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Why does work cause fatigue? A real-time investigation of fatigue, and determinants of fatigue in nurses working 12 hour shifts

Why does work cause fatigue? A real-time investigation of fatigue, and determinants of fatigue in nurses working 12 hour shifts
Why does work cause fatigue? A real-time investigation of fatigue, and determinants of fatigue in nurses working 12 hour shifts
Background: one of the striking regularities of human behavior is that a prolonged physical, cognitive, or emotional activity leads to feelings of fatigue. Fatigue could be due to (1) depletion of a finite resource of physical and/or psychological energy or (2) changes in motivation, attention, and goal-directed effort (e.g. motivational control theory).

Purpose: to contrast predictions from these two views in a real-time study of subjective fatigue in nurses while working.

Methods: one hundred nurses provided 1,453 assessments over two 12-hr shifts. Nurses rated fatigue, demand, control, and reward every 90 min. Physical energy expenditure was measured objectively using Actiheart. Hypotheses were tested using multilevel models to predict fatigue from (a) the accumulated values of physical energy expended, demand, control, and reward over the shift and (b) from distributed lag models of the same variables over the previous 90 min.

Results: virtually all participants showed increasing fatigue over the work period. This increase was slightly greater when working overnight. Fatigue was not dependent on physical energy expended nor perceived work demands. However, it was related to perceived control over work and perceived reward associated with work.

Conclusions: findings provide little support for a resource depletion model; however, the finding that control and reward both predicted fatigue is consistent with a motivational account of fatigue.
0883-6612
551-562
Johnston, Derek W.
d9477acd-c76f-4e5a-a96c-04887a4686e3
Allan, Julia L.
2b98cce8-6e9a-436f-b8d2-e25d2f41ccbe
Powell, Daniel J.H.
e1e53a46-a37b-425b-ac15-e82f99033f46
Jones, Martyn C.
4d6e8658-7097-40c8-a39d-0aab77f09d62
Farquharson, Barbara
252d8882-fbc5-4029-b8b9-6a4dc00e0b21
Bell, Cheryl
31e1d6a4-e74a-4c8e-9ace-54e7be335222
Johnston, Marie
97013367-b846-4113-b4e1-eeeb0ede2429
Johnston, Derek W.
d9477acd-c76f-4e5a-a96c-04887a4686e3
Allan, Julia L.
2b98cce8-6e9a-436f-b8d2-e25d2f41ccbe
Powell, Daniel J.H.
e1e53a46-a37b-425b-ac15-e82f99033f46
Jones, Martyn C.
4d6e8658-7097-40c8-a39d-0aab77f09d62
Farquharson, Barbara
252d8882-fbc5-4029-b8b9-6a4dc00e0b21
Bell, Cheryl
31e1d6a4-e74a-4c8e-9ace-54e7be335222
Johnston, Marie
97013367-b846-4113-b4e1-eeeb0ede2429

Johnston, Derek W., Allan, Julia L., Powell, Daniel J.H., Jones, Martyn C., Farquharson, Barbara, Bell, Cheryl and Johnston, Marie (2019) Why does work cause fatigue? A real-time investigation of fatigue, and determinants of fatigue in nurses working 12 hour shifts. Annals of Behavioral Medicine, 53 (6), 551-562. (doi:10.1093/abm/kay065).

Record type: Article

Abstract

Background: one of the striking regularities of human behavior is that a prolonged physical, cognitive, or emotional activity leads to feelings of fatigue. Fatigue could be due to (1) depletion of a finite resource of physical and/or psychological energy or (2) changes in motivation, attention, and goal-directed effort (e.g. motivational control theory).

Purpose: to contrast predictions from these two views in a real-time study of subjective fatigue in nurses while working.

Methods: one hundred nurses provided 1,453 assessments over two 12-hr shifts. Nurses rated fatigue, demand, control, and reward every 90 min. Physical energy expenditure was measured objectively using Actiheart. Hypotheses were tested using multilevel models to predict fatigue from (a) the accumulated values of physical energy expended, demand, control, and reward over the shift and (b) from distributed lag models of the same variables over the previous 90 min.

Results: virtually all participants showed increasing fatigue over the work period. This increase was slightly greater when working overnight. Fatigue was not dependent on physical energy expended nor perceived work demands. However, it was related to perceived control over work and perceived reward associated with work.

Conclusions: findings provide little support for a resource depletion model; however, the finding that control and reward both predicted fatigue is consistent with a motivational account of fatigue.

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More information

e-pub ahead of print date: 16 August 2018
Published date: June 2019

Identifiers

Local EPrints ID: 510485
URI: http://eprints.soton.ac.uk/id/eprint/510485
ISSN: 0883-6612
PURE UUID: 0c8aa563-5042-4a59-986a-3dbc80fbdbf6
ORCID for Daniel J.H. Powell: ORCID iD orcid.org/0000-0003-4995-6057

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Date deposited: 13 Apr 2026 09:43
Last modified: 14 Apr 2026 02:19

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Contributors

Author: Derek W. Johnston
Author: Julia L. Allan
Author: Daniel J.H. Powell ORCID iD
Author: Martyn C. Jones
Author: Barbara Farquharson
Author: Cheryl Bell
Author: Marie Johnston

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