Factors associated with insomnia among Chinese front‐line nurses fighting against COVID‐19 in Wuhan: A cross‐sectional survey

Abstract

Aim: To investigate the prevalence of insomnia among front-line nurses fighting against COVID-19 in Wuhan, China, and analyse its influencing factors. Background: Insomnia is an important factor that can affect the health and work quality of nurses. However, there is a lack of big-sample studies exploring factors that affect the insomnia of nurses fighting against COVID-19. Method: This cross-sectional study using the Ascension Insomnia Scale, Fatigue Scale-14 and Perceived Stress Scale took place in March 2020. Participants were 1,794 front-line nurses from four tertiary-level general hospitals. Results: The prevalence of insomnia among participants was 52.8%. Insomnia was predicted by gender, working experience, chronic diseases, midday nap duration, direct participation in the rescue of patients with COVID-19, frequency of night shifts, professional psychological assistance during the pandemic, negative experiences (such as family, friends or colleagues being seriously ill or dying due to COVID-19), the degree of fear of COVID-19, fatigue and perceived stress. Conclusion: The level of insomnia among participants was higher than the normal level. Interventions based on influencing factors should be implemented to ensure nurses' sleep quality. Implications for Nursing Management: An in-depth understanding of the influencing factors of insomnia among front-line nurses can help nurse managers develop solutions to improve front-line nurses' sleep quality, which will enhance the physical and mental conditions of nurses and promote the quality of care.

Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis

“…Stress was estimated in 40 studies [ 18 , 20 , 25 , 27 , 29 , 33 , 35 , 36 , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] ]. The overall pooled point estimates of prevalence for stress varied between 10% and 84% ( Fig.…”

“…The pooled prevalence according to the month of data collected was as follows: February: 32% ( n = 14; 95% CI 25–41; I2 = 98), March: 45% (n = 6; 95% CI 37–53; I2 = 96) and April: 50% ( n = 13; 95% CI 35–66; I2 = 98). Seventeen studies [ 20 , 35 , 36 , 39 , 43 , 44 , 46 , 54 , [57] , [58] , [59] , [60] , [61] , [62] , [63] , 67 , 69 ] involving nurses who were working on the frontline showed stress prevalence at 46% (95% CI = 39–54; I 2 = 97), whereas 20 studies including mixed nurses working in the frontline and second line showed the stress prevalence was 42% (95% CI = 31–53, I 2 = 99). Thirteen studies that used the Perceived Stress Scale (PSS) showed a pooled prevalence of stress at 50% (95% CI = 41–59, I 2 = 98), whereas eight studies [ 35 , 45 , [54] , [55] , [56] , 63 , 64 , 67 ] using the Impact of Event Scale-Revised (IES-R) had a pooled prevalence of 50% (95% CI = 37–63, I 2 = 99).…”

“…The prevalence rate of sleep disturbance in 18 studies [ 24 , 26 , 36 , 48 , 52 , 55 , 56 , 59 , 72 , 79 , 82 , 84 , 86 , 88 , 96 , 104 , 109 , 110 ] ranged from 12% to 87% ( Fig. 5 : Forest plots) with pooled prevalence estimates of 43% (4082/10,697 participants, 95% CI 36–50).…”

Investigating the Psychological Impact of COVID-19 among Healthcare Workers: A Meta-Analysis

“…Under the random effects model, the overall prevalence of insomnia in a sample size of 18,546 was 27.8% (95% CI: 21.4-35.3, I 2 = 98.1%; p < 0.001; Figure A1 in Appendix C across 11 studies [16][17][18]25,26,32,44,63,64,76,79]. The insomnia severity index (ISI) was used across eight studies [17,18,26,32,44,63,64,79] and a pooled prevalence of 62.8 (95% CI: 44.8-77.9; I 2 = 98.2%; p value < 0.001) was found.…”

“…Subgroup analyses of stress across different categories 20,21,31,32,34,41,44,48,54,58,60,62,64,66,73,76]. …”