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系統識別號 U0026-1302202018352900
論文名稱(中文) 探討輪班工作之精神科護理人員健康促進生活型態對失眠之影響:台灣精神醫療機構調查
論文名稱(英文) Exploring the effect of Health promoting lifestyle on insomnia among psychiatric nurses with shift work in Taiwan: A Nationwide Survey
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 108
學期 1
出版年 109
研究生(中文) 沈淑華
研究生(英文) Shu-Hua Shen
學號 TA8991076
學位類別 博士
語文別 英文
論文頁數 63頁
口試委員 指導教授-顏妙芬
召集委員-簡以嘉
口試委員-黃芷苓
口試委員-馬慧英
口試委員-陳清惠
中文關鍵字 失眠  健康生活型態  精神科護理人員 
英文關鍵字 Insomnia  Health Promoting Lifestyle Profile-II  Psychiatric nurses 
學科別分類
中文摘要 背景:醫院提供醫療照護服務是不間斷的,需護理人員輪班提供照護服務。然而,輪班工作晝夜節律會影響護理人員的身心健康。尤其精神科護理人員面對精神病人因心智及情緒產生行為問題,其身心負荷更有別於其他科別的護理人員,因此關注精神科護理人員之健康問題是重要課題。
目的:了解全國精神專科醫院精神科護理人員健康生活型態對失眠之影響。
方法:採橫斷式研究法,以全國精神專科醫院護理人員為研究對象,使用「個人基本資料問卷表」、「中文版健康生活型態II-52 ( Health promotion lifestyle profile II」共52題及「中文版雅典失眠量表(Chinese version of the Athens Insomnia, CAIS- 8)」共8題之問卷調查表,以階層迴歸統計分析方法了解於控制精神科護理人員人口學變項、健康危害因子及不同輪班方式後,健康生活型態對失眠的影響。
結果:有效樣本數1669位護理人員,以女性為主(n = 1,549;佔92.8%);平均年齡為34.39歲(SD = 8.72),教育程度大學以上者佔68.4%(n = 1,142),護理服務工作年資平均為11.8年,小於5年者居多佔29.8%(n = 498);有健康危害因子佔10.4%(n = 174);健康促進生活型態總平均分數為2.45(SD = 0.41),分項次中以人際關係(2.69; SD = 0.47)和靈性成長(2.60; SD = 0.53)得分最高,得分較低的分別為身體活動(2.08; SD = 0.57)和營養(2.40; SD = 0.44);有失眠佔47.1%(n = 696)。階層迴歸結果顯示人口學變項、輪班方式及健康促進生活型態可以預測失眠解釋力為23.5%,其中有健康危害因子(β = .160; p < .001)、護理人員輪班工作包括固定夜班(β = .066; p < .05)、固定晚班(β = .148; p < .001)及不固定班別(β = .121; p < .001)和健康促進生活形態分項次中健康責任(β = - .121; p < .01)、靈性成長(β = - .202; p < .001)、人際關係(β = - .155; p < .001)及壓力管理(β = - .427; p < .001)對失眠有關係達統計上顯著影響。
結論:在這項研究中,輪班工作和不健康的生活方式是導致精神科護理人員失眠主因。醫院管理者仍須關注其於晚、夜班輪班工作之護理人員健康促進生活型態,規劃不同班別間健康促進生活活動,尤以健康促進生活型態分項次中健康責任、靈性成長、人際關係及壓力管理之相關健康促進行為提升,以降低不健康危害因子與失眠。
英文摘要 Background: Hospitals provide uninterrupted medical care services that require nursing staff to work in shifts to assist in providing care services. However, the circadian rhythm of shift work may affect physical and mental health of nursing staff. Physical and mental burden among psychiatric nursing staff are heavier when compared with nurses in other departments due to the behavioral problems generated from the mental and emotional disorders of psychiatric patients. Therefore, it is an important issue to pay attention to health problems of psychiatric nursing staff.
Objectives: To explore the relationship between health promoting lifestyle and insomnia among psychiatric nurses in Taiwan.
Methods: This study was a cross-sectional research. The subjects of psychiatric nurses were recruited from psychiatric hospitals in Taiwan with a nationwide survey approach. Instruments used in the study includes 52-item “Chinese Health Promoting Lifestyle Profile-IIC”, and an 8-item “Chinese Version of the Athens Insomnia Scale (CAIS- 8). Hierarchical regression analysis was used to test the effects of healthy lifestyles on insomnia after controlling demographic characteristics, health risk factors, and different shift patterns among psychiatric nurses.
Results: Of 1669 nurses participated in this study. Most of the subjects were females (n = 1,549 ; 92.8%); the average age was 34.39 years (SD = 8.72); 68.4% (n = 1,142) had a bachelor’s degree or above, the average years of service was 11.8 years (SD = 8.55) whereas 29.8% (n = 498) had less than 5 years of service; 10.4% (n = 174) had health risk factors; The mean score of health promotion lifestyle was 2.45 points (SD = 0.41) with a scale of 1 to 4, and the sub-scales with the highest mean scores were Interpersonal Relationship (Mean = 2.69 points; SD = 0.47) and Spiritual Growth (Mean = 2.60 points; SD = 0.53) while Physical Activity (Mean = 2.08 points; SD = 0.57) and Nutrition (Mean = 2.40 points; SD = 0.44) scored lower. Of 696 (42%) nurses reported having insomnia. It was found through hierarchical regression that demographic variables, shift patterns and health promotion lifestyles provided 23.5% of explanatory power in the prediction of insomnia. Among them, health risk factors (β= .160; p < .001), nursing staff working in shifts including night shifts (β = .066; p < .05), evening shift (β = .148; p < .001) and non-fixed shift (β = .121; p < .001) as well as the sub-scales in Health Promotion Lifestyle including Health Responsibility (β = - .121; p < .01), Spiritual Growth (β = - .202; p < .001), Interpersonal Relationship (β = - .155; p < .001) and Stress Management (β= - .427; p < .001) all reached statistical significance.
Conclusion: In this study psychiatric nurses are found shift work and unhealthy lifestyle would cause insomnia among psychiatric nurses. Hospital managers still need to pay attention to the health promotion lifestyle of nursing staff working in the evening and night shifts and plan health promotion activities for different shifts. The health promotion behavior in the sub-scales of the Health Promotion Lifestyle, Health Responsibility, Spiritual Growth, Interpersonal Relationship and Stress Management in particular should be enhanced to reduce health risk factors and insomnia.
論文目次 Abstract in Chinese i
Abstract iii
Acknowledge v
Table of Contents vii
List of Tables ix
List of Figures x
Appendix xi
Chapter I Introduction 1
Chapter II Literature Review 4
2.1 Working shifts 4
2.2 Shift work psychiatric nurses 6
2.3 Development of Health Promoting Lifestyle-II (HPLP-II) 8
2.4 Health Promoting Lifestyle-II (HPLP-II) related research 10
2.5 Shift-Work Nurses and Health-Promoting Lifestyles 14
2.6 Insomnia 16
2.7 Shift-Work Nurses and Insomnia 17
2.8 Insomnia and Health-Promoting Lifestyles 19
2.9 Summary 21
2.10 Knowledge gap 22
Chapter III Purpose of the Study 23
3.1 Research Questions 24
Chapter IV Method 25
4.1 Definition of terms 25
4.2 Study Design 26
4.3 Subjects 27
4.4 Instrument 28
4.5 Data colleection 30
4.6 Data analysis 32
4.7 Ethical considerations 33
Chapter V Results 34
5.1 Subject Demographics 34
5.2 Insomnia and Health- promoting lifestyles- IIC Assessment 36
5.3 Hierarchical regression Socio- demographic and difference shift work psychiatry and health-promoting lifestyles to incident insomnia 39
Chapter VI Discussion 42
6.1 Demographics 42
6.2 Insomnia 43
6.3 HPLP-IIC 44
6.4 Insomnia is association with shifts work and HPLP – IIC 45
6.5 Study Limitations 47
Chapter VII Conclusion 48
References 50
參考文獻 Admi, H., Tzischinsky, O., Epstein, R., Herer, P., & Lavie, P. (2008). Shift Work in Nursing: Is it really a risk factor for nurses health and patients safety. Nursing Economics, 26(4):250-257.
Adriana, P. F., Ulla Dı´ez, S. M., & Padilla1y, J. L. (2012). Psychometric Properties of the Spanish Version of the Health-Promoting Lifestyle Profile II. Research in Nursing & Health, 35, 301–313.
Al‐Kandari, F., & Vidal, V. L. (2007). Correlation of the health‐promoting lifestyle, enrollment level, and academic performance of College of Nursing students in Kuwait. Nursing & Health Sciences, 9(2), 112-119.
Asaoka, S., Aritake, S., Komada, Y., Ozaki, A., Odagiri, Y., Inoue, S., Shimomitsu, T., & Inoue, Y. (2013). Factors Associated With Shift Work Disorder in Nurses Working With Rapid-Rotation Schedules in Japan: The Nurses’ Sleep Health Project. Chronobiology International, 30(4): 628–636.
Ardekani, Z. Z., Kakooei, H., Ayattollahi, S. M. T., Choobineh, A., & Seraji, N. (2008). Prevalence of Mental Disorder among Shift Work Hospital Nurses in Shiraz, Iran. Pakistan Journal of Biological Sciences, 11(12), 1605-1609.
Beebe, D., Chang, J. J., Kress, K., & Mattfeldt-Beman, M. (2017). Diet quality and sleep quality among day and night shift nurses. Journal of Nursing Management, 25, 549-557. Doi:10.1111/jonm.12492.
Benjamin, G. A. (1984), “Shift workers: improve the quality of life for employees who aren’t on the 9-to-5 routine”, Personnel Journal, 63, 72-76.
Bjorvatn, B., Dale, S., Ruth, H.E., Fiske, E., Pallesen, S., & Waage, S. (2012). Self-reported sleep and health among Norwegian hospital nurses in intensive care units. Nursing in Critical Care, 17(4), 180-188.
Bláfoss, R., Sundstrup, E., Jakobsen, M. D., Bay, H. Garde, A. H., & Andersen, L. L. (2019). Are Insomnia Type Sleep Problems Associated With a Less Physically Active Lifestyle? A Cross-Sectional Study among 7,700 Adults from the General Working Population. Frontiers in Public Health, 7, 11-9.
Bostrom, A. C. (2016). Technological advance in psychiatric nursing an update. Nursing Clinics of North American, 38(1), 151-160.
Bolge, S. C., Doan, J. F., Kannan, H., & Baran, R.W. (2009). Association of insomnia with quality of life, work productivity, and activity impairment. Quality of Life Research, 18(4), 415-422. doi: 10.1007/s11136-009-9462-6.
Booker, L. A., Magee, M., Rajaratnam, S. M.W., Sletten, T. L., & Howard, M. E. (2018). Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review. Sleep Medicine Reviews, 41, 220-233.
Bryer, J., Cherkis, F., & Raman, J. (2013). Health-promotion behaviors of undergraduate nursing students: A survey Analysis. Nursing education perspectives, 34(6), 410-415.
Cao, W. J., Chen, C. S., Hua, Y., Li, Y. M., Xu, Y. Y., & Hua, Q. Z. ( 2012). Factor analysis of a health-promoting lifestyle profile (HPLP) - Application to older adults in Mainland China. Archives of Gerontology and Geriatrics, 55, 632-638.
Chan, M. F. (2009). Factors associated with perceived sleep quality of nurses working on rotating shifts. Journal of Clinical Nursing, 18(2), 285-93.
Chen, N. W., Chang, T. H., Chang, S. P., & Song, H. Y. (2011). The association of health promoting lifestyle and quality of life among nurses. Cheng Ching Medical journal, 7(2), 27-37.
Chen, J., Davis, K. G., Daraiseh, N. M., Pan, W., & Davis, L. S. (2013). Fatigue and recovery in 12-hour dayshift hospital nurses. Journal of Nursing Management, 1-11. DOI: 10.1111/jonm.12062.
Chen, Y. C., Wu, H. P., Hwang, S. J., & Li, I. (2010). Exploring the components of metabolic syndrome with respect to gender difference and its relationship to health‐promoting lifestyle behavior : A study in Taiwanese urban communities. Journal of Clinical Nursing, 19(21‐22), 3031-3041.
Chiang, H. L., Chen, H. C., Bai, C. H., Che, H. H., Lee, M. B., Lai, S. H., Chou, Pesus. (2009). A validation study of the Chinese version of the Athens insomnia scale. Taiwanese Journal of Psychiatry, 23(1), 43-52.
Cremoninia, V., Pagnuccib, N., Giacomettic, F., & Rubbi, I. (2018). Health care professionals attitudes towards mental illness: observational. Archives of Psychiatric Nursing, 32, 24–30.
Dong, H., Zhang, Q., Sun, Z., Sang, F., & Xu, X. (2017). Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors. Bio Medicne Central psychiatry, 17-241. DOI: 10.1186/s12888-017-1402-3.
Eanes, L. (2015). The Potential Effects of Sleep Loss on a Nurse’s Health. The American Journal of Nursing, 115(4), 34-40.
Emma, K. T., Majeda, E. B., Oakcrum, M., & Tyroler, J. (2017). Nurses' health promoting lifestyle behaviors in a community hospital. Applied Nursing Research, 35, 77-81.
Fincham, S. M., Roomaney, R., & Kagee, A. (2015). The relationship between worldview, self-efficacy, psychological distress, and a health-promoting lifestyle among a South African undergraduate university sample. South African Journal of Psychology, 45(4), 508–520.
Gao, Y. Q., Pan, B. C., Sun, W., Wu, H., Wang, J. N., & Wang, L. (2012). Anxiety symptoms among Chinese nurses and the associated factors: a cross sectional study. Bio Medicine Central Psychiatry, 12, 141-150.
Garde, A. H., Hansen, A. M., & Hansen, J. (2009). Sleep length and quality, sleepiness and urinary melatonin among healthy Danish nurses with shift work during work and leisure time. International Arch Occupation Environ Health, 82, 1219–1228.
Harris, D. M. & Guten, S. (1979). Health-protective behavior: an exploratory study. Journal of Health & Social Behavior, 20(1), 17-29.
Hakime Mustafaei, N. A., & Rehrooz, B. (2018). Health-promoting behaviours of Iranian nurses and its relationship with some occupational factors: A cross sectional study. Journal Nursing Management, 26, 717–725.
Heikkilä, K., Virtanen, M., Oksanen, T., Knutsson, A. Clays, E., & Kivimäki, M. (2013). Job Strain and Health-Related Lifestyle: Findings from an Individual-Participant Meta-Analysis of 118000 Working Adults. American Journal of Public Health, 103(11), 2090-2097.
Hu, L. W., Ho, Y. F., Lin, P. C. (2012). Health-Promoting Lifestyles and Related Factors in Clinical Nurses, Journal of Nursing and Healthcare Research, 8(4), 257-268.
International Labour Organization. (1990) Shift Work. [Cited 12 Nov 2013]. Available from URL: http://www.ilo.org/wcmsp5/groups/public/—ed_protect/—protrav/—travail/documents/publication/wcms_ 170713.pdf.
Jung, H. S., & Lee, B. (2015). Contributors to shift work tolerance in South Korean nurses working rotating shift. Applied Nursing Research, 28, 150-155.
Johnson, R. L. (2005). Gender Differences in Health‐Promoting Lifestyles of African Americans. Public Health Nursing, 22(2), 130-137.
Kageyama, T., Nishikido, N., Kobayashi, T., Oga, J., & Kawashima, M. (2001). Cross-sectional survey on risk factors for insomnia in Japanese female hospital nurses working rapidly rotating shift systems. Journal of Human Ergology, 30, 149-154.
Kaneko, S. Y., Maeda, T., Sasaki, A., Sato, A., Tanaka, K., Kobayash, T., Tanaka, M., & Fukushima, T. (2004). Journal of Occupational Health, 46, 192-198.
Kim, M. J., Son, K. H., Park, H. Y., Choi, D. J., Yoon, C. H., Lee, H. Y., Cho, E. Y., & Cho, M. C. (2013). Association between shift work and obesity among female nurses: Korean Nurses' Survey. Bio Medicine Central Public Health, 13, 1204- 1217.
Knutsson, A. (2003). Health disorders of shift workers. Occupational Medicine, 53, 103–108.
Lee, L. V., Chia, A. R., Loy, S. L., Colega, M., Tham, E. K. H., Cai, S., Yap, F., Godfrey, K. M., Teoh, O. H., Goh, D., Tan, K. H., Chong, Y. S., Broekman, B. F. P., Chong, M. F. F.(2017). Sleep and Dietary Patterns in Pregnancy: Findings from the GUSTO Cohort. International Journal of Environmental Research and Public Health, 14(11), 1-14. doi: 10.3390/ijerph14111409.
Lee, R. L., & Loke, A. J. (2005). Health‐promoting behaviors and psychosocial well‐being of university students in Hong Kong. Public Health Nursing, 22(3), 209-220.
Leka, S., Hassard, J., & Yanagida, A. (2012). Investigating the impact of psychosocial risks and occupational stress on psychiatric hospital nurses' mental well‐being in Japan. Journal of Psychiatric and Mental Health Nursing, 19(2), 123-131.
Lim, S., Han, K., Cho, H., & Baek. H. (2019) Shift‐work nurses’ work environments and health‐promoting behaviors in relation to sleep disturbance: A cross‐sectional secondary data analysis. Journal of Clinical Nursing, 28, 1538-1545. Doi: 10.1111/jocn.14769.
Lo, W. Y., Chiou, S.T., Huang, N., & Chien, L.Y. (2016). Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey. International Journal of Nursing Studies, 64, 130-136.
Matheson, A., O’Brien, L., & Reid, J. A. (2014). The impact of shiftwork on health: a literature review. Journal of Clinical Nursing, 23, 3309–3320.
McElligott, D., Siemers, S., Thomas, L., & Kohn, N. (2009). Health promotion in nurses: Is there a healthy nurse in the house? Applied Nursing Research, 22(3), 211-215.
Mellinger, G. D., Balter, M. B., & Uhlenhuth, E. H. (1985). Insomnia and its treatment. Prevalence and correlates. Archives of General Psychiatry, 42(3), 225-232.
Ministry of Health and Welfare. (2017) Medical Personnel Inquiry System. [Cited 1 Jan 2017] Available from MOHW: https://ma.mohw.gov.tw/masearch.
Moudi1, A., Dashtgard, A., Salehiniya, H., Katebi, M. S., Razmara, M. R., & Jani, M. R. (2018). The relationship between health-promoting lifestyle and sleep quality in postmenopausal women. Biomedicine 8(2), 34-40. Doi: 10.1051/bmdcn/2018080211.
Muecke, S. (2005). Effects of rotating night shifts: literature review. Journal of Advanced Nursing, 50(4), 433–439.
National Institute of Health. Insomnia. Retrieved May 8, 2016, from http://www.nhlbi.nih.gov/health/health-topics/topics/insomnia.
Nea, F. M., Kearney, J., Livingstone, M. B. E., Pourshahidi, L. K., & Corish, C. A. (2015). Dietary and lifestyle habits and the associated health risks in shift workers. Nutrition Research Reviews, 28(2), 143-166.
Niu, S. F., Chung, M. H., Chen, C. H., Hegney, D. H., O’Brien, A. & Chou, K. U. (2011). The Effect of Shift Rotation on Employee Cortisol Profile, Sleep Quality, Fatigue, and Attention Level: A Systematic Review. Journal of Nursing Research, 19(1), 68-80.
Ohida, T., Kamal, A., Uchiyama, M., Kim, K., Takemura, S., Sone T., & Ishii, T. (2001). The Influence of Lifestyle and Health Status Factors on Sleep Loss among the Japanese General Population. Sleep Epidemiology, 24(3), 333-338.
Pender, N. J. (1987). Health promotion in nursing practice (2nd Ed.). Stamford CT: Appleton & Lange.
Pender, N. J. (1996). Health promotion in nursing practice. East Norwalk: App lepton &Lange.
Perry, L., Gallagher, R., & Duffield, C. (2015). The Health and Health Behaviors of Australian metropolitan nurses: an exploratory study. Biomedical Central Nursing, 14, 45.
Perry, L., Xu, X., Gallagher, R., Nicholls, R., Sibbrit, D., & Duffield, C. (2018). Lifestyle Health Behaviors of Nurses and Midwives: The 'Fit for the Future' Study. International Journal of Environmental Research and Public Health, 15, 945.
Pérez‐Fortis, A., Díez, U., Sara, M., & Padilla, J. L. (2012). Psychometric properties of the Spanish version of the health‐promoting lifestyle profile II. Research in Nursing & Health, 35(3), 301-313.
Rezaei‐Adaryani, M., & Rezaei‐Adaryani, M. (2012). Health‐promoting lifestyle of a group of Iranian medical, nursing and allied health students. Journal of Clinical Nursing, 21(23-24), 3587-3589.
Rush, K. L., Kee, C. C., & Rice, M. (2005). Nurses as imperfect role models for health promotion. Western. Journal of Nursing Research, 27(2), 166-183.
Shen, S. H., Yen, M., Yang, S. L., & Lee, C. Y. (2016). Insomnia, anxiety, and heart rate variability among nurses working different shift systems in Taiwan. Nursing and Health Sciences, 18, 203-229. Doi: 10.1111/nhs.12257.
Smith, P., Fritschi, L., Reid, A., & Mustard, C. (2013). The relationship between shift work and body mass index among Canadian nurses. Applied Nursing Research, 26, 24-31.
Soldatos, C. R., Dikeos, D. G., & Paparrigopoulos, T. J. (2000). Athens Insomnia Scale validation of an instrument based on ICD-10 criteria. Journal of Psychosomatic Research, 48(6), 555-560.
Soldatos, C. R., Dikeos, D. G., & Paparrigopoulos, T. J. (2003). The diagnostic validity of the Athens Insomnia Scale. Journal of Psychosomatic Research, 55, 263 – 267.
Taiwanese Society of Psychiatry (Translated) (2014). Desk reference to the diagnostic criteria from DSM-5 (Author: American Psychiatric Association). Taipei City: Ho-chi(Original publication year: 2013).
Tan, S. L., Storm, V., Reinwand, D. A., Wienert, J., Vries, H. D., & Lippke, S. (2018). Positive Associations of Sleep, Physical Activity, Fruit and Vegetable Intake as Predictors of Quality of Life and Subjective Health Across Age Groups: A Theory Based, Cross-Sectional Web-Based Study. Frontiers in Psychology, 9, 1-13. doi:10.3389/fpsyg.2018.00977.
Tajik, M., Galvão, H. M., & Siqueira, C. E. (2010). Health survey instrument development through a community-based participatory research approach: Health promoting lifestyle profile (HPLP-II) and Brazilian immigrants in Greater Boston. Journal of Immigrant and Minority Health, 12(3), 390-397.
Teng, H. L., Yen, M., & Fetzer, S. (2010). Health promotion lifestyle profile‐II: Chinese version short form. Journal of Advanced Nursing, 66(8), 1864-1873.
Tol, A., Tavassoli, E., Shariferad, G.R., Shojaeezadeh, D. (2013). Health promoting lifestyle and quality of life among undergraduate students at school of health, Isfahan University of medical sciences. Journal of Education and Health Promotion, 2-11.
The Alfred P. Sloan Foundation. Work-family information on: Shift work. Sloan Work and Family. 2010; 11: 1. https://workfamily.sas. upenn.edu/sites/workfamily.sas.upenn.edu/files/imported/pdfs/minib_ shiftwork.pdf
Trumble, W. R., Brown, L., Stevenson, A., & Siefring, J. (2002). Shorter Oxford English Dictionary: On Historical Principle (5th Ed.). New York: by Oxford University Press.
Tsai, Y. C., & Liu, C. H. (2002). Factors and symptoms associated with work stress and health-promoting lifestyles among hospital staff: a pilot study in Taiwan. Bio Medical Central Health Services Research, 12, 1-8.
Tsuboi, S., Hayakawa, T., Kanda, H., & Fukushima, T. (2009). The relationship between clustering health-promoting components of lifestyle and bone status among middle-aged women in a general population. Environmental Health and Preventive Medicine, 14(5), 292-298.
Waage, S., Pallesen, S., Moen, B. E., Magerøy, N., Flo, E., Milia, L. D. & Bjorvatn, B. (2014). Predictors of shift work disorder among nurses: a longitudinal study. Sleep Medicine, 15, 1449-1455.
White, L., & Keith, B. (1990). The effects of shift work on the quality and stability of marital relations. Journal of Marriage and the Family, 52, 453-462. Doi: 10.2307/353039
Walker, S. N., Sechrist, K. R. & Pender, N. J. (1987). The health-promoting lifestyle profile: development and psychometric characteristics. Nursing. Research, 36, 76-81.
Walker, S. N., & Hill-Polerecky, D. M. (1996). Psychometric evaluation of the revised Health-Promoting Lifestyle Profile. Paper presented at the 123rd Annual Meeting of the American Public Health Association, San Diego, California.
Wang, X. S., Armstrong, M. E. G., Cairns, B. J., Key, T. J., & Travis, R. C. (2011). Shiftwork and chronic disease: the epidemiological evidence. Occupational Medicine, 61, 78–89.
Webster’s international dictionary of the English language (3th Ed.). (2002). Springfield, MA: Merriam-Webster.
Wei, C. N., Harada, K., Ueda, K., Fukumoto, K., Minamoto, K., & Ueda, A. (2012). Assessment of health-promoting lifestyle profile in Japanese university students. Environmental Health and Preventive Medicine, 17(3), 222-227.
W. H. O. (2015). From 20151123:http://www.who.int/mediacentre/factsheets/fs355/en
Yamada, Y., Kameda, M., Noborisaka, Y., Suzuki, H., Honda, M., & Yamada, S. (2001). Comparisons of psychosomatic health and unhealthy behaviors between cleanroom workers in a 12-hour shift and those in an 8-hour shift. Journal of Human Ergology, 30(1-2), 399-403.
Yoshinaga, N., Nosaki, A., Hayashi, Y., Tanoue, H., Shimizu, E., Kunikata, H., Okada, Y., & Shiraishi, Y. (2015). Cognitive Behavioral Therapy in Psychiatric Nursing in Japan. Nursing Research and Practice, 9, 1-10.doi.org/10.1155/2015/529107.
Zhang, S. C., Wei, C. N., Fukumoto, K., Harada, K., Ueda, K., Minamoto, K., & Ueda, A. (2011). A comparative study of health-promoting lifestyles in agricultural and non-agricultural workers in Japan. Environmental Health and Preventive Medicine, 16(2), 80-89.
Żuralska, R., Anand, J. S., Mziray, M., & Schetz, D. (2015). The anxiety levels in Polish hospital nurses experiencing various emotional disturbances. Progress in Health Sciences, 15(2). 142-148.
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