Association of shift work with stress among registered nurses at a tertiary care hospital of Karachi, Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Rotating shift work in registered nurses is necessary for providing 24 hours health care services to patients in hospitals. However, it is associated with stress, poor sleep quality and eating disorder among nurses. Objective: To assess the association of rotating shift work with stress among nurses working at a tertiary care hospital. Design: Comparative Cross- Sectional study Setting: Private tertiary care hospital in Karachi Pakistan. Participants: We included only registered nurses of non-critical areas and excluded those who were working in critical and psychiatric wards. Methods: We conducted a cross sectional study from March 05, 2017 to June 05, 2017 on a sample of 70 registered nurses from day shift and 70 nurses from rotating shift working in the non-critical wards and day care units of the Aga Khan University Karachi. We used a pretested questionnaire known as Cohen Stress scale. The questionnaire also contained questions pertaining to demographic data and occupational characteristics of the nurses. We used chi square test for association between categorical variables. Ordinal logistic regression was used assess the association of rotating shift work with stress among nurses. Results: All 70 nurses in working rotating and day shifts completed the questionnaire. The mean age of the nurses working in rotating and day shift was 27.62±4.44and 30.52 ± 5.23 years respectively. We found that the odds of having low stress to moderate or severe stress among nurses working in rotating shift with interrupted sleep was 5.10 times (95% CI:2.32- 11.24) as compared to nurses working in day shift with no interrupted sleep adjusting for all other variables in the model. Conclusion: Findings from this study suggest a positive association of rotating shift work with stress among registered nurses. We suggest that the nursing managers should consider the findings of this study when arranging schedules for work and design shift schedules systems that reduce stress among register nurses, who work in rotating shift. Key words: Nurses, Rotating shift work, Stress.

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