ARTICLE INFO

Article Type

Original Research

Authors

Ashnagar   M. (1)
Ghanbary Sartang   A. (*)
Habibi   E. (2)
Abedi   M. (3)






(*) School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
(1) Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
(2) Department of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
(3) Center Tehran Branch, Islamic Azad University, Tehran, Iran

Correspondence

Address: School of Health, Isfahan University of Medical Sciences, Hezar Jarib Street, Isfahan, Iran
Phone: -
Fax: -
aioobghanbary@ymail.com

Article History

Received:  September  20, 2018
Accepted:  December 9, 2018
ePublished:  December 31, 2018

BRIEF TEXT


Circadian rhythm is the 24-hour changes of behavioral and metabolic activities in living organisms. Understanding the circadian rhythm is necessary in hiring labor in the shift working system.

… [1-3]. Studies show that today more than 20% of the world's workforce has to work in the shift working system [4]. According to the several studies, those who work in shift working suffer from physical and mental disorders [8]. Job burnout, anxiety and depression are complications related to the work environment [9, 10, 11]. Job stresses are also specific responses that due to the type of occupation can affect the person [12]. Hyoudo has studied stress and depression in shift workers, and has concluded that stress in shift workers is more than non-shift workers, and the symptoms of depression and the prevalence of smoking in shift workers is more and there is a positive correlation between the symptoms of depression and working in the shift working system [13]. Delpasand et al. examined the relationship between shift working and job rotation with job burnout and concluded that emotional exhaustion and depersonalization are high in shift workers and there is a direct relationship between job burnout and shift working [14]…. [15].

The aim of this study was to investigate the relationship between job burnout, depression, anxiety, and stress with circadian rhythm in military personnel.

This research is a descriptive-analytic study.

This study was conducted on the personnel of ICT in a military headquarter in October 2016.

100 military personnel (50 day workers and 50 shift workers) who were at least working for 6 months in the shift working system were randomly selected.

For data collection, Circadian Type Inventory (CTI), Maslach Burnout Inventory (MBI), and Depression and Anxiety Stress Scale (DASS-21) were used. CTI is a 11-item quantitative and qualitative questionnaire for assessing the circadian rhythm developed by Di Milia et al. Validity and reliability of CTI were confirmed by Jafari et al. and its Cronbach's alpha was obtained 0.76. Five items represents the stability of the circadian rhythm (flexibile/rigid (FR)), which are scored 0-5, and 6 items measure the amplitude of the circadian rhythm (languid/vigorous (LV)), which are scored 0 to 6. Individuals who gain a high score from FR variables are flexible, suitable for shift working, and capable of awakening during unusual times of day or night, whereas individuals who obtain a high score from LV variables are called languid and have difficulty dealing with feelings of sleepiness and lethargy resulting from insomnia [16]. MBI is a 11-item questionnaire which was developed by Maslach et al. Its validity and reliability have been assessed in Iran by Ghahremani et al. with the Cronbach's alpha of 0.83. MBI is scored on a 5-point Likert scale (0=never, 1=very low, 2=low, 3=moderate, 4=moderate to high, 5=high and 6=very high). Scores 25 to 60 indicate the low levels of job burnout, 60 to 90 indicate moderate levels of job burnout and 90 and above represent high levels of job burnout [17]. DASS-21 is a 21-item questionnaire assessing depression (7 questions), anxiety (7 questions) and stress (7 questions) with a total score of 0 to 63, and individuals who gain the scores near 63 are more at risk for depression, anxiety and stress. Validity and reliability of this questionnaire were reported 0.77 by Samani et al. [18]. The t-test and ANOVA test were used to analyze the data using SPSS 19 software.

The mean age of the day worker and shift worker groups were 31.7±5.7 and 36.1±7.3 years, respectively (Table 1). Gastrointestinal disorder was reported in 3 day workers and 26 shift workers.The mean scores of circadian rhythm, DASS-21 scale, and burnout were higher in the shift workers than day workers (Table 2). 39 and 17 vigorous subjects were in the day worker and shift worker groups, respectively. In addition, 34 and 13 flexibile subjects were in the day worker and shift worker groups, respectively. Based on the independent t-test results, there was a significant difference between circadian rhythm and burnout (p=0.02) and depression (p=0.03), anxiety (p=0.02) and stress (p=0.01) in shift workers, whereas there was no significant difference between circadian rhythm and burnout (p=0.08), depression (p=0.07), anxiety (p=0.07), and stress (p=0.09). The results of ANOVA test indicated that there was a significant difference between burnout in day workers and shift workers and burnout was higher in shift workers (p=0.01). In addition, there was a significant difference between the DASS-21 scale in day workers and shift workers, and depression (p=0.02), anxiety (p=0.01), and stress (p=0.01) were higher in shift workers. Furthermore, there was a significant difference in the variables of circadian rhythm in day workers and shift workers (p=0.01). According to the ANOVA results, by aging (p=0.02) and work experience (p=0.03), the LV scores increased in shift workers and decreased in day workers, whereas FR scores decreased in shift workers and increased in day workers.

… [19]. Omidi et al. investigated the relationship between shift working and depression and anxiety and concluded that depression and anxiety levels were significantly different in the shift workers and day workers, which is consistent with the findings of this study [20]. Zare et al. studied the effect of the type of circadian rhythm on job stress and burnout in shift working and concluded that the higher the LV scores of the circadian rhythm, the greater the job stress, and people are sooner experienced burnout [21]. Koch et al. studied the relationship between circadian rhythm and stress and anxiety and indicated that in shift workers with the low FR scores and high LV scores are more at risk for stress and anxiety, which is consistent with the results of this study [22]…. [27].

Similar studies with a larger sample size are recommended.

Unwillingness of the participants to complete the questionnaires was one of the limitations of the study. The lack of similar studies was another limitation of this study, which made the discussion section difficult.

Type of circadian rhythm affects burnout and depression, anxiety and stress among shift workers and the individuals should be hired in the shift working according to the type of circadian rhythm. People with high FR and low LV should be selected for the shift working as well as elderly people and those with more work experience should not be recruited in the shift working or should be less recruited.

This study was done and supported as a research project in a military center. The authors are grateful to all those who have contributed to this research, especially Mr. Karami.

None declared.

The present study was conducted with the permission of the military headquarter and in accordance with ethical considerations (ethics committee code No. 2203).

None declared.

TABLES and CHARTS

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CITIATION LINKS

[1]Hastings MH, Maywood ES, O’Neill JS. Cellular circadian pacemaking and the role of cytosolic rhythms. Curr Biol. 2008;18(17):806-15.
[2]Merrow M, Spoelstra K, Roenneberg T. The circadian cycle: Daily rhythms from behavior to genes. EMBO Rep. 2005;6(10):930-5.
[3]Golden SS, Canales SR. Cyanobacterial circadian clocks- timing is everything. Nat Rev Microbiol. 2003;1(3):191-9.
[4]Drake CL, Roehrs T, Richardson G, Walsh JK, Roth T. Shift work sleep disorder: Prevalence and consequences beyond that of symptomatic day workers. Sleep. 2004;27(8):1453-62.
[5]Choobineh A, Rajaeefard A, Neghab M. Problems related to shiftwork for health care workers at Shiraz University of Medical Sciences. East Mediterr Health J. 2006;12(3-4):340-6.
[6]Costa G. Shift work and health: Current problems and preventive actions. Saf Health Work. 2010;1(2):112-23.
[7]Di Milia L, Smith PA, Folkard S. A validation of the revised circadian type inventory in a working sample. Personal Individ Differ. 2005;39(7):1293-305.
[8]Costa G. Shift work and occupational medicine: An overview. Occup Med. 2003;53(2):83-8.
[9]Maslach C, Schaufeli WB, Leiter MP. Job burnout. Ann Rev of Psychol. 2001;52(1):397-422.
[10]Kaviani H, Mousavi AS. Psychometric properties of the Persian version of beck anxiety inventory (BAI). Tehran Univ Med Sci. 2008;66(2):136-40. [Persian]
[11]Dobson KA, Mohammadkhani P. Psychometric characteristics of Beck-II inventory in patients with major depressive disorder in a period of relative improvement. J Rehabil. 2007;8(29):80-6. [Persian]
[12]Beehr TA, Franz TM. The current debate about the meaning of job stress. J Organ Behav Manag. 1987;8(2):5-18.
[13]Hyoudo H. A study of the work conditions, daily living habits and occupational stress of nurses and care workers employed by nursing care medical facilities. J Rural Med. 2009;4(1):7-14.
[14] Delpasand M, Raeissi P, Begdeli F, Shahabi M. The impact of job rotation on nurses burnout in Ayatollah Kashani hospital, Tehran: A case study. Iran Occup Health J. 2011;7(4):9-17. [Persian]
[15]Folkard S, Monk TH, LOBUAN MC. Towards a predictive test of adjustment to shift work. Ergonomics. 1979;22(1):79-91.
[16] Jafari A, Hashemi-nejad N, Sadeghi M, Baneshi MR, Haji-maghsoudi S, Rastegari A. Internal consistency and confirmatory factor analysis of persian version circadian type inventory in iranian day worker and shift worker employees, 2011-2012. Iran Occup Health J. 2013;10(3):45-51. [Persian]
[17]Ghahramani M, Arastehnazar Z, Meemar MA. Effect of locus control on burnout in instructors of iranian governments literal movement. Q J Career Organ Coun. 2011;4(4):291-7. [Persian]
[18]Samani S, Jokar B. Investigation validity and reliability short verion depression, anxiety and stress scale. J Soc Sci Hum Shiraz Univ. 2007;26(3):65-76.
[19]Habibi E, Dadkhah Tehrani S, Ghareh Baei S, Mahaki B. A survey of the relationship between shift work and job burnout in nurse staff of Alzahra hospital application maslach’s burnout questionnaire. J Health Sys Res. 2015;11(1):77-87. [Persian]
[20]Omidi Hosein Abadi H, Abbasi Esfajir AA. Relationship between night shift and nurses' depression and anxiety. Q J Nurs Manag. 2015;4(2):29-38. [Persian]
[21]Zare Z, Choobineh A, Keshavarzi S. Association of amplitude and stability of circadian rhythm, sleepquality, and occupational stress with sickness absence among a gas company employeesd: A cross sectional study from Iran. Saf Health Work. 2017;8(3):276-81.
[22]Koch CE, Leinweber B, Drengberg BC, Blaum C, Oster H. Interaction between circadian rhythms and stress. Neurobiol Stress. 2016;6:57-67.
[23]Ghanbary Sartang A, Ashnagar M, Habibi E, Nowrouzi I, Ghasemi H. The relationship of body mass index and waist-hip ratio with shift work among military personnel in 2016. J Occup Health Epidemiol. 2015;4(4):252-9. [Persian]
[24]Di Lorenzo L, De Pergola G, Zocchetti C, L'abbate N, Basso A, Pannacciulli N, et al. Effect of shift work on body mass index: results of a study performed in 319 glucose-tolerant men working in a Southern Italian industry. Int J Obes Relat Metab Disord. 2003;27(11):1353-8.
[25]Stimpfel AW, Sloane DM, Aiken LH. The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Aff. 2012;31(11):2501-9.
[26]Coffey LC, Skipper JK, Jung FD. Nurses and shift work: Effects on job performance and job‐related stress. J Adv Nurs. 1988;13(2):245-54.
[27]Sahebi L, Ayatollahi M. Mental health status of hospitals staffs in Shiraz. Horizon Med Sci. 2007;12(4):26-33. [Persian]