Psychological, lifestyle and coping contributors to chronic fatigue in shift-worker nurses

This paper is a report of a study to assess the following in shift-worker nurses: (1) the relationships amongst chronic fatigue and psychological variables including anxiety, mood and locus of control; (2) the relationships amongst chronic fatigue and a number of lifestyle factors such as shiftwork, sleep and exercise; and (3) various coping behaviours that best predict chronic fatigue.

In the shift-working population, individual psychological, lifestyle and coping differences influence fatigue levels. However, some of these factors are somewhat unexplored and their relative contribution to fatigue remains poorly understood. Methods. An exploratory design was adopted with 111 eldercare shift-worker nurses. Data were collected during 2006. Nurses completed self-administered questionnaires examining fatigue, anxiety, mood disturbance, locus of control, sleep, work, lifestyle and coping characteristics.

Multiple regressions showed that mood disturbance, locus of control and trait anxiety are statistically significant predictors of chronic fatigue. Poor sleep quality was the lifestyle factor which most strongly contributed to fatigue. Other lifestyle predictors included higher workload perception, lack of exercise and the non-availability of support. Whilst problem-focused coping behaviours were not associated with fatigue, coping by using alcohol, letting emotions out and avoiding the situation significantly predicted chronic fatigue.

The challenge for improving the fatigue outcomes requires further investigation of the profile of a nurse who is at a high risk of fatigue, and then integrating this profile into a fatigue management programme which considers relative contributions of the psychological, lifestyle and coping factors.