| Insufficient sleep is common among nursing staff and can have serious health consequences. Sleep duration has been related to shift work, but other possible predictors in the work environment have been largely ignored.;Utilizing a model integrating Spielman's Three-Factor Model of Insomnia and Punnett's Conceptual Framework on Overview of Associations among Working Conditions, Socioeconomic Position, Health Behaviors, and Selected Health Outcomes, this study tested the complex model to identify the relationships among work environment, sleep and health outcomes of formal caregivers. Using a retrospective, cross-sectional design, this study analyzed data collected between January, 2008, and October, 2009, with 1,129 formal caregivers in fifteen Skilled Nursing Facilities (SNFs).;The formal caregivers in this study were primarily female, younger than 60 years, White or Black, with a high school or college education, and overweight or obese. Nearly half of the participants (45.4%) reported short sleep duration (≤6 hours/24-hours). After controlling for confounders, Poisson regression showed that work-family conflict and night shift work predicted short sleep duration of formal caregivers; multivariate linear regressions showed that work-family conflict predicted formal caregivers' physical health; and work-family conflict, safety climate, and shift work predicted formal caregivers' mental health. Sleep duration was positively associated with both physical and mental health; physical and mental health were negatively correlated with each other. In addition, sleep duration partially mediated the association between work-family conflict, safety climate and mental health of formal caregivers.;The conceptual model explained sleep and health from an occupational health perspective. The study results promote a better understanding of the relationships among work environment, sleep, and health outcomes of formal caregivers and contribute to the development of effective workplace intervention programs that address work environmental features to improve formal caregivers' sleep and overall well-being. |
