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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors

Authors: Hongyun Dong, Qiong Zhang, Zihua Sun, Fengxin Sang, Yingzhi Xu

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

This study aimed to determine the prevalence of sleep disturbances among clinical nurses in general hospitals in Mainland China, and identify its associate factors.

Methods

Using a cross-sectional design, a total of 5012 clinical nurses selected by random cluster sampling completed the survey on the Pittsburgh Sleep Quality Index (PSQI), measures of quality of life indexed by the Medical Outcomes Study 12-item Short-Form Health Survey, occupational stress evaluated by the Job Content Questionnaire, lifestyle and sociodemographic details.

Results

The average PSQI score of 4951 subjects was 7.32 ± 3.24, including 3163 subjects with PSQI ≥5, accounting for 63.9%. Multivariate Logistic regression analysis showed that the risk factors for sleep disturbances in nurses were female gender, the Emergency department and ICU, many years of service, high night shift frequency, professional status: primary and intermediate, employment status: temporary, poor quality of life: poor mental health, low perceived health, high occupational stress (high psychological demand, low job control and low workplace social support).

Conclusions

Sleep disturbances are highly prevalent among clinical nurses in general hospitals in Mainland China. Many of the factors listed above were associated with the prevalence of sleep disturbances in nurses, and occupational stress plays an important role in the development of sleep disturbances in Chinese clinical nurses.
Literature
1.
Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA. 1989;262(11):1479–84.CrossRefPubMed
2.
Mellinger GD, Balter MB, Uhlenhuth EH. Insomnia and its treatment. Prevalence and correlates. Arch Gen Psychiatry. 1985;42(3):225–32.CrossRefPubMed
3.
Ohayon MM, Smirne S. Prevalence and consequences of insomnia disorders in the general population of Italy. Sleep Med. 2002;3(2):115–20.CrossRefPubMed
4.
Ohayon MM, Paiva T. Global sleep dissatisfaction for the assessment of insomnia severity in the general population of Portugal. Sleep Med. 2005;6(5):435–41.CrossRefPubMed
5.
Mieda M, Sakurai T. Orexin (hypocretin) receptor agonists and antagonists for treatment of sleep disorders. Rationale for development and current status. CNS Drugs. 2013;27(2):83–90.CrossRefPubMed
6.
Rosado IV, Russo GH, Maia EM. Generating health elicits illness? The contradictions of work performed in emergency care units of public hospitals. Cien Saude Colet. 2015;20(10):3021–32.CrossRefPubMed
7.
Kuppermann M, Lubeck DP, Mazonson PD, Patrick DL, Stewart AL, Buesching DP, Fifer SK. Sleep problems and their correlates in a working population. J Gen Intern Med. 1995;10(1):25–32.CrossRefPubMed
8.
9.
Shahly V, Berglund PA, Coulouvrat C, Fitzgerald T, Hajak G, Roth T, Shillington AC, Stephenson JJ, Walsh JK, Kessler RC. The associations of insomnia with costly workplace accidents and errors: results from the America insomnia survey. Arch Gen Psychiatry. 2012;69(10):1054–63.CrossRefPubMed
10.
Kessler RC, Berglund PA, Coulouvrat C, Hajak G, Roth T, Shahly V, Shillington AC, Stephenson JJ, Walsh JK. Insomnia and the performance of US workers: results from the America insomnia survey. Sleep. 2011;34(9):1161–71.CrossRefPubMedPubMedCentral
11.
Nadaoka T, Kanda H, Oiji A, Morioka Y, Kashiwakura M, Totsuka S. Headache and stress in a group of nurses and government administrators in Japan. Headache. 1997;37(6):386–91.CrossRefPubMed
12.
Lin KC, Huang CC, Wu CC. Association between stress at work and primary headache among nursing staff in Taiwan. Headache. 2007;47(4):576–84.CrossRefPubMed
13.
Costa G. Shift work and occupational medicine: an overview. Occup Med (Lond). 2003;53(2):83–8.CrossRef
14.
Pallesen S, Bjorvatn B, Mageroy N, Saksvik IB, Waage S, Moen BE. Measures to counteract the negative effects of night work. Scand J Work Environ Health. 2010;36(2):109–20.CrossRefPubMed
15.
Vogel M, Braungardt T, Meyer W, Schneider W. The effects of shift work on physical and mental health. J Neural Transm (Vienna). 2012;119(10):1121–32.CrossRef
16.
Bobbio A, Bellan M, Manganelli AM. Empowering leadership, perceived organizational support, trust, and job burnout for nurses: a study in an Italian general hospital. Health Care Manag Rev. 2012;37(1):77–87.CrossRef
17.
18.
Wilkins K, Beaudet MP. Work stress and health. Health Rep. 1998;10(3):47–62. (ENG); 49-66 (FRE).PubMed
19.
Ming EE, Adler GK, Kessler RC, Fogg LF, Matthews KA, Herd JA, Rose RM. Cardiovascular reactivity to work stress predicts subsequent onset of hypertension: the air traffic controller health change study. Psychosom Med. 2004;66(4):459–65.CrossRefPubMed
20.
Akerstedt T, Knutsson A, Westerholm P, Theorell T, Alfredsson L, Kecklund G. Sleep disturbances, work stress and work hours: a cross-sectional study. J Psychosom Res. 2002;53(3):741–8.CrossRefPubMed
21.
Rusli BN, Edimansyah BA, Naing L. Working conditions, self-perceived stress, anxiety, depression and quality of life: a structural equation modelling approach. BMC Public Health. 2008;8:48.CrossRefPubMedPubMedCentral
22.
Choenarom C, Williams RA, Hagerty BM. The role of sense of belonging and social support on stress and depression in individuals with depression. Arch Psychiatr Nurs. 2005;19(1):18–29.CrossRefPubMed
23.
Li J, Yang W, Cheng Y, Siegrist J, Cho SI. Effort-reward imbalance at work and job dissatisfaction in Chinese healthcare workers: a validation study. Int Arch Occup Environ Health. 2005;78(3):198–204.CrossRefPubMed
24.
Gao YQ, Pan BC, Sun W, Wu H, Wang JN, Wang L. Depressive symptoms among Chinese nurses: prevalence and the associated factors. J Adv Nurs. 2012;68(5):1166–75.CrossRefPubMed
25.
Wilkins K. Work stress among health care providers. Health Rep. 2007;18(4):33–6.PubMed
26.
Patrick PK. Burnout: job hazard for health workers. Hospitals. 1979;53(22):87–8. 90PubMed
27.
Ndejjo R, Musinguzi G, Yu X, Buregyeya E, Musoke D, Wang JS, Halage AA, Whalen C, Bazeyo W, Williams P, et al. Occupational health hazards among healthcare workers in Kampala, Uganda. J Environ Public Health. 2015;2015:913741.CrossRefPubMedPubMedCentral
28.
Tsai PS, Wang SY, Wang MY, Su CT, Yang TT, Huang CJ, Fang SC. Psychometric evaluation of the Chinese version of the Pittsburgh sleep quality index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14(8):1943–52.CrossRefPubMed
29.
Wong WS, Fielding R. The co-morbidity of chronic pain, insomnia, and fatigue in the general adult population of Hong Kong: prevalence and associated factors. J Psychosom Res. 2012;73(1):28–34.CrossRefPubMed
30.
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRefPubMed
31.
Buysse DJ, Reynolds CF 3rd, Monk TH, Hoch CC, Yeager AL, Kupfer DJ. Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh sleep quality index (PSQI). Sleep. 1991;14(4):331–8.PubMed
32.
Ware J Jr, Kosinski M, Keller SD. A 12-item Short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.CrossRefPubMed
33.
Jenkinson C, Layte R, Jenkinson D, Lawrence K, Petersen S, Paice C, Stradling J. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health Med. 1997;19(2):179–86.CrossRefPubMed
34.
Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, et al. Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. International quality of life assessment. J Clin Epidemiol. 1998;51(11):1171–8.CrossRefPubMed
35.
Lam CL, Tse EY, Gandek B. Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual Life Res. 2005;14(2):539–47.CrossRefPubMed
36.
Liang Y, Lu W, Wu W. Are social security policies for Chinese landless farmers really effective on health in the process of Chinese rapid urbanization? A study on the effect of social security policies for Chinese landless farmers on their health-related quality of life. Int J Equity Health. 2014;13:5.CrossRefPubMedPubMedCentral
37.
Yang WJ, Li J. Measurement of psychosocial factors in work environment: application of two models of occupational stress. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2004;22(6):422–6.PubMed
38.
Li J, Yang W, Liu P, Xu Z, Cho SI. Psychometric evaluation of the Chinese (mainland) version of job Content questionnaire: a study in university hospitals. Ind Health. 2004;42(2):260–7.CrossRefPubMed
39.
Wang LJ, Chen CK, Hsu SC, Lee SY, Wang CS, Yeh WY. Active job, healthy job? Occupational stress and depression among hospital physicians in Taiwan. Ind Health. 2011;49(2):173–84.CrossRefPubMed
40.
Karasek RA Jr. Job demands, job decison latitude, and mental strain: implications for job redesign. Adm Sci Q. 1979;242:285–308.CrossRef
41.
Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The job Content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998;3(4):322–55.CrossRefPubMed
42.
Wang L, Qin P, Zhao Y, Duan S, Zhang Q, Liu Y, Hu Y, Sun J. Prevalence and risk factors of poor sleep quality among Inner Mongolia medical university students: a cross-sectional survey. Psychiatry Res. 2016;244:243–8.CrossRefPubMed
43.
Sadeghniiat-Haghighi K, Yazdi Z, Kazemifar AM. Sleep quality in long haul truck drivers: a study on Iranian national data. Chin J Traumatol. 2016;19(4):225–8.CrossRefPubMedPubMedCentral
44.
Li RH, Wing YK, Ho SC, Fong SY. Gender differences in insomnia--a study in the Hong Kong Chinese population. J Psychosom Res. 2002;53(1):601–9.CrossRefPubMed
45.
Cho HS, Kim YW, Park HW, Lee KH, Jeong BG, Kang YS, Park KS. The relationship between depressive symptoms among female workers and job stress and sleep quality. Ann Occup Environ Med. 2013;25(1):12.CrossRefPubMedPubMedCentral
46.
Ghalichi L, Pournik O, Ghaffari M, Vingard E. Sleep quality among health care workers. Arch Iran Med. 2013;16(2):100–3.PubMed
47.
Tsai YC, Liu CH. Factors and symptoms associated with work stress and health-promoting lifestyles among hospital staff: a pilot study in Taiwan. BMC Health Serv Res. 2012;12:199.CrossRefPubMedPubMedCentral
48.
49.
Lajoie P, Aronson KJ, Day A, Tranmer J. A cross-sectional study of shift work, sleep quality and cardiometabolic risk in female hospital employees. BMJ Open. 2015;5(3):e007327.CrossRefPubMedPubMedCentral
50.
Voderholzer U, Al-Shajlawi A, Weske G, Feige B, Riemann D. Are there gender differences in objective and subjective sleep measures? A study of insomniacs and healthy controls. Depress Anxiety. 2003;17(3):162–72.CrossRefPubMed
51.
Schubert CR, Cruickshanks KJ, Dalton DS, Klein BE, Klein R, Nondahl DM. Prevalence of sleep problems and quality of life in an older population. Sleep. 2002;25(8):889–93.PubMed
52.
Leger D, Scheuermaier K, Philip P, Paillard M, Guilleminault C. SF-36: evaluation of quality of life in severe and mild insomniacs compared with good sleepers. Psychosom Med. 2001;63(1):49–55.CrossRefPubMed
53.
Breslau N, Roth T, Rosenthal L, Andreski P. Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry. 1996;39(6):411–8.CrossRefPubMed
54.
Roberts RE, Shema SJ, Kaplan GA, Strawbridge WJ. Sleep complaints and depression in an aging cohort: a prospective perspective. Am J Psychiatry. 2000;157(1):81–8.CrossRefPubMed
55.
Chang PP, Ford DE, Mead LA, Cooper-Patrick L, Klag MJ. Insomnia in young men and subsequent depression. The Johns Hopkins precursors study. Am J Epidemiol. 1997;146(2):105–14.CrossRefPubMed
56.
Wong WS, Fielding R. Prevalence of insomnia among Chinese adults in Hong Kong: a population-based study. J Sleep Res. 2011;20(1 Pt 1):117–26.CrossRefPubMed
57.
Benbir G, Demir AU, Aksu M, Ardic S, Firat H, Itil O, Ozgen F, Yilmaz H, Karadeniz D. Prevalence of insomnia and its clinical correlates in a general population in Turkey. Psychiatry Clin Neurosci. 2015;69(9):543–52.PubMed
58.
Bjorvatn B, Dale S, Hogstad-Erikstein R, Fiske E, Pallesen S, Waage S. Self-reported sleep and health among Norwegian hospital nurses in intensive care units. Nurs Crit Care. 2012;17(4):180–8.CrossRefPubMed
59.
Trousselard M, Dutheil F, Naughton G, Cosserant S, Amadon S, Duale C, Schoeffler P. Stress among nurses working in emergency, anesthesiology and intensive care units depends on qualification: a job demand-control survey. Int Arch Occup Environ Health. 2016;89(2):221–9.CrossRefPubMed
60.
Zhang HS, Li Y, Mo HY, Qiu DX, Zhao J, Luo JL, Lin WQ, Wang JJ, Wang PX. A community-based cross-sectional study of sleep quality in middle-aged and older adults. Qual Life Res. 2017;26(4):923–33.
61.
Yazdi Z, Sadeghniiat-Haghighi K, Loukzadeh Z, Elmizadeh K, Abbasi M. Prevalence of sleep disorders and their impacts on occupational performance: a comparison between shift workers and Nonshift workers. Sleep Disord. 2014;2014:870320.CrossRefPubMedPubMedCentral
62.
Korompeli A, Chara T, Chrysoula L, Sourtzi P. Sleep disturbance in nursing personnel working shifts. Nurs Forum. 2013;48(1):45–53.CrossRefPubMed
63.
Manenschijn L, van Kruysbergen RG, de Jong FH, Koper JW, van Rossum EF. Shift work at young age is associated with elevated long-term cortisol levels and body mass index. J Clin Endocrinol Metab. 2011;96(11):E1862–5.CrossRefPubMed
64.
Lee WW, Park JB, Min KB, Lee KJ, Kim MS. Association between work-related health problems and job insecurity in permanent and temporary employees. Ann Occup Environ Med. 2013;25(1):15.CrossRefPubMedPubMedCentral
65.
Pirani E, Salvini S. Is temporary employment damaging to health? A longitudinal study on Italian workers. Soc Sci Med. 2015;124:121–31.CrossRefPubMed
66.
67.
68.
Laszlo KD, Pikhart H, Kopp MS, Bobak M, Pajak A, Malyutina S, Salavecz G, Marmot M. Job insecurity and health: a study of 16 European countries. Soc Sci Med. 2010;70(6):867–74.CrossRefPubMedPubMedCentral
69.
Muenster E, Rueger H, Ochsmann E, Letzel S, Toschke AM. Association between overweight, obesity and self-perceived job insecurity in German employees. BMC Public Health. 2011;11:162.CrossRefPubMedPubMedCentral
70.
Buddeberg-Fischer B, Klaghofer R, Stamm M, Siegrist J, Buddeberg C. Work stress and reduced health in young physicians: prospective evidence from Swiss residents. Int Arch Occup Environ Health. 2008;82(1):31–8.CrossRefPubMed
71.
Sehlen S, Vordermark D, Schafer C, Herschbach P, Bayerl A, Pigorsch S, Rittweger J, Dormin C, Bolling T, Wypior HJ, et al. Job stress and job satisfaction of physicians, radiographers, nurses and physicists working in radiotherapy: a multicenter analysis by the DEGRO quality of life work group. Radiat Oncol. 2009;4:6.CrossRefPubMedPubMedCentral
72.
73.
Nomura K, Nakao M, Sato M, Ishikawa H, Yano E. The association of the reporting of somatic symptoms with job stress and active coping among Japanese white-collar workers. J Occup Health. 2007;49(5):370–5.CrossRefPubMed
74.
Hope A, Kelleher CC, O'Connor M. Lifestyle practices and the health promoting environment of hospital nurses. J Adv Nurs. 1998;28(2):438–47.CrossRefPubMed
Metadata
Title
Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors
Authors
Hongyun Dong
Qiong Zhang
Zihua Sun
Fengxin Sang
Yingzhi Xu
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1402-3

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