The relation between routines for shiftwork scheduling and sickness absence at a Norwegian hospital: A cross-sectional study

Int J Nurs Stud. 2023 May;141:104477. doi: 10.1016/j.ijnurstu.2023.104477. Epub 2023 Mar 3.


Background: Shift work is associated with negative health outcomes. Routines for scheduling of shift work can help reduce negative health outcomes of shift work and improve work-life balance and social well-being for nurses working shift work.

Objective: To investigate the association between organizational units' routines for shift work scheduling and nurses' sickness absence at the unit level.

Design: Cross-sectional study design combining quantitative questionnaire data on shift work scheduling routines with data of mean percentage of sickness absence at the unit, mean level of exhaustion at the unit, mean age and percentage of women working at the unit.

Participants: A total of 126 leaders at organizational units with nurses working shift work schedule at Oslo University Hospital answered a questionnaire about shift work scheduling.

Measures: Three aspects of health-promoting shift work scheduling (fatigue-reducing scheduling, organizational health measures, and individual adaptation) and the extent to which operational considerations were made during shift work scheduling were used as independent variables. Covariates were mean age of nurses at each unit, mean percent female nurses, and mean exhaustion at unit level. Percent sickness absence was used as a dependent variable.

Methods: Questionnaire data on shift work scheduling routines was merged with information on average age of employees in the unit, ratio female nurses, and units' average score on exhaustion. Multivariable linear regression analyses were used to assess the contribution of routines for shift work scheduling after controlling for mean level of exhaustion, average age, and proportion of women at each unit.

Results: The factors "fatigue reducing scheduling", "organizational health measures" and "operational considerations" had no observed total effect on mean sickness absence. Individual adjustment in shift work scheduling had a direct negative association with sickness absence after controlling for other shift work scheduling routines, exhaustion, age, and gender.

Conclusions: There is a relationship between the units' routines for shift work scheduling and mean sickness absence at the unit, and the possibility of individual adjustment was the only aspect of shift work scheduling that had an above-zero association with sickness absence.

Tweetable abstract: Routines for scheduling of shift work that enable employees to make individual adjustments to improve quality of family/leisure activities are associated with lower rates of sickness/absence.

Keywords: Empowerment; Exhaustion; Health promotion; Involvement; Nurses; Occupational health; Scheduling; Shift work; Sickness absence.

MeSH terms

  • Cross-Sectional Studies
  • Fatigue
  • Female
  • Hospitals, University
  • Humans
  • Norway
  • Shift Work Schedule*