Western Journal of Nursing Research最新文献

Background: Adequate sleep is critical for nurses, affecting their physical, emotional, and occupational health. Nurses suffer from higher levels of sleep disorders than the national average, especially night-shift nurses, with rates as high as 61%. Irregular work/sleep patterns and occupational stress are the main contributors to inadequate sleep for nurses. Not only does this issue impact nurses, but insufficient sleep has been linked to billions of dollars lost due to decreased productivity and medical errors.

Purpose: This integrative review explores and evaluates existing research on nonpharmacologic interventions designed to improve sleep function and quality for nurses.

Methods: A systematic search was performed to find research interventions that improved nurses' sleep. CINAHL, Scopus, and OVID Medline databases were searched using the terms (sleep OR circadian rhythm) AND (intervention OR sleep hygiene) AND (nurs*). After the initial search, reference lists and secondary sources were evaluated for potential articles for inclusion.

Results: This review included 33 articles. Interventions included exercise, lighting manipulation, supplements, aromatherapy, education, music therapy, and mindfulness/meditation. All 7 exercise interventions included in this review improved participants' sleep length and quality. Nearly all mindfulness and aromatherapy interventions that promote relaxation and stress reduction were effective. Exposing nurses to bright light did not necessarily correlate with increased sleep but did improve fatigue levels at work.

Conclusion: Prioritizing sleep can ensure the health and safety of nurses, and further research is still needed. Health care organizations can positively impact this problem by implementing effective practices to improve the sleep health of nurses.

Background: Shift work and scheduling are major contributors to occupational stress for nurses, leading to job dissatisfaction and risk of turnover. Nurse scheduling processes are complex, as they are dynamically linked to nurse staffing and patient demand.

Objective: This study sought to describe barriers and facilitators influencing job and scheduling satisfaction among staff nurses and nurse managers.

Methods: We used a qualitative descriptive design. The sampling frame included staff nurses and nurse managers employed at an urban academic medical center. Participants (N = 16) completed individual semi-structured Zoom interviews from August 2023 to February 2024, which were audio recorded and transcribed. Data were analyzed using content analysis.

Results: The overarching theme identified was "Scheduling is everything," reflecting the importance of scheduling for nurses' satisfaction in and outside of work. Both staff nurses and managers identified tensions between scheduling for patient care needs (e.g., adequate staffing) and scheduling to optimize staff needs (e.g., health, sleep). They also identified staffing shortfalls as a contributor to these scheduling tensions. Staff nurses reported that scheduling challenges compromised their health and well-being, caused work-family conflict, and influenced turnover intentions. Facilitators of scheduling satisfaction included scheduling flexibility, autonomy, and equity. Participants also provided pragmatic ideas for improving scheduling processes.

Conclusions: Our study explored perspectives on job and scheduling satisfaction through the lens of both staff and managers. Scheduling challenges contribute to nurses' job dissatisfaction and turnover intentions. By increasing scheduling flexibility, equity, and integrating nurse-led innovations into the scheduling process, healthcare organizations can potentially increase nurse retention.

Background: Working at night leads to misalignment between the biological clock and the work/sleep schedule, resulting in sleepiness and impaired performance during the night shift and poor quality, shortened sleep during the day; this is greatly impaired in older individuals.

Objective: To describe night work and sleep experiences from the perspective of older (aged 50-65) nurses.

Methods: Seven virtual focus groups were formed comprising 19 older nurses who worked regular 8-hour night shifts (at least 6 consecutive hours between midnight and 6 am) to learn about their shift work and sleep experiences. Two facilitators and 2 research assistants independently reviewed and coded the transcripts using qualitative content analysis.

Results: Nine themes were identified in 3 domains: (a) night shift challenges and difficulties, including first night shift is most difficult; never feel rested working nights; and personal health concerns and benefits from working nights; (b) sleep challenges and difficulties, including inconsistent sleep timing when switching between nights and days; extended (24+ hours) time awake before and after consecutive nights; difficulty maintaining long and sound daytime sleep; and napping before night shifts for better performance; and (c) family and social challenges and support, including childcare, family, personal obligations, and social activities affect sleep; aging of self and children influences sleep and prioritization of sleep.

Conclusions: The findings help understand challenges and struggles to obtain adequate sleep and safe work performance in older night shift nurses. These insignts are critical for designing and implementing feasible and acceptable interventions to improve sleep in this high-risk occupational group.

Background: Nursing shift work disrupts circadian rhythms, negatively impacting physical and mental health. Night shift workers face the added challenge of shift work disorder. Resilience training may help mitigate these effects and improve perceived organizational support.

Objective: We aimed to examine the effect of the Community Resilience Model^® training on outcomes (ie, perception of organizational support, resilience, burnout, distress, and intention to leave) among shift workers at an academic medical center while exploring differences in demographics, work characteristics, and outcomes by shift type (day vs night).

Methods: Training was offered to all nursing roles. Work characteristics, demographics, and nurse outcomes were collected via an online survey. Binomial logistic regressions were conducted for all outcomes.

Results: Of our sampling (N = 878), 52.6% were nurse staff, 23% usually worked night shifts, and 28% attended training. Night shift workers reported significantly lower perceptions of organizational support (P = .03) and resilience (P = .005). Over 55% of night shift workers reported burnout compared to 45% of day shift workers. Sixty-three percent of night and 51% of day shift workers were distressed (P = .002). Training attendees reported significantly higher perceptions of organizational support. Participants reporting higher perceived organizational support also reported less burnout, distress, and intention to leave.

Conclusion: Participants in resilience training rated higher perceptions of organizational support, particularly among night shift workers, who reported lower support, resilience, and higher burnout and distress. These results suggest that resilience training may benefit night shift workers by enhancing support and reducing negative outcomes.

Background: Hispanic and Latinx dementia family caregivers frequently face heightened stress, which can negatively impact their health and well-being. Balancing employment and caregiving responsibilities adds to this burden, potentially influencing decision-making involvement and sleep.

Objective: This study examined the relationship between employment status, caregiver involvement in everyday decision-making, and sleep duration among Hispanic and Latinx dementia caregivers.

Methods: A sample of 138 Hispanic and Latinx dementia caregivers completed online surveys on their daily caregiving experiences. Cross-tabulations and linear regression were used to analyze associations between employment status (full-time, part-time, retired, stopped working due to caregiving), decision-making (eg, daily activities, meals, medical care), and total sleep time.

Results: Participants had a mean age of 55.1 years (SD = 14), were predominantly female, and primarily cared for a parent. Caregivers who stopped working due to caregiving were more involved in planning activities (χ² = 20.21, P < .027). Retired caregivers were more involved in meal planning (χ² = 17.34, P < .01), and those who stopped working were more involved in medical decisions (χ² = 35.45, P < .001). Greater decision-making involvement predicted shorter total sleep time (β = -0.198, P < .01). However, the interaction between full-time employment and decision-making involvement was significant (β = 0.235, P = .05), suggesting that full-time employment buffered the negative impact of decision-making involvement on sleep duration.

Conclusions: Findings highlight the complex relationship between employment status, decision-making involvement, and sleep among Hispanic and Latinx dementia caregivers. Culturally tailored interventions that consider both caregiving decision-making and employment-related demands may help support caregiver health and well-being.

Background: Long-haul truck drivers experience many challenges while working "on the road." These challenges include, but are not limited to, problems with sleep, access to health care, and loneliness. It is also known that they have tend to have a number of chronic medical conditions, including mental health diagnoses.

Objective: The purpose of this study was to explore how sleep, loneliness, and health care access are related to depression, post-traumatic stress, number of medical diagnoses, and medication use among long-haul truck drivers.

Methods: A total of 98 participants were recruited to the study by way of Facebook-based and trucking industry-specific websites. Potential participants reviewed an online study information sheet and clicked forward to the survey, indicating their consent to participate. At that point, participants engaged with a 60-item online Qualtrics survey containing items related to the variables of interest and demographics.

Results: Participants were primarily married or partnered white males aged 54 years old. They experienced poor sleep, moderate loneliness and depression, and probable post-traumatic stress. The final model showed that while all the independent variables, except the number of medications prescribed, predicted the dependent variables, sleep quality significantly influences mental health in this sample.

Conclusions: Ongoing education of providers, truck drivers, and their employers on the significance of sleep on mental health is essential. Addressing loneliness, using multiple modalities, should be considered. Finally, the importance of mental health and social connections should be stressed by all providers who encounter truck drivers to support their well-being.

Background: Double-duty nurse caregivers manage caregiving responsibilities within their professional nursing roles and in personal family caregiving contexts. This dual role often leads to complex challenges and conflicting demands between caregiving roles. Nurses who are family caregivers experience both professional and personal caregiving burdens and strains.

Objectives: This study explored the experiences of double-duty nurses, highlighting the unique challenges they encounter.

Methods: This qualitative descriptive analysis explored the experiences of double-duty nurse caregivers through semi-structured interviews. Participants (n = 16) were recruited throughout the United States and interviewed via Zoom. Qualitative descriptive and thematic analyses were used to analyze the data.

Findings: Interviews from 16 participants were analyzed. Participants described their roles as a blessing and a curse, highlighting the emotional toll and professional fulfillment associated with caregiving. Major themes included (1) the nurse of the family; (2) family and professional caregiving conflicts; (3) better nurses for patients and family caregivers; and (4) dual support needs.

Conclusion: The study underscores the multifaceted challenges that double-duty nurse caregivers face and emphasizes the necessity for comprehensive support strategies. Interventions should address emotional resilience, financial stability, and access to supportive resources to mitigate burnout and sustain caregiving practices within the nursing profession. Nurses carrying both roles may need additional workplace, family, and community support to manage their caregiving roles.

Background: More than half of surrogate decision-makers experience regret after making decisions for a patient in the intensive care unit (ICU). This risk is enhanced following patient death yet may be buffered by their emotion regulation tendencies.

Objective: We investigated how a patient's survival outcome (alive/deceased) influenced their surrogate decision-maker's risk of developing decision regret and how their cognitive reappraisal tendencies for emotion regulation mitigate this risk.

Methods: Using data collected from a randomized controlled trial, we performed a secondary analysis of 158 surrogate decision-makers for incapacitated, mechanically ventilated adults within 4 ICUs at a tertiary medical center. We measured cognitive reappraisal tendency at study enrollment and decision regret 90 days post-enrollment. Adjusting for individual and process-related factors, we used logistic regression to examine the association between a patient's survival outcome and their risk of experiencing decision regret and the moderating role of cognitive reappraisal tendency on this relationship.

Results: Fifty percent of surrogate decision-makers reported decision regret. Surrogates of deceased patients had 5.7 times greater odds of regret than those of survivors. Among these surrogates, a 1 standard deviation increase in their cognitive reappraisal tendency was associated with a 4-fold reduction in their odds of experiencing regret.

Conclusions: Surrogate decision-makers of decedents are more likely to experience regret. These odds decrease as the surrogate's tendency to use cognitive reappraisal increases. Reappraisal-based interventions could improve psychological outcomes for surrogate decision-makers, highlighting a novel opportunity for targeted support in critical care settings.

Background: Cardiac patients often experience sleep problems and reduced physical activity (PA) after cardiac surgery. Sleep and PA are known to have a reciprocal interaction, but their temporal dynamic relationship remains unexplored in this population.

Objective: This study aimed to examine the temporal bidirectional relationship between sleep and PA after cardiac surgery using a cross-lagged panel model (CLPM).

Methods: This exploratory, longitudinal study involved a secondary analysis of previous data. The sample consisted of 33 adults who had undergone open-heart surgery at least 10 weeks prior. Five sleep and four PA variables were measured over 7 days using a wrist-worn ActiGraph. Data were analyzed using CLPM.

Results: Participants (mean age = 60.8 ± 10.1 years) had undergone cardiac surgery an average of 85.7 ± 91.2 months previously. The most common surgery type was coronary artery bypass grafting. Mean total sleep time was 6.4 ± 1.2 hours, below the recommended average of 7 hours, while average moderate-to-vigorous PA (117.8 ± 70.3 min/day) exceeded US guidelines. CLPM revealed unidirectional causation between sleep and PA; improved sleep efficiency predicted higher kilocalories expended and lower sedentary time the next day, while no PA predicted subsequent sleep.

Conclusions: Improving sleep quality may enhance postsurgery PA, emphasizing the importance of integrated strategies targeting both behaviors in clinical and home-based rehabilitation programs. Future studies should explore the temporal dynamics between sleep and PA with a larger sample at different time points after surgery, while incorporating relevant covariates and mediators to deepen the understanding of these complex interactions.

Background: Cognitive impairment is the most common residual symptom following COVID infection, reported in approximately 22% of adults diagnosed with COVID-19. Subjective cognitive decline is considered a significant early indicator of the progression of Alzheimer's disease. There is limited research investigating subjective cognitive decline following COVID-19 infection.

Purpose: The purpose of this study was to examine the relationship between COVID-19 infection and subjective cognitive decline in adults.

Methods: In this comparative and cross-sectional study, data were collected via an online survey involving 98 adults diagnosed with COVID-19 and 317 adults never diagnosed with COVID-19. The mean age of participants was 30.2 ± 8.4 years, and 36.6% were female. The revised Everyday Cognition Scale was used to assess subjective cognitive decline. Data analysis included descriptive statistics, one-way analysis of covariance, and hierarchical multiple regression.

Results: After controlling for covariates, adults diagnosed with COVID-19 experienced significantly greater subjective declines in memory (P = .002), language (P = .002), organizational ability (P = .03), attention (P = .003), and global cognition (P = .007) than those never diagnosed with COVID-19. Furthermore, COVID-19 diagnosis was a significant predictor of worse subjective declines in these domains of cognition.

Conclusion: Findings highlight the associations between COVID-19 infection and subjective cognitive decline across various domains. These results underscore the need for longitudinal studies to explore the progression of cognitive decline. Early detection and management of cognitive dysfunction can prevent further deterioration of cognitive function.