Impact of shift work on the cortisol awakening response and stress: a longitudinal study in female shifting monthly nurses
Abstract Background: Although the majority of shift nurses are female, there is still an expectation that they fulfil the traditional role of women in the family, often conflicting with shift work, increases stress, and affects cortisol secretion patterns. This study was to understand the changes in the cortisol awakening response (CAR) and work stress in nursing personnel working in different shifts. Methods: 41 female shift nurses were recruited that fit criteria using purposive sampling. We obtained personal information, administered the Taiwan Nurse Stress Checklist (NSC), and the nurses themselves collected saliva samples upon waking and 30 minutes after waking for three consecutive days at home. We then analyzed the data obtained using a hierarchical linear model. Results: The results revealed that night-shift nurses derived significantly more stress from an inability to complete personal tasks than did day-shift nurses ( B = 4.39, p < .001) or evening-shift nurses ( B = 3.95, p < .001). Night-shift nurses also exhibited significantly lower CARi than did day-shift nurses ( B = -3.41, p < .001) or evening-shift nurses ( B = -2.92, p < .01) as well as significantly lower cortisol levels 30 minutes after waking than did day-shift nurses ( B = -3.88, p < .001) or evening-shift nurses ( B = -3.31, p < .01). Conclusions: This study indicate that female night-shift nurses displayed the lowest CARi and cortisol levels 30 minutes after waking and are more negatively affected by being unable to complete personal tasks.