| ObjectivesTo investigate the sleep quality of nurses in 3A hospitals;to explore its influencing factors;to provide reference and guidance for improving the sleep quality of nurses.Research Subjects and Research MethodsThis research uses random cluster sampling method to conduct a field survey from July to September 2007.The survey is carried out with 1508 nurses in eight 3A hospitals in Beijing,Shanghai,Guangzhou and Chongqing as its research subjects. There are 1413 valid questionnaires received,accounting for 93.70.All the research subjects are female.The following scales are adopted in the questionnaires of this research: Pittsburgh Sleep Quality Index Scale,Self-rated Health Measurement Scale (SRHMS),Nursing Job Stressor Inventory(NJSI),M aslach Burnout Inventory (MBI),etc.In this research,the database is established by using Foxpro 6.0,and the data is processed by applying SPSS13.0 software.The statistical methods used include Descriptive Analysis,t Test,Homogeneity Test of Variances,Variance Analysis, Analysis of Correlation,Multiple Stepwise Regression Analysis etc. Results1.The total score of the Pittsburgh Sleep Quality Index(PSQI) for the nurses in 3A hospitals is(6.04±3.00).With the statistics of the scores of each component of sleep quality,we can tell that the nurses in 3A hospitals score the highest in the daytime dysfunction,sleep time and subjective sleep quality.The major impacts for the nurses' sleep quality in 3A hospitals are difficulty in falling asleep,shallow sleep and waking up early.2.Analysis on impacts of different demographic factors to the nurses' sleep quality.(1) Dividing the nurses into different groups according to their age,education level, and title of the technical post,we compare the differences of subjective sleep quality, sleep disorders,daytime functional disorders and PSQI scores.The result shows no statistical significance.(2) Dividing the nurses into different groups according to their workout,we compare the differences of the total score of sleep quality of nurses in 3A hospitals and the component score.The results indicate statistical significance(P＜0.05) in each group except sleep disorders.(3) Dividing the nurses into different groups according to their marriage status,we compare the different scores of the sleep quality of nurses in 3A hospitals.The results show no statistical significance in PSQI scores and sleep disorders.The difference is mainly reflected in subjective sleep quality and daytime functional disorders.3.The impacts of lifestyle on the sleep quality of nurses in 3A hospitals Dividing the nurses into different groups according to whether they always have breakfasts and participate in regular physical exercises(more than three times a week,about half an hour for each time),we compare the different scores of the sleep quality of nurses in 3A hospitals.The results show no statistical significance in daytime functional disorders and PSQI scores of the different groups.The difference is mainly reflected in subjective sleep quality and sleep disorders.4.Dividing the nurses into different groups according to their characters and confidence levels,we find that it has a statistical significance(P＜0.05) in different groups in the aspects of sleep quality,sleep disorders,daytime functional disorders and PSQI scores of nurse in 3A hospitals.5.Analysis of the family,economy,and security factors o that affect the sleep quality of nurses in 3A hospitals(1) Dividing the nurses into different groups according to their residential housing area and the per capita income of the family,we find that it has no statistical significance in different groups in the aspects of sleep quality,sleep disorders, daytime functional disorders and PSQI scores of nurse in 3A hospitals.(2) Dividing the nurses into different groups according to their satisfaction with their financial income and relations with their families,we find that it has a statistical significance(P＜0.05) in different groups in the aspects of sleep quality,sleep disorders,daytime functional disorders and PSQI scores of nurse in 3A hospitals.(3) Dividing the nurses into different groups according to the state of their sexual life,we find that no statistical significance in different groups is showed in the aspects of sleep disorders and PSQI scores of nurse in 3A hospitals,but a statistical significance is showed in the aspects of subjective sleep quality and daytime functional disorders.(4) Dividing the nurses into different groups according to their forms of medical security,we find that it has a statistical significance in different groups in all the aspects except that of sleep disorders of nurses in 3A hospitals.6.Analysis of the work factors that affect the sleep quality of nurses in 3A hospitals (1) Dividing the nurses into different groups according to their mood at work, feelings of the work,career prospects,and the number of night shifts,we find that it has a statistical significance(P＜0.05) in different groups in the aspects of sleep quality,sleep disorders,daytime functional disorders and PSQI scores of nurse in 3A hospitals.(2) Dividing the nurses into different groups according to their feelings of work intensity,we find that no statistical significance in different groups is showed in the aspects of sleep disorders and PSQI scores of nurse in 3A hospitals,but a statistical significance is showed in the aspects of subjective sleep quality and daytime functional disorders.(3) Dividing the nurses into different groups according to their feelings of night shifts,we find that it has a statistical significance(P＜0.05) in different groups in all the aspects except that of sleep disorders of nurse in 3A hospitals.7.Comparative analysis and correlation analysis of nurses'self-rated health status in 3A hospitals based on different sleep qualities(1) The scores of the self-rated health status of the group of nurses with better sleep quality are obviously higher than those of the other two groups.After comparing the means,we find that it has a statistical significance(P＜0.01) in the scores of the self-rated health status of the group of nurses with better sleep quality,and the scores of each dimension and subscale of the self-rated health status of the other two groups.(2) The scores of the self-rated health are significantly negatively correlated (P＜0.01) with the scores of each factor of sleep quality and the total score of the sleep quality of nurses in3A hospitals.8.Correlation analysis between the status of sleep quality and the factors like work burnout and job stressors (1) The scores of the impact of emotional exhaustion in the aspect of work burnout on the sleep quality of nurses in 3A hospitals are significantly positively correlated with the seven factors and the overall score of the sleep quality(P＜0.01). Depersonalization is significantly positively correlated with time for sleep and daytime functional disorders,and PSQI scores(P＜0.01).Decreased personal accomplishment is significantly positively correlated with sleeping time,time for sleep,sleep disorders,sleeping pills,daytime functional disorders,and PSQI scores (P＜0.01).(2) The five factors of job stressors are significantly negatively correlated with subjective sleep quality,sleeping time,daytime functional disorders and PSQI scores (P＜0.01),but not significantly correlated with sleep efficiency and sleep disorders.9.Multiple stepwise regression analysis is conducted in the research.The dependent variables are the scores of the subscales and the overall scores of the sleep quality of nurses in 3A hospitals,while the independent variables are the scores of the three factors of the self-rated health,the scores of the three factors of work burnout,and the scores of the five factors of job stressors.When a=0.05,the factors that are found in regression equations are physical health,psychological health,emotional exhaustion, decreased personal accomplishment,nursing,and workload.The highest correlation is found between the overall sleep quality and the self-rated psychological health in the self-rated health.Conclusion1.The overall sleep quality of nurses in 3A hospitals is under average,lower than normal people both at home and abroad.The major problems of the sleep quality of nurses in 3A hospitals are daytime functional disorders,decreased sleeping time,and decreased subjective sleep quality.The major problems that influence the sleep quality of nurses in 3A hospitals are difficulty in falling asleep,shallow sleep or early wake-up.2.There is significant impact of the factors like hospital management system, personality,self-confidence level,lifestyle,medical insurance forms,personal feelings of financial income,relations with their families,and work cognition on sleep quality;while there is no obvious impact of factors like age,educational level, professional titles,marital status,residential housing area,per capita income of the family and work intensity on sleep quality..There is obvious impact of the self-rated health status of nurses in 3A hospitals on sleep quality,which indicates their close relationship,and the impact of factors like physical pain,burnout,emotional stability, sense of loneliness,daily living,living conditions and overall health assessment on sleep quality is significant.3.The means of the scores of emotional exhaustion and decreased personal accomplishment are high,while that of depersonalization is moderate.There is close relationship between the sleep quality of nurses in 3A hospitals and work burnout. The more emotional exhaustion and decreased personal accomplishment the nurses have,the worse their sleep quality will be.Hence,there is significant impact of the 14 factors in the aspects of emotional exhaustion,depersonalization,and decreased personal accomplishment on the sleep quality of nurses in 3A hospitals..The job stressors of nurses in 3A hospitals are mainly reflected in the aspects of nursing and the work,time distribution and workload.The sleep quality of nurses in 3A hospitals is closely related with each factor of job stressors.The more work stress the nurses suffer,the worse their sleep quality will be.There is significant impact of the factors like lack of understanding and support among colleagues,frequent shifts,low social status,lack of sufficient knowledge to fulfill the mental requirement of patients and their families,unclear definition of work,and conflict with doctors on the sleep quality of nurses in 3A hospitals. 4.The major factors that influence the sleep quality of nurses in 3A hospitals are their physical health,mental health,emotional exhaustion,and factors related to nursing, and the overall sleep quality is most closely related with psychological health.Characteristics and innovation1.It is the first overall investigation and research on the sleep quality of nurses in 3A hospitals in several big cities in China.With a large sample size,the results of the research are highly representative.2.It is the first systematic and thorough investigation and research on the sleep quality of nurses in local and military hospitals in cities in China.3.It is the first paper to adopt Pittsburgh Sleep Quality Index Scale,Self-rated Health Measurement Sscale,the Maslach Burnout Inventory(MBI),and Nursing Job Stressor Inventory(NJSI) to explore the factors that influence the sleep quality of nurses in 3A hospitals in China.Limitations and Implications1.Restrained by the conditions of the research,the scope of this investigation is limited to the 3A hospitals in only four big cities.Whether the results can generally represent the current situation of the sleep quality of nurses in 3A hospitals needs to be further studied and verified.2.As a cross-section survey,the limited results of the research need further experimental verification.3.Constrained by the objective conditions in reality,effective control wasn't efficiently carried out when participants were filling in the questionnaire.Therefore, the results may,to some extend,have certain negative impact on the conclusions.The future sampling cities could be expanded to cover small and medium-sized cities and different levels of hospitals,so as to improve the scale analysis;nurses in hospitals at other levels could be surveyed as the subject of comparative study for in-depth exploration;further study could be conducted to select a single hospital as an intervention to verify the results of this research.
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