Emotional Labor and Depressive Symptoms Among Healthcare Workers: The Role of Sleep

BACKGROUND

Depression is the second leading cause of disability worldwide. Health care workers report a higher prevalence of depressive symptoms than the general population. Emotional labor has contributed to poor health and work outcomes. However, the mechanism for the potential association between emotional labor and depressive symptoms has not been well studied. This study examines the relationship between emotional labor and depressive symptoms and whether sleep plays a role in explaining this relationship.

METHODS

In 2018, health care workers (n = 1,060) from five public sector facilities in the northeast United States participated in this cross-sectional survey. The survey included questions on participants' surface-acting emotional labor (masking one's feelings at work), depressive symptoms, sleep duration and disturbances, and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables.

FINDINGS

There was a significant association between emotional labor and depressive symptoms (β = 0.82, p < .001). Sleep disturbances, but not short sleep duration, partially mediated this association. Neither sleep variable moderated this association.

CONCLUSIONS/APPLICATION TO PRACTICE

Depressive symptoms were prevalent among health care workers and were associated with emotional masking. Sleep disturbances play an important intermediate role in translating emotional labor to depressive symptoms in these workers. Effective workplace programs are needed to reduce health care workers' emotional labor to improve their mental health. Sleep promotion should also be emphasized to mitigate the negative effect of emotional labor and promote mental wellbeing.

750 Sleep disturbances mediates the association between emotional labor and depressive symptoms among healthcare workers

Introduction

Depression is the second leading cause of disability worldwide. Healthcare workers report a higher prevalence of depressive symptoms than the general population. Emotional labor has contributed to poor health and work outcomes. However, the mechanism for the potential association between emotional labor and depressive symptoms has not been well studied.

Methods

In 2018, healthcare workers (n=1,060) from five public sector facilities in the northeast U.S. participated in this cross-sectional survey. The survey included questions on participants’ surface-acting emotional labor (masking one’s feelings at work), depressive symptoms, sleep duration and disturbances, and socio-demographics.

Results

Nearly a quarter (21.7%) of the participants reported depressive symptoms, over a half (53.6%) reported short sleep duration (≤6 hours per day), and nearly one third (32.2%) reported sleep disturbances. There was a significant association between emotional labor and depressive symptoms (β=0.82, p&lt;0.001) among these workers. Sleep disturbances, not short sleep duration, partially mediated this association by 17%. Both sleep disturbances and short sleep duration did not modify this association.

Conclusion

Depressive symptoms were prevalent among healthcare workers and were associated with emotional masking. Sleep disturbances play an important intermediate role in translating emotional labor to depressive symptoms in these workers. Effective workplace programs are needed to reduce healthcare workers’ emotional labor in order to improve their mental health. Sleep promotion should be emphasized to mitigate the negative effect of emotional labor and promote healthcare workers’ mental wellbeing.

Support (if any)

The Center for the Promotion of Health in the New England Workplace is supported by Grant Number 1 U19 OH008857 from the National Institute for Occupational Safety and Health (CDC). This work is solely the responsibility of the authors and does not necessarily represent the official views of NIOSH. We are grateful to the CPH-NEW Research Team working together to collect the questionnaire data.

The Comorbidity of Musculoskeletal Disorders and Depression: Associations with Working Conditions Among Hospital Nurses

Background: Musculoskeletal disorders (MSDs) are the leading cause of pain and disability among nurses and are frequently accompanied by depression. However, the association between the comorbidity of MSDs and depression and working conditions has not been studied, which was the aim of this study. Methods: In 2015, all nurses (n = 1,102) employed at a community hospital in the Northeast United States were invited to participate in this cross-sectional study. A survey was distributed in which participants were asked to report on MSDs, depressive symptoms, as well as subjective working conditions assessed including physical demands, psychological demands, decision authority, social support, and work-family conflict. Findings: 397 nurses responded (36%), and the prevalence of the comorbidity of MSDs and depression was 14.5%. Poisson regression (PR) models suggested that work-family conflict was associated with increased risk of the comorbidity (PR = 2.18; 95% confidence interval [CI] = 1.33-3.58), as was 8-hour night shift (PR = 2.77; 95% CI = [1.22, 6.31]) or 12-hour day shift (PR = 2.20; 95% CI = [1.07, 4.50]). Other working conditions were not directly associated with the comorbidity. Conclusions/Application to Practice: The comorbidity of MSDs and depression is prevalent among hospital nurses, and work-family conflict and working night shift or longer shifts were significantly associated with this. Effective workplace programs are needed to address nurses' working conditions to reduce their work-family conflict, thereby improving their musculoskeletal and mental health.