Abstract
Objectives
Depression and anxiety are prominent in paramedics, as is the prevalence of shift
work disorder (SWD), a circadian sleep condition comorbid with mental health disorders.
However, the role of mental health risk factors for SWD is largely unknown. This study
investigated whether mental health levels in recruit paramedics before shift work
predicted greater risk of SWD at 6-months into their career and explored whether shift
and sleep factors mediated this relationship.
Design
A longitudinal study.
Setting
Victoria, Australia.
Participants
Recruit paramedics were assessed at baseline (n = 101; ie, pre-shift work) and after 6-months (n = 93) of shift and emergency work.
Measurements
At both time points, participants completed self-reported measures of depression (Patient
Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Questionnaire-7), and
SWD (SWD-Screening Questionnaire). Participants also filled a sleep and work diary
for 14-days at each timepoint.
Results
After 6-months of emergency work 21.5% of paramedics had a high SWD risk. Logistic
regression models showed baseline depression predicted 1.24-times greater odds for
SWD at 6-months. Through Lavaan path analysis we found shift and sleep variables did
not mediate the relationship between baseline mental health and SWD risk. Baseline
depression was associated with increased sleepiness levels following paramedics’ major
sleep periods at 6-months. Pre-existing depression levels also predicted greater perceived
nightshift workload.
Conclusions
Our results highlight depression symptoms before emergency work are a risk factor
for SWD within 6-months of work. Depression represents a modifiable risk factor amenable
to early interventions to reduce paramedics’ risk of SWD.
Keywords
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Article info
Publication history
Published online: November 15, 2022
Accepted:
September 22,
2022
Received in revised form:
June 6,
2022
Received:
October 24,
2021
Identification
Copyright
© 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
