An Evaluation of the Effectiveness of Shift Work Preparation Strategies

This study investigated whether workers who followed strategies for preparing and coping with the demands of shift work had more positive attitudes, and better physical and mental health. One hundred and twenty-two nurses completed a questionnaire measuring sleep, eating, fitness, and socializing strategies, as well as satisfaction with sleep, social life, shift work, and physical health and psychological well being. Nurses who followed the recommendations relating to socializing rated themselves more positively in terms of psychological well being, had fewer sleep problems, and were more satisfied with shift work and their social life. Physical fitness was also related to better health and psychological well being. In contrast, sleep and eating strategies did not significantly predict attitudes or behavior ratings. Explanations for the findings and their implications for shift workers are discussed. Shift work is a way of life for millions of full and part-time workers around the world including a sizeable proportion of the New Zealand work force. Unfortunately, many problems can result from shift work including sleep disturbances (Akerstedt, 1984; Aschoff, 1981; Kogi, 1982; Monk, 1987; Rutenfranz, Colquhoun, Knauth & Gnata 1977; Rutenfranz, 1982; Tepas & Monk, 1987), dietary or digestive problems (Rutenfranz, 1982; Stewart & Wahlqvist., 1985), difficulties structuring family and social interactions (Knutson, Akerstedt & Orth-Gomer, 1986; Simon, 1987; Tepas, 1985; Walker, 1985; Weiss, 1981), and more frequent accidents (DeVries-Griever & Meijman, 1987). Various strategies have been offered which suggest ways to avoid and cope with the problems associated with shift work (e.g., Jung, 1988; Monk, 1988; Monk & Folkard, 1992; Simon, 1990; Siebenaler & McGovern, 1991; Wedderburn & Scholarios, 1993,Williams, 1995). However there has been relatively little empirical validation of the effectiveness of these strategies (Tepas, 1993). The objective of this study was to examine the effects of shift preparation and coping strategies on shift worker's attitudes and health. A correctly set biological clock is arguably the single most important factor in ensuring a shift worker has good sleep and fewer jet-lag type symptoms (Monk & Folkard, 1992). Strategies designed to reduce disrupted sleeping patterns typically attempt to synchronize the body's biological clock as quickly as possible with the pattern of work activity and sleep required by a shift. Strategies suggested to aid adjustment of the biological clock to a night orientation include a routine of going to bed and rising at a set time for each particular shift (Jung, 1988; Monk, 1988; Simon, 1990; Siebenaler & McGovern, 1991; Williams, 1995), having meals at set times (Jung, 1988; Monk, 1988; Simon, 1990; Williams, 1995)and regular exercise (Jung, 1988; Simon, 1990). It is also recommended to have a 3 to 4 hour block of sleep time on days off which overlaps with the time the shift worker will be sleeping during the next working day (Siebenaler & McGovern, 1991). This strategy of `anchor sleep' can stabilize the circadian rhythms (Minors & Waterhouse, 1981), and result in less desynchronisation of circadian rhythms (Raymond, 1988). Shift workers should also ensure that their sleeping environment affords a good sleep by using curtains to ensure that the bedroom is as dark as possible (Monk, 1988; Simon, 1990; Shearer, 1991; Williams, 1995), that it is as quiet as possible (Monk, 1988; Simon, 1990; Siebenaler & McGovern, 1991; Monk & Folkard, 1992), and that the room temperature is cool but comfortable (Williams, 1995). To aid sleep onset, research suggests that the stimulant caffeine should be avoided within four hours of bedtime (Buysse, 1991). Sleeping pills should also be avoided wherever possible because they do nothing to rectify the chronic circadian misalignment problem which is the cause of sleeping problems (Smolensky & Reinberg, 1990). …