Questionnaire investigation on occurrence post-traumatic stress disorder and sleep quality of nurses in emergency department / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the relationship between post-traumatic stress disorder (PTSD) and sleep quality among emergency nurses, as well as the regulatory effects of gender on this relationship. Methods Two hundred and forty eight nurses in departments emergency of 8 tertiary general hospitals in Zhejiang province from October 2017 to February 2018 were enrolled as the respondents including 62 males and 186 females. The differences in sleep quality and PTSD among nurses of different genders were analyzed by questionnaires; the PTSD checklist and Pittsburgh sleep quality index (PSQI) were used to evaluate PTSD and sleep quality situations of different gender nurses; the correlations of PTSD, PSQI total score and each dimension score were analyzed by Pearson correlation analysis; and the regulatory role of gender on PTSD and PSQI score were analyzed by multiple linear regression method. Results The survey showed that the positive rate of sleep disorder was 46.77% (116/248) and the positive rate of PTSD was 43.95% (109/249) in emergency nurses. The total scores of PTSD and each score of following dimensionsre-experience symptoms, avoidance symptoms, high alert symptoms, and the total scores of PSQI and each score of dimensions of sleep quality, sleep entering time, sleep time, sleep efficiency, sleep disorders and using hypnotics of male nurses were significantly lower than those of the female nurses (total scores of PTSD 33.94±9.36 vs. 38.05±5.69, re-experience symptoms 9.43±2.62 vs. 10.40±2.39, avoidance symptoms 14.85±4.43 vs. 16.54±3.69, high alertness symptoms 9.66±2.35 vs. 11.04±2.49; total scores of PSQI 7.39±1.42 vs. 8.32±3.52, sleep quality0.91±0.42 vs. 1.08±0.49, sleep time 1.82±0.77 vs. 1.69±0.69, sleep efficiency 0.85±0.44 vs. 1.07±0.45, sleep disorders 1.08±0.29 vs. 1.33±0.56, hypnotics 0.23±0.08 vs. 0.46±0.12, all P < 0.05). Pearson correlation analysis showed that re-experience symptoms of female nurses had no significant correlations with sleep time and sleep efficiency (all P >0.05), but had significant positive correlations with other dimensions of PSQI (all P < 0.05), and the correlation coefficient was 0.22 - 0.64; in the aspect of male nurses, re-experience symptoms and hypnotic drugs, as well as high alert symptoms and sleep disorders, time function were of no correlations (all P > 0.05), but with other PSQI dimensions showed significant positive correlations (all P < 0.05), and the correlation coefficient was 0.11 - 0.43. The multiple linear regression analysis showed that the re-experiencing symptoms, avoidance symptoms and high alertness symptoms were positive predictive PSQI scores (β= 0.840, 0.970, 0.500, P = 0.026, 0.012, 0.000); the relationship between re-experiencing symptoms, high alertness symptoms and scores of PSQI could be adjusted by gender (β= 0.950, 0.290, P = 0.003, 0.032), the re-experiencing symptoms and high alertness symptoms could positively predict the PSQI scores of female nurses (β= 0.440, 0.570, P = 0.017, 0.001), and were slightly worse in predicting the PSQI scores of male nurses (β= 0.390, 0.110, P = 0.004, 0.048). Conclusion The predictive effect of PTSD different dimensions on PSQI score varies with difference in gender, and compared with male emergency nurses, the stress state of female emergency nurses is more easily to reduce sleep quality.