The mediating role of sleep quality in the relationship between professional identity and anxiety symptoms among emergency nurses: a cross-sectional study.

Background: Emergency nurses have long been exposed to high-intensity workloads and psychologically demanding environments, placing them at increased risk of anxiety symptoms. Professional identity is considered an important occupational resource that may buffer psychological distress, yet little is known about the mechanisms through which it influences anxiety. Sleep quality, a crucial determinant of mental health, may serve as a potential mediator in this association. Objective: This study aimed to examine the relationship between professional identity and anxiety symptoms among emergency nurses and to explore whether sleep quality mediates this association. Methods: A cross-sectional study was conducted among 179 emergency nurses from a tertiary teaching hospital in China. Participants completed the Generalized Anxiety Disorder Scale (GAD-7), the Pittsburgh Sleep Quality Index (PSQI), and the Professional Identity Scale for Nurses (PISN). Based on a GAD-7 cutoff score of ≥5, participants were classified into the anxiety group ( Results: The prevalence of anxiety symptoms was 38.5%. Nurses with anxiety showed significantly poorer sleep quality and lower professional identity levels compared with non-anxious nurses ( Conclusion: Lower professional identity and poor sleep quality are significant risk factors for anxiety symptoms among emergency nurses. Sleep quality plays a partial mediating role in this association. Interventions designed to strengthen professional identity while improving sleep health may effectively reduce anxiety symptoms in this workforce.