The association between Shift Work and Mental Health Outcomes Among Korean Nurses

Abstract

Objectives Shift work is a common occupational factor among nurses and has been associated with adverse health outcomes. However, evidence regarding its impact on mental health outcomes such as anxiety, depression, and fatigue remains limited in Korea. Therefore, the aim of this study was to investigate the association between shift work and mental health outcomes, including generalized anxiety disorder (GAD), depressive symptoms, and fatigue, among nurses.

Methods This study used the Korean Nurses’ Health Study (KNHS) Cohort from 2013 to 2015, totaling 20,613 nurses. The measured outcomes included generalized anxiety disorder (GAD), depressive symptoms, and fatigue in relation to shift work. We used chi-square tests and multiple logistic regression analyses adjusting for sociodemographic and occupational covariates, with subgroup analyses stratified by sleep problems.

Results Shift workers showed a higher prevalence of [GAD: 62.7%], [depressive symptoms: 32.2%], and [fatigue: 76.7%] compared with non-shift workers. In multivariable logistic regression models, shift work was significantly associated with increased odds of GAD (OR: 1.18, 95% CI: 1.10-1.27), depressive symptoms (OR: 1.45, 95% CI: 1.32-1.59), and fatigue (OR: 1.41, 95% CI :1.30-1.53). Stratified analyses revealed that, even without sleep problems, shift work was associated with a 1.54-fold higher risk of depressive symptoms. These findings underscore the association between shift work and mental health, particularly depressive symptoms.

Conclusion Shift work was significantly associated with higher risks of anxiety, depression, and fatigue among Korean nurses, even in the absence of sleep problems. These findings highlight the need for workplace interventions and policies to mitigate the adverse effects of shift work on mental health.