Sleep Quality and the Depression-Anxiety-Stress State of Frontline Nurses Who Perform Nucleic Acid Sample Collection During COVID-19: A Cross-Sectional Study

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Abstract

Objective

To explore the sleep quality and depression-anxiety-stress state of frontline nurses in high-risk areas who conduct nucleic acid sampling testing for COVID-19 to provide a basis for formulating intervention programs in crisis management.

Methods

From August 22 to 30, 2021, a convenient sampling method was used in Zhangjiajie City, Hunan Province, China. A total of 248 frontline nurses who performed nucleic acid sample collection were selected. The following tests were used: the general information questionnaire, Pittsburgh Sleep Quality Questionnaire (PSQI), and Depression–Anxiety Stress Scale (DASS-21).

Results

A total of 236 nurses completed the survey; 88.14% (n = 208) were women, the average age was 33.02±6.81, the PSQI score was 15 (13–17), and 231 (97.88%) nurses had sleep disorders during the period in Zhangjiajie, 219 nurses (81.36%) had anxiety, 135 nurses (45.76%) had depression, and 112 nurses (42.59%) felt stressed. Spearman correlation analysis was used to associate the PSQI with the DASS-21. The results showed that the use of hypnotic drugs was negatively correlated with DASS-21 (P<0.05), while the rest were positively correlated. The results of the multivariate analysis of sleep disorders showed that depression, anxiety, and stress were related to sleep quality (P<0.05), and there was no statistical difference in the other variables.

Conclusion

During the COVID-19 pandemic, the sleep quality and depression-anxiety-stress state of the frontline nurses performing nucleic acid testing were adversely affected. Sleep disturbance is a serious problem among nurses testing for the delta strain during the pandemic. Anxiety, stress, and depression are associated with sleep disorders. It is necessary to take corresponding measures and conduct crisis management interventions to improve sleep quality and mental health adjustment during public health emergencies.

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Most cited references 45

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The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

Daniel J. Buysse, Charles Reynolds III, Timothy H Monk … (1989)

Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.

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Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

Jianbo Lai, Simeng Ma, Ying Wang … (2020)

Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.

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The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

P.F. Lovibond, S.H. Lovibond (1995)

The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in a normal sample of N = 717 who were also administered the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The DASS was shown to possess satisfactory psychometric properties, and the factor structure was substantiated both by exploratory and confirmatory factor analysis. In comparison to the BDI and BAI, the DASS scales showed greater separation in factor loadings. The DASS Anxiety scale correlated 0.81 with the BAI, and the DASS Depression scale correlated 0.74 with the BDI. Factor analyses suggested that the BDI differs from the DASS Depression scale primarily in that the BDI includes items such as weight loss, insomnia, somatic preoccupation and irritability, which fail to discriminate between depression and other affective states. The factor structure of the combined BDI and BAI items was virtually identical to that reported by Beck for a sample of diagnosed depressed and anxious patients, supporting the view that these clinical states are more severe expressions of the same states that may be discerned in normals. Implications of the results for the conceptualisation of depression, anxiety and tension/stress are considered, and the utility of the DASS scales in discriminating between these constructs is discussed.

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Author and article information

Journal

Journal ID (nlm-ta): Psychol Res Behav Manag

Journal ID (iso-abbrev): Psychol Res Behav Manag

Journal ID (publisher-id): prbm

Title: Psychology Research and Behavior Management

Publisher: Dove

ISSN (Electronic): 1179-1578

Publication date (Electronic): 26 November 2021

Publication date Collection: 2021

Volume: 14

Pages: 1889-1900

Affiliations

[1 ]Department of Nursing, The First People’s Hospital of Changde City , Changde, 415000, Hunan Province, People’s Republic of China

Author notes

Correspondence: Xue-Qing Zhang Department of Nursing, The First People’s Hospital of Changde City , 818 Renmin Road, Changde, 415000, Hunan Province, People’s Republic of China Email 382731326@qq.com

[*]

These authors contributed equally to this work

Author information

Ping Liu http://orcid.org/0000-0002-2542-4577

Xue-Qing Zhang http://orcid.org/0000-0002-8851-596X

Article

Publisher ID: 338495

DOI: 10.2147/PRBM.S338495

PMC ID: 8631986

PubMed ID: 34858069

SO-VID: 2c488cba-76ee-4129-9bb6-c5d35c2e5582

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 16 September 2021

Date accepted : 16 November 2021

Page count

Figures: 0, Tables: 8, References: 46, Pages: 12

Funding

Funded by: the Changde Science and Technology Bureau for Emergency Special Project of COVID-19 in Changde City, Hunan Province;

This research was supported by the Changde Science and Technology Bureau for Emergency Special Project of COVID-19 in Changde City, Hunan Province (2020SK003). If necessary, the data can be opened to the public.

Sleep Quality and the Depression-Anxiety-Stress State of Frontline Nurses Who Perform Nucleic Acid Sample Collection During COVID-19: A Cross-Sectional Study

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Novel Coronavirus Disease COVID-19

Most cited references 45

The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories

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