El consumo de cannabis como factor causal en la esquizofrenia 1 Estudios retrospectivos

THE IMPACT OF SHIFT WORK ON NURSES: VIEWS FROM THE FIELD

Chapter Preamble

This chapter presents the findings of the content analysis of data collected from two open-ended questions at the end of the original survey which was conducted among employed nurses’ who were members of the QNMU in 2013. Analysis of the data for this study compared nurse shift and non-shift workers’ concerns regarding nursing profession.

Aim

The aim of the content analysis of the open-ended questions was to compare and contrast the concerns of nurse shift and non-shift workers regarding their profession (considering specific keywords, such as resilience, shift work, fatigue, stress, anxiety, satisfaction, mood, morale, depression, burnout, work/life balance, and environment)and reach a triangulation.

Data Collection

The original survey, which was conducted among nurses who were members of QNMU in 2013, included two open-ended questions at the end. Participants had the opportunity (unlimited word counts space) to express their concerns about the future of the nursing and midwifery profession and to provide strategies for the QNMU to address those concerns. The research question of this research component was selected to be purposefully broad in order to gauge nurses’ concerns about the nursing profession as a whole rather than to prime them specifically about shift work. Although the two open-ended questions were not specifically designed to answer the author’s research question, it was considered worthwhile to analyse the comments. Given that a large proportion of those who completed the survey also completed the open-ended questions, comments from participants were analysed with the intention

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of supporting and extending the quantitative findings. Analysis of qualitative data not only can assist to explore and understand human experiences, by interpreting

phenomena in regard to the meaning people bring to them, but also it may raise issues that researcher had not considered in the research design, adding to the quality of results achieved (Bowling, 2009; Greenhalgh & Taylor, 1997). Therefore, as it was possible and valuable to deeply understand and compare the nurse shift and non- shift workers’ perceptions about their work, and their concerns and suggested strategies about the future of nursing.

Open-ended Questions

The two open-ended questions at the end of the survey were:

 What concerns you the most about the future of the nursing and midwifery profession?

 What areas should the QNMU focus on to address these concerns?

The research question explored in this study was:

 Do nurses who work shifts have different concerns regarding the future of nursing compared to nurses who do not work shifts (considering specific keywords, such as resilience, shift work, fatigue, stress, anxiety, satisfaction, mood, morale, depression, burnout, work/life balance, and environment)?

Participant Demographics

The 1,495 participant nurses included 1,046 shift workers (male = 91, female = 954), and 449 non-shift workers (male = 25, female = 423). The participants’ age ranged from 19 to 72 years. The mean age of nurses was 47 (SD = 11). Participants worked in a variety of health sectors including private and public aged care, private and public acute sector, private and public community health, private domiciliary nursing, and nursing agency. Shift worker nurses worked different shift patterns such as three shifts (am, pm, nights), only evening shifts, only night shifts, morning and

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evening shifts, and evening and night shifts. As the data revealed, their work

experience ranged between 0–55 years (mean = 21.20). See Table 4.1 which displays a comparison between shift workers and non-shift workers in terms of age,

experience, sector worked, shifts and gender.

Data Analysis

A content analysis was undertaken of the transcripts in order to generate a rich description of participants’ experience (Cavanagh, 1997; Elo & Kyngäs, 2008; Hill, Thompson, & Williams, 1997; Kondracki et al., 2002; Vaismoradi et al., 2013). Transcripts were divided into two groups: shift workers and non-shift workers. The author read a copy of the transcripts several times to understand the content related to each group. Then the statements that corresponded to specific keywords, such as resilience, shift work, fatigue, stress, anxiety, satisfaction, mood, morale, depression, burnout, work/life balance, and environmentwere identified. The meaningful units or words were then manually coded. For example, the statement: ‘My future

professional development as an aged care RN’ was coded as ‘career progression’. This process yielded 51 codes.

Following this initial process, the codes were manually categorised into themes and subthemes according to their contextual relation or link with each other. For instance, the code ‘dissatisfaction’ and all related keywords such as ‘career progression’, which had a link to the ‘dissatisfaction’ code, were categorised as subthemes under the main theme ‘dissatisfaction’. Finally, the themes and subthemes were interpreted to gain a comprehensive understanding or re-contextualization of the topic. Appendix M shows the manual coding process of extracts from both nurse shift workers and non-shift workers.

Two main themes were extracted from the overall data. These were Dissatisfaction and Stress. Each theme also included several subthemes. These subthemes were then compared between the nurse shift workers and their non-shift worker counterparts in terms of the proportion of the sample whose responses reflected each subtheme. Following the suggestions by Hill et al. (1997), a subtheme

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was described as general if it applied to 70–100% of each group, typical if it applied to 50–70% of each group, variant if it applied to 20–50%, and absent if the theme was absent from the group.

Content Analysis Results

Table 5.1 shows the emergent themes and subthemes from nurse shift

workers and non-shift workers. The respondents are differentiated by codes that were generated by SPSS. The themes and their subthemes are now discussed by: shift- workers only; non-shift workers; both shift and non-shift workers.

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Emergent themes and Subthemes from Nurse Shift workers and Non-shift workers.

Themes and subthemes Shift

workers

Non-shift workers