The links among workload, sleep quality, and fatigue in nurses: a structural equation modeling approach

ABSTRACT

Background

Occupational fatigue of nurses can jeopardize health and safety of both nurses and patients. Therefore, it is important to discover the major factors related to fatigue in order to implement appropriate preventive programs. The aim of the present study was to investigate the links among workload, sleep quality, and fatigue.

Methods

Workload, sleep quality, and occupational fatigue were measured using the NASA-Total Load Index (TLX), the Pittsburgh Sleep Quality Index (PSQI), and the Swedish Occupational Fatigue Inventory (SOFI-20), respectively. Data associated with registered nurses from university hospitals located in Hamadan, Iran, were collected. A structural equation modeling (SEM) approach was used to determine the links among workload, sleep quality, and occupational fatigue.

Results

One hundred and sixty-two nurses participated in this study. The mean age and experience were 32.1 (±7.5) and 8.1 (±6.8) years, respectively. The results of the SEM model showed that the direct effect of workload on fatigue was not significant (path coefficient = 0.15, p = 0.076), while workload had a significant effect on sleep quality (path coefficient=−0.25, p < 0.01) and sleep quality had a significant effect on fatigue (path coefficient=−0.35, p < 0.01). Therefore, the effect of workload on fatigue is fully mediated by sleep quality.

Conclusions

As the effect of workload on fatigue was totally mediated by sleep quality, fatigue may be reduced by implementing sleep quality promotion programs.

KEYWORDS:

• Ergonomics
• accident prevention
• fatigue

Acknowledgements

The authors would like to thank Vice-Chancellor for Research and Technology of Hamadan University of Medical Sciences. We also would like to thank all nurses who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Data would be available on request.

Additional information

Funding

This work was supported by the Vice-Chancellor for Research and Technology of Hamadan University of Medical Sciences (grant number: 9611107197).

Notes on contributors

Fakhradin Ghasemi

Fakhradin Ghasemi is an assistant professor in occupational health and now is working in Department of Ergonomics in Hamadan University of Medical Sciences. He is interested in all aspects of human factors and ergonomics, particularly those which are related to safety. Moreover, he is interested in various modeling approaches such as structural equation modeling, Bayesian network, fuzzy logic and regression analysis.

Parnia Samavat

Parnia Samavat and Fatemeh Soleimani both are students in Occupational Health and Safety Engineering in Hamadan University of Medical Sciences. They are spending their last semester now. Their main interest is ergonomics.

Fatemeh Soleimani

Parnia Samavat and Fatemeh Soleimani both are students in Occupational Health and Safety Engineering in Hamadan University of Medical Sciences. They are spending their last semester now. Their main interest is ergonomics.