title: Sleepiness in Spanish nursing staff--influence of chronotype and care unit in circadian rhythm impairment: research protocol.
abstract: OBJECTIVE
  To determine how prevalent circadian rhythm impairments are in nurses working in medical, surgical and intensive care units in five Spanish hospitals and how the quality of night-time sleeping and sleepiness affect the nurses' morning and evening chronotypes.
  
  
  BACKGROUND
  Shift work is a recognized work pattern for nurses in all countries. Given the important role that nurses play in hospital care, it is vital to establish what repercussions this has on the nurses' working schedules and how any disturbance in circadian rhythm affects patient safety.
  
  
  METHODS
  A multicentre, observational, descriptive and cross-sectional study in seven hospitals in the Spanish National Health System.
  
  
  METHODS
  A stratified sample of 1,300 nurses is being collected in three types of units: medical, surgical and intensive care. The 3-year study started in January 2012 and will continue until December 2014, with no exclusion criteria. The Kronowise(®) will be used to monitor the nurses' circadian rhythms, by recording their activity, position and wrist temperature. We will also use three questionnaires to evaluate sleep quality, daytime drowsiness and chronotype: (a) Pittsburg Sleep Quality Index; (b) Epworth Daytime Sleepiness Scale; and (c) Morning and Evening Questionnaire. Data will be collected from each hospital and statistical analysis will be carried out using the SPSS 19.0.
  
  
  CONCLUSIONS
  The study findings will show the current state of the nurses' circadian rhythms and how shift work can affect them and their job performance. Funding for this 3-year study was granted in December 2011 by the Spanish Health Research Fund (PI 11/00646, Health Ministry). This project is also funded by the Instituto de Salud Carlos III (RETICEF, RD12/0043/0011, RD12/0043/0006).
authors.affiliation: Nursing and Healthcare, Research Unit (Investén-isciii), Madrid, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Moreno-Casbas
authors.affiliation: Faculty of Nursing, University of Murcia, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Ruzafa-Martinez
authors.affiliation: Department of Animal Physiology, Faculty of Biology, University of Murcia, Spain.
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Rol
authors.affiliation: Department of Animal Physiology, Faculty of Biology, University of Murcia, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Madrid
authors.affiliation: Nursing and Healthcare, Research Unit (Investén-isciii), Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Serrano Pinto
authors.affiliation: Nursing and Healthcare, Research Unit (Investén-isciii), Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: González-María
authors.affiliation: Research Healthcare Unit, Hospital Vall D'Hebron, Barcelona, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Fuentelsaz-Gallego
mesh_terms: D002940:Circadian Rhythm / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009721:Nurse Midwives / Q000706:statistics & numerical data; D009726:Nurses / Q000706:statistics & numerical data; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D013030:Spain / Q000453:epidemiology; D014940:Work Schedule Tolerance / Q000502:physiology*
keywords: circadian rhythms; cross-sectional study; midwife; nurses; nursing; sleep; sleep disorders