A questionnaire survey on overtime work and shift systems was conducted for 10,000 nurses randomly selected from a list of about 530,000 nurses working in hospitals and registered at the Japanese Nursing Association. Valid replies were collected from 3,010 nurses. Of these replies, 2,010 included remarks written in the free remark space of the questionnaire forms. These remarks concerned nursing work being done, overtime work and shift systems, safety in health care, work-life balance and various demands for and experiences in improving health care work and working conditions. By classifying the contents of these remarks, 47 key words were extracted regarding working conditions and occupational safety and health for hospital nurses. The collected remarks were then analyzed by examining how their contents corresponded to these key words.
The results revealed that the nurses had diverse views concerning the ways to reform the existing health care systems and improve their work and working conditions. In particular, the views expressed were characteristically focusing on medical safety, excessive fatigue due to overtime work and work-life balance while engaging in irregular night shifts and excessively doing overtime. Based on the analyzed results of the free remarks, the importance of establishing constructive strategies is highlighted for building supportive policies and systems towards improving the quality of work and life of nurses. The strategies should address the reduction of working time for night workers and the provision of appropriate support measures in accordance with the life stages of nurses. Similarly highlighted is the need to develop practical means for nurses of acquiring health and safety measures and skills in conducting nursing work and life.
It is recommended to analyze the free remarks collected from questionnaire surveys in addition to summarizing the results for structured questions of the questionnaires. As exemplified by the analysis of remarks by nurses, free remarks contained in questionnaire surveys can be utilized as important sources of basic information for promoting the social efforts towards improving the quality of the work and life of the survey participants.
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