Exploring the Associations between Chronotype, Night Shift Work Schedule, Quality of Work Life, and Sleep Quality among Maternal and Child Health Nurses: A Multicentre Cross-Sectional Study

Aim. To examine the state of sleep quality among maternal and child health (MCH) nurses and explore the associations between chronotype, night shift work schedule, quality of work life, and sleep quality among MCH nurses. Background. MCH nurses, who play an important role in protecting the health of women and children, often experience poor sleep quality. However, research on the sleep quality of MCH nurses has been scarce following implementation of the three-child policy in China. Methods. A multicentre cross-sectional study was conducted with 1426 MCH nurses. Data were collected using a demographic questionnaire, participants' self-reported chronotype, the Pittsburgh Sleep Quality Index, and the Work-Related Quality of Life-2 scale. A chi-squared test, independent samples t-test, Pearson correlation test, and binary logistic regression analysis were used to analyse the data. Results. Of the 1426 respondents, 57.9% reported poor sleep quality. Binary logistic regression analysis indicated that chronotype, including intermediate-morning, intermediate-evening, and evening (reference: morning), and quality of work life, including stress at work, control at work, and general well-being, had effects on sleep quality among MCH nurses. Older age, frequent caffeine intake, and irregular meals were also associated with poor sleep quality. However, night shift work schedule did not affect sleep quality in the adjusted model. Conclusions. Poor sleep quality was common among MCH nurses. The findings of this study also illustrate that chronotype and quality of work life are closely related to sleep quality. Implications for Nursing Management. Nursing managers should be aware of MCH nurses' chronotype and quality of work life and tailor interventions to address both modifiable and nonmodifiable factors associated with sleep to improve MCH nurses' sleep quality.