Chronotype, nursing activity, and gender: A systematic review

J Adv Nurs. 2019 Apr;75(4):734-748. doi: 10.1111/jan.13876. Epub 2018 Nov 19.

Abstract

Aim: To synthesize evidence about the effect of individual circadian preference (chronotype) and gender in the development of sleep and mood problems in nursing professionals.

Background: Shift workers are more prone to having unhealthy habits and unfavourable clinical conditions than nonshift workers. These associations are mediated by chronotype and gender differences have also been detected.

Design: A quantitative systematic review.

Data sources: Electronic searches were performed in MEDLINE, Scopus, ScienceDirect, and Web of Science from 1 July 2012 - 1 July 2017.

Review methods: A systematic review was conducted using the Cochrane Collaboration guidelines and two quality assessment tools: the National Heart, Lung and Blood Institute and GRADE. Inclusion criteria were quantitative studies where the sample consists entirely of nurses, analysing circadian rhythms or individual chronotype or gender and sleep/mood disturbances in nursing activity. The review was reported using the PRISMA statement.

Results: A total of 23 studies were included in the review (five cohort studies and 18 cross-sectional studies). Data on gender-specific attention were scarce (two studies) and showed a higher incidence of sleep problems. Female nurses with eveningness-oriented personality seem to be more prone to having sleep disorders, insomnia, fatigue, and anxiety than male and morningness ones.

Conclusions: Evidence seems to show that female nurses with an evening-oriented preference suffer more problems of insomnia, sleepiness, fatigue, and anxiety. The impact of our results may affect nurses, patient safety and the quality of clinical practice.

目的: 综合个人昼夜节律偏好(时型)和性别对护理专业人员睡眠和情绪问题发展的影响的证据。 背景: 轮班员工比不轮班员工更容易养成不健康的习惯和不良的临床状况。这些联系由时型作为媒介,同时,也涉及性别差异。 设计: 定量系统性评价。 数据来源: 2012年7月1日至2017年7月1日期间,在MEDLINE、Scopus、Science-Direct和科学网进行电子搜索。 综述方法: 使用科克伦协作组织指南和两个质量评估工具进行系统性评价:国家心肺血液研究所和GRADE。纳入标准是定量研究,其中,样本完全由护士组成,以分析护理活动中的昼夜节律或个体时型或性别以及睡眠/情绪障碍。使用PRISMA声明对这项评价进行报告。 结果: 评价中共包含23项研究(五项队列研究和18项横向研究)。在性别方面,并无特别关注(两项研究),并且,性别方面的数据突显出睡眠问题的发生率较高。夜型人女性护士似乎比男性和晨型人更容易出现睡眠障碍、失眠、疲劳和焦虑。 结论: 证据似乎表明,有着夜型偏好的女性护士失眠、嗜睡、疲劳、焦虑等问题较多。研究结果可能会影响到护士、患者的安全以及临床实践的质量。.

Keywords: chronobiology; chronotype; circadian rhythm; gender; mood; nursing; nursing activity; patient safety; sleep; systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Chronobiology Disorders / etiology*
  • Circadian Rhythm / physiology
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Mood Disorders / etiology*
  • Nursing*
  • Observational Studies as Topic
  • Occupational Diseases / etiology*
  • Sex Characteristics
  • Sleep Wake Disorders / etiology*
  • Work Schedule Tolerance / physiology