Chinese Medicine Constitution that Influences Sleep Quality and Fatigue among Chinese Nurses Working in Shifts in Japan and China
Nurses who work in shifts may face poor sleep quality and oppressive fatigue. The purpose of this study was to clarify Chinese medicine constitution that influences sleep quality and fatigue among Chinese nurses engaged in shift work. Considering that these conditions might differ according to living environments, studies were conducted both in Japan and China. Data were gathered using the attributes of nurses, the Pittsburgh Sleep Quality Index to evaluate sleep quality, the Jikaku-sho shirabe to evaluate fatigue, and the Constitution in Chinese Medicine Questionnaire, which evaluates Chinese medicine constitution according to nine criteria. The survey was conducted via internet, with data analyzed from 100 Chinese subjects in Japan and 100 Chinese subjects in China. Increase in age, living in China, Qi-deficiency constitution and Blood-stasis constitution were causal factors for lower sleep quality. Sleep quality was significantly lower among nurses in China than those in Japan. The following factors were observed to be causal factors for increased fatigue: longer histories of working in shifts, living in Japan, poorer quality sleep, Qi-deficiency constitution, Yang- and Yin-deficiency constitution, Qi-stagnation constitution and Inherited special constitution. Nurses in Japan showed significantly greater fatigue at the end of a night shift than did those in China. It is suggested that adjustments of Qi-deficiency constitution and Blood-stasis constitution can improve sleep quality in nurses who work in shifts. We believe that improving sleep quality and making adjustments to the five types of Chinese medicine constitution can work to reduce fatigue.
Keywords:Japan-China comparison, Chinese nurses who work in shifts, Chinese medicine constitution, Sleep quality, Fatigue
Chang, W. P., & Chang, Y. P. (2019). Relationship between job satisfaction and sleep quality of female shift-working nurses: Using shift type as moderator variable. Industrial Health, 57(6), 732-740. https://doi.org/10.2486/indhealth.2018-0258 DOI: https://doi.org/10.2486/indhealth.2018-0258
Chiba, S. (2008). Shift workers and sleep disorders. Journal of Transportation Medicine, 62(5-6), 132-140.
China Association of Chinese Medicine. (2009). Classification and determination of Chinese medicine constitution (ZYYXH/T157-2009). World Journal of Integrated Traditional and Western Medicine, 4(4), 303-304. https://doi.org/10.13935/j.cnki.sjzx.2009.04.015
Doi, Y., Minowa, M., Okawa, M., & Uchiyama, M. (1998). Development of the Japanese version of the Pittsburgh Sleep Quality Index. Japanese Journal of Psychiatry Treatment, 13(6), 755-763.
Fang, J. B., & Qi, C. J. (2009). Research on occupational fatigue in nurses and the influencing factors. Journal of Nursing Science, 24(1), 1-4. https://doi.org/10.3870/hlxzz.2009.01.001
Guo, Y. F., Liu, J. B., Guo, A. M., Han, W., & Gao, N. (2021). Analysis of current sleep quality of 170 ICU night shift nurses and influencing factors. Journal of Nursing (China), 28(7), 59-63. https://doi.org/10.16460/j.issn1008-9969.2021.07.059
Hao, Y. (2013). The correlation of chronic fatigue syndrome and its impact factors and TCM constitution and clinical research [Doctoral dissertation, Guangzhou University of Chinese Medicine]. https://chkdx.cnki.net/Kreader/CatalogViewPage.aspx?dbCode=CDMH&filename=1013226589.nh&tablename=CDMH1219&compose=&first=1&uid=
Hohashi, N. (2019). A Family Belief Systems Theory for transcultural family health care nursing. Journal of Transcultural Nursing, 30(5), 434-443. https://doi.org/10.1177/1043659619853017 DOI: https://doi.org/10.1177/1043659619853017
Imanaka, K. (2020). An introduction to Chinese medicine for healthcare professionals: By knowing the patient’s constitution, you will understand the illness. Osaka, Japan: Medica Shuppan.
Japan Federation of Medical Worker’s Unions. (2019). 2019 Night shift conditions survey results. Iryo Rodo, 628, 8-36.
Kageyama, T., Nishikido, N., Kobayashi, T., Oga, J., & Kawashima, M. (2002). Relationship between work stress and insomnia among female hospital nurses with irregularly rotating shiftwork. Japanese Journal of Mental Health, 17(2), 50-57. https://doi.org/10.11383/kokoronokenkou1986.17.2_50
Liang, X., Wang, Q., Jiang, Z., Li, Z., Zhang, M., Yang, P., Wang, X., Wang, Y., Qin, Y., Li, T., Zhang, T., Wang, Y., Sun, J., Li, Y., Luo, H., & Li, L. (2020). Clinical research linking Traditional Chinese Medicine constitution types with diseases: A literature review of 1639 observational studies. Journal of Traditional Chinese Medicine, 40(4), 690-702. https://doi.org/10.19852/j.cnki.jtcm.2020.04.019
Liu, Y. J. (2002). Blood stasis as a cause of disease and elimination of insomnia through its reduction: Characteristics of Wang Qingren’s treatment of sleep disorders by eliminating blood stasis. Inner Mongol Journal of Traditional Chinese Medicine, 21(5), 31-32. https://doi.org/10.16040/j.cnki.cn15-1101.2002.05.041
Liu, Z. X., Shi, Q. P., Yang, H. X., Zhang, J. J., & Zhang, Q. Y. (2020). Reliability and validity evaluation of Pittsburgh Sleep Quality Index in nursing population. Journal of Shantou University Medical College, 33(3), 173-176. https://doi.org/10.13401/j.cnki.jsumc.2020.03.011
Nagasaka, A., & Ishizuka, Y. (1997). Insomnia in shift workers. Progress in Medicine, 17(8), 2114-2119.
Nakano, E., Yasukata, F., Yamazumi, Y., Higashi, A., Yahiro, Y., & Satou, K. (2013). The actual situation of the Chinese medicine medical care education in the nursing basic education. FPU Journal of Nursing Research, 10(2), 65-71. https://www.fukuoka-pu.ac.jp/academics/nurse/bulletin2/10_2pdf/10_2_2.pdf
Nawa, S., & Takahashi, Y. (2019). A study on work engagement of ward nurses in their fourth to ninth years of employment at a public university hospital: With the focus on family background and intention to continue work. Journal of Japan Society of Nursing Research, 42(3), 474. https://doi.org/10.15065/jjsnr.20190731150
Nishida, M., Kitahara, M., Shiozaki, M., Sugiura, A., & Kasuya, E. (2018). Behavioral survey of night shift nurses during work shifts in acute care wards. Proceedings of The Japan Society of Nursing: Nursing Management, 48, 137-140.
Omura, M., Stone, T. E., & Levett-Jones, T. (2018). Cultural factors influencing Japanese nurses’ assertive communication. Part 1: Collectivism. Nursing & Health Sciences., 20(3), 283-288. https://doi.org/10.1111/nhs.12411 DOI: https://doi.org/10.1111/nhs.12411
Oriyama, S., Miyakoshi, Y., & Kayahara, M. (2019). Characteristics of sleep states, sleepiness and fatigue among nurses working in 12-hour double shifts. Journal of Japan Academy of Nursing Science, 39, 19-28. https://doi.org/10.5630/jans.39.19 DOI: https://doi.org/10.5630/jans.39.19
Saito, K., Muramatsu, Y., Yoshimine, F., & Mashima, I. (2012). Influence of sleep disorder and burn-out upon near-accidents of medical errors in nurses. Japanese Journal of Psychosomatic Medicine, 52(10), 955-962. https://doi.org/10.15064/jjpm.52.10_955
Shen, M. N. (2019). Investigation and analysis of work pressure, sleep, fatigue and related factors of operating room nurses. World Journal of Sleep Medicine, 6(6), 843-844. https://doi.org/10.3969/j.issn.2095-7130.2019.06.067
Suzuki, N. (2019). Nine classification of constitution: A new method for evaluating mibyou (pre-symptomatic state). Journal of Japan Mibyou Association, 25(2), 14-21.
Tachi, N. (2003). Reliability and validity of a newly developed questionnaire for work-related fatigue feelings. Journal of the Nagoya City University Medical Association, 54(2), 77-82.
Troynikov, O., Watson, C. G., & Nawaz, N. (2018). Sleep environments and sleep physiology: A review. Journal of Thermal Biology, 78, 192-203. https://doi.org/10.1016/j.jtherbio.2018.09.012 DOI: https://doi.org/10.1016/j.jtherbio.2018.09.012
Wang, Q. (2008). On Chinese constitutional theory from three aspects. Journal of Beijing University of Traditional Chinese Medicine, 31(10), 653-655.
Wang, Z. X., Lv, Y. Q., Zhou, Y. M., Xie, H. T., Wang, L. H., Cardenas, X., Shimizu, F., & Wu, X. Y. (2022). Comparison of shift-working Chinese nurses in Japan with those in China regarding to their constitution of Chinese medicine, feeling of fatigue and sleep quality. Research Bulletin of Kyoto Koka Women’s University and College, 59, 83-106.
Wu, X. (2020). Natural life theory of Chinese medical nursing. Tokyo, Japan: Japanese Nursing Association Publishing Company.
Wu, Y. T. (2007). Three constitutional types most likely to have insomnia during summer. Health World, 9, 22.
Xu, R., Hu, K. L., Yi, S. Y., Wang, Y., & Wang, H. (2015). Survey analysis of current participation in public activities and sleep needs among post-night shift nurses. Journal of Nursing (China), 22(16), 30-32. https://doi.org/10.16460/j.issn1008-9969.2015.16.030
Xu, S. X. & Gu, T (2014). Progress in research to develop a humanistic shift system for nursing staff. Modern Nurse, 2, 25-26.
Yan, H., Zhu, Y. B., Li, T., Li, Y. N., Yu, X. H., Shi, H. M., Wang, L. R., Shi, M. R., Suo, Y. F., & Lu, J. (2017). Correlation analysis between traditional Chinese medicine constitution and sleep quality. Tianjin Journal of Traditional Chinese Medicine, 34(11), 726-729. https://doi.org/10.11656/j.issn.1672-1519.2017.11.03
Zhang, H. M., Hu, L. S., Qian, H. N., Zheng, S. Z., & Wang, Q. (2006). Investigation and analysis on distribution of Qi-insufficiency constitution in different people groups. Journal of Beijing University of Traditional Chinese Medicine, 29(3), 200-202. https://doi.org/10.3321/j.issn:1006-2157.2006.03.015
Zhong, S. H., & Liu, Q. (2015). Research status and prospects of the influence of dietary adjustment on Chinese medicine constitution. Hainan Medical Journal, 26(23), 3517-3519. https://doi.org/10.3969/j.issn.1003-6350.2015.23.1272
Zhu, Y. B. (2014). Application of the nine classifications of Chinese medicine constitution to health promotion. Proceedings of the 17th Annual Meeting of the Japanese Society for Complementary and Alternative Medicine, 17, 32-33.
Zhu, Y., Origasa, H., Uebaba, K., Xu, F., & Wang, Q. (2008). Development and validation of the Japanese version of the constitution in Chinese medicine questionnaire (CCMQ). Kampo Medicine, 59(6), 783-792. https://doi.org/10.3937/kampomed.59.783 DOI: https://doi.org/10.3937/kampomed.59.783
Zou, H., Lan, X., & Li, C. (2016). Relationship among anxiety, depression, social and self-efficacy in night-shift nurse. International Medical Journal, 23(3), 275-278.
How to Cite
Copyright (c) 2023 Zhixia Wang, Naohiro Hohashi, Xiaoyu Wu
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Most read articles by the same author(s)
- Naohiro Hohashi, PhD, RN, PHN, FAAN, Jaroensuk Pinyo, BS, RN, Shiho Araki, BS, RN, Minami Taniguchi, BS, RN, Ethnographic Research on the Impact of COVID-19 on Families with Older Adults Residing on Remote Islands in Japan: Directed Content Analysis Based on the Concentric Sphere Family Environment Theory , Journal of Rural Community Nursing Practice: Vol. 1 No. 1 (2023): March