05). In a stepwise multiple regression analysis, 23.1% of variance in quality of sleep can be explained by TP and heart rate. The sleep quality of female nurses was poor and this affected their autonomic nervous system, which can contribute unfavorable consequences for their health.

Why Are Spanish Nurses Going to Work Sick? Questionnaire for the Measurement of Presenteeism in Nurses

Presenteeism is defined as the presence of the worker at their workplace despite not being in optimal physical or mental conditions. Presenteeism is a phenomenon that has been poorly studied in the context of healthcare. Despite the many negative consequences associated with presenteeism, to date, no studies have investigated this issue in nurses in Spain. The objective was to develop and validate a questionnaire on presenteeism to be used by nursing staff in Spain.

METHODS

A psychometric study for the development and validation of a questionnaire. The PRESENCA^® questionnaire on presenteeism was created by a panel of experts, based on a survey comprised of 31 Likert-type items.

RESULTS

In total, 355 nurses completed the questionnaire. The factorial analysis revealed the existence of 3 factors and confirmed appropriate levels of validity and reliability (alpha = 0.729).

CONCLUSIONS

The PRESENCA^® questionnaire is the first tool developed and validated in Spanish for the assessment of presenteeism in nursing. Our findings demonstrate that this scale has appropriate psychometric properties and its use may facilitate the detection of presenteeism among professionals. As a result, use of this questionnaire may contribute towards the improvement of clinical safety.