An Empirical Study On The Relationship Between Nurses' Occupational Stress And Insomnia

Objective:To investigate the current situation and related factors of occupational stress and insomnia of nurses and analyze the relationship between occupational stress and sleep quality of nurses;On this basis,from the perspective of ecology and positive psychology,explore the mediating role of psychological capital,organizational support and family support in the relationship between nurses'occupational stress and insomnia,respectively.Methods:In this study,a cross-sectional survey was conducted between March 2019 and August 2019 to select nursing staff in a Third grade A level comprehensive hospital in Lixia District,Jinan.Stratified sampling was conducted in departments of internal,external,obstetrics and gynecology,pediatrics,emergency room,operating room and ICU.Self-administered questionnaires were conducted among 720 nursing staff and informed consent was obtained.658 effective questionnaires were collected in the study.The tools were used in the survey including:Basic Information Questionnaire,Job Content Questionnaire,Psychological Capital Scale,Perceived Organizational Support Scale,Family APGAR index Scale,and Athens Insomnia Scale.Excel 2013 and IBM SPSS Statistics 22.0 software were used for data processing,and the significance test level was P<0.05.Descriptive analysis,independent sample T test,one-way ANOVA,Chi-square test,Logistic regression analysis,hierarchical regression analysis,Pearson correlation analysis,and PROCESS 3.4 Model 4 mediating effect Model test were used for data analysis.Results:1.A single factor analysis showed that job title(?~2=11.977),working hours per week(?~2=4.235),working years(?~2=7.981),monthly income(?~2=6.080),negative life events(?~2=12.530),and sports(?~2=6.504)were the influential factors of occupational stress(P<0.05).Binary logistic regression analysis found that nurses with negative life events in the past year were 1.757 times more likely to have occupational stress than nurses without negative life events.Nurses with moderate physical activity were less prone to occupational stress than nurses with light physical activity(P<0.05).2.A single factor analysis found that the employment form(F=2.762),work department(F=3.077),position(T=2.322),working hours per week(T=-2.027),chronic illness(T=-2.825),blood pressure level(F=4.309),negative life events(T=-5.340),smoking(F=4.312),and night shifts(T=3.663)all had impacts on insomnia(P<0.05).Hierarchical regression analysis of the effects of insomnia found that when only demographic characteristics were taken as independent variables(model 1),the effects of work department,position,employment forms,weekly working hours,chronic illness,and negative life events on insomnia symptoms were statistically significant and could explain the variance of 13.8%.After introducing occupational stress variables(Model 2),in addition to the influence of department,position,employment form,weekly working time,negative life events,job control,job demand and social support also had effects on insomnia(P<0.05).The regression coefficient of job demand in the model was ?>0,and the regression coefficients of job control and social support in the model were ?<0.3.The bivariate correlation analysis found that the four dimensions of psychological capital(efficiency,hope,resilience,optimism)and job control(r=0.352,r=0.309,r=0.255,r=0.251,P<0.01),social support(r=0.363,r=0.359,r=0.294,r=0.346,P<0.01)were positively correlated,but they were negatively correlated with insomnia(r=-0.343,r=-0.366,r=-0.300,r=-0.414,P<0.01)and except that resilience was not related to job demand(r=-0.038,P>0.05),the others(efficiency,hope,optimism)were negatively correlated with job demand(r=-0.104,r=-0.145,r=-0.104,P<0.01);organizational support was positively correlated with job control(r=0.319,P<0.01)and social support(r=0.510,P<0.01),but negatively correlated with job demand and insomnia(r=-0.214,r=-0.358,P<0.01);family support was positively related with job control and social support(r=0.119,r=0.158,P<0.01),not related with job demand(r=-0.005,P>0.05),but negatively correlated with insomnia(r=-0.126,P<0.01);job control,social support were negatively correlated with insomnia(r=-0.246,r=-0.311,P<0.01),job demand was positively correlated with insomnia score(r=0.152,P<0.01),and their correlations were statistically significant(P<0.05).4.Empirical studies on occupational stress and insomnia found that:(1)Psychological capital had mediating effects in all dimensions of occupational stress(job control,job demands,social support)and insomnia.In the job control-psychological capital-insomnia model,the mediating effect(-0.032)and direct effect(-0.035)accounted for 47.8%and 52.2%of the total effect(-0.067)respectively;in the job demand-psychological capital-insomnia model,the mediating effect(0.029)and direct effect(0.086)accounted for 25.2%and 74.8%of the total effect(0.115),respectively;In the social support-psychological capital-insomnia model,the mediating effect(-0.093)and direct effect(-0.172)accounted for 35.1%and 64.9%of the total effect(-0.265),respectively.(2)Perceived organizational support had mediating effects in the three dimensions of occupational stress(job control,job demands,social support)and insomnia.In the job control-perceived organization support-insomnia model,the mediating effect(-0.025)and direct effect(-0.042)accounted for 37.3%and 62.7%of the total effect(-0.067),respectively;in the job demand-perceived organization support-insomnia model,the mediating effect(0.047)and the direct effect(0.068)accounted for 40.9%and 59.1%of the total effect(0.115)respectively;in the social support-perceived organization support-insomnia model,the mediating effect(-0.097)and the direct effect(-0.168)accounted for 36.6%and 63.4%of the total effect(-0.265),respectively.(3)The test of the mediating effect of family support on occupational stress(job control,job demand,social support)and insomnia found that bootstrap 95%CI of the mediating effect all included 0;meanwhile,the Sobel test found that the mediating effects of family support in the three models were none significant(Z=-1.425,P>0.05;Z=0.382,P>0.05;Z=-1.444,P>0.05),which indicated that the mediating role of family support was not statistically significant in the relationship between occupational stress(job control,job demand,social support)and insomnia.Conclusions:1.This study found that the incidence of nurses' occupational stress and insomnia was at a middle-to-high level compared with previous studies,which proves that nurses' occupational stress and insomnia incidence have increased in recent years.2.Title,working hours per week,working years,monthly income,negative life events,and sports were the influencing factors of occupational stress;experiencing negative life events in the past year and lack of sports were the main risk factors for nurses' occupational stress.3.Work department,position,employment form,working hours per week,chronic diseases,negative life events in the past year,job control,job demand,and social support were the main influencing factors of insomnia.4.Nurses' occupational stress,psychological capital and insomnia were related to each other,and psychological capital played mediating roles in the relationship between all the dimensions of occupational stress and insomnia.5.Nurses' occupational stress,perceived organizational support and insomnia were related to each other,and organizational support played mediating roles in the relationship between all the dimensions of nurses' occupational stress and insomnia.6.Family support did not have a mediating effect between nurses' occupational stress and insomnia,but there was a significant negative correlation between family support and insomnia.