Models of shiftwork and health: an examination of the influence of stress on shiftwork theory

This paper critically reviews models of shiftwork and health and provides a historical overview of changes in the conceptualization of the association between them. Models are hypothetical and conceptually broad, becoming more so as they move away from linear, chronobiological to multidirectional, psychological conceptualizations. We attribute this tendency to the use of stress frameworks to explain the relationship between shiftwork and health. We assess the usefulness of stress as an explanatory concept in terms of how it affects shiftwork research and practice and make recommendations for future practice and theory development.