The Mediating Role of Sleep Quality in the Relationship Between Quick-Return Shift Work Schedules and Work-Family Conflict: A Cross-Sectional Study.

Background: Nursing is a highly demanding profession involving shift-work schedules around the clock. Rest time between shifts is an issue that has gained increasing research attention in recent years, with brief rest periods (< 11 hours) between shifts coined "quick-return." Quick-return work schedules have been linked to negative health outcomes such as poor sleep quality and stress, which may create a vicious cycle that can contribute to work-family conflict.

Purpose: This study aimed to investigate mediation models exploring the role of sleep quality in mediating the relationship between quick-return work shift schedules and work-family conflict among female nurses with children.

Methods: A cross-sectional approach was used, and data were collected from 131 female nurses with children under the age of 18 years between October 2020 and February 2021 in three hospitals. The participants completed a set of questionnaires to evaluate quick-return frequency within the past week, sleep quality between different types of shifts (morning [07:00-15:00]-night [23:00-07:00], evening [15:00-23:00]-morning, night-evening, morning-morning, evening-evening, night-night, and 2 days off), work-family conflict, workload, and sociodemographic factors. Seven mediation models were conducted using the SPSS PROCESS macro.

Results: Only one mediation model was supported. In the supported model, sleep quality between morning-night shifts mediates the relationship between quick-returns within the past week and work-family conflict. Specifically, shift-work schedules with higher numbers of quick-returns within the past week were significantly associated with poorer sleep quality between morning-night shifts (B = 1.047, SE = 0.457, 95% CI [0.142, 1.952]), which was in turn significantly associated with higher work-family conflict (B = -0.548, SE = 0.205, 95% CI [-0.953, -0.143]). Notably, whereas the indirect effect between quick-returns within the past week and work-family conflict was significant (B = -0.574, SE = 0.311, 95% CI [-1.301, 0.079]), the direct effect was not (p = .169).

Conclusions: The findings of this study show the potentially negative effects of a specific type of quick-return work schedule on sleep quality in nurses, which in turn has a significant impact on nurses' personal and family lives. Because sleep is a modifiable behavior, optimizing this behavior may result in better recovery between shifts. Furthermore, nurse managers should ensure their staff are not assigned work schedules that require quick-returns to work between morning and night shifts.