Publication:

Fatigue, depression and anxiety among nurses working in shift in a tertiary care hospital in South India

Background Shift work has become a social and economic necessity, as most sectors like the healthcare require round the clock operation. Extended and variable working hours leads to desynchronization of the body’s circadian rhythm. Thus, shift work is commonly associated with various physical and mental disorders like insomnia, fatigue, depression, anxiety, cognitive impairment, etc. The aim of the study was to assess the prevalence of sleep deprivation and hence, the levels of fatigue, depression and anxiety among shift working nurses.

Methods This cross-sectional study was conducted among shift working nurses. Sleep deprivation among 97 female and 3 male healthy nurses of age 20-50 years was assessed by Epworth Sleepiness Scale (ESS). Fatigue Severity Scale, Patient Health Questionnaire (PHQ-9) and Hamilton Anxiety Rating Scale (HAM-A) were used for assessing fatigue, depression and anxiety respectively. Level of Sleep deprivation, Depression and Anxiety were expressed in Proportion. Difference in fatigue levels during day and night shift was analyzed using Wilcoxon Signed-Ranks Test.

Results Analysis of ESS, showed, 69% of shift working nurses had poorer sleep quality. The level of fatigue experienced following a night shift work was significantly higher than that following day shift work (Z= 3.34, p = 0.0008). Moderate to severe depression and anxiety was observed in 15% and 16% of the nurses working in shift.

Conclusions Thus, shift work is inevitably associated with sleep deprivation. There exists an increased prevalence of fatigue, depression and anxiety among shift working nurses.