From support and interaction to continuance: affective pathways and the bright side of cognitive load in English-medium instruction.

Poor sleep quality is a prevalent concern among nurses and has been associated with increased risks of cardiovascular disease, emotional dysregulation, and impaired cognitive function. In clinical environments, nurses with poor sleep quality also exhibit reduced work productivity, which contributes to compromised patient safety. Accordingly, poor sleep quality undermines both nurses’ health and care quality. Irregular rotating shifts, often involving night shifts and extended work hours, disrupt circadian rhythms and physiological regulation, thereby diminishing sleep quality. Nurses working night shifts have reported significantly lower sleep quality than do those working only day shifts. In addition to shift-related disruptions, profession-specific demands also influence sleep. Nurses are frequently exposed to considerable emotional and cognitive demands, particularly in intensive care units (ICUs), where they provide continuous care to critically ill patients. Collectively, these occupational characteristics place ICU nurses at increased risk for impaired sleep quality. Sleep quality is frequently evaluated through subjective measures. The Pittsburgh Sleep Quality Index (PSQI) is one of the most widely used instruments and comprises seven components: sleep latency, sleep duration, sleep efficiency, sleep disturbances, daytime dysfunction, use of sleep medication, and subjective sleep quality. Many previous studies have tended to use a composite PSQI score to represent sleep quality rather than examining the roles of individual components.