The aims of this study were to examine the extent of decisional conflict in end-of-life cancer treatments and to investigate the influences and predictors of decisional conflict among family surrogates. A cross-sectional, descriptive, correlational design was applied. Data were collected from a convenience sample of 102 family members who had participated in end-of-life cancer decision-making. We enrolled participants from inpatient oncology units at a university hospital in South Korea from May 2014 to January 2016. The results indicated that many family surrogates had high levels of decisional conflict and psychological stress after end-of-life cancer decision-making. Hierarchical multiple regression analyses demonstrated that decisional conflict had significant, substantial influences on decision regret and psychological stress after controlling for demographic variables. Family surrogates who were aware of the patients' wishes about end-of-life treatments and those who had good family functioning had less decisional conflict. To relieve decisional conflict regarding end-of-life cancer treatment among family surrogates, it is necessary to encourage patients to share their end-of-life treatment wishes with family members and to consider family functioning in the end-of-life decision-making process.

Background In-depth investigation of the factors that exacerbate sleep disturbance among night-shift workers is essential to develop a successful implementation strategy to improve sleep. Although some characteristics of work associated with sleep disturbances have been investigated, there are inconsistencies in the findings. This study aimed to assess the influence of working time and work characteristics on sleep disturbance among night-shift workers. Methods This study was a secondary data analysis of a nationally representative sample of data from the fifth Korean Working Condition Survey in 2017. A total of 1,790 wage workers aged between 19 and 64 years with night shift schedules were selected and analyzed. A multiple logistic regression analysis was conducted to analyze the influences of working time characteristics, including shift type, frequency of night shift, and extended work; as well as work characteristics, including physical work demands, workload, emotional work demands, social support, and communication, on sleep disturbance among night-shift workers. Results Of those analyzed, 8.4% of night-shift workers experienced sleep disturbances. Night-shift workers with extended work, higher workloads, and emotional work demands were more likely to experience sleep disturbances (OR = 1.53, 95% CI = 1.05 to 2.23; OR = 1.01, 95% CI = 1.01 to 1.03; OR = 1.03, 95% CI = 1.02 to 1.05; respectively). Conclusion Extended work, higher workload, and emotional work demands were significant factors for sleep disturbance among night-shift workers. These findings highlight the importance of adjusting work demands and mitigating extended work to reduce sleep disturbance in night-shift workers.

BackgroundSleep disturbance is a common issue among rotating night shift workers and is closely related to health risks. The present study aimed to determine the effectiveness of pharmacological and non-pharmacological sleep interventions for the management of sleep disturbance among rotating night shift workers.MethodsFor this systematic review and meta-analysis, we searched six electronic databases—EMBASE, CINAHL, Cochrane Library, PubMed, Scopus, and Web of Science—for randomized controlled trials and clinical trials published from January 1990 to June 2022. The quality of eligible studies was independently assessed by three authors using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies. The meta-analysis was performed based on the random effects model using the Comprehensive Meta-Analysis software. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsOf the 1019 studies retrieved, 30 met the inclusion criteria for the systematic review; 25 were selected for the meta-analysis. Sleep interventions were categorized as follows: pharmacological approach (n = 7), light therapy (n = 9), cognitive behavioral approach (n = 7), aroma or alternative therapy (n = 4), and shift schedule modification (n = 3). The overall mean effect size of the interventions was moderate (Hedges' g = 0.59; 95% confidence interval = 0.33–0.84, z = 4.50, p < 0.001).ConclusionSleep interventions were effective in promoting sleep or reducing sleep disturbance among rotating night shift workers. These findings provide evidence of the effectiveness of various pharmacological and non-pharmacological sleep interventions for managing sleep health in the work environment of rotating night shift workers.

Background: In-depth investigation of the factors that exacerbate sleep disturbance among night-shift workers is essential to develop a successful implementation strategy to improve sleep. Although some characteristics of work associated with sleep disturbances have been investigated, there are inconsistencies in the findings. This study aimed to assess the influence of working time and work characteristics on sleep disturbance among night-shift workers.Methods: This study was a secondary data analysis of a nationally representative sample of data from the fifth Korean Working Condition Survey in 2017. A total of 1,678 wage workers aged between 15 and 59 with night shift schedules were selected and analyzed. A multiple logistic regression analysis was conducted to analyze the influences of working time characteristics, including shift type, frequency of night shift, and extended work; as well as work characteristics, including physical work demands, workload, emotional work demands, social support, and communication, on sleep disturbance among night-shift workers. Results: Of those analyzed, 7.6% of night-shift workers experienced sleep disturbances. Night-shift workers with extended work and higher physical and emotional work demands were more likely to experience sleep disturbance. Conclusion: Extended work and higher physical and emotional work demands were significant factors for sleep disturbance among night-shift workers. These findings highlight the importance of adjusting work demands and mitigating extended work to reduce sleep disturbance in night-shift workers.