Sleep quality as a mediator between perceived stress and dry eye severity among Chinese nurses

Aim: This study aims to investigate the prevalence and influencing factors of dry eye among Chinese nurses, and to explore the relationship between nurses' perceived stress, sleep quality and dry eye. Methods: This study adopted a cross-sectional survey design and distributed electronic questionnaires through Wechat platform. A total of 450 valid questionnaires from nurses across the country were collected. The survey included demographic and sociological information on nurses, dry eye symptoms (Ocular Surface Disease Index), sleep quality (Pittsburgh Sleep Quality Index), and perceived stress (Perceived Stress Scale). Generalized linear model was used to analyze the factors affecting the symptoms of dry eye in nurses. The Process plug-in in SPSS was used to conduct mediation analysis using Bootstrap method. Results: Among the 450 nurses included, the prevalence of dry eye reached 66%. Specifically, mild dry eye accounted for 27.56%, moderate dry eye accounted for 14.89%, severe dry eye accounted for 23.56%. Multivariate analysis revealed that years in nursing, hospital grade, contact lens and frame glasses wearing, sleep quality and perceived stress were influencing factors for dry eye. Mediation analysis revealed that the bootstrap 95% confidence interval for the mediating effect of PSS score on OSDI score via PSQI score does not include zero. Conclusion: The prevalence of dry eye in Chinese nurses is very high, and the proportion of moderate to severe dry eye is relatively large. Years in nursing and wearing contact lenses or rimmed glasses were risk factors for dry eye in nurses. The perceived pressure and sleep quality are the direct risk factors of dry eye, and the perceived pressure can also influence the occurrence and development of dry eye through the mediating effect of sleep quality.