Jeanne S. Ruggiero

Effects of Napping on Sleepiness and Sleep-Related Performance Deficits in Night-Shift Workers: A Systematic Review

Night-shift workers are prone to sleep deprivation, misalignment of circadian rhythms, and subsequent sleepiness and sleep-related performance deficits. The purpose of this narrative systematic review is to critically review and synthesize the scientific literature regarding improvements in sleepiness and sleep-related performance deficits following planned naps taken during work-shift hours by night workers and to recommend directions for future research and practice. We conducted a literature search using the Medline, PsychInfo, CINAHL, Cochrane Library, and Health and Safety Science Abstracts databases and included English-language quasi-experimental and experimental studies that evaluated the effects of a nighttime nap taken during a simulated or actual night-work shift. We identified 13 relevant studies, which consisted primarily of small samples and mixed designs. Most investigators found that, despite short periods of sleep inertia immediately following naps, night-shift napping led to decreased sleepiness and improved sleep-related performance. None of the studies examined the effects of naps on safety outcomes in the workplace. Larger-scale randomized clinical trials of night-shift napping and direct safety outcomes are needed prior to wider implementation.

Organizational Culture, Quality of Work Life, and Organizational Effectiveness in Korean University Hospitals

Purpose: This study investigated correlates and predictors of organizational effectiveness, focusing on organizational culture and quality of work life. Design: Convenience sample of 145 nurses working in Korean university hospitals responded to a self-administered questionnaire. Findings: There were significant correlations between organizational culture, quality of work life, and organizational effectiveness. R 2 was 44.7% in the hierarchical multiple regression model, explaining and predicting organizational effectiveness. Discussion: Intact organizational culture and quality of work life for nurses will undoubtedly lead to improved organizational effectiveness. Without efficient and effective nursing care, desired patient outcomes cannot be achieved.

Sleep and Psychomotor Vigilance in Female Shiftworkers

The purpose of this study was to evaluate the relationships between sleep and psychomotor vigilance in female nurses and the changes in these variables over time. Participants comprised 16 staff registered nurses (10 day, 6 night; aged 30–65 years [M = 47.6; SD = 8.1]) who wore wrist actigraphs continuously and completed a 10-min psychomotor vigilance test (PVT-192, Ambulatory Monitoring, Inc., Ardsley, New York) and the Stanford Sleepiness Scale (SSS) in their homes before and after work for three consecutive 24-hr periods. Repeated measures ANOVA revealed that night nurses slept significantly less than day nurses, F(1, 15) = 26.06, p ≤ .001; M = 227.88 ± 37.03 min versus M = 365.75 ± 59.01 min, respectively, daily for three consecutive days. Night nurses napped more frequently and had more changes in the length of their main sleep periods than day nurses. Day nurses reported more wake episodes during main sleep periods. Night nurses were sleepier after work than day nurses; both groups had increased sleepiness after work for the first 2 days and similar psychomotor vigilance test results. These findings suggest that sleep deprivation, irregular sleep patterns, and sleepiness are significant issues for shiftworking nurses. Future study of the characteristics of sleep and sleepiness in a larger sample would be useful to evaluate the focus for interventions to improve sleep and alertness in shiftworking nurses.

Factors Affecting Job Satisfaction of Immigrant Korean Nurses

Purpose: An increasing number of foreign-born nurses are working in the United States. Nurses’ job satisfaction is a critical issue for quality patient care. The purpose of this study was to examine factors affecting the job satisfaction of immigrant Korean nurses. Design: We used a cross-sectional mailed survey design. A convenience sample (n = 105) of members of the Greater New York Korean Nurses Association currently working or had previously worked in the United States completed the questionnaires. We used hierarchical regression to test the effects of acculturation and life satisfaction on job satisfaction. Results: Most participants were female (n = 98, 93.3%) aged 27 to 70 years (mean = 52.27 years, SD = 10.67). In the regression model, life satisfaction, self-esteem, and perceived stress predicted job satisfaction (F = 5.127, p < .001) and explained 44.5% of the variance of job satisfaction. Discussion and Conclusion: U.S. nurses need to gain insight into factors influencing job satisfaction in Korean nurses to promote retention and quality care.

Sleep Patterns of Emergency Department Nurses on Workdays and Days Off.

Background: Shift workers, particularly night workers, are prone to disrupted circadian rhythms and sleep deprivation resulting in fatigue and sleepiness, thereby endangering patient safety. Little is known about the sleep patterns of emergency nurses who work highly variable around-the-clock schedules to meet the demands of fluctuating patient census and acuities throughout the 24-hour period. Purpose: The purpose of this pilot study was to determine whether there are shift-related sleep pattern differences in emergency department nurses over seven consecutive 24-hour periods that include both workdays and days off. Methods: A New Jersey mailing list (1514 members) was rented from the Emergency Nurses’ Association. Three hundred on this list were systematically sampled and invited by mail to participate. The final sample consisted of 35 emergency nurses. Participants wore actigraphs for 24 hours each day for 7 days and completed sleep diaries upon awakening from their daily main sleep periods. Queries included caffeine and hypnotics usage. The nurses also completed the Standard Shiftwork Index General Biographical Information Section for demographic and scheduling data. Participants received a

Treatment options for insomnia.

50 honorarium upon completion of the protocol. The actigraph data were downloaded into a personal computer using Act Millennium and analyzed with Action W software (Ambulatory Monitoring, Inc., Ardsley, NY, USA). Results: Sleep durations ranged from 6.6 to 8.1 hours on workdays and from 6.2 to 8.1 hours on days off. There were no significant shift- or workday-related differences in sleep patterns. However, trends indicated that, regardless of shift, workday sleep became more disturbed and less efficient toward the end of the week. Daily caffeine usage was reported by 85.9% of the sample. Conclusions/Implications for Practice: Shift working nurses need to obtain adequate and consistent sleep on workdays and days off throughout the work week to reduce fatigue and to provide safe patient care. Understanding the sleep patterns of emergency nurses and their schedules is critical to facilitating the development of shift-specific sleep promotion interventions to enhance sleep and thereby counteract fatigue.

Insomnia, Fatigue, Anxiety, Depression, and Quality of Life of Cancer Patients Undergoing Chemotherapy

Abstract Complaints of insomnia, including reports of difficulty initiating and remaining asleep, are often reported to primary healthcare providers. Nurse practitioners must be prepared to screen patients for this common sleep disorder as well as understand the latest treatment options for optimal patient outcomes .