The effect of sleep problems on core self-evaluations in undergraduate nursing students and the role of emotion regulation and resilience: A cross-sectional study

Background: Nursing students are prone to sleep problems that affect their core self-evaluations. However, little attention has been paid to the specific roles of emotion regulation (including cognitive reappraisal and expressive suppression) and resilience in this process. Objectives: This study aimed to explore 1) the direct effect of sleep problems on core self-evaluations among nursing students; 2) the chain-mediating effect of cognitive reappraisal and resilience on the relationship between sleep problems and core self-evaluations; 3) the moderating effect of expressive suppression on the direct relationship between sleep problems and core self-evaluations; and 4) the moderating effect of expressive suppression on the indirect relationship between sleep problems affecting core self-evaluations through resilience. Methods: A total of 345 nursing students completed a survey conducted between September and October 2022. Data was analyzed using descriptive analysis, Fisher exact test, Kruskal-Wallis H test, Spearman correlation analysis, and hierarchical regression analysis. Additionally, the SPSS PROCESS V4.0 plug-in was used to verify the moderated chain-mediating effect. Results: Sleep problems directly affected core self-evaluations among nursing students. Cognitive reappraisal and resilience played a partial chain-mediating role in the relationship between sleep problems and core selfevaluations, with expressive suppression having a direct moderating effect. Conclusions: Opportunities exist for enhancing the core self-evaluations of nursing students by addressing their sleep problems, promoting cognitive reappraisal strategies, and increasing resilience. Additionally, encouraging expressive suppression can mitigate the negative impact of sleep problems on nursing students' core selfevaluations.