Individual and joint associations of daily sleep and stress with daily well-being in hospital nurses: an ecological momentary assessment and actigraphy study

Vigoureux, Taylor; Lee, Soomi

doi:10.1007/s10865-021-00207-z

Cited by 11 publications

(11 citation statements)

References 45 publications

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“…The experience of disrupted sleep is not surprising – not only are stressful events known to impair normal sleep, but there is also an association between anxiety, depression and sleep disturbances [ 50 , 51 ]. The detrimental effect of sleep disturbances on physical health and well-being [ 52 , 53 ], is a concern at any time, but especially so during a pandemic when HCWs are working longer hours and under greater demands than usual.…”

Section: Discussionmentioning

confidence: 99%

Detrimental changes to the health and well-being of healthcare workers in an Australian COVID-19 hospital

Stubbs

Achat

Schindeler

2021

BMC Health Serv Res

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Background Most studies examining the psychological impact of COVID-19 on healthcare workers (HCWs) have assessed well-being during the initial stages or the peak of the first wave of the pandemic. We aimed to measure the impact of COVID-19 and potential changes over time in its impact, on the health and well-being of HCWs in an Australian COVID-19 hospital. Methods An online questionnaire assessed current and retrospective physical and mental health; psychological distress (Kessler Psychological Distress Scale); lifestyle behaviours; and demographics, providing measures of health and wellbeing at three phases of the pandemic. Targeted staff were invited to participate via email and in-person. Additional promotional activities were directed to all staff. Changes in general health, mental health and psychological distress were examined using McNemar’s Chi-square. Associations between other categorical variables were tested using Chi-Square or non-parametric equivalents as appropriate. Logistic regression explored risk factors for current distress. Results Four hundred thirty-three eligible HCWs answered all (74 %) or part of the questionnaire. Current self-rated health and mental health were significantly better than during the height of the pandemic, but had not returned to pre-pandemic levels. Psychological distress was significantly more common during the height of the pandemic (34.2 %) than currently (22.4 %), and during the height of the pandemic distress was significantly more common among younger than older HCWs. Females were significantly more likely to be distressed that males currently, but not during the height of the pandemic. High distress during the height of the pandemic was more likely to be maintained by HCWs who were less physically active than usual during the height of the pandemic (OR = 5.5); had low self-rated mental health before the pandemic (OR = 4.8); and who had 10 or more years of professional experience (OR = 3.9). Conclusions The adverse effects of the pandemic on HCWs have lessened with the easing of pandemic demands, but health and well-being have not reverted to pre-pandemic levels. This indicates continued exposure to elevated levels of stress and/or a sustained effect of earlier exposure. Initiatives that provide ongoing support beyond the pandemic are needed to ensure that HCWs remain physically and mentally healthy and are able to continue their invaluable work.

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Section: Discussionmentioning

confidence: 99%

Detrimental changes to the health and well-being of healthcare workers in an Australian COVID-19 hospital

Stubbs

Achat

Schindeler

2021

BMC Health Serv Res

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“…EMA sleep variables not included here are reported elsewhere, and items were adapted from questions in previous work (Buxton et al, 2016; Buysse et al, 1989; Lee et al, 2019, 2021; Vigoureux & Lee, 2021). TIB was assessed as the difference between bedtime (i.e., “When did you go to bed last night [that is, get into bed with the intention of sleeping]?”) and waketime (i.e., “When did you get up this morning?”).…”

Section: Methodsmentioning

confidence: 99%

Adapting Research to a Global Pandemic

Vigoureux

Mason

et al. 2022

Nursing Research

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BackgroundMandated social distancing practices and quarantines in response to COVID-19 have resulted in challenges for research on healthcare workers, such as hospital nurses. It remains unknown whether nursing studies utilizing complex methodology like sleep actigraphy and ecological momentary assessment (EMA) can be conducted remotely without compromising data quality.ObjectivesWe aimed to (a) disseminate our remote study protocol for sleep actigraphy and EMA data from hospital nurses during COVID-19, (b) assess feasibility and acceptability of this approach for studies on hospital nurses, and (c) examine the reliability and ecological validity of sleep characteristics measured across 14 days.MethodsUsing an online platform, we provided 86 outpatient nurses from a cancer hospital with detailed video/text instructions regarding the study and facilitated virtual study onboarding meetings. Feasibility was assessed by comparing adherence rates to a similar in-person study of nurses from the same hospital; acceptability was evaluated through content analysis of qualitative study feedback. Multilevel modeling was conducted to assess changes in sleep characteristics as a function of study day and daily stressful experiences.ResultsAdherence to EMA (91.8%) and actigraphy (97.9%) was high. EMA adherence was higher than the in-person study of inpatient day-shift nurses from the same hospital. Content analyses revealed primarily positive feedback, with 51.2% reporting “easy, clear, simple onboarding” and 16.3% reporting the website was “helpful.” Six participants provided only negative feedback. Sleep characteristics did not change as a function of study day except for self-reported quality, which increased slightly during Week 1 and regressed toward baseline after that. A higher incidence of stressor days or higher stressor severity followed nights with shorter-than-usual time in bed or poorer-than-usual sleep quality, supporting the ecological validity for these methods of assessing sleep in nurses.DiscussionFindings suggest that a fully remote study protocol for EMA and actigraphy studies in nursing yields robust feasibility, acceptability, reliability, and validity. Given the busy schedules of nurses, the convenience of this approach may be preferable to traditional in-person data collection. Lessons learned from COVID-19 may apply to improving nursing research postpandemic.

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“…Due to missingness in sleep variables, 655–720 daily observations were used in analyses. The EMA time in bed variable had the greatest missingness, and comparisons between those with high versus low missingness can be found elsewhere (Vigoureux & Lee, 2021). Proc Glimmix with Poisson distribution was used for models predicting stressor frequency, and Proc Mixed was used for models predicting stressor severity.…”

Section: Methodsmentioning

confidence: 99%

Daily associations between sleep and stressors in nurses with and without children

Harris

Vigoureux

Lee

2021

Journal of Sleep Research

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Summary Previous research shows that adults with children have poorer sleep overall than adults without children. Poorer sleep is associated with experiencing more frequent and severe stressors. The daily link between sleep and stressors may differ by parenting status; yet this potential difference has not been addressed, especially in nurses who provide care both at work and home. This study examined whether the sleep–stress relationship is stronger for nurses with children than those without. During 14 days of ecological momentary assessment, 60 hospital nurses (24 parents) reported their previous night's sleep characteristics upon waking. Three times daily, they also reported whether they encountered any stressors and how severe those stressors were. Associations were assessed at the within‐ and between‐person levels with parenting status as a between‐person moderator. After controlling for covariates, previous night's poorer sleep quality, lower sleep sufficiency, and shorter time in bed were associated with perceiving more frequent or severe stressors the following day. Some of these daily associations were moderated by parenting status, such that the sleep–stressor link was only significant for parents, with the magnitude of association being stronger for those with 2+ children relative to 1 child. These findings suggest that nurses with children are at greater risk for a stronger linkage between poorer sleep and greater stressor frequency and severity. A stronger sleep–stressor relationship could have compounding effects on health. Improving sleep in this group may be critical to reduce their stress and improve the quality of care across work and home.

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Individual and joint associations of daily sleep and stress with daily well-being in hospital nurses: an ecological momentary assessment and actigraphy study

Cited by 11 publications

References 45 publications

Detrimental changes to the health and well-being of healthcare workers in an Australian COVID-19 hospital

Detrimental changes to the health and well-being of healthcare workers in an Australian COVID-19 hospital

Adapting Research to a Global Pandemic

Daily associations between sleep and stressors in nurses with and without children

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