Decoding the impact of night/day shiftwork on well-being among healthcare workers

Decoding the impact of night/day shiftwork on well-being among healthcare workers

The correlation results (see Table 1) show that age is moderately to slightly negatively associated with quality of life in the physical, social, and environmental domains, but this does not extend to the psychological domain. Men tend to have a stronger connection with psychological domains compared to women. Being single is associated with a more pronounced negative impact on all quality-of-life domains. Higher levels of education are linked to a lesser negative impact on the quality of life across the psychological, social relationship, and environmental domains, though this does not apply to the physical domain. Concerning work-related factors, average working hours slightly negatively impact the physical quality of life. Daytime work schedules have a moderate to slight negative correlation with quality of life in psychological, social relationship, and environmental domains. Meanwhile, physical quality of life has a slight yet significant negative correlation with perceived social support and a moderate negative relationship with psychological distress, including depression, anxiety, and stress. The psychological domain of quality of life has a moderate negative correlation with perceived social support and a slight negative correlation with psychological distress, notably depression. Social relationships in quality of life are moderately negatively affected by perceived social support and slightly by psychological distress, such as depression and anxiety. The environmental aspect of quality of life moderately suffers from the negative impacts of perceived social support and is negatively influenced by psychological distress, including depression, anxiety, and stress.

Table 1 Descriptive statistics and correlation matrix.

Our exploration of the connection between work schedules (day shift and night shift) and quality of life (environmental, physical, psychological and social relationship) (see Table 2) showed that work schedules (night shift) were significantly related to environmental well-being (β = 0.71) and physical health (β = 0.54). Work schedule (day shift) was significantly related to psychological health (β =  − 1.20) and social relationships (β = 0.73); this thus supports the first hypothesis.

Table 2 Direct relationships.

The connection between work schedules and psychological distress (depression, anxiety, and stress) showed that work schedules (night shift) significantly influence these outcomes. Specifically, night shift workers are associated with an increase in anxiety (β = 3.78), stress (β = 3.9) and depression (β = 1.46); this supports the second hypothesis.

Depression’s effects, while not significant for environmental well-being, manifested as negative for both physical (β =  − 0.07) and psychological health (β =  − 0.38). A mild positive association was observed between depression and social relationships (β = 0.03).

Upon deeper investigation into the consequences of anxiety on various quality-of-life domains, it emerged that heightened anxiety marginally augments environmental well-being (β = 0.03). Notably, anxiety has a pronounced negative impact on physical health (β =  − 0.30). In the domain of psychological health, a rise in anxiety is linked to worsened outcomes, evidenced by a coefficient of β = 0.12, and significant at the p < 0.01 level. Regarding social relationships, the influence of anxiety (β = 0.00) remains statistically non-significant.

Stress demonstrated a negative effect on environmental well-being (β =  − 0.20) while positively influencing both physical (β = 0.18, p < 0.01) and psychological health (β = 0.23). The relationship between stress and social relationships did not achieve statistical significance. This complex result has made the findings unclear, not less likely for generalisation.

When considering the moderating effect of perceived social support on the relationship between work schedules and psychological distress dimensions, it was found that this interaction significantly diminishes anxiety (β =  − 0.04) and stress (β =  − 0.06). However, its moderating effect on depression was not statistically significant, thus also creating an inconclusive finding on the forth hypothesis.

In Table 3, we have delved deep into understanding the influence of the interplay between perceived social support and work schedules on various health dimensions, particularly considering the mediating roles of stress, depression, and anxiety.

Table 3 Specific indirect effect.

Our findings suggest that stress significantly mediates, especially when considering the impact on environmental well-being. When employees experience variations in their work schedules and simultaneously perceive varying levels of social support, this changes stress levels, significantly affecting their environmental well-being (β = 0.011, p = 0.001).

However, when we turn our attention to depression as a potential mediator for the same relationship, the effect is not statistically significant. The coefficient is β = 0.000, with a significance level of p = 0.286, indicating that the path through depression does not substantially influence environmental well-being.

Anxiety, another pivotal mental health dimension, also showcases its mediating ability. Our analysis revealed a significant negative indirect effect of the perceived social support and work schedule interaction on psychological health via anxiety (β =  − 0.005, p = 0.006). Similarly, stress emerges as a significant mediator, negatively impacting psychological health (β =  − 0.013, p = 0.001). However, its influence on social relationships is not statistically significant (β = 0.001, p = 0.119).

Further, the mediation effect of depression on physical health is observed to be on the cusp of significance (β = 0.001, p = 0.074). Anxiety’s role as a mediator between the interaction and environmental well-being is evident and significant (β =  − 0.001, p = 0.035), whereas its effect on social relationships does not achieve statistical significance.

One of the most pronounced findings is the strong negative indirect effect of the perceived social support and work schedule interaction on physical health, mediated by stress (β =  − 0.01, p = 0.001). Additionally, while depression’s mediating effect on psychological health is positive, it is marginally significant (β = 0.007, p = 0.060). When mediating the relationship with physical health, anxiety’s influence emerged as significant and positive (β = 0.011, p = 0.001).

This investigation explains how perceived social support and work schedules, two pivotal factors in today’s work environment, interact and influence various health dimensions. The mediating roles of stress, depression, and anxiety bring forth an intricate tapestry of relationships, emphasising the importance of considering multiple pathways when exploring workplace well-being.

The complex interplay between work schedules (day and night shift), psychological distress (anxiety, depression, and stress), and perceived social support levels sheds light on how different domains of quality of life (environmental, physical, psychological, and social relationships) are influenced (see Table 4).

Table 4 Probing Moderated Indirect Relationships (Slope Analysis).

When considering anxiety as the intermediary, those with heightened anxiety levels show a subtle but discernible link between their work schedules and environmental (quality of life), represented by an effect of β = 0.02 (95% CI [0.003, 0.047]). This connection intensifies slightly for individuals with lower anxiety levels, where the effect is β = 0.05 (95% CI [0.008, 0.092]).

PSS levels reveal a negative association between work schedules and physical health. For those with higher PSS levels, the effect is β =  − 0.22 (95% CI [− 0.317, − 0.123]), and it becomes even more pronounced for those at the lower end of the PSS spectrum, with an effect of β =  − 0.50 (95% CI [− 0.606, − 0.403]). Additionally, the relationship between work schedules and psychological outcomes, mediated by anxiety, is evident with a value of β = 0.09 (95% CI [0.044, 0.151]) for the higher PSS group. This effect amplifies for those with lower PSS, which stands at β = 0.21 (95% CI [0.121, 0.311]) (see Fig. 2).

Figure 2
figure 2

Interaction graph between work schedules, perceived social support, and anxiety.

Moving on to stress as the mediating factor, higher PSS individuals exhibit a more robust connection between their work schedule and environmental outcomes, marked by β = 0.08 (95% CI [0.016, 0.148]). In contrast, those with lower PSS levels reveal a negative association, denoted by β =  − 0.19 (95% CI [− 0.26, − 0.118]). When considering stress, physical health outcomes show a negative relationship for higher PSS individuals, with an effect of β =  − 0.07 (95% CI [− 0.138, − 0.013]). This trend reverses for the lower PSS group, where the effect is positively marked at β = 0.17 (95% CI [0.108, 0.237]). The psychological domain, mediated by stress, reflects a decreasing influence of work schedule with increased perceived social support for the higher PSS group β =  − 0.09, 95% CI [− 0.181, − 0.018]). For those with lower PSS, the effect is positively marked at β = 0.22 (95% CI [0.135, 0.31]) (See Fig. 3).

Figure 3
figure 3

Interaction graph between work schedules, perceived social support, and stress.

In summary, the nature of one’s work schedule and anxiety or stress levels can significantly shape various life outcomes. The direction and strength of these relationships are further shaped by the individual’s perceived stress levels, underscoring the multifaceted nature of human experiences and well-being.

Some noteworthy patterns emerge in exploring how perceived social support influences the relationship between work schedules and various outcomes (see Table 5). When anxiety acts as the mediating factor, an increase in perceived social support slightly diminishes the indirect effect of work schedule on environmental outcomes, as indicated by a value of β =  − 0.001 (95% CI [− 0.002, 0.000], p = 0.035). In contrast, for physical outcomes, the indirect influence of work schedule through anxiety becomes more pronounced with a value of β = 0.011 (95% CI [0.006, 0.017], p < 0.001) as perceived social support rises. The scenario flips for psychological outcomes, where the indirect effect dampens with increased perceived social support, marked by β =  − 0.005 (95% CI [− 0.008, − 0.002], p = 0.006). For social relationships, perceived social support does not seem to play a significant moderating role, as the relationship was not statistically significant.

Table 5 Index of moderated mediation.

Considering the mediating effect of depression, the data does not show a significant moderating effect of perceived social support on the indirect relationship between work schedule and environmental outcomes. However, there is a positive but non-significant relationship for physical outcomes, with a value of β = 0.001 (95% CI [0.000, 0.003], p = 0.074). The psychological domain reveals a non-significant relationship with increased perceived social support, as indicated by β = 0.007 (95% CI [0.000, 0.014], (p = 0.060]). Social relationship outcomes, on the other hand, do not show a significant influence.

Lastly, when considering stress as the mediator, the environmental outcomes show a strengthening of the indirect effect with increasing perceived social support, represented by β = 0.011 (95% CI [0.007, 0.015], p < 0.001). Physical outcomes present a decrease in the indirect effect with a value of β =  − 0.01 (95% CI [− 0.014, − 0.006], p < 0.001). Psychological outcomes echo this decreasing trend, more strongly marked by β =  − 0.013 (95% CI [− 0.018, − 0.008], (p < 0.001]). Though slightly positive for social relationships, the effect remains statistically insignificant.

The impact of work schedules on various life outcomes channelled through anxiety, depression, and stress is delicately shaped by the levels of perceived social support an individual receives. The effects, whether amplifying or dampening, underscore the intricate interplay between work conditions, emotional well-being, and the cushioning effect of social support; thus, this supports H4a & b.

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