Abstract
This study examined sleep quality and its associated factors among clinical nurses in a Grade A tertiary hospital in Jiangsu Province, China. Specifically, it investigated the demographics, lifestyles, health-related issues, psychologies, and administrative factors associated with poor sleep quality and development of nursing-management recommendations based on the findings. A quantitative cross-sectional survey design was used. A total of 150 registered nurses from ten clinical departments participated in the study. Data were collected through online questionnaire that included demographic information, lifestyle and health-related variables, administrative factors, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI), the Perceived Stress Scale (PSS-10), and measures of perceived organizational support. Descriptive statistics, group comparisons, Spearman correlation, univariate analysis, and binary logistic regression were used. Poor sleep quality defined as PSQI > 5 was observed among 96 respondents (64.0%). Excessive daytime sleepiness (ESS = 10) was also reported by 96 respondents (64.0%). Insomnia symptoms (ISI = 8) were present in 97 respondents (64.7%), while 67 respondents (44.7%) met the criterion for clinical insomnia (ISI = 15). No statistically significant differences in ESS or PSQI scores were found across demographic groups. In the adjusted logistic regression model, low perceived organizational support (OR = 43.26), frequent night shifts (OR = 8.12), and high perceived workload (OR = 4.35) were significantly associated with higher odds of poor sleep quality. Regular exercise was associated with lower odds of poor sleep quality (OR = 0.33). The findings indicate that poor sleep quality is highly prevalent among clinical nurses and is primarily associated with modifiable organizational and work-related factors. Nursing administrators should strengthen organizational support, improve shift scheduling, manage workload and staffing conditions, and promote accessible health and stress-management programs for nurses.