Abstract
Introduction
Depression is prevalent among nursing students. Rumination and sleep-wake rhythms are associated to mental illness; however, no clear path has been found. This exploratory study aimed to examine the associations among circadian activity rhythms (CAR), rumination, and depressive symptoms in female nursing students; further, to test a hypothesized CAR conceptual model.
Methods
A total of 148 female nursing junior students in China completed a battery of questionnaires, including Athens Insomnia Scale (AIS), Ruminative Responses Scale (RRS), and Self-rating Depression Scale (SDS). Wrist actigraphy was used to collect total sleep time, CAR, and acrophase (time of the peak of the fitted activity curve). The path analysis was explored by using SPSS and AMOS.
Results
The mean age of the students was 20.64 years (SD = 0.86). About 58.8% of the participants were either mild or moderate depressed. About 93.9% of the students reported significant insomnia symptoms (AIS scores >6). Rumination was measured by the RRS (M= 2.01, SD = 0.54), and students scored higher in brooding than that of reflective pondering (2.07 vs. 1.95). The average of TST was 394.59 minutes (SD = 51.92). The CAR ranged from 0.40 to 0.98, with a mean of 0.75 (SD = 0.11). The acrophase ranged from 12:46 to 20:14 (median 16:30), with a later acrophase indicates of a more delayed circadian phase. The final model shows satisfactory fit (χ2= 2.238, p= .327); a better CAR can indirectly reduce depressive symptoms by directly reducing brooding (B = -1.149) and improving insomnia symptoms (B = -6.6443).
Conclusion
In order to prevent psychological problems of nursing students, ruminating and CAR should be part of health screening. The novel conceptual model provides a basis for reforming nursing education to prevent psychological problems.
Support (if any)
Chinese National Natural Science Foundation [71603279]
Precision of entrained circadian activity rhythms under natural photoperiodic conditions
