Impacts of Insomnia among Bachelor Novice Nurses

at the Fiji School of Nursing.

School of Nursing

College of Medicine, Nursing & Health Sciences

Fiji National University

Saadiya Nisha– A00076149

Josefa Nofoimuli – A00078265
Luisa O’Brien– A00072089
Prashiv Prakash – A00076154

2023

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Table of Contents Page
Number
1. Introduction………………………………………………………………………………………………………... 3

2. Significance of Proposed Research…………………………………………………………………….... 4

3. Problem Statement……………………………………………………………………………………………… 5

4. Research Objective and Research Questions……………………………………………............. 6

5. Literature Review…………………………………………………………………………………………………. 7

6. Methodology……………………………………………………………………………………………………..... 9

6.1 Research Design………………………………………………………………………………………….…. 9

6.2 Population and sampling technique…………........................................................ 9

6.3 Data Collection Method…………………………………………………………………………………. 10

6.4 Data Analysis Technique………………………………………………………………………………… 11

6.5 Ethical Consideration……………………………………………………………………………………... 12

7. Time Frame………………………………………………………………………………………………………….. 13

8. Budget………………………………………………………………………………………………………………….. 14

9. Communication of Research Findings…………………………………………………………………... 15

10. Reference List………………………………………………………………………………………………….…... 16

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1. Introduction

The body needs enough sleep to maintain healthy physiological, psychological

and cognitive functioning. For the best patient care in the healthcare industry,

getting enough sleep is crucial. Lack of sleep increases the likelihood of

procedural errors, endangering the clients. Poor brain function results in a

neurological system that has not received enough sleep (Okano et al, 2019).

Academic performance frequently suffers as a result of the cognitive Impairment

brought on by sleep loss. Positive lifestyle practices and good sleeping habits

should be preserved to prevent issues of sleep deprivation. Academic and

financial pressures placed on students can exacerbate physiological stress,

which may result in poorer sleep. College students are considered more prone to

having bad sleep habits, insomnia, and daytime tiredness. Each night, humans

need a certain amount of sleep, to function correctly. According to (Okano et al,

2019), adults require eight hours of sleep on average. When a suitable amount of

sleep is not maintained, sleep deprivation occurs. In particular, sleep deprivation

is very common among nursing students. We have had many restless nights as

nursing students because of employment schedules, necessary courses and

clinical rotations. Over time, a person`s physiological health, psychological

health, and cognitive performance may all suffer from sleep deprivation (Okano

et al, 2019). Students who lack sleep are more likely to miss class due to illness

or perform poorly while in class, which reduces the effectiveness of each unit of

information distributed that day. Therefore, it's critical to look at the effects of

sleep on the body and techniques to improve it.

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2. Significance of Proposed Research

The proposed research on the impact of insomnia among Bachelor of Nursing

novices in the Fiji School of Nursing is significant for several reasons. Firstly,

nurses are a critical component of the healthcare system and play a vital role in

patient care. Sleep deprivation due to insomnia can impair their ability to

perform their duties effectively, leading to medical errors and compromised

patient safety (Gong, 2021). Nursing students are at a critical stage in their

education and training. They are required to learn and assimilate vast amounts

of information while also gaining practical experience in clinical settings.

Insomnia can negatively affect their ability to learn and retain information,

leading to poor academic performance.

Nursing novices in Fiji may face unique challenges related to insomnia due to

cultural factors, lifestyle habits, and environmental factors. Understanding the

impact of insomnia on this specific population can help identify potential

interventions and strategies for prevention (Lehmann, 2013).

The proposed research on the impact of insomnia among Bachelor of Nursing

novices in the Fiji School of Nursing is significant as it can provide valuable

insights into the effects of insomnia on nursing students' academic

performance and patient care. The findings can inform interventions and

strategies for prevention that can improve the overall health outcomes of both

nursing students and patients.

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3. Problem statement

Insomnia is a common sleep disorder that affects many individuals worldwide.

In the context of Bachelor of Nursing novices at the Fiji School of Nursing,

insomnia can have a significant impact on their academic performance, clinical

practice, and overall well-being. The proposed research aims to investigate the

impact of insomnia among Bachelor of Nursing novices in the Fiji School of

Nursing.

One problem statement that the proposed research will address is the effect of

insomnia on academic performance. Lack of sleep can lead to poor

concentration, memory impairment, and difficulty in learning new information

(Gong, 2021). As nursing students are required to retain vast amounts of

information and apply them in clinical settings, insomnia may hinder their ability

to perform well academically.

Another problem statement that the proposed research will address is the

impact of insomnia on clinical practice. Sleep deprivation can affect decision-

making skills, reaction time, and motor coordination, which are crucial skills for

nursing practice. Insomnia may also lead to fatigue and burnout, which can

compromise patient safety and quality of care (Lehmann, 2013).

The proposed research will investigate the impact of insomnia on the overall

well-being of Bachelor of Nursing novices. Insomnia can lead to mood

disturbances such as irritability, anxiety, and depression. These psychological

effects can further exacerbate the negative impact on academic performance

and clinical practice.

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 4. Research Objective and Research Question

Research Objectives

4.1. To identify the influence of insomnia among nursing novices in the Fiji

School of Nursing.

4.2. To highlight the coping strategies executed by the nursing novices to

reduce the burden of sleep deprivation.

Research Question

4.3. What is the influence of insomnia among nursing novices?

4.4. What are coping strategies executed by nursing novices to reduce the

burden of sleep deprivation?

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 5. Literature review

Insomnia is a common sleep disorder characterized by difficulty falling asleep, staying

asleep, or waking up too early and not being able to fall back asleep. Insomnia can

have negative effects on an individual's physical and mental health, including fatigue,

irritability, poor concentration, and decreased job performance (Basavanthappa, 2011).

Student nurses are particularly vulnerable to insomnia due to the demands of their

academic studies and clinical rotations. The purpose of this literature review is to

examine the effects of insomnia among student nurses.

To begin with, there was a study aimed to investigate the prevalence of daytime

sleepiness and fatigue among Turkish nursing students (Alimoglu & Donmez, 2005).

The results showed that 68% of the participants reported daytime sleepiness and 73%

reported fatigue. Another study examined the relationship between work schedules and

the risk of occupational errors among medical residents. The results showed that

residents who worked night shifts had a higher risk of making errors than those who

worked day shifts (Arora et al, 2009). In another study, the researchers aimed to

describe the sleep quality of nursing students and identify factors associated with poor

sleep quality (Azagra-Lopez, 2016). The results showed that poor sleep quality was

associated with high levels of stress, poor academic performance, and low physical

activity. Another systematic review aims to examine sleep patterns and disturbances

among nursing students. The results showed that nursing students had poor sleep

quality, short sleep duration, and high levels of daytime sleepiness (Bano & Kundi,

2018). In addition, another study examined the association between shift work and

health behaviours among Korean adults (Cho, 2016). The results showed that shift

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workers had poorer health behaviours than non-shift workers. Another researchers’

study investigated the prevalence and consequences of shift work sleep disorder

among shift workers. The results showed that shift workers had higher rates of insomnia

and other sleep disorders than non-shift workers (Drake et al, 2004). Another study

examined the relationship between sleepiness, fatigue, and job performance among

nurses working 12-hour shifts. The results showed that nurses who reported poor sleep

quality had higher levels of fatigue and made more errors on the job (Geiger-Brown et

al, 2012). Nevertheless, Hsieh’s cross-sectional study examined the sleep quality of

nursing students and identify factors that influence sleep quality. The results showed

that poor sleep quality was associated with high levels of stress, poor physical health,

and low social support (Hsieh & Chen, 2018). A meta-analysis also examined the

prevalence of sleep disorders and psychological symptoms among Chinese college

students. The results showed that insomnia was the most common sleep disorder

among college students (Li, 2017). Another study executed by Wolfson examined the

validity of a sleep habits survey for adolescents. The results showed that the survey

was a reliable and valid measure of adolescent sleep habits (Wolfson, 2003).

In conclusion, insomnia is a prevalent problem among student nurses that can have

negative effects on their physical and mental health as well as their job performance.

Factors such as stress, poor academic performance, and shift work can contribute to

poor sleep quality among nursing students. Healthcare institutions should take steps to

address this issue by providing education on healthy sleep habits and creating work

schedules that prioritize employee well-being.

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6. Methodology

6.1. Research design

Exploring and comprehending people's irrational experiences and viewpoints is

the main goal of this qualitative study. Surveys are a frequently utilised tool in

this research since they enable researchers to gather information from a lot of

participants in a short amount of time. In this study, a survey was utilised to

acquire information about people's experiences and perceptions of their

encounters with insomnia. To choose study participants, a convenient sampling

technique was employed, which entails choosing people who are readily

available and eager to take part in the study. Due to its usefulness and

convenience in compiling a sizable sample size, this approach was chosen.

6.2. Population and sampling technique

The study's target population consists of 198 nursing students from a nursing

school in Fiji. They were between the ages of 18 and 21. A formula developed

by Taro Yamane (Yamane, 1976) with a 95% confidence interval and a +/- 5%

margin of error will be used to determine the sample size for this investigation.

With the following equation: n = N / [1 + N (e) 2]

Where e is the degree of precision (0.05), N is the population size (198), and n

is the sample size.

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Formula: n = N / [1 + N (e) 2]

= 198/ [1+ 198 (0.05)2]

= 132

20% of 132 =26

Therefore, 158 is the sample size to cater for the loss of subjects in which a

convenient sampling technique was utilized in this study. Insomnia is indirectly

related to novice nursing students since the individuals know insomnia based

on their perception.

6.3. Data collection method

6.3.1 Questionnaire Development:

As part of our research, we will be using a borrowed questionnaire from a

previous study to gather data on the sleep habits of first-year nursing students.

The questionnaire will ask participants about their sleep duration, bedtime and

wake-up time, sleep quality, and daytime functioning. By utilizing this

questionnaire, we hope to gain insight into the sleep patterns of nursing

students and identify any potential issues that may be affecting their academic

performance or overall well-being.

The questionnaire will consist of two sections:

a. Section 1: Sociodemographic Information - This section will gather data on

participants' age, gender, academic year, and any previous experience with

insomnia.

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 b. Section 2: Insomnia and Its Impacts - This section will assess insomnia

symptoms using validated scales, such as the Insomnia Severity Index

(ISI). It will also explore the impact of insomnia on academic performance,

mental health, physical health, and overall quality of life using Likert scale-

based questions and open-ended prompts.

6.3.2 Data Collection Process:

Data collection will be conducted on-site at the Fiji School of Nursing. The

researchers will contact potential participants through official channels, explain

the study's purpose and procedures, and seek their voluntary participation.

Participants will be provided with written informed consent forms and the self-

administered questionnaire. They will be given adequate time to complete the

questionnaire privately and return it in a sealed envelope.

6.4. Data analysis technique

The collected data will be analyzed using appropriate statistical methods and software

packages. Descriptive statistics will be employed to summarize the sociodemographic

characteristics of the participants. The severity of insomnia symptoms will be assessed

using the ISI, and the impact of insomnia on different aspects of nursing novices' lives

will be analyzed using descriptive and inferential statistics. The researchers will also

conduct a thematic analysis of the open-ended responses to identify common themes

and patterns.

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 6.5. Ethical consideration

This study will adhere to ethical guidelines, ensuring participant confidentiality, voluntary

participation, informed consent, and the protection of participants' rights. All collected

data will be securely stored and used only for research purposes. The Ethics Committee

of the Fiji School of Nursing will be requested in reviewing and guiding the study to

avoid the breaching of the university’s standards.

6.5.1 CONFIDENTIALITY

We will maintain the confidentiality of all participant information. All information obtained

during the interview, recruitment procedure, and interview recording will be kept in a

participant's code. Participants will be made aware that all data collected will only be

used for research purposes and that no names will be used in data analysis or when the

research report is distributed.

6.5.2 Voluntary Informed Consent

Participants will be able to withdraw from the research at any time without incurring any

consequences because participation is entirely voluntary. Participants will get a packet

of information explaining the study procedure, their roles, and what to anticipate during

the interview sessions. This information sheet will also explain that an audio recorder

will be used to record the interview. Participants will be told that they will be contacted

after transcriptions are finished so they can view the transcribed verbatim and make any

adjustments if necessary.

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7. Time frame

Activities March April May

1. Review literature

2. Develop a proposal

3. Develop an instrument/

Borrow an instrument

4. Test instrument

5. Collect data

6. Analyze data

7. Write a report

8. Discuss and present the

report

9. Manuscript preparation

10. Submit the final report to

the relevant authority

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 8. Budget

Expenses Cost per unit Estimated cost

A4 paper $0.10 x 50 $5.00

Pen $0.25 x 40 $10.00

Pencil $0.10 x 40 $4.00

Printing of Questionnaires $0.15 x 40 $6.00

Data entry and data $4.00 x 30 days $120.00

analysis

Transport allowance $10.00 x 5days $50.00

including double checking

Report writing $21.00 x 3 people $63.00

Documentation and $90.00 $90.00

information to MOH

Publication for research $200.00 $200.00

study

Grand Total $548.00

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 9. Communication of Research findings

Oral and written modes of communication will be used to disseminate the study’s

findings in symposiums. The outcomes will be outlined in a written report and presented

to the FNU Council, the FNU Student Association, and the Fiji Nursing Council, who will

use the research findings to develop efficient tools, procedures, and/or policies on how

to assess the concerns of insomnia among bachelor nursing students and lessen sleep

deprivation using coping mechanisms.

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References

Adachi, M., Nagaura, Y., ETO, H., Kondo, H., & Kato, C. (2022). The impact of sleep–

wake problems on health-related quality of life among Japanese nursing college

students: a cross-sectional survey. Health and Quality of Life Outcomes, 20(1),

1-8.

Ahn, S. Y., & Kim, Y. J. (2015). The influence of smartphone use and stress on the

quality of sleep among nursing students. Indian J Sci Technol, 8(35), 1-6.

Alimoglu, M. K., & Donmez, L. (2005). Daytime sleepiness and fatigue among Turkish

Nursing students. Sleep and Biological Rhythms, 3(3), 142-146.

Arora, V. M., Georgitis, E., Woodruff, J. N., & Humphrey, H. J. (2009). Mismatch

Between residents' work schedules and their biological clocks increases the risk

of occupational errors. Medical Education, 43(7), 662-666.

Azagra-Lopez, C., Gallegos-Soler, A., Grau-Munoz, A., & Sánchez-Ortuño, M. M.

(2016). Sleep quality in nursing students: Description of related factors. Nurse

Education Today, 36, 448-452.

Bano, R., & Kundi, I. K. (2018). Sleep patterns and sleep disturbances among nursing

students: A systematic review. Sleep and breathing, 22(2), 505-512.

16
Basavanthappa, B. T. (2011). Essentials of Mental Health Nursing. Jaypee Brothers

Medical Publishers (P), Ltd.

Belingheri, M., Luciani, M., Ausili, D., Paladino, M. E., Di Mauro, S., De Vito, G., & Riva,

M. A. (2022). Sleep disorders and night-shift work in nursing students: a cross-

sectional study. La Medicina del lavoro, 113(1), e2022003

Cho, E., Lee, H., Ryu, S., & Lee, J. (2016). The association between shift work and

health behaviour: Findings from the Korean National Health and Nutrition

Examination Survey. BMC Public Health, 16(1), 1-9.

Drake, C. L., Roehrs, T., Richardson, G., Walsh, J. K., & Roth, T. (2004). Shift work

sleep disorder: Prevalence and consequences beyond that of symptomatic day

workers. Sleep, 27(8), 1453-1462.

Gallego-Gómez, J.I., González-Moro, M.T.R., González-Moro, J.M.R. ET

al.Relationship between sleep habits and academic performance in university

nursing students. BMC Nurs 20, 100 (2021).

Geiger-Brown, J., Trinkoff, A., Rogers, V. E., & Kane, R. L. (2012). Sleep, sleepiness,

fatigue, and performance of 12-hour-shift nurses. Chronobiology International,

29(2), 211-219.

Ghosh, T., Sarkar, D., Sarkar, K., Dalai, C. K., & Ghosal, A. (2021). A study on

smartphone addiction and its effects on sleep quality among nursing students in

17
 a municipality town of West Bengal. Journal of Family Medicine and Primary

Care, 10(1), 378.

Gong, W., Aspatwar, A., Wang, S., Parkkila, S., & Wu, X. (2021). COVID-19 pandemic:

SARS-CoV-2 specific vaccines and challenges, protection via BCG trained

immunity, and clinical trials. Expert Review of Vaccines, 20(7), 857–880.

Güneş, Z., & Arslantaş, H. (2017). Insomnia in nursing students and related factors: A

cross‐sectional study. International journal of nursing practice, 23(5), e12578.

Hsieh, Y. L., & Chen, C. S. (2018). Sleep quality of nursing students and its influential

factors: A cross-sectional study. Journal of Nursing Research, 26(3), 163-170.

Lehmann, C. U., Shorte, V., & Gundlapalli, A. V. (2013b). Clinical Informatics Sub-

Specialty Board Certification. Paediatrics in Review, 34(11), 525–530.

Li, Y., Wang, X., Jiang, Y., Zhang, Y., & Tian, X. (2017). Sleep disorders and

psychological symptoms among Chinese college students: A comprehensive

meta-analysis. Journal of Sleep Research, 26(6), 676-682.

Menon, B., Karishma, H. P., & Mamatha, I. V. (2015). Sleep quality and health

complaints among nursing students. Annals of Indian Academy of

Neurology, 18(3), 363–364

Okano, K., Kaczmarzyk, J.R., Dave, N. et al. Sleep quality, duration, and consistency

are associated with better academic performance in college students. Npj Sci.

Learn. 4, 16

18
Rabei, S., Mourad, G., & Hamed, A. E. D. (2020). Work stress and sleep disturbances

among internship nursing students. Middle East Current Psychiatry, 27(1), 1-6.

Santos, T. C. D. M. M. D., Martino, M. M. F. D., Sonati, J. G., Faria, A. L. D., &

Nascimento, E. F. D. A. (2016). Sleep quality and chronotype of nursing

students. Acta Paulista de Enfermagem, 29, 658-663.

Wolfson, A. R., Carskadon, M. A., Acebo, C., Swiffer, R., Fallone, G., Labyak, S. E., &

Martin, J. L. (2003). Evidence for the validity of a sleep habits survey for

adolescents. Sleep, 26(2), 213-216.

YILMAZ, D., TANRIKULU, F., & DIKMEN, Y. (2017). Research on sleep quality and the

factors affecting the sleep quality of nursing students. Current health sciences

journal, 43(1), 20.

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