目的 分析轮班睡眠障碍护士的失眠亚型特征，分析其失眠严重程度的潜在类别及影响因素，为临床精准干预提供依据。方法 2025年6-9月，便利抽取上海市6所三级甲等医院轮班363名护士，采用轮班工作睡眠障碍评估问卷、抑郁-焦虑-压力量表及失眠严重指数量表对其进行调查。通过潜在剖面分析确定潜在类别，运用决策树算法构建模型，采用多因素Logistic回归分析影响因素。结果 失眠严重程度分为3类：低症状-功能保留型（16.3%）、中度症状-日间受限型（53.7%）、高困扰-高功能损害型（30.0%）。决策树模型显示，焦虑、抑郁、工作年限、年龄、夜班入睡机会及婚姻状况是关键因素。咖啡因饮用频率、焦虑及抑郁情绪均是失眠严重程度类别的影响因素（均P＜0.05）。结论 轮班睡眠障碍护士的失眠严重程度存在异质性，本研究有助于早期识别高危群体并制订针对性干预措施。

Objective To analyze the sub-characteristics of insomnia in nurses with shift work,identify potential classes of insomnia severity and their influencing factors,and provide a basis for precise clinical intervention.Methods From June to September 2025,a convenience sample of 363 nurses with shift work disorder was recruited from 6 tertiary A hospitals in Shanghai.The Shift Work Disorder Assessment Questionnaire,Depression-Anxiety-Stress Scale,and Insomnia Severity Index were used for the investigation.Latent profile analysis was employed to identify potential classes,with a decision tree model constructed,and multivariate logistic regression used to analyze influencing factors.Results Insomnia severity was categorized into 3 classes:low symptoms-preserved function type (16.3%),moderate symptoms-daytime impairment type (53.7%),and high distress-high functional impairment type (30.0%).The decision tree model showed that anxiety,depression,years of work experience,age,opportunity for sleep during night shifts,and marital status were key factors.Caffeine consumption frequency,anxiety,and depression were influencing factors for insomnia severity classes (all P＜0.05).Conclusions There is heterogeneity in the severity of insomnia among nurses with shift work.This study facilitates early identification of high-risk groups and the development of targeted intervention strategies.

R47

上海市科学技术委员会创新生态建设计划“科普与科技传播”项目（25DZ2302500）；上海申康医院发展中心管理研究项目（2024SKMR-29）；上海市宝山区中西医结合医院优秀青年医学人才培养计划（2023BY009）