Shift Work and Psychological Distress Among Healthcare Workers: The Mediating Role of Sleep Quality and the...

Background/Objectives: The study evaluated the associations among shift work, sleep quality, psychological distress, and job dissatisfaction among healthcare workers and examined the indirect association between shift work and psychological distress through sleep quality. Methods: This cross-sectional analytical study included 276 healthcare workers at Adıyaman Kahta State Hospital. Sociodemographic and occupational characteristics were assessed using a questionnaire; psychological distress was measured with the Depression Anxiety Stress Scale-21 (DASS-21), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Associations were examined using regression and mediation analyses. Results: Overall, 51.1% of participants worked shifts, and 46.0% reported job dissatisfaction. Shift workers had higher PSQI scores than regular daytime workers (10.21 ± 3.22 vs. 7.90 ± 3.48; p < 0.001) and higher DASS total scores (25.16 ± 9.35 vs. 20.28 ± 13.43; p < 0.001). PSQI scores were positively correlated with depression, anxiety, and stress scores. The mediation analysis showed a statistically significant indirect association between shift work and psychological distress through poorer sleep quality; the direct association was not statistically significant after sleep quality was included in the model. Psychological distress was independently associated with job dissatisfaction. Conclusions: These findings suggest that sleep quality may represent a statistical intermediary in the association between shift work and psychological distress. Sleep-focused and organisational strategies may warrant evaluation as potential approaches to support healthcare worker well-being.