卫生研究

目的 探讨三级甲等医院护士睡眠质量与生活质量的关系，并验证社会支持与心理弹性的链式中介作用。方法 采用横断面整群抽样的方法，2023年11—12月对兰州市3家三甲医院的732名护士进行问卷调查。应用生活质量量表(SF-36)、心理弹性量表(CD-RISC)、匹兹堡睡眠质量指数(PSQI)和社会支持评定量表(SSRS)测量其生活质量、心理弹性、睡眠质量和社会支持水平，采用偏相关确定各因素间的关系。结果 (1)调查对象中以女性(95.5%)、汉族(98.2%)、本科(83.6%)、工龄6～19年(78.4%)、护师职称(52.9%)为主。(2)护士睡眠质量与社会支持程度呈负相关(r=-0.226,P<0.01),与心理弹性水平呈负相关(r=-0.118,P<0.01),与生活质量水平呈负相关(r=-0.502,P<0.01);社会支持程度与心理弹性水平呈正相关(r=0.311,P<0.01),与生活质量水平呈正相关(r=0.347,P<0.01);心理弹性水平与生活质量水平呈正相关(r=0.382,P<0.01)。(3)护士的睡眠状况对生活质量产生直接影响，即直接效应显著(直接效应占比84.3%,95%CI-18.951～-13.099);社会支持程度在睡眠质量与生活质量间部分中介效应显著，即间接效应1显著(间接效应1占比9.84%,95%CI-4.261～-1.179);社会支持程度和心理弹性水平在睡眠质量与生活质量间的链式中介效应显著，即间接效应2显著(间接效应2占比5.33%,95%CI-1.710～-0.682)。结论 社会支持程度和心理弹性水平在护士的睡眠状况与生活质量的关系中起链式中介作用。

OBJECTIVE To explore the relationship between sleep quality and quality of life of nurses in tertiary hospitals, and to verify the chain-mediated role of social support and psychological resilience.METHODS A questionnaire survey was conducted from November to December 2023 on 732 nurses from three tertiary hospitals in Lanzhou City, China, using cross-sectional whole cluster sampling. The Quality of Life Scale(SF-36), the Psychological Resilience Scale(CD-RISC), the Pittsburgh Sleep Quality Index(PSQI), and the Social Support Rating Scale(SSRS) were applied to measure their quality of life, psychological resilience, quality of sleep, and social support levels. A partial correlation was used to determine the relationship between the factors.RESULTS(1) The demographic characteristics were dominated by females(95.5%), Han Chinese(98.2%), and bachelor's degree(83.6%); the occupation-related characteristics were dominated by the length of service of 6-10 years(39.9%) and 11-19 years(38.5%), and the job title was dominated by nurse practitioner(52.9%).(2) Nurses' sleep quality was negatively correlated with the level of social support(r=-0.226, P<0.01), negatively correlated with the level of psychological resilience(r=-0.118, P<0.01), and negatively correlated with the level of quality of life(r=-0.502, P<0.01). The level of social support and the level of psychological resilience were positively correlated(r=-0.311, P<0.01). and positively correlated with the level of quality of life(r=0.347, P<0.01). The level of psychological resilience was positively correlated with the level of quality of life(r=0.382, P<0.01).(3) The sleep status of nurses had a direct impact on the quality of life, that is, the direct effect was significant(Direct effect accounted for 84.3%, 95%CI-18.951-13.099). The degree of social support has a significant partial mediating effect between sleep quality and quality of life, that is, indirect effect 1(Indirect effect 1 accounted for 9.84%, 95%CI-4.261--1.179). The degree of social support and the level of mental resilience have significant chain mediating effect between sleep quality and quality of life, that is, indirect effect 2 is significant(Indirect effect 2 accounted for 5.33%, 95%CI-1.710--0.682).CONCLUSIONLevel of social support and level of psychological resilience chain-mediated the relationship between sleep status and quality of life among nurses.