Abstract
Background
Psychiatric nurses routinely operate in high-stress, high-risk environments, making insomnia a prevalent issue that profoundly impacts their physical and mental well-being, as well as the quality of patient care. Empirical evidence suggests that insomnia not only diminishes occupational performance but also substantially increases the risk, posing a substantial risk to patient safety. Nevertheless, investigations into the underlying mechanisms driving insomnia among psychiatric nurses remain scarce.
Objectives
This study aims to explore the relationship between perceived organizational support and insomnia in psychiatric nurses, as well as to examine the mediating role of psychological capital through the development of a mediation model. The findings are intended to provide novel insights for hospital administrators in addressing insomnia among nursing staff.
Methods
A convenience sampling method was used to recruit 475 psychiatric nurses from three tertiary-level psychiatric specialty hospitals in Beijing. Data were collected between March and June 2024 using a general information questionnaire, the Perceived Organizational Support Scale (POSS), the Psychological Capital Questionnaire (PCQ), and the Athens Insomnia Scale (AIS). Statistical analyses included assessments for common method bias, descriptive statistics, one-way analysis of variance (ANOVA), independent samples t-tests, Pearson correlation analysis, and mediation analysis using Model 4 of Hayes’ PROCESS macro.
Results
(1) Of the 475 psychiatric nurses, 395 (83.16%) were identified as experiencing insomnia. (2) The mean scores for perceived organizational support, psychological capital, and insomnia symptoms were 39.11 ± 10.60, 106.35 ± 14.38, and 11.88 ± 5.55, respectively. (3) Perceived organizational support among nurses was positively correlated with psychological capital (r = 0.641, P < 0.001) and negatively correlated with insomnia (r = -0.348, P < 0.001). Additionally, psychological capital was negatively correlated with insomnia (r = -0.369, P < 0.001). (4) Mediation analysis revealed that the total effect of organizational support on insomnia was − 0.335. The direct effect was − 0.191, accounting for 57.01%, and the indirect effect via psychological capital was − 0.144, accounting for 42.99% of the total effect.
Conclusion
The prevalence of insomnia symptoms among psychiatric nurses is notably high, and perceived organizational support serves as a negative predictor of insomnia. Additionally, psychological capital partially mediates the relationship between organizational support and insomnia among nurses. These findings suggest that clinical nursing managers may alleviate insomnia in psychiatric nurses by implementing concrete interventions, such as enhancing organizational support through structured programs, and fostering psychological capital via targeted development initiatives and resilience training.
Clinical trial number
Not applicable.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12912-025-03554-3.
Keywords: Perceived organizational support, Psychological capital, Insomnia symptoms, Psychiatric nurses
Introduction
Insomnia is widely recognized as the most prevalent sleep disorder and the second most prevalent mental health disorder worldwide, primarily manifesting as difficulty in both initiating and maintaining sleep [1, 2]. Insomnia acting as a significant risk factor for various physiological and psychological conditions, making it a key factor influencing health throughout life. Insomnia can adversely impact an individual’s cognitive, emotional, and physical functions, ultimately compromising the immune system, disrupting metabolic processes, and increasing the risk of conditions such as depression, coronary artery disease, stroke, and obesity-related diseases [3–5]. Epidemiological studies reveal that the global prevalence of insomnia among nurses varies from 30.0 to 65.4%, while the domestic prevalence in China ranges from 37.0 to 63.9% [6–11]. Studies have indicated that insomnia impairs nurses’ cognitive functions, including attention and memory, leading to emotional instability, diminished work efficiency and quality, and more critically, elevating the risk of nursing errors, accidents, and disputes [12–15]. Psychiatric nursing is marked by unique characteristics, such as the heightened unpredictability and uncontrollability of patients’ cognition and behavior, which inherently pose greater occupational risks. Furthermore, the routine implementation of closed management systems limits nurses’ social interactions, constituting an additional source of stress. Therefore, psychiatric nurses face additional work-related stressors, which result in elevated levels of psychological strain and emotional burden, thus making them more prone to sleep disturbances. Previous studies on insomnia in nurses have predominantly concentrated on individual factors, such as demographic characteristics, personality traits, and work-related attributes [16–18]. Studies indicate that organizational support serves as a protective factor in the development of insomnia [10, 19].
Perceived organizational support refers to the degree to which employees perceive respect and care from their organization or institution [20]. Social support theory suggests that receiving support from others helps mitigate stress and assists in coping with challenges [21]. In the workplace, nurses who perceive understanding, encouragement, and support from their organization are better able to manage psychological stress and anxiety, leading to improvements in sleep quality [11, 19]. Studies suggest that nurses who perceive higher levels of organizational support are less likely to develop insomnia [11]. Building on the previous analysis, this study proposes Hypothesis 1: perceived organizational support is negatively associated with insomnia symptoms among psychiatric nurses. Previous studies have mainly focused on organizational behavior among nurses, with less attention paid to the impact of organizational support on nurses’ mental health. Studies have shown that organizational support is positively correlated with nurses’ psychological capital and self-efficacy, and negatively correlated with occupational stress, depression, and insomnia [22–24]. Psychological capital, defined as a positive psychological resource characterized by hope, efficacy, resilience, and optimism, has been increasingly recognized as a vital factor in buffering occupational stress and promoting mental well-being among healthcare workers [11, 25–29]. Compared with other constructs such as burnout, work stress, or compassion fatigue, psychological capital uniquely reflects an individual’s capacity to harness internal psychological strengths to adapt to challenging environments and recover from setbacks [25, 30]. Higher psychological capital has been linked to lower stress-related symptoms, better job performance, and improved patient outcomes in nurses [11, 27, 31, 32]. Studies have suggested that psychological capital may mediate the relationship between nurses’ perceived organizational support and their burnout, work engagement, occupational stress, and mental health [29, 33–38]. Thus, this study posits Hypothesis 2: psychological capital mediates the relationship between perceived organizational support and insomnia.
Psychiatric nurses play a pivotal role and bear significant responsibilities within healthcare teams, facing distinct and often high-pressure stressors and challenges. Compared to other nursing specialties, psychiatric nurses work in an especially demanding environment, requiring constant management of emotional fluctuations, emergencies, and the psychological burdens associated with patients experiencing mental health disorders. However, research examining the relationship between perceived organizational support, psychological capital, and insomnia among psychiatric nurses is still limited, highlighting the need for further investigation. This study focuses on psychiatric nurses as the research population, examining the interplay between perceived organizational support, psychological capital, and insomnia, and providing a comprehensive analysis of the effects of organizational support on insomnia. The objective is to offer new insights for clinical nursing managers to improve both sleep quality and overall well-being of psychiatric nurses.
Method
Study design and participants
This study employed a convenience sampling approach to recruit 475 psychiatric nurses from three tertiary-level psychiatric specialty hospitals in Beijing. Data collection was conducted between March and June 2024. The inclusion criteria were as follows: currently employed psychiatric nurses holding professional certification, with at least two years of work experience, who voluntarily provided informed consent to participate in the study. The exclusion criteria included nurses undergoing advanced training, those in residency programs, and nurses on maternity or medical leave during the study period. Prior to the formal investigation, a pilot study involving 80 nurses was conducted using the Athens Insomnia Scale, yielding a standard deviation (S) of 0.44 for insomnia scores. This value was used to calculate the required sample size with the formula N = 4Uα²S² / δ² [39], where the allowable error (δ) was 0.1 and significance level (α) was 0.05, resulting in N ≈ 298. Considering a 15% invalid response rate, the minimum target sample size was adjusted to 351. A total of 503 questionnaires were collected. After excluding invalid responses—including those with missing answers, uniform responses, or completion times shorter than 3 min—475 valid questionnaires were retained, resulting in a valid response rate of 94.43%.
The questionnaires were developed and disseminated using the QuestionStar platform. Following approval from the nursing department leadership, the questionnaire QR codes were distributed by hospital representatives to eligible clinical nurses. To avoid duplicate responses, each IP address was limited to a single submission, and mandatory fields, along with logical checks, were incorporated into the questionnaire. Upon completion of data collection, the research team utilized the QuestionStar platform for questionnaire retrieval and quality control.
Measurements
Demographic characteristics
Drawing on an extensive review of the relevant literature, the researcher independently developed a comprehensive questionnaire that included nine variables: gender, age, educational background, monthly income, marital status, professional title, position, employment type, and night shift status.
Measurement of perceived organizational support
The Perceived Organizational Support Scale (POSS) was initially developed by Eisenberger et al. [20] and subsequently adapted into Chinese by Ling et al. [40]. The scale is specifically designed to assess perceived organizational support among healthcare professionals, with a reported Cronbach’s α coefficient of 0.803. The scale comprises nine items and employs a 7-point Likert scale, with response options ranging from “strongly disagree” (1) to “strongly agree” (7). The total score can range from 9 to 63, with higher scores reflecting a stronger perception of organizational support. Previous research using POSS among nurse populations have reported good reliability, with Cronbach’s α coefficients around 0.889 [29]. In the present study, the Cronbach’s α coefficient of the scale was determined to be 0.893.
Measurement of psychological capital
The Psychological Capital Questionnaire (PCQ), initially developed by Luthans et al. [25] in 2007 and subsequently adapted into Chinese by Li et al. [25], is designed to assess the psychological capital of nurses. This questionnaire includes four key dimensions: self-efficacy, hope, resilience, and optimism, with a total of 24 items. The questionnaire utilizes a 6-point Likert scale, with responses ranging from “strongly disagree” (1) to “strongly agree” (6). The total score spans from 24 to 144, with higher scores reflecting greater psychological capital among nurses. Previous studies employing the PCQ in Chinese nursing populations have demonstrated the scale’s strong reliability and validity, with reported Cronbach’s α coefficients as high as 0.956 [11]. In this study, the scale demonstrated excellent internal consistency, with a Cronbach’s α of 0.949.
Measurement of insomnia
The Athens Insomnia Scale (AIS) is a widely recognized, validated self-assessment tool for evaluating sleep quality, frequently utilized in clinical settings to assess the sleep quality of healthcare professionals, including nurses [41]. The scale comprises eight items that assess various aspects of sleep quality, including total sleep duration, sleep efficiency, sleep onset latency, nocturnal awakenings, early awakenings, daytime mood, physical functioning, and daytime sleepiness. The scale employs a 4-point Likert response format, where participants rate items ranging from “none” (0) to “severe” (3), reflecting the severity of symptoms. The total score on the scale ranges from 0 to 24, with higher scores indicating worse sleep quality. Each item is scored on a scale from 0 (none) to 3 (severe), and the cumulative score ranges from 0 to 24, with higher scores reflecting greater sleep disturbances. A total score below 4 indicates the absence of insomnia symptoms, while scores ranging from 4 to 6 suggest the presence of mild insomnia, and scores exceeding 6 indicate moderate to severe insomnia symptoms. Previous studies using AIS among nurse populations have reported good reliability, with Cronbach’s α coefficients around 0.883 [27]. In the present study, the Cronbach’s α coefficient for the AIS was found to be 0.906, demonstrating excellent internal consistency.
Statistical methods
All statistical analyses in this study were performed using SPSS 27.0 and the PROCESS macro. (1) The Gaussian distribution of the data was assessed using the Kolmogorov-Smirnov (K-S) single-sample test and a P-P plot. The data were normally distributed. (2) The Harman single-factor test was employed to evaluate the potential presence of common method bias [42]. Principal component analysis identified five factors with eigenvalues exceeding 1, with the first factor accounting for 27.88% of the variance (below the 40% threshold), suggesting no substantial concerns regarding common method bias [42]. (3) All data in this study were standardized before analysis. (4) Descriptive statistics comprised frequency, percentage, mean, and standard deviation. (5) Independent sample t-tests and analysis of variance (ANOVA) were conducted to compare differences in insomnia scores across demographic characteristics. (6) Pearson correlation analysis was performed to investigate the associations among organizational support, psychological capital, and insomnia. (7) Model 4 of the PROCESS macro was employed to examine the mediating effect of psychological capital in the association between perceived organizational support and insomnia [43]. Additionally, a Bootstrap procedure with 5,000 resamples was applied to estimate the 95% confidence interval (CI). Gender, age, education, marital status, position, professional title, monthly income, and night shift were included as covariates. Statistical significance was established at p < 0.05 following result integration.
Results
Preliminary analyses
Descriptive statistics, independent sample t-tests, and analysis of variance (ANOVA) were utilized to describe and compare the demographic characteristics of psychiatric nurses in relation to their Athens Insomnia Scale (AIS) scores, as presented in Table 1.
Table 1.
Demographic characteristics and their impact on insomnia
| AIS | |||||
|---|---|---|---|---|---|
| Variables | N (%) | Mean | SD | t / F | p |
| Gender | 1.289 | 0.198 | |||
| Male | 66 (13.89) | 12.79 | 6.19 | ||
| Female | 409 (86.11) | 11.75 | 5.44 | ||
| Age (years) | 1.365 | 0.256 | |||
| ≤ 30 | 248 (52.21) | 11.87 | 5.51 | ||
| 30–40 | 182 (38.32) | 12.19 | 5.73 | ||
| > 40 | 45 (9.47) | 10.67 | 4.98 | ||
| Education | 1.369 | 0.255 | |||
| Junior college and below | 97 (20.42) | 12.05 | 5.52 | ||
| College | 376 (79.16) | 11.87 | 5.56 | ||
| Postgraduate | 2 (0.42) | 5.50 | 3.54 | ||
| Marital status | 0.524 | 0.593 | |||
| Single | 146 (30.74) | 11.52 | 5.78 | ||
| Married | 321 (67.58) | 12.06 | 5.45 | ||
| Divorced | 8 (1.68) | 11.25 | 5.85 | ||
| Position | 3.372 | < 0.001 | |||
| Nurse | 432 (90.95) | 12.15 | 5.64 | ||
| Nurse manager | 43 (9.05) | 9.19 | 3.69 | ||
| Professional title | 3.952 | 0.020 | |||
| Nurse | 114 (24.00) | 11.16 | 5.05 | ||
| Nurse practitioner | 200 (42.11) | 12.71 | 5.84 | ||
| Charge nurse and above | 161 (33.89) | 11.36 | 5.42 | ||
| Monthly income (RMB) | 3.099 | 0.046 | |||
| ≤ 5000 | 233 (49.05) | 12.29 | 5.82 | ||
| 5001–8000 | 172 (36.21) | 11.92 | 5.20 | ||
| > 8000 | 70 (14.74) | 10.41 | 5.30 | ||
| Night shift | 6.048 | < 0.001 | |||
| Yes | 379 (79.79) | 12.63 | 5.64 | ||
| No | 96 (20.21) | 8.93 | 3.99 | ||
Notes: Significant p-value are bold; N: Number; %: Percentage; AIS, Athens Insomnia Scale; SD, Standard deviation.
A total of 475 psychiatric nurses participated in this study, including 66 males (13.89%) and 409 females (86.11%). Among the nurses, 52.21% were under the age of 30. The majority (79.16%) held a bachelor’s degree, while 67.58% were married. Regarding income, 49.05% earned ≤ 5000 RMB per month. Concerning professional titles, 42.11% were nurse practitioners, and 90.95% held the role of nurse. Additionally, 79.79% were required to work night shifts.
Within the sample of 475 psychiatric nurses, 395 individuals (83.16%) were found to suffer from insomnia. This study showed significant differences between insomnia and position (t = 3.372, p < 0.001), professional title (F = 3.952, p < 0.05), monthly income (F = 3.099, p < 0.05), and night shift duties (t = 3.099, p < 0.001). Detailed information is provided in Table 1.
Preliminary correction analyses
The means, standard deviations, and the correlations between the variables are presented in Table 2. Correlation analysis revealed a positive correlation between perceived organizational support and psychological capital (r = 0.641, p < 0.001), and a negative correlation between organizational support and insomnia (r = -0.348, p < 0.001). Additionally, psychological capital was negatively correlated with insomnia (r = -0.369, p < 0.001).
Table 2.
Correlation analysis of perceived organizational support, psychological capital, and insomnia
| Variables | Mean | SD | 1 | 2 | 3 |
|---|---|---|---|---|---|
| 1. Perceived organization support | 39.11 | 10.60 | 1 | ||
| 2. Psychological capital | 106.35 | 14.38 | 0.641*** | 1 | |
| 3. Insomnia | 11.88 | 5.55 | -0.348*** | -0.369*** | 1 |
Notes: *** P < 0.001
The effect of perceived organizational support on insomnia: the mediating role of psychological capital
Following the standardization of all variables in this study, mediation analysis was performed using Model 4 from the PROCESS macro for SPSS (developed by Hayes) [43]. Gender, age, education, marital status, position, professional title, monthly income, and night shift were included as covariates. The results, summarized in Table 3, indicate that perceived organizational support had a significant total effect on insomnia (c = -0.335, SE = 0.043, t = -7.740, p < 0.001), with an initial R² of 0.192. Additionally, perceived organizational support significantly predicted psychological capital (a = 0.633, SE = 0.037, t = 17.265, p < 0.001). When both perceived organizational support and psychological capital were included in the model, the direct effect of organizational support on insomnia remained significant (c′ = -0.191, SE = 0.054, t = -3.514, p < 0.001), and psychological capital negatively predicted insomnia (b = -0.227, SE = 0.054, t = -4.217, p < 0.001). The inclusion of the mediator increased the model’s explanatory power, with R² rising to 0.234, indicating an incremental R² change (ΔR²) of 0.042.
Table 3.
Mediating effect of psychological capital between perceived organizational support and insomnia
| Regression model | Overall fit index | Significance of regression coefficients | |||||||
|---|---|---|---|---|---|---|---|---|---|
| variable | Independent variable | R | R 2 | F | β | SE | t | P | 95% CI |
| Psychological capital | 0.655 | 0.430 | 38.900 | ||||||
| Perceived organizational support | 0.633 | 0.037 | 17.265 | < 0.001 | 0.561 to 0.705 | ||||
| Gender | 0.002 | 0.038 | 0.047 | 0.963 | -0.073 to 0.076 | ||||
| Age | 0.114 | 0.051 | 2.247 | 0.025 | 0.014 to 0.214 | ||||
| Education | 0.057 | 0.037 | 1.513 | 0.131 | -0.017 to 0.130 | ||||
| Marital status | -0.032 | 0.044 | -0.732 | 0.465 | -0.119 to 0.055 | ||||
| Position | -0.023 | 0.042 | -0.548 | 0.584 | -0.106 to 0.060 | ||||
| Professional title | -0.004 | 0.054 | -0.077 | 0.938 | -0.110 to 0.102 | ||||
| Monthly income | -0.008 | 0.039 | -0.212 | 0.832 | -0.086 to 0.069 | ||||
| Night shift | 0.065 | 0.043 | 1.517 | 0.130 | -0.019 to 0.149 | ||||
| Insomnia | 0.484 | 0.234 | 14.205 | ||||||
| Perceived organizational support | -0.191 | 0.054 | -3.514 | < 0.001 | -0.298 to -0.084 | ||||
| Psychological capital | -0.227 | 0.054 | -4.217 | < 0.001 | -0.333 to -0.121 | ||||
| Gender | -0.067 | 0.044 | -1.539 | 0.125 | -0.154 to 0.188 | ||||
| Age | 0.031 | 0.059 | 0.520 | 0.603 | -0.086 to 0.147 | ||||
| Education | 0.019 | 0.044 | 0.441 | 0.659 | -0.066 to 0.105 | ||||
| Marital status | 0.124 | 0.051 | 2.412 | 0.016 | 0.023 to 0.225 | ||||
| Position | -0.045 | 0.049 | -0.918 | 0.359 | -0.142 to 0.052 | ||||
| Professional title | 0.065 | 0.063 | 1.035 | 0.301 | -0.058 to 0.188 | ||||
| Monthly income | -0.001 | 0.046 | -0.012 | 0.990 | -0.090 to 0.089 | ||||
| Night shift | -0.262 | 0.050 | -5.227 | < 0.001 | -0.359 to -0.164 | ||||
| Insomnia | 0.438 | 0.192 | 22.278 | ||||||
| Perceived organizational support | -0.335 | 0.043 | -7.740 | < 0.001 | -0.420 to -0.250 | ||||
| Gender | -0.068 | 0.045 | -1.521 | 0.129 | -0.156 to -0.020 | ||||
| Age | 0.005 | 0.060 | 0.082 | 0.935 | -0.113 to 0.123 | ||||
| Education | 0.006 | 0.044 | 0.144 | 0.886 | -0.080 to 0.093 | ||||
| Marital status | 0.131 | 0.052 | 2.511 | 0.012 | 0.029 to 0.234 | ||||
| Position | -0.040 | 0.050 | -0.796 | 0.462 | -0.138 to 0.058 | ||||
| Professional title | 0.066 | 0.064 | 1.032 | 0.303 | -0.059 to 0.191 | ||||
| Monthly income | 0.001 | 0.046 | 0.029 | 0.977 | -0.090 to 0.093 | ||||
| Night shift | -0.276 | 0.050 | -5.489 | < 0.001 | -0.365 to -0.178 | ||||
As presented in Table 4, a mediation model was evaluated following the method outlined by Hayes, utilizing the Bootstrap procedure with 5,000 resamples to calculate the 95% confidence interval. The results revealed that the direct effect of organizational support on insomnia was − 0.191 (95% CI: -0.298 to -0.084), with the confidence interval excluding zero, which accounted for 57.01% of the total effect. The mediating effect of psychological capital in the relationship between organizational support and insomnia was − 0.144 (95% CI: -0.210 to -0.072), with the confidence interval excluding zero, and this mediating effect accounted for 42.99% of the total effect. According to conventional benchmarks, this proportion reflects a moderate mediation effect [44–46]. These findings suggest that psychological capital serves as a partial mediator in the relationship between organizational support and insomnia. The mediating pathway through psychological capital in the relationship between organizational support and insomnia among psychiatric nurses is depicted in Fig. 1.
Table 4.
Total, direct, and indirect effects of perceived organizational support on insomnia
| Paths | Effect | Boot SE | Bootstrap 95% (CI) | Relative Mediation Effect |
|
|---|---|---|---|---|---|
| BootLL CI | BootUL CI | ||||
| Total effect of X on Y | -0.335 | 0.043 | -0.420 | -0.250 | |
| Direct effect of X on Y | -0.191 | 0.054 | -0.298 | -0.084 | 57.01% |
| Indirect effects (X→M→Y) | -0.144 | 0.035 | -0.210 | -0.072 | 42.99% |
Notes: Number of bootstrap samples for Bias-corrected Confidence Intervals (BC CI): 5,000. Level of confidence for all confidence intervals: 95%. X = Perceived organizational support; M = Psychological capital; Y = Insomnia. LL = lower level; UL = upper level
Fig. 1.
The mediation effect of psychological capital in the relationship between perceived organization support and insomnia. Note: *** p < 0.001
Discussion
The findings of this study indicate that the insomnia detection rate among psychiatric nurses was 83.16%, significantly higher than the insomnia detection rates of 34.00% reported by Lai et al. [7] in a cohort of 1,257 healthcare workers, and 57.29% reported by Du et al. [10] in a study involving 658 nurses from a tertiary first-class hospital in Shandong Province. The observed difference may be attributed to the distinct selection criteria of the study populations. In contrast, this study focused exclusively on psychiatric nurses, whereas Lai et al. [7] and Du et al. [10] included nurses from various clinical departments. Compared with nurses in other specialties, psychiatric nurses face unique professional challenges. First, psychiatric nurses are often confronted with patients suffering from mental illnesses, which requires managing unstable emotions, impulsive behaviors, and emergency situations. Such high-intensity emotional labor can exacerbate their psychological burden, consequently impairing sleep quality. Secondly, psychiatric nursing requires high levels of concentration and emotional regulation. Prolonged mental strain may elevate anxiety and stress, further negatively impacting sleep. Moreover, the work pace in psychiatric wards is distinct from that in other clinical departments. Certain nurses are required to work in shifts and maintain heightened alertness during nighttime hours to prevent self-harm or medical emergencies among patients. This irregular schedule can disrupt their circadian rhythms and sleep patterns, thereby worsening insomnia. In conclusion, these factors likely contribute to the higher insomnia rate observed among psychiatric nurses compared with those in other nursing specialties.
The findings of this study reveal a significant negative predictive association between organizational support and insomnia in psychiatric nurses, thereby confirming Hypothesis 1, which is consistent with previous studies [10, 11, 47]. A study by Wang et al. [11] demonstrated that perceived organizational support negatively predicted insomnia symptoms in clinical nurses. Mao et al. [48] identified a negative correlation between social support levels and insomnia symptoms. These results further corroborate the social support theory [13], which posits that higher levels of perceived organizational support are inversely related to the likelihood of insomnia. The work environment of psychiatric nurses is distinctive, demanding the management of unstable emotions and emergency situations among patients with mental illnesses, while simultaneously involving substantial emotional labor and psychological stress. In the absence of sufficient organizational support, psychiatric nurses are likely to experience heightened psychological burdens and occupational burnout, which may consequently exacerbate anxiety and stress, ultimately impairing sleep quality. Previous research [47] has also suggested that organizational support influences employee attitudes and behaviors, with employees who perceive lower levels of organizational support potentially experiencing increased work-related stress and negative emotions, thereby adversely affecting sleep. This study underscores the importance for hospital administrators to prioritize the influence of organizational support on insomnia among psychiatric nurses, advocating for improvements in organizational support, addressing nurses’ psychological and emotional needs, optimizing work scheduling, and fostering humanistic care and effective communication. These measures are expected to enhance the work environment and psychological well-being of psychiatric nurses, reduce insomnia prevalence, boost job satisfaction and work quality, ensure patient safety, and maintain the hospital’s reputation.
Furthermore, the findings of this study indicate that psychological capital partially mediates the relationship between organizational support and insomnia. Specifically, organizational support not only has a direct effect on insomnia but also indirectly influences it by enhancing psychological capital. The results indicate that psychiatric nurses’ perception of organizational support is positively associated with their psychological capital levels. A higher level of organizational support contributes to enhancing nurses’ psychological capital, thereby more effectively mitigating insomnia induced by work-related stress. This finding aligns with the results reported by Wang et al. [11]. Wang et al. also suggested that perceived organizational support enhances employees’ in-role and extra-role performance while reducing their stress levels and withdrawal behaviors [33]. Psychological capital, as a core internal resource, plays a crucial role in buffering the adverse effects of work-related stressors [49]. While psychiatric nurses often operate under sustained emotional demands, previous research suggests that individuals with higher levels of psychological capital are better equipped to manage stress, maintain emotional regulation, and reduce the risk of insomnia [11, 27, 50]. In this context, psychological capital may serve as a compensatory mechanism when external support is insufficient, reinforcing its importance in both personal resilience and institutional well-being strategies.
Furthermore, the findings of this study can be further interpreted through the lens of the Job Demands–Resources (JD-R) model of occupational stress. According to the JD-R model, job demands such as high emotional labor and irregular shift work increase psychological strain, whereas job resources like perceived organizational support and psychological capital can buffer these negative effects [33, 38]. Our results showing that organizational support directly reduces insomnia and indirectly influences it via psychological capital align well with this model, highlighting the critical role of organizational resources in mitigating the adverse impact of occupational stressors on psychiatric nurses’ sleep quality.
Therefore, enhancing the psychological capital of psychiatric nurses may further augment the buffering effect of organizational support on insomnia. To translate these findings into practical strategies, nursing managers are encouraged to implement targeted interventions aimed at strengthening both organizational support and psychological capital. These may include structured psychological capital training workshops to foster positive psychological traits and coping abilities, peer mentorship programs to promote a sense of belonging and emotional support, and optimized shift scheduling to minimize sleep disruptions. Collectively, such measures may alleviate occupational stress, improve sleep quality, and enhance the psychological well-being and professional performance of psychiatric nurses.
Limitations
This study is not without its limitations. First, although simple random sampling was employed, it may have led to overrepresentation of certain subgroups—such as younger nurses, or individuals more inclined to participate in online surveys—which could introduce sampling bias and reduce the generalizability of the results to psychiatric nurses in other regions, hospitals, or settings. Second, data collection relied on online self-report questionnaires, which may be subject to recall bias and selection bias, potentially affecting the validity of the findings. Third, the cross-sectional nature of this study limits our ability to draw causal conclusions. While the mediation model provides theoretical insight, temporal precedence cannot be established. Future research should employ longitudinal or experimental designs, such as multilevel modeling or cross-lagged panel analysis, to better examine causal pathways between perceived organizational support, psychological capital, and insomnia. Fourth, potential moderating variables such as gender, age, work experience, and night shift frequency were not examined in the current study. These factors may differentially influence the relationships among perceived organizational support, psychological capital, and insomnia. Future research could conduct subgroup or interaction analyses to explore these moderating effects, providing more nuanced insights into targeted interventions for specific nurse populations. Lastly, this study did not include several contextual and occupational factors—such as team support, actual workload, and prior clinical experience with psychiatric patients—which may influence both organizational support perception and sleep outcomes. Future investigations should consider these factors to enhance the comprehensiveness and ecological validity of the findings.
Conclusion
In conclusion, perceived organizational support not only directly influences insomnia in psychiatric nurses but also indirectly impacts it through psychological capital. The findings of this study indicate that both perceived organizational support and psychological capital serve as significant predictors of insomnia, underscoring the importance of organizational and individual psychological resources in improving sleep outcomes among psychiatric nurses. This study expands upon existing pathways through which perceived organizational support influences insomnia, specifically by identifying the mediating role of psychological capital, thereby affirming the complex interplay among these variables. Furthermore, the study demonstrates that for nurses with low levels of perceived organizational support, enhancing psychological capital constitutes an effective strategy for mitigating insomnia. Beyond theoretical implications, the findings have practical significance for nursing education and occupational health. Nursing management teams are encouraged to cultivate supportive work environments, implement psychological capital training programs, and integrate stress management and resilience-building content into continuing education curricula. These measures may enhance nurses’ psychological well-being, reduce the prevalence of insomnia, and ultimately improve the quality of patient care.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Acknowledgements
All the authors wish to thank all of the participants, and Hayes who provided the PROCESS macro for SPSS.
Abbreviations
- POSS
Perceived Organizational Support Scale
- PCQ
Psychological Capital Questionnaire
- AIS
Athens Insomnia Scale
- JD-R
Job Demands–Resources
Author contributions
Conceived and designed the research: JY-Z, RN-D, ZR-W, and HP-C. Performed the research: JX-C, NC, JZ, and SF-W. Data analyses: JY-Z and RN-D. Wrote the paper: JY-Z, RN-D, and HP-C. All authors reviewed the manuscript.
Funding
This study was supported by Beijing municipal hospital scientific research and Cultivation Program (PX2021072) and Beijing Municipal Science and Technology Project (Z181100001518005). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Data availability
De-identified textual data can be made available upon reasonable request to the corresponding author.
Declarations
Ethic approval and consent to participate
The study has been approved by the Ethics Committee of Beijing Huilongguan Hospital (Approval No. 2021-18) and adheres to the principles outlined in the Declaration of Helsinki. Before the survey was conducted, all participants were provided with a comprehensive explanation of the research objectives and gave informed consent.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Jian-yi Zhang and Ruo-nan Du contributed equally to this work.
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