Job satisfaction and sleep quality in nursing

SHORT COMMUNICATION
Job satisfaction and sleep quality in nursing professionals
Satisfação no trabalho e qualidade de sono entre trabalhadores de enfermagem
Edla Maria Silveira Luz1, Elaine Marqueze2, Claudia Moreno2
magem no hospital; admissão e escalonamento de pessoal; enfermagem do trabalho; saúde do trabalhador; trabalho em turnos; doenças
profissionais; carga de trabalho.
These findings are particularly applicable to nursing services,
in which work schedules are organized for the continuous
care of patients and include night work and irregular hours4.
Much scientific evidence exists about the negative physiological and psychological effects of work organization5.
Nursing is a profession that is part of a political, economic, and social context; thus, it is directly influenced by all of
these factors, both through legal questions and through the
economic policies adopted in Brazil at the beginning of the
1990s. In addition, transformations in the labor world have
impacted nursing. These factors can be observed in workers experiencing fear of unemployment and in workers subjected to long shifts and low wages, among other issues6. Job
dissatisfaction is considered by Dejours7 to be one of the fundamental burdens of health care workers because it is related
to significant aspects of the occupation. It may be caused
by feelings of indignation at being required to perform an
uninteresting task or by feeling dissatisfied with both salary
and work recognition.
Some studies have suggested that sleep disturbances,
which are common among shift workers, are associated
with psychosocial problems, such as job satisfaction8-10.
Assuming that sleep quality can influence job satisfaction, our aim was to assess the correlation between sleep
quality and job satisfaction among nursing professionals who work 12-hour shifts in a charity hospital in the
Southern Region of Brazil.
iNTRODUCTION
In the modern world, labor-related issues should no longer
be simply thought of as the immediate connection between
workers and their objectives. Changes in work environments
are more intense due to organizational, technological, and
social changes1.
Studies have reported that shift work can lead to alterations in sleep, digestive and nervous disturbances, cardiovascular diseases, and a disruption of family and social life2,3.
METHODS
This was a cross-sectional, quantitative epidemiological
study. The study was conducted in a regional charity hospital in the Southern state of Santa Catarina in Brazil. After
obtaining formal authorization from the hospital to perform
the study, the project was approved by the Ethics Committee of the Universidade do Sul de Santa Catarina.
The study population consisted of nursing assistants and
technicians who worked 12-hour night shifts. Of the 140
ABSTRACT
This study aimed to verify the correlation between job satisfaction and
sleep quality among nursing technicians and assistants who worked
12-hour night shifts at a philanthropic hospital in Tubarão (SC), Brazil. The participants of this study were 81 professionals, average age
31.9 years old (SD=8.18). Spearman correlation test showed a correlation between sleep quality and job satisfaction (r=-0.41; p<0.00).
Some aspects were reported as very satisfactory by these workers such
as work content and motivation towards the work as well as the extension in which they identify themselves with the hospital image.
Keywords: job satisfaction; nursing staff, hospital; personnel staffing and scheduling; occupational health nursing; occupational health;
shift work; occupational diseases; workload.
RESUMO
O objetivo deste estudo foi verificar a correlação entre satisfação no
trabalho e qualidade de sono em profissionais de enfermagem que trabalhavam em turnos noturnos de 12 horas em hospital filantrópico de
Tubarão (SC). Fizeram parte deste estudo 81 profissionais, com idade
média de 31,9 anos (DP=8,18). O teste de correlação de Spearman
mostrou que melhor qualidade de sono leva à satisfação no trabalho
(r=-0,41; p<0,00). Alguns aspectos mostraram-se bastante satisfatórios para esses trabalhadores, como conteúdo e motivação pelo trabalho, relacionamento com colegas e sua identificação com a imagem do
hospital.
Palavras-chave: satisfação no emprego; recursos humanos de enfer-
Curso de Medicina da Universidade do Sul de Santa Catarina (UNISUL), Tubarão (SC), Brazil.
Departamento de Saúde Ambiental da Faculdade de Saúde Pública da Universidade de São Paulo (USP), São Paulo (SP), Brazil.
Corresponding author: Edla Maria Silveira Luz – Universidade do Sul de Santa Catarina – Avenida José Acácio Moreira, 787 – Dehon – Caixa Postal: 370 – CEP 88704900 – Tubarão (SC), Brasil – E-mail: [email protected]
Received: October 26, 2010 – Accepted: July 29, 2011
1
2
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Job satisfaction and sleep quality
nursing professionals in the hospital, 81 worked the night
shift. The night shift workers were distributed among the 17
nursing units in the hospital that participated in the study.
These professionals worked one night (a 12-hour shift, from
7 pm until 7 am) and were off duty the following night, a
system that is termed “12 per 36 hours”.
The professionals in each work area were individually invited to participate in the research. The individual meetings
were held in the work place. The timing and duration of the
meetings depended on the availability of each professional
and the needs of the study.
The data collection was performed between April and
May of 2005. We used three questionnaires: 1) the Personal Data Questionnaire; 2) the Occupational Stress Indicator (OSI)11,12; and 3) the Pittsburgh Sleep Quality Index
(PSQI)13. It is important to point out that the Pittsburgh
Sleep Quality Index is negative scored, with the minimum
score meaning better sleep (score 0) and the maximum (score
21) meaning worse sleep.
We performed a descriptive analysis of the data and tested the Spearman rank-order correlation between job satisfaction and sleep quality.
RESULTS
The study participants worked in different sections of the
hospital. Most participants were from the Intensive Care
Unit (22.2%), followed by the surgery center (9.9%) and
the obstetrical center (9.9%). The remaining participants
(58%) were from different departments, such as pediatrics,
maternity, and emergency medicine.
The median age of the participants was 31.9 years, with
a maximum of 51 years and a standard deviation 8.18 years.
The majority were women (90.1%). Of the 81 workers who
participated in this study, 50.6% had children less than 12
years of age, and 49.4% do not have children in this age
group. The majority of the workers did not have secondary
employment (80.2%).
7.4%
7.4%
29.6%
Very good
Good
Poor
Very poor
55.6%
Figure 1. Subjective sleep quality.
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The Pittsburgh Sleep Quality Index had a mean of 11.4
points and a standard deviation of 3.1 points. The greatest
concentration of scores was between 5 points and 20 points,
and the median was 11 points.
Although the majority of those interviewed (42%) reported sleep of short duration (<5 hours/day), few considered their
sleep quality poor or very poor (37%) (Figure 1). Only 14.8%
of the subjects reported sleeping more than 7 hours.
Almost half of the workers (48.1%) reported disturbances in their sleep one to two times per week, and 4.9% reported problems in their sleep three times per week or more.
The percentage of workers who reported using medication
to sleep one or two times per week was 14.8%.
The job satisfaction and quality of sleep variables were
significantly correlated (r=-0.41 and p=<0.0), with a higher
job satisfaction corresponding to better sleep quality.
The job satisfaction variable had a mean of 65.7 points and
a standard deviation of 17.3 points. The minimum value possible on the scale is 22, and the maximum is 132 points.
The psychosocial job aspects that were most unsatisfactory for the study participants were communication and
flow of information (66.5%), use of individuals’ potential
(65.5%), the way that conflicts are resolved (60.5%), participation in important decisions (59.3%), evaluation procedures (59%), volume of work to be performed (58%), how
changes and innovations are implemented (55.8%), job security (51.9%), opportunities for reaching their career aspirations (51.8%), the type of assignments received (50.6%),
style of supervision by superiors (48.2%), flexibility and free
time (48.1%), salary in relation to experience (43.2%), psychological climate in the company (43.2%), and career opportunities (43.2%).
The aspects that gave the most satisfaction were relationships with other people in the company (67.9%), job content (60.5%), work motivation (58%), identification with
the image and achievements of the company (55.5%), the
possibility of growth and development at work (53%), and
the organizational structure of the company (46.9%).
DISCUSSION
The results of this study provided evidence for the correlation between job satisfaction and sleep quality, supporting
the idea that sleep quality indicates the degree of adaptation
to job demands in this population. According to Karagozoglu and Bingöl and the results presented here, poor sleep
quality is correlated with lower job satisfaction14. The association between sleep problems and work concerns has also
recently been demonstrated by Kristiansen et al.15.
For decades, studies have demonstrated that shift workers and night shift workers experience reduced sleep dura-
Luz EMS, Marqueze E, Moreno C
tion that is not compensated for during their free time16-19.
The accumulation of long-term sleep debt directly affects
job satisfaction, leading to lower job satisfaction due to the
shorter sleep duration20. As observed by Takahashi et al.21,
moreover, reduced sleep duration increases somnolence,
which can also be associated with low job satisfaction.
Regarding the actual work performed, the workers in
this study demonstrated satisfaction with the way they perceived their work, a finding that has also been previously
reported22-24. Silva studied the administrative professionals
of a large company in the Portuguese financial sector and
reported similar results. Satisfaction with the actual work
performed was identified as one of the major correlations
with job satisfaction24.
Although the prevalence of sleep medication use among
the workers was not high, the use frequency (up to two
times per week) deserves attention. Gordon et al. have
stressed that night shift workers show a quality of life-related increase in the use of alcohol, stimulants, and nervous
system depressants25.
Employee health is essential for good performance in any
institution. In nursing, low wages, demanding activities,
and tiring and repetitive night shifts aggravate the situation. This study demonstrated the significant relationship
between the psychosocial aspects of job satisfaction and
sleep quality.
The study population suffered from the influence of shift
work and night shift work. Shift work directly affects sleep
quality and consequently affects job satisfaction. Potential
changes should consider meeting the needs, expectations,
and wishes of employees to the extent that they are compatible with the demands of the tasks. Such changes will require
long-term, gradual implementation that may be constrained
by the economic, administrative, and human-resource limits
of organizations.
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