Circadian Rhythms Characteristics of Nurses Providing Direct Patient Care: An Observational Study

Dolu İ., Açıkgöz S., Rıza Demirbaş A., KARABULUT E.

Safety and Health at Work, vol.15, no.1, pp.102-109, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 15 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.1016/
  • Journal Name: Safety and Health at Work
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Index Islamicus, Directory of Open Access Journals
  • Page Numbers: pp.102-109
  • Keywords: Activity levels, Circadian rhythms, Cosinor analysis, Nursing, Shiftwork
  • Hacettepe University Affiliated: Yes


Background: In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. Methods: This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. Results: The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. Conclusion: Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.