Prevalence and influencing factors of sleep disorder among nurses in tertiary hospitals
Under the environment of long-term heavy workload, shift work system and high requirement of work quality, health care workers were lower status of physical and mental health than other groups. As a typical physical problem, Sleep disorder has become the focus of attention. According to our results and previous studies, the overall prevalence of sleep disorder in hospital staffs was higher than the general population [6, 37–40]. However, the status in nurses was even more serious. A pilot study in Urumqi(Xinjiang,China) using PSQI to evaluate the quality of sleep in physicians, indicated 59.92% participants had sleep disorders[41], that was lower than our results. The Other researcher in Tehran(Iran) and Taiwan(China) also revealed that nurses had higher incidence rate than other health care workers[42–43]. However, as a high-risk group, compare to other health care workers, nurses were most likely to suffer from sleep disorder that be focused first.
The previous study found highly stress correlated positively with sleep disorder[6, 44].In our study, nurses had sleep disorder with felling economic, occupational and social stress. Nurses in tertiary hospitals need deal with different kinds of medical condition, keep learning new medical knowledge and solving different social relationship problem. In fact, nurses always be exposed to high level stress for a long time[45–46].The percentage of nurses (working hours༞40H per week) was 49.6% in our study. The previous studies indicated that heavy workload and longer working hours squeeze time for rest and exercise, and made nurses felling highly stress which influence quality of sleep[6]. However, along with the rapid rhythm of work and work time uncertainty, nurses develop a habit of irregular diet and exercise that affect the circadian rhythms which decrease the quality of life[2].
Prevalence and influencing factors of anxiety symptoms among nurses in tertiary hospitals
The prevalence of anxiety symptoms in nurses was 30.4% in our study that converged towards the results of similar studies[27, 47–49]. However, the prevalence in medical students and doctors were 12.5% and 21.1%, respectively[50–51]. The previous studies indicated, nurses were risk group of anxiety symptom in health care workers. Comparing with other populations in China, the prevalence was obvious higher[52–53]. According to the fact, it was warranted to in-depth studies and active interventions about anxiety symptoms in Chinese nurses.
Our study found higher education backgrounds was risk factor about anxiety symptom in nurses. The results of Liaoning general hospital also indicate nurses with higher education backgrounds may more likely be anxiety symptoms[27]. The results may reflect nurses with higher education backgrounds have higher learning and working target and demand. The previous study indicated nurses with regular meals have lower anxiety symptom(OR 0.719)that was similar with our study[27]. Keeping healthy lifestyle may be helpful for reducing anxiety symptoms in nurses. Longer working hours, heavier workload and lower salary make effort-reward imbalance in nurses that have negative effect for mental health and their job satisfaction[27, 54–55] however, a lot of researches have shown that the status of stress was significantly related to physical and mental health, including anxiety symptom[56–57].
The correlation between sleep disorder and anxiety symptoms that influence the quality of life
Several previous studies indicated sleep disorder have position relation with anxiety symptoms[58–59]. We also find the strong correlation between sleep disorder and anxiety symptom. We think there maybe correlation between physical health and mental health that the previous similar studies shown the same viewpoint[60].We also found nurses with sleep disorder or anxiety symptoms have lower quality of life, no matter PCS or MCS. The results may indicate that sleep disorder and anxiety symptom could respect poor quality of life. However, as the common influencing factors, stress, effort-reward imbalance and irregular lifestyle have significantly related to sleep disorder and anxiety symptom in our study. We should pay attention to these factors and talk steps to prevent these problems in nurses.
The previous studies shown that nurses with higher social support have higher quality of life, higher quality of sleep and lower anxiety symptoms[27, 61–62]. However, providing social support like peer support, may be helpful for quality of sleep, relieve anxiety and increase quality of life in tertiary hospitals’ nurses. The present results remanded hospital managers that need pay more attention on the effort-reward balance by effective system like building appropriate performance measures. Meanwhile, by building positive channel like group activity, nurses could relieve the stress form job, economy and social. In addition, by healthy education, let nurses in tertiary maintain good lifestyle like keep regular diet and exercises. In other words, improving the quality of life, decreasing sleep disorder and anxiety symptoms must be on the agenda.