Association between Sleep Quality, Fatigue, and Psychological Distress among Nurses Working in High-Acuity Units of a Tertiary Care Hospital, Lahore

Abstract

Background: Nurses' sleep quality and fatigue are significant occupational health issues particularly nurses working in high acuity units. Disturbance in sleep patterns, linked to lower cognitive function, emotional problems and higher clinical mistakes, is caused by factors like irregular shift work, long work hours and high stress levels. These are some of the challenges that are likely to be more severe in developing nations such as Pakistan, where there are fewer staff and more work to be done, and less research done locally. Objective: To determine the relationship between sleep quality, fatigue, and psychological distress among nurses working in a tertiary care hospital. Materials and Methods: It was a descriptive cross-sectional study that was carried out at Fatima Memorial Hospital, Lahore and was done over a period of four months. A convenient sampling method was used to pick a group of 113 staff nurses (diploma holders, Post-RN, and BSN nurses) to use as a sample. Structured questionnaire was used to gather data which comprised demographic, sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) and physical and mental fatigue measured by Chalder Fatigue Scale (CFS). Results: Most (64.3) of them were female, between 20 and 29 years (75.2) and within the five-year experience (71.7) range. The results showed that sleep disturbance (Mean=18.19), fatigue (Mean=17.55) and psychological distress were moderate to high (Mean=29.15). Correlation analysis demonstrated that all variables showed a strongly significant positive correlation: sleep quality and psychological distress (r=0.725, p=  0.001), sleep quality and fatigue (r=0.590, p= 0.001) and fatigue and psychological distress (r=0.551, p= 0.001). The level of fatigue was also considerably affected by gender (p=0.012). Conclusion: The quality of sleep, fatigue, and mental distress among nurses work in the environment with high acuity are closely interconnected. Sleep disruptions can be an important issue to tackle to enhance the well-being of nurses and patient safety. To alleviate these hazardous effects of work, the hospital management should adopt improved shift schedules, fatigue work management programs and universal mental health support facilities.