Establishment of Sleep Quality, Physical and Mental Health and Occupational Burnout Management Model for Shift Nursing Staff and Evaluation of Its Effectiveness

Study Overview
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Brief Summary
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The purpose of this study was to investigate the relationship between the personal characteristics and work characteristics of shift nurses and occupational burnout, sleep quality and physical and mental health. Use  acupressure  as an intervention to compare the status of shift nurses before and after intervention and to track after interventional therapy, 1, 2, and 3 months of longitudinal results.

Detailed Description
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The purpose of this study was to investigate the relationship between the personal characteristics and work characteristics of shift nurses and occupational burnout, sleep quality and physical and mental health. Use  acupressure  as an intervention to compare the status of shift nurses before and after intervention and to track after interventional therapy, 1, 2, and 3 months of longitudinal results. Use the Smart Care VIP bracelet to detect physical and mental conditions (psychological stress, physical fatigue) to assess the applicability of the Smart Care VIP bracelet as a Shift Care Staff Sleep Quality, Physical and Mental Health and Occupational Burnout Management System and evaluate effectiveness, and establishment of an effective management system. Most studies in China have shown that the use of acupressure to improve the sleep quality of nursing staff generally has its efficacy, but the lack of research at proves that acupressure is used by nursing staff to improve sleep quality and improve occupational burnout. It is expected to be from May to December 2020. The nursing staff of a medical center in Taipei will be selected for stratified sampling. The conditions for receiving the case are shift nurses who have served in the institution for more than one year. Subjective sleep is assessed using Epworth sleepiness scale. The objective part is to use the Smart Care VIP Bracelet to measure sleep time; Chinese version of the Chinese Health Questionnaire-12 (CHQ-12) and occupational burnout scale questionnaire as a tool for discussion. It is planned to randomly assign shift nurses to 42 acupressure groups and control group (sham), and use activity record (Smart Care VIP bracelet) to monitor and record fatigue Index and stress changes.

Official Title
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Assistant Head Nurse (Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan)

Conditions
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Sleep Quality, Occupational Burnout

Intervention / Treatment
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* Behavioral: acupressure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Shift nursing staff who have been employed in this institution for more than one year, and there have been more than two shift types in the past year. Can fill out the questionnaire and agree to participate in this research and sign the consent form. Chinese Health Questionnaire-12 > 1.5 Epworth sleepiness scale > 6.5 points Exclusion Criteria: Long-term (more than one month) taking sleeping pills such as Benzodiazepines, Stilnox, Imovane, etc. Nursing staff in the same ward as the PI. Encountered major life problems one month before the intervention, such as: falling out of love, family member's accident, personal diagnosis of illness, etc.

Ages Eligible for Study
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Minimum Age: 22 Years
Maximum Age: 63 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: acupressure<br>Every day before going to sleep, massage acupoints for eight consecutive weeks, followed by Shenmen→Neiguan→Hegu acupoints. | Behavioral: acupressure<br>* self-acupressure<br>|
| Sham Comparator: sham acupressure<br>Every day before going to sleep, massage acupoints for eight consecutive weeks, followed by Waiguan→Liangqiu→Tiaokou→ Chengshan acupoints | Behavioral: acupressure<br>* self-acupressure<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sleep quality | Epworth sleepiness scale(ESS)Epworth sleepiness Scale - Taiwan form (ESS-T): .The internal consistency of the scale Cronbach's α = .81, and then measured the reliability r = .74, p = .001. .The evaluation of the degree of drowsiness is expressed as a score of zero (never occurred) to three (almost all), with a total of 24 points. The higher the total score, the more severe the level of drowsiness. A zero score indicates the best situation. | 3 months | 
| Physical and Mental Health | Chinese Health Questionnaire-12 (CHQ-12): The reliability and validity of Cronbach'α was 0.83-0.92 (Cheng et al., 1990) CHQ-12 has 12 questions in total, two of which are positive. Ten questions of which are negative. It is a self-reported four-point scale. It is score from 0-0-1-1, with a total score of 12 points. | 3 months | 
| Chinese version of the Occupational Burnout Inventory: | The occupational burnout inventory consists of four subscales with 21 questions. All subscales have a score range of 0-100 points. The scale is measured by the respondent self-assessed the frequency of various problems in the past week. The total scale score is the sum of all subscale scores, and the higher the score, the higher the worker's feeling of burnout. The four subscales in the scale include personal burnout (5 questions), work burnout (5 questions), overwork (5 questions) and client burnout (6 questions). The Cronbach'α of the scale is above 0.84, and the scale has good construction validity and standard validity (Chang et al., 2007; Tseng, & Cheng, 2002; Yeh, Cheng, Chen, & Chiu, 2008). | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart Rate Variability, HRV -「Smart Care VIP Bracelet Watch」 | The Smart Care VIP Bracelet Watch worn on the subject's wrist for HRV monitoring to record changes in the individual's physical activity. The contents of the record include the total daily sleep time (hours), waking time (minutes), number of waking, physical and mental index (mental stress, physical burnout) and other data for each case. To obtain the heart rate variability index directly, which represents the low frequency (LF) (%) of the sympathetic nerve activity index. High frequency power (HF) (%) representing the parasympathetic nerve activity index, and low frequency / high frequency power ratio (LF / HF) representing the sympathetic / parasympathetic balance index. | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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health status, Sleep disturbances, HRV monitoring watch, shift rotation nurses, Occupational Burnout, acupressure