title: Shiftwork impacts and adaptation among health care workers.
abstract: BACKGROUND
  Shiftwork among health care workers impacts upon the safety and health of both employees and patients.
  
  
  OBJECTIVE
  To characterize shiftwork-related attitudes, behaviours, symptoms and coping strategies among health care workers, two validated questionnaires (the Standard Shiftwork Index and the Pressure Management Indicator) were used to identify factors predicting shiftwork adaptation.
  
  
  METHODS
  Participants (n = 376, response rate 25%) were grouped according to their work schedule (days, permanent evenings, rotating days plus evenings, permanent nights or relief and combined shifts). Indicators of lifestyle, work organization, sleep disruption, health and pressure management among workers on irregular shifts were compared with participants on day shifts, after adjustment for gender, age and marital status. Principal components analysis and ordinal logistic regression were used among irregular shiftworkers to identify factors predicting schedule adaptation.
  
  
  RESULTS
  Night and relief/combined shiftworkers reported a greater ability to accommodate irregular schedules and disrupted sleep, but were also more likely to report work-related impacts than day workers. Permanent night workers generally reported poorer health, more absenteeism and less job satisfaction than day workers. Factors associated with optimal work performance or schedule contentment among shiftworkers included adequate sleep, evening circadian preference, increased age and organizational satisfaction. Reduced work performance or schedule discontent was associated with sleep/wake difficulties and poor health.
  
  
  CONCLUSIONS
  This study confirmed previous research and identified factors that can be targeted for the development of more effective shiftwork adaptation programmes in a health care setting (sleep timing and duration, exercise and optimal health and organizational satisfaction).
authors.affiliation: Department of Epidemiology and Biostatistics, Center for Colon Cancer Research, University of South Carolina, Columbia, 29208, USA. burch@mailbox.sc.edu
authors.forename: James B
authors.initials: JB
authors.lastname: Burch
authors.forename: Jasmine
authors.initials: J
authors.lastname: Tom
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Zhai
authors.forename: Lela
authors.initials: L
authors.lastname: Criswell
authors.forename: Edward
authors.initials: E
authors.lastname: Leo
authors.forename: Kisito
authors.initials: K
authors.lastname: Ogoussan
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D016272:Occupational Health / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling; D013022:South Carolina; D014940:Work Schedule Tolerance / Q000502:physiology*