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

Assis, Bianca Bacelar de; Azevedo, Cissa; Moura, Caroline de Castro; Mendes, Patrick Gonçalves; Rocha, Larissa Lucas; Roncalli, Aline Alves; Vieira, Nayara Ferreira Mota; Chianca, Tânia Couto Machado

doi:10.1590/0034-7167-2021-0263

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (Suppl 3) • 2022 • https://doi.org/10.1590/0034-7167-2021-0263 copy

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

Factores asociados al estrés, la ansiedad y la depresión en profesionales de enfermería en el contexto hospitalario

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to determine the factors associated with stress, anxiety and depression, concomitantly, in nursing professionals who work in the hospital context.

Methods:

a quantitative and cross-sectional study with 353 nursing professionals from a hospital. A sociodemographic questionnaire and the Depression, Anxiety and Stress Scale-21 were used. Data were subjected to descriptive statistical analysis, difference and correlation tests.

Results:

the main factors associated with stress, anxiety and depression, concomitantly, were being female, compromised family and social support, lack of autonomy at work, hostile relationship with colleagues, lack of professional recognition and satisfaction, feeling of being overwhelmed and insecurity.

Conclusions:

demographic, physiological, social and work factors impact the levels of stress, anxiety and depression in nursing professionals. The adoption of coping strategies for modifiable factors should be considered, in order to provide better quality of life for these professionals.

Descriptors:
Stress Psychological; Anxiety; Depression; Hospitals; Nursing

Sociodemographic characteristics	n	Percentage (%)
Sex
Female	315	89.2
Male	38	10.8
Education
Nursing technicians	268	75.9
Nurses	85	24.1
Marital status
Single	121	34.3
Married/stable union	184	52.1
Widow	43	12.2
Divorced	5	1.4
Children
Yes	220	62.3
No	133	37.7

Psychosocial and work characteristics	n	Percentage (%)
Sleep well
Yes	155	43.9
No	198	56.1
Drink alcoholic beverages
Yes	106	30
No	247	70
Smoker
Yes	16	4.5
No	337	95.5
Good family support
Yes	325	92.1
No	28	7.9
Good social support
Yes	322	91.2
No	31	8.8
Monthly income (minimum wage)
One wage	69	19.5
Two to three wages	221	62.6
Four to five wages	44	12.5
Six to seven wages	15	4.2
Eight to ten wages	3	0.8
Above ten wages	1	0.3
Time working at the hospital
Less than a year	35	9.9
1 to 5 years	189	53.5
6 to 10 years	97	27.5
Over 10 years	32	9.1
Sector where they operate
Open	211	59.8
Closed	126	35.7
Administrative/organizational	32	9.1
Work shift
Full time	167	47.3
Morning	27	7.6
Afternoon	11	3.1
Night	148	41.9
Number of jobs
One	238	67.4
Two	113	32
Three or more	2	0.6
Have autonomy at work
Yes	217	61.6
No	135	38.4
Have a good relationship with co-workers
Yes	342	96.6
No	11	3.1
Feel professionally recognized
Yes	186	52.7
No	167	47.3
Feel professionally satisfied
Yes	232	65.7
No	121	34.3
Feel overwhelmed at work
Yes	265	75.1
No	88	24.9
Feel insecure at work
Yes	70	19.8
No	283	80.2

Tríade	Normal n (%)	Low n (%)	Moderate n (%)	Severe n (%)	Extremely severe n (%)	DASS_21 Median (interquartiles)
Depression	187 (52.97)	40 (11.33)	56 (15.86)	31 (8.79)	39 (11.04)	8 (4-18)
Anxiety	178 (50.42)	24 (6.80)	50 (14.16)	27 (7.65)	74 (21)	6 (2-16)
Stress	153 (43.34)	35 (9.91)	54 (15.30)	63 (17.85)	48 (13.60)	18 (8-28)

Variable	Stress Median (interquartiles)	p value	Anxiety Median (interquartiles)	p value	Depression Median (interquartiles)	p value
Sex^1†		0.000^* 1 Mann-Whitney test;		0.004^* 1 Mann-Whitney test;		0.032^* 1 Mann-Whitney test;
Women	20(10-28)		8(2-18)		8(4-20)
Men	8(1.50-16.50)		4(0.00-8)		6(1.50-12)
Education¹		0.318		0.118		0.317
Technician	18(8-28)		7(2-18)		8(4-20)
Nurse	8(1.50-16.50)		4(0.00-8)		6(1.50-12)
Marital status²		0.956		0.423		0.809
Single	18(8-26)		4(2-16)		8(4-18)
Married/stable union	16(8-28)		8(2-18)		8(2.5-18)
Divorced	16(6-28)		8(2-16)		8(4-22)
Have children¹		0.495		0.786		0.578
Yes	16(8-28)		8(2-16)		8(4-20)
No	20(8-26)		6(2-17)		8(4-18)
Sleep well^1†		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**
Yes	12(4-22)		4(0.00-10)		6(2-14)
No	22(12-32)		10(4-20)		10(6-22)
Drink alcoholic beverages¹		0.557		0.511		0.773
Yes	12(8-28)		8(2-18)		8(4-18)
No	18(8-28)		6(2-16)		8(4-20)
Smoker¹		0.302		0.214		0.244
Yes	18(8-28)		6(2-16)		8(4-20)
No	18(8-27)		6(2-16)		8(4-18)
Good family support^2†		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**
Yes	16(8-26)		6(2-16)		8(2-18)
No	28(20.5-36)		18(12-25.5)		22(12.5-29.5)
Good social support^1†		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**
Yes	16(8-26)		6(2-16)		8(2-16.5)
No	28(16-36)		18(6-24)		22(12-30)
Monthly income² (minimum wage)		0.729		0.668		0.615
One wage	29(20-28)		8(3-20)		10(3-20)
Two to three wages	10(8-27)		6(2-16)		8(4-18)
Four to five wages	21(10.5-8)		7(2.5-15.5)		9(4-20)
Six to seven wages	12(6-26)		6(2-16)		4(0-20)
Eight to ten wages	10(8-10)		6(4-6)		6(4-6)
Above ten wages	16(16-16)		2(2-2)		4(4-4)
Time working at the hospital²		0.274		0.767		0.121
Less than a year	2(6-26)		6(2-16)		4(2-10)
1 to 5 years	18(8-27)		8(2-16)		8(4-18)
6 to 10 years	20(8-28)		8(2-18)		10(-20)
Over 10 years	14(4.5-25.5)		6(0.0-13.5)		8(2.5-17.5)
Sector where they operate²		0.508		0.582		0.377
Open	18(8-28)		8(2-18)		8(4-18)
Closed	16(8-26)		4(2-14.5)		8(2-18)
Administrative/organizational	23(18.5-27.5)		7(4-20.5)		14(5-20)
Work shift²		0.050^* 1 Mann-Whitney test;		0.500		0.031^* 1 Mann-Whitney test;
Full time	20(10-28)		8(2-20)		10(4-20)
Morning	18(10-24)		6(2-14)		8(2-14)
Afternoon	12(8-24)		8(0.0-14)		8(2-18)
Night	14(6-26)		6(2-14)		8(4-18)
Have autonomy at work^1†		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**
Yes	14(6-24)		4(2-12)		6(2-14)
No	24(12-30)		12(2-20)		14(6-24)
Have a good relationship with co-workers^1†		*<0.001^ 1 Mann-Whitney test;**		0.050^* 1 Mann-Whitney test;		0.005^* 1 Mann-Whitney test;
Yes	16(8-26)		6(2-16)		8(4-18)
No	36(26-42)		18(18-22)		18(14-28)
Feel professionally recognized^1†		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**
Yes	14(6-24)		4(2-14)		6(2-12.5)
No	32(10-30)		8(2-20)		12(6-22)
Feel professionally satisfied^1†		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**		*<0.001^ 1 Mann-Whitney test;**
Yes	14(6-25.5)		4(2-14)		6(2-14)
No	22(14-32)		12(4-22)		14(6-22)
Feel overwhelmed at work^1†		*<0.001^ 1 Mann-Whitney test;**		0.019^* 1 Mann-Whitney test;		*<0.001^ 1 Mann-Whitney test;**
Yes	20(10-28)		8(2-18)		10(4-20)
No	10(4-24)		4(0.5-12)		4(0.5-10)
Feel insecure at work^1†		*<0.001^ * p<0.05;**		*<0.001^ * p<0.05;**		*<0.001^ * p<0.05;**
Yes	26(14-32)		16(6-22.5)		17(6-26.5)
No	16(8-26)		4(2-14)		8(2-16)

Variable		Stress	Anxiety	Depression
Age¹ 1 Spearman’s correlation test;	r	-0.162	-0.069	-0.016
Age¹ 1 Spearman’s correlation test;	p value	0.002^* * p<0.05.	0.198	0.762
Number of jobs¹ 1 Spearman’s correlation test;	r	-0.133	-0.080	-0.098
Number of jobs¹ 1 Spearman’s correlation test;	p value	0.012^* * p<0.05.	0.136	0.065
Hours worked per day¹ 1 Spearman’s correlation test;	r	-0.022	0.015	0.016
Hours worked per day¹ 1 Spearman’s correlation test;	p value	0.674	0.773	0.761

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[1] Corresponding author: Bianca Bacelar de Assis, E-mail: bibacelar@hotmail.com