Development and validation of a nomogram for screening poor sleep quality among night-shift nurses

Abstract This study aimed to develop and validate a practical nomogram to screen poor sleep quality among night-shift nurses, providing an effective screening tool for managing their occupational health. A cross-sectional study was conducted involving 595 night-shift nurses selected between January and March 2026. The nurses were randomly divided into two groups in a ratio of 7:3. Data were collected using a general information questionnaire, the Pittsburgh Sleep Quality Index, the Generalized Anxiety Disorder Scale, and the Fatigue scale-14. Univariate and multivariate logistic regression analyses were conducted to develop a nomogram model. The performance was evaluated by discrimination, calibration, and clinical utility. The nomogram included eight associated factors: age, marital status, department affiliation, weekly working hours, monthly night shifts, drinking coffee or tea, generalized anxiety disorder, and fatigue. The area under the ROC curve in the training and validation set was 0.856 (95% CI: 0.823–0.882) and 0.849 (95% CI: 0.821–0.876), respectively. Calibration showed excellent fit across all datasets. The decision curve confirmed that the nomogram offers good clinical net benefits. This study provides a simple and practical tool for occupational health screening, early intervention, and targeted health management in medical institutions.