Insomnia, fatigue and psychosocial well‐being during COVID‐19 pandemic: A cross‐sectional survey of hospital nursing staff in the United States

Abstract

Aims and objectives To describe the levels of insomnia, fatigue and intershift recovery, and psychological well‐being (burnout, post‐traumatic stress and psychological distress), and to examine differences in these measures based on work‐related characteristics among nursing staff during COVID‐19 pandemic in the United States. Background The COVID‐19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide. A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic. Design Cross‐sectional study. Methods Hospital nurses and nursing assistants ( N = 587) were recruited online between May–June 2020. The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery‐15), burnout (Maslach Burnout Inventory‐Human Services Survey), post‐traumatic stress (Short Post‐Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire‐4), and questions on work and demographics. The STROBE checklist was followed for reporting. Results The sample had subthreshold insomnia, moderate‐to‐high chronic fatigue, high acute fatigue and low‐to‐moderate intershift recovery. The sample experienced increased emotional exhaustion and depersonalisation, increased personal accomplishment, moderate psychological distress and high post‐traumatic stress. Nurses who cared for COVID‐19 patients had significantly scored worse on almost all measures than their co‐workers. Certain factors such as working hours per week and the frequency of 30‐min breaks were significant. Conclusion Nursing staff experienced poor sleep, fatigue and multiple psychological problems during the COVID‐19 pandemic. Moreover, staff who were involved in the care of COVID‐19 patients, worked more than 40 h per week and skipped 30‐min breaks showed generally worse self‐reported outcomes. Relevance to clinical practice Nursing administration is recommended to monitor for fatigue and distress on nursing units, re‐visit current scheduling practices, reinforce rest breaks and provide access to mental health and sleep wellness resources with additional support for their front‐line nursing groups.

Factors Associated With Healthcare Workers' Insomnia Symptoms and Fatigue in the Fight Against COVID-19, and the Role of Organizational Support

“…During the early stages of the COVID-19 epidemic, HCWs often worked longer each day. Under these circumstances, breaks were crucial to alleviating fatigue (39). In line with previous research, insomnia symptoms and feelings of fatigue were found to be inversely correlated with sleep duration (40).…”

COVID-Well Study: Qualitative Evaluation of Supported Wellbeing Centres and Psychological First Aid for Healthcare Workers during the COVID-19 Pandemic

“…Similar findings have been demonstrated in the context of healthy lifestyle behaviours at work (e.g., physical activity), where job-related barriers to engagement in health behaviours included the structure and nature of the working day (high workload, front line job requirements), workplace culture and norms (resentment from colleagues, no break culture) and organizational concerns (cost of lost time, public perceptions) [ 65 ]. Lack of work breaks and an absence of suitable rest areas is particularly common amongst healthcare workers [ 66 , 67 , 68 , 69 ], although it is well-established that long hours and consecutive shifts without breaks have negative psychological impacts, and health and safety implications for healthcare workers and patients [ 23 , 70 ]. Within-day work breaks can reduce fatigue and negative emotions [ 71 ].…”

UK advanced practice nurses’ experiences of the COVID-19 pandemic: a mixed-methods cross-sectional study

“…Open access very experienced, having worked in the NHS for many years and have previously reported higher levels of job satisfaction and well-being than other areas of the NHS. 19 Increased fear due to the pandemic has been associated with higher levels of burnout in Spain, 22 decreased psychological well-being in the USA 23 and higher intention to leave in the Philippines. 24 Studies in China and Iran have already shown that healthcare staff who are not properly equipped in this crisis are at high risk of mental health conditions such as depression, anxiety and post-traumatic stress disorder.…”