Sleep quality status, anxiety, and depression status of nurses in infectious disease department

Relationship between shift type and sleep quality in rotating-shift nurses with chronotype as a moderator variable

BACKGROUND

Rotating-shift nurses are susceptible to sleep disorders due to numerous factors, such as their biological clock, emotions, and age. At present, a lack of research exists on whether chronotype and shift type jointly influence the sleep quality of nurses.

AIM

To verify whether chronotype is a moderator variable of the relationship between shift type and sleep quality in nurses in order to provide empirical evidence for future mental and physical health improvement.

METHOD

Clinical rotating-shift nurses at a medical center in northern Taiwan were recruited as participants between November 1, 2023, and December 13, 2023. All of the nurses were working a monthly rotating shift schedule. Hierarchical multiple regression analysis was employed to investigate whether the influence of shift type on sleep quality in nurses varied with chronotype. The STROBE checklist was used for reporting this study.

RESULTS

The participants were 255 rotating-shift nurses in this study. Hierarchical multiple regression results revealed that rotating-shift nurses who were older (B = 0.19, p = 0.029), had greater physical fatigue (B = 0.27, p = 0.016), and had more negative emotions (B = 0.17, p = 0.011) suffered from poorer sleep quality. After controlling the above factors, we further found that chronotype indeed had moderating effects on the influence of shift type on sleep quality (B = -1.83, p = 0.049).

CONCLUSIONS

This study demonstrates that early- and intermediate-type nurses are more suitable for working the day and evening shifts, whereas late-type nurses are more suitable for working the night shift.

IMPLICATION FOR NURSING AND HEALTH POLICY

Coordinating chronotype with shift type will ensure that shift schedules better match the biological clocks of nurses; such individual considerations could help to improve their sleep quality.

Anxiety and burnout in infectious disease nurses: the role of perceived stress and resilience

BACKGROUND

Nurses serving in infectious disease ward represent a distinct occupational group that has attracted considerable attention following epidemic outbreaks. However, prior to this study, no research had delved into the underlying mechanism linking anxiety to burnout symptoms among infectious disease nurses. This study aimed to explore investigate the association between anxiety and burnout among nurses working in such environments and scrutinized the mediating role of perceived stress and the moderating influence of resilience on the principal relationship.

METHODS

Employing a cross-sectional study using a web-based design, data were collected from 1,579 clinical nurses working in infectious disease ward across 50 hospitals in China. Participants responded to questionnaires assessing anxiety, perceived stress, resilience and burnout. Statistical analyses encompassed descriptive statistics, one-way analyses of variance, independent-samples t-tests, Pearson correlations, and bootstrapping techniques to evaluate the indirect and moderating effects.

RESULTS

The study revealed that 62.13% of the respondents reported high levels of burnout, and 55.92% experienced moderate to high degrees of emotional exhaustion among infectious disease nurses. Significant correlations were observed between anxiety, perceived stress, resilience, and each component of burnout (P < 0.05). Notably, the mediating effect of perceived stress was accounting for 30.61% of the relationship between anxiety and burnout. Simple slope analysis demonstrated that perceived stress significantly predicted emotional exhaustion at both low (B = 0.854, t = 16.586, and P < 0.001) and high (B = 0.498, t = 9.503, and P < 0.001) levels of resilience. The perceived stress and emotional exhaustion were more serious when resilience levels were lower.

CONCLUSION

Anxiety was identified as a critical risk factor for burnout among nurses in infectious disease units. The relationship between anxiety and burnout was markedly affected by the levels of perceived stress and resilience. Specifically, the deleterious impact of perceived stress on burnout was amplified in nurses with diminished resilience relative to those with heightened resilience. Based on these findings, it is imperative to allocate resources for stress management programs and resilience training. Such initiatives would bolster support for nurses in infectious disease wards, ultimately enhancing their job satisfaction and well-being.

Heterogeneity in sleep problems and suicide risk among adults with depression: a cross-sectional study

In this paper, we investigated the relationship between different levels of sleep and the risk of suicide among depressive patients. The sample consisted of 301 adults with depression who were recruited from a hospital in Ningxia, China. The Pittsburgh Sleep Quality Index (PSQI) and the Self-Rating Depression Scale (SDS) were applied to evaluate the quality of sleep and the degree of depression. The Suicidal Risk Factor Assessment Form evaluated suicide risk. A Latent Class Analysis (LCA) has been performed with MPLUS 7.0 to investigate the most probable category of the PSQI sub-scales. Multivariate Logistic Regression was applied to analyse the relation between Sleep Quality and Suicide Hazard in Adult Depressive Patients. Classes identified were "Global sleep impairment", "Poor sleep quality", "Short sleep duration" and "Good sleep quality." Patients with poor overall sleep quality and clear daytime dysfunction had a higher risk of suicide than those with good sleep quality. The results are helpful in understanding the relationship between the variability of sleep patterns and the risk of suicide among depressed people, and it is suggested that some sleep variables may have a higher predictive value than others. The results will provide guidance on how to improve and implement therapy for depressive disorders in adults, and to lower suicidal rates.

Prevalence and factors associated with the poor quality of sleep among Indian nurses

BACKGROUND

Nursing health workers deal with a variety of issues that may have an unfavorable influence on their capability to peaceful sleep. The consequences of poor quality of the sleep can lead to increased fatigue, decreased concentration, and a higher risk of medical and nursing errors. The purpose of this research study was to determine in the occurrence and associated factors for poor quality of the sleep among Indian nurses.

MATERIALS AND METHODS

The participants in this cross-sectional study were selected by the use of a multi-stage sampling technique. A total of 25 hospitals (across 4 zones) were randomly sampled. A total of 850 (out of 1250) nurses participated in the study. To collect socio-demographic data, a self-administered questionnaire was employed. PSQI scale was implemented to assess quality of sleep, and the other scale of DASS-21 was used to assess mental well-being.

RESULTS

The majority of nurses had mild (6-7 hours) as well as moderate (5-6 hours) levels of difficulty in the duration of sleep time. The occurrence of poor quality of the sleep in nursing professionals is high. 9.2% had depression, 13.7% had anxiety, and 18.9% faced, which appears to be linked to insufficient sleep in the adjusted model. In the univariate study, additional night shifts and additional shift hours were substantially related to insufficient sleep.

CONCLUSION

Nurses' quality of sleep is substantially hampered due to various reasons, and nurse mangers should devise the framework to avoid its harmful effects and to provide desirable management and high-quality patient care.

Characterising Potential Subtypes and Influencing Factors of Sleep Quality in Psychiatric Nurses by Latent Profile Analysis

Background

Sleep is a crucial factor affecting an individual's physical and mental health. Psychiatric nurses work under high stress and load, and it is necessary to understand the sleep quality of psychiatric nurses and the influencing factors. However, individual-centred studies of psychiatric nurses' sleep are limited.

Aims

To explore the heterogeneity in sleep quality among psychiatric nurses, to identify the factors influencing different subtypes, and to provide targeted strategies and measures to improve their sleep quality.

Methods

From August to October 2022, 298 psychiatric nurses working in a mental health centre in Liaoning Province were selected as the participants. The study involved administering the following two questionnaires: the general information questionnaire and the Pittsburgh Sleep Quality Index (PSQI). Data analyses included latent profile analysis, Kruskal-Wallis H test, and multiple logistic regression.

Results

The prevalence of poor sleep quality (PSQI >5) among psychiatric nurses was 54.7%. The sleep quality of psychiatric nurses could be classified into the following three distinct profiles: good sleep quality, moderate sleep quality, and poor sleep quality. Nurses who were over 40 years of age, unmarried/divorced/separated/widowed, worked more than 40 hours per week, experienced significant life events in the past year, had poor nurse-patient relationships, and had chronic diseases were more likely to have poorer sleep quality.

Conclusions

There was significant heterogeneity in sleep quality among psychiatric nurses. Age, marital status, work schedule, total weekly working hours, night shifts, special life events, nurse-patient relationships, and chronic diseases were associated with their sleep quality. Implications. The heterogeneity and influencing factors of sleep quality in psychiatric nurses provided evidence for individualized interventions in the future. This trial is registered with ChiCTR2200062347.

Latent class analysis of the sleep quality of night shift nurses and impact of shift-related factors on the occupational stress and anxiety

AIMS

The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift-related factors predispose nurses to higher levels of occupational stress and anxiety.

DESIGN

This is a cross-sectional study.

METHODS

From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety.

RESULTS

The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non-Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night-shift frequency of 3-4 times per month, night-shift durations of 9-12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift-related factors that increased the levels of occupational stress and anxiety.

CONCLUSION

The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety.

IMPACT

By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well-being and work schedules.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Sleep quality and mental health among Chinese nurses after the COVID-19 pandemic: A moderated model

INTRODUCTION AND AIMS

In the specialized nursing setting, nurses are susceptible to developing negative mental health issues. Such conditions among nurses can potentially result in unfavorable medical outcomes. Consequently, this study aims to explore the role of social support in regulating between sleep and mental health in nurses.

METHODS

A cross-sectional study was carried out in September 2022 on 1219 nurses in Quanzhou. The study comprised general demographic information and utilized various questionnaires, namely the Social Support Rate Scale (SSRS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Generalized Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). The data analysis was performed using t-tests, ANOVAs, Pearsons correlations and hierarchical regression analyses in SPSS software.

RESULTS

Results show that significant associations of sleep quality and social support with anxiety and depression. Simple slope analysis shows that under low levels of social support, sleep quality has a positive impact on anxiety(β = 0.598) and depression(β = 0.851), and the impact is significant. Under high levels of social support, sleep quality also has a positive impact on anxiety(β = 0.462) and depression(β = 0.578), but the impact is smaller. This indicates that as the level of social support increases, the positive predictive effect of sleep quality on anxiety and depression gradually diminishes.

CONCLUSIONS

Social support has the potential to alter the impact of sleep quality on anxiety and depression. Therefore, healthcare policymakers need to focus on enhancing the level of social support and mitigating the impact of poor sleep on anxiety and depression.

The association of spousal depressive symptoms and cognitive function among older adults: mediation and moderated mediation analyses

OBJECTIVES

To test whether contagious depressive symptoms mediate the association between spousal depressive symptoms (spousal-DS) and the other spouse's cognitive function, and test the moderated mediation of social activities engagement and sleep quality.

STUDY DESIGN

A total of 3,230 adults aged ≥60 and one of his/her close relatives were interviewed in 2016 in Xiamen, China.

METHODS

Cognitive function and depressive symptoms were measured by MoCA and GDS-15/CES-D-10, respectively. Social activities engagement and sleep quality were self-reported. Mediation and moderated mediation were tested by PROCESS macro with 5000 bootstrapping re-samples.

RESULT

Among all, 1,193 pairs were husband-wife with complete information and were included. The mean ages of older adults and their spouses were 68.35 ± 6.53 and 66.53 ± 7.91 years, respectively. The mean MoCA and GDS-15 scores for older adults were 22.21 ± 5.45 and 1.73 ± 2.17, respectively. The average score of CES-D-10 for spouses was 14.18 ± 4.77. Spousal-DS were associated with cognitive functions of older adults via the contagious depressive symptoms (indirect effect: -0.048, 95% confidence interval (CI): (-0.075, -0.028)). Such mediation can be buffered by attending social activities (interaction: -0.062, 95% CI: (-0.111, -0.013)) and improving sleep quality (interaction: -0.034, 95% CI: (-0.057, -0.012)).

CONCLUSION

Cognitive function of older adults was associated with his/her spouse's depressive symptoms, and the association was mediated by contagious depressive symptoms and moderated by social activities as well as sleep quality.

The relationship between sleep quality and anxiety and depression among older caregivers of centenarians in China: A cross-sectional study

To explore the relationship between sleep quality and anxiety and depression in older caregivers. From April 2020 to November 2022, GAD-7, GDS-15, and PSQI were used to measure anxiety, depression, and sleep quality. The correlation of each variable was explored by regression analysis. Among 442 caregivers ≥ 65 years old, the prevalence of sleep disorders, anxiety, and depression was 40.5 %, 20.2 %, and 26.4 %. After adjustment for multiple potential confounders, anxiety (OR1.1; 95 % CI 1-1.2) and depression (OR 1.29; 95 % CI 1.21-1.38) were associated with sleep disorders. Daytime dysfunction components of PSQI measurements were associated with anxiety(P < 0.05). Meanwhile, sleep efficiency, sleep medication use, and daytime dysfunction components of PSQI measurements were associated with depression(P < 0.05). Therefore, the sleep quality of older caregivers is strongly related to anxiety and depression. It is necessary to provide sleep guidance or professional intervention for older caregivers to reduce anxiety and depression.

Neuropsychiatric Adverse Events Following Antiretroviral Therapy in People Living with HIV: A Real-World Study of Dynamic Trends and Risk Factors in Hangzhou, China

Purpose

Neuropsychiatric adverse events (NPAEs) occur frequently in people living with human immunodeficiency virus (PLWH) receiving antiretroviral therapy (ART). This study aimed to assess the dynamic trends and risk factors of NPAEs among PLWH in Hangzhou taking efavirenz (EFV)- or dolutegravir (DTG)- or elvitegravir (EVG)-based regimens.

Patients and Methods

A total of 287 ART-naive PLWH were included in this study, EFV (400mg)- (n = 122), EFV (600mg)- (n = 37), DTG- (n = 73), EVG-based (n = 47) and other ART regimens (n = 8) as the initial ART regimen were administered for 12 months. All data were collected at five time points within a 12-month follow-up. The Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale were used to evaluate sleep disorders and anxiety and depression symptoms, respectively. The dynamic trends and potential risk factors of NPAEs were investigated using a generalized linear mixed model.

Results

Mean age was 29.4 (SD: 7.5) years with 97.2% males. After 12 months of ART, the prevalence of sleep disorders and anxiety decreased significantly, although only a slight improvement was observed for depression. In addition, there was a significant positive correlation between sleep disorders, anxiety, and depression. The risk factors for NPAEs differed slightly depending on the choice of ART regimen, but the seven factors most commonly associated with NPAEs were age, sex, marital status, education level, smoking status, body mass index, and WHO clinical stage. Treatment-induced changes in CD4-positive T-cell count and virological suppression did not depend on the particular choice of ART regimen.

Conclusion

The prevalence of sleep disorders and anxiety changed significantly over time on ART and the risks of these disorders were associated with seven common clinical and demographic factors.