Sleep quality of nurses in the emergency department of public hospitals in China and its influencing factors: a cross-sectional study

Abstract

Background: Studies have shown that poor sleep could result in many unpleasant consequences and is prevalent in nurses. Considering the fact of high stress, overwhelming workload and many night shifts in the emergency department in China, this study aimed to evaluate the current status of emergency nurses' sleep quality in public hospitals in Shandong, China and explored its influencing factors. Methods: A self-administered questionnaire incorporating the Job Content Questionnaire and Pittsburgh Sleep Quality Index (PSQI) was conducted among 4856 emergency nurses in five randomly selected city emergency command systems in Shandong, China. The association of potential influencing factors, including occupational, psychosocial and individual factors, with poor sleep (PSQI> 5) was quantified by multivariate logistic regression analysis. Results: The average PSQI score of 4730 emergency nurses in public hospitals was 8.2 ± 3.9, including 3114 (65.8%) subjects with PSQI > 5 and 2905 (61.4%) > 8; these figures were found highest for 337 emergency nurses in 14 tertiary hospitals with 11.8 ± 4.3, 257 (76.3%) and 232 (68.8%), followed by 1044 emergency nurses in 43 secondary hospitals with 9.5 ± 3.9, 725 (69.4%) and 675 (64.7%) and 3349 emergency nurses in 167 primary hospitals with 7.4 ± 3.5, 2132 (63.7%) and 1998 (59.7%). The following factors were associated with poor sleep: hospital level (tertiary vs. primary, secondary vs. primary), female sex, less of exercise, long work hours per week, many patients in the charge of at night, high monthly night shift frequency (4-6 vs. never, ≥7 vs. never) and high occupational stress. Conclusions: The sleep quality of emergency nurses in public hospitals in China was poor, especially in tertiary hospitals. Many factors as listed above, especially occupational stress, night shift taking and workload at night, should be considered when improving emergency nurses' sleep quality.

Sleep quality and common mental disorder in the hospital Nursing team

“…In relation to income, most of the professionals reported earning from three to five minimum wages, having only one job and working up to 40 hours during the week, which is similar to a research study carried out in the North of Paraná (Brazil), in which professionals had only one job (56.7%) and earned from one to two minimum wages ( 7 ) . Likewise, another study developed in China, with nurses working in different hospital units, presented 4,185 female professionals, with only one job and who worked up to 45 weekly hours ( 21 ) .…”

“…Similarly, a study in hospital units in Iran obtained 77.4% (418) of the nurses considered as with poor sleep ( 11 ) . Another study, developed in China with 4,730 nurses working in emergency units, found 65.8% of the professionals with altered sleep ( 21 ) . This finding is similar to the study conducted in India, which obtained 83.2% of the nurses as with poor sleep ( 10 ) .…”

“…Likewise, a study also conducted in China with 1,500 nurses in six hospitals from the Shandong province associated the existence of depression symptoms with the presence of sleep disorders and, consequently, with lesser control of the work environment. Nurses are susceptible to the development of work-related mental disorders, thus impairing the quality of the care provided ( 21 ) .…”

“…In another study conducted in public hospitals in China, presence of poor sleep quality among nurses was obtained, with 68.8% of those that worked in high-complexity tertiary institutions presenting severe sleep disorders associated with great service demand, a greater number of patients to care of in the night shift and absence of recognition of the work performed ( 21 ) .…”

Relationship between Emotional Intelligence, Sleep Quality and Body Mass Index in Emergency Nurses

“…It is known that nurses routinely suffer alterations in sleep quality, not only due to work schedules, also because of psychological stress [ 24 , 25 , 26 ]. Sleeping few hours per day for a prolonged period of time is associated with an alteration of the brain mechanism and its function in the emotional field, resulting in a more negative mood (behavioral impairment) [ 11 , 27 , 28 , 29 ]. Lack of sleep has been found to impair abilities that have a specific role in EI and may affect emotion processing [ 28 , 30 ].…”