Relationship of Stress and Insomnia with Depression among Health Care Workers in Hamadan, Iran: Application of Path Analysis

Abstract

Objectives: Various causal pathways play a role in the occurrence of depression in healthcare workers. This study aimed to assess the effect of perceived stress and insomnia on depression in healthcare workers using path analysis in Hamadan, Iran. Methods: In this cross-sectional study, healthcare workers from Shahid Beheshti and Sina hospitals in Hamedan in 2023 were recruited. Perceived stress with two subscales of perceived helplessness and perceived self-efficacy, as well as insomnia and depression, were investigated using validated questionnaires. The path analysis was applied to assess the association. Results: In total, 235 healthcare workers (35.7% nurses) were included. Gender, age, monthly working hours, and number of night shifts per month had a significant impact on depression (P<0.05). Path analysis demonstrated that except for the effect of perceived self-efficacy on insomnia, all standardized regression weights for relationships were statistically significant (P<0.05). The effect size of perceived helplessness on depression was the strongest compared to other relationships (standardized regression weight = 0.40). The direct effect of perceived helplessness and perceived self-efficacy on depression or insomnia as a mediator had a good fit to the data. Conclusion: As evidenced by the obtained results, with the implementation of intervention and preventive programs to reduce stress and improve sleep, the occurrence of depression in healthcare workers is expected to decrease significantly.