Factors associated with stress, anxiety and depression in nursing professionals in the hospital context

Exploring factors affecting nurse anxiety in Northwest Ethiopia: a multicenter study

Introduction

Anxiety is a commonly reported mental health disorder that significantly contributes to the global burden of disease. However, proper counseling, problem-solving strategies, and promotion of healthy lifestyle practices have a positive effect on reducing nurse anxiety, but there is limited evidence in Ethiopia, particularly in this study area. Therefore, this study aimed to assess the prevalence and identify factors affecting nurse anxiety in Northwest Ethiopia's comprehensive specialized hospitals.

Methods

An institution-based cross-sectional study was conducted among 746 study participants from April 14 to May 20, 2023. A simple random sampling technique was used. An interviewer-administered questionnaire was used. Data were entered into EpiData version 4.6.0 and exported to STATA version 17 for analysis. In binary logistic regression, variables with a p-value of less than 0.25 were considered candidates for multivariable logistic regression. An association was declared at a p-value of less than 0.05 with a 95% confidence interval.

Result

In this study, the prevalence of anxiety was 33.9%. Thus, being female [adjusted odds ratios (AOR) = 1.53, 95% CI = 1.08, 2.22], working in an emergency department (AOR = 3.65, 95% CI = 1.83, 7.28), working night duty shifts (AOR = 3.12, 95% CI = 2.19, 4.46), having conflict with coworkers (AOR = 1.7, 95% CI = 1.14, 2.51), and having poor social support (AOR = 2.13, 95% CI = 1.23, 3.69) were variables significantly associated with anxiety.

Conclusion

This study revealed that one-third of nurses experienced anxiety, which is a critical indicator of mental health within this population. Important factors that were found to be significantly associated with anxiety include being female, working in the emergency department, having a conflict with coworkers, having poor social support, and working night duty shifts. These findings show the need for the implementation of counseling services and the adaptation of effective coping strategies for nurses working at comprehensive specialized hospitals. Understanding the impact of anxiety on nurses is important to design interventions aimed at improving their mental health and job satisfaction.

Exploring the Association Between Behavioural Modification in Response to the Prevailing Economic Crisis and Mental Health Outcomes of Nurses from Teaching Hospitals, Sri Lanka

Introduction

The nursing profession is a cornerstone in the healthcare workforce. Yet, it remains vulnerable to severe mental health challenges, stemming from a complex interplay of social and occupational factors. It is evident that crisis situations have profound influence on the mental-wellbeing of nurses.

Objective

To explore the association between behavioural modification in response to the prevailing economic crisis and mental health outcomes of nurses from teaching hospitals, Sri Lanka.

Methods

This cross-sectional study was carried out among nursing professionals (n = 261) who are employed in distinct teaching hospitals (n = 7) in Sri Lanka. Considering the bed-capacity of each hospital, participants were purposively selected and invited to complete an online-based self-administered questionnaire to collect demographic characteristics and lifestyle modifications to deal with the economic crisis, while Depression, Anxiety, and Stress Scale (DASS-21) a set of three self-reported scales to assess the level of depression, anxiety, and stress, was used. Data was analyzed using the SPSS 23.0 version, Descriptive analysis was performed to present frequencies of both demographic characteristics and lifestyle and symptoms of depression, anxiety, and stress, while the Chi-square test was used to determine the association between selected independent variables and mental health outcomes. A multivariate regression model was performed to determine the predictors of mental health outcomes of the study participants.

Results

There were a total of 261 participants, 86.2% were married, and 66.2% had children. The proportion of mild to extreme depression, anxiety, and stress were 58.2%, 65.9%, and 72.0% respectively. In response to the economic challenges, 91.6% of study participants reported reducing expenditures on general household needs, while the proportion of participants who curtailed spending on food, monthly savings, and entertainment were 75.9%, 79.3%, and 73.6% respectively. Notably, 81.6% of participants initiated the process of applying for overseas employment, and 50.6% pursued academic programs to be eligible for foreign placements.

Conclusion

The present study observed a higher level of depression, anxiety and stress among nurses from teaching hospitals in Sri Lanka. It was noted that nurses had taken steps to respond to financial strain by reducing essential elements of their routine. Additionally, study participants chose to seek foreign placements as a solution to the economic burden, as a result just over half of the respondents completed an academic program in order to be qualified for jobs abroad. Further, these initiatives are significantly associated with negative emotional disorders of the participants. Therefore, interventions should be implemented to promote positive mental health outcomes of nursing professionals in Sri Lanka.

Effect of cardiovascular biofeedback on nursing staff stress: a randomized controlled clinical trial

OBJECTIVE

to assess the effect of cardiovascular biofeedback on nursing staff stress when compared to an activity without self-monitoring.

METHOD

a randomized controlled clinical trial, carried out with nursing professionals from a university hospital. The intervention group (n=58) performed cardiovascular biofeedback, and the control (n=57) performed an online puzzle without self-monitoring, totaling nine meetings over three weeks. The outcome was assessed using the Stress Symptoms and Work-Related Stress scales, and the biological marker heart rate variability. The generalized estimating equations method was used.

RESULTS

the intervention had no effect on self-reported instruments (p>0.050). However, there was an effect of time (p<0.050) on all heart rate variability indicators, demonstrating changes over the sessions.

CONCLUSION

cardiovascular biofeedback showed promising results in the biological marker, suggesting that it can be used in nursing staff as a complementary therapy by promoting better autonomic nervous system regulation.

Perceptions, maltreatment and religion as predictors of the psycho-emotional impact on nurses during the COVID-19 pandemic

OBJECTIVES

to analyze the relationship between perceptions, abuse and religion with the psycho-emotional impact on nurses during the COVID-19 pandemic.

METHODS

descriptive-analytical cross-sectional study. It took place between 2020 and 2021 and a total of 319 clinical nurses in Peru were interviewed using the DASS-21. Associations were assessed using Spearman's Rho and multiple regression.

RESULTS

18.5% had some degree of stress; 50.2%, anxiety and 29.1%, depression. Experience of abuse, self-perception of mental health and religion were predictors of stress, anxiety and depression. The length of work experience predicts stress and anxiety. In addition, self-perception of information and gender were predictors of depression.

CONCLUSIONS

peruvian nurses have high levels of stress, anxiety and depression, and this psycho-emotional impact was associated with perceptions, experiences of abuse and religion.

Factors associated with recognition at work among nurses and the impact of recognition at work on health-related quality of life, job satisfaction and psychological health: a single-centre, cross-sectional study in Morocco

OBJECTIVES

To describe the sociodemographic, occupational and health factors that influence nurses' recognition at work and to examine a recognition pathway model to assess the relationship between recognition at work and health-related quality of life (HRQOL), job satisfaction, anxiety and depression.

DESIGN

This is a cross-sectional observational study with prospective data collection based on a self-report questionnaire.

SETTING

University hospital centre in Morocco.

PARTICIPANTS

The study included 223 nurses with at least 1 year of practice at the bedside in care units.

MEASURES

We included the sociodemographic, occupational and health characteristics of each participant. The Fall Amar instrument was used to measure job recognition. HRQOL was measured using the Medical Outcome Study Short Form 12. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Job satisfaction was measured using a rating scale (ranging from 0 to 10). Path analysis was used to examine the nurse recognition pathway model to assess the relationship between nurse recognition at work and key variables.

RESULTS

The participation rate in this study was 79.3%. Institutional recognition was significantly correlated with gender, midwifery specialty and normal work schedule: β=-5.10 (-8.06, -2.14), β=-5.13 (-8.66, -1.60) and β=-4.28 (-6.85, -1.71), respectively. Significant correlations were found between recognition from superiors and gender, mental health specialisation and normal work schedule: β=-5.71 (-9.39, -2.03), β=-5.96 (-11.17, -0.75) and β=-4.04(-7.23, -0.85), respectively. Recognition from coworkers was significantly associated with mental health specialisation: β=-5.09 (-9.16, -1.01). The trajectory analysis model found that supervisor recognition had the best impact on anxiety, job satisfaction and HRQOL.

CONCLUSIONS

Recognition from superiors is important in maintaining nurses' psychological health, HRQOL and job satisfaction. Therefore, managers in hospitals should address the issue of recognition at work as a potential personal, professional and organisational lever.