The Cross-Level Influence of Medical Students’ Perception of Stress on Sleep Quality—A Moderated Mediation Model

Background Medical students, the healthcare practitioners in the future, are under greater pressure and prone to physical and mental health problems such as anxiety, depression, and sleep disorders compared with other non-medical specialties. Methods This study investigated the perceived stress of medical students in China and the relationship between their sleep quality. Based on the Cognitive Appraisal Theory and the Perseverative Cognition Hypothesis, we constructed a cross-sectional structural equation model (SEM) with stress perception as a predictor, sleep quality as an outcome variable, and work rumination and social support as buffer moderators. An online survey of 350 medical students from a medical university were collected, 318 of the participants were defined as study objects. Results The results of the study found that medical student’s stress perception negatively affects sleep quality; work rumination plays a mediating role in the relationship between stress perception and sleep quality; perceived social support plays a negative cross-level moderating role between stress perception and work rumination, and also plays a positive cross-level moderating role between work rumination and sleep quality. Conclusions This study provided evidence for the design of stress regulation methods for medical students as well as intervention techniques to improve sleep quality among medical students.