Earticle

Purpose: The aim of this study was to identify influencing factors for sleep quality among shift-working nurses based on a three-factor scoring model that included sleep efficacy, sleep quality and daily dysfunction. Methods: A cross-sectional survey of 513 nurses in a hospital in Shanghai, China, was conducted using a self-reported questionnaire. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed based on the three-factor PSQI model: Factor 1, sleep efficacy; Factor 2, sleep quality; Factor 3, daily disturbances. Results: After adjusting for age, marital status, and having children, multivariate logistic regression analysis showed that participants who had previous shift work experience which was at least 6 months ago, or were currently performing shift work were significantly more likely to have poor sleep quality (PSQI > 5) than those who had never done shift work (adjusted odds ratios of 3.943 and 3.975, respectively, both p < .001). Mean scores of the three individual factors increased significantly among nurses currently performing shift work compared with those who had never done shift work (Factor 1, b = 0.61, p < .001; Factor 2, b = 1.86, p < .001; Factor 3, b = 0.45, p = .002). Mean scores of Factor 2 and Factor 3 increased significantly among nurses with previous shift work experience compared with those who had never done shift work (Factor 2, b = 1.15, p = .003; Factor 3, b = 0.52, p = .005). Conclusions: Performing current shift work and performing shift work previously were significantly associated with poor sleep quality. An appropriate arrangement and intervention strategies are needed in Chinese hospitals in order to improve sleep quality among shift-working nurses.

Purpose: This study investigates the associations among fear of the coronavirus disease (COVID-19), post-traumatic stress disorder (PTSD) symptoms, psychological distress, and sleep quality among shift nurses in tertiary hospitals in Mongolia during the COVID-19 pandemic. Methods: A cross-sectional study was conducted among 204 shift nurses from two tertiary hospitals in Ulaanbaatar. Validated instruments were used to assess variables, which include the Fear of COVID-19 Scale, Impact of Event Scale-6, Depression Anxiety Stress Scales-21, and Pittsburgh Sleep Quality Index. Data were analyzed using descriptive statistics, Pearson’s correlation coefficients, and multiple linear regressions. Results: The prevalence of poor sleep quality in shift nurses was 65.2%. While fear of COVID-19 and PTSD symptoms showed significant bivariate correlations with sleep quality, psychological distress was the only significant independent predictor of poor sleep quality in the adjusted regression model (?=0.301, p＜.001). In addition, younger nurses and those with less clinical experience reported significantly higher levels of psychological distress and poor sleep quality. Conclusion: Psychological distress was the primary independent predictor of sleep quality among shift nurses in resource-constrained settings. Interventions aimed at improving sleep health should prioritize the mitigation of psychological distress through structured psychological support programs. Special attention should be directed toward early-career and frontline nurses who are more vulnerable to psychological burden.

Purpose: It is important to reduce stress and improve quality of life for shift nurses, who experiencehigh levels of occupational stress. Identifying evidence-based interventions to enhance their well-beingis crucial for both individual and healthcare system outcomes. This study aimed to evaluate the effectsof music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses. Methods: In this randomized controlled trial, participants were randomly assigned using computer-generatedrandom numbers. A total of 78 shift nurses who met the inclusion criteria were enrolled. The experimental treatment involved providing music therapy for one week to the music group andaromatherapy for one week to the aroma group, whereas the control group followed their usual dailyroutines for one week. Results: No significant differences were observed among the three groups concerninggeneral characteristics and baseline dependent variables, thereby confirming the homogeneityof the groups. Nevertheless, post-intervention analyses demonstrated significant improvements in perceivedstress (F = 5.55, p = .006), stress index (F = 3.38, p = .039), quality of life (F = 11.79, p < .001),and happiness (F = 9.29, p < .001) in the experimental groups. Conclusion: Both music therapy andaromatherapy were found to be effective in mitigating stress and improving quality of life and happinessamong shift nurses. Therefore, these interventions can be regarded as valuable strategies for improvingoverall well-being within this population.

Purpose : This descriptive study aimed to identify relationships among shift work nurses’ job stress, fatigue, happiness, and sleep quality and the factors causing decrease in sleep quality to establish fundamental data for effective intervention strategies. Methods : The data were collected using a structured questionnaire from June 11 to 19, 2018, and study participants were 198 nurses working rotating shifts in a university hospital. Results : The quality of sleep showed a mean of 15.77±5.30 and was varied depending on the number of night shifts (p=.001), health status (p=.008), and the number of discomforts at work (p<.001). Sleep quality also showed a significant relationship with job stress (r=.15, p=.040), fatigue (r=.35, p<.001), and happiness (r=-.24, p=.001). Multiple regression analysis (Adj R2=.275) indicated that factors affecting the quality of sleep included the number of discomforts (β=.31, p<.001), fatigue (β=.22, p=.002), and the number of night shifts (β=.19, p=.002). Conclusion : This study suggests that individuals, hospitals, and social systems need to coordinate the number of night shifts and improve discomfort and fatigue by considering factors influencing rotating shift work nurses’ sleep quality.

본 연구는 교대 근무 간호사와 비교대 근무 건강증진, 정신건강, 삶의 질을 위한 건강프로그램을 개발하기 위한 기초자료를 제공하기 위해 일개도시 종합병원에 근무하고 있는 간호사들을 대상으로 삶의 질에 영향을 미치는 요인을 파악하고자 시도되었다. 일반적인 특성 결과 교대 근무 간호사와 비교대 근무 간호사 사이에 연령, 결혼여부, 총 근무 경력, 직위와 근무 병동에서 유의한 차이가 있다고 나왔다(p<.05). 생활습관 및 스트레스, 건강․복지 프로그램에서 수면시간, 식사습관, BMI, 건강․복지지원 프로그램 지원여부의 차이는 유의한 관계가 있다고 나타났다(p<.05). 그러나 스트레스에서는 교대 근무 간호사와 비교대 근무 간호사와의 유의한 차이는 없었고(p>.05), 가장 많은 스트레스 원인으로는 직장생활이라고 대답한 비율이 많았다. 교대 근무 간호사와 비교대 근무 간호사의 건강증진행위의 점수는 교대 근무 간호사와 비교대 근무 간호사 모두 보통수준을 의미하였고 교대 근무 간호사가 비교대 근무 간호사 보다 점수가 낮았다. 두 그룹 사이의 건강증진행위는 연령, 결혼, 직위를 통제한 공분산분석 결과, 유의한 차이가 있는 것으로 나타났다(p<.05). 교대 근무 간호사와 비교대 근무 간호사의 정신건강은 두 그룹 모두 비교적 양호한 것으로 분석이 되고 교대 근무 간호사가 비교대 간호사 보다 점수가 높게 측정이 되었다. 두 그룹 간 정신건강은 연령, 결혼, 직위를 통제한 공분산분석에서 유의한 차이가 없었다(p>.05). 교대 근무 간호사와 비교대 근무 간호사의 삶의 질은 1~5점의 범위에서 점수가 높을수록 삶의 질이 좋은 것을 의미하는데 총 대상자의 평균 총점은 2.85 점이었고 교대 근무 간호사의 점수는 보통보다는 약간 낮은 점수가 나왔고, 비교대 근무 간호사의 점수는 보통 점수가 나왔다. 교대 근무 간호사가 비교대 근무 간호사보다 점수가 낮은 것으로 나타났다. 두 그룹 간 삶의 질은 연령, 결혼, 직위를 통제하였을 때에도 유의한 차이가 있음을 확인하였다(p<.05). 근무형태에 따른 일반적인 특성인 연령, 결혼, 직위와 건강증진행위, 정신건강, 삶의 질을 로지스틱 회귀분석으로 분석하였을 때 결혼과 삶의 질에서 유의한 차이가 있다고 나타났다. 비교대 근무에서 교대 근무보다 삶의 질 점수가 높을 확률이 많다고 나타났다(OR=3.397, 95%CI= 1.694-6.812). 삶의 질에 대한 관련요인의 설명력은 48.4%로 근무형태가 비교대일수록, 스트레스가 적을수록, 건강․복지프로그램 지원이 있을수록 건강증진행위 수행도가 높고 정신건강이 좋을수록 삶의 질 점수가 높아진다고 나타났다. 그러므로 교대 근무 간호사와 비교대 근무 간호사를 대상으로 건강증진행위의 수행을 높일 수 있는 프로그램의 개발과 스트레스 관리를 도와주는 건강지원 프로그램을 개발하는 등, 본 연구 결과를 토대로 영향을 미치는 요인들 간에 단계를 확인한 경로분석이나 모형검증 등 간호사의 삶의 질을 향상시킬 수 있는 연구가 지속적으로 수행되어야 할 것으로 생각한다.

Purpose: The purpose of this study was to compare and contrast health promoting behaviors, mental health, and quality of life between shift nurses and non-shift nurses and to evaluate factors influencing their quality of life. Method: Data were collected by questionnaires from 113 non-shift nurses and 265 shift nurses who had been working at one of five hospitals in Incheon for more than one year. Descriptive statistics, ANCOVA, logistic regression, and multiple regression were used in performance of data analysis. Results: For shift nurses’ mean total scores for health promoting behaviors and quality of life were significantly lower than those for non-shift nurses’(p<.05). Result of logistic regression analyses indicated that marital status (OR=2.092, 95%CI=1.174-3.729) and quality of life (OR=3.397, 95%CI=1.694-6.812) were significant between shift nurses and non-shift nurses. Non-shift work, low stress, provision of health-welfare programs, high score for health promoting behavior, and good mental health status showed an association with better quality of life (explained 48.3% of variance). Conclusion: Educational, policy, and regulatory approaches are required in order to improve mental health and quality of life for nurses, which may be influenced by their unhealthy behaviors such as irregular dietary patterns, while provision of counseling programs may be helpful to enhancement of nurses’ mental health.

Purpose: This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses. Methods: This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data. Results: The final model showed good fit to the empirical data: ${\chi}^2/df=2.19$, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (${\beta}=.32$), perceived shift work status (${\beta}=-.16$), stress response (${\beta}=.16$), shift work experience (${\beta}=.15$), perceived health status (${\beta}=-.14)$, and circadian rhythm (${\beta}=-.13$) explaining 36.0% of the variance. Conclusion: The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.

Purpose: The purpose of this study was to identify factors associated with work-related quality of life (WRQoL) in shift-working nurses. Methods: The design was a cross-sectional obser vational study. The participants were 187 nurses who were shift-working at C university hospital. Data were collected using structured self-administered questionnaires from December 7 to 31, 2022. The data were analyzed using linear multiple regression. Results: WRQoL in shift-working nurses was borderline between low and moderate (75.35±9.46). Factors associated with WRQoL were job satisfaction (?=0.75, p＜.001) and quality of sleep (?=?0.12, p=.017), and these variables explained 58.4% of the variance in WRQoL. Conclusion: Job satisfaction and quality of sleep should be considered to improve WRQoL in shift-working nurses. Employers or managers should create a supportive organizational climate to maintain family and work balance and to reduce job stress for shift-working nurses. Shift-working nurses are also encouraged to adhere to healthy behaviors for those who are experiencing poor sleep quality.

Purpose: This study was an experimental study to compare the inhalation effects of aroma essential oil on the quality of sleep (QOS) for shift nurses after working nights. Methods: The participants were 60 healthy adults who didn't have any disease. As an experimental treatment, the participants in the experimental group were asked to inhale essential oil for 3 minutes at a distance of approximately 10 cm from their nose and then they were asked to sleep with the aroma stone beside their head (within a 30 cm distance). QOS were measured four times on Pretest, Day 1, Day 2, and Day 3 after they slept. To measure QOS, Perceived QOS (Numeric Rating Scale), the Verran & Synder-Halpern (VSH) Sleep Scale were used, and number of awakenings (NoA) was measured by Actigraph. Results: There were no significant differences in the homogeneity tests for general characteristics and dependent variables prior to the experiments, except for VSH of subjective sleep quality. Also, there was no significant interaction between group and time. The VSH of the experimental group was higher than the control group (F=6.39, p=.002). The NoA between the experimental group and the control group was significantly different after experimental treatment 3rd day (F=13.35, p=.001). Conclusion: The findings show that the inhalation of aroma essential oil had effects to increase the quality of sleep. Therefore, the inhalation of aroma essential oil could be applied to general nursing interventions to improve the quality of sleep.

Purpose: This study aimed to investigate the associations of sleep, dietary behaviors and physical activity with quality of life amongshift-work nurses. Methods: For this cross-sectional descriptive study, data were collected from 191 shift-work nurses in a tertiaryhospital. Multiple linear regression analysis was used to identify the relationships among variables. Results: The levels of sleep quality,dietary behaviors and physical activity were low. Factors associated with quality of life among shift-work nurses included sleep disturbance(B=-0.16, β=-0.26, p<.001), dietary behaviors (B=0.28, β=0.24, p<.001), and physical activity (B=0.05, β=0.19, p<.001). The strongest factor was sleep disturbance. Conclusion: In order to improve quality of life among shift-work nurses, it is significant toencourage and maintain health behaviors such as sleep, dietary behaviors and physical activity. Under the circumstances where shiftworkcannot be avoided, personal efforts made by nurses to establish their own living standards for positive health behaviors willbenefit their quality of life.

Purpose: This study compared sleep quality, insomnia, chronic fatigue, and work performance between nurses working fixed night shifts and those working rotating three-shift schedules and examined the relationships among these variables by work schedule type. Factors associated with work performance were also identified. Methods: This cross-sectional survey included nurses working at a university hospital. Data were collected using structured questionnaires measuring sleep quality, assessed with the Korean version of the Pittsburgh Sleep Quality Index, insomnia, chronic fatigue, and work performance. Data were analyzed using descriptive statistics, nonparametric tests, Spearman’s correlation coefficients, and hierarchical multiple regression analysis using SPSS version 30.0 program. Results: Insomnia differed significantly between nurses working fixed night shifts and those working rotating three-shift schedules. Among nurses on rotating three-shift schedules, poorer sleep quality, greater insomnia, and higher chronic fatigue were significantly associated with lower work performance, whereas sleep-related variables were not significantly associated with work performance among fixed-night-shift nurses. Hierarchical multiple regression analysis showed that education level, job satisfaction and fixed-night-shift work were significant factors associated with work performance. The final model explained 17.0% of the variance in work performance, with an adjusted R2 of .15. Job satisfaction showed the strongest association. Conclusion: The relationship between sleep-related factors and work performance differed by work schedule type. These findings suggest that interventions to improve nurses’ work performance should combine sleep health management with organizational strategies, particularly efforts to improve job satisfaction. The role of fixed-night-shift nursing systems should be examined further in future studies.

Purpose: The objective of this study was to investigate the relationships between sleep quality, fatigue, depression and health promoting behavior by shift-work patterns in university hospital nurses. Methods: A cross-sectional, descriptive survey was conducted using a convenient sample. The self-administered questionnaires were given to 165 nurses(shift workers 91, non-shift workers 74) employed in two university hospital located in Seoul and Gyeunggi-do. Data were collected from February to March, 2010. Results: The shift workers showed significantly lower sleep quality and health promoting behavior, and higher fatigue than non-shift workers. There were significant correlations between fatigue, depression and health promoting behavior in shift workers. There were significant correlations between sleep quality, fatigue, depression and health promoting behavior in non-shift workers. In multiple linear regression analysis, after controlling for total work experiences, predictor of health promoting behavior in shift workers was only fatigue (β =-.29, p<.001). Predictors of health promotion behavior in non-shift workers were depression (β =-.37, p=.002) and fatigue (β =-.27, p=.023). Conclusion: This study was not clear why sleep quality does not have a comparable effect on health promotion behaviors of shift-workers as well as non-shift workers. However, future research is needed to determine the various risk factors influencing on health promotion behaviors by which shift-work pattern exacerbates fatigue.

Purpose: The aim of this research was to identify the mediating effects of sleep quality on the relationship between job stress and stress response of shift-working nurses. Methods: The participants in this study were 150 nurses who had more than 6 months of shift-working experience. A survey was conducted from May to June 2017 in a hospital in Gyeonggi-do, South Korea. The data were collected through self-report questionnaires The collected data were analyzed using SAS 9.4 program. The analysis was based on Baron and Kenny's model to examine the mediating effects of sleep quality on the relationship between job stress and stress response of shift-working nurses. Results: In the first and second steps, job stress was identified as a significant predictor of sleep quality(β=.29, p=.001) and stress response(β=.24, p=.004). In the third step, sleep quality was observed as a significant predictor of stress response, and the direct relationship between job stress and stress response was not significant(β=.07, p=.291). Sleep quality was found to exhibit complete mediating effect on the relationship between job stress and stress response. Conclusions: The results of this study suggest that strategies for managing the stress of shift-working nurses should include effective ways to ensure sleep quality.

The SLA 3d printer is the first of the commercial 3D printer. The 3D printed output is printed hanging on the bed that move to the upper position. Sandblasted bed is used to prevent layer shift. If sandblasting is wrong, the 3D printed output is layer shifted. For this reason, 3D printer manufacturing companies inspect the bed surface. However, the sandblasted surface has variety of irregular shapes and craters, so it is difficult to establish a quality control standard. To solve problems, this paper presents a standardized sandblasting histogram and threshold. We present a filter that can increase the classification rate.

The purpose of this study was to examine the relationship between sleep disorders, job satisfaction, health promotion behavior, quality of life, turnover intention. And also to find the predicting factors on turnover intention of shift and non-shift nurses. A descriptive study design was used. Study subjects were 239 nurses worked as a shift (167) and non-shift (72) in two general hospitals in P city. Turnover Intent, Sleep disorders, Job satisfaction, practicing health promotion profile and quality of life scales were used to collect the data. Data were analyzed by descriptive statistics and Pearson's correlation coefficient for find the relationship between study variables. Stepwise multiple regressions used to find predicting factors of turnover intention with other variables. The shift group showed lower Job satisfaction, practice of health promotion behavior and intention of turnover than non-shift nurses. The most important predictive factors of turnover intention in of shift group was job satisfaction (β =-. 477, p <.001) and non-shift group was health promotion behavior (β =-. 295, p = .040) than other factors. Findings showed that turnover intention highly influenced by job satisfaction than health promoting behavior and quality of life. This study suggests organizational efforts to provide sufficient staffing and nurse managers should make more concentration to allot work schedule in order to avoid over load shift nurses and promote quality of client care.

Purpose: This study was conducted to identify the effects of caffeine intake by shift workers on sleep, considering various variable related to the sleep health of shift workers. Methods: A descriptive survey study was conducted with 128 employees who worked shifts. Respondents were surveyed on their of caffeine intake behavior, schedule type, quality of sleep, health promotion behavior, and occupational stress. Differences in their quality of sleep were assessed using the t-test and analysis of variance, while factors influencing the effect of caffeine intake on the quality of sleep were analyzed using hierarchical logistic regression. Results: The average Pittsburgh Sleep Index, Korean Version score of those surveyed was 7.3±3.25, indicating that their quality of sleep was low. On the other hand, their aveage daily intake of caffeine was 1.6±0.99 cups (1 cup =150 mL) and 116.4±77.58 mg/dL of caffeine. When the various variables that could have affected the quality of sleep were corrected, an increase in the amount of caffeine consumed was found to lead to a decrease in the quality of sleep (p=.015). Conclusion: Caffeine intake by shift workers has a significant bearing on their quality of sleep; therefore, such intake should be adjusted to improve their sleep health.

본 연구의 목적은 병원근무 여성 간호사의 우울 정도를 확인하고, 순환 교대근무와 수면의 질이 우울에 미치는 영향을 규명하기 위한 것이다. 연구대상자는 서울지역 2개 대학병원에 근무하는 총 295명의 간호사로 수집된 자료는 기술통계 및 다중회귀분석을 이용하여 분석하였다. 연구결과 참여자의 71.2%가 우울한 것으로 응답했으며(CES-D 총점 ≥ 16), 간호사 우울의 유의한 영향요인으로는 수면의 질, 순환 교대근무, 근무기간(1-2.9년, 10년 이상)으로 나타 났다. 본 연구결과를 바탕으로 여성 간호사들의 우울을 감소시키기 위해서는 수면의 질과 순환 교대근무의 부정적 영 향을 개선 시킬 수 있는 중재가 마련되어야 할 것으로 고려된다.

The aim of this study was to investigate the level of depression among female hospital nurses and the influence of rotating shift work and quality of sleep on depression. A total of 295 nurses in Seoul were recruited and the data were analyzed using descriptive statistics and multiple regression analysis. The number of depressed nurses was 71.2%(CES-D total score ≥ 16) and factors influenced on nurses’ depression were quality of sleep, rotating shift work, and work experience in nursing(1-2.9 years, more than 10 years). Based on the result of this study, nurse managers and hospital organization should use appropriate interventions to improve quality of sleep and negative effects of rotating shift work for nurses.

COVID-19 pandemic has resulted in the increased number of patients and contactless consultations in the hospital, consequently leading to the reduced consultation time of physicians and the limited amount of information delivered regarding on diagnosis, consultation, and precautions. Communication problem between physicians and patients might lead to such phenomena as incorrectly recognized information by patients, drug misuse and side effects, and undelivered precautions, which, in turn, degrade the medical quality. In this study, we use an intuitive trend analysis to analyze trends in AI medical chatbot service quality in practice, in terms of functionality and operational process. Additionally, we discuss shifts in dimensions in service quality of AI medical chatbot aligned with dimensions found in SERVQUAL. The observations of this study reveal that there has been an increase in reliability and empathy. Dimensions. This study will contribute to the AI medical Chabot service quality improvement in both theoretical and practical perspectives.

The current rapid technological innovation through the proliferation of smart government is demanding to shift the organizational culture and innovations for quality of work life in public-sector organizations. Referring to previous studies, this paper addressed the effect of organizational culture and innovations on quality of work life through the moderation of smart work system participation of the Korean public-sector organizations. Data was collected from the Korea Institute of Public Administration (KIPA) for both central and local public employees in South Korea. Results found that development culture significantly affected organizational innovations; and subsequently, organizational innovations significantly play a mediating role to the quality of work life in public-sector organizations. Then, smart work system participation through smart work teleconference positively influenced both organizational culture and organizational innovation; whereas, on smart work center participation was a lacking of contribution. Therefore, it was proposed to address other internal organizational cultures (i.e. group culture and hierarchical culture) as the antecedent for further studies; ─ and strengthen and extend the integration of smart work system participation to develop organizational innovation for a better quality of work life. Then, strong potential leadership is also required in a collaborative social-network system among interest groups of public-sector organizations.