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Hernández-Bojorge S, Campos A, Parikh J, Beckstead J, Lajeunesse M, Wildman D. The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis. Int J Ment Health Nurs 2024; 33:523-545. [PMID: 38059541 DOI: 10.1111/inm.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023]
Abstract
Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.
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Affiliation(s)
- Santiago Hernández-Bojorge
- Department of Global and Planetary Health, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Adriana Campos
- Department of Global and Planetary Health, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Jeegan Parikh
- Department of Global and Planetary Health, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Jason Beckstead
- Department of Epidemiology, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Marc Lajeunesse
- Department of Integrative Biology, College of Arts and Sciences, University of South Florida, Tampa, Florida, USA
| | - Derek Wildman
- Department of Genomics, College of Public Health, University of South Florida, Tampa, Florida, USA
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Al Maqbali M, Alsayed A, Hughes C, Hacker E, Dickens GL. Stress, anxiety, depression and sleep disturbance among healthcare professional during the COVID-19 pandemic: An umbrella review of 72 meta-analyses. PLoS One 2024; 19:e0302597. [PMID: 38722888 PMCID: PMC11081353 DOI: 10.1371/journal.pone.0302597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/08/2024] [Indexed: 05/13/2024] Open
Abstract
The outbreak of SARS-CoV-2, which causes COVID-19, has significantly impacted the psychological and physical health of a wide range of individuals, including healthcare professionals (HCPs). This umbrella review aims provide a quantitative summary of meta-analyses that have investigated the prevalence of stress, anxiety, depression, and sleep disturbance among HCPs during the COVID-19 pandemic. An umbrella review of systematic reviews and meta-analyses reviews was conducted. The search was performed using the EMBASE, PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar databases from 01st January 2020 to 15th January 2024. A random-effects model was then used to estimate prevalence with a 95% confidence interval. Subgroup analysis and sensitivity analyses were then conducted to explore the heterogeneity of the sample. Seventy-two meta-analyses involved 2,308 primary studies were included after a full-text review. The umbrella review revealed that the pooled prevalence of stress, anxiety, depression, and sleep disturbance among HCPs during the COVID-19 pandemic was 37% (95% CI 32.87-41.22), 31.8% (95% CI 29.2-34.61) 29.4% (95% CI 27.13-31.84) 36.9% (95% CI 33.78-40.05) respectively. In subgroup analyses the prevalence of anxiety and depression was higher among nurses than among physicians. Evidence from this umbrella review suggested that a significant proportion of HCPs experienced stress, anxiety, depression, and sleep disturbance during the COVID-19 pandemic. This information will support authorities when implementing specific interventions that address mental health problems among HCPs during future pandemics or any other health crises. Such interventions may include the provision of mental health support services, such as counseling and peer support programs, as well as the implementation of organizational strategies to reduce workplace stressors.
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Affiliation(s)
| | - Ahmad Alsayed
- Faculty of Pharmacy, Department of Clinical Pharmacy and Therapeutics, Applied Science Private University, Amman, Jorden
| | - Ciara Hughes
- Institute of Nursing and Health Research School of Health Sciences, Ulster University, Belfast, United Kingdom
| | - Eileen Hacker
- University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Geoffrey L. Dickens
- Midwifery and Health Faculty of Health and Life Sciences, Mental Health Nursing Department of Nursing, Northumbria University, Newcastle-Upon-Tyne, United Kingdom
- Adjunct Professor Western Sydney University, Parramatta, NSW, Australia
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Wu JY, Li H, Shuai JK, He Y, Li PC. Evidence summary on the non-pharmacological management of sleep disorders in shift workers. Sleep Breath 2024; 28:909-918. [PMID: 37587356 PMCID: PMC11136795 DOI: 10.1007/s11325-023-02901-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE This study aimed to evaluate, and integrate the relevant evidence on the non-pharmacological management of sleep disorders in shift workers to provide a reference for improving sleep of shift workers. METHODS According to the "6S" pyramid model of evidence, a comprehensive search was conducted in evidence-based databases, including BMJ-Best Practice, UpToDate, DynaMed, Cochrane Library, and Joanna Briggs Institute (JBI); clinical practice guideline websites, such as the Guidelines International Network; professional association websites, such as the World Sleep Society; and literature databases, including PubMed, Embase, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Biology Medicine disc (CBM) from inception to November 30, 2022. Two researchers independently evaluated the literature in accordance with the evaluation standards; conducted the extraction, classification, and synthesis of the evidence; and evaluated its grade and recommendation grade. RESULTS A total of 18 studies were included, including 2 clinical decisions, 2 guidelines, 3 expert consensuses, and 11 systematic reviews. In total, 25 pieces of evidence were summarized from 6 aspects: sleep assessment, sleep scheduling, sleep hygiene, light therapy, workplace intervention, and other managements. CONCLUSION This study summarized the best evidence for the non-pharmacological management of sleep disorders in shift workers. Shift workers should reasonably arrange their sleep time and develop good sleep hygiene. Additionally, work organizations should jointly promote sleep to improve the sleep conditions of shift workers and promote their physical and mental health.
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Affiliation(s)
- Jin-Yu Wu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
| | - Hui Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
| | - Jun-Kun Shuai
- Department of Emergency Medicine, Affiliated Hospital of Chengdu University, No.82, North 2nd Section, 2nd Ring Road, Chengdu, 610081, Sichuan, China
| | - Yue He
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China
| | - Peng-Cheng Li
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China.
- West China School of Nursing, Sichuan University, No.37, Guoxue Alley, Chengdu, 610044, Sichuan, China.
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Coelho J, Micoulaud-Franchi JA, Philip P. Associations between Sleep Hygiene and Mental Complaints in a French Healthcare Worker Population during the COVID-19 Crisis: A Cross-Sectional Analysis to Personalize Sleep Health Interventions. Clocks Sleep 2024; 6:246-254. [PMID: 38804278 PMCID: PMC11130789 DOI: 10.3390/clockssleep6020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor sleep hygiene and mental health complaints among healthcare workers and examine their associations. We investigated participants' typical sleep-wake patterns on workdays and free days as indicators of sleep hygiene. Sleep efficiency and social jetlag were calculated as the ratio of mean sleep duration to time spent in bed, while sleep rebound was defined as the difference in mean sleep duration between workdays and free days. Social jetlag was determined as the difference in mid-sleep timing between workdays and free days, with mid-sleep defined as the midpoint between bedtime and wake-up time. Insomnia severity was assessed using the Insomnia Severity Index (ISI), daytime sleepiness using the Epworth Sleepiness Scale (ESS), and symptoms of anxiety and depression using the Patient Health Questionnaire 4 (PHQ-4). Fatigue was measured using a single item inspired by the Maslach Burnout Inventory (MBI). A total of 1562 participants (80.5% women, mean age 40.0 years) were included in the study. The results revealed that 25.9% of participants slept less than 6 h, 24.3% had a sleep efficiency of less than 85%, 27.3% experienced a sleep rebound of more than 2 h, and 11.5% reported a social jetlag exceeding 2 h. Additionally, 33.9% of participants reported insomnia, 45.1% reported excessive daytime sleepiness, 13.1% reported fatigue, 16.5% reported symptoms of depression, and 35.7% reported symptoms of anxiety. After adjustment, mean sleep duration and sleep efficiency were associated with most mental health complaints. Sleep rebound and social jetlag were associated with significant insomnia but not with anxiety or depression symptoms. Our findings underscore the high prevalence of poor sleep hygiene and mental health complaints among healthcare workers, exacerbated by the COVID-19 crisis. We advocate for the promotion of sleep health through behavioral sleep strategies to safeguard the well-being of healthcare professionals.
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Affiliation(s)
- Julien Coelho
- SANPSY, UMR 6033, CNRS, University of Bordeaux, F-33000 Bordeaux, France; (J.-A.M.-F.); (P.P.)
- CHU Bordeaux, Service Universitaire de Médecine du Sommeil, F-33000 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- SANPSY, UMR 6033, CNRS, University of Bordeaux, F-33000 Bordeaux, France; (J.-A.M.-F.); (P.P.)
- CHU Bordeaux, Service Universitaire de Médecine du Sommeil, F-33000 Bordeaux, France
| | - Pierre Philip
- SANPSY, UMR 6033, CNRS, University of Bordeaux, F-33000 Bordeaux, France; (J.-A.M.-F.); (P.P.)
- CHU Bordeaux, Service Universitaire de Médecine du Sommeil, F-33000 Bordeaux, France
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Fronteira I, Mathews V, Dos Santos RLB, Matsumoto K, Amde W, Pereira A, de Oliveira APC, Craveiro I, Chança R, Boniol M, Ferrinho P, Poz MRD. Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations. HUMAN RESOURCES FOR HEALTH 2024; 22:10. [PMID: 38273317 PMCID: PMC10809470 DOI: 10.1186/s12960-024-00892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR). METHODS We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes. RESULTS The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted. DISCUSSION PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Verona Mathews
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Ranailla Lima Bandeira Dos Santos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Osvaldo Cruz, Rua Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, Brazil
| | - Karen Matsumoto
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Woldekidan Amde
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Alessandra Pereira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Zhu Y, Meng R, Jiang C, Yang N, Huang M, Wang X, Zou W, Lou C, Xiao R, Lu J, Xu J, Jiménez-Correa U, Ma H, Spruyt K, Dzierzewski JM. Sleep quality and subjective well-being in healthcare students: examining the role of anxiety and depression. Front Public Health 2023; 11:1281571. [PMID: 38213643 PMCID: PMC10784115 DOI: 10.3389/fpubh.2023.1281571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/16/2023] [Indexed: 01/13/2024] Open
Abstract
Objective Sleep issues, negative emotions, and health conditions are commonly co-occurring, whereas their associations among healthcare students have yet to be elucidated. This study aimed to examine whether anxiety and depression mediate the relationship between sleep quality and subjective well-being in healthcare students. Methods A cross-sectional survey was conducted among Chinese healthcare students (N = 348). A battery of paper-and-pencil questionnaires-the Sleep Quality Questionnaire (SQQ), World Health Organization-Five Well-Being Index (WHO-5), and Patient Health Questionnaire-4 (PHQ-4) were applied. Descriptive analysis with means (standard deviations) and counts (proportions), Spearman correlation analysis between the SQQ, WHO-5, and PHQ-4, and mediation analysis via structural equation models were performed. Results Correlation analysis revealed statistically significant associations between sleep quality, anxiety and depression, and well-being among healthcare students. Mediation analysis identified that poor sleep quality produced relatively low levels of self-reported well-being, which were entirely attributable to anxiety and depression. Conclusion Sleep quality was associated with subjective well-being, and this interrelationship was fully mediated by anxiety and depression. Interventions aimed at promoting sleep quality of healthcare students may contribute to promoting their well-being by reducing anxiety and depression.
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Affiliation(s)
- Yihong Zhu
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Mengyi Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xiaowen Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Wenjing Zou
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Chen Lou
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ruohan Xiao
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jingjing Lu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jiale Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ulises Jiménez-Correa
- Sleep Disorders Clinic, Research Division, Medicine Faculty, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China
| | - Karen Spruyt
- Université Paris Cité, NeuroDiderot, INSERM, Paris, France
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Xie W, Liu M, Okoli CTC, Zeng L, Huang S, Ye X, Liu F, Wang J. Construction and evaluation of a predictive model for compassion fatigue among emergency department nurses: A cross-sectional study. Int J Nurs Stud 2023; 148:104613. [PMID: 37839306 DOI: 10.1016/j.ijnurstu.2023.104613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Compassion fatigue is a syndrome resulting from long-term work-related traumatic event stress exposure of medical staff. The emergency department is considered to be a high-risk, high-intensity and high-stress work environment, with a high prevalence of trauma and violence. Nurses in the emergency department are more prone to compassion fatigue than nurses in other departments. Compassion fatigue not only affects the physical and mental health, and job satisfaction of emergency department nurses, but also causes serious consequences for patients, such as poor patient outcome, medical errors, and increased patient mortality during hospitalization. OBJECTIVES Our study aims to develop and evaluate a predictive model for compassion fatigue among emergency department nurses. DESIGN A cross-sectional study. DATA SOURCES The emergency department nurses (N = 1014) were recruited from 21 tertiary hospitals (from Chengdu, Chongqing, Guiyang, Guangzhou and Shanghai) in central, southwestern, southern, and eastern China from July 25, 2022 to October 30, 2022. METHODS Univariate and multiple logistic regression analyses were used to determine the potential predictive factors associated with compassion fatigue in emergency department nurses. A nomogram was built based on the predictive factors and internally evaluated using a bootstrap resampling method (1000 bootstrap resamples). The performance of the predictive model was evaluated by measuring the Hosmer-Lemeshow goodness of fit test and calibration curve. RESULTS The prevalence of compassion fatigue among emergency department nurses was 75.9 %. The multiple logistic regression analysis revealed that the independent predictive factors for compassion fatigue among emergency department nurses were working position, job satisfaction, diet habit, sleep hours per day, occupational stress, physical harassment and the level of workplace violence, all of which were identified to create the nomogram. The Hosmer-Lemeshow goodness of fit test indicated that the predictive model was well calibrated (χ2 = 11.520, P = 0.174). The bootstrap-corrected concordance index of nomogram was 0.821 (95 % CI: 0.791-0.851). The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities. CONCLUSIONS A predictive model of compassion fatigue among emergency department nurses has been developed, based on the general demographic, work-related and lifestyle characteristics, occupational stress, and workplace violence, with satisfactory predictive ability. This model can identify emergency department nurses who are at high risk of compassion fatigue. Our study provides an empirical basis for early detection, early diagnosis and early intervention of emergency department nurses at high risk of compassion fatigue.
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Affiliation(s)
- Wanqing Xie
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Manli Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Chizimuzo T C Okoli
- University of Kentucky College of Nursing, 517 College of Nursing Building, Lexington, KY 40536, USA.
| | - Li Zeng
- Sichuan Nursing Vocational College, No. 173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province 610100, China.
| | - Shuqi Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Fan Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Nursing Key Laboratory of Sichuan Province, West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jialin Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China.
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Wang L, Zhu R, Zhou X, Zhang Z, Peng D. Altered local and remote functional connectivity in mild Alzheimer's disease patients with sleep disturbances. Front Aging Neurosci 2023; 15:1269582. [PMID: 37920381 PMCID: PMC10619161 DOI: 10.3389/fnagi.2023.1269582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023] Open
Abstract
Objectives This study aimed to investigate local and remote functional connectivity in mild Alzheimer's disease patients with sleep disturbances (ADSD) and those without sleep disturbances (ADNSD). Methods Thirty eight mild AD patients with sleep disturbances and 21 mild AD patients without sleep disturbances participated in this study. All subjects underwent neuropsychological assessments and 3.0 Tesla magnetic resonance scanning. Static and dynamic regional homogeneity (ReHo) were used to represent the local functional connectivity. Seed-based whole-brain functional connectivity was used to represent the remote functional connectivity. The seed was chosen based on the results of ReHo. Results Compared to ADNSD, ADSD showed decreased static ReHo in the left posterior central gyrus and the right cuneus and increased dynamic ReHo in the left posterior central gyrus. As for the remote functional connectivity, comparing ADSD to ADNSD, it was found that there was a decreased functional connection between the left posterior central gyrus and the left cuneus as well as the left calcarine. Conclusion The current study demonstrated that, compared with ADNSD, ADSD is impaired in both local and remote functional connectivity, manifested as reduced functional connectivity involving the primary sensory network and the primary visual network. The abnormality of the above functional connectivity is one of the reasons why sleep disorders promote cognitive impairment in AD. Moreover, sleep disorders change the temporal sequence of AD pathological damage to brain functional networks, but more evidence is needed to support this conclusion.
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Affiliation(s)
- Lei Wang
- Department of Neurology, Beijing Geriatric Hospital, Beijing, China
| | - Rui Zhu
- Department of Neurology, Beijing Geriatric Hospital, Beijing, China
| | - Xiao Zhou
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhiyong Zhang
- Department of Neurology, Beijing Geriatric Hospital, Beijing, China
| | - Dantao Peng
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
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Moshayedi AJ, Uddin NMI, Khan AS, Zhu J, Emadi Andani M. Designing and Developing a Vision-Based System to Investigate the Emotional Effects of News on Short Sleep at Noon: An Experimental Case Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:8422. [PMID: 37896515 PMCID: PMC10610979 DOI: 10.3390/s23208422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023]
Abstract
Background: Sleep is a critical factor in maintaining good health, and its impact on various diseases has been recognized by scientists. Understanding sleep patterns and quality is crucial for investigating sleep-related disorders and their potential links to health conditions. The development of non-intrusive and contactless methods for analyzing sleep data is essential for accurate diagnosis and treatment. Methods: A novel system called the sleep visual analyzer (VSleep) was designed to analyze sleep movements and generate reports based on changes in body position angles. The system utilized camera data without requiring any physical contact with the body. A Python graphical user interface (GUI) section was developed to analyze body movements during sleep and present the data in an Excel format. To evaluate the effectiveness of the VSleep system, a case study was conducted. The participants' movements during daytime naps were recorded. The study also examined the impact of different types of news (positive, neutral, and negative) on sleep patterns. Results: The system successfully detected and recorded various angles formed by participants' bodies, providing detailed information about their sleep patterns. The results revealed distinct effects based on the news category, highlighting the potential impact of external factors on sleep quality and behaviors. Conclusions: The sleep visual analyzer (VSleep) demonstrated its efficacy in analyzing sleep-related data without the need for accessories. The VSleep system holds great potential for diagnosing and investigating sleep-related disorders. The proposed system is affordable, easy to use, portable, and a mobile application can be developed to perform the experiment and prepare the results.
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Affiliation(s)
- Ata Jahangir Moshayedi
- School of Information Engineering, Jiangxi University of Science and Technology, Ganzhou 341000, China; (A.J.M.); (N.M.I.U.); (A.S.K.)
| | - Nafiz Md Imtiaz Uddin
- School of Information Engineering, Jiangxi University of Science and Technology, Ganzhou 341000, China; (A.J.M.); (N.M.I.U.); (A.S.K.)
| | - Amir Sohail Khan
- School of Information Engineering, Jiangxi University of Science and Technology, Ganzhou 341000, China; (A.J.M.); (N.M.I.U.); (A.S.K.)
| | - Jianxiong Zhu
- School of Mechanical Engineering, Southeast University, Nanjing 211189, China
| | - Mehran Emadi Andani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Via Casorati, 37131 Verona, Italy
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Chou FY, Chiu TF, Huang FW, Hsu TY, Liu CY, Lin CH, Huang PY, Lin KM, Wu SH. The effect of exercise on the risk of metabolic syndrome associated with sleep insufficiency: a cross-sectional study. Front Cardiovasc Med 2023; 10:1192241. [PMID: 37808885 PMCID: PMC10556234 DOI: 10.3389/fcvm.2023.1192241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Sleep disturbance and insufficient sleep have been linked to metabolic syndrome, increasing cardiovascular disease and mortality risk. However, few studies investigate the joint effect of sleep and exercise on metabolic syndrome. We hypothesized that regular exercise can mitigate the exacerbation of metabolic syndrome by sleep insufficiency. Objective The aim of this study was to investigate whether exercise can attenuate or eliminate the relationship between sleep insufficiency and metabolic syndrome. Method A total of 6,289 adults (mean age = 33.96 years; women: 74.81%) were included in the study, a cross-sectional study conducted based on the results of employee health screening questionnaires and databases from a large healthcare system in central Taiwan. Participants reported sleep insufficiency or not. Self-reported exercise habits were classified into 3 levels: no exercise, exercise <150 min/week, and exercise ≧150 min/week. Multiple logistic regression and sensitivity analyses were conducted to understand the joint associations of sleep patterns and exercise with metabolic syndrome with exposure variables combining sleep duration/disturbances and PA. Results Compared with the reference group (sufficient sleep), individuals with sleep insufficiency had a higher risk for metabolic syndrome [adjusted odds ratio (AOR) = 1.40, 95% confidence interval (95% CI): 1.01-1.94, p < 0.05] in females aged 40-64 years, but not in other populations. Sleep insufficiency was not associated with the risk of metabolic syndrome among individuals achieving an exercise level of <150 min/week, and in particular among those achieving ≧150 min/week in all populations in our study. Conclusion Sleep insufficiency was related to a higher risk of metabolic syndrome in female healthcare staff aged 40-64 years. Being physically active with exercise habits in these individuals, the risk of metabolic syndrome was no longer significant.
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Affiliation(s)
- Fan-Ya Chou
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Te-Fa Chiu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Fen-Wei Huang
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Tai-Yi Hsu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chien-Yu Liu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chin-Han Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Po-Yao Huang
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Kuei-Ming Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Hao Wu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
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Shi R, Wang F, Xu W, Fu L. Association of age and night flight duration with sleep disorders among Chinese airline pilots. Front Public Health 2023; 11:1217005. [PMID: 37744512 PMCID: PMC10513407 DOI: 10.3389/fpubh.2023.1217005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Night flights might aggravate sleep disorders among aging airline pilots, posing a threat to flight safety. In this study, we assess the prevalence of sleep disorders as well as the combined effects of night flight duration and aging on sleep disorders. Method A cross-sectional study was conducted between July and December, 2021. Participants were recruited from a commercial airline. Sleep disorders were evaluated using the Pittsburgh Sleep Quality Index (PSQI). The interaction effect of night flight duration and age on sleep disorders and their correlates were examined using logistic regression models. Results In total, 1,208 male airline pilots were included in the study, with a median age of 34 (interquartile range [IQR]: 29-39) years. The overall prevalence of sleep disorders was 42.6%. The multivariate logistic regression identified an interaction between night flight duration and age on sleep disorders (adjusted odds ratio [aOR] of the interaction term was 5.85 95% CI: 2.23-15.34 for age ≥ 45 years; 1.96 95% CI:1.01-3.81 for the age group 30-44 years). Longer night flight duration (aOR: 4.55; 95%CI: 1.82-11.38) and body mass index (BMI) ≥28.0 kg/m2 (aOR: 0.16; 95% CI: 0.03-0.91) were significantly associated with sleep disorders in participants aged ≥45 years. Hyperuricemia (aOR: 1.54; 95% CI: 1.09-2.16) and regular exercise (aOR: 0.23; 95% CI: 0.08-0.70) were significantly associated with sleep disorders in the 30-44 years age group. Conclusion The mean monthly night flight duration and aging had a synergistic effect on airline pilots' sleep disorders, implying an aging and work-related mechanistic pathogenesis of sleep disorders in airline pilots that requires additional exploration and intervention.
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Affiliation(s)
- Ruizi Shi
- Shanghai Institute of Aviation Medicine, Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Fang Wang
- Shanghai Hospital of Civil Aviation Administration of China, Gubei Branch of Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wanying Xu
- Shanghai Institute of Aviation Medicine, Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Fu
- Shanghai Hospital of Civil Aviation Administration of China, Gubei Branch of Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China
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12
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Wang S, Huang T, Weisskopf MG, Kang JH, Chavarro JE, Roberts AL. Multidimensional Sleep Health Prior to SARS-CoV-2 Infection and Risk of Post-COVID-19 Condition. JAMA Netw Open 2023; 6:e2315885. [PMID: 37252741 PMCID: PMC10230315 DOI: 10.1001/jamanetworkopen.2023.15885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/15/2023] [Indexed: 05/31/2023] Open
Abstract
Importance The association of multiple healthy sleep dimensions with post-COVID-19 condition (PCC), also known as long COVID, has not been investigated. Objective To examine whether multidimensional sleep health before and during the COVID-19 pandemic, prior to SARS-CoV-2 infection, was associated with the risk of PCC. Design, Setting, and Participants This prospective cohort study (2015-2021) included Nurses' Health Study II participants who reported testing positive (n = 2303) for SARS-CoV-2 infection in a substudy series of COVID-19-related surveys (n = 32 249) between April 2020 and November 2021. After exclusion for incomplete information about sleep health and nonresponse to a question about PCC, 1979 women were included in the analysis. Exposures Sleep health was measured both before (June 1, 2015, to May 31, 2017) and early (April 1 to August 31, 2020) in the COVID-19 pandemic. Prepandemic sleep score was defined according to 5 dimensions: morning chronotype (assessed in 2015), 7 to 8 hours of sleep per day, low insomnia symptoms, no snoring, and no frequent daytime dysfunction (all assessed in 2017). On the first COVID-19 substudy survey (returned between April and August 2020), average daily sleep duration and sleep quality for the past 7 days were queried. Main Outcomes and Measures SARS-CoV-2 infection and PCC (≥4 weeks of symptoms) were self-reported during 1 year of follow-up. Comparisons were examined between June 8, 2022, and January 9, 2023, using Poisson regression models. Results Of the 1979 participants reporting SARS-CoV-2 infection (mean [SD] age, 64.7 [4.6] years; 1979 [100%] female; and 1924 [97.2%] White vs 55 [2.8%] other races and ethnicities), 845 (42.7%) were frontline health care workers, and 870 (44.0%) developed PCC. Compared with women who had a prepandemic sleep score of 0 or 1 (least healthy), those who scored 5 (most healthy) had a 30% lower risk of developing PCC (multivariable-adjusted relative risk, 0.70; 95% CI, 0.52-0.94; P for trend <.001). Associations did not differ by health care worker status. No or little daytime dysfunction prepandemic and good sleep quality during the pandemic were independently associated with a lower risk of PCC (relative risk, 0.83 [95% CI, 0.71-0.98] and 0.82 [95% CI, 0.69-0.99], respectively). Results were similar when PCC was defined as having 8 or more weeks of symptoms or as having ongoing symptoms at the time of PCC assessment. Conclusions and Relevance The findings indicate that healthy sleep measured prior to SARS-CoV-2 infection, both before and during the COVID-19 pandemic, may be protective against PCC. Future research should investigate whether interventions on sleep health may prevent PCC or improve PCC symptoms.
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Affiliation(s)
- Siwen Wang
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Marc G. Weisskopf
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Hui-Ren Z, Li-Li M, Qin L, Wei-Ying Z, Hai-Ping Y, Wei Z. Evaluation of the correlation between sleep quality and work engagement among nurses in Shanghai during the post-epidemic era. Nurs Open 2023. [PMID: 37036900 DOI: 10.1002/nop2.1735] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/21/2022] [Accepted: 03/20/2023] [Indexed: 04/12/2023] Open
Abstract
AIM To examine the status quo and influencing factors of sleep quality and work engagement of nurses participating in COVID-19 during the post-epidemic era and to study the relationship between them. DESIGN We conducted a cross-sectional survey and correlational and predictive logic to determine the association between sleep quality and work engagement among nurses in Shanghai during the post-epidemic era. METHODS This design involved 1060 frontline nurses in Shanghai. The Pittsburgh Sleep Quality Index questionnaire and the Utrecht Work Engagement Scale-9 scales were used for data collection. RESULTS This study found that the sleep quality of frontline nurses was impaired and the nurses with poor sleep accounted for 48.20% during the post-epidemic era. The work engagement of frontline nurses was at the medium level. Factors affecting nurses' sleep quality were the number of nurse night shifts, family support and nurse health. The factors affecting the nurse work engagement were monthly income, profession title, family support and self-health status. There was a positive correlation between nurses' sleep quality and work engagement.
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Affiliation(s)
- Zhuang Hui-Ren
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ma Li-Li
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Liu Qin
- Department of Nursing, Health School Attached to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Zhang Wei-Ying
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yu Hai-Ping
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhao Wei
- Suzhou Science & Technology Town Hospital, Tongji University School of Medicine, Shanghai, China
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Cheng H, Liu G, Yang J, Wang Q, Yang H. Shift work disorder, mental health and burnout among nurses: A cross-sectional study. Nurs Open 2023; 10:2611-2620. [PMID: 36539975 PMCID: PMC10006599 DOI: 10.1002/nop2.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/12/2022] [Accepted: 11/20/2022] [Indexed: 12/24/2022] Open
Abstract
AIM The aim of the study was to examine the relationships among nurses' shift work disorder, mental health and burnout to inform efforts to alleviate shift work disorder. DESIGN This cross-sectional study was conducted in China using a web-based platform for questionnaire. METHODS The study was comprised of a convenience sample of 1,268 Registered Nurses from 21 public hospitals in mainland China from June 2019-July 2019. Participants completed a web-based survey designed to collect demographic and other self-reported data. An independent sample t test and Pearson correlation were performed to analyse the relationship between shift work disorder, mental health and burnout. RESULTS The vast majority (98.2%) of the participants were women between the ages of 20-59 years. The participants exhibited a higher incidence of mental health problems (58.1%) and burnout (65.5%) and those with shift work disorder exhibited a higher risk of mental health problems and burnout than those who did not have shift work disorder. Our research demonstrated that shift work disorder, combined with other variables, accounted for 40.5% of the variance in mental health (R2 = .405, adjusted R2 = .401, F = 107.214, p < .001) and 36.5% in burnout (R2 = .365, adjusted R2 = .361, F = 90.323, p < .001). Moreover, burnout negatively regulated the relationship between shift work disorder and mental health. CONCLUSION High-risk nurses with shift work disorder were at a much higher risk of mental health problems and burnout.
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Affiliation(s)
- Hui Cheng
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Guangbi Liu
- Department of Nursing, The People's Hospital of Bishan District, Chongqing, China
| | - Junyi Yang
- Department of Nursing, The People's Hospital of Bishan District, Chongqing, China
| | - Qiaohong Wang
- Nursing College of Shanxi Medical University, Taiyuan, China
| | - Hui Yang
- Nursing College of Shanxi Medical University, Taiyuan, China
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15
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Sun M, Li X, Yao J, Huang X, Kang Y, Li Z. Psychological status of medical staff dedicated to nucleic acid collection in COVID-19 epidemic during closed-loop management: A cross-sectional study. Front Public Health 2023; 11:1131971. [PMID: 36969671 PMCID: PMC10036577 DOI: 10.3389/fpubh.2023.1131971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundTo investigate the depression, anxiety and somnipathy situation occurred in the nucleic acid collection staff during the closed-loop management period of COVID-19. And try to understand the influencing factors of related psychological status.MethodsA cross-sectional study of 1,014 nucleic acid collection staff from seven Chinese hospitals was conducted. Various investigation methods were involved in the questionnaires to collect data, including 12-items self-made questionnaire survey of basic demographic information, 9-items patient health questionnaire depression scale (PHQ-9), 7-items generalized anxiety disorder scale (GAD-7) and Pittsburgh sleep quality index (PSQI). Data analysis was performed using SPSS version 26.0 and Excel software. Mann-Whitney U-test, Chi-square test, correlation analysis, mono-factor analysis and binary logistic regression were applied accordingly for further analysis.ResultsThe positive rate of depression, anxiety and sleep disorder of 1,014 nucleic acid collectors under closed-loop management were 33.5, 27.2, and 50.1%, respectively. Depression was significantly positively correlated with anxiety and sleep (P < 0.05). The scores of depression scale were positively correlated with the age and the fear for infection (r = 0.106, 0.218, both P < 0.05); The scores of anxiety scale were also positively correlated with the age and the fear for infection (r = 0.124, 0.225, both P < 0.05); The length of service, collection time and the degree of worry about infection and was positively correlated with the score of sleep scale (r = 0.077, 0.074, 0.195, both P < 0.05); Education level had a significant negative association with PHQ-9, GAD-7 and PSQI (r = −0.167,−0.172, both P < 0.05). Binary logistic regression analysis showed that age, technical title, education level, collection time, collection frequency, collection location, fear for infection and external environment were important influencing factors of depression, anxiety and sleep disorders.ConclusionThe results of this study suggested that when carrying out nucleic acid collection mission, managers should intervene to optimize the collection location, control the duration of each collection mission, replace the collection staff in time and pay close attention to the psychological state of the collection staff.
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Affiliation(s)
- Mingzhu Sun
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xiaowei Li
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
- *Correspondence: Xiaowei Li
| | - Jie Yao
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Xi Huang
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Yujuan Kang
- Department of Nursing, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Zixuan Li
- School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
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Lin Y, Huang Y, Xi X. Association between lifestyle behaviors and health-related quality of life among primary health care physicians in China: A cross-sectional study. Front Public Health 2023; 11:1131031. [PMID: 36969630 PMCID: PMC10030863 DOI: 10.3389/fpubh.2023.1131031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/16/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundPrimary health care (PHC) serves as the gatekeeper of health system and PHC physicians take on significant obligations to provide health care services in the pursuit of Universal Health Coverage (UHC). PHC physicians' health-related quality of life (HRQoL) can have a strong impact on patients, physicians and the health care system. Lifestyle interventions are found to be effective to improve HRQoL. The purpose of this study was to evaluate the association between lifestyle behaviors and HRQoL among PHC physicians, so that lifestyle intervention can be tailored by policy makers for health promotion.MethodsA survey covering 31 provinces and administrative regions in China was conducted in 2020 using a stratified sampling strategy. Data on sociodemographic characteristics lifestyle behaviors and HRQoL were collected by a self-administered questionnaire. HRQoL was measured through EuroQol-five dimension-five level (EQ-5D-5L) instrument. A Tobit regression model was performed to evaluate the association between sociodemographic characteristics, lifestyle behaviors and HRQoL.ResultsAmong 894 PHC physicians who completed the survey, Anxiety/Depression (AD) was the dimension with the most problems reported (18.1%). Regular daily routine (β = 0.025, 95%CI 0.004 to 0.045) and good sleep quality (β = 0.049, 95% CI = 0.029 to 0.069) were protective factors for HRQoL, while smoking (β = −0.027, 95% CI = −0.079 to −0.003) and frequency of eating breakfast (β = −0.041, 95%CI = −0.079 to −0.003) were negatively associated with HRQoL. Physical activity and alcohol drinking were not significantly associated with HRQoL.ConclusionThese findings suggest that tailored interventions on daily routine, improving sleep quality, and tobacco control among PHC physicians may be effective strategies to improve their HRQoL.
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Amiri S. Sleep quality and sleep-related issues in industrial workers: a global meta-analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:154-167. [PMID: 34970939 DOI: 10.1080/10803548.2021.2024376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives. Sleep-related issues are important health issues. This study aimed to investigate the global prevalence of sleep-related issues in industrial workers. Methods. A syntax of keywords was used to search the PubMed, Web of Science and Scopus databases. The search time was limited to articles published until September 2020, and the search range was in English. Events and samples were extracted for each study to calculate the prevalence. For all subgroups, events and samples were extracted to calculate the results of the subgroups. The random-effects method was used in the analysis. Heterogeneity was examined at the levels of all analyses. Results. Forty-eight articles were included in the analysis as eligible studies. Sleep-related issues have 30% prevalence in the 95% confidence interval (CI) [25, 35%]. The prevalence of sleep-related issues in men was 38%, 95% CI [31, 45%] and in women was 32%, 95% CI [14, 50%]. The prevalence of poor sleep quality, insomnia, sleep duration <7 h, snoring and sleepiness was 36, 22, 37, 29 and 10%, respectively. Conclusions. Sleep-related issues have a high prevalence in industrial workers, and the cause of these differences needs to be addressed and increasing insights provided to prevent and treat sleep disorders.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Barpanda S, Saraswathy G. The impact of COVID 19 pandemic on fatigue, sleeping disorders, and quality of work-life among healthcare workers. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2023. [DOI: 10.1080/20479700.2022.2157931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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19
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Cybulska AM, Weymann A, Rachubińska K, Grochans S, Wójcik G, Grochans E. Factors Associated with Insomnia and Aggression among Healthcare Workers during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1433. [PMID: 36674188 PMCID: PMC9859312 DOI: 10.3390/ijerph20021433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
(1) Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic. The aim of the study was to assess insomnia, sleep disturbances, and aggression and identify the associated risk factors among healthcare workers during the COVID-19 pandemic. (2) A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss−Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a self-administered questionnaire. (3) The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p = 0.038), marital status (p = 0.043), and working with patients suffering from COVID-19 (p = 0.024) were statistically significant contributors to insomnia. Age was found to significantly correlate with total aggression (r = −0.133 p = 0.031), verbal aggression (r = −0.138 p = 0.025), and anger (r = −0.151 p = 0.014). The analysis demonstrated statistically significant relationships between gender and physical aggression (p = 0.017), anger (p = 0.032), and hostility (p = 0.002). A statistically significant positive correlation between the quality of sleep as per the PSQI and all subscales of the BPAQ was found (p < 0.001). (4) A considerable proportion of HCWs experienced sleep disturbances during the outbreak, stressing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and mental health problems and adjust interventions under pandemic conditions.
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Affiliation(s)
- Anna Maria Cybulska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Agnieszka Weymann
- Independent Clinical Public Hospital No. 2 in Szczecin, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 72-111 Szczecin, Poland
| | - Kamila Rachubińska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Szymon Grochans
- Department of Clinical Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Grzegorz Wójcik
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
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Xiao N, Xu X, Ma Z, Yu X, Feng Y, Li B, Liu Y, He G, Fan J, Li B, Zhao X. Sleep quality was associated with adverse reactions after coronavirus disease 2019 vaccination among healthcare workers: A longitudinal paired study. Front Behav Neurosci 2023; 16:867650. [PMID: 36688124 PMCID: PMC9845944 DOI: 10.3389/fnbeh.2022.867650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 11/15/2022] [Indexed: 01/05/2023] Open
Abstract
Background Many countries have currently relied on various types of vaccines for the public to control the coronavirus disease 2019 (COVID-19) pandemic. The adverse reactions (ARs) after vaccination may affect vaccination coverage and confidence. However, whether sleep quality was associated with ARs after vaccination remains unclear. Methods We designed a longitudinal paired study within a hospital setting. We collected data about the side effects within 7 days after two doses of scheduled vaccination among healthcare workers (HCWs). All HCWs were asked to complete a sleep survey indexed by the Pittsburgh Sleep Quality Index (PSQI) before vaccination and after a 1-month follow-up. Then, we explored the relationship between sleep quality before or after vaccination and the occurrence of ARs. Results A total of 345 HCWs were recruited to receive COVID-19 vaccination. The sleep quality became worse after vaccination. All local and systemic reactions were mild or moderate in severity (32.46%), and no serious adverse event was reported. Binary logistic regression showed participants with poor sleep quality (PSQI > 5) than good sleep quality (PSQI ≤ 5) before the two doses of vaccination, respectively, exhibited 1.515 and 1.107 times risk of ARs after each vaccination (both p < 0.001). Conclusion There is an apparently complex bidirectional relationship between sleep quality and COVID-19 vaccination adverse effects. Poor sleep quality significantly increases the risk of mild ARs after vaccination, while vaccination may cause a temporary decline in sleep quality.
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Affiliation(s)
- Ning Xiao
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Xingli Xu
- Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiyue Ma
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoxu Yu
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Feng
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Bilan Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuping Liu
- Department of Health Management Center and Institute of Health Management, Sichuan Provincial People’s Hospital, Chengdu, China
| | - Gang He
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiangang Fan
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,Jiangang Fan,
| | - Bin Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,Bin Li,
| | - Xiaolong Zhao
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People’s Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, China,*Correspondence: Xiaolong Zhao,
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21
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Chen Y, Wang P, He Y, Jiang F, Liu H, Liu Y, Liu T, Tang YL, Zhu J. Gender differences in the association between lifestyle behaviors and mental health among psychiatrists in China. J Affect Disord 2022; 318:196-203. [PMID: 36041580 DOI: 10.1016/j.jad.2022.08.089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Mental health symptoms are common among health professionals and the influence of lifestyle behaviors on psychiatrists' mental health is insufficiently understood. Based on a nationwide sample, we aimed to survey the lifestyle behaviors and mental health status among psychiatrists, and to identify the co-occurrence and gender differences in lifestyle behaviors. METHODS Data were collected through an anonymous questionnaire among psychiatrists in China. Depression, Anxiety and Stress Scale - 21 (DASS-21) was used to evaluate mental health symptoms. Latent class analysis (LCA) was used to explore the co-occurrence of lifestyle behaviors. The multivariate logistic regression model was used to examine the effects of demographic and lifestyle factors. RESULTS 4520 psychiatrists were included in the analysis with 11.5 % of them reporting smoking, 10 % reporting alcohol misuse, 35.2 % reporting physical inactivity, and 23.1 % reporting insomnia. The prevalence of depression, anxiety and stress symptoms were 29.2 %, 34.5 %, and 12.2 %, respectively. Significant gender differences were found in smoking (P < 0.001), alcohol misuse (P < 0.001), and physical inactivity (P < 0.001), but not in insomnia. Based on these four high-risk health behaviors above, three lifestyle behavior clusters with huge gender differences were identified through the LCA. Accordingly, the unhealthy lifestyle classes, though defined differently for males and females, were significantly associated with depression, anxiety, and stress. CONCLUSIONS The co-occurrence and significant gender differences in multiple lifestyle behaviors exist in this group, highlighting the need for gender-specific comprehensive interventions against mental health symptoms and the urgency of promoting their well-being.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Feng Jiang
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, USA; Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioural Sciences, Emory University, Atlanta, USA.
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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22
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Postpandemic Stress Disorder among Health Care Personnel: A Cross-Sectional Study (Silesia, Poland). Behav Neurol 2022; 2022:1816537. [DOI: 10.1155/2022/1816537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/16/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Postpandemic stress disorder (PPSD) is an unofficial term that refers to posttraumatic stress disorder (PTSD), a mental disorder resulting from increased stress, anxiety, and trauma associated with unpleasant life experiences. Many scientific studies indicate that symptoms of increased stress, job burnout, anxiety, and depressive disorders are associated with medical personnel performing their professional duties around COVID-19 patients. Objective. The purpose of this study was to assess the prevalence of symptoms that may indicate the presence of PPSD symptoms—depression, anxiety, and stress—in medical personnel. Material and Methods. The survey included 300 people, representatives of medical personnel. The group was divided into two sections. The first section numbered 150 and consisted of personnel in direct contact with COVID-19 patients (FR); the second group also consisted of 150 medical professionals, who but no longer directly involved in helping with COVID-19 cases (SR). The survey was conducted by indirect survey method using CAWI (computer-assisted web interview). The survey used a questionnaire technique. A proprietary tool enriched with standardized psychometric scales: BDI, GAD-7, FCV-19S, and PSS-10 was used. Kruskal-Wallis and Mann–Whitney
statistical tests were used in the statistical processing of the data. The probability level was 0.05. Results. Statistical inference made it clear that mental health problems that may indicate trauma are mainly present in the FR group. These symptoms decreased slightly in comparison between periods 2020 and 2021 (
). Conclusions. The COVID-19 pandemic significantly increased the prevalence of depression, anxiety, and stress among first responders. To ensure the psychological well-being of first responders, early assessment and care of mild depression, anxiety, and stress should be promoted to prevent the development of moderate and severe forms.
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23
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Huang G, Lee TY, Banda KJ, Pien LC, Jen HJ, Chen R, Liu D, Hsiao STS, Chou KR. Prevalence of sleep disorders among first responders for medical emergencies: A meta-analysis. J Glob Health 2022; 12:04092. [PMID: 36269052 PMCID: PMC9585923 DOI: 10.7189/jogh.12.04092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Shift work and irregular work schedules among first responders have been associated with physical and psychological problems such as sleep disorders. We conducted the first meta-analysis to explore and estimate the prevalence of sleep disorders among first responders for medical emergencies. Methods We searched four databases: Web of Science, Psych Info, CINAHL, and PubMed. The Generalized Linear Mixed model (GLMM) was used to estimate the prevalence estimates of sleep disorders in R software and the DerSimonian-Lard random-effects model in Comprehensive Meta-Analysis was used to explore associated comorbidities for OSA and insomnia, presented as odds ratios (ORs) and confidence intervals (CIs). The Cochran's Q, τ2, and the statistics were used to assess heterogeneity and the moderator analysis was conducted to identify moderator variables. Results Twenty-eight studies with 100 080 first responders were included from the total of 1119 studies retrieved from the databases. The prevalence rates for sleep disorders were 31% (95% CI = 15%-53%) for shift work disorder (SWD), 30% (95% CI = 18%-46%) for obstructive sleep apnea (OSA), 28% (95% CI = 19%-39%) for insomnia, 28% (95% CI = 24%-33%) for excessive daytime sleepiness (EDS), 2% (95% CI = 1%-4%) for restless leg syndrome, and 1% (95% CI = 0%-5%) for narcolepsy. Anxiety (OR = 2.46; 95% CI = 1.99%-3.03%), cardiovascular disease (CVD) (OR = 2.03; 95% CI = 1.43-2.88), diabetes mellitus (DM) (OR = 1.93; 95% CI = 1.41-2.65), depression (OR = 1.89; 95% CI = 1.01-3.56), gastroesophageal reflux disease (GERD) (OR = 1.83; 95% CI = 150-2.22), and post-traumatic stress disorder (PTSD) (OR = 1.78; 95% CI = 1.33-2.39) were associated with OSA. Depression (OR = 9.74; 95% CI = 4.67-20.3), anxiety (OR = 9.22; 95% CI = 3.81-22.3), and PTSD (OR = 7.13; 95% CI = 6.27-8.10) were associated with insomnia. Age, gender, first responders, continent, study quality, study design, and assessment tool were significant moderator variables for OSA, insomnia, and EDS. Conclusions This meta-analysis found a substantially high prevalence of sleep disorders including SWD, OSA, insomnia, and EDS among first responders for medical emergencies. Early assessment and management of sleep disorders among first responders is necessary to promote good, quality sleep to help prevent anxiety, depression, CVD, DM, GERD, and PTSD.
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Affiliation(s)
- Garry Huang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan.,Australasian College of Paramedicine, Australia.,Australian Institute of Project Management, Australia
| | - Tso-Ying Lee
- Nursing Research Center, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kondwani Joseph Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Li-Chung Pien
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Ju Jen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Doresses Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Wan Fang Hospital, Taipei Medical University.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shu-Tai Shen Hsiao
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Superintendent Office, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
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24
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Shi W, Chen C, Cui Q, Deng F, Yang B, Cao Y, Zhao F, Zhang Y, Du P, Wang J, Li T, Tang S, Shi X. Sleep disturbance exacerbates the cardiac conduction abnormalities induced by persistent heavy ambient fine particulate matter pollution: A multi-center cross-sectional study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156472. [PMID: 35660605 DOI: 10.1016/j.scitotenv.2022.156472] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Fine particulate matter (PM2.5) exposure and sleep disturbance have been significantly associated with adverse cardiovascular outcomes, however, the combined effects of these two factors are still unclear. We conducted a multi-center cross-sectional study from November 2018 to May 2019 in the Beijing-Tianjin-Hebei region in China to investigate the potential modifying effects of sleep disturbance on associations between cardiac conduction abnormalities and PM2.5 exposure, as well as the combined effects of sleep disturbance and heavy pollution episodes, which were defined based on the PM2.5 mass concentration (≥75 μg/m3, falling in the 75th/90th percentile) and duration (1 day and ≥2 days). The sleep quality and sleep duration of all participants were evaluated using the Pittsburgh Sleep Quality Index. Standard 12-lead electrocardiogram (ECG) test was performed to measure the heart rate (HR), QRS duration (time taken for ventricular depolarization), HR corrected QT interval (time for ventricular depolarization and repolarization) and PR interval (time for atrioventricular conduction). Multivariable linear regression models were performed to evaluate the associations of PM2.5 and heavy pollution events on ECG parameters and the joint effects with sleep disturbance. We found PM2.5 exposure was independently associated with prolonged QRS and QTc intervals. Association between PM2.5 and the QTc interval was significantly stronger in participants with poor sleep quality. For each 10-μg/m3 increase in PM2.5 concentration, the QTc interval in the participants with poor sleep quality increased by 0.41 % (95 % confidence interval: 0.19, 0.64). In addition, heavy PM2.5 pollution episodes, especially extremely heavy pollution of long duration, were found to have synergistic effects with sleep disturbance on ECG parameters. Our findings provide evidence that PM2.5 exposure, especially heavy pollution episodes, may increase abnormal cardiac conduction and have a synergistic effect with sleep disturbance. Improving sleep hygiene is crucial to protect the heart health of the general population.
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Affiliation(s)
- Wanying Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Cui
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Ecology and Environment, Inner Mongolia University, Hohhot, China
| | - Fuchang Deng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bo Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health, Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Yaqiang Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaonan Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Song Tang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
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25
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Wu S, Wu C, Wang X, Fei W, Fu Y. Mediating effect of circadian rhythm between work stress and sleep quality in Chinese shift-working nurses: A cross-sectional survey. Nurs Open 2022; 10:560-569. [PMID: 35964326 PMCID: PMC9834518 DOI: 10.1002/nop2.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/08/2022] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM This study examined the mediating effect of circadian rhythm amplitude (LV) and stability (FR) between work stress and sleep quality among Chinese shift-working nurses (SWNs). DESIGN A cross-sectional study. METHODS Three-hundred and seventy-nine nurses working in shifts were investigated by convenient sampling from six hospitals in Shanghai, China. The mediating effect was analysed using the structural equation model with bootstrapping procedures. RESULTS Work stress could directly affect shift nurses' sleep quality and indirectly affect sleep quality through circadian rhythm amplitude and stability. The total indirect effects of work stress on sleep quality accounted for 36.7% of the total effect. The study revealed that poor sleep quality is very common among SWNs, which deserves attention. The mediating effect of the circadian rhythm provides new insights to improve sleep quality, not only by lightening the work stress but also by improving circadian rhythm in SWNs.
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Affiliation(s)
- Songqi Wu
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina,Nursing DepartmentShanghai Tenth People's Hospital Affiliated to Tongji UniversityShanghaiChina
| | - Caiqin Wu
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Xiaohan Wang
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina,School of Public HealthChina Medical UniversityShenyangChina
| | - Wenling Fei
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina,Nursing DepartmentShanghai Tenth People's Hospital Affiliated to Tongji UniversityShanghaiChina
| | - Yue Fu
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina
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26
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DOS SANTOS MA, PEREIRA FH, DE SOUZA CALIARI J, OLIVEIRA HC, CEOLIM MF, ANDRECHUK CRS. Sleep and Professional Burnout in Nurses, Nursing Technicians, and Nursing Assistants During the COVID-19 Pandemic. J Nurs Res 2022; 30:e218. [PMID: 35674665 PMCID: PMC9301687 DOI: 10.1097/jnr.0000000000000501] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/21/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic may trigger sleep disorders and burnout in nursing professionals. PURPOSE This study was designed to describe the occurrence of sleep disorders and burnout in a nursing team during the COVID-19 pandemic and to identify the associated factors. METHODS A cross-sectional approach was used. The questionnaire was administered via the Internet. All of the participants were nursing professionals who had provided care during the COVID-19 pandemic, and data were collected between June and August 2020. Sociodemographic and work characterization instruments, the Jenkins Sleep Scale, and the Maslach Burnout Inventory were used. RESULTS Five hundred seventy-two nursing professionals (nurses, nursing technicians, and nursing assistants) responded. Slightly over one quarter (26.4%) presented a sleep disorder, and 17.3% presented burnout. Professional category was a factor found to be associated with having a sleep disorder. Moreover, a lower prevalence both of disorders and of starting to use sleep medication was found among nurses than nursing assistants. Moreover, an association was found between having a high level of emotional exhaustion burnout and being a nursing technician, having a higher number of patients needing care, and starting to use sleep medication. The level of burnout related to depersonalization was significantly higher for nursing assistants, those with a weekly workload of 50 hours or more, and those starting to use sleep medication. Furthermore, burnout related to personal accomplishment was significantly higher in those starting to use sleep medication. Among the participants with sleep disorders, according to Jenkins Sleep Scale results, all of the participants presented a high or moderate level of emotional exhaustion and a high level of burnout related to personal accomplishment. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The findings indicate that the incidence of sleep disorders and burnout were high among nursing professionals during the COVID-19 pandemic and mainly related with starting to use sleep medication. The results demonstrate the importance of detecting and assessing the frequency of sleep disorders and professional exhaustion. Interventions that aim to improve sleep quality and working conditions for these professionals should be developed.
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Affiliation(s)
- Mariana Alvina DOS SANTOS
- PhD, RN, Adjunct Professor, Federal University of Mato Grosso do Sul, Três Lagoas, Mato Grosso do Sul, Brazil
| | - Flávia Helena PEREIRA
- PhD, RN, Professor, Federal Institute of Science, Education and Technology of the South of Minas Gerais, Passos, Brazil
| | - Juliano DE SOUZA CALIARI
- PhD, RN, Professor, Federal Institute of Science, Education and Technology of the South of Minas Gerais, Passos, Brazil
| | | | - Maria Filomena CEOLIM
- PhD, RN, Associate Professor, Faculty of Nursing, Campinas State University, Campinas, São Paulo, Brazil
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27
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Sleep Disorders and Mental Stress of Healthcare Workers during the Two First Waves of COVID-19 Pandemic: Separate Analysis for Primary Care. Healthcare (Basel) 2022; 10:healthcare10081395. [PMID: 35893217 PMCID: PMC9394272 DOI: 10.3390/healthcare10081395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 12/20/2022] Open
Abstract
Background: During the recent pandemic, Healthcare Professionals (HCPs) presented a significant prevalence of psychological health problems and sleep disturbances. The aim of this study was to assess the impact of COVID-19 on HCPs’ sleep and mental stress with a separate analysis for primary care HCPs. Methods: A cross-sectional observational study with an online anonymized, self-reported questionnaire was conducted in May 2020 (1st wave) and repeated in December 2020 (2nd wave). Patient health questionnaire-4 (PHQ-4), dimensions of anger reactions-5 (DAR-5) scale, 3-item UCLA loneliness scale (LS) and sleep condition indicator (SCI) were used. Results: Overall, 574 participants were included from the 1st wave, 514 from the 2nd and 469 were followed during both. Anxiety and depression were significantly higher during the 2nd wave vs. the 1st (32.8% vs. 12.7%, p < 0.001 and 37.7% vs. 15.8%, p < 0.001). During the 2nd wave, HCPs scored significantly higher in DAR-5 (9.23 ± 3.82 vs. 7.3 ± 3.3, p < 0.001) and LS (5.88 ± 1.90 vs. 4.9 ± 1.9, p < 0.001) with worse sleep quality SCI (23.7 ± 6.6 vs. 25.4 ± 3.2, p < 0.001). This was more evident in primary care HCPs. Significant correlations were found between SCI and PHQ4, DAR5 and LS. Conclusion: There is a need to support HCPs’ mental health and sleep, especially in those working in primary care.
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28
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Li TM, Pien LC, Cheng WJ. Direction and magnitude of social jetlag are associated with obesity: Results from a sample of hospital employees. Chronobiol Int 2022; 39:1242-1248. [PMID: 35796193 DOI: 10.1080/07420528.2022.2090953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Social jetlag, the discrepancy between social and biological timing, has been suggested to disturb metabolic functions. However, the relationship between social jetlag and obesity has been inconsistent in other studies. In this study we examined the association between social jetlag and obesity among day and shift workers. We invited 2508 day workers and 1383 shift workers from a hospital worker health cohort to participate in a 2018-2019 survey on their sleep behaviors. Shift-specific social jetlag was quantified using the Munich ChronoType Questionnaire, and body mass index was measured during annual physical examinations. The distributions of shift-specific social jetlag were illustrated, and logistic regression analysis was used to examine the association between social jetlag and obesity. We found that high level of social jetlag (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.08-1.47) and positive social jetlag (OR = 2.25, 95% CI = 1.30-3.90) during evening shifts were associated with obesity after adjustment for age, sex, health behaviors, and sleep quality. During night shift periods, sleep time varied greatly on free days, but the participants slept at similar times, namely 16:00, on workdays. In conclusion, phase advance on workdays and high levels of social jetlag were associated with obesity. Sleep timing should therefore be recommended according to the relative phase of individuals' preferred sleep time and work time.
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Affiliation(s)
- Tin-May Li
- Department of Psychiatry, Taichung Prison Pei-Teh Hospital, Taichung, Taiwan.,Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
| | - Li-Chung Pien
- Program in Nursing, College of Nursing, Taipei Medical UniversityPost-Baccalaureate, Taipei, Taiwan
| | - Wan-Ju Cheng
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan.,Department of Public Health, China Medical University, Taichung, Taiwan
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29
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Rahman HA, Hatsanee A, Menjeni NA, Salleh ZA, Hamid RA, Ali M. Perceived sleep quality: a comparison between hospital nurses and student nurses. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:578-588. [PMID: 35678818 DOI: 10.12968/bjon.2022.31.11.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The prevalence of poor sleep quality is high among nurses, and affects them physically and psychologically as well as organisational functioning. However, evidence on equipping student nurses with good sleep practices that could mitigate poor sleep as they transition into the nursing workforce is lacking. AIM This study compared the prevalence and quality of good sleep among hospital nurses and student nurses. METHODS A descriptive cross-sectional study of 130 hospital nurses and 130 student nurses in Brunei was carried out. Sleep quality was assessed using the Pittsburgh Sleep Quality index. Multiple logistic regression was applied. RESULTS Hospital nurses were 4.29 times more likely to experience poor sleep than student nurses. Those who were overweight were 2.35 times more likely to have poor sleep quality than those with a healthy weight. Although students had significantly good sleep latency, needing less time to fall asleep, they experienced significantly more sleep disturbances, shorter sleep duration and less sleep efficiency. CONCLUSION The prevalence of poor sleep quality among nurses in Brunei is higher than global estimates. Stakeholders such as nursing leaders, nursing educators and healthcare policymakers should prepare student nurses and help existing nurses by formulating strategies to promote working schedules and rosters that minimise circadian disruption.
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Affiliation(s)
- Hanif Abdul Rahman
- Assistant Professor, PAPRSB Institute of Health Sciences, and Research Scholar, School of Nursing, University of Michigan
| | | | | | | | | | - Mursidi Ali
- Lecturer, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam
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Spanish version of Jenkins Sleep Scale in physicians and nurses: psychometric properties from a Peruvian nationally representative sample. J Psychosom Res 2022; 157:110759. [PMID: 35358746 DOI: 10.1016/j.jpsychores.2022.110759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the psychometric properties of the Spanish version of Jenkins Sleep Scale with 4 items (JSS-4) of the Peruvian health system's (PHS) nurses and physicians. METHODS We carried out a psychometric study based on secondary analysis in a sample from a nationally representative survey that used acomplex sampling design. The participants were physicians and nurses aged 18-65 years, working in PHS private and public facilities, who have fulfilled all JSS-4 items. We performed a confirmatory factor analysis. Reliability was evaluated via two estimates - classic alpha (α) and categorical omega (ω) coefficients. Also, we tested the invariance across groups of variables. The convergent validity was evaluated based on the relation between JSS-4 and PHQ-2 using Pearson's correlation coefficient and effect size (Cohen's d). Also, we designed normative values based on percentiles. RESULTS We included 2100 physicians and 2826 nurses in the analysis. We observed that the unidimensional model has adequate goodness-of-fit indices and values of α and ω coefficients. No measurement invariance was found between the groups of professionals and age groups; however, invariance was achieved between sex, monthly income, work-related illness, and chronic illness groups. Regarding the relation with other variables, the JSS-4 has a small correlation with PHQ-2. Also, profession and age-specific normative values were proposed. CONCLUSION JSS-4 Spanish version has adequate psychometric properties in PHS nurses and physicians.
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Gao C, Wang L, Tian X, Song GM. Sleep quality and the associated factors among in-hospital nursing assistants in general hospital: A cross-sectional study. Heliyon 2022; 8:e09393. [PMID: 35600445 PMCID: PMC9118489 DOI: 10.1016/j.heliyon.2022.e09393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/04/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background Sleep quality and the associated factors in professional nurses have been extensively investigated. However, as an important part of the workforce in hospitals, sleep quality and influencing factors among in-hospital nursing assistants is rarely investigated. Aim This study aimed to assess the sleep quality and the associated factors of in-hospital nursing assistants in general hospital. Methods A cross-sectional survey study was conducted in a tertiary general hospital. Data were collected from 187 in-hospital nursing assistants using convenience sampling from June to July 2018. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate participants’ sleep quality. A multiple linear regression was performed to identify associated factors with sleep quality. Results This study revealed a mean PSQI score of 5.96 ± 3.64 among all participants, of which 62.3% (114/187) participants suffered from impaired sleep quality. In-hospital nursing assistants with significant medical condition, low monthly income, irregular diet and high family burden reported more worse sleep quality. Conclusion The study showed that poor sleep quality is a highly prevalent issue among Chinese in-hospital nursing assistants in general hospital. Measures to enhance nursing assistants’ wellbeing status (health and burden) and improve their salary (monthly income) are recommended.
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Affiliation(s)
- Chang Gao
- Department of Nursing, Tianjin Hospital, Tianjin 300211, China
| | - Li Wang
- Ward I at Department of Upper Extremity Trauma, Tianjin Hospital, Tianjin 300211, China
| | - Xu Tian
- Nursing Department, Universitat Rovira I Virgili, Tarragona 43002, Spain
- Corresponding author.
| | - Guo-Min Song
- Department of Nursing, Tianjin Hospital, Tianjin 300211, China
- Corresponding author.
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Zare F, Sadeghian F, Alatab S, Chaman R, Mirrezaie SM. COVID-19 epidemic effects on sleep quality among health sector workers: A follow up study. Chronobiol Int 2022; 39:1015-1026. [PMID: 35393918 DOI: 10.1080/07420528.2022.2058402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Health care workers (HCWs) were vulnerable to sleep disturbances in normal circumstances. Poor sleep quality (PSQ) is common during the coronavirus disease 2019 (COVID-19) epidemic. The aim of this study is evaluation of sleep quality among healthcare workers during COVID-19 epidemic in a cohort study. In a follow-up study, we assessed sleep quality in 453 Iranian HCW participants in late-April 2021, after approximately 8 weeks of the epidemic of COVID-19. In order to compare the sleep quality in the two time intervals, during and before COVID-19, we used the recorded data of the same group of participants who were enrolled in a study named SHAHWAR (SHAhroud Health care Workers Associated Research) cohort that is focused on the health of HCWs who work at the Shahroud university of medical sciences. Data collection process in the SHAHWAR study started on October 2, 2019 and continued until February 19, 2020. Our results showed sleep quality worsened among shift-workers during COVID-19 outbreak; however, it was improved among non-shift staff. Sleep quality was more likely to be worsening if HCWs had shift-working roles [OR: 1.84(1.11-3.06), and if they experienced death in their families [OR: 5.06(1.60-12.80)]; however, having a paramedical role was a protective effect [OR: 0.52(0.27-092)], for poor quality sleep. Sleep quality worsened during the epidemic among HCWs. A greater impact, in terms of higher PSQI index, in this group of workers was seen in shift working staff.
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Affiliation(s)
- Fariba Zare
- Center for Health Related Social and Behavioral Sciences Research Shahroud, University of Medical Sciences, Shahroud, Iran
| | - Farideh Sadeghian
- Center for Health Related Social and Behavioral Sciences Research Shahroud, University of Medical Sciences, Shahroud, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Chaman
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyed Mohammad Mirrezaie
- Center for Health Related Social and Behavioral Sciences Research Shahroud, University of Medical Sciences, Shahroud, Iran.,Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
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Li Y, Chen B, Hong Z, Sun Q, Dai Y, Basta M, Tang X, Qin Q. Insomnia symptoms during the early and late stages of the COVID-19 pandemic in China: a systematic review and meta-analysis. Sleep Med 2022; 91:262-272. [PMID: 34732293 PMCID: PMC8479411 DOI: 10.1016/j.sleep.2021.09.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Evidence suggests that the outbreak of the coronavirus disease 2019 (COVID-19) and the prevention/control measures for COVID-19 may cause insomnia during the acute phase of COVID-19 pandemic in China. However, it is unclear whether insomnia sustains during the later phases of the pandemic. METHODS We searched PubMed/Medline, EMBASE, PsycINFO and China National Knowledge Infrastructure from the 27th December 2019 to the 2nd February 2021. As early stage studies on COVID-19 pandemic in China were defined as those conducted prior to April 1st, 2020, while late stage studies were those conducted after April 1st, 2020. RESULTS A total of 98 studies with 193,889 participants were included. The pooled prevalence of insomnia symptoms among all populations was 39.1% (95% CI 36.2-42.0%); the pooled prevalence of insomnia symptoms during the early and late stages of COVID-19 in China were 37.0% (95% CI 34.1-39.9%) and 41.8% (95% CI 33.6-50.0%), respectively. Importantly, there was no significant difference regarding the prevalence of insomnia symptoms between the early and late stages of COVID-19. Meta-regression showed that healthcare workers, COVID-19 patients, patients with chronic medical conditions and patients with mental disorders had a higher prevalence of insomnia symptoms compared to the general population. This association remained significant in healthcare workers and patients with chronic medical conditions after adjusting for age, gender, areas of high or low prevalence of COVID-19 cases, anxiety and depression. CONCLUSIONS Over one third of our sample present insomnia symptoms during the early stage of COVID-19 pandemic in China. Interestingly, prevalence of insomnia symptoms sustains high during the late stage of the pandemic despite the control of the disease and the amelioration of its adverse effects. Our findings suggest that insomnia symptoms related to COVID-19 appear to persist of over time.
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Affiliation(s)
- Yun Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Baixin Chen
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Zhuoting Hong
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Qimeng Sun
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yanyuan Dai
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Xiangdong Tang
- Sleep Medicine Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingsong Qin
- Laboratory of Human Virology and Oncology, Shantou University Medical College, Shantou, China
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Van Nguyen T, Liu HE. A cross-sectional study on sleep disturbances and associated factors among nurses. BMC Psychiatry 2022; 22:119. [PMID: 35168602 PMCID: PMC8848685 DOI: 10.1186/s12888-022-03748-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/31/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Many studies have measured sleep disturbances among nurses globally, but none have addressed this issue in Vietnam. Therefore, this study aimed to assess the prevalence of sleep disturbance and identify associated factors among staff nurses in Vietnam. To identify sleep disturbances and associated factors among staff nurses in Vietnam. METHODS A cross-sectional design was used in this study. Participant nurses (n = 420) completed a general information questionnaire, the Vietnamese version of the General Sleep Disturbance Scale (GSDS), the Perceived Stress Scale, and the Short Form 12. Data were collected between July and September 2019 from three public hospitals located in southwestern Vietnam. Data were analyzed using Chi-square, independent Student's t-test, and multivariate logistic regression analysis. RESULTS The average GSDS score was 41.10 (SD = 19.48), indicating sleep disturbances among 46.9% of nurses. Age, health condition, stress, and quality of life had an impact on sleep disturbance. Multivariate logistic regression analysis confirmed that nurses with high stress and poor physical health status were more likely to experience sleep disturbances. CONCLUSION Vietnamese nursing staff suffers from a high rate of sleep disturbances. Significant predictors included high stress and poor physical health status. Administrators of healthcare services should carefully consider how to conduct interventions to help the nurses handle their sleep disturbances such as stress management and physical health promotion.
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Affiliation(s)
- Tuan Van Nguyen
- grid.25488.330000 0004 0643 0300Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam ,grid.145695.a0000 0004 1798 0922School of Nursing, College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 33302 Taiwan, ROC
| | - Hsueh-Erh Liu
- School of Nursing, College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist, Taoyuan City, 33302, Taiwan, ROC. .,Department of Rheumatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, ROC. .,Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, ROC.
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Naik BN, Pandey S, Rao R, Verma M, Singh PK. Generalized anxiety and sleep quality among health care professionals during the COVID-19 pandemic: a cross-sectional study from a tertiary healthcare institution in Eastern India. Osong Public Health Res Perspect 2022; 13:51-61. [PMID: 35255678 PMCID: PMC8907607 DOI: 10.24171/j.phrp.2021.0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/10/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, healthcare professionals (HCPs) have experienced high levels of stress and anxiety because of the high risk of infection for themselves and their families. This has led to acute sleep problems for HCP. This study was designed to assess the anxiety and sleep quality of HCPs during the COVID-19 pandemic. Methods This cross-sectional study analyzed 370 HCPs employed at All India Institute of Medical Sciences Patna over 3 months, using the standard Generalized Anxiety Disorder 7-item scale (GAD-7) for suspected GAD and the Pittsburgh Sleep Quality Index for sleep quality. Results were tabulated and multivariable binomial logistic regression analysis was done to determine the predictors of poor sleep. Significance was attributed to p<0.05. Results Of the 370 HCPs screened, 52 (14.1%; 95% confidence interval [CI], 10.8%–18.1%) were found to have GAD and 195 (52.7%; 95% CI, 47.5%–57.9%) were found to be poor sleepers. The presence of any addictive habit (adjusted odds ratio [AOR], 1.833; 95% CI, 1.12–2.8), unprotected contact with COVID-19 cases (AOR, 1.902; 95% CI, 1.1–3.3), and the presence of GAD (AOR, 5.57; 95% CI, 2.5–12.4) were found to be predictors of poor sleep quality among HCPs. Conclusion A significant proportion of HCPs were found to have suspected GAD and were poor sleepers. This highlights the need for measures to confront this problem.
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Football and Zumba Training in Female Hospital Staff: Effects after 12 and 40 Weeks on Self-Reported Health Status, Emotional Wellbeing, General Self-Efficacy and Sleep Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031685. [PMID: 35162706 PMCID: PMC8834773 DOI: 10.3390/ijerph19031685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 11/26/2022]
Abstract
Background: This 40-weeks intervention study evaluates the effects on self-reported health status, emotional wellbeing, general self-efficacy and sleep problems among female hospital employees. Methods: 107 employees were cluster-randomized into three groups; football (FG), Zumba (ZG) and control (CG). Outcome measurements were conducted at baseline, 12 and 40 weeks. Weekly training frequencies in the first 12 and next 28 weeks were 2.4 ± 0.3 and 0.8 ± 0.2 in FG and 2.3 ± 0.3 and 0.9 ± 0.2 in ZG. Results: Compared to the CG, the ZG showed significant improvement in self-reported health status (p = 0.025), a reduced frequency of poor and restless sleep (on a 0–4 scale) (p = 0.004), as well as a tendency for reduction in the frequency of problems falling asleep (p = 0.055) and overall sleep problems (p = 0.051). Between baseline and 12 weeks, both the FG (p = 0.017) and the ZG (p = 0.017) showed within-group improvements in emotional wellbeing, whereas this improvement was maintained only in the ZG between baseline and 40 weeks (p = 0.002). The FG showed a significant within-group improvement in general self-efficacy (p = 0.012) between baseline and 12 weeks follow-up, with no such improvements in the other groups. Conclusion: The present findings revealed that a physical activity intervention with Zumba as well as football training may improve mental health and sleep outcomes in female hospital staff.
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Transcranial magnetic stimulation for sleep disorders in Alzheimer's disease: A double-blind, randomized, and sham-controlled pilot study. Neurosci Lett 2022; 766:136337. [PMID: 34762980 DOI: 10.1016/j.neulet.2021.136337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/25/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sleep disorders are commonly comorbid with Alzheimer's disease (AD), And these disorders interfere with each other in many aspects. To date, pharmacological treatments for sleep disorders are still limited, and studies investigating repetitive transcranial magnetic stimulation (rTMS) for sleep disorders in AD are still lacking. METHOD A single-center, randomized, double-blind, parallel-arm, and sham-controlled pilot study was conducted in AD patients with sleep disorders. Seventy subjects were randomly divided into the following two groups: the sham group (SG) and the intervention group (IG). We evaluated sleep changes using the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. We also assessed the patients' cognitive function by the Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-Cog). The intervention period was four weeks, and the patients were followed up in the 8th week to test the persistence of the effect of the rTMS intervention. RESULT Significant differences in the PSQI scores were found between the SG and IG at the end of the 4-week intervention (P = 0.001) and the 8-week follow-up (P < 0.001). There was also significant improvement in ADAS-Cog scores (4 weeks: P = 0.048, 8 weeks: P = 0.038). Activities of daily living (ADL) did not significantly differ between the SG and IG. CONCLUSION rTMS can effectively ameliorate sleep disorders in AD patients.
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Prekazi L, Hajrullahu V, Bahtiri S, Kryeziu B, Hyseni B, Taganoviq B, Gallopeni F. The Impact of Coping Skills in Post-traumatic Growth of Healthcare Providers: When Mental Health Is Deteriorating Due to COVID-19 Pandemic. Front Psychol 2021; 12:791568. [PMID: 34925193 PMCID: PMC8678123 DOI: 10.3389/fpsyg.2021.791568] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Frontline healthcare providers are consistently exposed to potentially traumatic events while assisting patients with COVID-19. Post-traumatic growth (PTG) happens when a person can transform trauma and use adversity in one’s advantage. In response to limited studies on positive outcomes that may occur from the pandemic; this study aimed to elucidate the positive impact of coping with COVID-19 outbreak on mental health, such as PTG. Methodology: The study comprised a sample of 691 healthcare providers 59% female, including physicians (n = 138) and nurses (n = 550), working in public health facilities in Kosovo, with an average age of 41.6 years (SD = 10.79). They were asked to complete a questionnaire with four parts: Socio-demographic, GHQ-28, COPE and PTGI. A deterioration of mental health with somatic symptoms leading to the escalation due to COVID-19 outbreak was found. Results: Female healthcare providers reported more clinical symptoms as well as higher coping skills scores than men. The domains in which positive changes were most frequently observed were Relating to Others, New Possibilities and Personal Strength. There was no significant direct effect of mental health on PTG in the mediation model, though a significant indirect effect was observed for coping skills. Conclusion: The results suggest that levels of mental health exacerbation do not play a conclusive role in determining levels of PTG, as long coping mechanisms are in place. The development and implementation of interventions to minimize COVID-19-related mental health consequences, by fostering PTG among healthcare providers could be highly beneficial in pandemic response work.
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Affiliation(s)
| | | | | | - Blerta Kryeziu
- Heimerer College, Prishtine, Kosovo.,Faculty of Medicine, Department of Nursing and Midwifery, University of Prishtina, Pristina, Kosovo
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Yılmaz M, Kıraç Y, Sahin MK. Sleep quality and related factors in a sample of Turkish healthcare workers during the COVID-19 pandemic: A cross-sectional study. Int J Clin Pract 2021; 75:e14813. [PMID: 34486780 PMCID: PMC8646597 DOI: 10.1111/ijcp.14813] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/28/2021] [Accepted: 09/03/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Increasing workloads and psychological pressure have led to fatigue among healthcare workers during the COVID-19 pandemic. Increasing stress and social isolation can also lead to sleep problems. The purpose of this study was to evaluate sleep quality and related factors among healthcare workers during the COVID-19 pandemic in Turkey. METHODS The data in this cross-sectional study were collected using an online questionnaire. This included sociodemographic data, the Multidimensional Scale of Perceived Social Support, the National Stressful Events Survey PTSD Short Scale and the Pittsburgh Sleep Quality Index. RESULTS Two hundred seventy-eight physicians, 104 nurses and 52 dentists were enrolled. The total prevalence of poor sleep quality was 56.7%. The prevalence of poor sleep quality was 67.3% in nurses, 55.4% in physicians and 42.3% in dentists. Poor sleep quality was more prevalent among women, nurses, hospital workers, frontline workers, individuals with <5 years of work experience, those with low social support and individuals with increased traumatic stress levels. High levels of social support and family social support were identified as protective factors against poor sleep quality. Multivariate regression analyses showed that poor sleep quality was significantly associated with working in hospitals and high traumatic stress levels during the COVID-19 pandemic. CONCLUSIONS Poor sleep quality was common among healthcare workers during the COVID-19 pandemic. Working in hospitals and high traumatic stress levels were identified as factors associated with poor sleep quality.
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Affiliation(s)
| | - Yıldız Kıraç
- Department of Family MedicineSchool of MedicineUniversity of Ondokuz MayısSamsunTurkey
| | - Mustafa Kursat Sahin
- Department of Family MedicineSchool of MedicineUniversity of Ondokuz MayısSamsunTurkey
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Shiri R, Karhula K, Turunen J, Koskinen A, Ropponen A, Ervasti J, Kivimäki M, Härmä M. The Effect of Using Participatory Working Time Scheduling Software on Employee Well-Being and Workability: A Cohort Study Analysed as a Pseudo-Experiment. Healthcare (Basel) 2021; 9:healthcare9101385. [PMID: 34683065 PMCID: PMC8544422 DOI: 10.3390/healthcare9101385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Shift workers are at increased risk of health problems. Effective preventive measures are needed to reduce the unfavourable effects of shift work. In this study we explored whether use of digital participatory working time scheduling software improves employee well-being and perceived workability by analysing an observational cohort study as a pseudo-experiment. Participants of the Finnish Public Sector cohort study with payroll records available between 2015 and 2019 were included (N = 2427). After estimating the propensity score of using the participatory working time scheduling software on the baseline characteristics using multilevel mixed-effects logistic regression and assigning inverse probability of treatment weights for each participant, we used generalised linear model to estimate the effect of using the participatory working time scheduling software on employees’ control over scheduling of shifts, perceived workability, self-rated health, work-life conflict, psychological distress and short sleep (≤ 6 h). During a 2-year follow-up, using the participatory working time scheduling software reduced the risk of employees’ low control over scheduling of shifts (risk ratio [RR] 0.34; 95% CI 0.25–0.46), short sleep (RR 0.70; 95% CI 0.52–0.95) and poor workability (RR 0.74; 95% CI 0.55–0.99). The use of the software was not associated with changes in psychological distress, self-rated health and work-life conflict. In this observational study, we analysed as a pseudo-experiment, the use of participatory working time scheduling software was associated with increased employees’ perceived control over scheduling of shifts and improved sleep and self-rated workability.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
- Correspondence:
| | - Kati Karhula
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Jarno Turunen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Aki Koskinen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Annina Ropponen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
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Low back pain and its correlations with poor sleep quality among health care providers. J Taibah Univ Med Sci 2021; 17:28-37. [PMID: 35140562 PMCID: PMC8801478 DOI: 10.1016/j.jtumed.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/08/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Methods Results Conclusion
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Qiu D, Li Y, Li L, He J, Ouyang F, Xiao S. Infectious Disease Outbreak and Post-Traumatic Stress Symptoms: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:668784. [PMID: 34421723 PMCID: PMC8376538 DOI: 10.3389/fpsyg.2021.668784] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/05/2021] [Indexed: 12/23/2022] Open
Abstract
Background: As one of the most widely researched consequence of traumatic events, the prevalence of post-traumatic stress symptoms (PTSS) among people exposed to the trauma resulting from infectious disease outbreak varies greatly across studies. This review aimed at examining the pooled prevalence of PTSS among people exposed to the trauma resulting from infectious disease outbreak, summarizing the possible causes of the inconsistencies in the current estimates. Methods: Systematic searches of databases were conducted for literature published on PubMed, EMBASE, Web of Science, the Cochrane Library, PsycArticles, and Chinese National Knowledge Infrastructure (CNKI) until 14 October 2020. Statistical analyses were performed using R software (registration number: CRD42020182366). Results: About 106 studies were included. The results showed that the pooled prevalence of PTSS among the general population exposed to the trauma resulting from infectious disease outbreak was 24.20% (95% CI: 18.54-30.53%), the pooled prevalence of PTSS among healthcare workers was 24.35% (95% CI: 18.38-1.51%), the pooled prevalence of PTSS among patients with infectious disease was 28.83% (95% CI: 18.53-44.86%), and the pooled prevalence of PTSS among suspected cases of infectious disease was 25.04% (95% CI: 18.05-34.73%). Mortality rate was a significant contributor to heterogeneity. Conclusions: Evidence suggests that PTSS were very common among people exposed to the trauma resulting from infectious disease outbreak. Health policymakers should consider both short-term and long-term preventive strategy of PTSS.
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Affiliation(s)
- Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Ling Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jun He
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Feiyun Ouyang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China
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Wang L, Peng D. Altered intrinsic brain activity in mild Alzheimer's disease patients with sleep disturbances. Neuroreport 2021; 32:942-948. [PMID: 34132706 DOI: 10.1097/wnr.0000000000001689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Sleep disturbances are one of the preventive factors to delay the onset and progression of Alzheimer's disease. Early identification of Alzheimer's disease patients prone to develop sleep disturbances to offer early medical intervention is important. Resting-state functional MRI is a widely used method to investigate the neural mechanisms and find neuroimaging biomarkers in neuropsychiatric diseases. In this study, we applied percent amplitude of fluctuation (PerAF) and mPerAF (divided by global mean PerAF) to test the strength of intrinsic brain activity in 38 mild Alzheimer's disease patients with sleep disturbances (ADSD) and 21 mild Alzheimer's disease patients without sleep disturbances (ADNSD). Compared with ADNSD, we found decreased intrinsic brain activity in the calcarine gyrus, the lingual gyrus, the fusiform gyrus extending to the parahippocampal gyrus, the precentral gyrus, the postcentral gyrus (all in the left hemisphere) and the left brainstem. Conclusively, ADSD exhibited reduced neural activity in specific brain regions related to the sensorimotor network and the visual network, which indicated the contribution of sleep disturbances to the progression of Alzheimer's disease. Especially, the ventral visual pathway to the hippocampus might serve for the memory impaired by sleep disturbances in Alzheimer's disease, and the brainstem might be critical in the initiation of sleep disturbances in Alzheimer's disease. These findings further elucidate the interactions between Alzheimer's disease and sleep disturbances and could help with the early recognition of Alzheimer's disease patients who tend to develop sleep disturbances.
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Affiliation(s)
- Lei Wang
- Peking University China-Japan Friendship School of Clinical Medicine
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - Dantao Peng
- Peking University China-Japan Friendship School of Clinical Medicine
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
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Yan Q, Qiu D, Liu X, Guo X, Hu Y. Prevalence of Smell or Taste Dysfunction Among Children With COVID-19 Infection: A Systematic Review and Meta-Analysis. Front Pediatr 2021; 9:686600. [PMID: 34414141 PMCID: PMC8369032 DOI: 10.3389/fped.2021.686600] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 07/15/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Smell and taste dysfunctions are common and have been reported as an early indicator of COVID-19. The prevalence of smell and taste dysfunctions among children with COVID-19 varies greatly across studies, which remains to be summarized quantitatively. This review aimed at examining the pooled prevalence of smell or taste dysfunctions among children with COVID-19, summarizing possible causes of the inconsistencies in the current estimates. Methods: Systematic searches of databases were conducted for literature published until 12 January 2021. Statistical analyses were performed using R software, the pooled prevalence was combined using random effects model. The Loney criteria were used for quality assessment. Results: A total of 18 eligible studies were included. The results showed that the pooled prevalence of smell dysfunction among children with COVID-19 was 15.97% (95% CI: 8.18-23.77%), the pooled prevalence of taste dysfunction among children with COVID-19 was 9.20% (95% CI: 4.25-14.16%), the pooled prevalence of smell or taste dysfunction among children with COVID-19 was 15.50% (95% CI: 10.30-20.70%) and the pooled prevalence of smell and taste dysfunction among children with COVID-19 was 20.21% (95% CI: 14.14-26.28%). Higher smell or taste dysfunction rates were associated with being female, younger age, smaller sample size, patients in Asia, and with comorbidities. Conclusions: Evidence suggests that smell or taste dysfunctions were common among children with COVID-19. Further research is needed to identify effective strategies for preventing and treating smell and taste dysfunctions among children with COVID-19.
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Affiliation(s)
- Qingzi Yan
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiang Liu
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
| | - Xiaolan Guo
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
| | - Yixiang Hu
- Department of Pharmacy, Xiangtan Central Hospital, Xiangtan, China
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45
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Al Maqbali M. Sleep disturbance among frontline nurses during the COVID-19 pandemic. Sleep Biol Rhythms 2021; 19:467-473. [PMID: 34230810 PMCID: PMC8247106 DOI: 10.1007/s41105-021-00337-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/18/2021] [Indexed: 11/30/2022]
Abstract
The main objective of this study is to assess the prevalence of sleep disturbance and related psychological factors (stress, anxiety and depression) among frontline nurses in Oman during the COVID-19 pandemic. A cross-sectional and descriptive correlational design using Qualtrics® software was used in this research. Data were collected using the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS). Logistic regression was performed to identify factors associated with poor sleep quality. Of the 987 frontline nurses who participated, 58.8% (n = 580) reported poor sleep quality. In an examination of PSQI components the mean sleep duration was 7.04 (SD = 1.59) hours per night, and the sleep latency mean was 38.18 min (SD = 31.81). Poor sleep (p < .05) was significantly associated with age, marital status, years of experience, comorbidity, and whether family members or relatives were suspected or confirmed with having COVID-19. Logistic regression showed that poor quality of sleep was significantly associated with stress, anxiety and depression symptoms. Sleep disturbance is a significant problem for frontline nurses working in Oman during the COVID-19 pandemic. Appropriate interventions to maintain the health conditions and reduce sleep disturbance among frontline nurses are needed in order to help support nurses' work during contagious disease outbreaks. These can be implemented through online workshops and training to enhance nurses' responses to the pandemic or to any further disease outbreaks.
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Affiliation(s)
- Mohammed Al Maqbali
- Department of Nursing Midwifery and Health, Northumbria University, Newcastle-Upon-Tyne, UK.,Al Buraimi Hospital Ministry of Health, Al Buraimi, Oman
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46
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Lyu X, Li K, Liu Q, Wang X, Yang Z, Yang Y, Yang Q, Wang H, Yuan N, Ji C, Kong F, Li W, Yin M, Li Z, Zou S, Zhao X, Fang X, Zhang C, Du X. Sleep status of psychiatric nurses: A survey from China. Nurs Open 2021; 9:2720-2728. [PMID: 34198365 PMCID: PMC9584482 DOI: 10.1002/nop2.972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/26/2021] [Accepted: 06/02/2021] [Indexed: 12/02/2022] Open
Abstract
Aim Our study aimed to evaluate the sleep status of psychiatric nurses in Chinese population and analyse the influencing factors. Design Cross‐sectional, correlation design with logistic regression analysis. Methods We investigated 1,044 psychiatric nurses from seven psychiatric hospitals in China. Pittsburgh Sleep Quality Index and Maslach Burnout Inventory General Survey were used as main measures. Results The average Pittsburgh Sleep Quality Index score of 1,044 psychiatric nurses was 7.00 ± 3.59, and 38.63% of nurses had a total Pittsburgh Sleep Quality Index score >7. Our study found that middle‐night shift nurses had poor sleep quality and sleep disorders are positively correlated with emotional exhaustion and cynical disregard for job burnout. Middle‐night shift nurses showed 1.586 times more likely to suffer from sleep disorders than those non‐middle‐night shift. The higher the score of emotional exhaustion, the greater the risk of sleep disorders.
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Affiliation(s)
- Xiaoli Lyu
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Kan Li
- Jiangxi Mental Hospital, Nanchang, China
| | - Qin Liu
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xinda Wang
- TaiCang Third People's Hospital, Taicang, China
| | - Zhong Yang
- The Third People's Hospital of Changshu, Changshu, China
| | - Yang Yang
- Mental Hospital of Yunnan Province, Kunming, China
| | - Qun Yang
- Nanchong Psychosomatic Hospital, Nanchong, China
| | - Hao Wang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Nian Yuan
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Caifang Ji
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Fanzhen Kong
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Weiqin Li
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ming Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Siyun Zou
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xueli Zhao
- Department of Emergency, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaojia Fang
- Department of Emergency, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Caiyi Zhang
- Department of Emergency, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
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Yue L, Zhao R, Xiao Q, Zhuo Y, Yu J, Meng X. The effect of mental health on sleep quality of front-line medical staff during the COVID-19 outbreak in China: A cross-sectional study. PLoS One 2021; 16:e0253753. [PMID: 34166474 PMCID: PMC8224907 DOI: 10.1371/journal.pone.0253753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 06/13/2021] [Indexed: 02/05/2023] Open
Abstract
Background The 2019 coronavirus disease (COVID-19) pandemic is a public health emergency of international concern and poses a challenge to the mental health and sleep quality of front-line medical staff (FMS). The aim of this study was to investigate the sleep quality of FMS during the COVID-19 outbreak in China and analyze the relationship between mental health and sleep quality of FMS. Methods From February 24, 2020 to March 22, 2020, a cross-sectional study was performed with 543 FMS from a medical center in Western China. A self-reported questionnaire was used to collect data anonymously. The following tests were used: The Self-Rating Anxiety Scale (SAS) for symptoms of anxiety, the Beck Depression Inventory (BDI) for depressive symptoms, and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality assessment. Results Of the 543 FMS, 216 (39.8%) were classified as subjects with poor sleep quality. Anxiety (P<0.001), depression (P<0.001), and the prevalence of those divorced or widowed (P<0.05) were more common in FMS with poor sleep quality than in participants with good sleep quality. The FMS exhibiting co-occurrence of anxiety and depression were associated with worse scores on sleep quality than those medical staff in the other three groups/categories. The difference in sleep quality between the FMS with only depression and the FMS experiencing co-occurrence of anxiety and depression was statistically significant (P<0.05). However, there was no significant difference in sleep quality between the FMS experiencing only anxiety and the FMS with co-occurrence of anxiety and depression (P > 0.05). Conclusions During the COVID-19 pandemic, there was a noteworthy increase in the prevalence of negative emotions and sentiments among the medical staff, along with poor overall sleep quality. We anticipate that this study can stimulate more research into the mental state of FMS during outbreaks and other public health emergencies. In addition, particular attention must be paid to enhance the sleep quality of FMS, along with better planning and support for FMS who are continuously exposed to the existing viral epidemic by virtue of the nature of their profession.
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Affiliation(s)
- Leiyu Yue
- West China School of Nursing, Sichuan University/Department of Mental Health Centre, West China Hospital, Sichuan University, Chengdu, PR China
| | - Rui Zhao
- Geriatric Psychiatric Ward 2, The Fourth People's Hospital of Chengdu, Chengdu, PR China
| | - Qingqing Xiao
- West China School of Nursing, Sichuan University/Department of Mental Health Centre, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yu Zhuo
- West China School of Nursing, Sichuan University/Department of Mental Health Centre, West China Hospital, Sichuan University, Chengdu, PR China
| | - Jianying Yu
- West China School of Nursing, Sichuan University/Department of Mental Health Centre, West China Hospital, Sichuan University, Chengdu, PR China
| | - Xiandong Meng
- West China School of Nursing, Sichuan University/Department of Mental Health Centre, West China Hospital, Sichuan University, Chengdu, PR China
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Alimoradi Z, Broström A, Tsang HW, Griffiths MD, Haghayegh S, Ohayon MM, Lin CY, Pakpour AH. Sleep problems during COVID-19 pandemic and its' association to psychological distress: A systematic review and meta-analysis. EClinicalMedicine 2021; 36:100916. [PMID: 34131640 PMCID: PMC8192091 DOI: 10.1016/j.eclinm.2021.100916] [Citation(s) in RCA: 185] [Impact Index Per Article: 61.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The emerging novel coronavirus disease 2019 (COVID-19) has become one of the leading cause of deaths worldwide in 2020. The present systematic review and meta-analysis estimated the magnitude of sleep problems during the COVID-19 pandemic and its relationship with psychological distress. METHODS Five academic databases (Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and Embase) were searched. Observational studies including case-control studies and cross-sectional studies were included if relevant data relationships were reported (i.e., sleep assessed utilizing the Pittsburgh Sleep Quality Index or Insomnia Severity Index). All the studies were English, peer-reviewed papers published between December 2019 and February 2021. PROSPERO registration number: CRD42020181644. FINDINGS 168 cross-sectional, four case-control, and five longitudinal design papers comprising 345,270 participants from 39 countries were identified. The corrected pooled estimated prevalence of sleep problems were 31% among healthcare professionals, 18% among the general population, and 57% among COVID-19 patients (all p-values < 0.05). Sleep problems were associated with depression among healthcare professionals, the general population, and COVID-19 patients, with Fisher's Z scores of -0.28, -0.30, and -0.36, respectively. Sleep problems were positively (and moderately) associated with anxiety among healthcare professionals, the general population, and COVID-19 patients, with Fisher's z scores of 0.55, 0.48, and 0.49, respectively. INTERPRETATION Sleep problems appear to have been common during the ongoing COVID-19 pandemic. Moreover, sleep problems were found to be associated with higher levels of psychological distress. With the use of effective programs treating sleep problems, psychological distress may be reduced. Vice versa, the use of effective programs treating psychological distress, sleep problems may be reduced. FUNDING The present study received no funding.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Hector W.H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Shahab Haghayegh
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Maurice M. Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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49
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Qiu D, Li Y, Li L, He J, Ouyang F, Xiao S. Prevalence of post-traumatic stress symptoms among people influenced by coronavirus disease 2019 outbreak: A meta-analysis. Eur Psychiatry 2021; 64:e30. [PMID: 33843547 PMCID: PMC8060540 DOI: 10.1192/j.eurpsy.2021.24] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/04/2021] [Accepted: 04/02/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND As one of the most widely researched consequence of traumatic events, the prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from coronavirus disease 2019 (COVID-19) outbreak varies greatly across studies. This review aimed at examining the pooled prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from COVID-19 outbreak. METHODS Systematic searches of databases were conducted for literature published on PubMed, EMBASE, Web of Science, the Cochrane Library, PsycArticle, and Chinese National Knowledge Infrastructure until October 14, 2020. Statistical analyses were performed using R software (PROSPERO registration number: CRD42020180309). RESULTS A total of 106,713 people exposed to the trauma resulting from the COVID-19 outbreak were identified in the 76 articles, of which 33,810 were reported with post-traumatic stress symptoms. The pooled prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from COVID-19 outbreak was 28.34%, with a 95% confidence interval of 23.03-34.32%. Subgroup analysis indicated that older age, male and bigger sample size were associated with higher prevalence of post-traumatic stress symptoms. After controlling for other factors, the results of meta-regression showed that the influence of gender and sample size on prevalence is no longer significant. CONCLUSIONS Symptoms of post-traumatic stress disorder (PTSD) were very common among people exposed to the trauma resulting from COVID-19 outbreak. Further research is needed to explore more possible risk factors for post-traumatic stress symptoms and identify effective strategies for preventing PTSD-related symptoms among people exposed to the trauma resulting from COVID-19 outbreak.
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Affiliation(s)
- Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Ling Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jun He
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Feiyun Ouyang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Mental Health Institute, Second Xian gya Hospital, Central South University, Changsha, Hunan, China
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50
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Lu L, Lok KI, Zhang Q, Zhang L, Xiang Y, Ungvari GS, Hall BJ, An FR, Xiang YT. Sleep disturbance and its association with quality of life among psychiatric nurses in China. PeerJ 2021; 9:e10659. [PMID: 33643702 PMCID: PMC7896499 DOI: 10.7717/peerj.10659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/07/2020] [Indexed: 12/23/2022] Open
Abstract
Background Sleep disturbance is associated with a number of negative adverse outcomes. This study examined the prevalence of sleep disturbance and its association with demographic and clinical characteristics and quality of life (QOL) in psychiatric nurses in China. Methods This is a multi-center, cross-sectional study involving 11 psychiatric hospitals in China. Three types of sleep disturbance (difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS) and early-morning awakening (EMA)) and QOL were measured by standardized questions or instruments. Results A total of 1,847 psychiatric nurses participated. The overall prevalence of at least one type of sleep disturbance was 71.5% (95% CI [69.3–73.5]); the prevalence of DIS, DMS and EMA was 58.5% (95% CI [56.2–60.8]), 53.7% (95% CI [51.4–56.0]) and 54.6% (95% CI [52.3–56.9]), respectively. Nurses with sleep disturbance had significantly lower QOL in physical (F(1, 1,846) = 219.12, P < 0.001), psychological (F(1, 1,846) = 72.18, P < 0.001), social (F(1, 1,846) = 37.57, P < 0.001) and environmental domains (F(1, 1,846) = 95.45, P < 0.001). Multivariable logistic regression analyses revealed that shift work (DIS, OR = 1.6, 95% CI [1.28–1.98]; DMS, OR = 1.2, 95% CI [1.001–1.54]; EMA, OR = 1.3, 95% CI [1.02–1.58]) and alcohol use (DIS, OR = 1.8, 95% CI [1.46–2.32]; DMS, OR = 1.8, 95% CI [1.43–2.23]; EMA, OR = 1.7, 95% CI [1.33–2.07]) were positively associated with sleep disturbance, while higher monthly income (DIS, OR = 0.5, 95% CI [0.38–0.75]; DMS, OR = 0.7, 95% CI [0.51–0.98]) was negatively associated with sleep disturbance. Conclusion Sleep disturbance was common among nurses in psychiatric hospitals in China, particularly those on shifts and having alcohol use. Health authorities should develop effective measures to reduce risk of sleep disturbance in this population.
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Affiliation(s)
- Li Lu
- Center for Cognition and Brain Sciences, University of Macau, Macau SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.,Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Ka-In Lok
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yifan Xiang
- Pui Ching Middle School Macau, Macao SAR, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia.,University of Notre Dame Australia, Fremantle, WA, Australia
| | - Brian J Hall
- Global and Community Mental Health Research Group, New York University (Shanghai), Shanghai, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Center for Cognition and Brain Sciences, University of Macau, Macau SAR, China.,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
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