{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:57:19Z","timestamp":1793383039431,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2021,6,13]],"date-time":"2021-06-13T00:00:00Z","timestamp":1623542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Faced with this critical situation and directly involved in the treatment and care of COVID\u201019 patients, front\u2010line healthcare workers are at high risk in terms of mental health symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims and Objectives<\/jats:title><jats:p>To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A multi\u2010site survey study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress\u201021 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It was found that the majority of the intensive care nurses fighting COVID\u201019 on the front\u2010line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the front\u2010line during the COVID\u201019 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.15918","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T05:06:55Z","timestamp":1623647215000},"page":"601-611","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Analysis of mental health symptoms and insomnia levels of intensive care nurses during the COVID\u201019 pandemic with a structural equation model"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2690-2179","authenticated-orcid":false,"given":"Didem","family":"Kandemir","sequence":"first","affiliation":[{"name":"School of Nursing Maltepe University \u0130stanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"Temiz","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Nursing Department Artvin Coruh University Artvin 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