Effect of occupational stress and resilience on insomnia among nurses during COVID-19 in China: a structural equation modelling analysis

Abstract

ObjectivesTo explore the effects of occupational stress and resilience on insomnia among Chinese nurses during the COVID-19 pandemic.Design, settings and participantsA quantitative description study. The data were collected via a cross-sectional survey. A total of 725 front-line nurses at three tertiary hospitals in western China were included from December 2022 to January 2023. The Connor-Davidson Resilience Scale, Job Content Questionnaire, and Athens Insomnia Scale were used to collect data from a self-reported online questionnaire.Outcome measuresThe outcome variable was insomnia, and structural equation modelling was used to assess the associations among resilience, occupational stress and insomnia.ResultsThe prevalence of insomnia among the participants was 58.76%. The structural equation model showed that resilience had a negative direct effect on insomnia and occupational stress, and occupational stress had a positive direct effect on insomnia. Involvement in COVID-19-related work has a positive effect on insomnia through occupational stress. In contrast, higher education levels improved insomnia through increased resilience.ConclusionA significantly higher prevalence of insomnia has been observed among Chinese nurses during the COVID-19 pandemic. Our study suggests that better resilience may improve insomnia by relieving occupational stress, and implementing measures to promote resilience is essential to reduce occupational stress in nurses and improve their sleep quality.