研究背景:台灣約有60％的醫護人員需輪班作業，其中32％輪班工作者有睡眠困擾的問題，輪班不僅會導致身心疲憊，影響健康、損害記憶、注意不集中與認知功能降低，並易增加錯誤的決策及意外事件，同時也是導致護理人員離職原因之一。然而，若為順時鐘換班，可在班別間有足夠的休息時間，有助於睡眠品質的調適。目前國內對於不同輪班型態其護理人員睡眠品質有何差異相關研究報告並不多見。故本研究目的探討不同輪班型態之護理人員其睡眠品質差異，此外也探討輪班護理人員人口學、輪班型態，以了解這些因素與睡眠品質之間的關係。
研究方法:本研究採橫斷式相關性研究設計，以立意取樣選取台灣南部某區域教學醫院內、外、婦、兒、急診、重症等23個單位，工作滿一年、且實際參與臨床照護（排除專職執行功能性護理之護理人員）142名護理人員為對象，研究工具採用中文版匹茲堡睡眠品質量表（Pittsburgh Sleep Quality Index, PSQI）來測量護理人員過去一個月內的睡眠品質：個人主觀睡眠品質、睡眠潛伏期、睡眠時數、睡眠效率、睡眠困擾、日間活動功能與安眠藥物使用，搭配受試者目前上班班別、最近三個月輪班順序（順時鐘或逆時鐘）、最近三個月個月內有幾種班別等資料進行檢測。問卷回收132份，問卷回收率93%，扣除填答不完全之問卷5份，有效問卷共127份，有效樣本回收率89.4%。以SPSS 20.0 統計軟體進行資料統計及分析，主要統計方法包括描述性統計、獨立樣本t檢定、單因子變異數分析、皮爾森積差相關分析及多元迴歸分析進行分析。
研究結果:本研究對象睡眠品質得分平均值7.82分（得分介於0-15分），研究結果發現睡眠品質不佳者有93人(73.2%)，顯現護理人員至少有三分之二者睡眠品質不佳。護理人員有無子女（t =2.00 , p = .04）、有無在職進修（t = -3.04 , p = .01）及近三個月輪班順序組別（F = 3.51 , p = .01）三項與整體睡眠品質得分有顯著差異，顯示沒有子女者、在職進修者、順時鐘輪班者有較好的睡眠品質；最小子女年齡與整體睡眠品質呈現顯著負相關（r =-.567 , p ＜.01），表示子女年齡越小整體睡眠品質越差。經由迴歸分析檢測得知睡眠品質之預測因子為輪班順序（p = .009），可預測整體睡眠品質的總變異量達到11.8%。
結論/實務應用:順時鐘輪班者較逆時鐘輪班及不固定班別者，有較好的睡眠品質。若無法排定固定式班別，宜採順時鐘方式排班，以利班別間有足夠的休息時間及睡眠。

SUMMARY
Clockwise rotation would can have enough time to rest between, help to adjust the quality of sleep. The objective of this study was to understand the relationship with working shift clockwise rotated and sleep quality. A cross-sectional design was used for this research study. 127 staff nurses from the following 23 units Medical ward, surgical ward, ob-gyn floor units, pediatrics ward, Intensive care units, and emergency department. Data were collected on sleep quality using the Chinese edition Pittsburgh Sleep Quality Index (C-PSQI) was used to assess subjective sleep quality. Subjects were asked to assess their sleep condition in the previous month.The second questionnaire was the demographic questionnaire, including the type of shifts three months(clockwise rotated or counter-clockwise) and there are several types of shifts three months. Data were analysed using Independent t-test , one-way ANOVA, and multiple regression analysis to test the difference of rotating shift and sleep quality groups. Results showed total of 93 (73.2%) participants were poor quality of sleep. The mean quality of sleep is 7.82 points ( range : 0-15 points). Sleep quality was significantly correlated to with or without children, study In-service, and the choice of rotating shift schedule . No children, study In-service, and clockwise rotation were indicated with better sleep quality. Worse sleeping quality of nurses was significantly correlated to Participants had younger kids （r =-.567 , p ＜.01）. Results from multiple linear regression analysis found that rotating shift schedule (p = .009) were associated with sleeping quality in nurses and explained 11.8% of the variances in sleep quality. If we adjust the clockwise rotated then we can of plenty of rest time and sleep of our colleagues in the healthcare system.

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