Background: work alienation is receiving increasing attention as a psychological risk at work, and little is known about the mechanisms of role ambiguity and work alienation in nurses in the context of the COVID-19 pandemic. This article aims to examine how role ambiguity affects work alienation among Chinese nurses during the two years after COVID-19 pandemic and verify emotional exhaustion as mediators. Methods: A cross-sectional study design was used to recruit 281 Chinese nurses. Nurses completed online questionnaires containing demographic characteristics, role ambiguity, emotional exhaustion, and work alienation, and SPSS 26.0 and AMOS 24.0 were used for data analysis and structural equation modelling. Results: work alienation scores were (34.64 ± 10.09), work alienation was correlated with role ambiguity and emotional exhaustion (r1 = 0.521, r2 = 0.755; p < .01), and role ambiguity was positively correlated with emotional exhaustion (r = 0.512; p < .01). A mediating effect of emotional exhaustion between role ambiguity and work alienation held (mediating effect of 0.288, 95% CI: 0.221–0.369, accounting for 74.8% of the total effect). Conclusion: Role ambiguity has a significant direct effect on nurses’ feelings of alienation and exacerbates alienation through emotional exhaustion. Clarifying roles at work and being less emotionally drained are effective ways to reduce nurses’ feelings of alienation.

Anxiety and depressive symptoms are both common in insomnia patients, and they share a critical bidirectional relationship. The available research suggests that transitioning from a disorder-level analysis to a symptom-level analysis may provide a clearer understanding of these relationships. A total of 1571 insomnia patients were enrolled in this study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), anxiety symptoms were evaluated using the Hamilton Rating Scale for Anxiety (HAM-A), and depressive symptoms were evaluated using the Hamilton Rating Scale for Depression (HAM-D). Subsequently, a network analysis was conducted for the statistical analysis. Among the present sample, the prevalences of depression and anxiety were 87.1% and 88.0%, respectively. We found that the strongest regularized partial correlations existed in the network between “C3: Sleep duration” and “C4: Habitual sleep efficiency” (r = 0.91). Two other strong regularized partial correlations were observed between “B3: Cognitive disturbance” - “B7: Hopelessness” (r = 0.36), “A2: Psychic anxiety” - “B5: Retardation” (r = 0.28). In addition, the item “C3: Sleep duration” had the highest strength centrality in the network, followed by “C1: Subjective sleep quality”, “C4: Habitual sleep efficiency”, “A2: Psychic anxiety”, “B1: Anxiety/Somatization”. The findings highlight the crucial role of the strongest regularized partial correlations and bridge symptoms in relation to depression and anxiety. Targeted interventions for clinical control of anxiety and depressive symptoms in insomnia patients are promising.