The association between perceived mortality exposure and nurses’ depressive symptomes, through life satisfaction, and sleep quality

Front Public Health. 2026 Jul 16;14:1872055. doi: 10.3389/fpubh.2026.1872055. eCollection 2026.

ABSTRACT

INTRODUCTION: Nurses working in high-mortality clinical settings are frequently exposed to patient suffering and death. This might contribute to occupational stress and adverse psychological outcomes. However, the mechanisms linking this exposure to depressive symptoms remain unclear. This study examines the association between perceived mortality exposure and depressive symptoms and the mediating roles of life satisfaction and sleep quality.

METHODS: A cross-sectional study was conducted among 200 nurses using an online survey. Data were analyzed using correlation, regression, and mediation analysis with Hayes’ PROCESS macro.

RESULTS: Perceived mortality exposure was significantly associated with higher depressive symptoms and poorer sleep quality. Life satisfaction was inversely associated with depressive symptoms, whereas sleep quality was not. Nonetheless, the overall regression model, including perceived mortality exposure and life satisfaction, explained only a modest proportion of the variance in depressive symptoms. The mediation analysis showed no significant indirect effects through life satisfaction or sleep quality.

DISCUSSION: Perceived mortality exposure represents a potentially significant occupational stressor for nurses, but the lack of mediation indicates that factors beyond life satisfaction and sleep quality may better explain its impact on depressive symptoms.

PMID:42534775 | PMC:PMC13422170 | DOI:10.3389/fpubh.2026.1872055