The Effect of Shift Rotation on Employee Cortisol Profile, Sleep Quality, Fatigue, and Attention Level: A Systematic Review

輪班工作對cortisol變化、睡眠品質、疲倦、注意力之影響：系統性文獻回顧

10.1097/JNR.0b013e31820c1879

鈕淑芬(Shu-Fen Niu)；鍾明惠(Min-Huey Chung)；陳瓊華(Chiung-Hua Chen)；Desley Hegney；Anthony O'Brien；周桂如(Kuei-Ru Chou)

睡眠品質 ； 疲倦 ； 輪班工作 ； 系統性文獻 ； 護理 ； sleep quality ； fatigue ； rotating shift work ； systematic review ； nursing

The Journal of Nursing Research

19卷1期（2011 / 03 / 01）

68 - 81

英文

背景　輪班的工作人員，特別是夜間工作者，因晝夜節律受干擾及不正常的睡眠型態，會產生睡眠剝奪、疲倦並降低警覺性及負向影響工作安全。 目的　回顧護理人員輪班對cortisol變化、睡眠品質、疲倦、注意力之影響。 方法　此系統性文獻查詢自1996自2008年發表之文章，資料庫搜尋包括SCOPUS、OVID、Blackwell Science、EBSCO Host、PsychINFO、Cochrane Controlled Trials Register及中華民國期刊論文索引，總共有28篇文獻納入。 結果　文獻中關於輪班工作對cortisol變化、睡眠品質、疲倦、注意力之影響的研究，所採用為實證等級Ⅱ至Ⅳ的證據。經由系統回顧發現，夜班工作者於睡醒週期及光暗週期發生衝突，引起的晝夜節律紊亂，影響睡眠品質產生疲倦並降低注意力，會導致工作效率降低。夜間工作者於日間體內cortisol分泌高時睡覺，會影響睡眠品質及睡眠時數，睡眠時數較白班工作者於夜間睡眠時數少1-4小時。大量的睡眠債會產生慢性疲倦。長期的疲勞和不足夠的休息，導致工作警覺性降低與意外事故增多。 結論　夜間工作者，因晝夜節律受干擾，會引起包括生理及心理上各種問題，並負向影響工作安全及效率。

Background: Disrupted circadian rhythm, especially working night duty together with irregular sleep patterns, sleep deprivation, and fatigue, creates an occupational health risk associated with diminished vigilance and work performance. Purpose: This study reviewed the effect of shift rotations on employee cortisol profile, sleep quality, fatigue, and attention level. Methods: Researchers conducted a systematic review of relevant articles published between 1996 and 2008 that were listed on the following databases: SCOPUS, OVID, Blackwell Science, EBSCO Host, PsycINFO, Cochrane Controlled Trials Register, and CEPS. A total of 28 articles were included in the review. Results: Previous research into the effects of shift work on cortisol profiles, sleep quality, fatigue, and attention used data assessed at evidence Levels Ⅱ to Ⅳ. Our systematic review confirmed a conflict between sleep-wake cycle and light-dark cycle in night work. Consequences of circadian rhythm disturbance include disruption of sleep, decreased vigilance, general feeling of malaise, and decreased mental efficiency. Shift workers who sleep during the day (day sleepers) experience cortisol secretion increases, which diminish the healing power of sleep and enjoy 1 to 4 hours less sleep on average than night sleepers. Sleep debt accumulation results in chronic fatigue. Prolonged fatigue and inadequate recovery result in decreased work performance and more incidents. Rotation from day shift to night shift and its effect on shift workers was a special focus of the articles retained for review. Conclusions: Disturbed circadian rhythm in humans has been associated with a variety of mental and physical disorders and may negatively impact on work safety, performance, and productivity.

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