Burnout, daytime sleepiness and sleep quality among technical-level Nursing students

Amaral, Kawanna Vidotti; Galdino, Maria José Quina; Martins, Júlia Trevisan

doi:10.1590/1518-8345.5180.3487

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Brasil

Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 29 • 2021 • https://doi.org/10.1590/1518-8345.5180.3487 copy

Burnout, daytime sleepiness and sleep quality among technical-level Nursing students^* * Paper extracted from master’s thesis “Burnout, sleep quality and excessive daytime sleepiness in students of the technical nursing course”, presented to Universidade Estadual de Londrina, Londrina, PR, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to evaluate the association of the burnout syndrome with daytime sleepiness and sleep quality among technical-level Nursing students.

Method:

a cross-sectional, analytical and quantitative study, conducted with 213 students from four technical Nursing courses in a city of Paraná, Brazil. Data collection was carried out using an instrument containing characterization information, the Maslach Burnout Inventory - Student Survey, the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive statistics and logistic regression.

Results:

the prevalence values of the burnout syndrome, excessive daytime sleepiness and poor sleep quality were 4.7%, 34.7% and 58.7%, respectively. Excessive daytime sleepiness significantly increased the chances of high emotional exhaustion (OR^adj: 5.714; p<0.001) and high depersonalization (OR^adj: 4.259; p<0.001). Poor sleep quality, especially sleep disorders, was associated with all dimensions of the syndrome (p<0.05).

Conclusion:

high levels of the burnout syndrome dimensions were associated with excessive daytime sleepiness and poor sleep quality. Educational institutions should include sleep hygiene and psychosocial support in their student health promotion programs.

Descriptors:
Disorders of Excessive Somnolence; Psychological Burnout; Nursing Students; Associate Nursing Education; Sleep; Sleep Deprivation

Variables	Coding	Absolute frequency	Relative frequency
Emotional exhaustion	Low	111	52.1
Emotional exhaustion	High	102	47.9
Depersonalization	Low	166	77.9
Depersonalization	High	47	22.1
Academic efficacy	Low	170	79.8
Academic efficacy	High	43	20.2
Burnout syndrome	No	203	95.3
Burnout syndrome	Yes	10	4.7
Excessive daytime sleepiness	No	139	65.3
Excessive daytime sleepiness	Yes	74	34.7
Sleep quality	Good	51	23.9
	Poor	125	58.7
	Sleep disorder	37	17.4

Independent variables	p-value	odds ratio unadjusted^* * Univariate binary logistic regression; (95% Confidence Interval)	p-value	odds ratio adjusted† (95% Confidence Interval)
Excessive daytime sleepiness	<0.001	6.178(3.261-11.702)	<0.001	5.714(2.918-11.187)
Gender			0.029	0.354(0.140-0.898)
Age			0.053	0.966(0.932-1.000)
Work			0.621	1.186(0.604-2.328)
Use of antidepressants			0.180	0.437(0.130-1.466)
Subjective sleep quality	0.013	1.480(1.085-2.019)	0.028	1.435(1.039-1.981)
Gender			0.023	0.371(0.158-0.872)
Age			0.003	0.952(0.921-0.983)
Work			0.082	1.744(0.931-3.265)
Use of antidepressants			0.240	0.516(0.171-1.555)
Sleep latency	<0.001	2.137(1.490-3.065)	<0.001	2.160(1.467-3.183)
Gender			0.044	0.409(0.172-0.976)
Age			0.010	0.957(0.925-0.990)
Work			0.034	2.033(1.056-3.913)
Use of antidepressants			0.113	0.401(0.129-1.242)
Sleep duration	0.006	1.380(1.097-1.736)	0.002	1.513(1.172-1.955)
Gender			0.004	0.265(0.108-0.651)
Age			0.001	0.947(0.915-0.979)
Work			0.304	1.401(0.737-2.666)
Use of antidepressants			0.153	0.437(0.140-1.360)
Habitual sleep efficiency	0.014	1.543(1.093-2.177)	0.019	1.541(1.074-2.210)
Gender			0.020	0.361(0.153-0.852)
Age			0.003	0.950(0.920-0.982)
Work			0.085	1.749(0.926-3.303)
Use of antidepressants			0.167	0.444(0.140-1.405)
Sleep disorders	<0.001	3.986(1.919-8.279)	<0.001	4.463(2.026-9.829)
Gender			0.010	0.312(0.129-0.755)
Age			0.005	0.952(0.920-0.986)
Work			0.133	1.653(0.858-3.184)
Use of antidepressants			0.057	0.313(0.094-1.038)
Use of sleep medications	0.116	1.200(0.956-1.508)	0.080	1.246(0.974-1.594)
Gender			0.017	0.353(0.150-0.828)
Age			0.002	0.949(0.918-0.981)
Work			0.132	1.618(0.865-3.028)
Use of antidepressants			0.109	0.391(0.124-1.231)
Daytime dysfunction	<0.001	4.407(2.741-7.087)	<0.001	4.401(2.660-7.282)
Gender			0.043	0.375(0.145-0.969)
Age			0.085	0.969(0.934-1.004)
Work			0.123	1.721(0.863-3.428)
Use of antidepressants			0.068	0.304(0.085-1.094)
Sleep quality
Good	<0.001		<0.001
Poor	0.001	3.466(1.631-7.365)	<0.001	3.542(1.622-7.735)
Sleep disorders	<0.001	15.065(5.212-43.543)	<0.001	17.065(5.548-52.490)
Gender			0.008	0.293(0.117-0.731)
Age			0.009	0.954(0.921-0.988)
Work			0.107	1.740(0.886-3.417)
Use of antidepressants			0.086	0.355(0.109-1.157)

Independent variables	p-value	odds ratio unadjusted^* * Univariate binary logistic regression; (95% Confidence Interval)	p-value	odds ratio adjusted† (95% Confidence Interval)
Excessive daytime sleepiness	0.001	3.291(1.678-6.456)	<0.001	4.259(2.037-8.905)
Gender			0.640	1.265(0.473-3.383)
Age			0.268	1.022(0.983-1.062)
Work			0.033	0.436(0.203-0.936)
Use of antidepressants			0.282	0.418(0.086-2.045)
Subjective sleep quality	0.025	1.541(1.055-2.250)	0.030	1.533(1.043-2.252)
Gender			0.718	1.191(0.461-3.080)
Age			0.767	1.006(0.969-1.043)
Work			0.276	0.673(0.330-1.372)
Use of antidepressants			0.327	0.461(0.098-2.166)
Sleep latency	0.019	1.637(1.085-2.471)	0.017	1.682(1.096-2.583)
Gender			0.643	1.253(0.483-3.249)
Age			0.630	1.009(0.972-1.047)
Work			0.339	0.704(0.343-1.445)
Use of antidepressants			0.240	0.394(0.083-1.866)
Sleep duration	0.100	1.248(0.958-1.624)	0.050	1.317(1.000-1.734)
Gender			0.922	0.953(0.364-2.492)
Age			0.912	1.002(0.966-1.039)
Work			0.121	0.562(0.271-1.164)
Use of antidepressants			0.289	0.434(0.093-2.030)
Habitual sleep efficiency	0.058	1.397(0.988-1.973)	0.053	1.421(0.995-2.030)
Gender			0.745	1.170(0.455-3.006)
Age			0.803	1.005(0.969-1.042)
Work			0.248	0.657(0.322-1.341)
Use of antidepressants			0.277	0.423(0.089-1.995)
Sleep disorders	0.002	3.324(1.537-7.186)	0.001	4.218(1.803-9.870)
Gender			0.797	1.135(0.433-2.971)
Age			0.537	1.012(0.974-1.051)
Work			0.112	0.546(0.259-1.151)
Use of antidepressants			0.129	0.274(0.052-1.460)
Use of sleep medications	0.671	1.060(0.809-1.389)	0.428	1.121(0.845-1.488)
Gender			0.806	1.125(0.440-2.873)
Age			0.909	1.002(0.966-1.039)
Work			0.197	0.625(0.307-1.276)
Use of antidepressants			0.266	0.409(0.085-1.977)
Daytime dysfunction	0.001	2.177(1.360-3.485)	0.001	2.452(1.471-4.088)
Gender			0.561	1.336(0.504-3.540)
Age			0.284	1.022(0.982-1.063)
Work			0.154	0.588(0.284-1.220)
Use of antidepressants			0.253	0.402(0.084-1.920)
Sleep quality
Good	0.005		0.003
Poor	0.198	1.875(0.719-4.887)	0.155	2.023(0.765-5.347)
Sleep disorders	0.002	5.357(1.821-15.762)	0.001	6.029(1.990-18.269)
Gender			0.804	1.130(0.430-2.966)
Age			0.582	1.011(0.973-1.050)
Work			0.182	0.609(0.294-1.263)
Use of antidepressants			0.227	0.380(0.079-1.826)

Independent variables	p-value	odds ratio unadjusted^* * Univariate binary logistic regression; (95% Confidence Interval)	p-value	odds ratio adjusted† (95% Confidence Interval)
Excessive daytime sleepiness	0.845	1.073(0.529-2.174)	0.865	1.067(0.503-2.266)
Gender			0.025	2.680(1.132-6.347)
Age			0.412	0.983(0.943-1.024)
Work			0.443	0.742(0.346-1.591)
Use of antidepressants			0.475	0.571(0.123-2.655)
Subjective sleep quality	0.133	1.342(0.914-1.970)	0.134	1.358(0.910-2.027)
Gender			0.019	2.821(1.182-6.734)
Age			0.451	0.985(0.946-1.025)
Working			0.524	0.784(0.371-1.657)
Use of antidepressants			0.477	0.571(0.122-2.675)
Sleep latency	0.072	1.468(0.966-2.231)	0.054	1.543(0.992-2.399)
Gender			0.014	3.005(1.249-7.231)
Age			0.527	0.987(0.948-1.028)
Work			0.633	0.831(0.389-1.776)
Use of antidepressants			0.375	0.493(0.104-2.348)
Sleep duration	0.053	1.308(0.996-1.716)	0.076	1.295(0.973-1.723)
Gender			0.060	2.324(0.964-5.602)
Age			0.390	0.982(0.944-1.023)
Work			0.309	0.673(0.314-1.444)
Use of antidepressants			0.413	0.522(0.110-2.471)
Habitual sleep efficiency	0.022	1.503(1.060-2.130)	0.018	1.552(1.077-2.236)
Gender			0.018	2.883(1.202-6.914)
Age			0.490	0.986(0.947-1.027)
Work			0.508	0.775(0.364-1.650)
Use of antidepressants			0.360	0.477(0.098-2.330)
Sleep disorders	0.180	1.664(0.790-3.505)	0.181	1.729(0.775-3.858)
Gender			0.026	2.660(1.122-6.305)
Age			0.486	0.986(0.947-1.026)
Work			0.387	0.717(0.337-1.525)
Use of antidepressants			0.358	0.474(0.097-2.328)
Use of sleep medications	0.207	1.193(0.907-1.568)	0.115	1.265(0.944-1.694)
Gender			0.024	2.719(1.142-6.477)
Age			0.399	0.983(0.944-1.023)
Work			0.379	0.712(0.335-1.517)
Use of antidepressants			0.288	0.419(0.084-2.086)
Daytime dysfunction	0.485	1.179(0.742-1.874)	0.506	1.182(0.722-1.933)
Gender			0.022	2.753(1.157-6.552)
Age			0.487	0.985(0.946-1.027)
Work			0.442	0.746(0.354-1.574)
Use of antidepressants			0.449	0.550(0.117-2.583)
Sleep quality
Good	0.009		0.009
Poor	0.614	1.269(0.503-3.201)	0.706	1.201(0.465-3.100)
Sleep disorders	0.009	4.000(1.411-11.336)	0.011	4.083(1.386-12.030)
Gender			0.021	2.859(1.175-6.954)
Age			0.560	0.988(0.948-1.029)
Work			0.451	0.745(0.346-1.602)
Use of antidepressants			0.338	0.455(0.091-2.277)

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[1] *
Paper extracted from master’s thesis “Burnout, sleep quality and excessive daytime sleepiness in students of the technical nursing course”, presented to Universidade Estadual de Londrina, Londrina, PR, Brazil.