The purpose of this study was to develop and test an structural model for sleep quality in 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 the shift nurses.
The participants were 285 female shift nurses from four general and university hospitals with over 300bed located in C and J city, Gyeongnam.
Data were collected from September 27 to October 20, 2016.
The instrument used in the study were the Pittsburgh Sleep Quality Index, Korean translation of Composite Scale, Perceived Health Status, Perceived Shift Work Status, Job Stress, Stress Response Inventory, Health Promoting Lifestyle Profile-Ⅱ (HPLP-Ⅱ), Sleep Hygiene Practice Scale.
Data were analyzed using SPSS/Win 18.0 program and AMOS 18.0 program.
The results of this study were as follows.
1. Final model showed good fit to the empirical data (/df=2.188, SRMR=.066, RMSEA=.065, AGFI=.850, TLI=.906, GFI=.926, GFI=.893, NFI=.874).
2. Hypothesis testing of the study showed:
1) Among 19 hypotheses, 16 hypotheses were supported. Variables of the final model accounted for 36.0% of the sleep quality of shift work nurses.
2) For the sleep quality, circadian type was a significant direct effect (γ=-.13, p=.030), an indirect effect(γ=-07,p=.006) and total effect (γ=-.21, p=.009). Perceived health status was significant direct effects (γ=-.14, p=.022), indirect effects(γ=-.15, p=.016) and total effect (γ=-.29, p=.009). Shift work experience was significant direct effect (γ=.15, p=.004) and total effect (γ=.13, p=.028). Perceived shift work status was a significant direct effect (γ=-.16, p=.010), indirect effect (γ=-.03, p=.027) and total effect(γ=-.19, p=.007). Job stress was a significant indirect effect (β=.12, p=.009), total effect(β=.11, p=.038). Stress response was significant direct effect(β=.16, p=.040), indirect effect(β=.11, p=.005), total effect(β=.27, p=.009). Sleep hygiene was a significant direct effect (β=.32, p<.001) and total effect (β=.32, p<.001).
3) For the Job stress, perceived health status (γ=-.21, p=.001), shift work experience (γ=.18, p=.002), perceived shift work status(γ=-.29, p<.001) was a significant direct effect and total effect.
4) For the Stress response, circadian type was a significant direct effect(γ=-021, p=<.001) and total effect (γ=-021, p=<.001). Perceived health status was a significant direct effect (γ=-.31, p<.001), an indirect effect(γ=.10,p=.009) and total effect(γ=-.40, p<.001). Shift work experience was significant direct effect(γ=.08, p=.012). Perceived shift work status was a significant indirect effect(β=-.13, p=.010) and total effect(γ=-.13, p=.010). Job stress was a significant direct effect(β=.46, p<.001) and total effect(β=.46, p<.001).
5) For the health promoting behavior, perceived health status was a significant direct effect(β=.24, p=.007) and total effect (γ=.24, p=.008).
6) For the sleep hygiene, circadian type was a significant indirect effect(γ=-.08, p=.002) and total effect(γ=-.12,p=.015). Perceived health status was a significant direct effect(γ=-.19, p=.002) an indirect effect(γ=-.14, p<=.009) and total effect(γ=-.33, p=.026). Perceived shift work status was a significant indirect effect(γ=-.05, p=.012) and total effect(γ=-.05, p=.012). Job stress was a significant indirect effect(β=.16, p=.009), and total effect(β=.16, p=.009). Stress response was significant direct effect(β=.35, p<.001) and total effect(β=.35, p<.001).
In 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 the strategies for improving sleep quality of the shift work nurses focus the sleep hygiene, perceived health status, stress response, circadian type, perceived shift work status, and shift work experience.