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Anger, Cynical Distrust, Nightmare Distress and Insomnia Among Nursing Personnel
Athanasios Tselebis1, Argyro Pachi1, Christos Sikaras2
1Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece.
Journal of Clinical Medicine
|May 27, 2026
Summary
Nurses experiencing anger, nightmare distress, and insomnia are common. Cynical distrust and nightmares mediate the link between anger and insomnia, suggesting interventions should address these interconnected issues.
Area of Science:
- Nursing
- Psychology
- Healthcare worker well-being
Background:
- The nursing profession faces significant emotional tolls, impacting healthcare workers' lives.
- Systemic pressures and moral injury contribute to anger and cynicism among nurses.
- This psychological strain can lead to insomnia and nightmare distress, creating a cycle of exhaustion.
Purpose of the Study:
- To explore the interrelationships between anger, cynical distrust, nightmare distress, and insomnia in nurses.
- To determine the prevalence rates of these symptoms within the nursing population.
- To understand how these "invisible" symptoms reflect the current state of healthcare.
Main Methods:
- A cross-sectional online study conducted in October 2025.
- Involved 441 hospital nurses.
- Utilized validated questionnaires: DAR-5, CDS-8, NDQ, and AIS.
Main Results:
- Prevalence rates: anger (41.5%), nightmare distress (6.6%), and insomnia (62.1%).
- Elevated cynical distrust was noted in 20.9% of nurses.
- Anger directly and indirectly associated with insomnia, mediated by cynical distrust and nightmare distress.
Conclusions:
- Anger, cynical distrust, and nightmare distress are significantly linked to insomnia in nurses.
- These findings suggest potential targets for interventions aimed at improving nurse well-being.
- Further experimental studies are needed to confirm intervention effectiveness.
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