Atypical work schedules are associated with poor sleep quality and mental health in Taiwan female nurses

  • Pei-Chen Lin
  • Chung-Hey Chen
  • Shung-Mei Pan
  • Chih-Hong Pan
  • Chiou-Jong Chen
  • Yao-Mei Chen
  • Hsin-Chia Hung
  • Ming-Tsang Wu
Original Article



To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan.


This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6–10 months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12).


Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.26; 95% CI, 1.57–3.28; and OR, 1.91; 95% CI, 1.39–2.63, respectively). Additionally, rotation shift nurses who had ≥2 days off after their most recent night shifts showed significantly improved sleep quality and mental health (PSQI decreased of 1.23 and CHQ-12 decreased of 0.86, respectively). Comparison of sleep quality between the first and second surveys showed aggravated sleep quality only in nurses who had an increased frequency of night shifts.


Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses.


Shift work Nurses Pittsburgh Sleep Quality Index (PSQI) Chinese Health Questionnaire-12 (CHQ-12) 



The authors express their thanks to Kaohsiung County Nurses Association and Kaohsiung City Nurses Association. The project was supported by the Institute of Occupational Safety and Health (No: ISOH95-M318, IOSH96-M318) and the National Science Council (No: NSC97-2314-B-037-018-MY3).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Pei-Chen Lin
    • 1
    • 2
  • Chung-Hey Chen
    • 3
    • 4
  • Shung-Mei Pan
    • 5
    • 11
  • Chih-Hong Pan
    • 6
  • Chiou-Jong Chen
    • 6
  • Yao-Mei Chen
    • 4
    • 7
  • Hsin-Chia Hung
    • 10
  • Ming-Tsang Wu
    • 1
    • 8
    • 9
  1. 1.Graduate Institute of Occupational Safety and HealthKaohsiung Medical UniversityKaohsiungTaiwan
  2. 2.Research and TrainingKaohsiung Municipal Hsiao-Kang HospitalKaohsiungTaiwan
  3. 3.Institute of Allied Health Sciences and Department of NursingNational Cheng Kung UniversityTainanTaiwan
  4. 4.College of NursingKaohsiung Medical UniversityKaohsiungTaiwan
  5. 5.Department of NursingKaohsiung Municipal Ta-Tung HospitalKaohsiungTaiwan
  6. 6.Institute of Occupational Safety and HealthCouncil of Labor AffairsExecutive Yuan, New Taipei CityTaiwan
  7. 7.Department of NursingKaohsiung Municipal Hsiao-Kang HospitalKaohsiungTaiwan
  8. 8.Department of Family MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
  9. 9.Center of Environmental and Occupational MedicineKaohsiung Municipal Hsiao-Kang HospitalKaohsiungTaiwan
  10. 10.Department of NursingMeiho UniversityPingTungTaiwan
  11. 11.Superintendent OfficeKaohsiung Medical University HospitalKaohsiungTaiwan

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