Pattern of shiftwork and health status among nurses in a university hospital in northeastern Thailand

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Kampanat Wangsan
Naesinee Chaiear
Kittisak Sawanyawisuth
Piyanee Klainin
Kanjana Simajareuk


This study was aimed to explore shiftwork patterns and health status among nurses at a university hospital in northeastern Thailand. A descriptive study was conducted. The study population was 1,221. The data were collected via self-reported questionnaire including personal information and the last month shift schedule. Descriptive statistics were applied using STATA v 10. The response rate was 68.1 % (831/1,221) and completion rate was 59.1% (721/1,221). There were 82.2% (593/721) participants had performed shiftwork. The shiftwork patterns were (a) day shift plus over time, (b) day and evening shift, (c) day and night shift, and (d) rotational shift. All of rotational shift were fast rotation with irregular shift pattern (n=531; 89.5%). Even though there was no pure forward or backward rotations, the researcher divided the participants into three groups (namely, primarily forward, primarily backward, and evenly split between backward and forward). Most shift workers performed primarily backward rotational pattern (n=479; 90.2%). A minority (n=143; 24.1%) did extended shifts:  median extended shift was once a month (IQR 1-3). The majority (n=523; 88%) of participants did quick return shifts (88%) (median=11 times/month, IQR7-13) Nearly one-third (28.0%) of participants had underlying diseases such as allergic rhinitis (7.9%), asthma (1.9%), and/or dyslipidemia (1.8%). Based on a BMI > 25 kg/m2, 17.5 % of the participants were obese. Over one-tenth (12.2%) of the participants had a sleep disorder and 14.9% used sleepiness- or drowsiness-inducing medication. Most of the participants had no depression (86.4%) and were at low risk of obstructive sleep apnea (76.0%). Comparing characteristics of shift and non-shift personnel, median age, proportion of married nurses and caffeine needed were lower for shift workers than the non-shift workers. Working experiences were shorter in shift workers than the non-shift workers and there was a statistically significant difference among job position, task, work unit, and salary. Likewise, shift workers had fewer underlying diseases, using sleepiness or drowsiness drug and depression. In conclusion, there was a high proportion of shift workers represented in the study, and most nurses did rotational shift with primarily backward rotation, quick return and extended shifts which are associated with a higher health risk. The health effect from shiftwork on the current study could not be concluded however, nearly one-third revealed some kinds of underlying diseases. The association of effect from shiftwork will be presented elsewhere.


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