A Cross-Sectional Network Analysis of Psychological Resilience and Multidimensional Sleep Quality in Nurses

This study examined the associations between nurses' resilience and specific components of sleep quality and explored whether prior experiences of patient attacks influenced these relationships.

Nurses work under demanding conditions that may compromise resilience and sleep health. Understanding these relationships may help inform targeted strategies to support well-being and practice.

A cross-sectional correlational study was conducted among registered nurses from tertiary hospitals in Southwest China (N = 697). Resilience was assessed using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) and sleep quality using the seven Pittsburgh Sleep Quality Index (PSQI) components. A psychometric network model was estimated using EBICglasso regularization. Strength centrality, bridge centrality and network accuracy and stability were assessed using bootstrap procedures. Group differences by patient attack experience were examined using the Network Comparison Test with false-discovery-rate correction.

The sleep components were closely interconnected. The strongest positive associations were observed between sleep duration and sleep efficiency and between sleep disturbances and daytime dysfunction. The strongest negative association was between sleep latency and subjective sleep quality. Sleep disturbances and subjective sleep quality were the most central nodes. Bootstrap analyses supported acceptable stability (CS = 0.52). Network structure did not differ significantly by patient attack experience.

Sleep disturbances and subjective sleep quality emerged as the most central components linking resilience and multidimensional sleep quality. Interventions targeting these core domains may offer a pathway to strengthen nurses' well-being.

Greater attention to resilience and sleep-focused support within hospital systems may help strengthen nurses' well-being and occupational health.