Impact of Perceived Stress on Work Engagement Among Intensive Care Unit Nurses: The Mediating Effects of Dispositional Mindfulness and Sleep Quality.

AIM: To investigate the mediating effects of mindfulness and sleep quality on the relationship between perceived stress and work engagement among intensive care unit (ICU) nurses in China.

DESIGN

A cross-sectional survey was conducted with 623 ICU nurses from tertiary hospitals in China.

METHODS

Data were collected using validated questionnaires, including the Perceived Stress Scale, Utrecht Work Engagement Scale-9, Five Facet Mindfulness Questionnaire, and Pittsburgh Sleep Quality Index. Correlation analysis and structural equation modelling were used to examine the mediating effects of mindfulness and sleep quality. Furthermore, partial correlations were conducted to control for confounders such as night shifts, and an a posteriori power analysis was performed.

RESULTS

Perceived stress was negatively correlated with work engagement (r = -0.559, p < 0.001) and dispositional mindfulness (r = -0.686, p < 0.001) and positively correlated with poor sleep quality (r = 0.475, p < 0.001). Structural equation modelling showed that perceived stress had a direct negative effect on work engagement (beta [β] = -0.432, p < 0.001) and an indirect effect mediated by mindfulness (β = -0.083, p < 0.001) and sleep quality (β = -0.043, p < 0.001). The combined mediating effects accounted for 22.44% of the total effect. The parallel mediation model showed superior fit compared to serial mediation and alternative models (AIC = 145.2 vs. 162.8; delta-chi-square = 18.6, p < 0.01).

CONCLUSION

Dispositional mindfulness and sleep quality were significantly associated with the relationship between perceived stress and work engagement among ICU nurses. These findings suggest that strategies aimed at improving dispositional mindfulness through training and sleep quality warrant investigation as potential means to mitigate perceived stress and enhance work engagement in this population.

PATIENT OR PUBLIC CONTRIBUTION: These findings provide actionable insights for nursing managers to develop interventions promoting mental well-being and productivity in ICU settings.