Zhang Y, Duffy J F, De Castillero E Ronan
Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA, USA.
Division of Sleep and Circadian Disorders, Brigham Women's Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
J Psychiatr Ment Health Nurs. 2017 Oct;24(8):620-628. doi: 10.1111/jpm.12409. Epub 2017 Aug 3.
Nurses are at a high risk for work-family conflict due to long and irregular work hours and multiple physical and psychosocial stressors in their work environment. Nurses report higher rates of depressive symptoms than the general public, leading to a high rate of burnout, absenteeism, and turnover. Work-family conflict is associated with negative consequences in nurses including physical illnesses and mental disorders.
Past research on this topic has not examined the mechanisms for the effect of work family conflict on depression. Studies rarely examine the influence of health behaviors such as sleep in explaining this association. Our study identified significant association of sleep disturbances with both work-family conflict and depressive symptoms in nurses. Our main contribution is reporting the important role of sleep disturbances in translating the effect of work-family conflict on depressive symptoms among nurses.
Nurses need to receive training in best practices for maintaining their own sleep and mental health. Organizations should include sleep health education and training in workplace health programs. Evidence-based interventions to promote healthy sleep practices such as cognitive behavioral therapy and complementary and integrative approaches should be evaluated for their effectiveness in addressing the impact of work-family conflict on the mental health of nurses. Healthcare organizations should incorporate mental health services as part of their Employee Assistance Program for nurses and include psychological and sleep disorders screening, counseling, and follow-up.
Introduction Depression has been identified as the leading cause of disability worldwide. Nurses report higher rates of depression than the general public. Work-family conflict is challenging for nurses and may lead to depression and poor health. However, the mechanisms for the effect of work-family conflict on depression have not been well understood. Aim The objective is to use a cross-sectional design to examine the role of sleep disturbances in the association between work-family conflict and depressive symptoms in nurses. Methods Questionnaires, measuring working conditions, work-family conflict, sleep disturbances and depressive symptoms were collected from 397 nurses at a not-for-profit community hospital in the north-eastern United States. Results We observed a significant association between work-family conflict and depressive symptoms (β = 2.22, p < .001) among nurses. Sleep disturbances partially mediated this association by 40.54%. Discussion Sleep disturbances play an important role in translating work-family conflict into depressive symptoms. Implications Evidence-based interventions to promote healthy sleep practices should be evaluated for their effectiveness in addressing the impact of work-family conflict on mental health. Organizations should include sleep education and training as a component of workplace health promotion and employee assistance programmes to mitigate the effect of work-family conflict and promote overall health in nurses.
由于工作时间长且不规律，以及工作环境中存在多种身体和心理社会压力源，护士面临着较高的工作与家庭冲突风险。护士报告的抑郁症状发生率高于普通公众，导致倦怠、旷工和离职率较高。工作与家庭冲突会给护士带来包括身体疾病和精神障碍在内的负面后果。
过去关于该主题的研究尚未探讨工作家庭冲突对抑郁影响的机制。研究很少考察睡眠等健康行为在解释这种关联中的影响。我们的研究确定了护士的睡眠障碍与工作家庭冲突和抑郁症状之间存在显著关联。我们的主要贡献是报告了睡眠障碍在工作家庭冲突对护士抑郁症状影响的转化过程中所起的重要作用。
护士需要接受关于保持自身睡眠和心理健康的最佳实践培训。组织应将睡眠健康教育和培训纳入工作场所健康计划。应评估基于证据的促进健康睡眠实践的干预措施，如认知行为疗法以及补充和综合方法，在解决工作家庭冲突对护士心理健康影响方面的有效性。医疗保健组织应将心理健康服务纳入其针对护士的员工援助计划，并包括心理和睡眠障碍筛查、咨询及随访。
引言 抑郁症已被确定为全球致残的主要原因。护士报告的抑郁症发生率高于普通公众。工作家庭冲突对护士来说具有挑战性，可能导致抑郁和健康状况不佳。然而，工作家庭冲突对抑郁影响的机制尚未得到充分理解。目的 目的是采用横断面设计，研究睡眠障碍在护士工作家庭冲突与抑郁症状关联中的作用。方法 在美国东北部一家非营利性社区医院，对397名护士进行问卷调查，测量工作条件、工作家庭冲突、睡眠障碍和抑郁症状。结果 我们观察到护士中工作家庭冲突与抑郁症状之间存在显著关联（β = 2.22，p <.001）。睡眠障碍部分介导了这种关联，中介效应为40.54%。讨论 睡眠障碍在将工作家庭冲突转化为抑郁症状方面起着重要作用。启示 应评估基于证据的促进健康睡眠实践的干预措施，在解决工作家庭冲突对心理健康影响方面的有效性。组织应将睡眠教育和培训作为工作场所健康促进和员工援助计划的一部分，以减轻工作家庭冲突的影响，促进护士的整体健康。
