三甲医院医务人员轮班工作与睡眠障碍的相关性
Correlation between shift work and sleep disorders of medical staff in tertiary hospitals
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摘要:
背景 医务人员的轮班工作现象尤为普遍，轮班工作可能会对医务人员的睡眠质量产生影响。
目的 评估医务人员的睡眠状况，探讨轮班工作与医务人员睡眠障碍之间的关系。
方法 采用方便抽样的方式于2019年11月10日-2020年1月19日向兰州市5所三甲医院的医务人员发放调查问卷。采用匹兹堡睡眠质量指数量表对医务人员的睡眠质量进行评估。采用描述性分析对医务人员的基本信息进行描述，比较不同特征组间睡眠障碍情况；采用logistic回归分析来探讨轮班工作与睡眠障碍发生的关系，并分别探讨了不同性别、职业和有无编制的医务人员轮班工作与睡眠障碍的关系。
结果 共纳入了1 623名医务人员，其中有1 027人患有睡眠障碍，其中女性883人；职业中护士患睡眠障碍的比例(730名，71.08%)更高。患睡眠障碍的医务人员平均年龄为(31.67±6.98)岁，平均轮班年限为(6.85±6.30)年。不同性别、年龄、职业、学历、职称、编制、轮班年限、吸烟、饮酒和运动的医务人员睡眠障碍检出率存在差异(
P < 0.05)。不同轮班年限的医务人员在量表 7个维度中以及总分的得分差异都具有统计学意义(P < 0.05)。与不轮班的医务人员相比，轮班 < 5年、5~ < 10年、10~ < 15年和≥ 15年的医务人员发生睡眠障碍的OR (95%CI )分别是2.38(1.71~3.32)、2.74(1.91~3.93)、2.57(1.61~4.10)、1.87(1.05~3.30)，P < 0.05。轮班年限 < 5年和10~ < 15年的医生与不轮班的医生患睡眠障碍的风险差异具有统计学意义(P < 0.05)；而对护士来说，轮班 < 5年、5~ < 10年和10~ < 15年的护士与不轮班的护士患睡眠障碍的风险差异具有统计学意义(P < 0.05)。与不轮班的女性医务人员相比，轮班年限 < 5年、5~ < 10年和10~ < 15年的女性医务人员患睡眠障碍的风险更高(P < 0.05)；与不轮班的医务人员相比，而有、无编制的医务人员轮班年限 < 5年、5~ < 10年和10~ < 15年的医务人员患睡眠障碍的风险更高(P < 0.05)。结论 医务人员轮班工作与睡眠障碍的发生存在相关关系，轮班工作是医务人员发生睡眠障碍的一个重要危险因素。
Abstract:Background Shift work is particularly common among medical staff, and may have an adverse impact on sleep quality.
Objective This investigation evaluates the sleep quality of medical staff and explores the relationship between shift work and sleep disorders.
Methods Questionnaires were distributed to medical staff in five grade-A tertiary hospitals in Lanzhou between November 10, 2019 and January 19, 2020 by means of convenient sampling. The Pittsburgh Sleep Quality Index Scale was used to assess the sleep quality among health care workers. Descriptive analysis was used to describe the basic information of medical staff and to compare the sleep disorders among different characteristic groups; logistic regression analysis was used to explore the relationship between shift work and sleep disorders in total participants and subgroups by gender, work type, and staffing respectively.
Results A total of 1 623 medical staff were included, of whom 1 027 were suffering from sleep disorders, including 883 women; The prevalence of sleep disorders was higher among nurses (730, 71.08%). The average ages and shift years of medical staff with sleep disorder were (31.67±6.98) and (6.85±6.30) years. The detection rates of sleep disorders were different among medical staff with different genders, ages, work types, educational levels, professional titles, staffing, years of shift, smoking, alcohol drinking, and physical exercise status (
P < 0.05). The medical staff with different shift years showed differences in the scores of seven dimensions and total PSQI (P < 0.05). Compared with those without shift work, theORs (95%CIs ) of sleep disorders among medical staff who worked shifts < 5, 5- < 10, 10- < 15, and ≥ 15 years were 2.38 (1.71-3.32), 2.74 (1.91-3.93), 2.57 (1.61-4.10), and 1.87 (1.05-3.30), respectively (P < 0.05). The relationship between shift work and sleep disorders also varied by work type, gender, and staffing of medical personnel:higher risks of sleep disorders in doctors who worked shifts < 5 and 10- < 15 years than in those did not (P < 0.05); higher risks in nurses, females, and permanent or contract medical staff with < 5, 5- < 10, and 10- < 15 years of work shift than in those without, respectively (P < 0.05).Conclusion There is a correlation between shift work and the prevalence of sleep disorders among medical staff. Shift work is an important risk factor for sleep disorders.
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