{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T06:10:13Z","timestamp":1784182213420,"version":"3.55.0"},"reference-count":72,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The demanding nature of modern healthcare systems is associated with substantial fatigue and stress among clinical nurses; however, the joint associations of mental health promotion and sleep concerns with fatigue and stress among nurses remain to be elucidated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter cross-sectional survey was conducted among clinical nurses from three tertiary hospitals in Anhui Province, China. Mental health promotion, sleep concerns, fatigue, and perceived stress were assessed using the Mental Health Promotion Scale, the Anxiety and Preoccupation about Sleep Questionnaire, the Multidimensional Fatigue Inventory, and the Chinese version of the Perceived Stress Scale, respectively. The complex relationships among these variables, and characterizations of different subgroups, were studied using network analysis and latent profile analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 352 distributed questionnaires were returned, of which 338 valid questionnaires were included in the analysis. Network analysis showed that certain dimensions of mental health promotion (values, personal development, and friendship) were negatively correlated with both fatigue and stress, while sleep concerns, particularly sleep-related preoccupation, were positively correlated with fatigue and stress. Within the network, values showed the highest strength centrality. Physical fatigue, tension, and sleep-related preoccupation were key bridging nodes connecting different construct communities. Latent profile analysis identified three statistically derived fatigue\/stress profiles: low fatigue\/low stress (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f33), moderate fatigue\/high stress (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f241), and high fatigue\/high stress (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f64).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mental health promotion showed a negative association with fatigue and stress among clinical nurses, with values representing a core dimension of mental health resources. Furthermore, sleep-related preoccupation was observed as a bridging node between psychological and physical dimensions. These findings identify occupational values, physical fatigue, tension, and sleep-related preoccupation as candidate constructs for evaluation in future longitudinal and intervention studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1810766","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:40:44Z","timestamp":1784180444000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations among mental health promotion, sleep concerns, fatigue, and stress in clinical nurses: network and latent profile analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Min","family":"Dong","sequence":"first","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingjie","family":"Xu","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxia","family":"Chen","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Yang","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Xie","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyu","family":"Li","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Ma","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanru","family":"Li","sequence":"additional","affiliation":[{"name":"First Affiliated Hospital of Bengbu Medical University","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/07487304211064218","article-title":"Disturbance of the circadian system in shift work and its health impact","volume":"37","author":"Boivin","year":"2022","journal-title":"J Biol Rhythm"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1186\/s12912-024-02474-y","article-title":"Stress mindset and nurses\u2019 sleep quality: 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