Loading [MathJax]/jax/output/SVG/jax.js
Research article Special Issues

Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era

  • Received: 04 October 2023 Revised: 10 December 2023 Accepted: 11 December 2023 Published: 18 December 2023
  • Introduction 

    The pandemic has led to notable psychological challenges among healthcare professionals, including nurses.

    Objective 

    Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience.

    Methods 

    Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected.

    Results 

    The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship.

    Conclusions 

    Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.

    Citation: Argyro Pachi, Athanasios Tselebis, Christos Sikaras, Eleni Paraskevi Sideri, Maria Ivanidou, Spyros Baras, Charalampos Milionis, Ioannis Ilias. Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era[J]. AIMS Public Health, 2024, 11(1): 36-57. doi: 10.3934/publichealth.2024003

    Related Papers:

    [1] Wenxue Huang, Yuanyi Pan . On Balancing between Optimal and Proportional categorical predictions. Big Data and Information Analytics, 2016, 1(1): 129-137. doi: 10.3934/bdia.2016.1.129
    [2] Dongyang Yang, Wei Xu . Statistical modeling on human microbiome sequencing data. Big Data and Information Analytics, 2019, 4(1): 1-12. doi: 10.3934/bdia.2019001
    [3] Wenxue Huang, Xiaofeng Li, Yuanyi Pan . Increase statistical reliability without losing predictive power by merging classes and adding variables. Big Data and Information Analytics, 2016, 1(4): 341-348. doi: 10.3934/bdia.2016014
    [4] Jianguo Dai, Wenxue Huang, Yuanyi Pan . A category-based probabilistic approach to feature selection. Big Data and Information Analytics, 2018, 3(1): 14-21. doi: 10.3934/bdia.2017020
    [5] Amanda Working, Mohammed Alqawba, Norou Diawara, Ling Li . TIME DEPENDENT ATTRIBUTE-LEVEL BEST WORST DISCRETE CHOICE MODELLING. Big Data and Information Analytics, 2018, 3(1): 55-72. doi: 10.3934/bdia.2018010
    [6] Xiaoxiao Yuan, Jing Liu, Xingxing Hao . A moving block sequence-based evolutionary algorithm for resource investment project scheduling problems. Big Data and Information Analytics, 2017, 2(1): 39-58. doi: 10.3934/bdia.2017007
    [7] Yaguang Huangfu, Guanqing Liang, Jiannong Cao . MatrixMap: Programming abstraction and implementation of matrix computation for big data analytics. Big Data and Information Analytics, 2016, 1(4): 349-376. doi: 10.3934/bdia.2016015
    [8] Tao Wu, Yu Lei, Jiao Shi, Maoguo Gong . An evolutionary multiobjective method for low-rank and sparse matrix decomposition. Big Data and Information Analytics, 2017, 2(1): 23-37. doi: 10.3934/bdia.2017006
    [9] Wenxue Huang, Qitian Qiu . Forward Supervised Discretization for Multivariate with Categorical Responses. Big Data and Information Analytics, 2016, 1(2): 217-225. doi: 10.3934/bdia.2016005
    [10] Yiwen Tao, Zhenqiang Zhang, Bengbeng Wang, Jingli Ren . Motality prediction of ICU rheumatic heart disease with imbalanced data based on machine learning. Big Data and Information Analytics, 2024, 8(0): 43-64. doi: 10.3934/bdia.2024003
  • Introduction 

    The pandemic has led to notable psychological challenges among healthcare professionals, including nurses.

    Objective 

    Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience.

    Methods 

    Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected.

    Results 

    The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship.

    Conclusions 

    Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.



    1. Introduction

    Multi-nominal data are common in scientific and engineering research such as biomedical research, customer behavior analysis, network analysis, search engine marketing optimization, web mining etc. When the response variable has more than two levels, the principle of mode-based or distribution-based proportional prediction can be used to construct nonparametric nominal association measure. For example, Goodman and Kruskal [3,4] and others proposed some local-to-global association measures towards optimal predictions. Both Monte Carlo and discrete Markov chain methods are conceptually based on the proportional associations. The association matrix, association vector and association measure were proposed by the thought of proportional associations in [9]. If there is no ordering to the response variable's categories, or the ordering is not of interest, they will be regarded as nominal in the proportional prediction model and the other association statistics.

    But in reality, different categories in the same response variable often are of different values, sometimes much different. When selecting a model or selecting explanatory variables, we want to choose the ones that can enhance the total revenue, not just the accuracy rate. Similarly, when the explanatory variables with cost weight vector, they should be considered in the model too. The association measure in [9], ωY|X, doesn't consider the revenue weight vector in the response variable, nor the cost weight in the explanatory variables, which may lead to less profit in total. Thus certain adjustments must be made for a better decisionning.

    To implement the previous adjustments, we need the following assumptions:

    X and Y are both multi-categorical variables where X is the explanatory variable with domain {1,2,...,α} and Y is the response variable with domain {1,2,...,β} respectively;

    the amount of data collected in this article is large enough to represent the real distribution;

    the model in the article mainly is based on the proportional prediction;

    the relationship between X and Y is asymmetric;

    It needs to be addressed that the second assumption is probably not always the case. The law of large number suggests that the larger the sample size is, the closer the expected value of a distribution is to the real value. The study of this subject has been conducted for hundreds of years including how large the sample size is enough to simulate the real distribution. Yet it is not the major subject of this article. The purpose of this assumption is nothing but a simplification to a more complicated discussion.

    The article is organized as follows. Section 2 discusses the adjustment to the association measure when the response variable has a revenue weight; section 3 considers the case where both the explanatory and the response variable have weights; how the adjusted measure changes the existing feature selection framework is presented in section 4. Conclusion and future works will be briefly discussed in the last section.


    2. Response variable with revenue weight vector

    Let's first recall the association matrix {γs,t(Y|X)} and the association measure ωY|X and τY|X.

    γs,t(Y|X)=E(p(Y=s|X)p(Y=t|X))p(Y=s)=αi=1p(X=i|Y=s)p(Y=t|X=i);s,t=1,2,..,βτY|X=ωY|XEp(Y)1Ep(Y)ωY|X=EX(EY(p(Y|X)))=βs=1αi=1p(Y=s|X=i)2p(X=i)=βs=1γssp(Y=s) (1)

    γst(Y|X) is the (s,t)-entry of the association matrix γ(Y|X) representing the probability of assigning or predicting Y=t while the true value is in fact Y=s. Given a representative train set, the diagonal entries, γss, are the expected accuracy rates while the off-diagonal entries of each row are the expected first type error rates. ωY|X is the association measure from the explanatory variable X to the response variable Y without a standardization. Further discussions to these metrics can be found in [9].

    Our discussion begins with only one response variable with revenue weight and one explanatory variable without cost weight. Let R=(r1,r2,...,rβ) to be the revenue weight vector where rs is the possible revenue for Y=s. A model with highest revenue in total is then the ideal solution in reality, not just a model with highest accuracy. Therefore comes the extended form of ωY|X with weight in Y as in 2:

    Definition 2.1.

    ˆωY|X=βs=1αi=1p(Y=s|X=i)2rsp(X=i)=βs=1γssp(Y=s)rsrs>0,s=1,2,3...,β (2)

    Please note that ωY|X is equivalent to τY|X for given X and Y in a given data set. Thus the statistics of τY|X will not be discussed in this article.

    It is easy to see that ˆωY|X is the expected total revenue for correctly predicting Y. Therefore one explanatory variable X1 with ˆωY|X1 is preferred than another X2 if ˆωY|X1ˆωY|X2. It is worth mentioning that ˆωY|X is asymmetric, i.e., ˆωY|XˆωX|Y and that ωY|X=ˆωY|X if r1=r2=...=rβ=1.

    Example.Consider a simulated data motivated by a real situation. Suppose that variable Y is the response variable indicating the different computer brands that the customers bought; X1, as one explanatory variable, shows the customers' career and X2, as another explanatory variable, tells the customers' age group. We want to find a better explanatory variable to generate higher revenue by correctly predicting the purchased computer's brand. We further assume that X1 and X2 both contain 5 categories, Y has 4 brands and the total number of rows is 9150. The contingency table is presented in 1.

    Table 1. Contingency tables:X1 vs Y and X2 vs Y.
    X1|Y y1 y2 y3 y4 X2|Y y1 y2 y3 y4
    x11 1000 100 500 400 x21 500 300 200 1500
    x12 200 1500 500 300 x22 500 400 400 50
    x13 400 50 500 500 x23 500 500 300 700
    x14 300 700 500 400 x24 500 400 1000 100
    x15 200 500 400 200 x25 200 400 500 200
     | Show Table
    DownLoad: CSV

    Let us first consider the association matrix {γY|X}. Predicting Y with the information of X1, or X2 is given by the association matrix γ(Y|X1), or γ(Y|X2) as in Table 2.

    Table 2. Association matrices:X1 vs Y and X2 vs Y.
    Y|ˆY ^y1|X1 ^y2|X1 ^y3|X1 ^y4|X1 Y|ˆY ^y1|X2 ^y2|X2 ^y3|X2 ^y4X2
    y1 0.34 0.18 0.27 0.22 y1 0.26 0.22 0.27 0.25
    y2 0.13 0.48 0.24 0.15 y2 0.25 0.24 0.29 0.23
    y3 0.24 0.28 0.27 0.21 y3 0.25 0.24 0.36 0.15
    y4 0.25 0.25 0.28 0.22 y4 0.22 0.18 0.14 0.46
     | Show Table
    DownLoad: CSV

    Please note that Y contains the true values while ˆY is the guessed one. One can see from this table that the accuracy rate of predicting y1 and y2 by X1 on the left are larger than that on the right. The cases of y3 and y4, on the other hand, are opposite.

    The correct prediction contingency tables of X1 and Y, denoted as W1, plus that of X2 and Y, denoted as W2, can be simulated through Monte Carlo simulation as in Table 3.

    Table 3. Contingency table for correct predictions: W1 and W2.
    X1|Y y1 y2 y3 y4 X2|Y y1 y2 y3 y4
    x11 471 6 121 83 x21 98 34 19 926
    x12 101 746 159 107 x22 177 114 113 1
    x13 130 1 167 157 x23 114 124 42 256
    x14 44 243 145 85 x24 109 81 489 6
    x15 21 210 114 32 x25 36 119 206 28
     | Show Table
    DownLoad: CSV

    The total number of the correct predictions by X1 is 3142 while it is 3092 by X2, meaning the model with X1 is better than X2 in terms of accurate prediction. But it maybe not the case if each target class has different revenues. Assuming the revenue weight vector of Y is R=(1,1,2,2), we have the association measure of ωY|X, and ˆωY|X as in Table 4:

    Table 4. Association measures: ωY|X, and ˆωY|X.
    X ωY|X ˆωY|X total revenue average revenue
    X1 0.3406 0.456 4313 0.4714
    X2 0.3391 0.564 5178 0.5659
     | Show Table
    DownLoad: CSV

    Given that revenue=i,sWi,skrs,i=1,2,...,α,s=1,2,...,β,k=1,2, we have the revenue for W1 as 4313, and that for W2 as 5178. Divide the revenue by the total sample size, 9150, we can obtain 0.4714 and 0.5659 respectively. Contrasting these to ˆωY|X1 and ˆωY|X2 above, we believe that they are similar, which means then ˆωY|X is truly the expected revenue.

    In summary, it is possible for an explanatory variable X with bigger ˆωY|X, i.e, the larger revenue, but with smaller ωY|X, i.e., the smaller association. When the total revenue is of the interest, it should be the better variable to be selected, not the one with larger association.


    3. Explanatory variable with cost weight and response variable with revenue weight

    Let us further discuss the case with cost weight vector in predictors in addition to the revenue weight vector in the dependent variable. The goal is to find a predictor with bigger profit in total. We hence define the new association measure as in 3.

    Definition 3.1.

    ˉωY|X=αi=1βs=1p(Y=s|X=i)2rscip(X=i) (3)

    ci>0,i=1,2,3,...,α, and rs>0,s=1,2,...,β.

    ci indicates the cost weight of the ith category in the predictor and rs means the same as in the previous section. ˉωY|X is then the expected ratio of revenue and cost, namely RoI. Thus a larger ˉωY|X means a bigger profit in total. A better variable to be selected then is the one with bigger ˉωY|X. We can see that ˉωY|X is an asymmetric measure, meaning ˉωY|XˉωY|X. When c1=c2=...=cα=1, Equation 3 is exactly Equation 2; when c1=c2=...=cα=1 and r1=r2=...=rβ=1, equation 3 becomes the original equation 1.

    Example. We first continue the example in the previous section with new cost weight vectors for X1 and X2 respectively. Assuming C1=(0.5,0.4,0.3,0.2,0.1), C2=(0.1,0.2,0.3,0.4,0.5) and R=(1,1,1,1), we have the associations in Table 5.

    Table 5. Association with/without cost vectors: X1 and X2.
    X ωY|X ˆωY|X ˉωY|X total profit average profit
    X1 0.3406 0.3406 1.3057 12016.17 1.3132
    X2 0.3391 0.3391 1.8546 17072.17 1.8658
     | Show Table
    DownLoad: CSV

    By profit=i,sWi,skrsCki,i=1,2,..,α;s=1,2,..,β and k=1,2 where Wk is the corresponding prediction contingency table, we have the profit for X1 as 12016.17 and that of X2 as 17072.17. When both divided by the total sample size 9150, they change to 1.3132 and 1.8658, similar to ˉω(Y|X1) and ˉω(Y|X2). It indicates that ˉωY|X is the expected RoI. In this example, X2 is the better variable given the cost and the revenue vectors are of interest.

    We then investigate how the change of cost weight affect the result. Suppose the new weight vectors are: R=(1,1,1,1), C1=(0.1,0.2,0.3,0.4,0.5) and C2=(0.5,0.4,0.3,0.2,0.1), we have the new associations in Table 6.

    Table 6. Association with/without new cost vectors: X1 and X2.
    X ωY|X ˆωY|X ˉωY|X total profit average profit
    X1 0.3406 0.3406 1.7420 15938.17 1.7419
    X2 0.3391 0.3391 1.3424 12268.17 1.3408
     | Show Table
    DownLoad: CSV

    Hence ˉωY|X1>ˉωY|X2, on the contrary to the example with the old weight vectors. Thus the right amount of weight is critical to define the better variable regarding the profit in total.


    4. The impact on feature selection

    By the updated association defined in the previous section, we present the feature selection result in this section to a given data set S with explanatory categorical variables V1,V2,..,Vn and a response variable Y. The feature selection steps can be found in [9].

    At first, consider a synthetic data set simulating the contribution factors to the sales of certain commodity. In general, lots of factors could contribute differently to the commodity sales: age, career, time, income, personal preference, credit, etc. Each factor could have different cost vectors, each class in a variable could have different cost as well. For example, collecting income information might be more difficult than to know the customer's career; determining a dinner waitress' purchase preference is easier than that of a high income lawyer. Therefore we just assume that there are four potential predictors, V1,V2,V3,V4 within the data set with a sample size of 10000 and get a feature selection result by monte carlo simulation in Table 7.

    Table 7. Simulated feature selection: one variable.
    X |Dmn(X)| ωY|X ˉωY|X total profit average profit
    V1 7 0.3906 3.5381 35390 3.5390
    V2 4 0.3882 3.8433 38771 3.8771
    V3 4 0.3250 4.8986 48678 4.8678
    V4 8 0.3274 3.7050 36889 3.6889
     | Show Table
    DownLoad: CSV

    The first variable to be selected is V1 using ωY|X as the criteria according to [9]. But it is V3 that needs to be selected as previously discussed if the total profit is of interest. Further we assume that the two variable combinations satisfy the numbers in Table 8 by, again, monte carlo simulation.

    Table 8. Simulated feature selection: two variables.
    X1,X2 |Dmn(X1,X2)| ωY|(X1,X2) ˉωY|(X1,X2) total profit average profit
    V1,V2 28 0.4367 1.8682 18971 1.8971
    V1,V3 28 0.4025 2.1106 20746 2.0746
    V1,V4 56 0.4055 1.8055 17915 1.7915
    V3,V2 16 0.4055 2.3585 24404 2.4404
    V3,V4 32 0.3385 2.0145 19903 1.9903
     | Show Table
    DownLoad: CSV

    As we can see, all ωY|(X1,X2)ωY|X1, but it is not case for ˉωY|(X1,X2) since the cost gets larger with two variables thus the profit drops down. As in one variable scenario, the better two variable combination with respect to ωY|(X1,X2) is (V1,V2) while ˉωY|(X1,X2) suggests (V3, V2) is the better choice.

    In summary, the updated association with cost and revenue vector not only changes the feature selection result by different profit expectations, it also reflects a practical reality that collecting information for more variables costs more thus reduces the overall profit, meaning more variables is not necessarily better on a Return-Over-Invest basis.


    5. Conclusions and remarks

    We propose a new metrics, ¯ωY|X in this article to improve the proportional prediction based association measure, ωY|X, to analyze the cost and revenue factors in the categorical data. It provides a description to the global-to-global association with practical RoI concerns, especially in a case where response variables are multi-categorical.

    The presented framework can also be applied to high dimensional cases as in national survey, misclassification costs, association matrix and association vector [9]. It should be more helpful to identify the predictors' quality with various response variables.

    Given the distinct character of this new statistics, we believe it brings us more opportunities to further studies of finding the better decision for categorical data. We are currently investigating the asymptotic properties of the proposed measures and it also can be extended to symmetrical situation. Of course, the synthetical nature of the experiments in this article brings also the question of how it affects a real data set/application. It is also arguable that the improvements introduced by the new measures probably come from the randomness. Thus we can use k-fold cross-validation method to better support our argument in the future.



    Acknowledgments



    We would like to thank all participants in this study.

    Conflicts of interest



    The authors declare no conflicts of interest.

    [1] Wise J (2023) Covid-19: WHO declares end of global health emergency. BMJ 381: 1041. https://doi.org/10.1136/bmj.p1041
    [2] Harris E (2023) WHO declares end of COVID-19 global health emergency. JAMA 329: 1817. https://doi.org/10.1001/jama.2023.8656
    [3] World Health OrganizationCoronavirus disease (COVID-2019) situation reports (2020). Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/
    [4] Nkengasong JN (2021) COVID-19: Unprecedented but expected. Nat Med 27: 363-366. https://doi.org/10.1038/s41591-021-01269-x
    [5] Huremović D (2019) Brief history of pandemics (pandemics throughout history). Psychiatry of Pandemics 16: 7-35. https://doi.org/10.1007/978-3-030-15346-5_2
    [6] Van Damme W, Dahake R, Delamou A, et al. (2020) The COVID-19 pandemic: Diverse contexts; different epidemics—How and why?. BMJ Global Health 5: e003098. https://doi.org/10.1136/bmjgh-2020-003098
    [7] Milionis C, Ilias I, Tselebis A, et al. (2023) Psychological and social aspects of vaccination hesitancy—implications for travel medicine in the aftermath of the COVID-19 crisis: A narrative review. Medicina 59: 1744. https://doi.org/10.3390/medicina59101744
    [8] Ke R, Sanche S, Romero-Severson E, et al. (2020) Fast spread of COVID-19 in Europe and the US suggests the necessity of early, strong and comprehensive interventions. medRxiv [Preprint] : 2020.04.04.20050427. https://doi.org/10.1101/2020.04.04.20050427
    [9] Read J M, Bridgen J R, Cummings D A, et al. (2021) Novel coronavirus 2019-nCoV (COVID-19): early estimation of epidemiological parameters and epidemic size estimates. Philos T Roy Soc B 376: 20200265. https://doi.org/10.1098/rstb.2020.0265
    [10] Syangtan G, Bista S, Dawadi P, et al. (2021) Asymptomatic SARS-CoV-2 carriers: A systematic review and meta-analysis. Front Public Health 8: 587374. https://doi.org/10.3389/fpubh.2020.587374
    [11] Litchfield I, Shukla D, Greenfield S (2021) Impact of COVID-19 on the digital divide: A rapid review. BMJ Open 11: e053440. https://doi.org/10.1136/bmjopen-2021-053440
    [12] Tselebis A, Sikaras C, Milionis C, et al. (2023) A moderated mediation model of the influence of cynical distrust, medical mistrust, and anger on vaccination hesitancy in nursing staff. Eur J Investig Health Psychol Educ 13: 2373-2387. https://doi.org/10.3390/ejihpe13110167
    [13] Park E, Kim WH, Kim SB (2022) How does COVID-19 differ from previous crises? A comparative study of health-related crisis research in the tourism and hospitality context. Int J Hosp Manag 103: 103199. https://doi.org/10.1016/j.ijhm.2022.103199
    [14] Contreras GW, Burcescu B, Dang T, et al. (2021) Drawing parallels among past public health crises and COVID-19. Disaster Med Public Health Prep 18: 1-7. https://doi.org/10.1017/dmp.2021.202
    [15] Dubey S, Biswas P, Ghosh R, et al. (2020) Psychosocial impact of COVID-19. Diabetes Metab Syndr 14: 779-788. https://doi.org/10.1016/j.dsx.2020.05.035
    [16] Tselebis A, Pachi A (2022) Primary mental health care in a new era. Healthcare 10: 2025. https://doi.org/10.3390/healthcare10102025
    [17] Marvaldi M, Mallet J, Dubertret C, et al. (2021) Anxiety, depression, trauma-related, and sleep disorders among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Neurosci Biobehav Rev 126: 252-264. https://doi.org/10.1016/j.neubiorev.2021.03.024
    [18] Varghese A, George G, Kondaguli SV, et al. (2021) Decline in the mental health of nurses across the globe during COVID-19: A systematic review and meta-analysis. J Glob Health 11: 05009. https://doi.org/10.7189/jogh.11.05009
    [19] Pachi A, Sikaras C, Ilias I, et al. (2022) Burnout, depression and sense of coherence in nurses during the pandemic crisis. Healthcare 10: 134. https://doi.org/10.3390/healthcare10010134
    [20] Chávez Sosa JV, Mego Gonzales FM, Aliaga Ramirez ZE, et al. (2022) Depression associated with caregiver quality of life in post-COVID-19 patients in two regions of Peru. Healthcare 10: 1219. https://doi.org/10.3390/healthcare10071219
    [21] Sikaras C, Zyga S, Tsironi M, et al. (2023) The mediating role of depression and of state anxiety οn the relationship between trait anxiety and fatigue in nurses during the pandemic crisis. Healthcare 11: 367. https://doi.org/10.3390/healthcare11030367
    [22] Jahrami H A, Alhaj O A, Humood A M, et al. (2022) Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression. Sleep Med Rev 62: 101591. https://doi.org/10.1016/j.smrv.2022.101591
    [23] Tselebis A, Lekka D, Sikaras C, et al. (2020) Insomnia, perceived stress, and family support among nursing staff during the pandemic crisis. Healthcare 8: 434. https://doi.org/10.3390/healthcare8040434
    [24] Sikaras C, Tsironi M, Zyga S, et al. (2023) Anxiety, insomnia and family support in nurses, two years after the onset of the pandemic crisis. AIMS Public Health 10: 252-267. https://doi.org/10.3934/publichealth.2023019
    [25] Yazdi Z, Sadeghniiat-Haghighi K, Javadi AR, et al. (2014) Sleep quality and insomnia in nurses with different circadian chronotypes: Morningness and eveningness orientation. Work 47: 561-567. https://doi.org/10.3233/WOR-131664
    [26] Jessica R Dietch, Daniel J Taylor, Kristi Pruiksma, et al. (2021) The nightmare disorder index: Development and initial validation in a sample of nurses. Sleep 44: zsaa254. https://doi.org/10.1093/sleep/zsaa254
    [27] Kelly W E (2022) Bad dreams and bad sleep: Relationships between nightmare frequency, insomnia, and nightmare proneness. Dreaming 32: 194-205. https://doi.org/10.1037/drm0000203
    [28] Lin YQ, Lin ZX, Wu YX, et al. (2020) Reduced sleep duration and sleep efficiency were independently associated with frequent nightmares in Chinese frontline medical workers during the coronavirus disease 2019 outbreak. Front Neurosci 14: 631025. https://doi.org/10.3389/fnins.2020.631025
    [29] Hublin C, Kaprio J, Partinen M, et al. (1999) Nightmares: Familial aggregation and association with psychiatric disorders in a nationwide twin cohort. Am J Med Genet 88: 329-336. https://doi.org/10.1002/(SICI)1096-8628(19990820)88:4<329::AID-AJMG8>3.0.CO;2-E
    [30] Ohayon MM, Guilleminault C, Priest RG (1999) Night terrors, sleepwalking and confusional arousals in the general population: Their frequency and relationship to other sleep and mental disorders. J Clin Psychiatry 60: 268-276. https://doi.org/10.4088/jcp.v60n0413
    [31] Bjorvatn B, Magerøy N, Moen BE, et al. (2015) Parasomnias are more frequent in shift workers than in day workers. Chronobiol Int 32: 1352-1358. https://doi.org/10.3109/07420528.2015.1091354
    [32] Acker KH (1993) Do critical care nurses face burnout, PTSD, or is it something else?: getting help for the helpers. AACN Clin Issues Crit Care Nurs 4: 558-565.
    [33] Kaubisch LT, Reck C, von Tettenborn A, et al. (2022) The COVID-19 pandemic as a traumatic event and the associated psychological impact on families-A systematic review. J Affect Disord 319: 27-39. https://doi.org/10.1016/j.jad.2022.08.109
    [34] Li Y, Abbas Q, Manthar S, et al. (2022) Fear of COVID-19 and secondary trauma: Moderating role of self-efficacy. Front Psychol 13: 838451. https://doi.org/10.3389/fpsyg.2022.838451
    [35] Qiu D, Li Y, Li L, et al. (2021) Prevalence of post-traumatic stress symptoms among people influenced by coronavirus disease 2019 outbreak: A meta-analysis. Eur Psychiatry 64: e30. https://doi.org/10.1192/j.eurpsy.2021.24
    [36] Secrist ME, John SG, Harper SL, et al. (2020) Nightmares in treatment-seeking youth: The role of cumulative trauma exposure. J Child Adolesc Trauma 13: 249-256. https://doi.org/10.1007/s40653-019-00268-y
    [37] Milanak ME, Zuromski KL, Cero I, et al. (2019) Traumatic event exposure, posttraumatic stress disorder, and sleep disturbances in a national sample of U.S. adults. J Trauma Stress 32: 14-22. https://doi.org/10.1002/jts.22360
    [38] Stewart NH, Koza A, Dhaon S, et al. (2021) Sleep disturbances in frontline health care workers during the COVID-19 pandemic: Social media survey study. J Med Internet Res 23: e27331. https://doi.org/10.2196/27331
    [39] Sateia M J (2014) International classification of sleep disorders-third edition. Chest 146: 1387-1394. https://doi.org/10.1378/chest.14-0970
    [40] Brock MS, Powell TA, Creamer JL, et al. (2019) Trauma associated sleep disorder: Clinical developments 5 years after discovery. Curr Psychiatry Rep 21: 80. https://doi.org/10.1007/s11920-019-1066-4
    [41] Mysliwiec V, Brock MS, Creamer JL, et al. (2018) Trauma associated sleep disorder: A parasomnia induced by trauma. Sleep Med Rev 37: 94-104. https://doi.org/10.1016/j.smrv.2017.01.004
    [42] Kim Cohen J, Turkewitz R (2012) Resilience and measured gene–environment interactions. Dev Psychopathol 24: 1297-1306. https://doi.org/10.1017/S0954579412000715
    [43] Pietrzak R H, Southwick S M (2011) Psychological resilience in OEF–OIF Veterans: Application of a novel classification approach and examination of demographic and psychosocial correlates. J Affect Disord 133: 560-568. https://doi.org/10.1016/j.jad.2011.04.028
    [44] Southwick SM, Bonanno GA, Masten AS, et al. (2014) Resilience definitions, theory, and challenges: Interdisciplinary perspectives. Eur J Psychotraumatol 1: 5. https://doi.org/10.3402/ejpt.v5.25338
    [45] Cheng M Y, Wang M J, Chang M Y, et al. (2020) Relationship between resilience and insomnia among the middle-aged and elderly: Mediating role of maladaptive emotion regulation strategies. Psychol Health Med 25: 1266-1277. https://doi.org/10.1080/13548506.2020.1734637
    [46] Palagini L, Moretto U, Novi M, et al. (2018) Lack of resilience is related to stress-related sleep reactivity, hyperarousal, and emotion dysregulation in insomnia disorder. J Clin Sleep Med 14: 759-766. https://doi.org/10.5664/jcsm.7100
    [47] Cooper A L, Brown J A, Leslie G D (2021) Nurse resilience for clinical practice: An integrative review. J Adv Nurs 77: 2623-2640. https://doi.org/10.1111/jan.14763
    [48] Pachi A, Kavourgia E, Bratis D, et al. (2023) Anger and aggression in relation to psychological resilience and alcohol abuse among health professionals during the first pandemic wave. Healthcare 11: 2031. https://doi.org/10.3390/healthcare11142031
    [49] Pachi A, Anagnostopoulou M, Antoniou A, et al. (2023) Family support, anger and aggression in health workers during the first wave of the pandemic. AIMS Public Health 10: 524-537. https://doi.org/10.3934/publichealth.2023037
    [50] Jérémie Potvin, Laura Ramos Socarras, Geneviève Forest (2021) 669 increased nightmares during the COVID-19 pandemic: Exploring the role of resilience and emotions. Sleep 44: A261-A262. https://doi.org/10.1093/sleep/zsab072.667
    [51] Faul F, Erdfelder E, Lang AG, et al. (2009) Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods 41: 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
    [52] Schoemann AM, Boulton AJ, Short SD (2017) Determining power and sample size for simple and complex mediation models. Soc Psychol. Personal Sci 8: 379-386. https://doi.org/10.1177/1948550617715068
    [53] Belicki K (1992) The relationship of nightmare frequency to nightmare suffering with implications for treatment and research. Dreaming 2: 143-148. https://doi.org/10.1037/h0094355
    [54] Belicki K (1992) Nightmare frequency versus nightmare distress: Relations to psychopathology and cognitive style. J Abnorm Psychol 101: 592-597. https://doi.org/10.1037/0021-843X.101.3.592
    [55] Böckermann M, Gieselmann A, Pietrowsky R (2014) What does nightmare distress mean? Factorial structure and psychometric properties of the Nightmare Distress Questionnaire (NDQ). Dreaming 24: 279-289. https://doi.org/10.1037/a0037749
    [56] Smith BW, Dalen J, Wiggins K, et al. (2008) The brief resilience scale: Assessing the ability to bounce back. Int J Behav Med 15: 194-200. https://doi.org/10.1080/10705500802222972
    [57] Kyriazos TA, Stalikas A, Prassa K, et al. (2018) Psychometric evidence of the Brief Resilience Scale (BRS) and modeling distinctiveness of resilience from depression and stress. Psychology 9: 1828-1857. https://doi.org/21527180-201807-201808160034-201808160034-1828-1857
    [58] Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2003) The diagnostic validity of the Athens Insomnia Scale. J Psychosom Res 55: 263-267. https://doi.org/10.1016/s0022-3999(02)00604-9
    [59] Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2000) Athens Insomnia Scale: Validation of an instrument based on ICD-10 criteria. J Psychosom Res 48: 555-560. https://doi.org/10.1016/s0022-3999(00)00095-7
    [60] Hayes A F, Rockwood N J (2020) Conditional process analysis: Concepts, computation, and advances in the modeling of the contingencies of mechanisms. Am Behav Sci 64: 19-54. https://doi.org/10.1177/0002764219859633
    [61] Hayes AF (2015) An index and test of linear moderated mediation. Multivariate Behav Res 50: 1-22. https://doi.org/10.1080/00273171.2014.962683
    [62] Sikaras C, Ilias I, Tselebis A, et al. (2021) Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece. AIMS Public Health 9: 94-105. https://doi.org/10.3934/publichealth.2022008
    [63] Tziallas D, Goutzias E, Konstantinidou E, et al. (2018) Quantitative and qualitative assessment of nurse staffing indicators across NHS public hospitals in Greece. Hell J Nurs 57: 420-449.
    [64] Tselebis A, Gournas G, Tzitzanidou G, et al. (2006) Anxiety and depression in Greek nursing and medical personnel. Psychol Rep 99: 93-96. https://doi.org/10.2466/pr0.99.1.93-96
    [65] Papathanasiou IV, Damigos D, Mavreas V (2011) Higher levels of psychiatric symptomatology reported by health professionals working in medical settings in Greece. Ann Gen Psychiatry 10: 28. https://doi.org/10.1186/1744-859X-10-28
    [66] Cheung T, Yip PS (2015) Depression, anxiety and symptoms of stress among Hong Kong nurses: A cross-sectional study. Int J Environ Res Public Health 12: 11072-11100. https://doi.org/10.3390/ijerph120911072
    [67] Scarpelli S, Alfonsi V, Mangiaruga A, et al. (2021) Pandemic nightmares: Effects on dream activity of the COVID-19 lockdown in Italy. J Sleep Res 30: e13300. https://doi.org/10.1111/jsr.13300
    [68] Gorgoni M, Scarpelli S, Alfonsi V, et al. (2021) Pandemic dreams: Quantitative and qualitative features of the oneiric activity during the lockdown due to COVID-19 in Italy. Sleep Med 81: 20-32. https://doi.org/10.1016/j.sleep.2021.02.006
    [69] Kilius E, Abbas NH, McKinnon L, et al. (2021) Pandemic nightmares: COVID-19 lockdown associated with increased aggression in female university students' dreams. Front Psychol 12: 644636. https://doi.org/10.3389/fpsyg.2021.644636
    [70] Scarpelli S, Gorgoni M, Alfonsi V, et al. (2022) The impact of the end of COVID confinement on pandemic dreams, as assessed by a weekly sleep diary: A longitudinal investigation in Italy. J Sleep Res 31: e13429. https://doi.org/10.1111/jsr.13429
    [71] Picchioni D, Goeltzenleucher B, Green DN, et al. (2002) Nightmares as a coping mechanism for Stress. Dreaming 12: 155-169. https://doi.org/10.1023/A:1020118425588
    [72] Nielsen T, Levin R (2007) Nightmares: A new neurocognitive model. Sleep Med Rev 11: 295-310. https://doi.org/10.1016/j.smrv.2007.03.004
    [73] Tselebis A, Zoumakis E, Ilias I (2021) Dream recall/affect and the hypothalamic-pituitary-adrenal axis. Clocks Sleep 3: 403-408. https://doi.org/10.3390/clockssleep3030027
    [74] Woodward S H, Stegman W K, Pavao J R, et al. (2007) Self-selection bias in sleep and psychophysiological studies of posttraumatic stress disorder. J Trauma Stress: Off Publication Int Soc Trauma Stress Stud 20: 619-623.
    [75] Schredl M (2003) Effects of state and trait factors on nightmare frequency. Eur Arch Psychiatry Clin Neurosci 253: 241-247. https://doi.org/10.1007/s00406-003-0438-1
    [76] Carr M, Nielsen T (2017) A novel differential susceptibility framework for the study of nightmares: Evidence for trait sensory processing sensitivity. Clin Psychol Rev 58: 86-96. https://doi.org/10.1016/j.cpr.2017.10.002
    [77] Schredl M, Gilles M, Wolf I, et al. (2019) Nightmares and stress: A longitudinal study. J Clin Sleep Med 15: 1209-1215. https://doi.org/10.5664/jcsm.7904
    [78] Gieselmann A, Ait Aoudia M, Carr M, et al. (2019) Aetiology and treatment of nightmare disorder: State of the art and future perspectives. J Sleep Res 28: e12820. https://doi.org/10.1111/jsr.12820
    [79] Musse FCC, Castro LdS, Sousa KMM, et al. (2020) Mental violence: The COVID-19 nightmare. Front Psychiatry 11: 579289. https://doi.org/10.3389/fpsyt.2020.579289
    [80] Riemann D, Spiegelhalder K, Feige B, et al. (2010) The hyperarousal model of insomnia: A review of the concept and its evidence. Sleep Med Rev 14: 19-31. https://doi.org/10.1016/j.smrv.2009.04.002
    [81] Feige B, Al-Shajlawi A, Nissen C, et al. (2008) Does REM sleep con-tribute to subjective wake time in primary insomnia? A com-parison of polysomnographic and subjective sleep in 100 patients. J Sleep Res 17: 180-190. https://doi. org/10.1111/j.1365-2869.2008.00651.x
    [82] Feige B, Baglioni C, Spiegelhalder K, et al. (2013) The microstructure of sleep in primary insomnia: An overview and extension. Int J Psychophysiol 89: 171-180. https://doi.org/10.1016/j.ijpsycho.2013.04.002
    [83] Perlis M L, Giles D E, Mendelson W B, et al. (1997) Psychophysiological insomnia: The behavioural model and a neurocognitive perspective. J Sleep Res 6: 179-188. https://doi.org/10.1046/j.1365-2869.1997.00045.x
    [84] van Liempt S (2012) Sleep disturbances and PTSD: A perpetual circle?. Eur J Psychotraumato 2012: 3. https://doi.org/10.3402/ejpt.v3i0.19142
    [85] Barzilay R, Moore T, Greenberg D, et al. (2020) Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers. Transl Psychiat 10: 1-8. https://doi.org/10.1038/s41398-020-00982-4
    [86] Baskin RG, Bartlett R (2021) Healthcare worker resilience during the COVID-19 pandemic: An integrative review. J Nurs Manag 29: 2329-2342. https://doi.org/10.1111/jonm.13395
    [87] Labrague LJ (2021) Pandemic fatigue and clinical nurses' mental health, sleep quality and job contentment during the covid-19 pandemic: The mediating role of resilience. J Nurs Manag 29: 1992-2001. https://doi.org/10.1111/jonm.13383
    [88] Pachi A, Tselebis A, Ilias I, et al. (2022) Aggression, alexithymia and sense of coherence in a sample of schizophrenic outpatients. In Healthcare 10: 1078. https://doi.org/10.3390/healthcare10061078
    [89] Tselebis A, Moulou A, Ilias I (2001) Burnout versus depression and sense of coherence: Study of Greek nursing staff. Nurs Health Sci 3: 69-71. https://doi.org/10.1046/j.1442-2018.2001.00074.x
    [90] Tselebis A, Anagnostopoulou T, Bratis D, et al. (2011) The 13 item family support scale: Reliability and validity of the Greek translation in a sample of Greek health care professionals. Asia Pacific Family Med 10: 1-4. https://doi.org/10.1186/1447-056X-10-3
    [91] Tselebis A, Bratis D, Pachi A, et al. (2013) Chronic obstructive pulmonary disease: Sense of coherence and family support versus anxiety and depression. Psychiatriki 24: 109-116.
    [92] Ungar M (2008) Resilience across cultures. Brit J Soc Work 38: 218-235. https://doi.org/10.1093/bjsw/bcl343
    [93] Kuldas S, Foody M (2022) Neither resiliency-trait nor resilience-state: Transactional Resiliency/e. Youth Soc 54: 1352-1376. https://doi.org/10.1177/0044118X211029309
    [94] Pollock A, Campbell P, Cheyne J, et al. (2020) Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: A mixed methods systematic review. Cochrane Database Syst Rev 11: CD013779. https://doi.org/10.1002/14651858.CD013779
    [95] McCallum L (2022) Supporting resilience and well-being in health and social care professionals during pandemics. Evid Based Nurs 25: 104. https://doi.org/10.1136/ebnurs-2020-103382
    [96] Zeng LN, Zong QQ, Yang Y, et al. (2020) Gender difference in the prevalence of insomnia: A meta-analysis of observational studies. Front Psychiatry 11: 577429. https://doi.org/10.3389/fpsyt.2020.577429
    [97] La YK, Choi YH, Chu MK, et al. (2020) Gender differences influence over insomnia in Korean population: A cross-sectional study. PLoS One 15: e0227190. https://doi.org/10.1371/journal.pone.0227190
    [98] Mong JA, Cusmano DM (2016) Gender differences in sleep: Impact of biological gender and gender steroids. Phil Trans R Soc B 371: 20150110. https://doi.org/10.1098/rstb.2015.0110
    [99] Moline ML, Broch L, Zak R (2004) Sleep in women across the life cycle from adulthood through menopause. Med Clin N Am 88: 705-36. https://doi.org/10.1016/j.mcna.2004.01.009
    [100] Polo Kantola P, Erkkola R, Helenius H, et al. (1998) When does estrogen replacement therapy improve sleep quality?. Am J Obst Gynec 178: 1002-1009. https://doi.org/10.1016/S0002-9378(98)70539-3
    [101] Schredl M, Reinhard I (2001) Gender differences in nightmare frequency: A meta-analysis. Sleep Med Rev 15: 115-121. https://doi.org/10.1016/j.smrv.2010.06.002
    [102] Schredl M (2014) Explaining the gender difference in nightmare frequency. Am J Psychol 127: 205-213. https://doi.org/10.5406/amerjpsyc.127.2.0205
    [103] Cappadona R, De Giorgi A, Di Simone E, et al. (2021) Sleep, dreams, nightmares, and sex-related differences: A narrative review. Eur Rev Med Pharmacol Sci 25: 3054-3065. https://doi.org/10.26355/eurrev_202104_25559
    [104] Resuehr D, Wu G, Johnson RL, et al. (2019) Shift work disrupts circadian regulation of the transcriptome in hospital nurses. J Biol Rhythms 34: 167-177. https://doi.org/10.1177/0748730419826694
    [105] Sardella A, Lenzo V, Basile G, et al. (2022) Gender and psychosocial differences in psychological resilience among a community of older adults during the COVID-19 pandemic. J Pers Med 12: 1414. Https://doi.org/10.3390/jpm12091414
    [106] Peyer KL, Hathaway ED, Doyle K (2022) Gender differences in stress, resilience, and physical activity during the COVID-19 pandemic. J Am Coll Health 24: 1-8. https://doi.org/10.1080/07448481.2022.2052075
    [107] Zhang M, Zhang J, Zhang F, et al. (2018) Prevalence of psychological distress and the effects of resilience and perceived social support among Chinese college students: Does gender make a difference?. Psychiatry Res 267: 409-413. https://doi.org/10.1016/j.psychres.2018.06.038
    [108] Croghan IT, Chesak SS, Adusumalli J, et al. (2021) Stress, resilience, and coping of healthcare workers during the COVID-19 pandemic. J Prim Care Community Health 12: 21501327211008448. https://doi.org/10.1177/21501327211008448
    [109] Alessandri G, Eisenberg N, Vecchione M, et al. (2016) Ego-resiliency development from late adolescence to emerging adulthood: A ten-year longitudinal study. J Adolesc 50: 91-102. https://doi.org/10.1016/j.adolescence.2016.05.004
    [110] Gooding PA, Hurst A, Johnson J, et al. (2012) Psychological resilience in young and older adults. Int J Geriatr Psychiatry 27: 262-270. https://doi.org/10.1002/gps.2712
    [111] Tselebis A, Bratis D, Karkanias A, et al. (2008) Associations on dimensions of burnout and family support for a sample of Greek nurses. Psychol Rep 103: 63-66. https://doi.org/10.2466/pr0.103.1.63-66
    [112] Suran M (2023) Overworked and Understaffed, More Than 1 in 4 US Nurses Say They Plan to Leave the Profession. JAMA 330: 1512-1514. https://doi.org/10.1001/jama.2023.10055
    [113] Christianson J, Johnson N, Nelson A, et al. (2023) Work-related burnout, compassion fatigue, and nurse intention to leave the profession during COVID-19. Nurse Leader 21: 244-251. https://doi.org/10.1016/j.mnl.2022.06.007
    [114] Chen Y, Zhang Y, Jin R (2020) Professional identity of male nursing students in 3-year colleges and junior male nurses in China. Am J Men's Health 14: 1557988320936583. https://doi.org/10.1177/1557988320936583
    [115] Kim S O, Moon S H (2021) Factors infuencing turnover intention among male nurses in Korea. Int J Environ Re Public Health 18: 9862. https://doi.org/10.3390/ijerph18189862
    [116] Nadorff MR, Nadorff DK, Germain A (2015) Nightmares: under-reported, undetected, and therefore untreated. J Clin Sleep Med 11: 747-750. https://doi.org/10.5664/jcsm.4850
    [117] Ayşe GÖK, Koğar EY (2021) A meta-analysis study on gender differences in psychological resilience levels. Cyprus Turk J Psychiatry Psychol 3: 132-143.
    [118] Boardman JD, Blalock CL, Button TM (2008) Sex differences in the heritability of resilience. Twin Res Hum Genet 11: 12-27. https://doi.org/10.1375/twin.11.1.12
    [119] Hirani S, Lasiuk G, Hegadoren K (2016) The intersection of gender and resilience. J Psychiatr Ment Health Nurs 23: 455-467. https://doi.org/10.1111/jpm.12313
  • publichealth-11-01-003-s001.pdf
  • Reader Comments
  • © 2024 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(2868) PDF downloads(222) Cited by(8)

Article outline

Figures and Tables

Figures(2)  /  Tables(5)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog