在臨床醫療工作中，護理人員為主要照護人力，當住院病人需24小時照顧時，輪班成為必然的工作型態。輪班制度容易造成人員壓力及影響睡眠品質，因而發生照護疏失而影響病人安全。本研究即為探討輪班護理人員自覺壓力與睡眠品質之相關影響。
目的：探討輪班護理人員自覺壓力與睡眠品質。
方式：採橫斷式研究，以結構式問卷收集資料，自2016年7月4日至2016年7月15日，於台灣南部地區某區域教學醫院調查158位護理人員。問卷包含個人基礎資料、自覺壓力量表(PSS)與匹茲堡睡眠品質指標(PSQI)。搜集之資料以SPSS 22.0版套裝軟體進行統計分析，包含描述性分析、Kolmogor-Smirnov檢定、無母數檢定、邏輯斯迴歸分析等統計方法。 結果：(1) 輪班護理人員睡眠品質得分為7.02±3.04，睡眠品質不佳者佔74.1%。每日睡眠時間不足6小時的佔60.1％，主觀睡眠品質差者佔38.7%。自覺壓力總分為19.04±5.41，其中壓力感受偏高佔57.6%，以「常覺得自己是駕馭事情的主人」的壓力最高。整體睡眠品質(PSQI)與壓力程度有顯著差異(p <0.05)。(2)不同職位護理人員與自覺壓力有顯著差異(p <0.05)。不同職位(p <0.05)、工作單位(p <0.05 )、輪班方式(p<0.05)、輪班頻率(p <0.05)的睡眠品質有顯著差異。(3)以邏輯斯迴歸分析發現，自覺壓力總分可作為睡眠品質的預測因子，自覺壓力每增加1分，睡眠品質變差的風險為1.109倍，意指壓力越大，睡眠品質會愈差。
結論：非行政職位之輪班護理人員的自覺壓力大於行政職位人員。高達七成以上的輪班護理人員睡眠品質不佳，入睡不易，六成人員每日睡眠時間不足六小時。職位、工作單位、輪班方式與換班頻率均顯著影響睡眠品質。睡眠品質的預測因子為自覺壓力總分。 Objective: The aim of this study was to explore the perceived stress and sleep quality in shift-working nurses.
Methods: Nurses from regional teaching hospital in southern Taiwan (n = 158) participated in this cross-sectional study between July 4 and July 15, 2016. Demographics, Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI) were included in questionnaire. Descriptive analysis, Kolmogor- Smirnov test, nonparametric statistics and logistic regression were applied by using SPSS (22.0 version) for data analysis.
Result: (1) The PSQI score was 7.02 ± 3.04. 74.1% nurses were poor sleepers. 60.1% nurses’ daily sleep time was less than 6 hours and 38.7% had poor subjective sleep quality. PSS score was 19.04 ± 5.41. The highest pressure went to "Often feel that they are the master of controlling things ". Enrolled participants with higher stress level had higher PSQI scores. (2) Stess level was significant different in nursing staff with different titles. Positions (p <0.05), work units (p <0.05), shifts work pattern (p <0.05), shift frequency (p <0.05) also affected sleep quality. (3) Logistic regression analysis showed that perceived stress of nurses (OR=1.109，CI=1.032~1.192，p<0.010) was associated with sleep quality.
Conclusion: The pressure of non-administrative staff is greater than that of administrative staff. 74.1% nurses were poor sleepers, 60% slept less than six hours a day. Shift-working nurses were difficult to fall asleep. Positions, work units, 12 hour shifts, 8 hour shifts and shift mode significantly affected sleep quality of nurses. Predicting factor of nurses’ sleep quality is perceived stress score.
