Shift Pattern Transition on the Health and Well-Being of Nurses: A Convergent Parallel Analysis

This study aimed to examine the impact of shift pattern transitions on the health and well-being of nurses and to explore their experiences during this transition. This study utilized a mixed-method research design using the convergent parallel approach. The quantitative component employed a descriptive-correlational design involving 85 staff nurses in a government hospital in Surigao City. Data were collected using an adapted Standard Shiftwork Index (SSI). Descriptive and inferential statistics, including frequency, percentage, weighted mean, standard deviation, Chi-square, and Cramer’s V, were used for analysis. The qualitative component involved in-depth interviews with purposively selected nurses to explore their experiences regarding shift transitions, and the data were analyzed using thematic analysis. The findings revealed varying levels of health and well-being among nurses following the shift pattern transition, with experiences of sleep disruption, fatigue, and stress, while others reported improved work-life balance and adaptation over time. Qualitative themes highlighted physical and psychological effects, coping strategies, and the role of social and organizational support. Overall, shift pattern transitions influence nurses’ health, well-being, and work performance. The integration of quantitative and qualitative findings informed the development of a Health and Well-Being Enhancement Plan to support nurses in adapting to shift changes.

Shift pattern transition, Nurses, Health and well-being, Shift work, Mixed-methods research

1. Al Ma’mari, A., Al Rawahi, S., & Al Hinai, H. (2022). Impact of shift work on nurses’ sleep quality, fatigue, and health: A cross-sectional study in Oman. BMC Nursing, 21(1), 314–322. https://doi.org/10.1186/s12912-022-00954-4 [Google Scholar] [Crossref]

2. Bakker, A. B., & Demerouti, E. (2007). The Job Demands–Resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328. https://doi.org/10.1108/02683940710733115 [Google Scholar] [Crossref]

3. Barton, J., S. Folkard, Smith, L. R., E.R. Spelten, & P.A. Totterdell. (2007). Standard Shift work index manual. Journal of Applied Psychology, 60, 159–170. https://www.researchgate.net/publication/292754272_Standard_Shift_work_index_manual [Google Scholar] [Crossref]

4. Barton, J., Spelten, E., Totterdell, P., Smith, L., Folkard, S., & Costa, G. (1995). The Standard Shiftwork Index: a battery of questionnaires for assessing shiftwork-related problems. Work & Stress, 9(1), 4–30. https://doi.org/10.1080/02678379508251582 [Google Scholar] [Crossref]

5. Chang, W.-P., & Liu, Y.-M. (2021). Influence of rotating shifts and fixed night shifts on sleep quality in nurses: A meta-analysis. Chronobiology International, 38(11), 1657–1670. https://doi.org/10.1080/07420528.2021.1931273 [Google Scholar] [Crossref]

6. Costa, G. (2016). The impact of shift and night work on health. Applied Ergonomics, 53(Part A), 1–10. https://doi.org/10.1016/j.apergo.2015.07.001 [Google Scholar] [Crossref]

7. Creswell, J. W., & Plano Clark, V. L. (2023). Designing and conducting mixed methods research (4th ed.). SAGE Publications. [Google Scholar] [Crossref]

8. Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: A theoretical review. Human Resources for Health, 18(1), Article 41. https://doi.org/10.1186/s12960-020-00469-9 [Google Scholar] [Crossref]

9. De Kock, J. H., Latham, H. A., Leslie, S. J., Grindle, M., Munoz, S.-A., Ellis, L., Polson, R., & O’Malley, C. M. (2023). A rapid review of the impact of shift work on nurses’ health, well-being, and performance. Journal of Nursing Management, 31(1), 12–25. https://doi.org/10.1111/jonm.13731 [Google Scholar] [Crossref]

10. De Kock, R., Lammers, M., & van der Velden, P. (2023). Shift work, sleep disturbances, and mental well-being among nurses: A cross-sectional European study. International Journal of Environmental Research and Public Health, 20(5), 4012. https://doi.org/10.3390/ijerph20054012 [Google Scholar] [Crossref]

11. Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W. B. (2001). The Job Demands–Resources model of burnout. Journal of Applied Psychology, 86(3), 499–512. https://doi.org/10.1037/0021-9010.86.3.499 [Google Scholar] [Crossref]

12. Folkard, S., & Tucker, P. (2003). Shift work, safety and productivity. Occupational Medicine, 53(2), 95–101. https://doi.org/10.1093/occmed/kqg047 [Google Scholar] [Crossref]

13. Folkman, S. (2013). Stress: Appraisal and coping. In M. D. Gellman & J. R. Turner (Eds.), Encyclopedia of behavioral medicine (pp. 1913–1915). Springer. https://doi.org/10.1007/978-1-4419-1005-9_215 [Google Scholar] [Crossref]

14. Jang, I., & Kim, J. (2021). Influence of resilience, coping strategies, and social support on nurses’ work-related stress. Journal of Nursing Management, 29(6), 1683–1692. https://doi.org/10.1111/jonm.13304 [Google Scholar] [Crossref]

15. Jang, S., & Kim, H. (2021). The role of coping strategies in moderating fatigue and job satisfaction among rotating-shift nurses. Journal of Nursing Management, 29(4), 878–886. https://doi.org/10.1111/jonm.13284 [Google Scholar] [Crossref]

16. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company. [Google Scholar] [Crossref]

17. Li, Q., Chen, R., & Wang, J. (2023). Effects of rotating and fixed shift schedules on nurses’ health outcomes: A comparative study. Nursing Open, 10(2), 1255–1264. https://doi.org/10.1002/nop2.1550 [Google Scholar] [Crossref]

18. Maulibulung Hutapea, R., & Marulitua, S. (2024). Coping mechanisms and psychological resilience among nurses exposed to changing shift patterns. BMC Nursing, 23(1), 144–152. https://doi.org/10.1186/s12912-024-01536-8 [Google Scholar] [Crossref]

19. Min, Y.-S., Lee, H.-A., Kwon, S.-C., Lee, I., Kim, K., Ji Sun Kim, Jae Hyun Han, & Lee, H.-Y. (2023). Occupational and Psychological Factors Associated With Burnout in Night Shift Nurses. Psychiatry Investigation, 20(10), 904–911. https://doi.org/10.30773/pi.2023.0084 [Google Scholar] [Crossref]

20. Niu, C., Zhang, L., & Xu, Y. (2024). The association of shift pattern transition with fatigue, sleep quality, and anxiety among Chinese nurses. Journal of Advanced Nursing, 80(6), 1652–1663. https://doi.org/10.1111/jan.15832 [Google Scholar] [Crossref]

21. Niu, S.-F., Chung, M.-H., Chen, C.-H., Hegney, D., O’Brien, A., & Chou, K.-R. (2024). The effect of shift rotation on nurses’ sleep quality, fatigue, and work performance. Journal of Clinical Nursing, 33(3–4), 845–856. https://doi.org/10.1111/jocn.16852 [Google Scholar] [Crossref]

22. Peršolja, M. (2023). Effects of nurses’ schedule characteristics on fatigue. Nursing Management, 54(4),2837.https://doi.org/10.1097/01.numa.0000921904.11222.11 [Google Scholar] [Crossref]

23. Peršolja, M. (2023). Shift work, fatigue, and burnout among nurses: A systematic review. Nursing Outlook, 71(2), 101–109. https://doi.org/10.1016/j.outlook.2022.10.004 [Google Scholar] [Crossref]

24. Peršolja, M. (2023). The relationship between night shift, burnout, and psychological health among nurses: A systematic review. BMC Nursing, 22(1), 155–162. https://doi.org/10.1186/s12912-023-01246-3 [Google Scholar] [Crossref]

25. Saksvik-Lehouillier, I., Bjorvatn, B., Hetland, H., Mjeldheim Sandal, G., & Pallesen, S. (2022). Individual, situational, and lifestyle factors related to shift work tolerance among nurses. Journal of Advanced Nursing, 78(1), 98–110. https://doi.org/10.1111/jan.14942 [Google Scholar] [Crossref]

26. Saksvik-Lehouillier, I., Knapstad, M., & Bjorvatn, B. (2022). Night shift work, fatigue, and sleep disturbances: A prospective cohort study among Norwegian nurses. Frontiers in Psychology, 13, 879476. https://doi.org/10.3389/fpsyg.2022.879476 [Google Scholar] [Crossref]

27. United Nations. (2023). Sustainable Development Goals Report 2023: Special edition. United Nations Publications. [Google Scholar] [Crossref]

28. Varghese, B., Maurice, A., Abdulkareem, T., & Prindeze, N. (2023). Nurses’ experiences working 12-hour shifts in a tertiary-level hospital: A qualitative study. BMC Nursing, 22, 371. https://doi.org/10.1186/s12912-023-01371-0 [Google Scholar] [Crossref]

29. Wangsan, K., Chaiear, N., Sawanyawisuth, K., Klainin-Yobas, P., Simajareuk, K., & Boonsawat, W. (2022). Which shift-work pattern is the strongest predictor for poor sleep quality in nurses? International Journal of Environmental Research and Public Health, 19(21), 13986. https://doi.org/10.3390/ijerph192113986 [Google Scholar] [Crossref]

30. Xiao, Q., Huang, X., Yang, T., Huang, L., Li, N., Wang, J., Huang, J., Huang, Y., Huang, H., & Wang, Y. (2024). Determinants of sleep quality and their impact on health outcomes: A cross-sectional study on night-shift nurses. Frontiers in Psychiatry, 15, 1506061. https://doi.org/10.3389/fpsyt.2024.1506061 [Google Scholar] [Crossref]

31. Yu, L., Zhou, H., Li, J., & Yu, X. (2025). Shift work sleep disorder in nurses: A concept analysis. BMC Nursing, 24, 18. https://doi.org/10.1186/s12912-024-02651-z [Google Scholar] [Crossref]

32. Harris, R., Kavaliotis, E., Drummond, S. P. A., & Wolkow, A. P. (2024). Sleep, mental health, and physical health in new shift workers transitioning to shift work: A systematic review and meta-analysis. Sleep Medicine Reviews, 76, 101927. https://doi.org/10.1016/j.smrv.2024.101927 [Google Scholar] [Crossref]

33. Ito-Masui, A., Sakamoto, R., Matsuo, E., Yamamoto, Y., Takahashi, M., & Kubo, T. (2025). Sleep and well-being before and after a shift schedule change in intensive care unit nurses: An observational study using wearable sensors. International Journal of Environmental Research and Public Health, 22(3), 1148. https://doi.org/10.3390/ijerph22031148 [Google Scholar] [Crossref]

34. Jung, Y. J., & Kim, H. (2025). Job satisfaction, quality of life, and turnover intention among nurses: A comparative study of pattern-based and rotating shift schedules. Healthcare, 13(20), 2551. https://doi.org/10.3390/healthcare13202551 [Google Scholar] [Crossref]

35. Okechukwu, C. E., Tibiri, E. B., Awolu, O. O., & Okwor, J. C. (2023). The relationship between working night shifts and depression among nurses: A systematic review and meta-analysis. Healthcare, 11(7), 937. https://doi.org/10.3390/healthcare11070937 [Google Scholar] [Crossref]

36. Qtait, M., Al-Hamdan, Z., Al-Faouri, I., & Al-Smadi, A. (2025). The impact of rotating shift work on nurse burnout: A systematic review of contributing factors and organizational strategies. SAGE Open Nursing, 11, 23779608251374232. https://doi.org/10.1177/23779608251374232 [Google Scholar] [Crossref]

37. Harris, R., Kavaliotis, E., Drummond, S. P. A., & Wolkow, A. P. (2024). Sleep, mental health and physical health in new shift workers transitioning to shift work: Systematic review and meta-analysis. Sleep Medicine Reviews, 76, 101927. https://doi.org/10.1016/j.smrv.2024.101927 [Google Scholar] [Crossref]

38. Ito-Masui, A., Sakamoto, R., Matsuo, E., et al. (2025). Sleep and well-being before and after a shift schedule change in ICU nurses: An observational study using wearable sensors. [Journal details as indexed in PMC]. [Google Scholar] [Crossref]

39. Jung, Y. J., & Kim, H. (2025). Job satisfaction, quality of life, and turnover intention among nurses: A comparative study of pattern-based and rotating shift schedules. Healthcare, 13(20), 2551. https://doi.org/10.3390/healthcare13202551 [Google Scholar] [Crossref]

40. Okechukwu, C. E., et al. (2023). The relationship between working night shifts and depression among nurses: A systematic review and meta-analysis. Healthcare, 11(7), 937. https://doi.org/10.3390/healthcare11070937 [Google Scholar] [Crossref]

41. Qtait, M., et al. (2025). The impact of rotating shift work on nurse burnout: A systematic review of contributing factors and organizational strategies. SAGE Open Nursing. https://doi.org/10.1177/23779608251374232 [Google Scholar] [Crossref]

42. Chen, Y.-H., Lou, S.-Z., Yang, C.-W., Tang, H.-M., Lee, C.-H., & Jong, G.-P. (2022). Effect of marriage on burnout among healthcare workers during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19(23), 15811. https://doi.org/10.3390/ijerph192315811 [Google Scholar] [Crossref]

43. Harris, R., Kavaliotis, E., Drummond, S. P. A., & Wolkow, A. P. (2024). Sleep, mental health and physical health in new shift workers transitioning to shift work: A systematic review and meta-analysis. Sleep Medicine Reviews, 76, 101927. https://doi.org/10.1016/j.smrv.2024.101927 [Google Scholar] [Crossref]

44. Inchingolo, A. D., Malcangi, G., Di Venere, D., et al. (2025). Guidelines for reducing the adverse effects of shift work and night work in healthcare. Healthcare, 13(17), 2148. https://doi.org/10.3390/healthcare13172148 [Google Scholar] [Crossref]

45. Jung, Y. J., & Kim, H. (2025). Job satisfaction, quality of life, and turnover intention among nurses: A comparative study of pattern-based and rotating shift schedules. Healthcare, 13(20), 2551. https://doi.org/10.3390/healthcare13202551 [Google Scholar] [Crossref]

46. Kisanuki, N., Takase, M., & Yamamoto, M. (2024). Unveiling the challenges encountered by newly graduated nurses during night shifts: A descriptive qualitative study. International Journal of Nursing Sciences, 11(4), 447–456. https://doi.org/10.1016/j.ijnss.2024.08.009 [Google Scholar] [Crossref]

47. Lim, H., & Kim, B. (2025). Navigating night shifts: A qualitative study of exploring sleep experiences and coping strategies among nurses. BMC Nursing, 24, Article 3001. https://doi.org/10.1186/s12912-025-03001-3 [Google Scholar] [Crossref]

48. Saksvik-Lehouillier, I., & Sørengaard, T. A. (2023). Comparing shift work tolerance across occupations, work arrangements, and gender. Occupational Medicine, 73(7), 427–433. https://doi.org/10.1093/occmed/kqad090 [Google Scholar] [Crossref]