The relationship of sleep quality among internship nurses with clinical learning environment and mental stress: a cross-sectional survey

Abstract

BackgroundPrevious evidence has supported an association between sleep quality and psychological stress. However, the association between internship nurses' sleep status and its relevant factors is poorly understood. ObjectiveThe aim of this study was to investigate sleep quality and its related factors in clinical learning environment and mental stress. MethodsA cross-sectional survey was conducted by three instruments: Clinical Learning Environment, Supervision, and Nurse Teacher Evaluation Scale (CLES + T), Stress Rating Scale for practicing nurses (SRS) and Pittsburgh Sleep Quality Index (PSQI). ResultsA total of 508 (91.86%) of 553 students experienced poor sleep quality. The structural equation model showed a correlation of the PSQI with the CLES + T (r = −0.21, p < 0.001), a correlation of the PSQI with the SRS (r = 0.32, p < 0.001), and a correlation of the SRS with the CLES + T (r = −0.22, p < 0.001). Linear regression analysis showed that education (B = −0.56, p < 0.001), willingness to engage in nursing after graduation (B = −0.75, p < 0.001), pedagogical atmosphere in the ward (B = −0.05, p < 0.001) measured by the CLES + T, workload (B = 0.11, p = 0.01), interpersonal relationships (B = −0.12, p = 0.03), and conflicts between study and work (B = 0.12, p < 0.001) on the SRS were significant factors influencing the PSQI. ConclusionsPoor sleep quality is common among internship nurses and it's affected by clinical environment and mental stress. It's necessary to apply more tailored education programs to promote nursing development.