International Journal of Africa Nursing Sciences 18 (2023) 100530

Contents lists available at ScienceDirect

International Journal of Africa Nursing Sciences

journal homepage: www.elsevier.com/locate/ijans

Assessment of night-shift effects on nurses’ health and work performance at

South Gondar zone public hospitals, 2022
Tadila Dires a, *, Dejen Getaneh Feleke b, Tekalign Amera a, Berihun Bante a, Abraham Tsedalu a,
Adane Birhanu a, Ermias Sisay b, Tigabu Munye a, Sheganew Fetene c, Gebrie Kassaw a,
Agimasie Tigabu a
a
Department of Adult Health Nursing, College of Health Science, Debre Tabor University, Ethiopia
b
Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Ethiopia
c
Department of Emergency and Critical Care Nursing, College of Health Science, Debre Tabor University, Ethiopia

A R T I C L E I N F O A B S T R A C T

Keywords: Introduction: Nurses in hospitals across the world work shift to provide patient care 24 h a day. Shift work, which
Night-shift for nurses often includes working overnight, disrupts natural processes. The night shift work can have serious
Nurses negative physical and psychological effects on nurses’ health and work performance. It has been shown that
Health
night shift work has been associated with sleep disturbances, altered physical and mental health, complicated
Work performance
Effect
interpersonal relationships, and a decrease in the quality of nursing care.
Aim: This study aims to assess night-shift effects on nurses’ health and work performance at South Gondar Zone
Public Hospitals, in 2022.
Method: A cross-sectional study design was conducted at four hospitals, which are Debre Tabor Comprehensive
Specialized Hospital, Addis Zemen Primary Hospital, Mekane Eyesus Primary Hospital, and Nifas Meucha Pri­
mary Hospital. A structured self-administered questionnaire was used to collect the data from 1st December 2021
to 1st February 2022. Data were entered into Epi data version 4.2 and then exported to SPSS version 24 for
analysis. Data were summarized by using percentages and frequencies and the association between demographic
factors and feelings of nurses about night shift work was assessed by using a bivariate and multivariable logistic
regression model.
Result: The findings of the study revealed the majority of nurses (68 %) disliked night shift work. Night shift
exposed nurses to different health problems such as loss of sleep (27.9 %), muscular strain (24.6 %), persistent
tiredness (16.4 %), and backache (12.3 %,). Night shift work also affects the work performance of nurses by
increasing workload 96(39.3 %), tiredness 74 (30.3 %), and by lowering concentration 38(15.6 %). Gender
(AOR = 1.94; 95 % CI: 1.06–3.57), educational status (AOR = 2.36; 95 % CI: 1.21–4.60), and marital status
(AOR = 2.08; 95 % CI: 1.09–3.98) were significantly associated with the feeling of nurses about night shift work.
Conclusion: In this study the majority of nurses disliked night shift work. Nurses suffered from different health
problems including physical and psychological problems. Night shift work also affects the work performance of
nurses by increasing workload and tiredness as well as by lowering the concentration of nurses.

1. Introduction processes, resulting in circadian misalignment, disturbed sleep, and

light-induced suppression of melatonin levels at night. Also, lab results
The National Sleep Foundation defines shift work as work that occurs indicate that cardiometabolic stress and cognitive impairment are
on a schedule other than the usual 9:00 to 17:00 every day. This may increased through shift work and sleep loss (Kecklund & Axelsson,
include evening or night, early morning, and rotational shifts. Nurses in 2016).
hospitals worldwide work day and night to deliver care to patients Numerous individuals desire to work the night shift because there
(Dall’Ora & Dahlgren, 2020). Working at night disrupting natural are fewer disturbances and interruptions from administrative personnel,

* Corresponding author at: Department of Adult Health Nursing, College of Health Science, Debre Tabor University, Po Box-272, Debre Tabor, Ethiopia.
E-mail address: [email protected] (T. Dires).

https://doi.org/10.1016/j.ijans.2023.100530
Received 1 July 2022; Received in revised form 15 January 2023; Accepted 16 January 2023
Available online 20 January 2023
2214-1391/© 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
nc-nd/4.0/).
T. Dires et al. International Journal of Africa Nursing Sciences 18 (2023) 100530

fewer meetings, shorter commutes since there is less traffic, and receive 2.3. Study design and participants
higher pay (Morelock, 2017). However, studies have shown that the
night shift can have physical and psychological effects on nurses’ health A cross-sectional study design was conducted. All nurses working in
and their job performance (Books, Coody, Kauffman, & Abraham, 2017; these hospitals were participated in the study.
Merchaoui et al., 2017). Night shift work has been associated with sleep
disturbances, disrupted circadian rhythms, altered physical and mental
health, complicated interpersonal relationships, and a decrease in the 2.4. Data collection techniques
quality of nursing care (Lee, Chen, Tseng, Lee, & Huang, 2015).
Researchers clinched that night shift work was associated with an To assess the effect of night shift work on the health and work per­
increased risk of developing breast cancer, colorectal cancer, obesity, formance of nurses, a questionnaire was adapted from other similar
and type-2 diabetes (Books et al., 2017). Another study’s findings also studies (Books et al., 2017; Madide, 2003) and validated by experts.
showed that professionals working the night shift experience poor Their opinions, suggestions, and recommendations about the required
health status, providing further evidence that night shift workers’ health information, the content of the questions, the question’s wording and
is at risk (Awosoga et al., 2020; Burch et al., 2009). putting questions into meaningful order and format were used to adapt
Night shift work is associated with an increase in pro-inflammatory and direct the questionnaire, in addition to this Cronbach Alpha was
markers and the development of risk factors leading to metabolic syn­ calculated (=0.8). The questionnaire had two parts: demographic in­
drome (Bahinipati, Sarangi, Pathak, & Mohapatra, 2022). There is also formation: This part presents the demographic data which included
an increased risk of family stressors, and mood changes because of different items such as (gender, age, educational level, working unit, and
working the night shift (Books et al., 2017). marital status). In addition, information related to characteristics of
In addition to that, nurses who work the night shift may experience night work such as the feeling of nurses for the night shift, sleeping hours
decreased ability to provide optimum care for their families and for their after the end of the night shift, methods to induce sleep after night shift,
own needs, which also affects their ability to provide maximum care to workload during night shift, health problems experienced by nurses
the patient and their families (Abdelkader). Studies showed that during night shift, and exposure to occupational injuries during night
increased years of work as a shift worker were associated with more shift. A total of four diploma nurses as data collectors and four BSc
frequent burnout in healthcare workers (Wisetborisut, Angkurawar­ nurses as a supervisor (who have experience in data collection) were
anon, Jiraporncharoen, Uaphanthasath, & Wiwatanadate, 2014). On the selected. After presenting the study purpose and getting written
other hand, cognitive performance was impaired more during the night informed consent from each study participants, data collectors provide
shift so this affects the work performance of healthcare workers (Kazemi the self-administered questionnaires to participants. To complete the
et al., 2016). Night shift work is associated with impaired alertness and questionnaire required a maximum of thirty minutes. The participants
work performance due to sleep loss and circadian misalignment complete the questionnaire in the selected hospitals (at their working
(Ganesan et al., 2019). place). A total of 260 questionnaires were distributed, from these 244
A study conducted in South Africa showed that night shift work were completed and received back.
causes psychosocial strain and physiological strain for nurses. Nurses
had more complaints about the night shift than the day shift (Madide, 2.5. Operational definitions
2003). In an Ethiopia study conducted to assess shift-related sleeping
disorders showed that a quarter of shift workers, and nurses are suffering Night shift work is any shift that falls between the hours of 11 pm
from shift work sleep disorders. The number of nights on average per and 3 am. Common jobs that include night shifts include doctors, nurses,
month for the last year and working in three-shift rotations were paramedics, and other healthcare practitioners.
significantly associated with shift work sleep disorders (Haile, Asnakew, An effect is an event, condition, or state of affairs that is produced by
Waja, & Kerbih, 2019). To avoid health issues and to maintain the well- a cause.
being of nurses it is critical to understand the nature of the problem and Health is a state of physical, mental, and social well-being, not just
provide nurses and other workers with ways to reduce risks and manage the absence of disease or infirmity.
night-shift work. Studies provide the range of individual coping strate­ Work performance is how well an individual performs a job, role,
gies and organizational support used by shift working nurses, some of task, or responsibility.
these include the promotion of the benefits of social support, hobbies, The feeling of nurses about night shift work is defined as nurses
time management, mindfulness, exercise, diet, and sleep practices while either like or dislike working night shift.
increasing awareness of the possible dangers of social isolation (More­
lock, 2017; Savic et al., 2019). Although night shift work is implemented
in Ethiopian hospitals, no study is available on the effect of night shift 2.6. Data quality control, data processing, and analysis
schedules specifically on the health and work performance of nurses.
Therefore, the current study was conducted to contribute data on this The quality of the data was assured by pre-testing the questionnaire
issue. on 5 % of the sample at Leul Alemayehu Heath Center before the start of
the actual study to test the appropriateness, clarity, and completeness of
2. Methods the questionnaire for the study. Training about the data collection tool
as well as data collection procedures was given to data collectors and
2.1. Study area supervisors for a total of one day before the data collection process. The
collected data were checked daily for completeness, accuracy, and
The study was carried out at randomly selected South Gondar Zone clarity by supervisors. The principal investigator checked every ques­
Public Hospitals such as Addis Zemen Primary Hospital, Nifas Meucha tionnaire before data entry. Data were entered into Epi data 4.2 then
Primary Hospital, Debre Tabor Comprehensive Specialized Hospital, exported to SPSS version 24 for analysis. Data were summarized by
and Mekane Eyesus Primary Hospital, using percentages and frequencies and the association between de­
mographic factors and feelings of nurses on night shift schedule was
2.2. Study period assessed by using a bivariate and multivariable logistic regression
model. An adjusted Odds ratio with a 95 % confidence interval was
The study was conducted from 1st December 2021 to 1st February computed to determine the level of significance. A P-value less than or
2022. equal to 0.05 is considered significant.

2
T. Dires et al. International Journal of Africa Nursing Sciences 18 (2023) 100530

2.7. Ethical consideration

60
50%
Ethical Clearance was obtained from the ethical review committee of 50

Score of respondants
Debre Tabor University, College of Health Sciences with identification
40
number 1874/2014. The participants of the study were informed about 33.6%
the purpose of the study, the importance of their participation, and their 30
right to withdraw at any time. Verbal informed consent was obtained
20 16.4%
and informed written voluntary consent was signed before the initiation
of the data collection. To ensure confidentiality there was no informa­ 10
tion identifying the participants in particular.
0
It pay better Did not prefer a Prefer a night shift
3. Result night shift schedule
Preferance of night shift work among nurses
3.1. Socio-demographic characteristics of respondents

The response rate was 244(94 %) the remaining nurses were not Fig. 1. The preference of working night shift schedule over the other shifts
participating in this study due to sick leave, maternity leave, and annual among nurses.
leave and some did not volunteer to participate. Among the total 244
study participants, 184(75.4 %) were between the 20–30 age group, 140
Table 2
(57.4 %) were male, 158(64.8 %) had a BSc and above, 150(61.5 %)
Effect of Night Shift Work on Sleeping Habits of Nurses.
were married, majority of nurses were orthodox Christians 183 (75 %)
and Amhara 200 (82 %), (Table 1). Question Response Frequency Percentage
%

Do you get enough sleep after night Yes 46 18.9

3.2. The preference for the night shift work over the other shifts among
work? No 198 81.1
nurses How many hours do you sleep after Less than 5 196 80.3
night work? hrs.
Among the total respondents 122 (50 %) of nurses prefer night shift 6-8hr 42 17.2
work over the other shifts because it pays better,82 (33.6 %) did not More than 6 2.5
8hrs
prefer night shift work and only 40 (16.4 %) of nurses prefer night shift After the night shift do you experience Yes 142 58.2
work over the other shift because it suits their lifestyle (Fig. 1). any problems falling asleep? No 102 41.8
What do you use to induce sleep Hot 42 17.2
during the night shift schedule? beverage
3.3. Effect of night shift work on the sleeping habits of nurses
Alcohol 16 6.6
drink
The majority of nurses 198 (81.1 %) did not get enough sleep after Listen to 64 26.2
night shift work, 196 (80.3 %) of nurses slept for less than 5hrs after music
night shift work, 142 (58.2 %) of nurses faced difficulty in falling asleep Reading 42 17.2
None 80 32.8
after night shift work, 80 (32.8 %) of nurses did not use any strategies to
induce sleep (Table 2). Note n = 244.

3.4. The feeling of nurses about the night shift work and the remaining 78 (32 %) of nurses liked the night shift work (Fig. 2).

The feeling of nurses about night shift work was assessed. The
3.5. The effect of the night shift work on the health, attitude, and social
findings revealed that 166 (68 %) of nurses disliked the night shift work
life of nurses

Table 1 Among the total respondents 82 (74.6 %) nurses experienced that

Sociodemographic Characteristics of Respondent. night shift work affected their health in any way of these 68 (27.9 %)
Variable Categories Frequency Percentage % had a loss of sleep, 60(24.6 %) had muscular strain, and 24 (9.8 %) had
Age group 20–30 184 75.4 been exposed to needle stick injury. Night shift work affects the social
Above 30 60 24.6
Sex Male 140 57.4
Female 104 42.6
Educational status Diploma 86 35.2
BSc and above 158 64.8
Marital status Non married 94 38.5
Married 150 61.5
Work experience 1–5 year 136 55.7
>=6years 108 44.3
Working unit Medical 62 25.4
Surgical 66 27
Emergency 48 19.7
Opd 32 13.1
Other 36 14.8
Religion Orthodox 183 75
Muslim 38 15.6
Others 23 9.4
Ethnicity Amhara 200 82
Others 44 18

Note n = 244. Fig. 2. The feeling of nurses about night shift work.

3
T. Dires et al. International Journal of Africa Nursing Sciences 18 (2023) 100530

life of nurses 156 (63.9 %) and it also sometimes affects the attitude of Table 4
nurses 160 (65.6 %) (Table 3). The Effect of The Night Shift on The Work Performance of Nurses.
Question Response Frequency Percentage
3.6. Effect of the night shift on the work performance of nurses Nurses carry heavy workload on the Strongly 96 39.3
night shift than on the day shift agree
This study showed that nurses agreed that night shift affected their Agree 74 30.3
Neutral 24 9.8
work performance in different ways. From these, 96 (39.3 %) nurses
Disagree 40 16.4
strongly agree that nurses carry a heavier workload on the night shift Strongly 10 4.1
than on the day shift, 74 (30.3 %) nurses were tired while working at disagree
night, and 38 (15.6 %) had a low level of concentration during the night I have more energy to perform during Agree 108 44.3
shift (Table 4). the night shift Disagree 136 55.7
When working on the night shift Active 96 39.3
which of the following do you Moderately 64 26.2
3.7. Factors associated with the feeling of nurses about night shift work experience? active
Tired 74 30.3
Moderately 10 4.1
Gender, age, educational level, marital status, work experience, and
tired
working unit had a p-value of <0.25 in bivariable logistic regression How do you find your level of Almost high 14 5.7
analysis and were entered in the multivariable logistic regression model. concentration when working the Normal 182 74.6
Thus, after adjusting for confounding variables; gender, marital status, night shift? Almost low 38 15.6
and educational level were found to be associated with feelings of nurses I don’t know 10 4.1

about night shift work at a p-value of <0.05. Note n = 244.

In this study, the odds of disliking night shift work in female nurses
were 1.94 (AOR = 1.94; 95 % CI: 1.06–3.57) higher than in male nurses. this study, nearly half of the nurses were listening to music, using a hot
Nurses who attained a BSc degree and above were 2.36 times more likely beverage, reading, and drinking alcohol to induce sleep. This contra­
to dislike a night shift schedule than diploma nurses (AOR = 2.36; 95 % dicted with the finding in Nineveh Governorate that the majority of
CI: 1.21–4.60). Moreover, married nurses were more likely to dislike the nurses did not take anything to induce sleep (Allawa, 2014).
night shift schedule than non-married nurses (AOR = 2.08; 95 % CI: In this study-two-thirds of the respondents showed that working
1.09–3.98) (Table 5). night shift affected their health, this result comes in agreement with a
study carried out in Saudi Arabia which demonstrates that the night shift
4. Discussion affects the psychological and overall well-being of nurses (Qanash et al.,
2021). In this study the majority of nurses suffered from different health
The findings of this study revealed that half of the nurses prefer night problems such as loss of sleep, frequent headaches, backache, and
shift work over the other shifts because it pays better. But almost more persistent tiredness. This agreed with the finding of a previous study that
than two-third of respondents did not get enough sleep after night shift the majority of nurses suffered from different health problems as a result
work. This is supported by a study conducted in the United States and of night shift work (Fietze et al., 2009).
Italian cities indicating that the most injurious effects of night-shift work Another health-related problem is exposure to occupational injury
is the deterioration of sleep patterns due to both circadian rhythm and disease. The findings showed about one-third of respondents were
disruption and increased sleep homeostatic pressure (Books et al., 2017; exposed to different occupational injuries such as muscle strain and
Ferri et al., 2016). In this study, more than half of the nurses slept less needle stick injury which is lower than another finding of a similar study
than 5 h after the end of the shift, and only less than half of the nurses that the majority of nurses were exposed to muscle strain (64 %), and
slept 6–8 h and more than 8 h. The finding of this study was higher than needle stick injury (30 %) (Allawa, 2014). Loss of sleep, tiredness, and
the finding in Nineveh Governorate study indicating that nearly half of loss of concentration might expose nurses to needle stick injury exposing
the nurses slept less than 5 h but also agreed with this finding that less them to acquired infectious diseases such as HIV and Hepatitis B or C
than half of the nurses slept 6–8 h and more than 8 h (Allawa, 2014). In viruses and other viral infections. This is in agreement with a study done
in Nigeria state that night shift work has consequences for all nurses
Table 3 including health hazards and stresses of work itself (Isah, Iyamu, &
Effect of Night Shift Work on Health, Attitude, and Social Life of Nurses. Imoudu, 2008).
Question Response Frequency Percentage The majority of nurses showed that nurses carry a heavier workload
% on the night shift than the day shift schedule which is supported by a
Does the night shift schedule affect Yes 182 74.6 similar study that the majority of nurses feel that the night shift had a
your health in any way? No 62 25.4 heavier workload than the day shift (Allawa, 2014). A Study in Japan
Which of the following do you Frequent 36 14.8 also showed that night shift carries a heavy workload for most nurses,
currently experience? headache the workload is not limited to physical but also mental workload (Ohida
Backache 30 12.3
Persistent 40 16.4
et al., 2001). A study in South Africa also showed that the nurses feel the
tiredness night shift carries a heavier workload than the day shift (Madide, 2003).
Loss of sleep 68 27.9 The heavier workload might cause physical exhaustion of nurses and
None 70 28.7 might result in declining work performance of nurses.
Have you sustained any Needlestick 24 9.8
This study’s findings revealed that less than half of nurses were tired
occupational injuries during the injury
last 24 months? Muscular train 60 24.6 during the night shift work comparable with the finding of a previous
None 160 65.6 study at Jordan university hospital that (41 %) of nurses became tired
Does the night shift schedule disturb Agree 156 63.9 during work at night (Abdalkader & Hayajneh, 2008). This may affect
your social life? Disagree 88 36.1 the work performance of nurses by altering their cognitive function as
Does the night shift schedule affect Almost always 34 13.9
your attitude? Sometimes 160 65.6
well as their level of concentration.
Almost never 44 18
I don’t know 6 2.5

Note n = 244.

4
T. Dires et al. International Journal of Africa Nursing Sciences 18 (2023) 100530

Table 5 were exposed to different risks of night shift work. Half of the nurses
Factors Associated with the Feeling of Nurses about Night Shift work. prefer the night shift over the other shifts because it pays better, but
Variables The feeling of nurses COR (95% AOR (95% CI) nurses suffer from different health problems, including, loss of sleep,
toward night shift CI) persistent tiredness, and occupational injuries. It also affects the work
work performance of nurses by altering their level of concentration,
Dislike (n Like (n, increasing workload, and altering the social life and attitude of nurses.
%) %) Therefore, it is better to understand the nature of the problem and help
166 (68) 78 (32) nurses to prevent the long-term impact of night shift work.
Gender
Male 32(22.9) 108 1 1
7. Limitation of the study
(77.1)
Female 46(44.2) 58(55.8) 2.67 1.94
(1.54–4.65) (1.06–3.57)* The response rate was 94 % as a result of the absence of some of the
Age (in Year) study participants during the period of data collection due to sick leave,
20-30 52(28.3) 132 1 1 annual leave, and maternity leave. We used a cross-sectional study
(71.7)
design so this cannot establish a cause-and-effect relationship or analyze
≥31 26(43.3) 34(56.7) 1.94 1.42
(1.06–3.54) (0.71–2.81) behavior over some time.
Educational level
Diploma 17(19.8) 69(80.2) 1 1
BSC and above 61(38.6) 97(61.4) 2.55 2.36 Declaration of Competing Interest
(1.37–4.74) (1.21–4.60) *
Marital status
The authors declare that they have no known competing financial
Non-married 19(20.2) 75(79.8) 1 1
Married 59(39.3) 91(60.7) 2.55 2.08
interests or personal relationships that could have appeared to influence
(1.40–4.67) (1.09–3.98) * the work reported in this paper.
Work experience
(year)
1-5 36(26.5) 100 1 1 Acknowledgment
(73.5)
≥6 42(38.9) 66(61.1) 1.76 1.80
We would like to thank all authors and participants of the studies.
(1.02–3.04) (0.98–3.30)
Working unit
Medical ward 23(37.1) 39(62.9) 1.53 1.18
(0.62–3.74) (0.46–3.04) Authors’ contributions
Surgical ward 14(21.2) 52(78.8) 0.70 0.95
(0.27–1.78) (0.35–2.56) TDN, the corresponding author, worked on designing the study,
Emergency 24(50.0) 24(50.0) 2.60 2.61 training and supervising the data collectors, interpreting the result, and
(1.03–6.54) (0.97–7.06)
OPD 7(21.9) 25(78.1) 0.72 0.80
preparing the manuscript. The co-authors namely DGF, TAB, BB, ATA,
(0.24–2.21) (0.25–2.59) ESC, TMA, GKY, AT, SFT played their role in analyzing and interpreting
Others 10(27.8) 26(72.2) 1 1 the result. Moreover, the co-authors wrote the manuscript. All the au­
Ethnicity thors have read and agreed to the final manuscript.
Amhara 61(30.5) 139 0.69
(69.5) (0.35–1.37)
Others $
17(38.6) 27(61.4) 1 References
Religion
Orthodox 69(37.7) 114 2.87 Abdalkader, R. H., & Hayajneh, F. A. (2008). Effect of the night shift on nurses working
(62.2) (0.93–8.80) in intensive care units at Jordan University Hospital. European Journal of Scientific
Muslim 5(13.2) 33(86.8) 0.72 Research, 23(1), 70–86.
(0.17–3.01) Allawa, R. R. (2014). Assessment of night-shift effects on Nurses’ Health in Intensive
Others$$ 4(17.4) 19(82.6) 1 Care Units in Some Hospitals of Nineveh Governorate. Mosul Journal of Nursing, 2(1),
9–12.
reference
1 *p-value < 0.05 $Oromo, SNNP $$protestant, catholic COR: Crude odds Awosoga, O., Steinke, C., Nord, C., Doan, J., Varsanyi, S., Meadows, J., … Murphy, S.
ratio; AOR: Adjusted odds ratio. (2020). Exploring the role of shift work in the self-reported health and well-being of
long-term and assisted-living professional caregivers in Alberta, Canada. Human
Resources for Health, 18(1), 1–10.
5. Recommendations Bahinipati, J., Sarangi, R., Pathak, M., & Mohapatra, S. (2022). Effect of the night shift on
development of metabolic syndrome among health care workers. Journal of Family
Medicine and Primary Care, 11(5), 1710–1715.
It is recommended that healthcare organizations should be aware of Books, C., Coody, L. C., Kauffman, R., & Abraham, S. (2017). Night shift work and its
the negative impact of night shift work on the health and work perfor­ health effects on nurses. The Health Care Manager, 36(4), 347–353.
mance of nurses, in order to provide a place for taking a nap, consider Burch, J. B., Tom, J., Zhai, Y., Criswell, L., Leo, E., & Ogoussan, K. (2009). Shiftwork
impacts and adaptation among health care workers. Occupational Medicine, 59(3),
the need for workplaces to deliberate shift workers’ preferences, facili­ 159–166.
tate schedule requests, and have effective support networks. It is better Dall’Ora, C., & Dahlgren, A. (2020). Shift work in nursing: Closing the knowledge gaps
to distribute the night shift work carefully, and nurses should be aware and advancing innovation in practice. International Journal of Nursing Studies, 112,
Article 103743.
that night shift work might affect their physical and mental well-being. Ferri, P., Guadi, M., Marcheselli, L., Balduzzi, S., Magnani, D., & Di Lorenzo, R. (2016).
Nurses should examine their physical and mental health status period­ The impact of shift work on the psychological and physical health of nurses in a
ically and must use different coping strategies during night shift work. general hospital: A comparison between rotating night shifts and day shifts. Risk
Management and Healthcare Policy, 9, 203.
Researchers should further explore the impact of night shift work on Fietze, I., Knoop, K., Glos, M., Holzhausen, M., Peter, J. G., & Penzel, T. (2009). Effect of
healthcare workers and would have to give direction to decision and the first night shift period on sleep in young nurse students. European Journal of
policymakers. Applied Physiology, 107(6), 707–714.
Ganesan, S., Magee, M., Stone, J. E., Mulhall, M. D., Collins, A., Howard, M. E., …
Sletten, T. L. (2019). The impact of shift work on sleep, alertness, and performance
6. Conclusion in healthcare workers. Scientific Reports, 9(1), 1–13.
Haile, K. K., Asnakew, S., Waja, T., & Kerbih, H. B. (2019). Shift work sleep disorders and
associated factors among nurses at federal government hospitals in Ethiopia: A cross-
In this study the majority of nurses disliked night shift work and they
sectional study. BMJ Open, 9(8), e029802.

5
T. Dires et al. International Journal of Africa Nursing Sciences 18 (2023) 100530

Isah, E., Iyamu, O., & Imoudu, G. (2008). Health effects of night shift duty on nurses in a Morelock, S. G. (2017). The night shift: Follow the evidence to survive and thrive.
university teaching hospital in Benin City, Nigeria. Nigerian Journal of Clinical Nursing2020, 47(12), 46–51.
Practice, 11(2), 144–148. Ohida, T., Kamal, A., Sone, T., Ishii, T., Uchiyama, M., Minowa, M., & Nozaki, S. (2001).
Kazemi, R., Haidarimoghadam, R., Motamedzadeh, M., Golmohamadi, R., Soltanian, A., Night-Shift work-related problems in young female nurses in Japan. Journal of
& Zoghipaydar, M. R. (2016). Effects of shift work on cognitive performance, sleep Occupational Health, 43(3), 150–156.
quality, and sleepiness among petrochemical control room operators. Journal of Qanash, S., Alwafi, H., Barasheed, S., Bashnaini, S., Andergiri, R., Yaghmour, L., …
Circadian Rhythms, 14. Alsywid, B. (2021). Impact of night shifts on sleeping patterns, psychosocial and
Kecklund, G., & Axelsson, J. (2016). Health consequences of shift work and insufficient physical well-being among healthcare professionals: A cross-sectional study in a
sleep. BMJ, 355. tertiary hospital in Saudi Arabia. BMJ Open, 11(9), e046036.
Lee, C.-Y., Chen, H.-C., Tseng, M.-C.-M., Lee, H.-C., & Huang, L.-H. (2015). The Savic, M., Ogeil, R. P., Sechtig, M. J., Lee-Tobin, P., Ferguson, N., & Lubman, D. I. (2019).
relationships among sleep quality and chronotype, emotional disturbance, and How do nurses cope with shift work? A qualitative analysis of open-ended responses
insomnia vulnerability in shift nurses. Journal of Nursing Research, 23(3), 225–235. from a survey of nurses. International Journal of Environmental Research and Public
Madide, S. (2003). Effects of night shift schedules on nurses working in a private hospital Health, 16(20), 3821.
in South Africa. Wisetborisut, A., Angkurawaranon, C., Jiraporncharoen, W., Uaphanthasath, R., &
Merchaoui, I., Bouzgarrou, L., Mnasri, A., Mghanem, M., Akrout, M., Malchaire, J., & Wiwatanadate, P. (2014). Shift work and burnout among health care workers.
Chaari, N. (2017). Influence of shift work on the physical work capacity of Tunisian Occupational Medicine, 64(4), 279–286.
nurses: A cross-sectional study in two university hospitals. Pan African Medical
Journal, 26(1), 1–10.