臺灣博碩士論文加值系統

【研究背景】
護理人員為台灣高疲勞職業之一，政府相關當局欲藉由改善護病比來降低護理人員疲勞程度，但職場留任率仍不佳。自2008年開始有醫院試行12小時輪班制度來改善減少延遲下班及離職率等問題，但延長工時對護理人員疲勞程度影響實為一大隱憂，更有研究指出12小時輪班制上班日睡眠不足，而檢視國內外研究針對12小時輪班制度對於疲勞之影響至今尚無定論，實需更多研究深入探討。
【研究目的】
了解8小時與12小時輪班制度中護理人員的職業疲勞與睡眠情形，比較兩種輪班制度中職業疲勞與睡眠品質的差異，並找出相關因子。同時檢視8小時與12小時輪班制度中超時工時的情形與差異。
【研究方法】
本研究以橫斷式研究設計，採立意取樣法，於2016年10月至2016年11月期間在北部某醫學中心以結構性問卷進行收集資料，本研究工具包含：工作特質量表、職場疲勞量表、職業性疲憊耗竭復原量表、成人版睡眠型態偏好量表、匹茲堡睡眠量表與睡眠日誌。統計分析以IBM SPSS 19.0統計軟體分析，以描述性統計呈現基本屬性、超時工時、職業疲勞、睡眠品質的分布情形，再以輪班制度分組進行護理人員於職業疲勞及睡眠品質的差異檢定。
【研究結果】
本研究案共納入223位受試者，平均年齡為29.8±6.5歲，介於22~51歲，平均工作年資為6.7±6.0年。睡眠品質方面，輪班護理人員的年齡(p=0.03)與年資(p=0.02)越大其睡眠品質較差；有喝咖啡習慣者睡眠品質也較無喝咖啡習慣者差(p=0.02)；個人晨昏時型(chronotype)若能與輪班班別相配合能有更好的睡眠品質(p=0.03)。在不同輪班制當中，8小時輪班護理人員上班日睡眠時數平均為6.93±1.62小時，較12小時輪班護理人員的6.14±1.72小時長且達統計上顯著差異(p=0.00)，但整體睡眠品質在不同輪班制度上並無統計顯著差異。
在職業疲勞方面，輪班護理人員的年齡(p=0.03)、年資(p=0.04)與工作疲勞呈現負相關；住宿舍者其對服務對象疲勞與工作過度投入的程度較高；在家需照顧子女或老人者在工作疲勞、對服務對象疲勞和工作過度投入程度較低；有喝咖啡習慣者對服務對象疲勞得分較高，其急性疲勞程度也較高。而在不同輪班制度中，8小時與12小時輪班護理人員在各疲勞面向上無統計上顯著差異，但12小時輪班護理人員有較好的班間恢復程度(p=0.00)。
超時工時方面，本研究對象中超過九成護理人員有延遲下班的問題，平均延遲下班時數為53.8±48.1分鐘，8小時輪班護理人員平均超時工時為56.4±48.4分鐘，12小時輪班制護理人員平均超時工時為49.5±45.2分鐘，兩組間無統計上顯著差異。
【結論】
12小時與8小時輪班制度護理人員的職場疲勞與睡眠品質沒有明顯差異，且12小時輪班制度護理人員可藉由較長且連續的休假日來規劃休閒生活以利疲勞恢復，在工作流程上也有減少交班干擾的優點，可作為護理人員另一種輪班選擇。未來研究建議針對延遲下班進一步探討，以減少超時工時對於護理人員疲勞之影響，並同時監測病人照護相關指標，以了解延長工時對病人安全之影響。

【Background】
While Occupational fatigue among nurses has raised concerns in recent years, Taiwan government legislated for nurse-patient ratios but has limited effects. Since 2008, there were few hospitals that introduced a 12-hour shift system to reduce overtime and to increase retention rate, but extended worktime may effect nurses’ performance and patient safety. It is inconclusive that whether long working hours have negative impact on nurses’ fatigue level.
【Aim】
This study investigated the status of occupational fatigue and sleep quality of nurses on 12-hour and 8-hour shifts and identified individual factors. Time off-work was also gathered to exam if the 12-hour shift system can reduce overtime for nurses in Taiwan.
【Methods】
A cross-sectional survey was conducted in a medical center in north Taiwan between September 2016 and November 2016. The Data were collected from structured questionnaires including: job content questionnaire, occupational burnout inventory, occupational fatigue exhaustion/recovery scale (OFER), morning-evening questionnaire (MEQ), Pittsburg sleep quality index (PSQI) and sleep diary. IBM SPSS 19.0 software was used to analyze the data.
【Results】
There were 223 participants, with which the mean age was 29.8±6.5 and the mean seniority was 6.7±6.0 years. Age, seniority and daily coffee consumption were positively correlated with PSQI (all p< .03), and higher PSQI represented poor sleep quality. Nurses could have better sleep quality if their rotation shift matched with their chronotype (p=0.03). Nurses with 8-hour shift had longer total sleep time on work day than the 12-hour shift ones (6.93 vs 6.14 hours, p=0.00), but there was no significant difference on sleep quality between the two shift systems.
Higher work-related burnout was associated with age(p=0.03) and seniority(p=0.04), higher client-related burnout was associated with hospital dormitory staying, child or elder careburden was associated with lower work-related burnout and lower client-related burnout, and daily coffee consumption was associated with higher client-related burnout and more acute fatigue. Overall, occupational fatigue was not differed by the two shift systems, but 12-hour shifts nurses had better inter-shift recovery (p=0.00).
Over 90% nurses worked overtime, with mean time-overwork was 53.8±48.1 minutes, nurses on 8-hour dayshift had more serious overtime problem, but there was no significant difference between the two shift systems on overtime.
【Conclusion】
12-hour shift system can be an option for nurses in Taiwan considering the benefits on longer day-off and less handover-time, but there should be interventions to reduce overtime. Furture studies should focus on patient care quality and patient safety.

口試委員會審定書 i
誌謝 ii
中文摘要 iii
英文摘要 v
圖目錄 ix
表目錄 x
第一章 緒論 1
第一節 研究動機與重要性 1
第二節 研究目的 3
第三節 名詞定義 4
第二章 文獻回顧 5
第一節 護理人員的輪班工作 5
第二節 8小時與12小時輪班時制度的優勢與隱憂 8
第三節 護理人員的職業疲勞. 12
第三章 研究方法 14
第一節 研究架構 14
第二節 研究設計、收案場所與對象選擇 15
第三節 樣本數估算 16
第四節 研究工具 17
第五節 資料收集流程 20
第六節 統計資料分析 21
第七節 研究倫理 22
第四章 研究結果 23
第一節 研究對象基本屬性、工作特質與超時工時 24
第二節 8小時與12小時輪班護理人員職業疲勞現況與差異 35
第三節 8小時與12小時輪班護理人員睡眠現況與差異 41
第四節 8小時與12小時輪班制度護理人員職業疲勞相關因子 49
第五節 8小時與12小時輪班制度護理人員睡眠品質相關因子 56

第五章 討論 59
第一節 輪班護理人員的職業疲勞 59
第二節 輪班護理人員的睡眠 64
第三節 護理人員的超時工作 66
第六章 結論與建議 67
第一節 結論 67
第二節 建議與應用 68
第三節 研究限制與未來研究建議 69
參考文獻 70
中文文獻 70
英文文獻 72
附錄 78
附錄一 Dr. Winwood同意授權使用職業型疲憊耗竭復原量表中文版之email紀錄 78
附錄二 臺大醫院倫理委員會審查通過公文 79
附錄三 成人睡眠型態偏好量表翻譯內容 82

中文文獻
李育茹（2014）．台灣臨床護理人員執業環境與職業壓力、離職意圖之探討（未發表的碩士論文）．台灣大學護理學研究所，台北市。
李宜芳（2016）．女性護理人員職場疲勞探討（未發表的碩士論文）．長榮大學護理學研究所，台南市。
李靜怡（2011）．輪班護理人員壓力失眠易感性、晨昏約日型態與睡眠品質之相關性研究（未發表的碩士論文）．臺灣大學護理學研究所，台北市。
林怡芳（2015）．護理人員性功能、睡眠及生活品質關係性之研究．台灣大學醫學院護理學系研究所，台北市。
林美吟（2008）．護理人員輪班工作對女性性功能之影響-以中部兩家地區教學醫院為例（未發表的碩士論文）．臺北醫學大學公共衛生學系暨研究所，台北市。
林洺秀、郭智宇（2013）・工作環境安全衛生狀況認知調查－2013年・勞動部勞動與職業安全衛生研究所。
林怡芳、張秀如、王莉婷（2017）．護理12小時輪班制度在臺灣可行嗎？護理雜誌，64（2），124–129。
周春芬、方進博（2015）．護理人員工作特質與職業疲勞的相關性研究．護理雜誌，62（5）,41-50。doi:10.6224/JN.62.5.41
胡佩怡、蕭淑銖（2013）・我國護理人員執業環境及身心健康之探討・勞動部勞動與職業安全衛生研究所。
洪瑜儒、林佩蓁、潘純媚、陳秋蓉、何啟功、吳明蒼（2016）．護理人員的輪班工作與睡眠品質、身心健康及家庭功能之間的相關性．勞工安全衛生研究季刊，15（1）,17-30。
柯惠文（2009）．中區急診護理人員輪班制度及其睡眠品質相關性之探討（未發表的碩士論文）．弘光科技大學護理學研究所，台中市。
姚開屏（2005）．台灣簡明版世界衛生組織生活品質問卷之發展及使用手冊（第二版）．世界衛生組織生活品質問卷台灣版問卷發展小組。
高淑芬、宋維村、李宇宙、丘彥南（1998）．中文版「睡眠型態偏好量表」之信效度．台灣精神醫學，12（2），98-109。
馮容莊、林碧珠（2010）．探討護理人員延遲下班之相關因素．榮總護理，27（1），10-19。doi: 10.6142/VGHN.27.1.10
許秀娟（2005）．醫院護理人員睡眠品質及其相關因素之探討（未發表的碩士論文）．臺中健康暨管理學院健康管理研究所，台中市。
陳瑞貞（2011）．女性輪班護理人員主客觀睡眠品質及其相關因素探究（未發表的碩士論文）．國立臺北護理學院護理研究所，台北市。
葉婉榆、鄭雅文、陳美如、邱文祥（2008）．職場疲勞量表的編製與信效度分析．台灣公共衛生雜誌，27（5），349-364。
黃宇黛（2009）．醫學中心護理人員身體活動與睡眠品質之相關性研究（未發表的碩士論文）．臺北醫學大學護理學研究所，台北市。
黃麗玲、黃薇瑄、葉德豐、鍾燕宜、林川雄、黃建財．（2015）．護理人員超時工作與疲勞之相關性分析．休閒運動保健學報，8，10-25。
楊婉珍、胡巧欣、吳一德(2014)．護理人員工作時間、進修壓力與職場疲勞相關之研究．運動休閒管理學報，11(1)，114-131。doi:10.6214/JSRM.1101.008
鄭慧華、鍾詩琦、廖玟君（2011）．不同班別護理人員的睡眠和飲食之探討．護理暨健康照護研究，7（4），295 - 304。doi：10.6225/JNHR.7.4.44
盧玉嬴、陳瑞貞、梁淑媛、吳淑芳(2014) ．護理人員之工作壓力與職場疲勞之相關性探討．護理暨健康照護研究，10(4)，276−285。
蕭桂榮（2009）．輪班護理人員的睡眠品質、壓力、疲勞與相關生理指標之探討（未發表的碩士論文）．長榮大學職業安全與衛生研究所，台南市。
 
英文文獻
Aaronson, L. S., Teel, C. S., Cassmeyer, V., Neuberger, G. B., Pallikkathayil, L., Pierce, J., Press, A.N., Williams, P.D., Wingate, A.(1993) Defining and measuring fatigue. Image Journal of Nursing Scholar, 31(1), 45-50.
Allebrandt, K. & Roenneberg, T. (2011). Sleep timing/duration, seasonality and genetic polymorphisms. Somnologie, 15(suppl. 1), 10.
Al-Naimi, S., Hampton, S. M., Richard, P., Tzung, C., & Morgan, L. M. (2004). Postprandial metabolic profiles following meals and snacks eaten during simulated night and day shift work. Chronobiology International, 21, 937-947.
Arendt, J. (2010). Shift work: coping with the biological clock. Occupational Medicine, 60, 10–20. doi:10.1093/occmed/kqp162
Ball, J., & Pike, G. (2009). Past imperfect, future tense. Results from the RCN Employment Survey. London: RCN.
Barker, L. M. and Nussbaum, M. A. (2011). Fatigue, performance and work environment: a survey of registered nurses. Journal of Advanced Nursing, 67(6):1370-1382.
Berger, A. M., & Hobbs, B. B. (2006). Impact of shift work on the health and safety of nurses and patients. Clinical Journal of Oncology Nursing, 10, 465–471.
Brudnowska, J., & Pepłońska, B. (2011). Night shift work and cancer risk: a literature review. Medycyna pracy,62(3), 323-338.
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Research, 28(2), 193-213. doi: 10.1016/0165-1781(89)90047-4
Caruso, C. C. (2015). Reducing Risks to Women Linked to Shift Work, Long Work Hours, and Related Workplace Sleep and Fatigue Issues. Journal of Women''s Health, 24(10), 789-794. doi: 10.1089/jwh.2015.5481.
Cellini, N., Buman, M. P., McDevitt, E. A., Ricker, A. A., & Mednick, S.C. (2013). Direct comparison of two actigraphy devices with polysomnographically recorded naps in healthy young adults. Chronobiology International, 30(5), 691-698. doi:10.3109/07420528.2013.782312.
Cheng, Y., Luh, W. M., & Guo, Y. L. (2003). Reliability and Validity of the Chinese Version of the Job Content Questionnaire (C-JCQ) in Taiwanese Workers. International Journal of Behavioral Medicine, 10(1), 15-30.
Chen, J., Davis, K. G., Daraiseh, N. M., Pan, W., & Davis, L. S. (2014). Fatigue and recovery in 12-hour dayshift hospital nurses. Journal of Nursing Management, 22(5), 593-603. doi: 10.1111/jonm.12062.
Chung, M. H., Chang, F. M., Yang, C. H., Kuo, B. J. & Hsu, N. (2009). Sleep quality and morningness–eveningness of shift nurses. Journal of Clinical Nursing, 18, 279–284. doi: 10.1111/j.1365-2702.2007.02160.x
Connor, J., Norton, R., Ameratunga, S., Robinson, E., Civil, I., Dunn, R., …, Jackson, R. (2002). Driver sleepiness and risk of serious injury to car occupants: population based case control study. BMJ, 324(7346), 1125.
Costa, G. (2003). Shift work and occupational medicine: an overview. Occupational medicine, 53(2), 83-88.
Drury, V., Francis, K., & Chapman, Y. (2009). Where have all the young ones gone: Implication for the nursing workforce. Online Journal of Issues in Nursing, 14(1), 11-12.
Duchon, J., Keran, C., & Smith, T. (1994). Extended workdays in an underground mine: a work performance analysis. Human Factors, 36(2), 258-269.
Estabrooks, C. A., Cummings, G. G., Olivo, S.A., Squires, J. E., Giblin, C., & Simpson, N. (2009). Effects of shift length on quality of patient care and health provider outcomes: systematic review. Quality Safe Health Care, 18, 181-188. doi:10.1136/qshc.2007.024232
Fang, J., Kunavilktikul, W., Olson, K., Chontawan, R., & Kaewthummanukul, T. (2008). Factors influencing fatigue in Chinese nurses. Nursing Health Science, 10(4), 291-299.
Fields, W. L., & Loveridge, C. (1988). Critical thinking and fatigue: how do nurses on 8 and 12 hour shifts compare? Nursing Economic$, 6(4), 189–191.
Flo, E., Pallesen, S., Åkerstedt, T., Magerøy, N., Moen, B. E., Grønli, J., …, Bjorvatn, B. (2013). Shift-related sleep problems vary according to work schedule. Occupational and Environmental Medicine, 70(4), 238-245. doi: 10.1136/oemed-2012-101091.
Fountain, I., Curzio, J. & Hunt, J. (1996). Issues involved in introducing the 12-hour shift. Journal of Research in Nursing, 1(5), 349-357. doi: 10.1177/136140969600100506
Geiger-Brown, J., Rogers, V. E., Trinkoff, A. M., Kane, R. L., Bausell, R. B., & Scharf, S. M. (2012). Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses. Chronobiology International, 29(2), 211-219. doi: 10.3109/07420528.2011.645752.
Ghalichi, L., Pournik, O., Ghaffari, M., Vingard, E. (2013). Sleep Quality among Health Care Workers. Archives of Iranian Medicine, 16(2), 100-108.
Griffiths, P., Dall''Ora, C., Simon, M., Ball, J., Lindqvist, R., Rafferty, A. M., Schoonhoven, L., …, RN4CAST Consortium. (2014). Nurses'' shift length and overtime working in 12 European countries: the association with perceived quality of care and patient safety. Medical Care, 52(11), 975-981. doi: 10.1097/MLR.0000000000000233.
Han, K., Trinkoff, A. M., & Geiger-Brown, J. (2014). Factors associated with work-related fatigue and recovery in hospital nurses working 12-hour shifts. Workplace Health & Safety, 62(10), 409-414. doi: 10.3928/21650799-20140826-01.
Janssen, N., Nijhuis, F. (2004). Associations between positive changes in perceived work characteristics and changes in fatigue. Journal of Occupational Environmental Medicine, 46, 866–875.
Jia, Y., Lu, Y., Wu, K., Lin, Q., Shen, W., Zhu, M., … & Chen, J. (2013). Does night work increase the risk of breast cancer? A systematic review and meta-analysis of epidemiological studies. Cancer Epidemiology, 37(3), 197-206. doi: 10.1016/j.canep.2013.01.005.
Kang, J. H., Miao, N. F., Tseng, I. J., Sithole, T., & Chung, M. H. (2015). Circadian Activity Rhythms and Sleep in Nurses Working Fixed 8-hr Shifts. Biological Research for Nursing, 17(3), 348-355. DOI: 10.1177/1099800414549454
Lac, G., & Chamoux, A. (2004). Biological and physiological responses to two rapid shiftwork schedules. Ergonomics, 47, 1339-1349.
Lim, E. Y., Uhm, J., Chang, E. J., Kim, N. Y., Ha, E. J., Lee, S. H., …, Kim, Y. H. (2014). Impact of 12-hour Shifts on Job Satisfaction, Quality of Life, Hospital Incident Reporting, and Overtime Hours in a Pediatric Intensive Care Unit. Journal of Korean Academy of Nursing Administration, 20(4), 353-361. doi: 10.11111/jkana.2014.20.4.353
Marino, M., Li, Y., Rueschman, M. N., Winkelman, J. W., Ellenbogen, J. M., Dulin, H., …, Buxton, O. M. (2013). Measuring sleep: accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography. Sleep, 36(11), 1747-1755. doi: 10.5665/sleep.3142.
McGettrick, K. S., & O''Neill, M. A. (2006). Critical care nurses--perceptions of 12-h shifts. Nursing in Critical Care, 11(4), 188-197. doi: 10.1111/j.1362-1017.2006.00171.x
Megdal, S. P., Kroenke, C. H., Laden, F., Pukkala, E., & Schernhammer, E. S. (2005). Night work and breast cancer risk: a systematic review and meta-analysis. European Journal of Cancer, 41(13), 2023-2032.
Moreno, C. R. C., Marqueze, E. C., Lemos, L. C., Soares, N., Lorenzi-Filho, G. (2012). Job satisfaction and discrepancies between social and biological timing. Biological Rhythm Research, 43(1), 73-80.
Morgan, L., Hampton, S., Gibbs, M., & Arendt, J. (2003). Circadian aspects of postprandial metabolism. Chronobiology International, 20, 795-808.
Morgenthaler, T., Alessi, C., Friedman, L., Owens, J., Kapur, V., Boehlecke, B., …, American Academy of Sleep Medicine. (2007). Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep, 30(4), 519-529.
Nurminen, T. (1998). Shift work and reproductive health. Scandinavian Journal of Work, Environment & Health, 24 (Suppl 3), 28-34.
O’Hare, E., Flanagan, D., Penzel, T., Garcia, C., Frohberg, D., Heneghan, C. (2015). A comparison of radio-frequency biomotion sensors and actigraphy versus polysomnography for the assessment of sleep in normal subjects. Sleep & Breathing, 19(1), 91-98. doi: 10.1007/s11325-014-0967-z.
Owens, J. (2001). Sleep loss and fatigue in medical training. Sleep and respiratory neurobiology, 7(6), 411-418.
Pilcher, J. J., Lambert, B. J., & Huffcutt, A. I. (2000). Differential effects of permanent and rotating shifts on self-report sleep length: A meta-analytic review. Sleep, 23(2), 155-163.
Piper, B.F. (1989). Fatigue: Current bases for practice. Key aspects of comfort. New York: Springer.
Presser, H. B. (1999). Towards a 24-hour economy. Science, 284(5421), 1778-1779. doi: 10.1126/science.284.5421.1778
Richardson, A., Dabner, N., & Curtis, S. (2003). Twelve-hour shift on ITU: a nursing evaluation. Nursing in Critical Care, 8(3), 103-108. doi: 10.1046/j.1478-5153.2003.00016.x
Richardson, A., Turnock, C., Harris, L., Finley, A., & Carson, S. (2007). A study examining the impact of 12-hour shifts on critical care staff. Journal of Nursing Management, 15(8), 838-846. doi: 10.1111/j.1365-2934.2007.00767.x
Rogers, A. E., Hwang, W. T., Scott. L. D., Aiken, L. H., & Dinges, D. F. (2004). The working hours of hospital staff nurses and patient safety. Health Affairs, 23(4), 202-212. doi: 10.1377/hlthaff.23.4.202
Ruggiero, J. S. (2003). Correlates of Fatigue in Critical Care Nurses. Research in Nursing & Health, 26, 434–444.
Ruggiero, J. S., & Avi-Itzhak, T. (2016). Sleep Patterns of Emergency Department Nurses on Workdays and Days Off. The Journal of Nursing Research, 24(2), 173-180. Doi: 10.1097/jnr.0000000000000121
Sadeh, A. (2011). The role and validity of actigraphy in sleep medicine: an update. Sleep medicine review, 15(4), 259-267.
Sagherian, K., & Geiger Brown, J. (2016). In-depth review of fatigue measures in shift workers. Fatigue: Biomedicine, Health & Behavior, 4(1), 24-38. doi:10.1080/21641846.2015.1124521
Samaha, E., Lal, S., Samaha, N.& Wyndham, J. (2007) Psychological, life- style and coping contributors to chronic fatigue in shift-worker nurses. Journal of Advanced Nursing 59(3), 221–232. doi: 10.1111/j.1365-2648.2007.04338.x
Smith, L., Folkard, S., Tucker, P., & Macdonald, I. (1998). Work shift duration: a review comparing eight hour and 12 hour shift systems. Occupational and Environmental Medicine, 55, 217-229. doi: 10.1136/oem.55.4.217
Souza, S. B. C., Tavares, J. P., Macedo, A. B. T., Moreira, P. W., Lautert, L. (2012). Influence of work shift and chronotype on the quality of life of nursing professionals. Revista Gaucha de Enfermagem, 33(4), 79-85.
Stone, P. W., Du, Y., Cowell, R., Amsterdam, N., Helfrich, T. A., Linn, R. W., …, Mojica, L. A. (2006). Comparison of nurse, system and quality patient care outcomes in 8-hour and 12-hour shifts. Medical Care, 44(12), 1099-1106. doi: 10.1097/01.mlr.0000237180.72275.82
Tsai, P. S., Wang, S. Y., Wang, M. Y., Su, C. T., Yang, T. T., Huang, C. J., & Fang, S. C. (2005). Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality Life Research, 14(8), 1943-1952.
Tucker, P., Barton, J., & Folkard, S. (1996). Comparison of eight and 12 hour shifts: impacts on health, wellbeing, and alertness during the shift. Occupational and Environmental Medicine, 53(11), 767-772. doi: 10.1136/oem.53.11.767
Van Cauter, E., Plat, L., & Copinschi, G. (1998). Interrelations between sleep and the somatotropic axis. Sleep, 21(6), 553-566.
Vetter, C., Fischer, D., Matera, J. L. & Roenneberg, T. (2015). Aligning work and circadian time in shift workers improves sleep and reduces circadian disruption. Current Biology, 25(7), 907-911. doi: http://dx.doi.org/10.1016/j.cub.2015.01.064
Waterhouse, J., Buckey, P., Edwards, B., & Reilly, T. (2003). Measurement of, and some reasons for differences in eating habits between day and night workers. Chronobiology International, 20, 1075-1092.
Williamson, A. M., Gower, C. G., & Clarke, B. C. (1994). Changing the hours of shiftwork: a comparison of 8- and 12-hour shift rosters in a group of computer operators. Ergonomics, 37(2), 287-298. doi: 10.1080/00140139408963646
Winwood, P. C., Lusington, K., & Winfield, A. H. (2006). Further development and validation of the occupational fatigue exhaustion recovery(OFER) Scale. Journal of Occupational and Environmental Medicine, 48(4), 381-389. doi:10.1097/01.jom.0000194164.14081.06
Yao, G., Chung, C. W., Yu, C. F., & Wang, J. D. (2002). Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version. Journal of the Formosan Medical Association, 101(5), 342-351.