The State of Fatigue and Sleep among Clinical Nurses in Japan

Early intervention into nurse burnout can prevent job separation among nurses and therefore the issue of nurses maintaining and improving their own physical and mental health is an important issue that can lead to improved quality of healthcare. Previous studies have assessed and shown the relation between sleep among nurses who work shifts and chronic disease, and sleep is thought to be a predictive index of chronic fatigue. However, the relationship between the degree of sleep problems and fatigue is not fully considered. In this study, the authors aimed to investigate the state of fatigue and sleep among clinical nurses in Japan.

This descriptive cross-sectional study was conducted from December 2015 to January 2016. The participants were nurses who worked in public hospitals with 500 beds in the major cities and regional cities of Hokkaido. The survey was an anonymous, self-administered drop-off survey. The survey description and questionnaire forms were distributed to the subjects through the nursing departments of the participating hospitals and they were recovered by the researcher from each hospital. Fatigue was quantitatively assessed using the Cumulative Fatigue Symptoms Index (CFSI), which comprised 81 items over eight categories in three clusters: mental symptoms; physical symptoms; and workplace environment dissatisfaction.

Among nurses in their twenties, the rate of complaints about anxiety and decrease in vitality were high, which was replaced with complaints about irritability among nurses in their thirties. The most popular complaint among nurses in their forties was general fatigue. There was no difference in complaint ratios concerning the workplace location among nurses in their twenties and thirties, nurses in their forties working in suburban areas complained about fatigue more than their urban area. Nurses with sleep problems related to anxiety have a significantly higher complaint rate for all the eight items of CFSI compared with the nurses who do not have such problems (p < 0.001).

In conclusion, these results indicate that nurses of all age groups complained of chronic fatigue syndrome, while those in their 20s complained of anxiety and decreased vitality, and those in their 30s complained of irritability, suggesting that Japanese nurses are placed in a situation in which they are more likely to transition to a state of burnout. In addition, it is essential to validate a burnout predictive index and assess nurses’ fatigue and lifestyle including sleep condition.

Article by Naomi Sumi, et al, from Hokkaido University, Sapporo, Japan.

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