Relationship among anxiety, depression, social and self-eﬃcacy in night-shift nurses
1Department of Neurology, Xinyu People's Hospital, 338025 Xinyu, Jiangxi, China
2Department of Anaesthesia, Critical Care and Pain Medicine, Fudan University Shanghai Cancer Center, 200032 Shanghai, China
3Department of Cardiology, Zhejiang Provincial People's Hospital, Aﬃliated People's Hospital, Hangzhou Medical College, 310014 Hangzhou, Zhejiang, China
4Department of Respiratory, Huashan Hospital, Fudan University, 200032 Shanghai, China
Submitted: 06 June 2021 Accepted: 16 July 2021
Online publish date: 10 August 2021
Night shift disturbs normal circadian rhythm, thus leads to several psychological problems. We aim to investigate the anxiety, depression, social support and self-efficacy of night-shift nurses compared with day-shift nurses and explore the association between emotional status and social support as well as the combined influence of social support and self-efficacy on emotional status. We conducted this quantitative comparative study in a hospital from January 1, 2019 to August 31, 2020, using the Hospital Anxiety and Depression Scale (HADS), Perceived Social Support Scale (PSSS), and General Self-Efficacy Scale (GSES). The HADS-A and HADS-D scores were higher for the night-shift nurses than for the day-shift nurses (7.38 ± 3.228 vs. 5.81 ± 3.180 and 6.79 ± 3.444 vs. 5.43 ± 3.155, respectively, P < 0.01). The family support, friend support, other support and total social support scores were lower for the night-shift nurses than for the day-shift nurses. In both groups, these scores were lower for nurses with suspected anxiety than for those without anxiety (61.16 ± 12.208 vs. 66.35 ± 9.976, P < 0.01) and were lower for nurses with suspected depression than for those without depression (59.91± 11.606 vs. 66.77 ± 10.320, P < 0.01). The item scores, total scores and total mean score for the night-shift nurses were significantly lower than those for the day-shift nurses (P < 0.01). Social support and self-efficacy had noticeable regression effects on nurses’ anxiety and depression, and both variables had significant negative effects on anxiety and depression. This study suggests that night-shift nurses may have higher anxiety and depression than day-shift nurses. Nurses with suspected anxiety and depression nurses may have lower social support than those without anxiety and depression.
Nurses; Anxiety; Depression; Social support; Self-efficacy
Hui-Xiu Liao,Hai Zou,Jie Pang,Hua-Hua Liu. Relationship among anxiety, depression, social and self-eﬃcacy in night-shift nurses. Signa Vitae. 2022.doi:10.22514/sv.2021.135.
 Adeniran R, Healy D, Sharp H, Williams JMG, Minors D, Waterhouse JM. Interpersonal sensitivity predicts depressive symptom response to the circadian rhythm disruption of nightwork. Psychological Medicine. 1996; 26: 1211–1221.
 Sircar BK, Saha MR, Deb BC, Singh PK, Pal SC. Effectiveness of oral rehydration salt solution (ORS) in reduction of death during cholera epidemic. Indian Journal of Public Health. 1990; 34: 68–70.
 Letvak S, Ruhm CJ, McCoy T. Depression in hospital-employed nurses. Clinical Nurse Specialist CNS. 2012; 26: 177–182.
 Jiao M, Ning N, Li Y, Gao L, Cui Y, Sun H, et al. Workplace violence against nurses in Chinese hospitals: a cross-sectional survey. BMJ Open. 2015; 5: e006719.
 de Leo D, Magni G, Vallerini A. Anxiety and depression in general and psychiatric nurses: a comparison. International Journal of Nursing Studies. 1982; 19: 173–175.
 Sawatzky JV. Stress in critical care nurses: Actual and perceived. Heart & Lung. 1996; 25: 409–417.
 Baba VV, Galperin BL, Lituchy TR. Occupational mental health: a study of work-related depression among nurses in the Caribbean. International Journal of Nursing Studies. 1999; 36: 163–169.
 Gao Y, Pan B, Sun W, Wu H, Wang J, Wang L. Anxiety symptoms among Chinese nurses and the associated factors: a cross sectional study. BMC Psychiatry. 2012; 12: 141.
 Dai C, Qiu H, Huang Q, Hu P, Hong X, Tu J, et al. The effect of night shift on sleep quality and depressive symptoms among Chinese nurses. Neuropsychiatric Disease and Treatment. 2019; 15: 435–440.
 Kuhn G. Circadian rhythm, shift work, and emergency medicine. Annals of Emergency Medicine. 2001; 37: 88–98.
 Ulas T, Buyukhatipoglu H, Kirhan I, Dal MS, Eren MA, Hazar A, et al. The effect of day and night shifts on oxidative stress and anxiety symptoms of the nurses. European Review for Medical and Pharmacological Sciences. 2012; 16: 594–599.
 Øyane NMF, Pallesen S, Moen BE, Akerstedt T, Bjorvatn B. Associations between night work and anxiety, depression, insomnia, sleepiness and fatigue in a sample of Norwegian nurses. PLoS ONE. 2013; 8: e70228.
 Kroenke CH, Kubzansky LD, Schernhammer ES, Holmes MD, Kawachi I. Social networks, social support, and survival after breast cancer diagnosis. Journal of Clinical Oncology. 2006; 24: 1105–1111.
 Hill J, Holcombe C, Clark L, Boothby MRK, Hincks A, Fisher J, et al. Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer. Psychological Medicine. 2011; 41: 1429–1436.
 Agard AS, Maindal HT. Interacting with relatives in intensive care unit. Nurses’ perceptions of a challenging task. Nursing in Critical Care. 2009; 14: 264–272.
 Paukert AL, Pettit JW, Kunik ME, Wilson N, Novy DM, Rhoades HM, et al. The roles of social support and self-efficacy in physical health’s impact on depressive and anxiety symptoms in older adults. Journal of Clinical Psychology in Medical Settings. 2010; 17: 387–400.
 Muris P. Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Personality and Individual Differences. 2002; 32: 337–348.
 Zheng R, Bloomer MJ, Guo Q, Lee SF. New graduate nurses’ coping with death and the relationship with death self‐efficacy and death anxiety: a multicentre cross‐sectional study. Journal of Advanced Nursing. 2021; 77: 795–804.
 Ding Y, Huang L, Feng C, Yang M, Zhang Y. Depression and self-efficacy in medical residents. Journal of Central South University. Medical Sciences. 2017; 42: 83–87. (In Chinese)
 Lev EL. Bandura’s theory of self-efficacy: applications to oncology. Scholarly Inquiry for Nursing Practice. 1997; 11: 21–43.
 Bandura A, Adams NE, Beyer J. Cognitive processes mediating behavioral change. Journal of Personality and Social Psychology. 1977; 35: 125–139.
 van der Heijden BIJM, Kümmerling A, van Dam K, van der Schoot E, Estryn-Béhar M, Hasselhorn HM. The impact of social support upon intention to leave among female nurses in Europe: Secondary analysis of data from the next survey. International Journal of Nursing Studies. 2010; 47: 434–445.
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