Latent profiles of professional identity and sleep quality and associations with anxiety symptoms among emergency nurses

Background Emergency nurses are exposed to sustained occupational stress and are at high risk for anxiety symptoms. Professional identity and sleep quality are both closely related to mental health; however, most existing studies have adopted variable-centered approaches that may obscure meaningful heterogeneity within this population. Methods A cross-sectional survey was conducted among registered emergency nurses at a tertiary teaching hospital in China between March and June 2024. Participants completed questionnaires assessing professional identity (Professional Identity Scale for Nurses), sleep quality (Pittsburgh Sleep Quality Index), and anxiety symptoms (Generalized Anxiety Disorder-7). Latent profile analysis was performed using the total professional identity score and seven sleep quality component scores as continuous indicators. Differences in anxiety symptoms and demographic characteristics across profiles were examined using chi-square tests and one-way ANOVA. Results Three latent profiles were identified: an Adaptive and Well-Functioning profile, a Sleep-Disturbed with Moderate Identity profile, and an At-Risk with Low Identity and Poor Sleep profile. These profiles showed significantly different prevalences of anxiety symptoms, whereas no significant differences were observed in demographic or occupational characteristics across profiles. Conclusions Emergency nurses exhibit distinct and clinically meaningful patterns of professional identity and sleep quality that are differentially associated with anxiety symptoms. The identification of a prominent Sleep-Disturbed profile as an important factor associated with higher levels of anxiety symptoms, even among nurses with relatively preserved professional identity. By explicitly capturing heterogeneity that would not be apparent using variable-centered approaches alone, a person-centered perspective may provide insights for the development of more tailored mental health support strategies for emergency nursing populations.