The role of sleep quality and perceived stress on depressive symptoms among tertiary hospital nurses: a cross-sectional study

Abstract

Background Nurses in tertiary hospitals are at high risk for depression. Understanding sleep quality and perceived stress may contribute to nurses’ mental health and health-related nursing productivity. The aim of this study was to investigate the role of sleep quality and perceived stress on depressive symptoms among nurses in tertiary hospitals. Methods A total of 2,780 nurses (overall response rate = 91.1%) were recruited through a cross-sectional survey in 23 tertiary hospitals in China. Questionnaires included the Self-Rating Depression Scale, the Pittsburgh Sleep Quality Index, and the Chinese Perceived Stress Scale. Variables that were significant in Chi-square tests were further entered into binary logistic stepwise regression. Results The prevalence of depressive symptoms was 60.3% (n = 1,676), of which 97.4% (n = 1,633) were female, and 77.8% were younger than 35 years (n = 1,304). Nurses who had moderate, poor, severe sleep quality and poor perceived pressure were more likely to be depressed. Master’s degree, 6–10 years of work, and physical activity were protective factors, while the opposite was the case for shift work and high dissatisfaction. Conclusions More than half of nurses working in tertiary care hospitals reported depressive symptoms, and lower sleep quality and higher perceived stress were more associated with this. Perceived stress is an interesting concept, which may provide a new entry point for the well-known idea that there is a relationship between poor sleep quality and depression. It is possible to reduce depressive symptoms among public hospital nurses by providing information on sleep health and stress relief.

Workplace violence and depressive symptoms: the mediating role of fear of future workplace violence and burnout among Chinese nurses

“…Our study showed that nurses with lower educational level, lower income, more night shift work per week, more years of work, longer work hours per week, or working in the emergency department were more likely to have depressive symptoms, which is consistent with previous studies [ 2 , 5 , 43 , 44 ]. Our study also showed that contract nurses were more likely to experience depressive symptoms compare to the formal employee.…”

“…Due to long work hours and high work pressure, nurses’ health is very likely to be negatively affected by depression [ 1 ]. Depression often involves a loss of interest in activities that were once enjoyable, feelings of worthlessness or guilt, difficulty sleeping, changes in appetite, and decreased energy or motivation [ 2 ], and the high prevalence of depressive symptoms among nurses has become a global problem [ 3 ]. Previous studies found that the prevalence of depressive symptoms among American nurses was 18% [ 4 ], while that among Chinese nurses was significantly higher, 48.83% [ 5 ].…”

Association of anxiety, depression symptoms and sleep quality with chronic kidney disease among older Chinese

“…Several factors may contribute to this phenomenon. First, participants with anxiety, depression symptoms and poor sleep quality may experience great stress during their life, [27–30] and then result in the activation of sympathetic excitation, which was associated with the occurrence of CKD. Second, participants with these problems may cause endocrine disruption and changes in hormone levels, [31–33] which was associated with CKD.…”

Sleep Quality and Its Relationship to Anxiety and Hardiness in a Cohort of Frontline Italian Nurses during the First Wave of the COVID-19 Pandemic

“…The Insomnia Severity Index (ISI) is a 7-item self-report questionnaire assessing the nature, severity, and impact of insomnia via a 5-point Likert scale during the "last month", yielding a total score ranging from 0 to 28 [47]. The total score was interpreted as follows: absence of insomnia (0-7); sub-threshold insomnia (8)(9)(10)(11)(12)(13)(14); moderate insomnia (15)(16)(17)(18)(19)(20)(21); and severe insomnia (22)(23)(24)(25)(26)(27)(28). The dimensions evaluated were severity of sleep onset, sleep maintenance, early morning awakening problems, sleep dissatisfaction, interference of sleep difficulties with daytime functioning, noticeability of sleep problems by others, and distress caused by sleep difficulties.…”

“…According to a recent meta-analysis, the prevalence of sleep disturbances in Chinese nurses was 45.1% (CI 95%: 37.2-53.1%) [9], while Ielapi et al reported a prevalence of 65.4% [10]. Sleep disturbances can influence personal well-being and mental health, also causing depression [11], which has been reported in 60.3% of cases [12]. Furthermore, observational research has shown that a reduction in the time dedicated to sleep is associated with decreased productivity [13], quality of care, and patient safety [14].…”