ArticleFrontiers in public health2022
Night shifts, insomnia, anxiety, and depression among Chinese nurses during the COVID-19 pandemic remission period: A network approach.
Article in Frontiers in public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Prevalence of insomnia in nurses: a meta-analysis of observational studies using the insomnia severity index.Frontiers in public health · 2026Pooled it
- Mental health and the knowledge and attitude towards insomnia among medical staff in China: a cross-sectional study.BMJ open · 2026Article
- Network analysis of anxiety, depression, stress, and sleep disturbances in healthcare workers.Frontiers in psychiatry · 2026Article
- Exploring the mediating role of psychological resilience between social support and anxiety in nurses: a cross-sectional study in Chengdu, Sichuan, China.Frontiers in public health · 2026Article
- Psychometric network analysis of depression in hypertensive older adults: identifying core symptoms and modifiable risk factors.Frontiers in psychiatry · 2026Article
- Workplace Violence Against Nurses and Its Association With Mental Health and Turnover Intention: A National Cross-Sectional Study.Journal of nursing management · 2026Article
- Associations Between Night Shifts and Comorbid Depressive-Anxiety Symptoms Among Chinese Nurses: Indirect Associations via Sleep Quality and Duration.Journal of nursing management · 2026Article
- Network analysis of burnout, depression, and anxiety with occupational and personal outcomes among clinical nurses in China.Scientific reports · 2025Article
- Prevalence of depression and anxiety and related influencing factors in the Chinese population with noncommunicable chronic diseases: A network perspective.World journal of psychiatry · 2025Article
- Anxiety, depressive and insomnia symptoms among patients with depression: a network perspective.BMC psychology · 2025Article
- A multicenter cross-sectional study of gambling disorder among patients with methamphetamine use disorder in drug rehabilitation centers: prevalence, correlates, and network analysis.Annals of general psychiatry · 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
- Article
- Sleep disorders among frontline nurses after the COVID-19 outbreak: a large-scale cross-sectional study.Journal of neural transmission (Vienna, Austria : 1996) · 2025Article
- Association between screen time and depressive and anxiety symptoms among Chinese adolescents.Frontiers in psychiatry · 2025Article
- Network characteristics of the youth's insomnia and emotional symptoms and their gender differences.Frontiers in psychiatry · 2025Article
- The bridge between anxiety and insomnia symptoms among Chinese adults before and after SARS-CoV-2 vaccination: a network analysis.Frontiers in psychiatry · 2025Article
- Fatigue as a moderator in symptom networks of insomnia, anxiety, and depression: insights from moderated network analysis.Frontiers in psychiatry · 2025Article
- Changes in the Networks of Bedtime Procrastination and Anxiety Symptoms Among Chinese Adolescents.Depression and anxiety · 2025Article
- Interrelationships of stress, burnout, anxiety, depression, quality of life and suicidality among Chinese residents under Standardized Residency Training: a network analysis.Annals of medicine · 2024Article
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Authors and funding
6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Background: The outbreak of the COVID-19 pandemic imposed a heavy workload on nurses with more frequent night shifts, which led to higher levels of insomnia, depression, and anxiety among nurses. The study aimed to describe the symptom-symptom interaction of depression, anxiety, and insomnia among nurses and to evaluate the impact of night shifts on mental distress Methods: We recruited 4,188 nurses from six hospitals in December 2020. We used the Insomnia Severity Index, Patient Health Questionnaire-9, and Generalized Anxiety Disorder Scale-7 to assess insomnia, depression, and anxiety, respectively. We used the gaussian graphical model to estimate the network. Index expected influence and bridge expected influence was adapted to identify the central and bridge symptoms within the network. We assessed the impact of night shifts on mental distress and compared the network structure based on COVID-19 frontline experience. Results: The prevalence of depression, anxiety, and insomnia was 59, 46, and 55%, respectively. Nurses with night shifts were at a higher risk for the three mental disorders. "Sleep maintenance" was the central symptom. "Fatigue," "Motor," "Restlessness," and "Feeling afraid" were bridge symptoms. Night shifts were strongly associated with sleep onset trouble. COVID-19 frontline experience did not affect the network structure. Conclusion: "Sleep maintenance," "Fatigue," "Motor," and "Restlessness" were important in maintaining the symptom network of anxiety, depression, and insomnia in nurses. Further interventions should prioritize these symptoms.
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