The Effect of Shift Work on the Overall Health Status of Hospital-Employed Nursing Staff in Bosnia and Herzegovina: A Cross-Sectional Study

BACKGROUND Nursing is a profession frequently organized around shift work in order to guarantee the continuity of care throughout the 24 hours. However, working in shifts is coupled with the desynchronization of circadian rhythms and may result in adverse effects on nurses' health. Our previous work has demonstrated the presence of increased stress levels, reduced coping abilities and diminished life enjoyment in shift work nurses in comparison to those working only in accordance with the daily schedule. Here we aimed to appraise the effects of shift work on their overall health status. SUBJECTS AND METHODS We used a comparative cross-sectional approach on a sample of 157 hospital nursing professionals at the University Clinical Hospital Mostar. Study subjects were divided into two groups: a total of 51% study subjects were included in a specific type of shift work (i.e., 12-hour day shift / 24 hours off / 12-hour night shift / 48 hours off), while the remaining 49% adhered to the conventional 7-hour daily schedule. The instrument used was a Standard Shiftwork Index (SSI), together with a comprehensive appraisal of participants' socio-demographic characteristics. Descriptive and inferential statistical methods were applied, and statistical significance was set at p≤0.05 (two-sided). RESULTS The results have shown that nurses in shift work were significantly more burdened with gastrointestinal disturbances (p<0.001); more specifically, there was a higher frequency of appetite loss (p=0.003), heartburn (p=0.03), nausea (p<0.01) and weight gain (p=0.05) when compared to nursing professionals in the day shift. Conversely, there were no statistically significant differences in cardiovascular health between these two groups. In addition, nurses in shift work more frequently presented with headaches (p=0.001) and varicose veins of lower extremities (p=0.037) in comparison to nurses working only in accordance with the daily schedule. CONCLUSIONS Shift work can adversely influence psychophysical homeostasis, resulting not only in substandard performance of nursing staff, but also potentially hazardous effects on their overall health status. More specifically, we recognized shift work as a substantial risk factor for gastrointestinal and metabolic disorders in nurses; likewise, the increased prevalence of headaches may consequently have a detrimental effect on social and family relationships. All of this should be tackled in a holistic and organized way, together with any additional psychological/sleep issues.