Examining the Influence of Shift Length on Nurse Fatigue, Patient Care, Quality of Life, and Work-Life Dynamics in a Tertiary Hospital in Oman: Comparative Study.

Abstract

Background: The adoption of 12-h shifts in response to workforce shortages has raised questions about their impact on nurses' well-being and patient care quality. While international studies offer mixed findings, little is known about these effects in the Omani context. Aim: To compare the effects of 8-h and 12-h shifts on nurse fatigue, quality of life, satisfaction, turnover intention, and perceived patient care in a tertiary hospital in Oman. Methods: A comparative cross-sectional study was conducted with 100 nurses from Sultan Qaboos University Hospital using self-administered surveys. Descriptive statistics, t-tests, and chi-square tests were performed to compare outcomes across shift types. A multiple regression analysis was also conducted to assess predictors of quality of life, controlling for shift type, age, gender, marital status, satisfaction, fatigue, and unit assignment. Results: Nurses working 12-h shifts reported significantly higher levels of fatigue (p < 0.001; Cohen's d = 0.82) but also reported higher quality of life (p < 0.001; d = 0.91) and greater satisfaction with their shift length (p=0.001; d = 0.72). No significant differences were found in turnover intention. Patient falls were more frequently reported among 12-h shift nurses, while other safety incidents showed no significant variation. A multiple regression model predicting QOL was significant (F(16, 83) = 9.64, p < 0.001, adjusted R ² = 0.583). Satisfaction with shift was the strongest positive predictor (β = 0.432, p < 0.001, 95% CI [0.117, 0.287]), while working a 12-h shift had a significant negative association with QOL (β = -0.232, p=0.004, 95% CI [-0.603, -0.117]). Marital status showed a marginally significant positive effect (β = 0.180, p=0.051, 95% CI [-0.001, 0.555]). Conclusion: Despite increased fatigue, nurses working 12-h shifts reported higher quality of life, possibly due to more days off and enhanced work-life balance. However, elevated fatigue and fall rates warrant caution. The findings underscore the importance of implementing flexible and individualized scheduling policies rather than universally adopting 12-h shifts. Further longitudinal studies are needed to explore long-term effects of shift length on nurse and patient outcomes.