Frontiers in public health · 2026
Moderating effect of resilience on the associations of perceived stress and anxiety with unhealthy alcohol use and insomnia in Chinese hospital staff.
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Xu Shijie, Yang Guohai, Xu Xianhua, Li Mingji
Аннотация
OBJECTIVE: This study examined the relationships among perceived stress, anxiety, unhealthy alcohol use, and insomnia among hospital staff and explored whether resilience moderates these associations.
METHODS: We conducted a cross-sectional survey among 508 hospital staff members at a tertiary hospital in Hainan Province, China. Standardized psychometric instruments were employed, including the Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder Scale (GAD-7), Connor-Davidson Resilience Scale (CD-RISC-10), Alcohol Use Disorder Identification Test (AUDIT), and Insomnia Severity Index (ISI). Statistical analyses included descriptive statistics, t-tests/ANOVA, Pearson correlations, and moderation analyses using the PROCESS Macro (Model 1) with bootstrapping (5,000 samples, 95% CI).
RESULTS: Independent samples t-tests and ANOVA revealed that perceived stress, anxiety, resilience, and unhealthy alcohol use differed significantly across occupational, socioeconomic, and personal characteristics. Correlation analysis indicated that perceived stress and anxiety were positively correlated with unhealthy alcohol use and insomnia, while resilience was negatively associated with all adverse outcomes. PROCESS moderation analysis demonstrated that resilience significantly moderated the relationships between perceived stress/anxiety and unhealthy alcohol use; these associations were significant at low and moderate resilience levels but non-significant at high resilience levels. For insomnia, the associations remained significant across all resilience levels but progressively weakened as resilience increased.
CONCLUSION: Resilience moderates the associations between perceived stress/anxiety and unhealthy alcohol use/insomnia, with higher resilience levels progressively attenuating these associations. These findings highlight the importance of implementing systematic resilience-building interventions to safeguard the mental and behavioral health of healthcare workers.
METHODS: We conducted a cross-sectional survey among 508 hospital staff members at a tertiary hospital in Hainan Province, China. Standardized psychometric instruments were employed, including the Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder Scale (GAD-7), Connor-Davidson Resilience Scale (CD-RISC-10), Alcohol Use Disorder Identification Test (AUDIT), and Insomnia Severity Index (ISI). Statistical analyses included descriptive statistics, t-tests/ANOVA, Pearson correlations, and moderation analyses using the PROCESS Macro (Model 1) with bootstrapping (5,000 samples, 95% CI).
RESULTS: Independent samples t-tests and ANOVA revealed that perceived stress, anxiety, resilience, and unhealthy alcohol use differed significantly across occupational, socioeconomic, and personal characteristics. Correlation analysis indicated that perceived stress and anxiety were positively correlated with unhealthy alcohol use and insomnia, while resilience was negatively associated with all adverse outcomes. PROCESS moderation analysis demonstrated that resilience significantly moderated the relationships between perceived stress/anxiety and unhealthy alcohol use; these associations were significant at low and moderate resilience levels but non-significant at high resilience levels. For insomnia, the associations remained significant across all resilience levels but progressively weakened as resilience increased.
CONCLUSION: Resilience moderates the associations between perceived stress/anxiety and unhealthy alcohol use/insomnia, with higher resilience levels progressively attenuating these associations. These findings highlight the importance of implementing systematic resilience-building interventions to safeguard the mental and behavioral health of healthcare workers.