Occupational Stress and its Impact on Sleep Quality Among Nurses in Macao During the COVID-19 Pandemic: A Cross-Sectional Study

Abstract

Conducted during the COVID-19 pandemic, this study aimed to describe the prevalence of occupational stress and poor sleep quality among clinical nurses in Macao, identify associated factors, and examine the relationship between these variables under crisis conditions. A cross-sectional study design was employed. Data were collected from 214 clinical nurses at a hospital in Macao using a structured questionnaire that included sociodemographic information, the Chinese version of the Job Content Questionnaire (C-JCQ), and the Pittsburgh Sleep Quality Index (PSQI). The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and logistic regression. The results indicated that 32.7% of nurses experienced high occupational stress, and 50.5% suffered from poor sleep quality (mean PSQI score 7.85 ± 3.63), figures that reflect the immense strain of the pandemic era. Occupational stress was significantly associated with age, years of work experience, job title, night shift frequency, and salary (p < 0.05). Poor sleep quality was significantly associated with education level, alcohol consumption, and the presence of hobbies (p < 0.05). A significant correlation was found between dimensions of occupational stress and sleep quality. In conclusion, the pandemic amplified the significant issues of occupational stress and poor sleep quality among nurses in Macao. Hospital management must urgently implement targeted, evidence-based strategies to mitigate job-related stress and promote better sleep hygiene, thereby enhancing nurse well-being and building a more resilient workforce for future health crises.