Premenstrual Symptoms Risk Factors Among Newly Graduated Nurses in Shift Work: A Prospective Longitudinal Study

Purpose: The premenstrual symptoms (PMSs) are a common health issue affecting women of reproductive age and are associated with various physiological, psychological, and situational factors. Newly graduated nurses, when suddenly exposed to excessive workloads and shift work, may experience disturbances such as sleep disorders, fatigue, depression, and stress. These factors are related to PMS, and their occurrence varies. Therefore, this study aimed to understand the changes in PMS and its risk factors among newly graduated nurses across shift work periods, and investigate the longitudinal relationships between PMS and its risk factors based on the theory of unpleasant symptoms. Methods: This study constituted a secondary data analysis and employed a prospective longitudinal design. Newly graduated nurses were assessed three times: before starting shift work, six months after initiating shift work, and 18 months thereafter. Physiological (age, body mass index, alcohol consumption, dietary behavior), psychological (sleep quality, fatigue, depression, stress, life satisfaction), and situational (social support) factors were included as PMS-related factors. Results: PMS worsened six months after the initiation of shift work compared with those before, and this aggravation persisted even after 18 months of shift work (p < .001). Age (p = .043), sleep quality (p = .004), and fatigue (p < .001) were associated with PMS. An interaction between time and depression that affected PMS was observed (p = .021). Conclusion: Newly graduated nurses need to pay attention to the exacerbation of PMS after initiating shift work. Interventions to improve sleep quality and reduce fatigue are crucial for novice nurses, irrespective of shiftwork duration. Additionally, it is important to assess depressive symptoms before starting shift work and implement early interventions. Furthermore, the need for interventions addressing depression escalates with the increase in shiftwork duration.