Sleep quality and associated factors among nurses working at comprehensive specialized hospitals in Northwest, Ethiopia

The Relationship Between Sleep Quality and the Risk of Medication Errors in Nurses Working in Surgical Wards: A Multicenter Study

AIM

Determination of the relationship between sleep quality and the risk of medication errors in nurses working in surgical services.

METHODS

This multicenter, descriptive and correlational study was conducted with 192 nurses working in surgical wards of all training and research hospitals in Ankara, the capital of Türkiye, between January and December 2023. Data were collected using the "Nurse Information Form," "Pittsburgh Sleep Quality Index," "Epworth Sleepiness Scale," and "Medication Administration Error Scale." The suitability of numerical variables for normal distribution was examined graphically and with the Shapiro-Wilk test. Additionally, Mann-Whitney test, Kruskal-Wallis, Bonferroni, and Spearman's Rank Correlation Coefficient tests were used in the analyses. The STROBE checklist was followed in writing the study.

RESULTS

The median age of nurses was 27.0 (IQR = 8.0) years, and 38.5% were in the 21-25 age group. Among the nurses, 81.3% stated that they had sleep problems due to working hours, and 44.3% stated that they made medication errors due to insomnia. The nurses' Pittsburgh Sleep Quality Index total score median was 12.00 (IQR = 9.00), Epworth Sleepiness Scale score was 11.00 (IQR = 8.75), and Medication Administration Error Scale score was 85.00 (IQR = 25.75). No statistically significant relationship was found between nurses' Epworth Sleepiness Scale and Medication Administration Error Scale scores (rs = 0.042; p = 0.565). A statistically significant low-level relationship was found between the nurses' Epworth Sleepiness Scale score and the total Pittsburgh Sleep Quality Index score (rs = 0.387; p < 0.001). Statistically significant weak and very weak relationships were found between Medication Administration Error Scale and subjective sleep quality, sleeping pill use, and daytime dysfunction (p < 0.05).

CONCLUSION

The study found that nurses had poor sleep quality and daytime sleepiness. It was determined that nurses with sleep problems were at a higher risk of making medication errors.

PUBLIC CONTRIBUTION

Based on these results, it is recommended that nurses' working hours be planned to support their sleep patterns, and nurses be provided with adequate rest time during shift work hours. Additionally, nurses should be educated about sleep hygiene and the effects of sleep disorders, and more research should be conducted to understand the causes of medication errors and develop preventive strategies.

RELEVANCE TO CLINICAL PRACTICE

The basic principle of healthcare is to "do no harm." Among healthcare professionals, nurses have great responsibility in preventing medical errors. However, the excessive workload, high number of patients under their care, and working in a day-night shift system lead to fatigue and sleep deprivation. Sleep problems increases their tendency to make mistakes. This study aims to contribute evidence to the literature on the impact of sleep problems on medication errors.

Prevalence and Associated Factors of Poor Sleep Quality Among Nurses in a Tertiary Care Hospital: A Cross-Sectional Study

Background

Poor sleep quality among nurses negatively impacts job performance, patient care, and mental well-being, leading to compromised cognitive ability, decision-making, and increased errors, which ultimately jeopardize patient care and safety. This study aimed to determine the prevalence of poor sleep quality and its associated factors among nurses at a tertiary care hospital in Mogadishu, Somalia.

Methods

A cross-sectional study was conducted among nurses working at a tertiary care hospital between May and August 2024. Data were collected using a standardized questionnaire, which included socio-demographic information, the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety, and Stress Scale (DASS-21), and the Oslo Social Support Scale (OSSS-3). Bivariate and multivariate logistic regression analyses were used to identify risk factors for poor sleep quality. A p-value of 0.05 was considered the threshold for statistical significance.

Results

A total of 280 nurses participated in the study, with 45.7% (95% CI: 39.8-51.7) reporting poor sleep quality. The odds of reporting poor sleep quality were higher among female nurses (AOR = 2.68; 95% CI: 1.35-5.32), those working night shifts (AOR = 4.76; 95% CI: 2.06-11.02), those with poor social support (AOR = 2.82; 95% CI: 1.09-7.27), and those experiencing depression (AOR = 5.35; 95% CI: 2.22-12.88), anxiety (AOR = 5.58; 95% CI: 2.61-11.92), and stress (AOR = 3.92; 95% CI: 1.11-13.90).

Conclusion

This study revealed a significantly high prevalence of poor sleep quality among nurses. These findings underscore the importance of addressing sleep quality as a key component of nursing well-being. It is recommended that nursing managers assess both the mental and physical health of their staff, implement targeted interventions such as stress management and counseling, and develop workplace strategies to improve sleep, including flexible scheduling and education on sleep hygiene.

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.

The relationship between sleep quality and resilience among intensive care unit nurses: A cross-sectional study

Resilience is essential for intensive care unit (ICU) nurses, but poor sleep quality negatively affects their well-being and performance. This study analysed the link between sleep quality and resilience among 138 ICU nurses, considering socio-demographic variables (age, sex, education, professional experience). Data showed high rates of poor sleep (56.5%) and low and average resilience (84%). No significant relationship between socio-demographic variables and resilience or sleep quality was found, but a moderate negative correlation between sleep quality and resilience was identified (r = -.30; p < .001). Interventions to improve sleep and resilience are needed to enhance ICU nurses' well-being and performance. Increasing the level of resilience among ICU nurses is an important health-related protective factor. Moreover, an increase in resilience can enhance work commitment and improve their abilities to cope with many problems, ultimately contributing to their development.

Regional and Sectorial Distribution of Cardiovascular Risk Factors Among Sub-Saharan Africa Workforce: A Systematic Review

The sub-Saharan African region is currently experiencing an unprecedented cardiovascular disease (CVD) epidemic, with CVD accounting for the highest mortality among adults in the region. Changing demographic profiles, lifestyle choices, and preferences for corporate work are identified as root causes of the CVD epidemic in sub-Saharan Africa (SSA). The primary objective of this study was to determine the prevalence of CV risk factors among different regions, countries, and work sectors in SSA. The secondary objective is to identify the work sector with the highest cluster or aggregate of CV risk factors in SSA. This systematic review reports the prevalence of CV risk factors among corporate workers in SSA between 2010 and 2024. Reputable platforms, such as the Cochrane Library, Google Scholar, PubMed, Medline, and Science Direct, were searched for relevant data. A total of 105 studies involving 76,027 participants from nine countries were analyzed. East Africa, Central Africa, West Africa, and Southern Africa had the highest prevalence of unhealthy diet (100%), physical inactivity (80%), high BMI (76%), and metabolic syndrome (MS) (55%), respectively. Ethiopia and South Africa had the highest prevalence of unhealthy diet (100%) and MS (55%), respectively, while Nigeria had the highest prevalence of both stress (71%) and poor sleep (79%). The healthcare work sector had the highest cluster of CV risk factors and the highest prevalence of unhealthy diet (80%), central obesity (51%), and high total cholesterol (36%); the education sector ranked highest in physical inactivity (75%); the administration sector ranked highest in current tobacco smoking (27%) and dysglycemia (17%); and the finance sector workers had the highest prevalence of stress (62%). The prevalence of most risk factors among the corporate workforce in SSA is high, with significant distribution variation across different regions, countries, and work sectors.

Sleep quality, coping, and related depression: A cross-sectional study of Turkish nurses

BACKGROUND

The sleep quality of nurses affects both their health and standard of nursing care. Working conditions, depression, and coping potential can also lead to sleep problems.

INTRODUCTION

Sleep plays a crucial role in overall health at every stage of life. The purpose of this study is to determine the effect of sleep quality, depression, and coping mechanisms on the performance of nurses, whose sleep quality is strongly affected due to shift-based work.

METHODS

The sample of this descriptive correlational study consisted of 133 healthcare workers. Data were collected using the Personal Information Form, Beck Depression Inventory (BDI), Coping Response Inventory (CRI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) and evaluated using the t test, Mann-Whitney U test, one-way ANOVA, Enter method, and linear regression.

FINDINGS

One in three nurses reported having poor-quality sleep, and one in two nurses said they felt sleepy during the day. With declining sleep quality, the nurses' ability to cope with stress diminished, and their degree of depression increased.

DISCUSSION

The nurses' financial situation and level of depression were key factors that influenced their quality of sleep and capacity to handle stress. To improve nurses' sleep, the shift pattern needs to change.

CONCLUSION

To increase the quantity of sleep and enhance mental health, changes should be made to the shift schedules of nurses to allow for appropriate rest and reduce daytime sleepiness.

IMPLICATIONS FOR NURSING PRACTICE AND POLICIES

Improved working conditions for nurses and updated nursing standards are required to improve nurses health and wellbeng.

Prevalence and Mitigation of Cardiovascular Disease Risk Factors Among the Corporate Workforce in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Cardiovascular disease (CVDs) is the leading cause of mortality worldwide. Corporate workplaces have been identified as important environmental factors that can increase the risk and severity of CVDs. Evidence indicates that the risk and severity of CVDs can be effectively reduced by mitigating modifiable behavioural and intermediate risk factors. Although the prevalence of CVDs and their associated risk factors is increasing in sub-Saharan Africa (SSA), most published data from the region are hospital-based and may not be true estimates. This study investigated the prevalence and distribution of CVD risk factors among the corporate workforce in SSA and the effects of workplace wellness programmes (WWP) on these risk factors. Accordingly, a systematic search was performed using Google Scholar, Cochrane Library, PubMed, MEDLINE, Scopus and Science Direct for articles published between January 2010 and March 2024. A total of 105 studies (n = 76,027) across nine countries met the eligibility criteria and were analysed. The pooled prevalence of the risk factors was unhealthy diet (80%), high salt intake (32%), stress (58%), poor sleep (59%), physical inactivity (PI, 59%), alcohol consumption (29%), harmful alcohol consumption (26%), tobacco smoking (7%), khat chewing (6%), overweight (36%), obesity (23%), central obesity (44%), high blood pressure (29%), high total cholesterol (33%), high low-density lipoprotein cholesterol (LDL-c) (41%), low high-density lipoprotein cholesterol (HDL-c) (45%), hypertriglyceridaemia (17%), dysglycaemia (9%), and metabolic syndrome (MS; 45%). The highest prevalence of unhealthy diet and PI was recorded in East Africa and Central Africa, respectively, whereas West Africa had the highest prevalence of high body mass index (BMI). Ethiopia had the highest prevalence of unhealthy diets, whereas Nigeria had the highest prevalence of stress and poor sleep. The healthcare sector had the highest cluster of risk factors and the highest prevalence of unhealthy diets. Only 5.7% of the studies implemented WWP, which had significant mitigating effects on most risk factors. This study concluded that the prevalence of most modifiable CVD risk factors is high among the corporate workforce in SSA, which is higher than that in the general population in most cases, and a well-designed WWP can significantly mitigate these risk factors.

Psychosocial Risk Factors at Work and Sleep Quality in Healthcare Workers - A Cross-Sectional Study

Objective  To investigate psychosocial factors at work, sleep characteristics, and the correlation between these aspects in healthcare workers. Material and methods  A cross-sectional e-survey study was conducted with 125 workers of the Brazilian healthcare system, mostly from the Southeast region, from June 2021 to April 2022. Self-administered questionnaires in Google Forms were used to collect data on personal and occupational characteristics, psychosocial factors (Copenhagen Psychosocial Questionnaire), and sleep quality (Pittsburg Sleep Quality Index). Descriptive statistics and a point biserial correlation test were performed. Results  The most reported factors in the risk zone were burnout (86%), stress (81%), emotional demands (75%), work pace (61%), and work-family conflicts (55%). Most participants were classified as poor sleepers (74%), especially nursing technicians/assistants (86%). Burnout (r pb  = 0.33) and inadequate predictability (r pb  = 0.30) were associated with poor sleep quality. Conclusion  Intervention strategies to decrease burnout and increase predictability at work may assist in improving sleep quality among healthcare workers.

Latent Profile Analysis of Sleep Quality in Pregnant Women With Gestational Diabetes Mellitus and Its Influencing Factors

BACKGROUND

Sleep problems are prevalent among individuals diagnosed with gestational diabetes mellitus (GDM), significantly impacting their overall quality of life.

OBJECTIVE

This study sought to adopt a person-centered methodology to unveil the latent profiles of sleep quality and identify factors influencing sleep patterns in patients with GDM.

METHODS

The cross-sectional study gathered sociodemographic features, clinical information, sleep problems (Pittsburgh Sleep Quality Index), personality traits (Type D Personality Scale), social support (Perceived Social Support Scale), and self-efficacy (General Self-efficacy Scale). Latent profile analysis was conducted to identify profiles of sleep quality, while multinomial logistic regression was employed to ascertain the factors influencing these identified profiles.

RESULTS

Among the 431 participants, 423 (98.1%) completed the questionnaire, with 53.0% reporting moderate-to-poor sleep quality. This study identified 4 distinct profiles of sleep quality among patients with GDM: the "good sleep quality" group (47.0%), the "poor sleep quality-long sleep duration" group (10.0%), the "moderate sleep quality" group (25.3%), and the "poor sleep quality-short sleep duration" group (17.7%). Individuals with type D personality were associated with the "poor sleep quality-long sleep duration" [odds ratio (OR) = 3.21, P = .005], "moderate sleep quality" (OR = 2.65, P = .003), and "poor sleep quality-short sleep duration" group (OR = 2.31, P = .018). Individuals with a history of GDM were associated with "poor sleep quality-long sleep duration" group (OR = 3.46, P = .005).

CONCLUSIONS

The research revealed significant classification characteristics of sleep quality in patients with GDM, offering valuable insights for tailoring interventions to address distinct subcategories of sleep-related issues.

Sleep Quality and Its Contributing Factors Among Patients With Obesity: A Cross-Sectional Study

BACKGROUND

 Obesity is a major public health issue associated with a range of comorbid conditions, including sleep disturbances. Poor sleep quality is common in individuals with obesity, yet the factors contributing to this relationship remain underexplored, especially in non-Western populations. This study aimed to investigate sleep quality and its contributing factors among patients with obesity in the eastern region of Saudi Arabia.

METHODS

A cross-sectional study was conducted in multiple healthcare centers in the eastern region of Saudi Arabia. Two hundred adults (aged 18-65 years) with obesity (BMI ≥30 kg/m²) were recruited through convenience sampling. Data were collected using a structured questionnaire that assessed demographics, sleep patterns, lifestyle factors (e.g., physical activity, dietary habits, electronic device use), and comorbid health conditions. Sleep quality was self-reported using a four-point scale. Statistical analyses, including descriptive statistics and chi-square tests, were used to identify relationships between BMI and sleep quality.

RESULTS

 The mean age of participants was 42.5 years (SD = 12.3), with 56% female. Participants reported an average sleep duration of 5.8 hours per night (SD = 1.3). Over 50% of participants experienced poor sleep quality, and 64% reported symptoms of sleep apnea. Increasing BMI was associated with poorer sleep quality, with those in the highest BMI categories (BMI >42 kg/m²) reporting the worst sleep outcomes. Lifestyle factors such as physical inactivity (75%) and caffeine consumption (60.5% within six hours of bedtime) were also significantly associated with poor sleep quality.

CONCLUSIONS

Obesity is strongly associated with poor sleep quality in this cohort, with higher BMI and unhealthy lifestyle factors contributing to sleep disturbances. Interventions targeting weight management, physical activity, dietary habits, and sleep hygiene are essential for improving sleep quality and overall health in obese patients. Future research should explore the causal mechanisms between obesity and sleep disturbances and evaluate the effectiveness of integrated obesity and sleep interventions.

Sleep quality among emergency nurses and its influencing factors during COVID-19 pandemic: a cross-sectional study

Background

COVID-19 has probably contributed to sleep disturbance among nurses, especially those working at emergency departments (EDs). Sleep disorders in nurse managers can negatively impact their health and impair work performance and decision-making. This study aimed to explore the quality of sleep among nurses working in EDs and its influencing factors during the COVID-19 pandemic.

Method

In this study, a cross-sectional design was employed to assess the sleep quality of nurses working in EDs during the COVID-19 pandemic. The research recruited a convenience sample of emergency nurses, who were selectively sourced from four hospitals in Hail City. This recruitment occurred over the period from April to July 2022. Descriptive data analysis was conducted using SPSS, with the significance level set at 0.05.

Results

Among the 216 participants in the study, the majority (55.6%) were aged between 30 and 39 years, and 73.6% were female. Additionally, 64.4% were married, while 69.4% had a bachelor's degree, 20% held a diploma, and the remaining had a master's degree. Notably, a significant 81.5% of the nurses reported poor sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI), with an overall mean score of 10.55 indicating poor sleep. The study highlighted that poor sleep quality among nurses was linked to being female, being married, and not exercising regularly. Better sleep was associated with nurses who manage fewer patients per shift and have adequate monthly income.

Conclusion

The prevalence of poor sleep quality among Emergency nurses during the COVID-19 pandemic is high. There is a pressing need for targeted interventions to enhance sleep quality among ED nurses. Improving sleep quality is not only essential for the wellbeing of these nurses but is also likely to contribute to better patient care.

War Injuries and Nurses' Well-Being: Fatigue and Sleep Quality Among Critical Care Nurses in Najran Region, Saudi Arabia

Introduction Critical care nurses must maintain optimal work performance. Fatigue and sleep disturbance can limit safe practice and cause negative patient outcomes. This study aimed to explore fatigue and sleep quality among critical care nurses in the war zone in Najran City, Saudi Arabia. Methods A cross-sectional research design was used and a convenience sample was applied to include 352 nurses working in critical units at various hospitals in Najran City, Saudi Arabia. A self-administered questionnaire containing three parts was used: demographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), and the Fatigue Severity Scale (FSS). Results The study revealed that 232 nurses (65.9%) reported poor sleep quality. Regarding fatigue levels, 89 nurses (25.2%) reported severe fatigue and 113 (32.1%) reported moderate fatigue. Notably, caring for war-related injuries exhibited a significant positive correlation (r = 0.62, p = 0.0001). Experience correlated negatively (r = -0.47, p = 0.003) with sleep quality and fatigue scores. Most significantly, involvement in caring for war-related injuries showed a strong positive correlation (r = 0.71, p = 0.00001) with FSS scores. Conclusions Poor sleep quality was significantly widespread among the studied nurses. The results indicated that about one-quarter of the studied nurses reported severe fatigue, which was alarmingly prevalent among nurses. Nurses involved in caring for war-related injuries exhibited a strong positive correlation with both PSQI and FSS scores. Recommendations The authors recommend developing and implementing counseling and stress management programs to address the unique challenges faced by nurses caring for war-related injuries.

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.

Sleep quality and fatigue among nurses working in high-acuity clinical settings in Saudi Arabia: a cross-sectional study

BACKGROUND

Poor sleep quality is prevalent among nurses worldwide. Around two-thirds of nurses doing shift work are known to experience sleep problems and fatigue. Fatigue and sleep problems are linked to poor performance, impaired alertness, injuries, chronic diseases, compromised healthcare quality, and medical errors, all of which detrimentally impact nurses and threaten patients' safety. This area of research has received insufficient attention in Saudi Arabia; therefore, the purpose of this study was to examine the levels of sleep quality and perceived fatigue and their association among nurses working in acute care settings in comprehensive hospitals in Saudi Arabia.

METHODS

A descriptive cross-sectional study using the Pittsburgh Sleep Quality Index and Chalder Fatigue Scale. Data was obtained via an online questionnaire that was distributed to nurses using the QuestionPro platform through hospital administrators, social media (WhatsApp), and personal contact.

RESULTS

A total of 173 nurses completed the online survey. Most participants reported poor sleep quality (n = 127, 73.4%) and severe perceived fatigue (n = 156, 90.2%). Furthermore, the study revealed a significant correlation between the overall sleep disturbance and fatigue global scores (r = 0.57, P < 0.001), indicating that poor sleep quality was significantly associated with higher fatigue levels among the study sample.

CONCLUSIONS

The current study found a significant association between sleep quality and severe fatigue in nurses working in high acute care settings in Saudi Arabia. It is very clear from the results that nurses are experiencing poor sleep and severe fatigue, which in turn, will negatively impact the nurse's quality of life and patient safety.

Factors associated with poor sleep quality among construction workers in Arba Minch town, Ethiopia: A cross-sectional study

Background and Aims

Sleep is critical for human physical and cognitive health. Even though poor sleep quality had a major negative impact on workers' health and safety, there is a scarcity of study that attempts to demonstrate its magnitude and causative factors in labor-intensive environments.

Methods

A cross-sectional study design was employed. A total of 423 individuals were selected using a simple random sampling technique, starting from April 1, 2020 to May 1, 2020. Interviews were administered using the validated and pretested Pittsburgh Sleep Quality Index (PSQI) tool. EpiData version 4.4.3.1 was used for data entry and SPSS version 25 for analysis. To associate factors with poor sleep quality binary logistic regression model was fitted at 95% confidence interval (CI). A p < 0.25 and p < 0.05 were used to declare association in bivariable and multivariable analysis, respectively.

Results

A total of 415 building construction workers take part in this study, with a response rate of 98.1%. A PSQI global score showed 66.3% (95% CI: [0.63, 0.71]) of construction workers suffering from poor sleep quality. Working hours, work experience, previous injury status, managerial support on occupational safety and health, cigarette smoking, and job satisfaction were the factors that were associated with poor sleep quality significantly.

Conclusions

Two-thirds of construction workers suffer from poor sleep quality. Risk factors include shorter working years, longer working hours, prior injury, lack of managerial support, cigarette smoking, and low job satisfaction. Efficient health education and promotion through taking the identified associated factors into account could help reduce poor sleep quality.

Exploring the Associations between Chronotype, Night Shift Work Schedule, Quality of Work Life, and Sleep Quality among Maternal and Child Health Nurses: A Multicentre Cross-Sectional Study

Aim

To examine the state of sleep quality among maternal and child health (MCH) nurses and explore the associations between chronotype, night shift work schedule, quality of work life, and sleep quality among MCH nurses.

Background

MCH nurses, who play an important role in protecting the health of women and children, often experience poor sleep quality. However, research on the sleep quality of MCH nurses has been scarce following implementation of the three-child policy in China.

Methods

A multicentre cross-sectional study was conducted with 1426 MCH nurses. Data were collected using a demographic questionnaire, participants' self-reported chronotype, the Pittsburgh Sleep Quality Index, and the Work-Related Quality of Life-2 scale. A chi-squared test, independent samples t-test, Pearson correlation test, and binary logistic regression analysis were used to analyse the data.

Results

Of the 1426 respondents, 57.9% reported poor sleep quality. Binary logistic regression analysis indicated that chronotype, including intermediate-morning, intermediate-evening, and evening (reference: morning), and quality of work life, including stress at work, control at work, and general well-being, had effects on sleep quality among MCH nurses. Older age, frequent caffeine intake, and irregular meals were also associated with poor sleep quality. However, night shift work schedule did not affect sleep quality in the adjusted model.

Conclusions

Poor sleep quality was common among MCH nurses. The findings of this study also illustrate that chronotype and quality of work life are closely related to sleep quality. Implications for Nursing Management. Nursing managers should be aware of MCH nurses' chronotype and quality of work life and tailor interventions to address both modifiable and nonmodifiable factors associated with sleep to improve MCH nurses' sleep quality.