A qualitative study of shift-work nurses' sleep adaptation process.

Abstract

Background: Nurses scheduled on a rotating cycle of three-shift allocations experience changes in their sleep patterns due to misaligned sleep-wake cycles and circadian rhythms, and they struggle to adapt to irregular sleep schedules.

Aims: This study aimed to understand the nature and process of sleep adaptation in shift-working nurses in real-life situations and to explore how various conditions impact this process.

Methods: A qualitative, in-depth interview study was conducted with 10 nurses working in a three-shift rotation system at two tertiary hospitals in South Korea. Interviews were recorded, transcribed verbatim, and independently analysed by two researchers using a standardized analysis method.

Results: Nurses who cycle between three-shift allocations lead a sleep-centred life due to irregular work schedules. They struggle to establish regularity in their sleep patterns and to regain control of their lives. These nurses continuously strive to adapt their sleep within the framework of a Möbius strip, progressing through stages of awareness, trial and error, and transition.

Conclusions: The substantive theory of 'Trying to take initiative in life by discovering regularity amid irregular sleep' was derived from the sleep adaptation process of shift-working nurses. This theory provides a crucial foundation for developing practical strategies at both individual and institutional levels to promote sleep adaptation among shift-working nurses.