ArticleNature and science of sleep2021
Understanding the Mediating Role of Anxiety and Depression on the Relationship Between Perceived Stress and Sleep Quality Among Health Care Workers in the COVID-19 Response.
Article in Nature and science of sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed.
- Moral injury severity profiles and their pathways to negative emotions in medical staff: the differential mediating role of emotion regulation.BMC psychology · 2026Article
- Psychosocial factors associated with depression and sleep quality in patients with tuberculosis: a multicenter cross-sectional study.Journal of thoracic disease · 2026Article
- Predictors of sleep quality subscales among medical university employees in Iran: a Bayesian analysis of cross-sectional data.BMC public health · 2025Article
- Sleep and Mental Health: the Impact of the COVID-19 Pandemic on Healthcare Professionals.The Psychiatric quarterly · 2025Article
- Stress, Anxiety and Depressive Symptoms, Burnout and Insomnia Among Greek Nurses One Year After the End of the Pandemic: A Moderated Chain Mediation Model.Journal of clinical medicine · 2025Article
- A crossZhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Article
- Effects of perceived stress on college students' sleep quality: a moderated chain mediation model.BMC psychology · 2024Article
- Assessment of psychometric performance for the Chinese version of the Brief Inventory of Perceived Stress integrating exploratory graph analysis and confirmatory factor analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Assessing psychometric properties and measurement invariance of the Sleep Quality Questionnaire among healthcare students.BMC psychology · 2024Article
- Achievement motivation and mental health among medical postgraduates: the chain mediating effect of self-esteem and perceived stress.Frontiers in psychology · 2024Article
- Evaluation of burnout and stress perception levels of Turkish dental laboratory technicians according to affecting factors during the COVID-19 pandemic.Annals of medicine · 2023Article
- Depression in healthcare workers during COVID-19 pandemic: results from Czech arm of HEROES Study.Scientific reports · 2023Article
- The RU_SATED as a measure of sleep health: cross-cultural adaptation and validation in Chinese healthcare students.BMC psychology · 2023Observational
- Adaptation and validation of the Chinese version of the Sleep Quality Questionnaire.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Article
- Academic Stress and Sleep Quality among Chinese Adolescents: Chain Mediating Effects of Anxiety and School Burnout.International journal of environmental research and public health · 2023Article
- Depression and Anxiety Mediate the Association between Sleep Quality and Self-Rated Health in Healthcare Students.Behavioral sciences (Basel, Switzerland) · 2023Article
- Measurement Properties and Optimal Cutoff Point of the WHO-5 Among Chinese Healthcare Students.Psychology research and behavior management · 2023Article
- Burnout, emotional distress and sleep quality among Chinese psychiatric healthcare workers during the COVID-19 pandemic: a follow-up study.Frontiers in public health · 2023Article
- Article
- Educational degree differences in the association between work stress and depression among Chinese healthcare workers: Job satisfaction and sleep quality as the mediators.Frontiers in public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThere is an increasing amount of evidence exploring the adverse effects of perceived stress or anxiety and depression independently on sleep quality during the COVID-19 outbreak, although the underlying mechanisms are unclear. The aim of the current study was to explore the role of anxiety and depression as a potential mediator between perceived stress and sleep quality among health care workers.
methodsData were collected through an online survey using the snowball sampling method and comprised 588 current health care workers in Zhejiang and Hubei provinces, China, from February to March 2020. We administered the Sleep Quality Questionnaire (SQQ), the Perceived Stress Scale (PSS-10), the Patient Health Questionnaire (PHQ-4) and the sociodemographic characteristics and COVID-19-related characteristics questionnaire. Structural equation modelling (SEM) was used to examine the direct and indirect relationships between perceived stress, anxiety and depression, and sleep quality.
resultsThe average scores for sleep quality and perceived stress were 16.01 (95% CI [15.40, 16.57]) and 15.46 (95% CI [15.05, 15.87]), respectively. The positive rates of anxiety and depression symptom tests were 9.86% and 10.37%, respectively. The SEM results indicated that the original relationship between perceived stress and sleep quality was beta = 0.52 (
conclusionPoor sleep quality and high perceived stress were common during the COVID-19 crisis. Reducing perceived stress could help reduce anxiety and depression symptoms, thereby improving sleep quality among health care workers. In an attempt to promote psychological resources, we should perhaps take multiple measures, including personal tailored intervention and organizational humanistic concern.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.