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

Figures & data

Table 1 Demographic of Nurse Performing Nucleic Acid Test (N = 236)

Characteristics Variable	Frequency	Percent (%)
Gender
Male	28	11.86%
Female	208	88.14%
Age 33.02±6.86
≤25	37	15.68%
26~30	52	22.03%
31–40	109	46.19%
41~45	25	10.59%
46~50	13	5.51%
Education
College degree or below	45	19.07%
Bachelor’s degree	181	76.69%
Master’s degree or above	10	4.24%
Marital status
Unmarried	65	27.54%
Married	161	68.22%
Divorced/widowed	10	4.24%
Fertility status
No fertility	71	30.08%
One child	121	51.27%
Two children	44	18.64%
Years of working
<3	20	8.47%
3~5	18	7.63%
6–10	68	28.81%
11~15	88	37.29%
≥16	42	17.80%
Professional title
Junior an below	96	40.68%
Intermediate	117	49.58%
Senior	23	9.74%
Family support
NO	0	0%
Yes	236	100%
The only child
NO	140	59.32%
Yes	96	40.68%

Table 2 The Sources of Stress in Nurse Performing Nucleic Acid Test (N = 236)

Characteristics	Frequency	Percent (%)
Worried about insufficient supplies of protective materials
NO worried	193	81.78%
Mild worried	33	13.98%
Moderate worried	8	3.39%
Heavy worried	2	0.85%
Worried about occupational exposures
NO worried	42	17.80%
Mild worried	79	31.36%
Moderate worried	91	38.56%
Heavy worried	29	12.29%
Worried about personal knowledge or ability about COVID-19
NO worried	45	19.07%
Mild worried	99	41.95%
Moderate worried	64	27.12%
Heavy worried	28	11.86%
Worried about the Delta strain is more transmissible and faster to replicate
NO worried	42	17.8%
Mild worried	48	20.34%
Moderate worried	117	49.58%
Heavy worried	29	12.29%
Worried about the Delta strain is take longer to treat and recover and are more prone to severe illness.
NO worried	38	16.10%
Mild worried	107	45.34%
Moderate worried	70	29.66%
Heavy worried	21	8.90%
Worried about the cooperation of local residents
NO worried	135	57.20%
Mild worried	89	37.71%
Moderate worried	11	4.66%
Heavy worried	1	0.42%
Worried about not adapting to sleeping, eating and other lifestyle habits
NO worried	88	37.29%
Mild worried	38	16.10%
Moderate worried	89	37.71%
Heavy worried	21	8.90%

Table 3 The Training and Support in Nurse Performing Nucleic Acid Test (N = 236)

Characteristics	Frequency	Percent (%)
The training and examination related COVID-19
NO	0	0%
Yes	236	100.00%
The training and examination related to dress and undress Medical Coverall
NO	0	0%
Yes	236	100.00%
The training and examination related to perform Nucleic Acid Test
NO	0	0%
Yes	236	100.00%
Completed the vaccinated against COVID-19
NO	0	0%
Yes	236	100.00%
Psychological support during the assistance period
NO	11	4.66%
Yes	225	95.34%
Get support for sleep disorders during the assistance period
NO	86	36.44%
Yes	150	63.56%
Get humanistic care from local government during the assistance period
NO	2	0.85%
Yes	234	99.15%

Table 4 The Total Score and Subscales of PSQI Score in Nurse Performing Nucleic Acid Test (N = 236)

Characteristics	Median (M25-M75)	Percent (%)
Sleep disorders
Yes		5(2.12%)
No		231(97.88%)
Subscales score
Sleep quality	3(2–3)
Sleep latency	2(1–3)
The amount of sleep	2 (2–3)
Sleep efficiency	2(0–2)
Sleep disorders	3(2–3)
The hypnotic drug	1(1–1)
Diurnal dysfunction	3(2–3)
PSQI score	15(13–17)

Table 5 The Psychological Negative Emotion of DASS-21 in Nurse Performing Nucleic Acid Test (N = 236)

Characteristics	Depression	Anxiety	Pressure
Mean (SD)	10.18±4.00	11.67±4.49	13.32±5.59
Percent (%) Normal	128(54.24%)	44(18.64%)	151(63.98%)
Mild	74(31.36%)	49(20.76%)	33(13.98%)
Moderate	28(11.86%)	91(38.56%)	49(20.76%)
Heavy	5(2.12%)	28(11.86%)	3(1.27%)
Extremely heavy	1(0.42%)	24(1.17%)	0(0%)

Table 6 The Correlation Analysis Between Sleep Quality with Psychological Negative Emotion in Nurse Performing Nucleic Acid Test (N = 236)

Characteristics	Depression	Anxiety	Pressure
Sleep quality	0.662**	0.687**	0.578**
Sleep latency	0.304**	0.276**	0.348**
The amount of sleep	0.423**	0.408**	0.485**
Sleep efficiency	0.586**	0.594**	0.669**
Sleep disorders	0.276**	0.317**	0.308**
The hypnotic drug	−0.204**	−0.226**	−0.180**
Diurnal dysfunction	0.144*	0.136*	0.143*

Notes: *P<0.05, **P<0.01.

Table 7 The Univariate and Multivariate Analysis on Factors for Sleep Disorder Among Nurse Performing Nucleic Acid Test (N = 236)

Variable		Univariate	Multivariate
		β (95% CI) P-value	β (95% CI) P-value
Gender
	Female	0
	Male	0.09(−1.03,1.22) 0.8695
Age		0.05(0.00,0.10) 0.0592
	≤25	0
	26~30	−0.24(−1.43,0.95) 0.6879
	31–40	−0.01(−1.06,1. 04) 0.9868
	41~45	0.93(−1.51,2.36) 0.2063
	46~50	1.41(−0.37,3.19) 0.1229
Education
	College degree or below	0
	Bachelor’s degree	−0.14(−1.07,0.78) 0.07630
	Master’s degree or above	−1.40(−3.34,0.54) 0.1591
Marital status
	Unmarried	0
	Married	0.75(−0.06,1.56) 0.0763
	Divorced/widowed	1.20(−0.86,2.90) 0.2876
Years of working
	<3	0
	3~5	−0.27(−2.07,1.53) 0.7675
	6–10	0.55(−0.86,1.96) 0.4433
	11~15	0.60(−0.78,1.97) 0.3949
	≥16	1.24(−0.27,2.74) 0.1095
Professional title
	Junior an below	0
	Intermediate	0.57(−0.69,1.83) 0.3771
	Senior	1.52(−0.11,3.16) 0.0691
The only child
	NO	0
	Yes	−0.66(−1.39,0.07) 0.0787
Worried about insufficient supplies of protective materials
	NO worried	0	0
	Mild worried	−0.19(−1.21,0.83) 0.7189	0.24(−0.69,1.16) 0.6169
	Moderate worried	2.76(0.81,4.71) 0.0059	0.35(−1.30,2. 00) 0.6788
	Heavy worried	−5.61(−9.45,-1.77) 0.0046	−1.58(−4.82,1.66) 0.3400
Worried about occupational exposures
	NO worried	0	0
	Mild worried	0.37(−0.66,1.39) 0.4827	−0.25(−1.12,0.62) 0.5771
	Moderate worried	1.81(0.82,2.80) 0.0004	−0.18(−1.17,0. 81) 0.7429
	Heavy worried	2.41(1.12,3.69) 0.0003	−0.21(−1.48,1.06) 0.7517
Worried about personal knowledge or abilities about COVID-19
	NO worried	0	0
	Mild worried	1.79(0.87,2.71) 0.0002	0.41(−0.56,1.38) 0.4098
	Moderate worried	2.93(1.93,3.92) <0.0001	0.30(−0.79,1.38) 0.5910
	Heavy worried	3.55(2.32,4.78) <0.0001	−0.20(−1.45,1.06) 0.9720
Worried about the Delta strain is more transmissible and faster to replicate
	NO worried	0	0
	Mild worried	−0.19(−1.32,0.94) 0.7450	0.46(−0.58,1.50) 0.3874
	Moderate worried	1.61(0.65,2.57) 0.0012	−0.06(−1.01,0.90) 0.9095
	Heavy worried	1.68(0.39,2.97) 0.0114	−0.02(−1.17,1.13) 0.9720
Worried about the Delta strain is take longer to treat and recover and are more prone to severe illness.
	NO worried	0	0
	Mild worried	2.40(1.41,3.39) <0.0001	0.51(−0.57,1.59) 0.3585
	Moderate worried	2.32(1.26,3.38) <0.0001	0.01(−1.17,1.18) 0.9880
	Heavy worried	3.40(1.97,4.83) <0.0001	1.09(−0.35,2.53) 0.1399
Worried about the cooperation of local residents
	NO worried	0	0
	Mild worried	−0.54(−1.28,0.20) 0.1537	−0.10(−0.66,0.46) 0.7200
	Moderate worried	−3.36(−5.06,-1.67) 0.0001	−1.61(−2.98,-0.23) 0.0230
	Heavy worried	−2.00(−7.43,3.43) 0.0471	−0.88(−4.67,2.91) 0.6484
Worried about not adapting to sleeping, eating and other lifestyle habits
	NO worried	0	0
	Mild worried	0.20(−0.79,1.20) 0.6898	0.10(−0.67,0.87) 0.8069
	Moderate worried	2.12(1.35,2.89) <0.0001	0.08(−0.62,0.77) 0.8324
	Heavy worried	2.99(1.75,4.23) <0.0001	0.12(−0.96,1.20) 0.8267
Psychological support during the assistance period
	NO	0	0
	Yes	−0.67(−2.39,1.04) 0.4434	−0.22(−1.47,1.03) 0.7333
Get support for sleep disorders during the assistance period
	NO	0	0
	Yes	−0.85(−1.60,-0.11) 0.0256	0.02(−0.53,0.57) 0.9432
Get humanistic care from local government during the assistance period
	NO	0	0
	Yes	5.18(1.28,9.07) 0.0099	−0.46(−3.52,2.61) 0.7699
Depression
	Normal	0	0
	Mild	2.61(1.96,3.25) <0.0001	0.20(−0.75,1.14) 0.6849
	Moderate	4.35(3.43,5.27) <0.0001	1.86(0.14,3.58) 0.0357
	Heavy	5.65(3.64,7.66) <0.0001	3.44(0.90,5.99) 0.0086
	Extremely heavy	6.85(2.43,11.28) <0.0001	4.22(−0.29,8.74) 0.0684
Anxiety
	Normal	0	0
	Mild	2.99(2.21,3.77) <0.0001	2.95(2.16,3.73) <0.0001
	Moderate	4.54(3.85,5.23) <0.0001	3.65(2.41,4.89) <0.0001
	Heavy	5.31(4.40,6.21) <0.0001	3.56(1.92,5.21) <0.0001
	Extremely heavy	7.09(6.14,8.04) <0.0001	2.96(0.68,5.25) 0.0116
Pressure
	Normal	0	0
	Mild	2.71(1.84,3.58) <0.0001	1.55(0.77,2.32) 0.0001
	Moderate	3.75(3.01,4.50) <0.0001	1.91(1.16,2.66) <0.0001
	Heavy	4.92(2.29,7.56) 0.0003	1.26(−1.19,3.71) 0.3139
	Extremely heavy	/ /	/ /