【作者】 王慧； 路梦新； 封丹珺；

【Author】 Hui Wang;Mengxin Lu;Danjun Feng;School of Nursing and Rehabilation, Shandong University;Affiliated Hospital of Qingdao University;

【机构】 山东大学护理与康复学院； 青岛大学附属医院；

【摘要】 目的:睡眠是人类的基本生理需求,对人类的身心健康具有极为重要的意义。然而,随着生活节奏的加快以及学习压力的增大,医学生的睡眠问题越来越突出,入睡时间逐渐变的越来越晚,睡眠时长也越来越少。不充足的睡眠问题严重影响了学生的注意力,降低学习投入,影响学业表现。睡眠拖延作为影响医学生晚睡和睡眠不足的重要原因,本研究拟采用密集纵向的日记法的研究设计,探讨医学生夜晚睡眠拖延对第二天学习投入的影响,并考察睡眠质量和睡眠时长在其中的中介作用,以期为采取措施促进医学生的学习投入、增进学业表现提供依据。方法:本研究以山东省济南市某高校招募的122名医学生作为研究对象,并对其进行了连续14天的问卷追踪调查。研究对象完成一般资料调查表,并在每天早上醒来后报告昨晚的睡眠拖延,睡眠质量和睡眠时长;在每天晚上睡前填写当天的学业投入问卷。结果:以睡眠质量为中介变量的多水平结构方程模型结果显示,在个体间水平,睡眠质量与更好的学习投入正相关(β=0.273,P<0.05);在个体内水平,前一晚的睡眠拖延负向预测当晚的睡眠质量(β=-0.165,P<0.001),当晚的睡眠质量又正向预测第二天的学习投入(β=0.082,P<0.01),前一晚的睡眠质量在睡眠拖延与次日学习投入之间起完全中介作用(β=-0.012, 95%CI [-0.021,-0.003])。以睡眠时长为中介变量的多水平结构方程模型结果显示,在个体间水平,睡眠拖延与更短的睡眠时长有关(β=-0.498,P<0.001);在个体内水平,前一晚的睡眠拖延与更短的睡眠时长有关(β=-0.207,P=0.118),其余路径均不显著。结论:医学生的睡眠拖延会降低当晚的睡眠质量,减少睡眠时长;睡眠拖延可通过降低当晚的睡眠质量,而非睡眠时长,从而影响医学生的学业投入。未来研究可采取应对拖延行为的有效策略,减少拖延行为的发生,从而改善医学生的睡眠质量,进而促进医学生的学业投入,提高学业表现。更多还原

【Abstract】 Objectives: Sleep is a basic physiological need of human beings, which is extremely vital to their physical and mental health. However, with the accelerated pace of life and increasing academic pressure, the sleep problem of medical students has become more and more prominent. Medical students experience less sleep duration and poorer sleep quality. Inadequate sleep problem seriously affects students’ attention, reduces academic engagement and academic performance. Given bedtime procrastination is one of the most important reasons affecting medical students’ sleep, this study aimed to use an intensive longitudinal diary study design to investigate the effect of medical students’ night bedtime procrastination on their next-day study engagement, and to explore the mediating roles of sleep quality and sleep duration, which could provide evidence for taking measures to promote medical students’ academic engagement and enhance academic performance.Methods: A total of 122 medical students recruited from a university in Jinan, Shandong Province were investigated by questionnaires for 14 consecutive days. Study participants completed general information questionnaires and reported bedtime procrastination, sleep quality, and sleep duration upon waking up each morning; and filled out academic engagement questionnaires on the day before going to bed every night.Results: The multilevel structural equation model with sleep quality as a mediator variable showed that sleep quality was positively associated with academic engagement(β=0.273, P<0.05) at the between-person level. At the within-person level, bedtime procrastination was negatively associated with medical students’ night sleep quality(β=-0.165, P<0.001), which in turn positively predicted their next-day academic engagement(β=0.082, P<0.01).Night sleep quality fully mediated the effect of bedtime procrastination on next-day academic engagement(β=-0.012, 95% CI [-0.021,-0.003]). The multilevel structural equation model with sleep duration as a mediator variable showed that bedtime procrastination was associated with shorter sleep duration(β=-0.498, P<0.001) at the between-person level. At the within-person level, bedtime procrastination was associated with shorter sleep duration(β=-0.207, P=0.118), with the rest of the paths being nonsignificant.Conclusion: Bedtime procrastination was associated with shorter sleep duration and lower sleep quality at night.Medical students’ bedtime procrastination can affect their next-day academic engagement by reducing sleep quality rather than sleep duration at night. Future research could adopt effective strategies for alleviating bedtime procrastination behaviors, thereby improving medical students’ sleep quality, which in turn promotes their academic engagement and improves academic performance.更多还原