Depression, anxiety, stress and workplace stressors among nurses in tertiary health care settings

Background: Chronic job stress adversely impacts both mental health of nurses and patient care. There is paucity of data regarding workplace stressors and negative emotions among nurses. Aims: To assess depression, anxiety and stress among nurses and analyse their association with workplace stressors. Settings and Design: A hospital based cross-sectional study was conducted in two tertiary care hospitals. Methods and Material: Four hundred and thirty one nurses completed nurses rated depression, Anxiety and Stress instrument (DASS-21) and a questionnaire probing perceived workplace stressors on a 4 point Likert scale. The stressors across subgroups of workareas were compared. Satistical Analysis: Association between stress, anxiety or depression and workplace stressors were analysed using binary logistic regression. Results: 50.8% of nurses had stress; 74% had anxiety; 70.8% had depression. 79.1% had at least one of them. Stressed, anxious or depressed nurses were more concerned about lack of job satisfaction and conflicts with supervisors. Work-place stressors varied with work areas: private hospital, no job satisfaction, conflicts with doctors and patients; government hospital, acquiring infectious diseases; ICUs, inadequate salary; non-ICUs, odour and sounds in workplace and conflicts with patients. Conclusions: Prevalence of depression, anxiety and stress was high. Workplace stressors varied across different working areas. Interventions need are to be tailored accordingly.