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Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 51  |  Issue : 1  |  Page : 3-7

To investigate the association between sleep and happiness among nurses with different personality traits: A cross-sectional study


Occupational Therapy Training School and Centre, LTMMC and General Hospital, Mumbai, Maharashtra, India

Date of Submission19-Mar-2019
Date of Acceptance25-Mar-2019
Date of Web Publication19-Apr-2019

Correspondence Address:
Dr. Sushant Deepak Sarang
1505, Soham, Plot No. 66, Sector New 50, Nerul, Navi Mumbai - 400 706, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoth.ijoth_7_19

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  Abstract 


Background: Sleep and happiness play an important role in the functioning of a person. This study investigated the association between sleep and happiness among nurses and also studied if individual personality traits play a role. Objectives: To measure perceived stress, sleep, happiness and personality trait among nurses & To analyze the relationship between the sleep, happiness and personality trait. Study Design: A cross-sectional study design was chosen for the research. Methods: Thirty nursing staff (females, aged 22–53 years) were selected for the study. The Perceived Stress Scale (PSS) was used for screening stress. Those who scored low (0–13) on the PSS were included in the study. Written informed consent was obtained. Sleep quality, happiness, and personality traits were measured using the Pittsburgh Sleep Quality Index, Oxford Happiness Questionnaire, and Big Five Personality Test, respectively. Scores were analyzed using MedCalc Statistical Software. Results: The mean age of nursing staff with good sleep was 28 years and that with poor sleep was 36 years. It was found that 63% of nursing staff had poor sleep and 37% had good sleep. Among nursing staff with good sleep, 36% were unhappy and 64% were happy. Among nursing staff with poor sleep, 47.7% were unhappy and 52.6% were happy. The mean score for neuroticism was higher in patients with poor sleep (t-test, P = 0.003, 95% confidence interval: -7.96 to -1.76). Conclusions: Nursing staff with good sleep were happier compared to nurses with poor sleep though the difference was not significant. Sleep disturbances increased with age among nurses. The personality trait of neuroticism was higher in patients with poor sleep.

Keywords: Happiness, Occupational Therapy, Personality, Quality of Sleep


How to cite this article:
Sarang SD, Shitole RB, Karnam AG. To investigate the association between sleep and happiness among nurses with different personality traits: A cross-sectional study. Indian J Occup Ther 2019;51:3-7

How to cite this URL:
Sarang SD, Shitole RB, Karnam AG. To investigate the association between sleep and happiness among nurses with different personality traits: A cross-sectional study. Indian J Occup Ther [serial online] 2019 [cited 2019 Jul 20];51:3-7. Available from: http://www.ijotonweb.org/text.asp?2019/51/1/3/256604




  Introduction Top


Restful and adequate sleep provides the foundation for optimal occupational performance, participation, and engagement in daily life.[1],[2] The impact of sleep on function and participation is incorporated into the repertoire of occupational therapy practitioners and addressed across the life span.[2] Prevention and intervention strategies to address sleep needs lie within the scope of practice for occupational therapy.[2] Sleep insufficiency is also linked to chronic diseases such as hypertension, diabetes, depression, and obesity, along with cancer, early mortality, and reduced quality of life and productivity.[3]

Personality has been reported as a predictor of the objective sleep parameters. Understanding the link between personality and sleep may be important in the assessment and intervention of sleep.[4]

Happiness is often defined as a psychological state, following a sense of gratification regarding important human desires or needs.[5] Happier people have more stable circadian rhythms and better quality of sleep.[6]

This study aimed to find the relationship between sleep and happiness among the nursing staff of a municipal tertiary care hospital and whether this relationship differed according to the personality trait of the person. The nursing staff was included in this study with the belief that frequent change in shift duty hours and their pattern of routine work may have effects on their quality of sleep, due to disturbances in biological clock system.[1],[6]


  Methods Top


Study Design

A cross-sectional study design was chosen for the research. Nursing staff were included in the study from a tertiary care municipal hospital. Total number of participants enrolled in the study were n = 30.

Inclusion and Exclusion Criteria

Nursing staff with diploma/degree qualification and with age range of 22–53 years having minimum 1 year of experience in a tertiary care municipal hospital and only those who scored low stress on the Perceived Stress Scale (PSS) were included in the study. Nursing staff diagnosed with any psychiatry disorder were excluded from the study.

Procedure and Ethics

Permission and approval was obtained from the Institutional Ethics Committee prior to the conduct of the research. Data were collected from September 2018 to October 2018. All the nursing staff participants were explained about the study, and written informed consent was obtained from them. All the nursing staff participants were requested to fill up the PSS, Oxford Happiness Questionnaire (OHQ), Pittsburgh Sleep Quality Index (PSQI), and Big Five Personality Test (BFPT) questionnaires.

Outcome Measures

Perceived Stress Scale

PSS is a 14-item instrument rated on a 4-point Likert scale (“almost never” to “always”), which evaluates the perception of stressful events. An example item is, “In the last month, how often have you felt nervous and stressed?”

PSS scores are obtained by reversing responses (e.g. 0 = 4, 1 = 3, 2 = 2, 3 = 1, and 4 = 0) to the four positively stated items (items 4, 5, 7, and 8) and then summing across all scale items.

Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress. The PSS has adequate internal consistency (α =0.82).[7]

Pittsburgh Sleep Quality Index

The PSQI is a validated, self-administered questionnaire used to generate seven component scores. It contains 19 items, which measure subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime function. Each component score is weighed equally on a scale from 0 to 3, which are summed together to yield a global PSQI score. This score ranges from 0 to 21, with higher scores (≥6) indicating poor sleep quality.[8]

The Oxford Happiness Questionnaire

The Oxford Happiness Questionnaire is developed by psychologists Michael Argyle and Peter Hills at Oxford University. It is a 6-point Likert scale on agreement with 29 items. The sum of the scores is divided by the number of items to interpret the score. The scores are as follows: 1 = strongly disagree, 2 = moderately disagree, 3 = slightly disagree, 4 = slightly agree, 5 = moderately agree, and 6 = strongly agree. The scores are added and the total is divided by 29.[9] The score thus derived can be interpreted as follows:

  • 1–2: Not happy
  • 2–3: Somewhat unhappy
  • 3–4: Not particularly happy or unhappy
  • 4: Somewhat happy or moderately happy (satisfied)
  • 4–5: Rather happy (pretty happy)
  • 5–6: Very happy
  • 6: Too happy.


Big Five Personality Test

The BFPT is the best accepted and most commonly used model of personality in academic psychology. It is based on the statistical study of responses to personality items. The test consists of fifty items that you must rate on how true they are about you on a 5-point Likert scale. It takes most people 3–8 min to complete. It shows personality traits such as extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience.[10]

Data Analysis

Data analysis was done using Windows-based “MedCalc Statistical Software” version 18.2.1. (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2018).[11] P value was set at 0.05 level of significance, and 95% confidence interval (CI) values were computed. t-test was used for analyzing equality of means, and comparison of discrete data was analyzed using the Chi-square test. All testing was done using two-sided tests at alpha 0.05.


  Results Top


Of the nursing staff who participated in the study, 63% had poor sleep and 37% had good sleep. The mean age of nurses with good sleep was 28 years and that with poor sleep was 36 years and standard deviation (SD) was 11.71 [Table 1]. The OHQ percentages in nursing staff showed that 3.3% of the nursing staff were somewhat unhappy, 40.0% were not particularly happy or unhappy, 50% were somewhat happy or moderately happy (satisfied), and 6.7% were rather happy (pretty happy) [Table 2]. According to the OHQ among nurses with good sleep, 36% (4) were “unhappy (somewhat unhappy + not particularly happy or unhappy) and 64% (7) were happy (satisfied + pretty happy).” According to the OHQ among nurses with poor sleep, 47.7% (9) were “unhappy (somewhat unhappy + not particularly happy or unhappy) and 52.6% (10) were happy (satisfied + pretty happy).” The Spearman's correlation r was −0.107 (P = 0.574) and Fischer's Chi-square test χ2 was 0.346 (P = 0.708), which was nonsignificant at 95% CI [Table 3]. The mean score for neuroticism was higher in patients with poor sleep. The mean difference of neuroticism between good sleep and poor sleep was significant (t-test, P = 0.003, 95% CI: -7.96 to -1.76). Mean score for conscientiousness was lower in patients with poor sleep. The mean difference of extroversion, agreeableness, conscientiousness, and openness to experience between good sleep and poor sleep was not significant. Higher scores of conscientiousness were correlated with good sleep. Higher scores of neuroticism were correlated with poor sleep [Table 4].
Table 1: Sleep Quality Based on the Pittsburgh Sleep Quality Index Scores in Nursing Staff and Age of Nursing Staff Enrolled

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Table 2: Scores of Happiness among Nursing Staff with Good and Poor Sleep

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Table 3: Unhappy and Happy Scores among Nursing Staff with Good and Poor Sleep

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Table 4: Comparison Between Big Five Personality Test Scores in Good vs. Poor Quality Sleep

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  Discussion Top


Nursing staff are the largest workforce in health-care organizations. Their happiness is a key factor in positive patient experiences, patient satisfaction, and positive workplace environments.[12]. Restful sleep provides the basis for physical, mental, and psychological well-being in humans, and sleep deprivation is associated with less productive behavior.[1],[2] In a study of Gómez-García et al., it was found that nurses' personality characteristics may play a role in their attitude toward the people.[11]

The present research attempted to study if the pattern of sleep among nurses in a municipal tertiary care hospital affects their happiness. Further, it attempted to ascertain if individual personality traits also play a role in their feelings of happiness.

The quality of sleep was assessed using the PSQI, happiness was assessed using the OHQ, and personality traits were identified using the BFPT.

It was found that 63% of the nursing staff had poor sleep and 37% had good sleep. This could be because of the sociocultural factors of the nursing staff included in the study who worked in a tertiary care hospital in Mumbai where the commute to work is long and difficult. Furthermore, the nature of work and societal expectations can lead to having sleep as least priority. The study conducted by Kim JK et al. (2018) discussed that as many societies become more competitive and market oriented, for them sleep is easily regarded as a waste of time (and money), and they sacrifice their sleep.[9]

In this study, the mean age of nursing staff with good sleep was lower (28 years) compared to those with poor sleep (36 years). This is supported by Mander et al. (2017) who mentioned that normative aging is associated with a reduced ability to initiate and maintain sleep.[10]

This study states that the nursing staff with good sleep were happier than nursing staff with poor sleep though the difference was not significant, probably due to lesser sample size. Nursing staff in tertiary care municipal hospitals work for long hours, sometimes for emergency purpose. They also have to work in rotating shifts which may cause anxiety, insecurity, and loneliness and affect sleep pattern.[12] Sleep is important to restore optimum functioning. People need a certain amount of time alone, which serves as a restorative function.[13] According to the study conducted by Kim JK et al. (2018), the actual level of happiness experienced by a person is more when he/she considers happiness as more relational, controllable and incremental.[13]

This study revealed that personality traits can have an effect on sleep. The results showed that neuroticism was higher in nurses with poor sleep. Individuals who scored high on neuroticism were more likely than average to be moody and to experience such feelings as anxiety, worry, fear, anger, frustration, envy, jealousy, guilt, depressed mood, and loneliness.

This finding is supported by a study conducted on “Association between Personality Traits and Sleep Quality in Young Korean Women” by Kim H (2005), et al. They concluded that neuroticism was the strongest personality factor influencing sleep.[4] Personality may account for a relatively small but significant amount of the variance in sleep quality.

Prakash Pillai R (2018) in his study concluded that nursing staff in private sector had higher scores of neuroticism and lower scores of happiness. The study also established that there are generational differences in the happiness levels and personality traits of nursing staff in Kerala. It was also inferred that the personality trait and happiness of nurses are interrelated. Hence, it was important to take care of the happiness of care professionals as they were devoted to ensure the well-being and happiness of others around them.[14]

Advantages

The study focuses on sleep and happiness. The study has also considered the role of personality trait. In previous literature, sleep and happiness and its correlation with personality traits have not been studied. We attempted to study these comorbidities with respect to personality traits.

Limitation

The sample size was less in number. Many confounding factors such as family financial status, social support, and past emotional trauma were not studied.

Recommendations

Sleep should be considered as an important factor for psychological well-being. Personality may be a factor in poor sleep quality and should be considered in sleep interventions. Similar long-term studies can be conducted with larger sample size. Factors such as family financial status, social support, and past emotional trauma may be included in the study as it affects the happiness of a person. Persons with other occupations can be studied.


  Conclusions Top


Nursing staff with good sleep were happier compared to nursing staff with poor sleep though the difference was not significant. Sleep disturbances increased with age among nursing staff. The personality trait of neuroticism was higher in patients with poor sleep.

Acknowledgments

We sincerely thank Dr. Mrs. Mondkar, Dean LTMMC and LTMGH, for granting permission to conduct this study. We would like to express sincere gratitude to Dr. Rashmi Yeradkar, Associate Professor and Incharge, for her kind support and allowing us to conduct the study.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.



 
  References Top

1.
Palhares Vde C, Corrente JE, Matsubara BB. Association between sleep quality and quality of life in nursing professionals working rotating shifts. Rev Saude Publica 2014;48:594-601.  Back to cited text no. 1
    
2.
Occupational Therapy Practice Framework: Domain and Process (3rd Edition). American Journal of Occupational Therapy [Internet]. 2017;68. Available from: https://ajot.aota.org/article.aspx?articleid=1860439. [Last cited on 2018 Nov 16].  Back to cited text no. 2
    
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Centers for Disease Control and Prevention. (2015). Insufficient sleep is a public health problem. Retrieved from https://www.cdc.gov/features/dssleep/. [Last accessed on 2018 Nov 26].  Back to cited text no. 3
    
4.
Kim HN, Cho J, Chang Y, Ryu S, Shin H, Kim HL, et al. Association between personality traits and sleep quality in young Korean women. PLoS One 2015;10:e0129599.  Back to cited text no. 4
    
5.
Mushtaq Z. Happiness, Quality of Sleep and Academic Achievement among University Undergraduates. J Indian Acad Appl Psychol 2014;40:62-9.  Back to cited text no. 5
    
6.
Leither D. The Relation between Well-being, Sleep, Benevolence, and Personality [Bachelor of Science]. University of British Columbia (Okanagan); 2009.  Back to cited text no. 6
    
7.
Yazdanian A, Alavi M, Irajpour A, Keshvari M. Association between nurses' personality characteristics and their attitude toward the older adults. Iran J Nurs Midwifery Res 2016;21:9-13.  Back to cited text no. 7
    
8.
Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F. Test-retest reliability and validity of the Pittsburgh sleep quality index in primary insomnia. J Psychosom Res 2002;53:737-40.  Back to cited text no. 8
    
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Shin JE, Kim JK. How a good sleep predicts life satisfaction: The role of zero-sum beliefs about happiness. Front Psychol 2018;9:1589.  Back to cited text no. 9
    
10.
Mander BA, Winer JR, Walker MP. Sleep and human aging. Neuron 2017;94:19-36.  Back to cited text no. 10
    
11.
MedCalc Software bvba, Ostend, Belgium. Available from: http://www.medcalc.org; 2018. [Last accessed on 2018 Nov 28].  Back to cited text no. 11
    
12.
Hills P, Argyle M. The Oxford happiness questionnaire: A compact scale for the measurement of psychological well-being. Pers Individ Dif 2002;33:1073-1082.  Back to cited text no. 12
    
13.
Andreou E, Alexopoulos EC, Lionis C, Varvogli L, Gnardellis C, Chrousos GP, et al. Perceived stress scale: Reliability and validity study in Greece. Int J Environ Res Public Health 2011;8:3287-3298.  Back to cited text no. 13
    
14.
Pillai RP. Happiness and Personality Traits of Care Professionals: A Comparative Analysis of Nurses in Kerala. International Conference on Management and Information Systems [Internet]. 2018;ISBN 978-1-943295-12-8. Available from: http://www.icmis.net/icmis18/ICMIS18CD/pdf/S170-final.pdf. [Last cited on 2018 Dec 22].  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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