焦虑和压力知觉在远航海员疲劳与睡眠质量间的链式中介作用

职业与健康 ›› 2025, Vol. 41 ›› Issue (8): 1055-1059.

焦虑和压力知觉在远航海员疲劳与睡眠质量间的链式中介作用

甘雪洋¹, 宋杰², 苏清清², 高远²

1.解放军医学院研究生院,北京 100853;
2.解放军总医院第一医学中心护理部,北京 100853

收稿日期:2024-07-29 修回日期:2024-08-05 出版日期:2025-04-15 发布日期:2025-12-18
通信作者: 高远,副主任护师,E-mail：gaoyuanzd@163.com
作者简介:甘雪洋,女,在读硕士研究生,研究方向为心理护理。
基金资助:
军队课题（2021HL070）

Chain mediating effect of anxiety and stress perception on the relationship between fatigue and sleep quality in long-distance sailors

GAN Xueyang¹, SONG Jie², SU Qingqing², GAO Yuan²

1. Gradute School,Chinese PLA Medical School,Beijing 100853,China;
2. Department of Nursing,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China

Received:2024-07-29 Revised:2024-08-05 Online:2025-04-15 Published:2025-12-18
Contact: GAO Yuan,Deputy chief nurse,E-mail：gaoyuanzd@163.com

摘要/Abstract

摘要： 目的探讨远航海员疲劳与睡眠质量间的关系及焦虑症状、压力知觉在疲劳与睡眠间的中介效应。方法 2023年9月,采用焦虑自评量表、匹兹堡睡眠质量指数、压力知觉量表及多维疲劳量表对远航结束的1 025名海员进行问卷调查,并对结果进行分析。结果睡眠质量得分[M（P₂₅,P₇₅）]为4.00（2.00,6.00）分,焦虑得分为40.00（33.75,43.75)分,压力知觉得分为23.00（16.00,28.00）分,多维疲劳综合量表为38.00（28.00,51.00)分。不同年龄、文化程度、饮酒和家庭年收入的海员睡眠质量评分差异均有统计学意义（均P<0.01)。相关分析结果显示,焦虑症状、压力、疲劳与睡眠质量两两之间呈正相关（r=0.430~0.678,均P<0.01)。中介效应分析显示,疲劳对于睡眠质量的总效应为0.104,其中直接效应为0.066,占总效应的62.74%,焦虑症状、压力在疲劳与睡眠质量之间均存在中介效应,效应比为0.018和0.016,分别占总效应的16.76%和15.60%。焦虑症状和压力在疲劳和睡眠质量之间存在链式中介效应,效应值为0.006,占总效应的15.23%。结论疲劳会影响远航海员睡眠质量,也会通过焦虑症状、压力的链式中介作用间接影响睡眠质量。

关键词: 焦虑, 疲劳, 睡眠质量, 压力知觉, 中介效应

Abstract: Objective To explore the relationship between fatigue and sleep quality in long-distance sailors,as well as the mediating effect of anxiety symptoms and stress perception between fatigue and sleep. Method In September 2023,a questionnaire survey was conducted on 1 025 sailors who had completed their long-distance voyage using the self rating anxiety scale,Pittsburgh sleep quality index,stress perception scale,and multidimensional fatigue scale,and the results were analyzed. Results The sleep quality score of long-distance sailors was 4.00（2.00,6.00）points,anxiety score was 40.00（33.75,43.75）points,stress perception score was 23.00（16.00,28.00）points,and the multidimensional fatigue comprehensive scale score was 38.00（28.00,51.00）points.The differences in sleep quality scores among seafarers of different ages,educational levels,alcohol consumption,and annual family income were statistically significant（all P<0.01）.The correlation analysis results showed that anxiety symptoms,stress,fatigue,and sleep quality were positively correlated with each other（r=0.430-0.678,all P<0.01）.The mediation effect analysis showed that the total effect of fatigue on sleep quality was 0.104,with a direct effect of 0.066,accounting for 62.74% of the total effect.Anxiety symptoms and stress both had mediation effects between fatigue and sleep quality,with effect values of 0.018 and 0.016,respectively,accounting for 16.76% and 15.60% of the total effect. Anxiety symptoms and stress had a chain mediated effect between fatigue and sleep quality,with an effect value of 0.006,accounting for 15.23% of the total effect value. Conclusion Fatigue can affect the sleep quality of long-distance sailor,and indirectly affect sleep quality through a chain mediated effect of anxiety symptoms and stress.

Key words: Anxiety, Fatigue, Sleep quality, Stress perception, Mediating effect

中图分类号:

R833

甘雪洋, 宋杰, 苏清清, 高远. 焦虑和压力知觉在远航海员疲劳与睡眠质量间的链式中介作用. [J]职业与健康, 2025, 41(8): 1055-1059.

GAN Xueyang, SONG Jie, SU Qingqing, GAO Yuan. Chain mediating effect of anxiety and stress perception on the relationship between fatigue and sleep quality in long-distance sailors. [J]OCCUPATION AND HEALTH, 2025, 41(8): 1055-1059.

参考文献

[1] SHATTUCK N L,MATSANGAS P.Eating behaviors in sailors of the United States Navy:Meal-to-sleep intervals[J].Nutr Health,2021,27(1):3-8.
[2] LI H,LIU Y.Navy Sailors Health Behavior:A Multi-Factor Analysis of Circadian Rhythm on Naval Operational Capability[J].Am J Health Behav,2023,47(2):349-359.
[3] BAYGI F,SHIDFAR F,SHEIDAEI A,et al.Psychosocial issues and sleep quality among seafarers:A mixed Methods study[J].BMC Public Health,2022,22(1):695.
[4] MATSANGAS P,SHATTUCK N L.Habitability in berthing compartments and well-being of sailors working on U.S.Navy Surface Ships[J].Hum Factors,2021,63(3):462-473.
[5] 毛晓飞,谢亚纬,侯田雅,等.特殊工作环境海军官兵负性情绪与疲劳的关系:一般自我效能感的中介效应[J].海军医学杂志,2023,44(5):437-440.
[6] AN J,GAO W,LIU R,et al.Empirical study on the relationship between vacation schedule and seafarers' fatigue in Chinese seafarer population[J].Front Psychol,2022,13:838811.
[7] PARK H C,OH J.The relationship between stress and sleep quality:The mediating effect of fatigue and dizziness among patients with cardiovascular disease[J].Medicine(Baltimore),2023,102(20):e33837.
[8] HYSTAD S W,EID J.Sleep and fatigue among seafarers:the role of environmental stressors,duration at sea and psychological capital[J].Saf Health Work,2016,7(4):363-371.
[9] JENSEN H J,OLDENBURG M.Training seafarers to deal with multicultural crew members and stress on board[J].Int Marit Health,2020, 71(3):174-180.
[10] ALMOJALI A I,ALMALKI S A,ALOTHMAN A S,et al.The prevalence and association of stress with sleep quality among medical students[J].J Epidemiol Glob Health,2017,7(3):169-174.
[11] CHEN J,TUERSUN Y,YANG J,et al.Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province,China:A mediation analysis[J].BMC Med Educ,2022,22(1):627.
[12] 李姿慧,吴梦蝶,李琪,等.汉密尔顿焦虑量表和焦虑自评量表在功能性消化不良伴焦虑状态中的应用[J].长春中医药大学学报,2018,34(4):787-790.
[13] BUYSSE D J,REYNOLDS C F,3RD,MONK T H,et al.The pittsburgh sleep quality index:A new instrument for psychiatric practice and research[J].Psychiatry Res,1989,28(2):193-213.
[14] 杨廷忠,黄汉腾.社会转型中城市居民心理压力的流行病学研究[J].中华流行病学杂志,2003,24(9):11-15.
[15] SMETS E M,GARSSEN B,BONKE B,et al.The Multidimensional Fatigue Inventory(MFI) psychometric qualities of an instrument to assess fatigue[J].J Psychosom Res,1995,39(3):315-325.
[16] KERKAMM F,DENGLER D,EICHLER M,et al.Measurement Methods of fatigue,sleepiness,and sleep behaviour aboard ships:A systematic review[J].Int J Environ Res Public Health,2021,19(1):120.
[17] OLDENBURG M,BAUR X,SCHLAICH C.Occupational risks and challenges of seafaring[J].J Occup Health,2010,52(5):249-256.
[18] SHATTUCK N L,MATSANGAS P.Sunlight exposure,work hours,caffeine consumption,and sleep duration in the naval environment[J].Aerosp Med Hum Perform,2017,88(6):579-585.
[19] REMES O,BRAYNE C,VAN DER LINDE R,et al.A systematic review of reviews on the prevalence of anxiety disorders in adult populations[J].Brain Behav,2016,6(7):e00497.
[20] SHARMA M.Visualisation and bibliometric analysis of worldwide research trend of stress among seafarer:An extensive publication analysis[J].Int Marit Health,2021,72(1):64-75.
[21] RUSSO A,MULIĆ R,KOLIĆ I,et al.Longitudinal Study on the Effect of onboard service on seafarers' health statuses[J].Int J Environ Res Public Health,2023,20(5):4497.
[22] JEPSEN J R,ZHAO Z,VAN LEEUWEN W M.Seafarer fatigue:a review of risk factors,consequences for seafarers' health and safety and options for mitigation[J].Int Marit Health,2015,66(2):106-117.
[23] AZIMI YANCHESHMEH F,MOUSAVIZADEGAN S H,AMINI A,et al.Poor sleep quality,long working hours and fatigue in coastal areas:a dangerous combination of silent risk factors for deck officers on oil tankers[J].Int Marit Health,2020,71(4):237-248.
[24] JAMESON J T,MARKWALD R R,KUBALA A G,et al.Sleep deficiency,operational fatigue and the interplay of compromising factors:Analysis to aid in fatigue management[J].J Sleep Res,2023,32(3):e13788
[25] SMITH A P.An update on stress,fatigue and wellbeing:implications for naval personnel[J].Int Marit Health,2019,70(2):132-139.
[26] CASTELLI L,ELTER T,WOLF Fet al.Sleep problems and their interaction with physical activity and fatigue in hematological cancer patients during onset of high dose chemotherapy[J].Support Care Cancer,2022,30(1):167-176.