Department of Public Health, North South University, Dhaka, 1229, Bangladesh.
Armed Forces Medical College, Dhaka, 1206, Bangladesh.
BMC Health Serv Res. 2023 May 23;23(1):523. doi: 10.1186/s12913-023-09464-x.
The global outbreak of COVID-19 has created unprecedented havoc among health care workers, resulting in significant psychological strains like insomnia. This study aimed to analyze insomnia prevalence and job stressors among Bangladeshi health care workers in COVID-19 units.
We conducted this cross-sectional study to assess insomnia severity from January to March 2021 among 454 health care workers working in multiple hospitals in Dhaka city with active COVID-dedicated units. We selected 25 hospitals conveniently. We used a structured questionnaire for face-to-face interviews containing sociodemographic variables and job stressors. The severity of insomnia was measured by the Insomnia Severity Scale (ISS). The scale has seven items to evaluate the rate of insomnia, which was categorized as the absence of Insomnia (0-7); sub-threshold Insomnia (8-14); moderate clinical Insomnia (15-21); and severe clinical Insomnia (22-28). To identify clinical insomnia, a cut-off value of 15 was decided primarily. A cut-off score of 15 was initially proposed for identifying clinical insomnia. We performed a chi-square test and adjusted logistic regression to explore the association of different independent variables with clinically significant insomnia using the software SPSS version 25.0.
61.5% of our study participants were females. 44.9% were doctors, 33.9% were nurses, and 21.1% were other health care workers. Insomnia was more dominant among doctors and nurses (16.2% and 13.6%, respectively) than others (4.2%). We found clinically significant insomnia was associated with several job stressors (p < 0.05). In binary logistic regression, having sick leave (OR = 0.248, 95% CI = 0.116, 0.532) and being entitled to risk allowance (OR = 0.367, 95% CI = 0.124.1.081) showed lower odds of developing Insomnia. Previously diagnosed with COVID-19-positive health care workers had an OR of 2.596 (95% CI = 1.248, 5.399), pointing at negative experiences influencing insomnia. In addition, we observed that any training on risk and hazard increased the chances of suffering from Insomnia (OR = 1.923, 95% CI = 0.934, 3.958).
It is evident from the findings that the volatile existence and ambiguity of COVID-19 have induced significant adverse psychological effects and subsequently directed our HCWs toward disturbed sleep and insomnia. The study recommends the imperativeness to formulate and implement collaborative interventions to help HCWs cope with this crisis and mitigate the mental stresses they experience during the pandemic.
COVID-19 在全球范围内的爆发给医护人员带来了前所未有的破坏，导致他们出现了严重的失眠等心理压力。本研究旨在分析 COVID-19 病房中孟加拉国医护人员的失眠发生率和工作压力源。
我们于 2021 年 1 月至 3 月期间在达卡市多家设有 COVID-19 专用病房的医院进行了这项横断面研究，评估了 454 名医护人员的失眠严重程度。我们选择了 25 家医院进行方便抽样。我们使用包含社会人口学变量和工作压力源的结构化问卷进行面对面访谈。使用失眠严重程度量表（ISS）评估失眠严重程度。该量表有 7 个项目来评估失眠率，分为无失眠（0-7）；亚阈值失眠（8-14）；中度临床失眠（15-21）；和严重临床失眠（22-28）。最初确定 15 作为临床失眠的截断值。我们使用 SPSS 版本 25.0 进行卡方检验和调整后的逻辑回归，以评估不同的独立变量与具有临床意义的失眠之间的关联。
我们研究参与者中有 61.5%为女性。44.9%为医生，33.9%为护士，21.1%为其他医护人员。医生和护士的失眠发生率（分别为 16.2%和 13.6%）高于其他人员（4.2%）。我们发现具有临床意义的失眠与多种工作压力源有关（p<0.05）。在二元逻辑回归中，病假（OR=0.248，95%CI=0.116，0.532）和有权获得风险津贴（OR=0.367，95%CI=0.124.1.081）的医护人员发生失眠的几率较低。先前被诊断为 COVID-19 阳性的医护人员的 OR 为 2.596（95%CI=1.248，5.399），这表明负面经历会影响失眠。此外，我们发现任何关于风险和危害的培训都会增加失眠的几率（OR=1.923，95%CI=0.934，3.958）。
研究结果表明，COVID-19 的不稳定存在和不确定性导致了医护人员产生了严重的心理影响，从而导致他们的睡眠和失眠受到干扰。研究建议制定和实施协作干预措施的必要性，以帮助医护人员应对这一危机，并减轻他们在大流行期间所经历的精神压力。
