The impact of sleep toward executive functions among rapidly rotating shift nurses of emergency departments in Indonesia

Submitted: 11 September 2023
Accepted: 13 October 2023
Published: 31 October 2023
Abstract Views: 680
PDF: 260
HTML: 18
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Sleep problems are significant and are closely related to attention issues, impacting executive function disorders, especially among healthcare professionals, including nurses. In contemporary times, shift work has emerged as a new challenge for healthcare professionals, affecting their health, wellbeing, and cognitive functions. This study aimed to investigate the relationship between sleep and executive function among staff working in the Emergency Department (ED). The research was a cross-sectional study conducted on emergency nurses (EN) from four hospitals in Malang, Indonesia. Sleep quantity parameters, including total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE), were collected based on 7-day sleep diaries. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Executive function was assessed using a Trail Making Test (TMT). Data analysis was carried out using one-sample T-tests and multiple linear regression with a stepwise model. Around 82% of ER have poor sleep quality (PSQI > 5). Other findings WASO, TST, and SE reported a shorter duration compared to the healthcare population, while the duration of SOL was twice as long. the sources of executive function TMT-A, TMT-B, and TMT B-A were longer, and TMT B/A was shorter than the normal population. TST was negatively related to simple (TMT-A), alternating (TMT-B), and performance difference (TMT B-A) p values =0.000. This study concludes that fast-rotating shift ED nurses experienced poor sleep and executive function. The most significant factors influencing executive function were TST and BMI.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Beligala DH, De A, Geusz ME. A meta-analysis characterizing stem-like gene expression in the suprachiasmatic nucleus and its circadian clock. Biomed Res Int 2018; DOI: 10.1155/2018/3610603. DOI: https://doi.org/10.1155/2018/3610603
Teoh AN, Kaur S, Mohd Shukri NH, et al. Psychological state during pregnancy is associated with sleep quality: preliminary findings from MY-CARE cohort study. Chronobiol Int 2021;38:959–970. DOI: https://doi.org/10.1080/07420528.2021.1902338
Tse LA, Wang C, Rangarajan S, et al. Timing and Length of Nocturnal Sleep and Daytime Napping and Associations with Obesity Types in High-, Middle-, and Low-Income Countries. JAMA Netw Open 2021;4:e2113775. DOI: https://doi.org/10.1001/jamanetworkopen.2021.13775
Roestamadji RI, Luthfi M, Surboyo MDC, et al. Sleep time duration does not affect oral inflammation and periodontal health status in night-shift workers: A cross-sectional study. Nat Sci Sleep 2020;12:1083–1090. DOI: https://doi.org/10.2147/NSS.S279088
Zare Khormizi H, Salehinejad MA, Nitsche MA, et al. Sleep-deprivation and autobiographical memory: Evidence from sleep-deprived nurses. J Sleep Res 2018;28:e12683. DOI: https://doi.org/10.1111/jsr.12683
Hastoro MFR. Relationship Between Physical Workload, Sleep Quality, Work Climate, And Noise Level With Work Fatigue In Rolling Mill Workers In Sidoarjo Steel Industry. Indones J Public Heal 2022;17:319–330. DOI: https://doi.org/10.20473/ijph.v17i2.2022.319-330
Weinmann T, Vetter C, Karch S, et al. Shift work and cognitive impairment in later life - Results of a cross-sectional pilot study testing the feasibility of a large-scale epidemiologic investigation 11 Medical and Health Sciences 1117 Public Health and Health Services. BMC Public Health 2018;18:1–8. DOI: https://doi.org/10.1186/s12889-018-6171-5
Putra EK, Machfoed MH. Correlation of sleep quality and anxiety with pain intensity in primary headache patients. Medico-Legal Updat 2020;20:843–847.
Efendi F, Tonapa SI, Has EMM, et al. Effects of chair-based resistance band exercise on physical functioning, sleep quality, and depression of older adults in long-term care facilities: Systematic review and meta-analysis. Int J Nurs Sci 2023;10:72–81. DOI: https://doi.org/10.1016/j.ijnss.2022.12.002
Durán-Gómez N, Guerrero-Martín J, Pérez-Civantos D, et al. Night shift and decreased brain activity of ICU nurses: A near-infrared spectroscopy study. Int J Environ Res Public Health 2021;18:11930. DOI: https://doi.org/10.3390/ijerph182211930
Setyowati A, Yusuf A, Agianto, et al. Factors affecting shift work sleep disorder in female shift work nurses: Integrating shift workers’ coping with stress and transactional stress coping theory. J Public Health Res 2023;12:22799036231182024. DOI: https://doi.org/10.1177/22799036231182026
Dewanti NP, Jingga NA, Wahyudiono YDA. The relationship between work shifts and work environment with nurse fatigue in the emergency department. Int J Occup Saf Heal 2022;11:178–186. DOI: https://doi.org/10.20473/ijosh.v11i2.2022.178-186
Sun J, Stewart P, Chiew A, et al. Association between shift work and cognitive performance on the Trail Making Test in emergency department health officers. EMA - Emerg Med Australas 2021;33:711–717. DOI: https://doi.org/10.1111/1742-6723.13753
Setyowati A, Yusuf A, Haksama S, et al. Validity and Reliability of Shift Work Disorder Questionnaire among Indonesian Female Nurses. Malaysian J Public Heal Med 2021;21:145–150. DOI: https://doi.org/10.37268/mjphm/vol.21/no.3/art.1194
Gumenyuk V, Howard R, Roth T, et al. Sleep Loss, Circadian Mismatch, and Abnormalities in Reorienting of Attention in Night Workers with Shift Work Disorder Sleep 2014;37:545–556. DOI: https://doi.org/10.5665/sleep.3494
Kanda T, Tsujino N, Kuramoto E, et al. Sleep as a biological problem: an overview of frontiers in sleep research. J Physiol Sci 2016;66:1–13. DOI: https://doi.org/10.1007/s12576-015-0414-3
Tedjasukmana R, Budikayanti A, Islamiyah WR, et al. Sleep disturbance in post COVID-19 conditions: Prevalence and quality of life. Front Neurol 2023; DOI: 10.3389/fneur.2022.1095606. DOI: https://doi.org/10.3389/fneur.2022.1095606
Diamond A. Executive Functions. Annu Rev Clin Psychol 2014;64:135–168. DOI: https://doi.org/10.1146/annurev-psych-113011-143750
Lehto JE, Uusitalo-Malmivaara L. Sleep-related factors: Associations with poor attention and depressive symptoms. Child Care Health Dev 2014;40:419–425. DOI: https://doi.org/10.1111/cch.12063
Dong H, Zhang Q, Sun Z, et al. Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors. BMC Psychiatry 2017;17:241. DOI: https://doi.org/10.1186/s12888-017-1402-3
Feleke SA, Mulatu MA, Yesmaw YS. Medication administration error: Magnitude and associated factors among nurses in Ethiopia. BMC Nurs 2015;14:1–9. DOI: https://doi.org/10.1186/s12912-015-0099-1
Ohayon MM, Carskadon MA, Guilleminault C, et al. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: Developing normative sleep values across the human lifespan. Sleep 2004;27:1255–1273. DOI: https://doi.org/10.1093/sleep/27.7.1255
Dietch JR, Sethi K, Slavish DC, et al. Validity of Two Retrospective Questionnaire Versions of the Consensus Sleep Diary: The Whole Week and Split Week Self-Assessment of Sleep Surveys Jessica. Sleep Med 2019;63:127-136. DOI: https://doi.org/10.1016/j.sleep.2019.05.015
Alim IZ. Uji validitas dan reliabilitas instrumen pittsburgh sleep quality index versi Bahasa Indonesia [Test validity and reliability of the instrument pittsburgh sleep quality index Indonesia language version.] Jakarta: University of Indonesia , 2015.
Giovagnoli AR, Del Pesce M, Mascheroni S, et al. Trail making test: normative values from 287 normal adult controls. Ital J Neurol Sci 1996;17:305–309. DOI: https://doi.org/10.1007/BF01997792
Sánchez-Cubillo I, Periáñez JA, Adrover-Roig D, et al. Construct validity of the Trail Making Test: Role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. J Int Neuropsychol Soc 2009;15:438–450. DOI: https://doi.org/10.1017/S1355617709090626
Buysse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193–213. DOI: https://doi.org/10.1016/0165-1781(89)90047-4
Wolf LA, Perhats C, Delao A, et al. The Effect of Reported Sleep, Perceived Fatigue, and Sleepiness on Cognitive Performance in a Sample of Emergency Nurses. J Nurs Adm 2017;47:41–49. DOI: https://doi.org/10.1097/NNA.0000000000000435
Ruggiero JS, Avi-Itzhak T. Sleep Patterns of Emergency Department Nurses on Workdays and Days off. J Nurs Res 2016;24:173–180. DOI: https://doi.org/10.1097/jnr.0000000000000121
Kumar A, Sinha A, Varma JR, et al. Burnout and its correlates among nursing staff of intensive care units at a tertiary care center. J Family Med Prim Care 2021;10:443-448. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1651_20
Knowlton M, Riseden J. Emergency Department Nursing Burnout and Resilience. Adv Emerg Nurs J 2022;44:54-62. DOI: https://doi.org/10.1097/TME.0000000000000391
Membrive-Jiménez MJ, Gómez-Urquiza JL, Suleiman-Martos N, et al. Relation between Burnout and Sleep Problems in Nurses: A Systematic Review with Meta-Analysis. Healthcare (Basel) 2022;10:954. DOI: https://doi.org/10.3390/healthcare10050954
Di Muzio M, Reda F, Diella G, et al. Not only a Problem of Fatigue and Sleepiness: Changes in Psychomotor Performance in Italian Nurses across 8-h Rapidly Rotating Shifts. J Clin Med 2019;8:47. DOI: https://doi.org/10.3390/jcm8010047
Nakakubo S, Makizako H, Doi T, et al. Impact of poor sleep quality and physical inactivity on cognitive function in community-dwelling older adults. Geriatr Gerontol Int 2017;17:1823–1828. DOI: https://doi.org/10.1111/ggi.12973
Wardle-Pinkston S, Slavish DC, Taylor DJ. Insomnia and cognitive performance: A systematic review and meta-analysis. Sleep Med Rev 2019;48:101205. DOI: https://doi.org/10.1016/j.smrv.2019.07.008
Ferri P, Guadi M, Marcheselli L, et al. The impact of shift work on the psychological and physical health of nurses in a general hospital: A comparison between rotating night shifts and day shifts. Risk Manag Healthc Policy 2016;9:203–211. DOI: https://doi.org/10.2147/RMHP.S115326
Dall’Ora C, Ball J, Recio-Saucedo A, et al. Characteristics of shift work and their impact on employee performance and wellbeing: A literature review. Int J Nurs Stud 2016;57:12–27. DOI: https://doi.org/10.1016/j.ijnurstu.2016.01.007
Kantrowitz J, Citrome L, Javitt D, et al. GABA(B) receptors, schizophrenia and sleep dysfunction: a review of the relationship and its potential clinical and therapeutic implications. CNS Drugs 2009;23:681–691. DOI: https://doi.org/10.2165/00023210-200923080-00005
Wilckens KA, Ferrarelli F, Walker MP, et al. Slow-Wave Activity Enhancement to Improve Cognition. Trends Neurosci 2018;41:470–48 DOI: https://doi.org/10.1016/j.tins.2018.03.003
Singh A, Cao S, Kingyon J, et al. effects of cerebellar delta and theta frequency tACS on cognitive performance in patients with schizophrenia. Brain Stimul 2019;12:e99‐e100. DOI: https://doi.org/10.1016/j.brs.2018.12.201
Galván A. The Need for Sleep in the Adolescent Brain. Trends Cogn Sci 2020;24:79–89. DOI: https://doi.org/10.1016/j.tics.2019.11.002
Wilckens KA, Woo SG, Kirk AR, et al. Role of sleep continuity and total sleep time in executive function across the adult lifespan. Psychol Aging 2014;29:658–665. DOI: https://doi.org/10.1037/a0037234
Kuula L, Pesonen AK, Martikainen S, et al. Poor sleep and neurocognitive function in early adolescence. Sleep Med 2015;16:1207–1212. DOI: https://doi.org/10.1016/j.sleep.2015.06.017
Blackwood J, Shubert T, Forgarty K, et al. Relationships between Performance on Assessments of Executive Function and Fall Risk Screening Measures in Community-Dwelling Older Adults. J Geriatr Phys Ther 2016;39:89–96. DOI: https://doi.org/10.1519/JPT.0000000000000056

How to Cite

Setyowati, L., Chiu, H.-Y., Kurnia, A. D., Aini, N., Mashfufa, E. W., & Marta, O. F. D. (2023). The impact of sleep toward executive functions among rapidly rotating shift nurses of emergency departments in Indonesia. Healthcare in Low-Resource Settings, 11(2). https://doi.org/10.4081/hls.2023.11744