Quality of sleep among oncology nurses and intensive care nurses: A comparative study

Shatrughan Pareek; Narendra K Kaushik; Nitesh Kumar; Kapil Gupta; Anupam Pareek; Nitesh Kumawat; Yashawant Ramawat

doi:10.4103/ijmh.IJMH_2_21

ORIGINAL ARTICLE

Year : 2022 | Volume : 27 | Issue : 1 | Page : 58-62

Quality of sleep among oncology nurses and intensive care nurses: A comparative study

Shatrughan Pareek¹, Narendra K Kaushik², Nitesh Kumar³, Kapil Gupta⁴, Anupam Pareek², Nitesh Kumawat⁵, Yashawant Ramawat⁵
¹ Department of Nursing, Indian Railway Health Services, Bikaner, Rajasthan, India
² Government College of Nursing, SPMC & AGH, Bikaner, Rajasthan, India
³ Department of Emergency Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
⁴ Department of Emergency Medicine, Manipal Hospital, New Delhi, India
⁵ Department of Wound and Stoma Care, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India

Date of Submission	10-Jan-2021
Date of Decision	18-Apr-2021
Date of Acceptance	29-Jun-2021
Date of Web Publication	3-Dec-2021

Correspondence Address:
Shatrughan Pareek
Indian Railway Health Services, Bikaner 334001, Rajasthan.
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmh.IJMH_2_21

Abstract

Background: Nurses working in shift duties, including night duties, are subject to a cumulative sleep debt, a decreased quantity and quality of sleep, and continuous sleep deprivation. Hence, nurses working in shift duties are prone to sleep disturbance. Objective: To determine and compare the quality of sleep among oncology and intensive care unit (ICU) nurses. Materials and Methods: Descriptive approach was adopted for this study. The sample comprised 126 nurses working at the units of Prince Bijay Singh Memorial (PBM) Hospital, Bikaner, Rajasthan, who were selected by purposive sampling technique. The quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 20.0. Results: In this study, majority of the participants (60.32%) were men. Majority of the nurses (75.40%) were working on a regular basis. The mean sleep quality scores of intensive care and oncology nurses were 3.863 ± 1.988 and 5.317 ± 1.899, respectively. The observed difference was statistically significant (t = 4.097; p < 0.001). Overall, there was poor quality of sleep in 46% of the participants. The intensive care unit (ICU) nurses are more likely to have poor quality of sleep than oncology nurses (61.90% vs. 30.16%; Χ² = 18.15; p < 0.001). In addition, a moderate positive correlation (r = 0.6645, P = 0.0001^*) was observed between the sleep quality of ICU and oncology nurses. Among the intensive care nurses and oncology nurses, there was no significant association between sociodemographic variables such as gender, age, working status, job status, and the PSQI scores. (P > 0.05). Conclusion: Intensive care nurses and oncology nurses have poor quality of sleep, which can affect their health and professional performance. The ICU nurses have poorer quality of sleep than oncology nurses. Nurse administrators and hospital administration should take initiatives to reduce the prevalence of poor sleep among these nurses.

Keywords: Intensive care nurses, oncology nurses, quality of sleep, sleep disorder

How to cite this article:
Pareek S, Kaushik NK, Kumar N, Gupta K, Pareek A, Kumawat N, Ramawat Y. Quality of sleep among oncology nurses and intensive care nurses: A comparative study. Int J Med Health Dev 2022;27:58-62

How to cite this URL:
Pareek S, Kaushik NK, Kumar N, Gupta K, Pareek A, Kumawat N, Ramawat Y. Quality of sleep among oncology nurses and intensive care nurses: A comparative study. Int J Med Health Dev [serial online] 2022 [cited 2023 Feb 8];27:58-62. Available from: https://www.ijmhdev.com/text.asp?2022/27/1/58/331723

Introduction

Sleep is a complex bio-physiologic circadian vital process, which directly and indirectly relates to many day-to-day physical and mental functions of humans.^[1] Sleep is one of the basic and physiological needs of humans, which has significant impacts on the physical and mental health of humans.^[2] There is no doubt that sleep has a positive impact on humans’ health and well-being. Sleep disorders are the cause of morbidity and mortality and can decrease functional capacity and quality of life.^[3] Sleep is a necessity for nourishing, refreshing, and healing.^[4] As shift duty workers including nurses should be awake, whether partial or total of some of their nights, they face various hormonal disturbances, which makes them prone to sleep disorders. Moreover, nursing works are directly related to patients’ health status; it is very important to conduct observational programs and find possible solutions for their sleep disorders.^[5] Nursing profession has stringent and hectic working schedules, especially shift duties, which have been associated with noncommunicable diseases such as diabetes, hypertension, and orthopedic complications.^[4] Sleep disorders among shift nurses have been frequently reported at both individual and organizational levels.^[6] Poor quality of sleep related with shift work has a negative effect on the health status of nurses. The chances of altered sleep pattern increase with age by 20%–30%.^[7] Insomnia or disturbed sleep, as one of the most common sleep disorders, has a wide range of definition including difficulty in sleep initiation or maintenance, early-morning awakening, and nonrestorative sleep, which may discover firstly by fatigue, irritability, malaise, and eventually decrease in concentration.^[8] For instance, approximately 32%–54% of night workers have symptoms of insomnia or daytime sleepiness as compared with 18% of day workers who claim of the above symptoms. The prevalence of burnout in shift workers was 25% compared with 15% in nonshift workers, and having more sleeping hours per day was associated with lower odds of burnout among shift workers.^[9] Nurses working in shifts, including night shifts, are subject to a cumulative sleep debt, a decreased quantity and quality of sleep, and continuous sleep deprivation. They are vulnerable to work-related fatigue and, consequently, experience excessive daytime sleepiness. In Asia, the incidence of sleep disturbance among the general population ranged from 26.4% to 39.4%. On the contrary, several previous literatures have reported that impaired sleep is a common problem among nurses.^[3] Better work environments have also been linked to the overall quality of care and nursing care provided to patients.^[10] Less sleep duration and poor quality sleep can have huge effects on psychological, physical, and intellectual health.^[11] Hence, nurses working in shift duties are prone to sleep disturbance. Intensive care nurses and oncology nurses are specialized nurses, who care for critically ill patients and cancer patients, respectively. They require advance certificate and clinical experience in intensive care and oncology.

Materials and Methods

Quantitative research approach was adopted for the study, and the research design was descriptive prospective design. The study was conducted from June 2019 to December 2020. The sample comprised nurses working at the intensive care units (ICUs) of Prince Bijay Singh Memorial (PBM) Hospital, Bikaner, and Aachrya Tulsi Regional Cancer and Research Center, Bikaner, Rajasthan, who were selected by nonrandomized purposive sampling technique. In this study, a total of 126 nurses were selected (60 ICU nurses and 60 oncology nurses). Demographic data collection was done with the help of demographic profile, and the quality of sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI).^[12] The score range was 0–21, and scores ≥5 were considered poor quality of sleep. Moreover, the sleep score from 0 to 4 was considered good quality of sleep. Prior permission was obtained from the ethical committee and administrative authorities.

Inclusion criteria

Nurses who were present in the oncology and ICUs of the hospitals

Nurses who were willing to participate in the study

Nurses who were having at least 1-year experience of working in shift duties

Nurses who can read or respond either in Hindi or English.

Exclusion criteria

Nurses who were not available during the period of data collection

Nurses who were not involved in the night duties since the last 1 year

Nurses who were suffering from any acute illness, who were suffering from any sleep disorders, and who were having sleeping pills.

Data collection procedure

Formal permission to conduct the study was obtained from the concerned authorities of the hospitals. The investigator introduced self to the subjects and explained the purpose of the study. Written informed consent was obtained from the nurses. The PSQI scale was administered to the nurses to assess the quality of sleep by interview method on a one-to-one basis. Each nurse took about 15–20 min to answer the questions. Informed written consent was taken from the respondents, and confidentiality was maintained throughout the study.

Statistical analysis

Inferential and descriptive statistics were applied for the analysis of data. Frequency and percentage distributions were used to describe the sociodemographic data and quality of sleep among the nurses. Mean and standard deviation were used to assess the level of quality of sleep. Pearson’s correlation coefficient was calculated to evaluate the relation between oncology and ICU nurses regarding the quality of sleep. Chi-square test was used to determine the association between level of sleep and the selected sociodemographic variables. A value of P < 0.05 was considered statistically significant. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) software program, version 20.0 (IBM, Armonk, New York).

Results

In this study, majority of the participants (60.32%) were men, whereas 39.68% were women [Table 1]. Majority of the nurses (29.37%) were aged between 31 and 35 years. Nearly one-third of the nurses were having 4–6 years of working experience followed by 27.78% with 7–9 years’ working experience in their respective areas. Majority of the nurses (75.40%) were working on a regular basis, whereas 24.60% were on contractual ground. As shown in [Table 2], only 30.16% of the oncology nurses were suffering from poor quality of sleep, whereas 61.90% of the intensive care nurses had poor quality of sleep [Figure 1]. In addition, good quality of sleep was more common among oncology nurses (69.84%) as compared to intensive care nurses (38.10%). Overall, only 53.97% of the nurses had good quality of sleep. As shown in [Table 3], the mean sleep quality index score of the oncology nurses was 3.863 ± 1.988, whereas that of intensive care nurses was 5.317 ± 1.899 (t = 4.097; P < 0.001). Moreover, there was a moderate positive correlation between sleep quality of the intensive care and oncology nurses (r = 0.6645; p < 0.001) [Figure 2]. Overall, there was poor quality of sleep in 46% of the participants. The intensive care unit (ICU) nurses are more likely to have poor quality of sleep than oncology nurses (61.90% vs. 30.16%; Χ² = 18.15; p < 0.001). [Table 4] highlights the association between the demographic variables and the PSQI scores of the nurses working in the oncology and ICUs in selected hospitals. Among the ICU nurses, there was no significant association between sociodemographic variables such as gender (P = 0.384), age (P = 0.868), working status (P = 0.909), and job status (P = 0.780) with their PSQI scores. In addition, the findings revealed that among the oncology nurses, there was no significant association between sociodemographic variables such as gender (P = 0.714), age (P = 0.599), working status (P = 0.639), job status (P = 0.607) and their PSQI scores.

Table 1: Demographic and clinical profile of the nurses (n = 126)

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Table 2: Quality of sleep among intensive care nurses and oncology nurses (n = 126)

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Figure 1: Bar diagram showing frequency of the levels of quality of sleep in intensive care nurses and oncology nurses

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Table 3: Coefficient of correlation showing the relationship between Pittsburgh Sleep Quality Index scores of nurses working in oncology and intensive care units in selected hospitals (n = 126)

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Figure 2: Scatter diagram showing correlation of quality of sleep scores between oncology nurses and intensive care nurses

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Table 4: Association between demographic variables and Pittsburgh Sleep Quality Index scores of nurses working in oncology and intensive care units in selected hospitals (n = 126)

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Discussion

Sleep is an important aspect of human life. Nurses working in shift duties may experience poor quality of sleep. To the best of our knowledge, this is a novel study to compare the quality of sleep between ICU nurses and oncology nurses. In this study, it was found that the mean Pittsburg score was 4.92 ± 2.34. A study was conducted among 100 nurses working at the Federal Medical Centre, Birnin Kebbi, Kebbi State; the study highlighted that the mean Pittsburg score was 5.7 ± 2.7, and our finding was consistent with their study.^[4] This study highlighted that poor quality of sleep was nearly 46% among the nurses. The prevalence rate is lesser as compared to other research studies conducted by Bazrafshan et al.^[2] and Khatony et al.^[13] In a study conducted by Nagalakshmi et al.^[14] among 150 nurses working in shift duties to explore the quality of sleep and seven domains of sleep, 52% of shift duty nurses had poor quality of sleep, whereas only 25% of day shift nurses had poor quality of sleep. Our finding was consistent with their results.^[14] In a cross-sectional, descriptive-correlational study conducted by Momeni et al.on 180 ICU nurses regarding the quality of work life and sleep quality in Mazandaran University of Medical Sciences, Iran, 61.7% of ICU nurses reported poor quality of sleep.^[15] Our study also revealed that 61.90% of intensive care nurses had poor quality of sleep. According to the results of this study, only 30.16% of oncology nurses had poor quality of sleep. There was no study to support the above findings. Moreover, there was a moderate positive correlation (r = 0.6645) between sleep quality of intensive care and oncology nurses. Hence, it is a novel finding and hence, context data are not available. Sepehrmanesh et al^.[16] showed that variables such as age, gender, and working experience were not associated with quality of sleep. In this context, this study also highlighted that no significant association was reported between sociodemographic variables (gender, age, working status, and job status) and quality of sleep. Furthermore, Tarhan et al^.[17] also revealed that there was no significant association between age of the nurses and quality of sleep. This finding is consistent with the findings of our study. Overall, poor quality of sleep is prevalent in both intensive care nurses and oncology nurses. In view of the adverse effects of poor sleep quality on the health status and work performance of nurses, it is necessary to adjust the shift works of nurses employed in different sections of hospitals to improve their sleep quality. Hence, quality of sleep is important to enhance the outcomes of nursing services.

Conclusion

Quality of sleep is important for all human beings. This study shows that nearly half of the nurses had poor quality of sleep. In general, intensive care nurses have poor quality of sleep compared to oncology nurses, which can affect their health and professional performance. Moreover, the quality of sleep is not associated with demographic variables. Hence, it is suggested that nurse administrators and hospital administration should take actions to reduce the prevalence of poor sleep quality among nurses.

Limitation

This study was conducted at a single center with a limited sample size.

Acknowledgement

Nil.

Financial support and sponsorship

This study was self-funded.

Conflicts of interest

There are no conflicts of interest.

Contributor’s statement

Shatrughan Pareek, Narendra K. Kaushik, Nitesh Kumar, Kapil Gupta, Yashawant Ramawat, Nitesh Kumar, and Anupam Pareek designed the study, wrote the draft, were responsible for searching the articles, were responsible for analysis, and critically reviewed and modified the manuscript. The authors read and approved the final manuscript for publication.

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