{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:12:48Z","timestamp":1790611968520,"version":"4.1.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nurs"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditional approaches to assessing sleep quality in clinical nurses often overlook population heterogeneity and the complex interplay of influencing factors. This study employs Latent Profile Analysis (LPA) and Association Rule Mining (ARM) to identify distinct sleep quality subgroups and uncover key factor combinations, thereby informing targeted intervention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 1,686 nurses from 123 hospitals in Shandong Province were recruited through multistage stratified sampling. LPA was used to classify participants based on seven sleep dimensions from the Pittsburgh Sleep Quality Index (PSQI), while ARM was applied to identify frequent itemsets of sleep disorder triggers. Key influencing factors were further examined using univariate analysis and multivariate logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three latent sleep profiles were identified: high (63.11%), moderate (34.10%), and low (2.79%) sleep quality. The low-sleep subgroup was characterized by higher proportions of being unmarried\/divorced (42.55%), low monthly income (\u2264\u20093,000 CNY, 42.55%), non-permanent employment (76.60%), and severe psychological distress (44.68%). In contrast, the high-sleep subgroup featured higher rates of being married (85.62%), moderate income (3,001\u20137,000 CNY, 73.03%), and low psychological distress (51.32%). Key determinants included marital status (OR\u2009=\u20092.153\/2.252), income (OR\u2009=\u20099.098), employment type (OR\u2009=\u20091.475), and psychological state (OR\u2009=\u20090.060\u20130.555). ARM revealed distinct risk combinations: \u201clow income\u2009+\u2009non-permanent employment\u201d (lift\u2009=\u20093.895) for the low-sleep group; \u201cmarried\u2009+\u2009moderate income\u2009+\u2009non-permanent employment\u2009+\u2009patient conflict\u201d for the moderate group; and \u201chigh income\u2009+\u2009low psychological distress\u201d buffering night-shift effects in the high-sleep group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>By integrating LPA and ARM, this study reveals the multidimensional heterogeneity and interactive mechanisms underlying clinical nurses\u2019 sleep quality. The findings support a stratified intervention framework combining institutional safeguards with precision strategies to enhance sleep health management in nursing populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12912-025-04026-4","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:26:49Z","timestamp":1763411209000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Analysis of sleep patterns among clinical nurses: a latent profile and association rule mining approach"],"prefix":"10.1186","volume":"24","author":[{"given":"Ning","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lulu","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianying","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"issue":"1","key":"4026_CR1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.13213\/j.cnki.jeom.2021.20313","volume":"38","author":"Q Liu","year":"2021","unstructured":"Liu Q, Jiang L, Ye J, et al. Association between shift work and sleep disorders among healthcare workers in tertiary hospitals. J Environ Occup Med. 2021;38(1):76\u201382. https:\/\/doi.org\/10.13213\/j.cnki.jeom.2021.20313.","journal-title":"J Environ Occup Med"},{"issue":"1","key":"4026_CR2","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1002\/rnj.107","volume":"39","author":"CC Caruso","year":"2014","unstructured":"Caruso CC. Negative impacts of shiftwork and long work hours. Rehabil Nurs. 2014;39(1):16\u201325. https:\/\/doi.org\/10.1002\/rnj.107.","journal-title":"Rehabil Nurs"},{"issue":"11","key":"4026_CR3","doi-asserted-by":"publisher","first-page":"2740","DOI":"10.3969\/j.issn.2095-7130.2023.11.073","volume":"10","author":"L Yin","year":"2023","unstructured":"Yin L, Duan S, Peng X. Effects of sleep deprivation on sleep quality, emotional state, and nursing errors among night-shift nurses. World J Sleep Med. 2023;10(11):2740\u20132. https:\/\/doi.org\/10.3969\/j.issn.2095-7130.2023.11.073.","journal-title":"World J Sleep Med"},{"key":"4026_CR4","doi-asserted-by":"publisher","first-page":"2547","DOI":"10.2147\/RMHP.S315262","volume":"14","author":"D Liu","year":"2021","unstructured":"Liu D, Wu Y, Jiang F, Liu Y, Tang YL. The prevalence and associated factors of short sleep duration among nurses in tertiary public hospitals in china: findings from a National survey. Risk Manag Healthc Policy. 2021;14:2547\u201352. https:\/\/doi.org\/10.2147\/RMHP.S315262.","journal-title":"Risk Manag Healthc Policy"},{"issue":"3","key":"4026_CR5","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.amepre.2014.10.018","volume":"48","author":"F Gu","year":"2015","unstructured":"Gu F, Han J, Laden F, et al. Total and cause-specific mortality of U.S. Nurses working rotating night shifts. Am J Prev Med. 2015;48(3):241\u201352. https:\/\/doi.org\/10.1016\/j.amepre.2014.10.018.","journal-title":"Am J Prev Med"},{"key":"4026_CR6","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/s41606-018-0027-x","volume":"2","author":"BA Fadeyi","year":"2018","unstructured":"Fadeyi BA, Ayoka AO, Fawale MB, et al. Prevalence, predictors and effects of shift work sleep disorder among nurses in a Nigerian teaching hospital. Sleep Sci Pract. 2018;2:6. https:\/\/doi.org\/10.1186\/s41606-018-0027-x.","journal-title":"Sleep Sci Pract"},{"key":"4026_CR7","doi-asserted-by":"publisher","first-page":"i5210","DOI":"10.1136\/bmj.i5210","volume":"355","author":"G Kecklund","year":"2016","unstructured":"Kecklund G, Axelsson J. Health consequences of shift work and insufficient sleep. BMJ. 2016;355:i5210. https:\/\/doi.org\/10.1136\/bmj.i5210.","journal-title":"BMJ"},{"key":"4026_CR8","doi-asserted-by":"publisher","first-page":"103667","DOI":"10.1016\/j.ijnurstu.2020.103667","volume":"112","author":"L James","year":"2020","unstructured":"James L, James SM, Wilson M, et al. Sleep health and predicted cognitive effectiveness of nurses working 12-hour shifts: an observational study. Int J Nurs Stud. 2020;112:103667. https:\/\/doi.org\/10.1016\/j.ijnurstu.2020.103667.","journal-title":"Int J Nurs Stud"},{"issue":"7","key":"4026_CR9","doi-asserted-by":"publisher","first-page":"2123","DOI":"10.1111\/jonm.13351","volume":"29","author":"H Feng","year":"2021","unstructured":"Feng H, Qi X, Xia C, et al. Association between night shift and sleep quality and health among Chinese nurses: A cross-sectional study. J Nurs Manag. 2021;29(7):2123\u201331.","journal-title":"J Nurs Manag"},{"issue":"6","key":"4026_CR10","first-page":"815","volume":"30","author":"X Zeng","year":"2013","unstructured":"Zeng X, Xiao L, Zhang Y. Principles and case studies of latent class analysis. Chin J Health Stat. 2013;30(6):815\u20137.","journal-title":"Chin J Health Stat"},{"issue":"18","key":"4026_CR11","first-page":"61","volume":"35","author":"M Zhao","year":"2020","unstructured":"Zhao M, Su X, Li S, et al. Analysis of fall-related injury characteristics in elderly inpatients based on association rules. J Nurs Sci. 2020;35(18):61\u20134.","journal-title":"J Nurs Sci"},{"key":"4026_CR12","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.2147\/RMHP.S415349","volume":"16","author":"XK Liu","year":"2023","unstructured":"Liu XK, Huang DL, Meng LP, et al. Prevalence and risk factors underlying occupational stress and depression among clinical nurses in secondary and tertiary hospitals of China during COVID-19 setting. Risk Manag Healthc Policy. 2023;16:1377\u201389. https:\/\/doi.org\/10.2147\/RMHP.S415349. Published 2023 Aug 1.","journal-title":"Risk Manag Healthc Policy"},{"issue":"4","key":"4026_CR13","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1111\/inr.12692","volume":"68","author":"H Li","year":"2021","unstructured":"Li H, Dong S, He L, et al. Nurses\u2019 core emergency competencies for COVID-19 in china: A cross-sectional study. Int Nurs Rev. 2021;68(4):524\u201332. https:\/\/doi.org\/10.1111\/inr.12692.","journal-title":"Int Nurs Rev"},{"issue":"2","key":"4026_CR14","first-page":"103","volume":"29","author":"X Liu","year":"1996","unstructured":"Liu X, Tang M, Hu L, et al. Reliability and validity of the Pittsburgh sleep quality index. Chin J Psychiatry. 1996;29(2):103\u20137.","journal-title":"Chin J Psychiatry"},{"issue":"6","key":"4026_CR15","first-page":"627","volume":"16","author":"C Zhou","year":"2008","unstructured":"Zhou C, Chu J, Wang T, et al. Reliability and validity of the Chinese version of Kessler 10 psychological distress scale. Chin J Clin Psychol. 2008;16(6):627\u20139.","journal-title":"Chin J Clin Psychol"},{"issue":"1","key":"4026_CR16","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1037\/1076-8998.5.1.111","volume":"5","author":"JG Grzywacz","year":"2000","unstructured":"Grzywacz JG, Marks NF. Reconceptualizing the work-family interface: an ecological perspective. J Occup Health Psychol. 2000;5(1):111\u201326. https:\/\/doi.org\/10.1037\/1076-8998.5.1.111.","journal-title":"J Occup Health Psychol"},{"issue":"10","key":"4026_CR17","first-page":"41","volume":"10","author":"Q Jiang","year":"2001","unstructured":"Jiang Q. Perceived social support scale. Chin J Behav Med Sci. 2001;10(10):41\u20133.","journal-title":"Chin J Behav Med Sci"},{"issue":"1","key":"4026_CR18","doi-asserted-by":"publisher","first-page":"e12683","DOI":"10.1111\/jsr.12683","volume":"28","author":"H Zare Khormizi","year":"2019","unstructured":"Zare Khormizi H, Salehinejad MA, Nitsche MA, Nejati V. Sleep-deprivation and autobiographical memory: evidence from sleep-deprived nurses. J Sleep Res. 2019;28(1):e12683. https:\/\/doi.org\/10.1111\/jsr.12683.","journal-title":"J Sleep Res"},{"issue":"6","key":"4026_CR19","doi-asserted-by":"publisher","first-page":"2771","DOI":"10.1002\/nop2.978","volume":"9","author":"LJ Lee","year":"2022","unstructured":"Lee LJ, Wehrlen L, Ding Y, Ross A. Professional quality of life, sleep disturbance and health among nurses: A mediation analysis. Nurs Open. 2022;9(6):2771\u201380. https:\/\/doi.org\/10.1002\/nop2.978.","journal-title":"Nurs Open"},{"issue":"3","key":"4026_CR20","doi-asserted-by":"publisher","first-page":"e022172","DOI":"10.1136\/bmjopen-2018-022172","volume":"8","author":"B Cheval","year":"2018","unstructured":"Cheval B, Cullati S, Pihl-Thingvad J, et al. Impact of CAre-related regret upon sleep (ICARUS) cohort study. BMJ Open. 2018;8(3):e022172. https:\/\/doi.org\/10.1136\/bmjopen-2018-022172.","journal-title":"BMJ Open"},{"issue":"2","key":"4026_CR21","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.jsmc.2022.03.005","volume":"17","author":"BS McEwen","year":"2022","unstructured":"McEwen BS, Karatsoreos IN. Sleep deprivation and circadian disruption. Sleep Med Clin. 2022;17(2):253\u201362. https:\/\/doi.org\/10.1016\/j.jsmc.2022.03.005.","journal-title":"Sleep Med Clin"},{"issue":"8","key":"4026_CR22","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1037\/hea0000628","volume":"37","author":"RG Kent de Grey","year":"2018","unstructured":"Kent de Grey RG, Uchino BN, Trettevik R, et al. Social support and sleep: a meta-analysis. Health Psychol. 2018;37(8):787\u201398. https:\/\/doi.org\/10.1037\/hea0000628.","journal-title":"Health Psychol"},{"issue":"1","key":"4026_CR23","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.biopsych.2015.05.014","volume":"80","author":"MR Irwin","year":"2016","unstructured":"Irwin MR, Olmstead R, Carroll JE. Sleep disturbance and inflammation. Biol Psychiatry. 2016;80(1):40\u201352. https:\/\/doi.org\/10.1016\/j.biopsych.2015.05.014.","journal-title":"Biol Psychiatry"},{"key":"4026_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2025.03.006","author":"OS Hamilton","year":"2025","unstructured":"Hamilton OS, Steptoe A. Financial stress and sleep duration. Brain Behav Immun. 2025. https:\/\/doi.org\/10.1016\/j.bbi.2025.03.006.","journal-title":"Brain Behav Immun"},{"issue":"2","key":"4026_CR25","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1111\/jonm.123694","volume":"27","author":"S Cheng","year":"2019","unstructured":"Cheng S, Lin P, Chang Y, et al. Sleep quality mediates work-family conflicts and health status in nurses. J Nurs Manag. 2019;27(2):381\u20137. https:\/\/doi.org\/10.1111\/jonm.123694.","journal-title":"J Nurs Manag"},{"issue":"3","key":"4026_CR26","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/s10823-025-09543-y","volume":"40","author":"S Rote","year":"2025","unstructured":"Rote S, Cantu P, Angel J, Moon H, Antequera F, Markides K. Financial Strain, mental Health, and sleep disruption among Racially and ethnically diverse family caregivers during the COVID-19 pandemic. J Cross Cult Gerontol. 2025;40(3):289\u2013305. https:\/\/doi.org\/10.1007\/s10823-025-09543-y.","journal-title":"J Cross Cult Gerontol"},{"key":"4026_CR27","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.jad.2025.02.060","volume":"377","author":"L Chai","year":"2025","unstructured":"Chai L, Lu Z. The association between financial strain and mental health: the mediating and moderating roles of sleep problems in the UK household longitudinal study (UKHLS). J Affect Disord. 2025;377:245\u201353. https:\/\/doi.org\/10.1016\/j.jad.2025.02.060.","journal-title":"J Affect Disord"},{"issue":"1","key":"4026_CR28","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1111\/pcn.13170","volume":"75","author":"Y Kameno","year":"2021","unstructured":"Kameno Y, Hanada A, Asai D, et al. Individual psychotherapy using psychological first aid for frontline nurses at high risk of psychological distress during the COVID-19 pandemic. Psychiatry Clin Neurosci. 2021;75(1):25\u20137. https:\/\/doi.org\/10.1111\/pcn.13170.","journal-title":"Psychiatry Clin Neurosci"},{"issue":"2","key":"4026_CR29","doi-asserted-by":"publisher","first-page":"100850","DOI":"10.1016\/j.accpm.2021.100850","volume":"40","author":"A Caillet","year":"2021","unstructured":"Caillet A, Conejero I, Allaouchiche B. Job strain and psychological impact of COVID-19 in ICU caregivers during pandemic period. Anaesth Crit Care Pain Med. 2021;40(2):100850. https:\/\/doi.org\/10.1016\/j.accpm.2021.100850.","journal-title":"Anaesth Crit Care Pain Med"},{"key":"4026_CR30","doi-asserted-by":"publisher","first-page":"101202","DOI":"10.1016\/j.ienj.2022.101202","volume":"64","author":"Y Li","year":"2022","unstructured":"Li Y, Sun J, Sun D, et al. Nurses\u2019 perceptions of night shifts: A qualitative study. Int Emerg Nurs. 2022;64:101202. https:\/\/doi.org\/10.1016\/j.ienj.2022.101202.","journal-title":"Int Emerg Nurs"},{"issue":"5","key":"4026_CR31","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1002\/nur.22337","volume":"46","author":"Y Zhang","year":"2023","unstructured":"Zhang Y, Murphy J, Lammers-van der Holst HM, Barger LK, Lai YJ, Duffy JF. Interventions to improve the sleep of nurses: A systematic review. Res Nurs Health. 2023;46(5):462\u201384. https:\/\/doi.org\/10.1002\/nur.22337.","journal-title":"Res Nurs Health"},{"issue":"5","key":"4026_CR32","doi-asserted-by":"publisher","first-page":"2333","DOI":"10.1111\/jan.16603","volume":"81","author":"L Matricciani","year":"2025","unstructured":"Matricciani L, Clarke J, Wiley S, et al. Sleep of nurses: A comprehensive scoping review. J Adv Nurs. 2025;81(5):2333\u201344. https:\/\/doi.org\/10.1111\/jan.16603.","journal-title":"J Adv Nurs"},{"issue":"6","key":"4026_CR33","doi-asserted-by":"publisher","first-page":"48","DOI":"10.4037\/ccn2023177","volume":"43","author":"HL Stutting","year":"2023","unstructured":"Stutting HL. The relationship between rest breaks and professional burnout among nurses. Crit Care Nurse. 2023;43(6):48\u201356. https:\/\/doi.org\/10.4037\/ccn2023177.","journal-title":"Crit Care Nurse"}],"container-title":["BMC Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12912-025-04026-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12912-025-04026-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12912-025-04026-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T13:03:10Z","timestamp":1781614990000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12912-025-04026-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4026"],"URL":"https:\/\/doi.org\/10.1186\/s12912-025-04026-4","relation":{},"ISSN":["1472-6955"],"issn-type":[{"value":"1472-6955","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]},"assertion":[{"value":"2 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"In accordance with the ethical principles of the Declaration of Helsinki, confidentiality and anonymity were guaranteed in this study. All participants signed an informed consent form before starting the questionnaire. The Ethics Committee of Shandong University School of Public Health reviewed and approved the study (approval number: 20181219).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1403"}}