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Occupational stress among nurses across diverse healthcare services: a cross-

sectional study Estrés laboral entre enfermeros de diversos servicios de salud:
un estudio transversal...

Article in Journal Health NPEPS · June 2024

DOI: 10.30681/2526101012238

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http://dx.doi.org/10.30681/2526101012571 ORIGINAL ARTICLE

Occupational stress among nurses across diverse healthcare services:

a cross-sectional study

Estrés laboral entre enfermeros de diversos servicios de salud: un estudio transversal

Estresse ocupacional entre enfermeiros de diversos serviços de saúde: um estudo

transversal

Ana Luiza Ferreira Aydogdu1

ABSTRACT
Objective: to investigate the levels of occupational stress among nurses working in
different healthcare services in Brazil. Method: this is a cross-sectional study with data
collected from 416 nurses between May 31, 2023, and January 31, 2024, through an online
questionnaire covering sociodemographic variables and the Work Stress Scale. Data
analysis was conducted using PSPP version 1.6.2-g78a33a. The Mann-Whitney U and
Kruskal-Wallis tests were applied. Results: the majority of nurses (61.5%) presented high
levels of occupational stress. The sub-dimensions “Autonomy and control” (2.92 ± 0.95),
“roles and work environment” (2.77 ± 1.01) and “growth and recognition” (2.76 ± 1.11) of
the Work Stress Scale showed the highest scores of stress. There was no significant
relationship between the nurses’ sociodemographic variables and their occupational stress
scores (p>0.05). Conclusion: structural and cultural changes are crucial for reducing the
level of occupational stress among nurses. The study emphasizes the key role of healthcare
administrators and nurse managers in promoting healthier and more collaborative work
environments through effective management and leadership.
Descriptors: Occupational Stress; Nurse Administrators; Nursing; Working Conditions;
Workplace.

RESUMEN
Objetivo: investigar los niveles de estrés laboral entre enfermeros que trabajan en
diferentes servicios de salud en Brasil. Método: se trata de un estudio transversal, con
datos recopilados de 416 enfermeros entre el 31 de mayo de 2023 y el 31 de enero de
2024 a través de un cuestionario en línea. Se utilizó un cuestionario sociodemográfico y
la Escala de Estrés Laboral. El análisis de datos se realizó utilizando PSPP versión 1.6.2-
g78a33a. Se aplicaron pruebas de Mann-Whitney U y Kruskal-Wallis. Resultados: la
mayoría de los enfermeros (61,5%) presentó niveles elevados de estrés ocupacional. Las
subdimensiones “autonomía y control” (2.92 ± 0.95), “roles y ambiente de trabajo” (2.77
± 1.01) y “crecimiento y reconocimiento” (2.76 ± 1.11) de la Escala de Estrés Laboral
obtuvieron las puntuaciones más altas. No se encontró una relación significativa entre las

1Nurse. PhD, RN - Assistant Professor, Department of Nursing, Faculty of Health Sciences, Istanbul Health and Technology University.
E-mail: ana.luiza@istun.edu.tr ORCID ID: http://orcid.org/0000-0002-0411-0886 Corresponding author – Address: Sütlüce Mah.,
Imrahor Cad., No: 82. Beyoglu-Istanbul-Turkey. Postal Code: 34275.

This article is licensed under a Creative Commons Attribution 4.0 International license,
which allows unrestricted use, distribution, and reproduction in any medium, provided
the original publication is correctly cited.

Journal Health NPEPS. 2024 jan-jun; 9(1):e12238. ISSN 2526-1010

Aydogdu ALF. Occupational stress among nurses across diverse healthcare services...

variables sociodemográficas de los enfermeros y sus niveles de estrés laboral (p>0.05).

Conclusión: los cambios estructurales y culturales son cruciales para reducir el nivel de
estrés laboral entre los enfermeros. El estudio destaca el papel clave de los
administradores sanitarios y los gestores de enfermería en promover entornos de trabajo
más saludables y colaborativos mediante una gestión y liderazgo eficaces.
Descriptores: Estrés Laboral; Enfermeras Administradoras; Enfermería; Condiciones de
Trabajo; Lugar de Trabajo.

RESUMO
Objetivo: investigar os níveis de estresse ocupacional entre enfermeiros que trabalham
em diferentes serviços de saúde do território brasileiro. Método: trata-se de um estudo
transversal, com dados coletados de 416 enfermeiros entre 31 de maio de 2023 e 31 de
janeiro de 2024 por meio de um questionário online. Um questionário sociodemográfico
e a Escala de Estresse no Trabalho foram utilizados. A análise dos dados foi realizada
utilizando o PSPP versão 1.6.2-g78a33a. Foram aplicados os testes de Mann-Whitney U e
Kruskal-Wallis. Resultados: a maioria dos enfermeiros (61,5%) apresentou níveis elevados
de estresse ocupacional. As sub-dimensões “autonomia e controle” (2.92 ± 0.95), “funções
e ambiente de trabalho” (2.77 ± 1.01) e “crescimento e reconhecimento” (2.76 ± 1.11)
da Escala de Estresse no Trabalho obtiveram as pontuações mais altas. Não foi encontrada
uma relação significativa entre as variáveis sociodemográficas dos enfermeiros e seus
níveis de estresse ocupacional (p>0.05). Conclusão: mudanças estruturais e culturais são
cruciais para reduzir o nível de estresse ocupacional entre os enfermeiros. O estudo
destaca o papel fundamental dos administradores de saúde e gestores de enfermagem na
promoção de ambientes de trabalho mais saudáveis e colaborativos através de uma gestão
e liderança eficazes.
Descritores: Estresse Ocupacional; Enfermeiras Administradoras; Enfermagem;
Condições de Trabalho; Local de Trabalho.

INTRODUCTION Stress is characterized as a

response to external pressures and arises
Nursing is known to be a stressful when individuals are no longer able to
profession. Nurses are constantly exposed control their emotions and maintain a
to various risks that threaten both their natural state5. Stressful situations due to
physical and mental health 1. Several pressures in the work environment are
factors can trigger stress in nurses, such very common2. Occupational stress,
as the risk of acquiring infections, therefore, refers to the set of adverse
excessive working hours, a high patient physical, emotional, and psychological
load, role demands, exposure to physical reactions that can occur when there is an
and verbal violence, conflicts with imbalance between the demands of the
supervisors, and lack of autonomy and job and the individual’s ability to cope
recognition, among others2-4. with these demands6,7.

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The stressors affecting nurses care18. Therefore, retaining experienced

have become even more significant with nursing teams within healthcare
the advent of the COVID-19 pandemic. institutions should be one of the primary
The fear of contracting the disease and objectives of managers.
contaminating loved ones, the lack of Promoting a stress-free work
Personal Protective Equipment (PPE), the environment where nurses feel satisfied
illness and death of colleagues and in performing their duties brings benefits
discrimination against healthcare workers to both the professionals and their
who were initially considered as patients, directly impacting the success
spreaders of the disease, among other of the healthcare institution, as satisfied
factors, have increased the levels of nurses tend to be more efficient and
occupational stress among nurses1,8,9. effective19. Therefore, healthcare
Scientific research conducted in Brazil administrators and nurse managers should
and other countries identified the pay attention to signs of occupational
presence of stress in nurses before2,10 and stress among their team members,
during the COVID-19 pandemic1,11,12. seeking to develop measures aimed at
High levels of stress among nurses alleviating pressures at the workplace
pose a threat to both the professionals and implementing strategies for stress
and the patients under their care because management. This will improve the work
stressed nurses may struggle to provide environment and enable nurses to feel
quality care4,13. Additionally, there is a good while carrying out their functions20-
22
negative relationship between stress and .
job satisfaction. Poor working conditions It is understood that various
are strong reasons for nurses to feel factors can lead to occupational stress
dissatisfied while performing their duties, among nurses. Stress, in turn, can result
as the working hours are long, the salary in feelings of dissatisfaction and
is low, interpersonal conflicts are demotivation, negatively impacting the
numerous, and recognition is productivity and effectiveness of nurses.
minimal14,15. Additionally, it increases the likelihood of
Stress and job dissatisfaction are resignation requests, highlighting the
among the main reasons for nurse importance of addressing the issue. Thus,
turnover16,17, which in turn is another the objective of this study was to
factor that negatively impacts patient investigate the levels of occupational

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stress among nurses working in different questionnaire correctly were excluded

healthcare services across the Brazilian from the study.
territory. An online questionnaire was
employed for data collection. Google
METHODS Forms was used for the preparation and
distribution of the questionnaire. This
This is a cross-sectional, platform offers convenience for both
descriptive study with a quantitative researchers and participants, allowing
approach. It is reported following the tool respondents to complete the research
for observational studies in epidemiology instrument at any time and location24.
(STROBE)23. The target population Such flexibility of the research
consisted of nurses working in Brazil. The instrument is particularly advantageous
inclusion criteria for participation in the when aiming to reach participants from
survey were (a) being a nurse, (b) having different locations.
worked as a nurse in any department of Recruitment took place through
healthcare institutions for at least one various social media applications. Instant
year, and (c) having accepted to messages were sent to individuals
participate in the survey. residing in different Brazilian states who
Although the Federal Nursing identified themselves as nurses on their
Council provides information on the profiles. The messages included
number of active nurses in Brazil, it is not information about the study, the link to
possible to determine how many of them the Informed Consent Form (ICF), and the
meet the research criteria. Given that the Google Forms questionnaire. Data were
number of nurses in Brazil is very large collected between May 31, 2023, and
(approximately 700,000), the sample size January 31, 2024.
calculation was performed considering a The study was based on the
very large or unknown population. Helsinki Declaration. No identifiable
According to the calculation, a sample of information about the participants was
384 nurses would be sufficient, collected. The study received approval
considering a confidence interval of 95% from the Ethics Committee of the Anna
and a margin of error set at 0.05. Nery School of Nursing - São Francisco de
Participants who, despite meeting the Assis School Hospital of the Federal
inclusion criteria, did not fill out the University of Rio de Janeiro through the

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Brazil Platform (approval date: stress, as well as an analysis of existing

30.05.2023; decision number: 6.091.362). instruments. Specifically, 40% of the
The participants were asked to read the items were based on the stressors
consent page and select a response described in the Brazilian version of the
indicating their consent. Permission was Occupational Stress Indicator (OSI)25 and
obtained to use the Work Stress Scale the instrument by Rizzo, House and
(WSS). Lirtzman26 that addresses role conflict
A questionnaire comprising two and ambiguity. The scale was developed
sections was developed for data with the purpose of creating a
collection. The first section aimed to comprehensive, practical tool applicable
gather sociodemographic information and to various occupations in diverse work
characterize the participants, including environments. The WSS consists of 23
questions about personal characteristics items, and participants respond using a
such as age, gender, education, and Likert scale with five points of
marital status, as well as professional agreement: 1 (totally disagree), 2
characteristics like years of experience, (disagree), 3 (partially agree), 4 (agree),
work department, working hours, and and 5 (totally agree). The scale
type of shift, among others. The second encompasses five sub-dimensions:
part of the questionnaire consisted of the autonomy and control, roles and work
Work Stress Scale (WSS). A pilot test was environment, relationship with the
conducted with 40 participants recruited supervisor, interpersonal relationships,
in the same manner as the other and growth and appreciation.
participants, who had similar The interpretation of scores on
characteristics. Since no changes were the scale follows a general mean
needed to the research instrument after criterion, in which scores below 2.5
the pilot test, these participants were indicate a perceived low level of
also included in the final sample. occupational stress, scores equal to 2.5
The WSS was developed and indicate a moderate level of stress, and
validated for the Brazilian population by scores above 2.5 denote levels considered
Paschoal and Tamayo6 based on a review high. It is worth noting that the scale had
of the literature on organizational high internal consistency, with a
stressors of a psychosocial nature and Cronbach’s alpha coefficient of 0.916.
psychological reactions to occupational

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Data analysis was conducted RESULTS

using PSPP version 1.6.2-g78a33a. The
program was chosen for its compatibility Out of the 505 survey responses,
with a language similar to those accepted 89 either did not meet the inclusion
by SPSS statistical products and its criteria or were incomplete/incorrect.
availability for free use. Information such After excluding these questionnaires, the
as frequency, percentage, mean and final number of participants included in
standard deviations were used to present the analysis was 416.
descriptive statistics. The normality of The sample was predominantly
the data distribution was assessed using female (n=343, 82.5%), aged between 26
scatter plots and the Kolmogorov-Smirnov and 35 years (n=216, 51.9%). A significant
test. The Mann-Whitney U and Kruskal- proportion held post-graduate
Wallis tests were applied to examine the (specialization) degrees (n=338, 81.3%)
relationships between occupational stress and informed to be single (n=185, 44.5%).
and sociodemographic variables. The Demographic characteristics of the
statistical significance was set at p<0.05. participants are presented in Table 1.

Table 1 - Demographic characteristics of the participants. (n=416)

n %
Gender
Female 343 82.5
Male 73 17.5
Age
25 or less 42 10.1
26-35 216 51.9
36-45 117 28.1
46 or more 41 9.9
Highest educational level
Bachelors’ degree 39 9.4
Post-graduate (Specialization) 338 81.3
Master’s degree 33 7.9
Doctorate 6 1.4
Marital status
Single 185 44.5
Married 142 34.1
Stable union 63 15.1
Separated 6 1.4
Divorced 17 4.1
Widowed 3 0.7

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In terms of professional experience ranging from one to five years

characteristics, the majority of (n=231, 55.5%), and most of them worked
participants had only one job (n=299, on day shifts (n=321, 55.5%). The weekly
71.9%), worked in private healthcare work hours for most participants fell
institutions (n=194, 46.6%) primarily within the range of 40-48 hours (n=242,
situated in the Southeastern region of the 58.2%). The professional characteristics
country (n=172, 41.3%). A considerable of the participants are presented in Table
number of participants worked in nursing 2.
wards (n = 95, 22.8%), had a work

Table 2 - Professional characteristics of the participants. (n=416)

n %
Having more than one job
No 299 71.9
Yes 117 28.1
Type of organization
Private 194 46.6
Public 171 41.1
Public and Private* 51 12.3
Work region
Southeastern 172 41.3
Northeastern 102 24.5
Southern 78 18.8
Central-Western 35 8.4
Northern 29 7.0
Work department
Administration 67 16.1
Emergency service 65 15.6
Primary health 65 15.6
Intensive care unit 67 16.1
Operation room 25 6.0
Outpatient clinic 32 7.7
Nursing ward 95 22.8
Work experience as a nurse
1-5 years 231 55.5
6-10 years 88 21.2
11-15 years 59 14.2
16 or more years 38 9.1
Type of shift
Day 321 55.5
Night 63 15.1
Mixed 122 29.3
Working hours per week
20-24 10 2.4
30-36 91 21.9
40-48 242 58.2
50-54 18 4.3
60-64 29 7.0
70 or more 26 6.3

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Occupational stress results terms of the “relationship with the

supervisor”, 57.5% (n=239) had high levels
Among the participants, 61.5% of stress. In the “interpersonal
(n=256) exhibited a high level of relationships” sub-dimension, 52.6%
occupational stress. In the “autonomy (n=219) showed low levels of stress. In the
and control” sub-dimension of the WSS, “growth and recognition” sub-dimension,
63.7% (n=265) of participants 54.1% (n=225) of participants exhibited
experienced high levels of stress. high levels of stress. The occupational
Regarding the “roles and work stress levels of the Participants are
environment” sub-dimension, 58.4% summarized in Table 3.
(n=243) reported high levels of stress. In

Table 3 - Occupational stress levels of the participants. (n=416)

Stress levels n %
Autonomy and control
Low 129 31.0
Moderate 22 5.3
High 265 63.7
Roles and work environment
Low 173 41.6
Moderate - -
High 243 58.4
Relationship with the supervisor
Low 177 42.5
Moderate - -
High 239 57.5
Interpersonal relationships
Low 219 52.6
Moderate - -
High 197 47.4
Growth and recognition
Low 168 40.4
Moderate 23 5.5
High 225 54.1
WSS
Low 160 38.5
Moderate - -
High 256 61.5

Reliability of the scale and descriptive The scale demonstrated a high

statistics of the scores obtained by level of reliability. The Cronbach’s alpha
participants of the WSS was 0.94. The mean
occupational stress score among
participants was 2.78 ± 0.91, considered

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high. The sub-dimensions with the highest it is noteworthy that in the other two sub-
scores were “autonomy and control” dimensions, the mean occupational stress
(2.92 ± 0.95), “roles and work levels of the sample were also
environment” (2.77 ± 1.01), and “growth significantly high. Details are shown in
and recognition” (2.76 ± 1.11). However, Table 4.

Table 4 - Descriptive statistics of the scores obtained by participants and reliability coefficient

Sub-dimensions Min Max Mean SD Skewness Kurtosis Cronbach’s

alpha
Autonomy and 1.00 5.00 2.92 0.95 -0.01 -0.63 0.80
control
Roles and work 1.00 5.00 2.77 1.01 0.14 -0.79 0.77
environment
Relationship with 1.00 5.00 2.75 1.12 0.17 -0.94 0.84
the supervisor
Interpersonal 1.00 5.00 2.61 1.04 0.39 -0.65 0.68
relationships
Growth and 1.00 5.00 2.76 1.11 0.19 -0.87 0.78
recognition
WSS 1.00 4.83 2.78 0.91 0.04 -0.81 0.94

There were no statistically territory in the post-COVID-19 pandemic

significant differences in occupational period. Stress, a physiological response to
stress scores between groups of nurses challenging or threatening situations, is a
according to their sociodemographic complex reaction involving physical,
characteristics (p<0.05). The mean emotional, and behavioral aspects 5.
occupational stress scores were When these reactions are manifested as a
consistently high across all groups within result of work-related experiences, the
the various sociodemographic categories phenomenon is commonly referred to as
analysed. occupational stress6,7. The majority of
nurses participating in this study
DISCUSSION exhibited high levels of occupational
stress. These findings contrast with
This study is one of the first to previous studies conducted in Brazil. For
investigate the occupational stress levels example, in a study assessing the stress
among nurses working in different levels of nursing professionals working in
healthcare services across the Brazilian the Mobile Emergency Care Service of a

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Aydogdu ALF. Occupational stress among nurses across diverse healthcare services...

Brazilian city, the majority of the nurse turnover rate over the past two
participants did not experience stress27. years33.
Another study conducted in Brazil found The COVID-19 pandemic posed an
that members of the nursing team in unprecedented global threat, impacting
intensive care units of a public hospital all sectors of society. Nurses were
presented moderate levels of stress 28. particularly affected by the urgency and
The high rate of occupational scale of the crisis, leading to an increased
stress among the participants in the workload and role demands34. However,
present study may be one of the the pandemic also brought about a
consequences of the recent COVID-19 greater recognition of the essential role
pandemic, since Brazil was one of the of nurses in healthcare. It had an impact
countries most severely affected by the on the autonomy and challenges to
disease29. Many Brazilian nursing decision-making, with nurses often
professionals were infected and lost their making critical decisions independently
lives due to COVID-1930. Furthermore, the but facing limitations due to rapidly
post-pandemic period has been marked changing circumstances35. Naturally, all
by economic crises and a high these factors may have contributed to a
unemployment rate31, which may have significant rise in the level of
negatively impacted nurses, leading to an occupational stress among these
increase in their stress levels. These healthcare workers.
assertions are supported by the results of In a previous study conducted in
a study conducted with 2986 Brazilian Brazil, the female nursing staff exhibited
nursing professionals during the COVID-19 higher levels of occupational stress than
pandemic, where approximately 90% of their male colleagues27. On the other
participants reported occupational hand, in Lima et al.’s12 study, it was
stress12. Studies conducted in different identified that higher levels of education,
countries have also found that a income, and complexity of the care
significant percentage of nurses reported provided were associated with a higher
occupational stress due to the COVID-19 prevalence of occupational stress among
pandemic32. A study conducted in the nursing team members in Brazil.
United States identified that the Generally, healthcare institutions are
increased stress levels triggered by the surrounded by stress-triggering factors,
advent of COVID-19 resulted in higher but certain sectors, such as emergency

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services and intensive care units, may be identified in different studies as crucial
even more stressful due to workload, triggers of stress in nurses 2,37. Aspects
patients’ characteristics and their related to unclear definitions of the role
illnesses10,36. In the study conducted by of the nurses and a lack of autonomy to
Llapa-Rodriguez et al.2 in a Brazilian address care or managerial issues
university hospital, shifts and work units negatively impact the mental health of
showed significant associations with the these healthcare workers, leading to
presence of stress among nurses. All these occupational stress37. It is understood
findings from previous studies carried out that both lack of autonomy2,37 and
in Brazil differ from those of the current increase in autonomy without adequate
study, where there was no significant support and resources can trigger
relationship between the occupational stress among nurses 38.
sociodemographic variables of the nurses A study conducted in Indonesia
and their stress scores. High stress levels identified that the workload, work
were observed in all groups across environment, and dual role conflict were
different sociodemographic groups. The associated with occupational stress
observed uniformity highlights the among nurses3. It is observed that stress
widespread prevalence of occupational in nurses can be exacerbated due to role
stress among the participating nurses. overload10,22 and the lack of clear role
These results have significant boundaries and role incompatibility22,37.
implications for the health and well-being The results of a study conducted
of the nursing workforce, suggesting the in Canada suggest that promoting work
need for global interventions and environments where the efforts and
comprehensive approaches to manage achievements of nurses are recognized,
stress in the workplace. both formally and informally, is crucial
Occupational stress can be linked for mitigating occupational stress 39. A
to various factors. In a previous study similar result was observed in a study with
conducted in Brazil in which stress among Iranian nurses, indicating that the lack of
nurses was analysed, career stressor organizational support and recognition,
factors such as a lack of autonomy and along with societal devaluation, leads to
role ambiguity presented the most job stress40. All these findings align with
significant items2. Factors related to the those of the present study, where all sub-
lack of autonomy are consistently dimensions of the WSS showed high mean

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scores. However, the sub-dimensions there are persistent challenges such as

“autonomy and control,” “roles and work role definition, autonomy, and
environment,” and “growth and recognition. Historical influences,
recognition” had the highest mean scores including gender and social class barriers,
(2.92 ± 0.95, 2.77 ± 1.01, and 2.76 ± 1.11, economic demands, and resistance to
respectively). expanding nursing roles, have resulted in
It is important to highlight that limited autonomy, lack of recognition,
the sub-dimension “relationship with the and shortage of nurses. The relationship
supervisor” also showed a high mean between nurses and physicians is marked
score, indicating that the majority of by ongoing discussions about professional
participants experiencing high levels of autonomy and collaborative practice,
stress. It is known that interpersonal influenced in part by the predominant
relationships with supervisors directly femininity of the nursing profession.
impact the stress level among nurses. A These historical factors continue to shape
study with Filipino nurses emphasized the education, training, and overall
that the presence of toxic nursing leaders atmosphere of the nursing profession in
significantly increases nurses’ stress modern times43.
levels41. Conversely, a study in Iran Stress among nurses is
indicated that when leaders adopt intrinsically linked to various dimensions
transformational or transactional that directly impact the healthcare
leadership styles, nursing team members system. The health and well-being of
exhibit lower levels of stress 42. These nurses are negatively affected by
results are in line with those of the constant stress, what is manifested in
present study, demonstrating that the both physical and mental symptoms13.
leadership style adopted by nurse Chronic stress significantly influences job
managers interferes with the stress levels satisfaction, leading to lower levels of
of other nursing team members. professional contentment and increasing
However, it is noticeable that the factors the likelihood of burnout, contributing to
that stood out as triggers of high stress high turnover rates20,33. Results from a
levels in nurses in this study are related study conducted in Nigeria show that role
to historical aspects of the profession. conflict, workload, insufficient social
Despite the evolution and support, and a poor work environment,
achievements of the nursing profession, besides being stress triggers, have a

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significant negative relationship with media may not have been recruited, and
nurses’ job satisfaction21. These the inability to gauge non-response poses
challenges faced by nurses have direct a challenge. Finally, the use of self-report
repercussions on the quality of patient items increases the risk of recall or
care13. Stress can catalyse errors during response bias.
the work routine, directly impacting
patient safety. Therefore, addressing the CONCLUSION
nurses’ stress should be seen not only as
an individual issue but as a critical The majority of nurses presented
component of the healthcare system. high levels of occupational stress. In all
Another noteworthy factor is the need to sub-dimensions of the WSS, the mean
better prepare nurses for crises and the stress scores for the majority of nurses
moments that follow such critical were high. However, the sub-dimensions
situations20,32. Support programs “autonomy and control”, “roles and work
addressing the physical, mental, and environment” and “growth and
social needs of nurses can assist them to recognition” exhibited the highest values.
manage stress. There was no significant relationship
To the best of my knowledge, this between the sociodemographic variables
is the first study conducted to investigate of the nurses and their stress scores, as
the level of stress among Brazilian nurses high stress levels were observed in all
after the COVID-19 pandemic. The study groups across different sociodemographic
presents significant findings as it reveals groups.
a high rate of occupational stress among By highlighting issues related to
nurses from various sociodemographic autonomy, role demands, and recognition
groups. The elevated level of stress is as contributing factors to stress among
particularly linked to issues related to nurses, the results point to the need for a
autonomy, control, roles, work revision of management practices and
environment, growth and recognition. organizational structures in healthcare
Despite reporting important results, the institutions. Factors associated with high
study has limitations. Establishing causal levels of occupational stress in nurses
relationships remains unfeasible, and the have historical roots. Structural and
generalizability of the results is limited. cultural changes, such as promoting
Moreover, nurses who were not on social workplace autonomy, providing clear role

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definitions, and ensuring adequate practices and leadership styles that value
recognition, are crucial for reducing the creation of more collaborative work
occupational stress among nurses. environments. This includes the
Additionally, since negative relationships development of programs for
with supervisors also emerged as a psychological support and stress
significant factor in triggering management for nurses. By addressing
occupational stress in nurses, leadership these issues, the present study
styles aimed at fostering a healthy work contributes to the conception of healthier
environment need to be addressed. environments, enhancing not only the
Concurrently, the implementation of nurses’ experience but also the safety
effective stress management strategies is and quality of care provided to patients
also essential for improving the emotional and the community.
well-being of nurses. Further studies using different
Considering that stress among methodologies such as qualitative
nurses can have a direct impact on the approaches should be carried out to delve
quality of care, implementing more specifically into the reasons behind
interventions and policies aimed at stress among nurses. Exploratory studies
improving nurses’ working conditions is addressing innovative methods for stress
very important. Therefore, healthcare management could also provide valuable
administrators and nurse managers have contributions to the scientific literature.
a crucial role in promoting management

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Funding: The author declares that there was no funding.

Conflict of interest: The author declares no conflict of interest.

Authors' participation:
 Design: Aydogdu ALF.
 Development: Aydogdu ALF.
 Writing and proofreading: Aydogdu ALF.

How to cite this article: Aydogdu ALF. Occupational stress among nurses
across diverse healthcare services: a cross-sectional study. J Health NPEPS.
2024; 9(1):e12238.

Submited: 20/02/2024
Accepted: 01/06/2024

Journal Health NPEPS. 2024 jan-jun; 9(1):e12238.

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