skip to main content

Work-Related Fatigue Factors among Hospital Nurses: An Integrative Literature Review

Bader Abdullah Alahmadi  -  Nursing Supervisor, The University of Sydney, King Fahad Hospital, Saudi Arabia
*Manal Fehade Alharbi  -  Assistant Professor, Department of Maternity and Child Health Nursing, College of Nursing-King Saud University, Saudi Arabia
Open Access Copyright (c) 2019 Nurse Media Journal of Nursing

Citation Format:
Abstract

Background: Due to the demanding nature of nurses’ work and the current shortage of nurses, hospital nurses often find themselves working extra shifts, extended hours, and taking on more responsibilities. However, this added pressure on the body and mind results in fatigue which adversely affects nurses' health status as well as their ability to provide optimal health care procedures. Preventing fatigue and reducing its adverse consequences require comprehensive awareness about its diverse contributing factors.

Purpose: This study aimed to examine factors which influence fatigue among nurses employed in a hospital setting.

Methods: An integrative review was conducted to assess the quality of the research evidence, to find minor and major gaps in current research and the main issues in the area of the research and finally to bridge the research gaps. This integrative review identified a total of 12 relevant research studies from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Embase, PsycINFO, and a manual search. Data were reviewed in May 2017, using an integrative review, and then interpreted, analyzed and synthesized to identify the key contributing factors that influence fatigue among hospital nurses.

Results: The review revealed that significant factors such as organizational factors, nursing work characteristics, psychosocial factors as well as individual characteristics and demand, influenced the nurse fatigue. Work shifts, specifically night shifts and extended work shifts without sufficient inter-shift recovery were linked to higher levels of fatigue.

Conclusion: This review identified the significant factors affecting fatigue among nurses in hospital settings in various countries all around the world. Findings from this study may help healthcare organizations and policymaker to introduce strategies that mitigate fatigue among nurses.
Fulltext View|Download
Keywords: Fatigue; hospital; integrative review; nurses; work-related factors

Article Metrics:

  1. Australian Bureau of Statistics. (2010). Australian labour market statistics (No. 6105.0). Retrieved from http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/ B9BE5F9EA40AA538CA2577B50 00CB666/$File/61050_oct%202010.pdf
  2. Bae, S. H., Brewer, C. S., & Kovner, C. T. (2012). State mandatory overtime regulations and newly licensed nurses’ mandatory and voluntary overtime and total work hours. Nursing Outlook, 60(2), 60-71. doi: 10.1016/j.outlook.2011.06.006
  3. Barton, J. (1994). Choosing to work at night: A moderating influence on individual tolerance to shift work. Journal of Applied Psychology, 79(3), 449-454
  4. Boivin, D. B., & Boudreau, P. (2014). Impacts of shift work on sleep and circadian rhythms. Pathologie Biologie, 62(5), 292-301
  5. Boyle, D. (2011). Countering compassion fatigue: A requisite nursing agenda. The Online Journal of Issues in Nursing, 16(1):2
  6. Bureau of Labor Statistics. (2015). Occupational Outlook Handbook, 2014-15 Edition, Registered Nurses. Retrieved from http://www.bls.gov/ooh/ healthcare/registered-nurses.htm
  7. Canadian Centre for Occupational Health and Safety. (2017). Rotational shift-work: OSH answers. Retrieved from http://www.ccohs.ca/oshanswers/ergonomics/ shiftwrk.html
  8. 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
  9. Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care-associated infection. American Journal of Infection Control, 40(6), 486. doi: 10.1016/j.ajic.2012.02.029
  10. Critical Appraisal Skills Programme (2018). CASP (Qualitative) Checklist. Retrieved from https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf
  11. Eldevik, M. F., Flo, E., Moen, B. E., Pallesen, S., & Bjorvatn, B. (2013). Insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder in nurses having less than 11 hours in-between shifts. PLoS one, 8(8), e70882
  12. Fang, J., Kunaviktikul, W., Olson, K., Chontawan, R., & Kaewthummanukul, T. (2008). Factors influencing fatigue in Chinese nurses. Nursing Health Sciences, 10(4), 291-299
  13. Garde, A. H., Albertsen, K., Nabe-Nielsen, K., Carneiro, I. G., Skotte, J., Hansen, S. M., . . . Hansen, Å. M. (2012). Implementation of self-rostering (the PRIO project): Effects on working hours, recovery, and health. Scandinavian Journal of Work, Environment & Health, 38(4), 314-326
  14. 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
  15. Jung, H. S., & Lee, B. (2015). Contributors to shift work tolerance in South Korean nurses working rotating shift. Applied Nursing Research, 28(2), 150-155
  16. Kunert, K., King, M. L., & Kolkhorst, F. W. (2007). Fatigue and sleep quality in nurses. Journal of Psychosocial Nursing and Mental Health Services, 45(8), 30-37
  17. Lester, D. (2013). Measuring Maslow’s hierarchy of needs. Psychological Reports, 113(1), 15-17. doi: 10.2466/02.20.PR0.113x16z1
  18. Lockley, S. W., Barger, L. K., Ayas, N. T., Rothschild, J. M., Czeisler, C. A., & Landrigan, C. P. (2007). Effects of health care provider work hours and sleep deprivation on safety and performance. Joint Commission Journal on Quality and Patient Safety, 33(11), 7-17
  19. MacKusick, C. I., & Minick, P. (2010). Why are nurses leaving? Findings from an initial qualitative study on nursing attrition. Medsurg Nursing: Official Journal of the Academy of Medical- Surgical Nurses, 19(6), 335-340
  20. Morelock, S. (2016). Sustained vigilance and errors in critical care. Nursing Critical Care, 11(6), 38-47
  21. Morris, C. J., Aeschbach, D., & Scheer, F. A. J. L. (2012). Circadian system, sleep and endocrinology. Molecular and Cellular Endocrinology, 349(1), 91-104. doi: 10.1016/j.mce.2011.09.003
  22. Nagai, M., Morikawa, Y., Kitaoka, K., Nakamura, K., Sakurai, M., Nishijo, M., . . . Nakagawa, H. (2011). Effects of fatigue on immune function in nurses performing shift work. Journal of Occupational Health, 53(5), 312-319. doi: 10.1539/joh.10-0072-OA
  23. Niu, S. F., Chung, M. H., Chen, C. H., Hegney, D., O’Brien, A., & Chou, K. R. (2011). The effect of shift rotation on employee cortisol profile, sleep quality, fatigue, and attention level: A systematic review. Journal of Nursing Research, 19(1), 68-81
  24. Palhares, V. D., Corrente, J. E., & Matsubara, B. B. (2014). Association between sleep quality and quality of life in nursing professionals working rotating shifts. Revista de Saude Publica, 48(4), 594-601
  25. Rahman, H. A., Abdul-Mumin, K., & Naing, L. (2016). A study into psychosocial factors as predictors of work-related fatigue. British Journal of Nursing, 25(13), 757-763. doi: 10.12968/bjon.2016.25.13.757
  26. Smith-Miller, C. A., Shaw-Kokot, J., Curro, B., & Jones, C. B. (2014). An integrative review: Fatigue among nurses in acute care settings. JONA: The Journal of Nursing Administration, 44(9), 487-494. doi: 10.1097/NNA.0000000000000104
  27. Steege, L. M., & Rainbow, J. G. (2017). Fatigue in hospital nurses - ‘Supernurse’ culture is a barrier to addressing problems: A qualitative interview study. International Journal of Nursing Studies, 67, 20-28
  28. Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs, 31(11), 2501–2509. doi: 10.1377/hlthaff.2011.1377
  29. The Joint Commission. (2011). The Joint Commission Sentinel Events Alert. A complimentary publication of The Joint Commission, 48, 1-4
  30. Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553
  31. Winwood, P. C., Winefield, A. H., & Lushington, K. (2006). Work-related fatigue and recovery: The contribution of age, domestic responsibilities and shiftwork. Journal of Advanced Nursing, 56(4), 438-449. doi: 10.1111/j.1365-2648.2006.04011.x
  32. Yuan, S. C., Chou, M. C., Chen, C. J., Lin, Y. J., Chen, M. C., Liu, H. H., & Kuo, H. W. (2011). Influences of shift work on fatigue among nurses. Journal of Nursing Management, 19(3), 339-345

Last update:

  1. Commentary: Factors correlating with prolonged fatigue among emergency department nurses

    Michael Kleinknecht-Dolf. Journal of Research in Nursing, 24 (8), 2019. doi: 10.1177/1744987119880358
  2. Work Index and Contextual Variables as Predictors of Emergency Nurses’ Career Success

    Ali Mohammadzadeh, Elnaz Asghari, Mansour Ghafourifard. Nurse Media Journal of Nursing, 11 (2), 2021. doi: 10.14710/nmjn.v11i2.37875
  3. Work-Related Accumulated Fatigue among Doctors in Tertiary Hospitals: A Cross-Sectional Survey in Six Provinces of China

    Changmin Tang, Chaojie Liu, Pengqian Fang, Yuanxi Xiang, Rui Min. International Journal of Environmental Research and Public Health, 16 (17), 2019. doi: 10.3390/ijerph16173049
  4. Work-related musculoskeletal symptoms among Iranian nurses and their relationship with fatigue: a cross-sectional study

    Elahe Hosseini, Hadi Daneshmandi, Azadeh Bashiri, Roxana Sharifian. BMC Musculoskeletal Disorders, 22 (1), 2021. doi: 10.1186/s12891-021-04510-3
  5. Application of work system engineering analysis

    I Siregar, T H Nasution. IOP Conference Series: Materials Science and Engineering, 1122 (1), 2021. doi: 10.1088/1757-899X/1122/1/012060
  6. Shift handover quality in Saudi critical care units: determinants from nurses’ perspectives

    Ebtsam Aly Abou Hashish, Atheer Ahmed Asiri, Yara Khaled Alnajjar. BMC Nursing, 22 (1), 2023. doi: 10.1186/s12912-023-01348-z
  7. The predictive role of resilience and the ethical climate of hospital in the fatigue of surgical technologists working in operating rooms

    Masoume Rambod, Nilofar Pasyar, Marzieh Soltanian. BMC Psychology, 12 (1), 2024. doi: 10.1186/s40359-024-01881-9
  8. Occupational fatigue and sleep quality among the physicians employed in the emergency service of a COVID-19 pandemic hospital

    Hüseyin Avni DEMİR, Suzan HAVLİOĞLU. Journal of Surgery and Medicine, 6 (1), 2022. doi: 10.28982/josam.871527
  9. Exploring Work-related Anxiety Among Newly Graduated Nurses in the Riyadh Region

    Kholoud Alrashedi, Amira Boshra. Sudan Journal of Medical Sciences, 2023. doi: 10.18502/sjms.v18i2.13604
  10. Influencing factors of fatigue among public health nurses during the COVID‐19 pandemic: A cross‐sectional study

    Ok‐Hee Cho, Jeongeun Yoon, Mina Kim. Public Health Nursing, 40 (1), 2023. doi: 10.1111/phn.13131
  11. Occupational Fatigue and Associated Factors among Saudi Nurses Working 8-Hour Shifts at Public Hospitals

    Sharifah Abdulmuttalib Alsayed, Ebtsam Aly Abou Hashish, Farhan Alshammari. SAGE Open Nursing, 8 , 2022. doi: 10.1177/23779608221078158

Last update: 2024-12-11 03:35:22

  1. The influence of workload, body mass index (BMI), duration of work toward fatigue of nurses in Dr. M. Haulussy General Hospital Ambon

    Russeng S.S.. Systematic Reviews in Pharmacy, 11 (4), 2020. doi: 10.31838/srp.2020.4.41
  2. Commentary: Factors correlating with prolonged fatigue among emergency department nurses

    Michael Kleinknecht-Dolf. Journal of Research in Nursing, 24 (8), 2019. doi: 10.1177/1744987119880358