The experience of sleep disturbance of shift work nurses in hong kong
This presentation is the property of its rightful owner.
Sponsored Links
1 / 59

The experience of sleep disturbance of shift-work nurses in Hong Kong PowerPoint PPT Presentation


  • 93 Views
  • Uploaded on
  • Presentation posted in: General

The experience of sleep disturbance of shift-work nurses in Hong Kong. Kwong Chung Man, Cheung King Yee , Ng Kit Yee, Janice Cheung Joyce Chong,. Preview. Introduction Literature Review Aims of the Research Research Design & Data Collection Data Analysis & Result

Download Presentation

The experience of sleep disturbance of shift-work nurses in Hong Kong

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


The experience of sleep disturbance of shift work nurses in hong kong

The experience of sleep disturbance of shift-work nurses in Hong Kong

Kwong Chung Man, Cheung King Yee, Ng Kit Yee, Janice Cheung Joyce Chong,


Preview

Preview

  • Introduction

    • Literature Review

    • Aims of the Research

  • Research Design & Data Collection

  • Data Analysis & Result

  • Implication & Discussion

  • Limitation and Suggestion


Introduction

Introduction

Kwong Chung Man


The experience of sleep disturbance of shift work nurses in hong kong

迫自己入睡係一件痛苦嘅事!!!


Results of sleep deprivation

Lapses in attention and inability to stay focused

Reduced motivation

Compromised problem-solving

Confusion or bewilderment

Irritability or hostility

Unusual tenseness or anxiety

Memory lapses (particularly in short-term memory)

Impaired communication

Diminished reaction time

Faulty information processing and judgment

Slowed information processing

Diminished ability to detect and recognize the significance of subtle changes in a patient’s health

Inability to deal with the unexpected

Indifference and loss of empathy

(Hughes & Rogers, 2004)

Results of Sleep Deprivation


Factors influencing health of workers and tolerance to shift work giovanni costa 2003

Factors influencing health of workers and tolerance to shift work (Giovanni Costa, 2003)

  • Shift and night work are a well recognized risk factors for health and well-being

  • 20–30% of shift work workers have severe sleep problems, that force them to quit

  • ~10% do not complain at all during their shift work working life


The experience of sleep disturbance of shift work nurses in hong kong

  • Shift work impact on health

    • Perturbing the psychophysical homeostasis (circadian rhythms, sleeping and eating hours),

    • Decreasing vigilance and performance (errors, accidents),

    • Hampering family and social relations

    • A recognized risk factor for gastrointestinal, psychoneurotic and cardiovascular disorders


The experience of sleep disturbance of shift work nurses in hong kong

Dose shift work lead to poorer health habits: A comparison between women who had always done shift work with those who had never done shift work (Kivimaki & Kuisma, 2001)

  • Questionnaire to 2795 female nurses

  • Compare 506 shift worker with 183 day workers

  • Shift work was not associated with alcohol intake or sedentary lifestyle

  • Shift work in nurses increases smoking and being overweight to a degree that contributes to health problems


The experience of sleep disturbance of shift work nurses in hong kong

Sleep quality and responses to insufficient sleep in women on different work shifts (Edéll-Gustafsson, 2002)

  • Questionnaire to 156 women working in hospitals

  • The prevalence of insufficient sleep was 40%

  • Palpitation, increase susceptibility to infection, cognitive behavioral effects of fatigue, dysphoria, somatic distress

  • Negative responses were related to rotating work shifts

  • Negative responses were related to self-rated sleep quality


Research question

Research Question

The experience of sleep disturbance of shift-work nurses in Hong Kong


Aims of the research

Aims of the Research

  • To promote shift-work nurses’ health and well-being by knowing more about

    • the experience of sleep disturbance

    • the impacts of sleep disturbance

    • the perceived causes of sleep disturbance

    • the copings of sleep disturbance


Research design data collection

Research Design & Data Collection

Cheung King Yee


Sampling method

Sampling method

Purposive sampling

The sample units are chosen ‘purposively’ for having particular features or characteristics which will enable detailed exploration and understanding of the central themes and puzzles which the researchers wishes to study


Selection criteria

Selection criteria

  • Symbolic representation

    • shift-work nurses

    • with sleep disturbance experience

    • working in Hong Kong

  • Diversity

    • specialty

    • working experience

    • night shift (frequency and length)


Sample size

Sample size

  • Seven samples

    • all female nurses (1 Nursing Officer and 6 Registered Nurses)

    • aged between 25 – 45

    • 3 married and 4 single

    • working at acute hospital setting (2 in private hospital and 5 in public hospital)


Sample matrix

Sample matrix


Semi structured interviewing demographic information

Semi-structured interviewingDemographic information

Specialty: Medical Surgical A&E

paediatric psychiatric Orthopaedic

Intensive care unit

Others (please specify) ______

Working experience (Shift) : ______ (years)

How many night shift per month ______

How many working hours per night shift ______


Interview guide

Interview Guide

  • 請用1-10分 (最差1分, 最好10分) 評估你最近一個月的睡眠質素

  • 你睡得唔好的經驗係點樣

  • 睡得唔好對你有何影響

  • 睡得唔好的原因是什麼

  • 嘗試過什麼令你睡得好些

  • 需要有何改變可以令你睡得好些


Qualitative data collection

Qualitative Data Collection

  • Before the interview

    • Informed consent

      • Aims of research

      • Confidentiality

      • Right to withdraw

      • Seeking permission to record the data by audio-recording or note-taking

      • Length of interview around 15 to 20 minutes

    • Making appointment

      • Date / Time (on duty / off duty)

      • Location (working area / home / restaurant)

      • Means (face to face / over the telephone)


The experience of sleep disturbance of shift work nurses in hong kong

  • Interview process

Listen

Interviewer

Interviewee

Skills

Response


The experience of sleep disturbance of shift work nurses in hong kong

  • After the interview

    • Appreciation

    • Reconfirming about the confidentiality

    • Raw data management


Data analysis result

Data Analysis & Result

Ng Kit Yee


Data analysis

Data analysis

  • Thematic analysis

  • Typologies

    • Experience of sleep disturbance

    • Perceived causes of sleep disturbance

    • Impacts of sleep disturbance

    • Coping of sleep disturbance

    • Desires for improving sleep disturbance


Thematic chart

Thematic chart

(2) Perceived

causes

(1) Experience of sleep disturbance

(3) Impacts

Sleep Disturbance

(5) Desires for changes

(4) Coping

RESULT


Typologies 1 experience of sleep disturbance

1.1Difficulty initiating sleep

1.2 Difficulty maintaining sleep

1.3 Early morning wakening

1.4 Nonrestorative sleep

1.5 Shallow sleep

1.6 Nightmare

1.7 Hopelessness/helplessness

Typologies—(1) Experience of sleep disturbance


Typologies 1 experience of sleep disturbance1

1.1Difficulty initiating sleep

PA同A/N難入睡

輾轉反側 個腦不停諗嘢

好難瞓得著,好難先瞓得著,好耐先瞓得著

Typologies—(1) Experience of sleep disturbance

Sleep Disturbance


Typologies 2 perceived causes of sleep disturbance

Typologies–(2) Perceived causes of sleep disturbance

2.1 Physiological

2.2 Psychological / cognitive

2.3 Work stress

2.4 Other stress


Typologies 2 perceived causes of sleep disturbance1

2.2 Psychological / Cognitive

Responsible personality

Self reflection

Hypnotic dependency

Emotional upset

Strange environment

Typologies–(2) Perceived causes of sleep disturbance


Typologies 2 perceived causes of sleep disturbance2

2.2 Psychological / Cognitive

Responsibility personality

當個人越有責任心,就有壓力要自己做好D。

在自己能力範圍內就要做好D。

Technical在工作上handle得無問題,但依然stress,應該係咁 。

Typologies–(2) Perceived causes of sleep disturbance


Typologies 2 perceived causes of sleep disturbance3

2.2 Psychological / Cognitive

Self reflection

擔心自己做漏嘢可能自己有好多unfinished嘅business啦

但係完全冇壓力呢,我又覺得做人冇乜目的呢,

工作上嘅反思,每個人都想自己做得好啲就會常常反思,

Typologies–(2) Perceived causes of sleep disturbance


Typologies 2 perceived causes of sleep disturbance4

2.3 Work stress

Job nature

Shift duty

Interpersonal relationship (Job related)

Typologies–(2) Perceived causes of sleep disturbance


Typologies 2 perceived causes of sleep disturbance5

2.3 Work stress

Job nature

心情未ready去瞓覺

工作太過繁忙, 有時出事, 擔心明日怎樣同上司交待及根著要點樣處理

工作上一定有壓力啦

Typologies–(2) Perceived causes of sleep disturbance


Typologies 2 perceived causes of sleep disturbance6

2.3 Work stress

Shift duty

Sleeping day夜晚冇睡意,夜.遲D先想瞓

返A好驚會起唔到身

多數PA會食[安眠藥],AP就多數唔食,所以唔多唔少係壓力嘅問題嘅

PA Shift 返到屋企會諗吓自己有冇做漏嘢

Typologies–(2) Perceived causes of sleep disturbance

Sleep Disturbance


Typologies 3 impacts of sleep disturbance

Typologies–(3) Impacts of sleep disturbance

3.1 Biological

3.2 Psychological

3.3 Social


Typologies 3 impacts of sleep disturbance1

Typologies–(3) Impacts of sleep disturbance

  • 3.2 Psychological

  • Decrease concentration

  • Decrease motivation/ volition

  • Affecting creative and innovative ability

  • Money buying off stress

  • Dysphoria

  • Fear of making mistake in work

  • Learning ability

  • Poor money management

  • Mental fatigue


Typologies 3 impacts of sleep disturbance2

3.2 Psychological

Decrease concentration

唔夠呀, 第日返工時精神會好唔集中

Decrease motivation/ volition

我就好想去做運動,但係有時就變咗,err,我會冇咁主動力去做囉

做嘢冇乜推動力, 做事馬虎咗

Typologies–(3) Impacts of sleep disturbance


Typologies 3 impacts of sleep disturbance3

3.2 Psychological

Affecting creative and innovative ability

…如果夠瞓就可以係思想上同生活上創啲新路出哩,可以create啲嘢出哩,…唯有用番一貫的方法做嘢,無辦法creative

Money buying off stress

因為想令到情緒回復,會用錢令到自己情緒回復,包括食好嘢、着靚衫、去啲高尚地方

Typologies–(3) Impacts of sleep disturbance


Typologies 3 impacts of sleep disturbance4

3.3 social

Affect social life

Affect parenting quality

Affect spouse sleep

Withdrawal

Typologies–(3) Impacts of sleep disturbance


Typologies 3 impacts of sleep disturbance5

3.3 social

Affect social life

同埋唔哂輪班,星期六、日放假,可以同番現實生活嘅人有啲關係,譬如節日感覺,個啲都係自己life cycle嘅一種緩和,大圍氣候幫助到,輪班就唔係,輪班就脫離這種大圍氣候

Typologies–(3) Impacts of sleep disturbance


Typologies 3 impacts of sleep disturbance6

3.3 social

Affect parenting quality

成日有遺憾係自己啲仔女,無好好、又唔夠精神教佢,成日唯有因為自己的能力有限,陪住佢做嘅嘢,就係帶佢食好嘢、睇吓戲,因為自己唔哂點參與。因為太攰嗎。

因為有遺憾,細路仔啲成長期過咗就無

Typologies–(3) Impacts of sleep disturbance

Sleep Disturbance


Typologies 4 coping of sleep disturbance

4.1 Adaptive

4.2 Maladaptive

Typologies—(4) Coping of sleep disturbance


Typologies 4 coping of sleep disturbance1

4.1 Adaptive

Alternative therapy

Life-style modification

Cognitive adjustment

Try to complete all daily task

Self hypnosis

Change life view

Set priority in thinking

Typologies—(4) Coping of sleep disturbance


Typologies 4 coping of sleep disturbance2

4.2 Maladaptive

Habitual use of self medicated hypnotic in A/N and P/A shift

食安眠藥啦,安眠藥我係近…近呢一年我…食多咗非常有效嘅,簡直有上癮嘅,因為瞓得好舒服嘅

會連續晚晚都食,但係當我知道自己晚晚都食嗰輪呢,我就會真係停一停嘅啦,因為知自己唔好再依賴佢咁多,咁我會又再食少啲啦,盡量唔食啦,又用返我嘅平時方法多數PA會食,AP就多數唔食

Typologies—(4) Coping of sleep disturbance

Sleep Disturbance


Typologies 5 desires for changes of sleep disturbance

Typologies–(5) Desires for changes of sleep disturbance

5.1 Personal factors related

5.2 Work related


Typologies 5 desires for changes of sleep disturbance1

5.1 Personal factors related

Be more smart

Better time management

Set priority in thinking

Relaxation

Not depend on hypnotic

Be more optimistic

Typologies–(5) Desires for changes of sleep disturbance


Typologies 5 desires for changes of sleep disturbance2

5.1 Personal factors related

Be more smart

無食藥就精神好少少同埋記性比較好

即係唔夠瞓就會無咁醒(笑),夠瞓梗係會醒啲啦

Better time management

希望時間控制技巧會有所改善, 現在我會嘗試將D提早做, 等唔好咁迫

Set priority in thinking

開始要分priority,要分緊要同唔緊要

Typologies–(5) Desires for changes of sleep disturbance


Typologies 5 desires for changes of sleep disturbance3

5.1 Personal factors related

Relaxation

我諗都係要自己學識放鬆個人

迫自己入睡係一件痛苦嘅事

Not depend on hypnotic

唔使食毒藥

Be more optimistic

就算別人態度唔好, 都要叫自己退一步唸一唸, 以減少D磨擦, 希望可以好開心地放工

Typologies–(5) Desires for changes of sleep disturbance


Typologies 5 desires for changes of sleep disturbance4

5.2 Worked related

No need to work

咁梗係放假

No night shift

如果可以唔需要返night shift就好啦

Typologies–(5) Desires for changes of sleep disturbance

Sleep Disturbance


Result

Result

  • Perceived Cause

Job Nature

+

Personality

Shift Work


Result1

Impact

Result

  • Perceived Cause

Coping:

Adaptive

+

Mal-adaptive

Biological

Psychological


Matrix

Matrix


Implication discussion

Implication & Discussion

Janice Cheung


Implication

Implication

  • Provide framework to elicit the experience of sleep disturbance of shift work nurses in HK

  • Understand the perceived causes of sleep disturbance: focus on work stress related to shift work

  • Vicious cycle of sleep disturbance and work stress

  • Impacts of sleep disturbance on bio-psycho-social well-being


The experience of sleep disturbance of shift work nurses in hong kong

  • Explore the effective coping strategies of sleep disturbance

  • Emphasize on the maladaptive measure (habitual use of hypnotic): develop into dependency?

  • Implication for those who organize and manage shift work


Discussion

Discussion:

  • 1) Are medical errors related to sleep disturbance?

  • 2) How to help shift work healthcare worker sleep well?

  • 3) Are there any organizational factors inducing sleep disturbance?

  • 4) “Man fit Task” or “Task fit Man”?

  • 5) Discrepancy between male and female nurses on perceived causes of sleep disturbance?


Limitation and suggestion

Limitation and suggestion

Joyce Chong


Limitations

limitations

  • sampling deficiencies

  • design constraints

  • data collection/quality problems

    • Informal interviews e.g. setting

    • 5 interviewers, difficult to standardize

    • role conflicts: colleagues or even seniors

    • ideally audio-recordings with transcripts

    • 15-20 mins interviews only, not in-depth enough


Suggestions

suggestions

  • very limited literature & research in local context

  • larger scale, more hospitals (private+HA)

  • as follow-up study e.g. adding questions on hypnotic use

  • Methodologic pluralism: a multimethod/mixed-method (qualitative+quantitative) research

    • complementarity

    • enhanced theoretical insights

    • incrementality

    • enhanced validity

    • creating new frontiers


The experience of sleep disturbance of shift work nurses in hong kong

治失眠方

百合 15克

酸棗仁 15克

用水煎服,每天一劑


  • Login