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      Association between circadian rhythm and sleep quality among nursing interns: A latent profile and moderation analysis

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          Abstract

          Background

          Disturbances in circadian rhythms are common among night-shift workers and result in poor sleep quality. Nevertheless, the heterogeneity of circadian rhythms and their relationship with sleep quality is less explored in nursing interns. Therefore, we aimed to identify the latent subtypes of circadian rhythm, explore their relationship with sleep quality, and evaluate their moderating role between perceived stress and sleep quality in nursing interns.

          Materials and methods

          In all, 452 nursing interns were recruited between October 2020 and January 2021 from Be Resilient to Nursing Career (BRNC), which is a multicenter, prospective cohort of a career growth program for nursing students. They were assessed using the 10-item Chinese Perceived Stress Scale, Circadian Type Inventory, and Pittsburgh Sleep Quality Index. Latent profile analysis and moderation analysis were performed.

          Results

          Overall, 72.3% of the nursing interns reported poor sleep quality. We identified three latent subtypes of circadian rhythms, namely, Vigorousness (40.1%), Inadaptability (18.6%), and Flexibility (41.1%). Females (OR = 1.97, 95% Cl: 1.01–3.83, P = 0.047) with normal body mass index (OR = 1.62, 95% CI: 0.95–2.76, P = 0.078) were prone to Flexibility. Circadian rhythm types significantly moderated the association between perceived stress and sleep quality ( P < 0.05).

          Conclusion

          Nursing interns suffer from poor sleep. There exists heterogeneity of circadian rhythm subtypes in nursing interns, and attention should be paid to those with Inadaptability type. The association between perceived stress and sleep quality is significantly moderated by circadian rhythm subtypes.

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          Most cited references65

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

          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

            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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              Statistical Power Analysis for the Behavioral Sciences

              <i>Statistical Power Analysis</i> is a nontechnical guide to power analysis in research planning that provides users of applied statistics with the tools they need for more effective analysis. The Second Edition includes: <br> * a chapter covering power analysis in set correlation and multivariate methods;<br> * a chapter considering effect size, psychometric reliability, and the efficacy of "qualifying" dependent variables and;<br> * expanded power and sample size tables for multiple regression/correlation.<br>
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                Author and article information

                Contributors
                Journal
                Front Neurosci
                Front Neurosci
                Front. Neurosci.
                Frontiers in Neuroscience
                Frontiers Media S.A.
                1662-4548
                1662-453X
                03 November 2022
                2022
                : 16
                : 995775
                Affiliations
                [1] 1School of Nursing, Guangzhou University of Chinese Medicine , Guangzhou, China
                [2] 2School of Nursing, Southern Medical University , Guangzhou, China
                [3] 3School of Nursing, Guangdong Pharmaceutical University , Guangzhou, China
                Author notes

                Edited by: Andrew W. McHill, Oregon Health and Science University, United States

                Reviewed by: Anne M. Fink, University of Illinois at Chicago, United States; Tingting Cai, Fudan University, China

                *Correspondence: Zengjie Ye, zengjieye@ 123456qq.com

                This article was submitted to Sleep and Circadian Rhythms, a section of the journal Frontiers in Neuroscience

                Article
                10.3389/fnins.2022.995775
                9669491
                36408420
                cd3dd6a6-ab44-4a27-a127-f1366776fc7f
                Copyright © 2022 Wu, Lu, Xie, Chen, Zhang, Zhou and Ye.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 20 August 2022
                : 17 October 2022
                Page count
                Figures: 6, Tables: 1, Equations: 0, References: 65, Pages: 11, Words: 6204
                Categories
                Neuroscience
                Original Research

                Neurosciences
                perceived stress,circadian rhythm,sleep quality,latent profile analysis,moderation analysis,be resilient to nursing career (brnc),nursing interns

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