Work-Related Predictors of Sleep Quality in Chinese Nurses: Testing a Path Analysis Model

Sense of coherence on the relationship between COVID-19-related stress and sleep quality among nurses

AIM

We aimed to examine the mediating effects of the Sense of Coherence (SOC) on the relationship between stress and sleep in nurses during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A cross-sectional survey targeting nurses in Chiba and Tokyo during the summer of 2021 was conducted using Google Forms. Responses were obtained using the Pittsburgh Sleep Quality Index (PSQI), the 13-item version of the SOC scale (SOC-13), and questions regarding COVID-19-related stress. Structural equation modeling (SEM) was performed to investigate relevant relationships.

RESULTS

A total of 181 valid responses were obtained from 400 surveyed nurses. SEM analysis showed that COVID-19 stress was indirectly related to PSQI via its effect on SOC-13, with higher SOC-13 negatively correlated with PSQI.

CONCLUSIONS

Our findings suggest the need for interventions designed to promote SOC for nurses working under stressful conditions.

The influence of sociodemographic and health-related factors, clinical education status, and sleep quality on work-related quality of life among dental students

INTRODUCTION

With the premise that the demanding educational process and associated factors could influence the work-related quality of life (WRQoL) of dental students, this study aimed to investigate the influence of diverse sociodemographic and health-related factors, clinical education status, and sleep quality on the WRQoL of dental students.

MATERIALS AND METHODS

A three-part questionnaire was administered to a group of preclinical and clinical dental students studying in different classes. The first part of the questionnaire included various sociodemographic and health-related questions. In the second part, the multidimensional 23-item WRQoL scale, with established validity and reliability, was applied to evaluate the WRQoL of the students. The last part of the questionnaire included the Pittsburgh Sleep Quality Index, comprising 19 items. General linear models were created to predict subscale scores using sociodemographic and health-related characteristics, as well as univariate significant independent variables.

RESULTS

It was observed that the majority of the participants (78.2%) had poor sleep quality. Being clinical dental students had a significant and positive effect on the stress at work domain of WRQoL (p = .006), while it had a significant and negative effect on the home-work interface domain (p < .001). The decrease in sleep quality had a significant and negative effect on all domains of WRQoL (p < .05) except for the stress at work domain.

CONCLUSIONS

Clinical education status, regular smoking, and sleep quality significantly affect different domains of dental students' WRQoL. Changes in these factors should be considered in approaches to increasing students' WRQoL.

Psychopathology symptoms of frontline nurses under sudden public health crisis: A network analysis

Public health crises can significantly impact the emotional well-being of healthcare workers. Network analysis is a novel approach to exploring interactions between mental disorders at the symptom level. This study aimed to elucidate the characteristics of post-traumatic stress disorder (PTSD), anxiety, depression, and insomnia symptoms network among frontline nurses under sudden public health crisis. A cross-sectional survey was conducted online among 556 frontline nurses through convenience sampling in Hubei Province, China, from 21 February 2020, to 10 March 2020. Symptoms of PTSD, anxiety, depression, and insomnia were assessed by the Post-Traumatic Stress Disorder Checklist (PCL-5), Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9) and Insomnia Severity Index, respectively. Central symptoms (the most important symptoms, activation has the strongest influence the other nodes) and bridge symptoms (nodes where deactivation can prevent activation from spreading from one disorder to another) were identified via centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. We found that the correlation between PHQ-9 item 9 'suicidal thoughts' and PCL-5 item 16 'reckless or self-destructive behaviour' was the strongest. Moreover, 'reckless or self-destructive behaviour' was the strongest central symptom, and PHQ-9 item 3 'sleep problems' was the most important bridge symptom. Other major symptoms included GAD-7 item 6 'uncontrollable anxiety' and PHQ-9 item 2 'depressed or sad mood'. Timely, systemic targeting interventions on central symptoms and bridge symptoms may effectively alleviate co-occurring experiences of psychopathological symptoms among frontline nurses.

Poor sleep is associated with work environment among 10,087 French healthcare workers: Results from a nationwide survey

Poor sleep is a prevalent issue among healthcare workers and can have detrimental effects on their health. Various individual and professional factors, including the work environment, may contribute to poor sleep. However, only a limited number of studies have examined the simultaneous influence of these factors. Hence, we conducted a nationwide survey among graduated healthcare workers in both public and private healthcare facilities in France. The aim was to analyze the association between poor sleep, assessed using the Pittsburgh Sleep Quality Index (>5), and the work environment, evaluated using the Job Content Questionnaire. The study encompassed 10,087 healthcare workers, among whom 6,540 (64.8%) reported experiencing poor sleep. Nurses, health executives, nursing assistants, and other allied healthcare professionals were more likely to experience poor sleep compared to physicians. Through multivariate regression analysis, we identified several aspects of the work environment associated with an increased likelihood of poor sleep. These factors included high speed and quantity of work, high complexity and intensity, high fragmentation and unpredictability, limited decision-making latitude, underutilization of skills, lack of emotional support from colleagues, and sustained workplace bullying. These findings highlight the significance of considering the work environment in addressing sleep issues among healthcare professionals.

The impact of sleep quality on mental health in working Australians: A quasi-experimental approach

Work conditions such as job demand can impact individual sleep quality, and subsequently impact mental health. This study aims to investigate pathway effects of exogenous factors on mental health via sleep, and the direct effect of sleep quality on mental health in working Australians. We employ a novel method in public health studies, a quasi-experimental (instrumental variable) approach, which can address reciprocal relationships between sleep and mental health in order to estimate causal effect of sleep quality on mental health in a sample of 19,789 working Australians aged 25-64 from waves 2013, 2017, and 2021 of the Household, Income and Labour Dynamics in Australia (HILDA) survey data. We find that high job demand, as a valid instrument, adversely affects sleep quality, and the changes in sleep quality ultimately affect mental health of working Australians. These findings highlight the need for policies that address employment conditions by reducing high work demand or work pressure to mitigate poor sleep quality in the Australian workforce, ultimately improving workers' sleep quality and promoting better mental health, overall health outcomes and productivity.

Evaluation of sleep quality among nursing faculty: Application of the Pittsburgh Sleep Quality Index-A descriptive correlational study

AIM

The aim of this study was to describe the overall sleep quality, sleep patterns and severity of sleep difficulties among nursing faculty using the Pittsburgh Sleep Quality Index (PSQI).

DESIGN

Cross-sectional descriptive and correlational study.

METHODS

A survey of faculty recruited from Texas Board of Nursing approved colleges/schools was used. A purposive, convenience sample of 105 faculty completed the PSQI, a reliable and valid instrument, in an online setting. Data was collected from January 2019 through April 2019.

RESULTS

Nursing faculty reported sleep difficulty across all components, with more problems in sleep latency, sleep disturbances and subjective sleep quality. Overall, 70.5% of participants were reportedly "poor" sleepers, a salient finding. Faculty experienced poor sleep quality across all academic ranks and age groups. Sleep latency and subjective sleep quality were components that presented higher in severity for the youngest faculty.

Anxiety and its association with perceived stress and insomnia among nurses fighting against COVID-19 in Wuhan: A cross-sectional survey

Aims and Objectives

To investigate the present status of anxiety among nurses fighting the spread of COVID‐19 and its association with perceived stress and insomnia.

Background

With the outbreak of COVID‐19, nurses have been caring for infected patients for a considerable length of time in Wuhan, China. Previous COVID‐19 studies generally focused on patients' medical treatment, but few considered healthcare workers' psychological needs while working with a pandemic involving an unfamiliar infectious disease. Numerous nurses have experienced mental health problems, such as anxiety.

Design

The STROBE guidelines for a cross‐sectional questionnaire were implemented.

Methods

An online survey of 643 frontline nurses working with COVID‐19‐infected patients was conducted from 3–10 March 2020. Sociodemographic data were collected, and the Generalized Anxiety Disorder Scale, the Chinese Perceived Stress Scale and the Athens Insomnia Scale were administered.

Results

One‐third (33.4%) of participants reported anxiety, which was associated with perceived stress and insomnia among Chinese frontline nurses in Wuhan during the COVID‐19 pandemic. Significant associations were found between anxiety, perceived stress, insomnia, working four‐night shifts per week, experience working during more than two epidemics and fear of COVID‐19.

Conclusions

This study found that a substantial proportion of frontline nurses caring for COVID‐19‐infected patients experienced anxiety. We recommend that nurse managers focus on working conditions and cultivate safe and satisfactory work environments. Meanwhile, frontline nurses should foster awareness of mental health and rely on online resources for psychological training to alleviate anxiety.

Relevance to clinical practice

The findings of this study could facilitate better understanding of anxiety among frontline nurses; more importantly, healthcare authorities and nursing managers need to pay more attention to ensuring intervention training to reduce anxiety for frontline nurses worldwide.

The Effects of an Educational Program on the Professional Quality of Life and Health of Nurses: A Cluster Experimental Design

BACKGROUND

The complexity of the healthcare environment and intense workloads may negatively impact the health and professional quality of life (ProQOL) of nurses. Prior research has identified a significant association in nurses between ProQOL and health. Developing an intervention to improve the ProQOL and health of nurses may benefit the quality of nursing care.

PURPOSE

The aim of this study was to explore the effects of a compassion fatigue Resiliency, mindfulness Respiration, and Relatives and friends' support (i.e., 3Rs) educational program on ProQOL, physical health, and mental health in nurses.

METHODS

A cluster experimental design was used in this study to recruit registered nurses at two regional teaching hospitals in southern Taiwan as participants. The experimental group (n = 67) attended the 4-week (2-hours-per-week) 3R educational program. The control group (n = 57) received no intervention. The outcome variables, including compassion satisfaction, burnout, secondary traumatic stress, physical health, and mental health, were measured at baseline, at the end of the intervention (immediate effect), at 4 weeks postintervention (short-term effect), and at 12 weeks postintervention (medium-term effect). The study was conducted from May 2017 to December 2017.

RESULTS

Increases in compassion satisfaction and mental health and decreases in secondary traumatic stress were significantly greater in the experimental group than in the control group between baseline and all three posttest time points. Moreover, burnout decreased and physical health improved more significantly in the experimental group than in the control group between the baseline and end of intervention time points (p < .001).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The 3R educational program intervention, integrating compassion fatigue resiliency, mindfulness respiration, and support from relatives and friends, had immediate and positive effects on ProQOL as well as physical and mental health. Moreover, the intervention was shown to have short-term and medium-term positive effects on compassion satisfaction, secondary traumatic stress, and mental health. Nursing managers may apply programs that integrate compassion fatigue resiliency, mindfulness respiration, and relatives and friends' support to improve ProQOL and health in nurses.

Effects of aromatherapy with essential oil massage on the sleep quality of critical care nurses: A randomized controlled trial

The purpose of this study was to explore the effectiveness of an essential oil massage on the sleep quality of the critical care nurses. A randomized controlled trial with single blind was conducted. A total of 112 critical care nurses were recruited. Participants were randomly allocated to either the experimental or control group. Only the experimental group received four sessions consisting of a lavender essential oil massage. The results of this study revealed that the overall subjective sleep quality and objective sleep parameters did not reach a significant difference between the two groups before and after the intervention, but a progressive the subjective sleep quality score reduction was observed in the experimental group. The findings of this study might provide information to critical care nurses who are under high pressure to find the optional alternative way of managing their self-sleep health by employing safe and convenient alternatives through aromatherapy.

The predictive power of sleep quality by morning-evening chronotypes, job satisfaction, and shift schedule in nurses: A cross-sectional study

Background:

Among nurses, sleep quality is an important factor which can be associated with many other factors, including job satisfaction, Morning-Evening (ME) chronotypes, and shift schedule. Besides, poor sleep quality can cause some problems for nurses and negatively affect the quality of nursing care. Therefore, the present study aimed to determine the predictive power of sleep quality by ME chronotypes, job satisfaction, and shift schedule in nurses working in Urmia teaching hospitals in 2019.

Materials and Methods:

A total of 327 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences were recruited using stratified sampling. Data were collected using the demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Minnesota Satisfaction Questionnaire (MSQ), and the Composite Scale of Morningness (CSM). Data were analyzed using linear regression analysis and Pearson correlation coefficient.

Results:

The results of the Pearson correlation coefficient and linear regression analysis showed that the ME chronotypes (R² = 0.51, p = 0.006), job satisfaction (R² = 0.51, p = 0.001), and shift schedule (R² = 0.51, p = 0.005) are significantly correlated with the sleep quality among nurses.

Conclusions:

We concluded that the sleep quality was correlated with ME chronotypes, job satisfaction, and shift schedule, so that increased job satisfaction was associated with improved sleep quality, and the shift to the morning chronotype was associated with decreased sleep quality. Rotating shifts were also associated with higher sleep quality.