Shift-Work-Play: understanding the positive and negative experiences of male and female shift workers to inform opportunities for intervention to improve health and wellbeing

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Rowan P Ogeil
Michael Savic
Nyssa Ferguson
Dan I Lubman


Shift work, nurses, survey, co-design, gender


Objective: Our primary study aims are to (i) examine positive and negative aspects associated with shift work, and (ii) identify any gender differences that exist in a healthcare workforce. A secondary aim of the study was to identify opportunities for intervention, particularly in males given they have greater exposure to shift work across the population. Background: Shift work has been associated with detrimental physical and psychosocial outcomes in many studies; however, there has been little consideration of any positive perceived aspects associated with shift work. Additionally, while there has been less consideration of gender differences in medical settings such as nursing where there is a higher proportion of females working shifts. Study design and methods: Our study utilised mixed-methods, comprising a cross-sectional workforce survey given to both shift workers and non-shift workers (N=1398), and a co-design workshop aimed at male nurses, in order to identify opportunities for intervention among this group. Results: Shift workers were more likely than their non-shift work counterparts to report poorer overall health, to have higher levels of psychological distress, and to engage in greater levels of unhealthy behaviours (e.g. higher alcohol consumption, and greater levels of smoking), with these differences highest in male shift workers. Discussion: Analysis of the shift work experience revealed that the majority responses were negative (affecting sleep, diet, exercise, mental health), however one-in-five statements were positive with flexibility, and the ability to engage with services highlighted. Examining both positive and negative elements is important for providing a balanced insight into shift workers’ lives, and to inform targets for improving their health and wellbeing. Conclusion: Through identifying positive and negative elements associated with shift work it is possible to intervene to minimise the negative elements, and maximise positive elements. Our analysis highlights the importance of considering gender differences in both individual and organisational-level responses. Implications for research, policy, and practice: To effectively address the negative aspects of shift work, interventions at multiple levels involving both organisations and individuals that simultaneously target multiple outcomes (sleep, diet, exercise, opportunities to connect with peers) are likely to be more effective than individual measures alone.

What is known about the topic?

  • Shift work is common across many different industries, and is an integral part of the nursing profession, where nurses and midwives make up almost 50% of the worldwide shift working workforce.

  • Shift work has been associated with negative impacts on individual physical and psychological health and performance outcomes such as increased error rates.

What this paper adds:

  • This study confirms that shift work is associated with negative impacts however there are positive elements associated with shift work and these include flexibility and financial benefits.

  • Gender differences were apparent with risky alcohol use, higher smoking rates, and poorer health noted in males compared with females.

  • Our co-design workshop identified the potential for a holistic response based on the three pillars of health: sleep, diet and exercise as likely to be more effective than an intervention addressing only one of these domains.

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