Running head: DOES SHIFT WORK ADVERSLY AFFECT NURSES HEALTH?

A Literature Review
Does Shift Work Adversely Affect Nurses Health and Safety?
Avery Figliomeni
SN: 0595 350
Nisha Sutherland
Lakehead University
Nursing 1351
April 8th, 2016

I declare that this paper is my original work. Excepting where I have cited my own
previous work, this paper in its entirety, or any portion thereof, has not been submitted to
meet the requirements of any other credit course.
Student Signature: Avery Figliomeni

Date: April 8th, 2016

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

Nurses working shift work is inevitable. Shift work is work that takes place on a
schedule outside the traditional 9 am 5 pm day. To be able to provide 24-hour patientcentered care, nurses, and many other healthcare professionals need to work a variety of
different shifts, which means working throughout the night is unavoidable. Shift work
includes evening or night shifts, and early morning shifts. Health care institutions such as
hospitals, emergency rooms, long-term care facilities, and rehabilitation centres operate
24/7 and require staff to work through odd hours of the day to care for the patients and
residents. However, shift work can significantly affect nurses overall health. Many
negative health outcomes are associated with working hours that are outside our bodys
normal circadian cycle. Shift work can affect someones health in many different ways.
Shift work can cause many serious physical and mental health conditions that are
associated with being awake at strange hours of the day. It may also limit a persons
ability to live a healthy lifestyle, as it may be harder to exercise and eat healthy while one
works shift work and one's social life can also become affected and shift work can disrupt
family and personal lives. Overall, much research has been done on the adverse health
outcomes of shift work. This is a topic of interest for me as I am entering into the nursing
profession because I know that in the future I will be faced with shift work and it is
important to be educated about the outcomes that it may have on my health. Also, I
wanted to be able to have knowledge on ways to prevent these health outcomes and know
of any preventable measures that could be taken into consideration to protect my health
and other professionals health who also work in the nursing field.

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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Shift work and physiological health

Unfortunately, shift work may cause many disruptions to an individuals health
and wellbeing. Many studies have been done looking at the outcomes of shift work that
affect one's physiological health. Throughout my research, I looked at previous
investigations that looked at the different negative health risks and chronic conditions that
shift work can impose on workers.
Labyak, Lava, Turek, and Zee (2002) found that shift work affects sleep and
menstrual function in female nurses. In this particular study, 53% of women in the study
noted menstrual changes when working shift work while 47% of women reported no
change. Women, who reported changes with their menstrual cycle showed physiological
symptoms, slept approximately 1 hour less when working night shifts and reported
lengthened time to fall asleep. Labyak et al. (2002) suggest that sleep disturbances may
lead to menstrual irregularities, and change in the menstrual function may be an indicator
of shift work intolerance. Shift work often results in disturbances in circadian rhythms.
Our bodies are synchronized by a part of our brain, which is known as the circadian
clock. When this rhythm is disrupted many changes to one's body can occur. The
circadian rhythms play a very important and critical role in the regulation of many
physiological systems, including the reproductive system. Labyak et al. (2002) states in
the research that the 24-hour clock system plays an important part in regulating the
production, and the release of reproductive hormone, and in the timing of events in the
ovarian cycle so when it is disrupted many problems with the reproductive system can
arise because of the hormonal imbalance in the body. The sample size of this research
study was considerably small; researchers could have studied more subjects to get a more

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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significant outcome. However, the evidence was still reliable. It is important that female
nurses who wish to reproduce one day have accurate information on this topic so they can
protect themselves and potentially avoid infertility and other menstrual problems. This
study is relevant to my research question as it helps prove that shift work can have
adverse health effects.
Another physiological health risk that shift work imposes on workers is the risk
for metabolic syndrome. Metabolic syndrome is the cluster of any 3 of 5 conditions that
occur together and can increase an individuals risk for heart disease, stroke, and diabetes.
The five conditions that could potentially be clustered to in order for the presence of
metabolic syndrome to occur includes, increased blood pressure, high blood sugar, excess
body fat around the waist, and abnormal cholesterol or triglyceride levels. Metabolic
syndrome can have many adverse health effects on the body. Pietroiusti, Neri, Somma,
Coppeta, Iavicoli, Bergamaschi, and Magrini (2010) found the incidence of metabolic
syndrome among night-shift healthcare workers. Male and female nurses free from any
component of metabolic syndrome at baseline were evaluated annually for the
development of the disorder over a 4 years time period. The cumulative incidence of
metabolic syndrome was 9.0% among night shift workers and 1.8% among daytime
workers. Pietroiusti et al. (2010) found that the risk of developing metabolic syndrome is
strongly associated with nurses who work night shift work. This study was strong as it
examined both male and female and was conducted and examined annually for four
years. At baseline, all participants were free from any component of metabolic syndrome,
which made the results of the study very reliable in the end. Many of the subjects in this
study were censored throughout the 4-year period because they did not meet the criteria,

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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which was good because if they had stayed as part of the population it potentially could
have had an affect on how reliable to results were. This study is relevant to my research
question as it helps prove that shift work can have adverse health effects. My reason for
viewing this topic is to gain information on the connection between shift work and
metabolic syndrome.
Shift work and mental health
Numerous studies have revealed the negative health effects that shift work
imposes on nurses and many other professionals. Shift work has been shown to have
many serious effects on ones mental and emotion health status. Throughout my research
on the topic, I looked at previous studies that looked at different adverse mental health
outcomes that are a correlation with shift work.
Lee, Kim, Kim, Lee, and Kim (2015) found an association between shift work and
severity of depressive symptoms among female nurses. The aim of this study was to
determine the occurrence of depression and the association between shift work and
depression severity among female nurses. Lee et al. (2015) found that 35.2% of nurses
studied experienced severe depressive symptoms and 3.1% of nurses experienced normal,
mild, moderate, severely moderate and severe level of depressive symptoms. Lee et al.
(2010) found that the occurrence of depressive symptoms among nurses who worked
shifts was greater than those who did not work night shifts and suggests that shift work
may increase the severity of depressive symptoms among female nurses in South Korea.
This study only included those nurses with valid email addresses, which limits the sample
size to those who only had access to a computer or Internet connection at the time
participants, were being selected. Also the fact that subjects were not scanned at baseline

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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for any symptoms of depression or no health history was observed, this study could have
had unreliable results. Overall the results of this study were significant as a greater risk of
depressive symptoms occurred in those subjects who worked shift work, and that is what
this study was investigating. Depression is very serious and if it is happening as a cause
of shift work I think that it should be taken seriously, and people who do experience
depressive symptoms should seek help and guidance and possibly switch shift schedules.
I think that it is important for nurses to know that shift work may have many unhealthy
effects on their mental and emotional health.
Another study was conducted to examine the adverse mental health effects that
shift work can trigger. Lin, Liao, Chen, and Fan (2014) found the impact of shift work on
nurses' job stress; sleep quality and selfperceived health status. Stress is something that
is very important when it comes to nursing. The feeling of being stressed puts a very
heavy weight on your shoulders and it is hard to focus on important things and work
when you are stressed. Stress acts as a barrier to providing safe, ethical care to patients.
Lin et al. found in their cross-sectional study that regardless of the amount of shift work
performed, nurses reported moderate job stress; poor sleep quality and moderate selfperceived health when taking part in any shift work. In this study the highest level of job
stress that was reported was from self-perceived fatigue. This was a cross-sectional study
that did show significant results but a longitudinal study potentially could have shown
more reliable results. Overall the results of this study show that shift work can contribute
to a great deal of stress in ones life and it is important for nurses to be aware of these
effects of shift work. Ones mental health is very important and if it can be avoided
should not be affected by working shift work.

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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Lifestyle behaviors
Shift work can have an effect on the healthy lifestyle behaviors of an individual as
it can sometimes interfere with healthy eating habits and regular physical activity
routines. Some studies have been done to see if there is a correlation between shift work
and lifestyle behaviors outcomes. Although not a significant amount of evidence has been
seen, shift work can have a small effect on a persons health as a result of certain lifestyle
behaviors when working shiftwork.
Much research has been conducted on body mass index scores, and throughout
my study on the topic of adverse health outcomes of shift work, I looked at how shift
work has an effect on ones body mass index scores. Body mass index is a measure one's
self-reported weight multiplied by their height, which gives a score indicating whether
they are underweight, overweight, or obese. Smith, Fritschi, Reid, and Mustard (2013)
studied the relationship between shift work and body mass index among Canadian nurses.
Overall provinces and territories in Canada, a total of 9291 subjects completed a
telephone questionnaire. Body mass index, shift schedule, working conditions, health
behaviors, and employee-supported facilities were all considered throughout this study.
Smith et al. found that levels of body mass index were statistically higher among
respondents working night or mixed shift schedules than among day workers. This is
relevant to my research question as it relates to adverse health outcomes of working shift
work. I think that it is important that research has been done that shows BMI scores are
significantly higher in those who work shift work so that lifestyle behaviors can be taken
into consideration and changed to help improve these scores among this population.

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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Similarly, a study conducted by, Bekkers, Koppes, Rodenburg, Steeg, and Proper
(2015) found a relationship between night and shift work with weight change and
lifestyle behaviors. A sample size of 5951 subjects was categorized into groups and
studied. The groups were categorized into subjects that worked stable night or shift work,
subjects that worked day shift but switched to the night shift, subjects who worked nights
shifts or shift work and changed to day shift, and lastly subjects who did not work night
or shift work. Bekkers et al. found that a larger weight change was seen in normalweight workers that changed from working regular day shift to working night shift work
compared to those who do not work shift work. However, further investigation needs to
be done in order to confirm a positive association of night and shift work with weight
change in other categories of subjects that were studied. One disadvantage of this study is
the duration; a study period of only one year might have been too short to detect any
significant changes. Also, the use of self-reports could have led to bias results. Overall,
this study is relevant to my research question because it is evidenced that shift work can
have an influence on weight change and lifestyle behaviors in nurses.
Discussion: Relevance to Nursing Practice
The information I have found in this review of the literature is significant to
nursing practice, as much of the evidence suggests that shift work can have a significantly
adverse effect on an individuals health. Mentioned above, nursing is a profession that
relies on around the clock care to patients so shift work is a critical part of being a nurse.
In order to be a good, reliable, nurse you need to be at your optimal health to ensure that
you can provide your patients with the best care. If shift work is getting in the way of
safely caring for yourself and your patients it's important to take control and either

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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change lifestyle behaviors that are affecting your practice or maybe even consider
changing shift schedules. However, sometimes shift work may be your only option so
being aware of the potential health outcomes of shift work can be beneficial in protecting
yourself. Many students who enter into nursing school do not realize that working
through abnormal hours of the day will disrupt many body systems and result in adverse
health outcomes, so it is important that such evidence has been found to educate current
and future nurses. Many of the health outcomes discussed throughout the literature are
linked to sleep disturbances such as the body not getting enough sleep and the body
functioning at abnormal hours and disrupting the bodys 24-hour clock. Overall, this is
very relevant and important to nursing practice, as shift work is normal and an
unavoidable part of the job.
Conclusion
After reviewing the literature, I gathered lots of information and evidence
regarding the several harms of the unavoidable shift work among nurses. Many studies
showed a significant amount of evidence, however, a limited amount of the studies only
suggested a relatively small amount of evidence that shift work negatively affects health,
which is still sufficient, but more research should be done in order to have more credible
reliable evidence. Overall, no matter how big or how small the adverse health outcome
may be, or the amount of evidence to prove it, shift work still causes disruptions to the
body and it is a topic that should be stressed as a serious matter. Infertility, menstrual
function, metabolic syndrome, depression and stress are only a few of the many physical
and mental health outcomes that shift work can cause to ones well being. As a nurse it is
very important to have information on the adverse health outcomes of shift work.

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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References
Bekkers, M. B., Koppes, L. L., Rodenburg, W., van Steeg, H., & Proper, K. I. (2015).
Relationship of night and shift work with weight change and lifestyle behaviors.
Journal of Occupational and Environmental Medicine, 57(4), e37-e44.doi:
10.1097/JOM.0000000000000427
Diaz-Sampedro, E., Lopez-Maza, R., & Gonzalez-Puente, M. (2009). Eating habits and
physical activity in hospital shift workers. Enfermeria Clinica, 20(4), 229235.doi: 10.1016/j.enfcli.2010.03.005
Hedstrm, A., Akerstedt, T., Hillert, J., Olsson, T., & Alfredsson, L. (2011). Shift work at
young age is associated with increased risk for multiple sclerosis. Annals Of
Neurology, 70(5), 733-741 9p. doi:10.1002/ana.22597
Labyak, S., Lava, S., Turek, F., & Zee, P. (2002). Effects of Shiftwork on sleep and
menstrual function in nurses. Health Care for Women International, 23(6-7), 703714. doi: 10.1080/0739933029010744 9
Lee, H. Y., Kim, M. S., Kim, O., Lee, I. H., & Kim, H. K. (2015). Association between
shift work and severity of depressive symptoms among female nurses: the Korea
Nurses' Health Study. Journal of nursing management. doi: 10.1111/jonm.12298
Lin, S. H., Liao, W. C., Chen, M. Y., & Fan, J. Y. (2014). The impact of shift work on
nurses' job stress, sleep quality and selfperceived health status. Journal of
nursing management, 22(5), 604-612 doi: 10.1111/jonm.12020
Pietroiusti, A., Neri, A., Somma, G., Coppeta, L., Iavicoli, I., Bergamaschi, A., &
Magrini, A. (2010). Incidence of metabolic syndrome among night-shift
healthcare workers. Occupational & Environmental Medicine, 67(1), 54-57 4p.
doi:10.1136/oem.2009.046797

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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11

Smith, P., Fritschi, L., Reid, A., & Mustard, C. (2013). The relationship between shift
work and body mass index among Canadian nurses. Applied Nursing Research,
26(1), 24-31 8p. doi:10.1016/j.apnr.2012.10.001
Zhao, I., Bogossian, F., & Turner, C. (2012). The effects of shift work and interaction
between shift work and overweight/obesity on low back pain in nurses. Journal
Of Occupational & Environmental Medicine, 54(7), 820-825 6p.
doi:10.1097/JOM.0b013e3182572e6a

Appendix A: Search Terms

Date of Search
February 11th, 2016

Years Covered
2002-2015

Terms Used
Shift work, nurse, cognition,
accidents

Limits/ Restrictions
Peer-reviewed
Limit to- Linked full text
Nurses
Peer-reviewed
Limit to- Linked full text

February 11th, 2016

2002-2015

Shift work, fertility,

menstrual function

February 11th, 2016

2002-2015

Limit to-Linked full text

April 2nd, 2016

2002-2015

Occupational injury, illness,

shift work
Shift work, nurses, eating
habits, physical activity,
BMI, weight

April 5th, 2016

2002-2015

Shift work, depressive

symptoms, nurse, stress

Peer-reviewed
Limit to- Linked full text

Appendix B: Summary of Literature

Peer-reviewed
Limit to- Linked full text

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

Study and Purpose
(References)
Hedstrm, A., Akerstedt,
T., Hillert, J., Olsson, T., &
Alfredsson, L. (2011).
Shift work at young age is
associated with increased
risk for multiple sclerosis.
Annals Of Neurology,
70(5), 733-741 9p.
doi:10.1002/ana.22597

Design
Case Control
Design
(Observational
Study)

The purpose of this study

was to evaluate menstrual
function, fertility and
pregnancy outcomes in
nurses working shift-work,
and to examine the
relationship of sleep to

Key Implications

2- separate population based,

case control studies on
environmental and generic risk
factors for multiple sclerosis

The research team

found that both
samples
demonstrated a
link between
early age shift
work and a risk
for later
development of
multiple sclerosis

Resea
approp

*Duration effect:
those beginning
shift work as a
teenager and
working three or
more years in
shift work before
the age of 20
showed the
largest effect in
developing
multiple sclerosis

The tw
this re
signifi

53% (36) of
women noted
menstrual
changes working
shift work. 47%
(32) reported no
change

Sampl
small,
subjec
result

Second study
(Generic)
Prevalent cases fulfilling the
McDonald criteria were
identified from the registry
For each case a control was
randomly selected
November 2009- November
2010
5129 cases with MS
4509 matched controls

The authors purpose this

shift work association may
be due to interaction
between circadian rhythm
and immunological system
function

Labyak, S., Lava, S.,

Turek, F., & Zee, P.
(2002). Effects Of
Shiftwork On Sleep And
Menstrual Function In
Nurses. Health Care for
Women International,
23(6-7), 703-714.

Sample, Participants, Setting

First study (environmental)

Ages 16-70 years
Sweden
Participants selected via 37
study centres (universities and
hospitals)
April 2005- July 2010
1343 cases/ 2900 controls

The aim of this study was

to investigate the potential
association between shift
work and MS risk, which
has previously never been
investigated.

Thisstudyis
partofalarger
studyofnurses
workingina
large
metropolitan
hospitalinthe
Midwest.

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12

68 nurses < 40 years old

completed a survey (3 parts)
evaluating sleep, menstrual
functioning, and pregnancy
outcomes
Nurses recruited via fliers, and
asked to complete a
questionnaire
Nurses selected were those < 40
years of age and who met the
following criteria:
1) Reported regular menstrual
periods during most of their life;
2) Did not report diagnosis of
menstrual dysfunction;

Women who
reported changes
shows
physiological
symptoms, slept
approximately 1
hour less when
working night

Crossbecau
being

Subjec
eligibi
resear

Durati
enoug
chang
in the

Partic
study
wide r
differe

Partic
racial
streng

Nurse
and as
questi
collec
to gath
more c

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

menstrual function

3) Had not gone through

menopause and/or were not
experiencing peri-menopausal
symptoms;
4) Had not undergone uterine
surgery including tubal ligation,
hysterectomy and/or
ovariectomy
68 nurses 22-39 years of age
were included in the analysis
Participants must have been
working in current position for
at least 6 months
Average length of time that
participants had worked shift
work was 3.3 years with a range
of months- 13 years

13
13
shifts and
reported
lengthened time
to fall asleep
*Findings suggest
that sleep
disturbances may
lead to menstrual
irregularities, and
change in the
menstrual
function may be a
marker of shift
work intolerance

Racial distribution:
85% Caucasian
8% African American
4% Asian or Pacific Islander
3% Hispanic
Pietroiusti, A., Neri, A.,
Somma, G., Coppeta, L.,
Iavicoli, I., Bergamaschi,
A., & Magrini, A. (2010).
Incidence of metabolic
syndrome among nightshift healthcare workers.
Occupational &
Environmental Medicine,
67(1), 54-57
4p.doi:10.1136/oem.2009.
046797
The purpose of this study
was to assess whether a
casual relationship exists
between night shift work
and the development of
metabolic syndrome

Prospective
Study
Longitudinal

Male/ female nurses free from

any component of metabolic
syndrome at baseline, were
evaluated annually for the
development of the disorder
during a 4 year follow up
Control group consisted of male
and female nurses performing
daytime work only
January 2003- December 2007
N=738
Night shift nurses (average 4
night shifts/month)- 402
Day shift nurses- 336
114 subjects were censored:
(36) Changed schedules
(54) Did not perform annual
visit

The cumulative
incidence of
metabolic
syndrome was
9.0% (36/402)
among night shift
workers and 1.8%
(6/336) among
day time workers
Annual rate:
Night workers2.9%
Day workers0.5%
*Risk of
developing
metabolic
syndrome is
strongly

Male a
exami

At bas
free fr
metab
the res
reliabl

Subjec
year ti

Subjec
didnt
made

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

(18) Became pregnant
(4) Diagnosis of malignancy
(2) Accidental deaths

14
14
associated with
night shift work
in nurses
Casual
relationship
between
metabolic
syndrome and
shift work

Smith, P., Fritschi, L.,

Reid, A., & Mustard, C.
(2013). The relationship
between shift work and
body mass index among
Canadian nurses. Applied
Nursing Research, 26(1),
24-31
8p.doi:10.1016/j.apnr.2012
.10.001

Cross-sectional
study
Stratified design

The aim of this study was

to examine the relationship
between shift schedule and
body mass index among a
sample of Canadian nurses

N=9291
A small but
2005
significant
Over all provinces and territories difference in body
mass index scores
Out of 24 445 telephone
across shift
questionnaires, 8665 subjects
schedule
were selected to complete the
categories
survey
Night/ mixed
shifts increase the
body mass index
scores greater
than those
working regular
day time
schedules

Result

Subjects aged 21-67 years

Somew
size

Exam
provin

Furthe
very s

Also to investigate the role

of health behaviors,
psychosocial working
conditions, and employer
supported facilities as
mediators in this
relationship
Zhao, I., Bogossian, F., &
Turner, C. (2012). The
Effects of Shift Work and
Interaction
Between Shift Work and
Overweight/Obesity on
Low Back Pain in Nurses.
Journal Of Occupational
& Environmental

Longitudinal
study over two
years

928 lower back pain free nurses

(baseline) 6%male
Participants were selected from
the Nurses and Midwives Ecohort Study

34.4% (319)
subjects
developed lower
back pain over 2
years
Overweight/obese
subjects were
more likely to

Sampl

Subjec
pain a

Study

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

Medicine, 54(7), 820-825
6p.
doi:10.1097/JOM.0b013e3
182572e6a

The aim of this study was

to describe the current
state of nurses shift work
in
Taiwan and how it affects
nurses stress, sleep quality
and self-perceived health
status

Among the 5280 participants

who completed S1 and S2, 928
(17.5%) met the inclusion
criteria

develop lower
back pain than
daytime workers

320 were invited to participate;

226 (response rate=83.13%)
actually participated

The mean score

for job stress was
3.89, with scores
ranging from 0.28
to 6.64

period
for acc

Subjec
*Shift workers
they d
(N=4352 excluded) because they are at higher risk
reported having LBP at S1
for developing
(3239), they were Midwives and lower back pain
not in the nursing profession at
over time,
S1 (812), didnt provide
especially those
information about shift status
who are
(274), or became pregnant
overweight/ obese
during the study (27)

The purpose of this study

was to examine the
interaction between shift
work and obesity on low
back pain in nurses
*Examine whether or not
shift work is a risk factor
for LBP/ and the effects of
shift work and
overweight/obesity on
LBP over time among
nurses
Lin, S. H., Liao, W. C.,
Chen, M. Y., & Fan, J. Y.
(2014). The impact of shift
work on nurses' job stress,
sleep quality and self
perceived health status.
Journal of nursing
management, 22(5), 604612. DOI:
10.1111/jonm.12020

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15

Descriptive
Cross Sectional
Study

Female participants (21-59 years

old)
The target population for this
study included all general nurses
at four regional general in
Chiayi hospitals in Taiwan
August to September 2010
Instruments used:
Demographics (gender, age,
level of education, etc.), work
schedule forms, a stress
checklist (47 questions), a sleepquality measure and a selfperceived health-status measure
(five-point point Likert scale)
were used to collect data
Differences in job stress, sleep
quality, and self-perceived
health status were examined
using an independent t-test

The results
showed that
regardless of the
amount of shift
work they
performed, nurses
reported moderate
job stress; poor
sleep quality and
moderate selfperceived health
when taking part
in any shift work
The highest level
of reported job
stress was from
self-perceived
fatigue

One li
crossLongi
exami
marke
assess
stress,
health

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

Diaz-Sampedro, E.,
Lopez-Maza, R., &
Gonzalez-Puente, M.
(2009). [Eating habits and
physical activity in
hospital shift workers].
Enfermeria clinica, 20(4),
229-235.doi:
10.1016/j.enfcli.2010.03.0
05
The purpose of this study
was to assess the eating
habits and physical
activity of hospital shift
workers

Descriptive,
cross sectional
study

N=311
It was conducted using a
questionnaire using the variables
of the National Health
Questionnaire, which included
food consumption, body mass
index (BMI) and physical
activity

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16

The overall
percentage
response was
35.5%. A total of
140 nurses, with
the majority being
females
No significant
differences on
analyzing any of
the three variables
studied (BMI,
physical activity
and food
consumption)
associated with
shift-work
A more healthy
diet is observed in
shift workers
compared to a
fixed shift, with
the consumption
of fruit, eggs,
fish, cold meats,
snacks and
alcohol
72.9% of workers
carried out some
type of physical
activity and
27% of shift
workers were
inactive
In this study, shift
work did not
negatively
influence the
BMI, eating

The ev
not su
prove
althou
results

Not co
studie
actual
eating

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

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habits or physical
activity of the
hospital workers

Lee, H. Y., Kim, M. S.,

Kim, O., Lee, I. H., &
Kim, H. K. (2015).
Association between shift
work and severity of
depressive symptoms
among female nurses: the
Korea Nurses' Health
Study. Journal of nursing
management. doi:
10.1111/jonm.12298

Quantitative
study
Cohort study

9789 participants were analysed

Female
South Korean nurses

The aim of this study was

to determine the
prevalence of depression
and the relationship
between shift work and
depression severity among
female nurses

Bekkers, M. B., Koppes,

L. L., Rodenburg, W., van
Steeg, H., & Proper, K. I.
(2015). Relationship of
night and shift work with
weight change and
lifestyle behaviors.
Journal of Occupational
and Environmental
Medicine, 57(4), e37e44.doi:

The numbers of
nurses according
to the severity of
depressive
symptoms were
35.2% and 3.1%
for normal, mild,
moderate,
severely moderate
and severe level
of depressive
symptoms

Study
valid e
limits
who o

Only s

This study shows

a higher
prevalence of
depressive
symptoms among
nurses who
worked shifts and
suggests that shift
work may
increase the
severity of
depressive
symptoms among
female nurses in
South Korea
Cohort Study
(2008-2009)

N=5951
Groups:
Stable night or shift work, from
day work to night or shift work,
from night or shift work to day
work, no night or shift work

A larger weight
change was seen
in normal-weight
workers changing
from day to shift
work compared
with stable no
shift workers

2008-2009
Regression analyses were used

Further
investigation

A stre
data w
study
inform
covari

The us
led to
have o
underr

DOES SHFIT WORK ADVERSLY AFFECT NURSES HEALTH?

10.1097/JOM.0000000000
000427
The purpose of this study
was to prospectively study
the association of night
and shift work with weight
change and life style
behaviors

to study association changes in

night and shift work with weight
change and lifestyle behaviours

18
18

needs to be done
Study
in order to
been t
confirm a positive chang
association of
night and shift
work with weight
change in other
groups
This study did not
confirm an
association of
night and
shiftwork with
weight change
over 1 year,
except for
normal-weight
workers moving
from day to shift
work.