Sleep Quality and Influencing Factors of Nurses in Fever Clinics During Closed-Loop Management: An Exploratory Mixed-Methods Study

Background: During the COVID-19 pandemic, fever clinic nurses under closed-loop management faced high occupational stress and strict isolation, which may impair sleep quality. However, evidence in this population remains limited. This study investigated the sleep quality of fever clinic nurses during closed-loop COVID-19 management and identified associated factors. Methods: A sequential explanatory mixed-methods design approach was employed. Quantitative data were collected using the Pittsburgh Sleep Quality Index (PSQI) and Nurses’ Psychological Capital Scale from 33 front-line nurses, acknowledging the limited sample size. Semi-structured in-depth interviews were conducted with six nurses to provide qualitative insights. Results: The mean PSQI score was 8.16 ± 4.25, indicating moderate sleep disturbances among nurses. Factors associated with sleep quality included demographic and occupational factors (e.g., night shifts, work pressure) and psychological capital (self-efficacy, resilience, hope, and optimism). Qualitative analysis identified three themes: the impact of personal circumstances on sleep quality, psychological pressures during closed-loop management, and the role of self-regulation in coping. Conclusions: During the closed-loop management for COVID-19 pandemic prevention and control, the sleep quality of nurses in fever clinics was poor. This study identified personal circumstances, work pressure, and psychological capital as potential factors associated with sleep quality, suggesting that further research is needed to develop and test targeted interventions. These findings provide preliminary evidence that may inform future management strategies, but do not support definitive intervention recommendations.