Prevalence and Associated Factors of Depression and Insomnia among Intensive Care Unit Nurses in a Tertiary Care Hospital

Abstract

A descriptive correlational study was conducted to identify the prevalence and associated factors of depressive symptoms and insomnia among nurses who experienced and worked during the COVID-19 pandemic in an intensive care unit at a university hospital. Data were collected during the COVID-19 pandemic.  A total of 124 intensive care unit nurses were recruited using stratified random sampling. All nurses completed three questionnaires: 1) a demographic data form; 2) the Patient Health Questionnaire-9 form (PHQ-9) with a cut-off point PHQ-9 equal to or greater than 9, with a sensitivity of 84%, specificity of 77%, positive predictive value of 21%, negative predictive value of 99, positive likelihood ratio of 3.71, and Area Under the Curve (AUC) = 0.89; and 3) the Insomnia Severity Index (ISI), which has a sensitivity of 86.1% and specificity of 87.7% reported at the cut-off point equal to or greater than 10. The data were analyzed using descriptive statistics, Chi-squared test, and multivariate logistic regression.

This study revealed that the average age of the intensive care unit nurses was 33.95 (SD = 9.61)years old. The most common pre-existing condition was allergies, prevalent in 19.4% of nurses. The most prevalent existing psychiatric condition was depression, prevalent in 5.6% of nurses. Approximately 5.6% of nurses use sedatives or sleep aids such as melatonin and antihistamines. The average duration of work was 11 (SD = 9.54) years. Most intensive care unit nurses sleep less than 6 hours per night, accounting for 57.3%. The prevalence of depressive symptoms was 9.68%. Factors associated with depressive symptoms included individuals
who had a day-shift schedule of eleven hours or more (adjusted OR = 6.80, 95% CI: 1.16-40.01, p-value = 0.034), and those who reported a total sleep time of less than 6 hours per night (adjusted OR = 15.11, 95% CI: 1.03-221.19, p-value = 0.047). In terms of insomnia, a prevalence of 15.32% was observed. Factors related to insomnia included a history of psychiatric disorder (adjusted OR = 9.35, 95% CI: 1.01-86.62, p-value = 0.049), using sedatives or sleep aids (adjusted OR =16.49, 95% CI: 1.61-169.36, p-value = 0.018), a total sleep time per night of less than six hours (adjusted OR =19.42, 95% CI: 2.56-147.1, p-value = 0.004), and working in an internal medicine intensive care unit or intensive cardiac care unit (adjusted OR = 5.31, 95% CI: 1.31- 21.55, p-value = 0.019). As such, it is important to promote work schedules appropriate to the needs of intensive care nurses and emphasize the significance of rest during shifts to help reduce the prevalence of depressive symptoms and insomnia.