Occupational stress and associated factors among clinical nurses caring for COVID-19 patients in a Vietnamese tertiary hospital.

Background: Nursing professional is one of the most stressful jobs, particularly during the COVID-19 pandemic. When caring for COVID-19 patients, nurses face challenging conditions and limited resources, as well as the fear of infecting themselves and their families, putting them at risk for depression, anxiety, and insomnia. The purpose of this study was to determine the frequency, sources, and risk factors for occupational stress among clinical nurses caring for COVID-19 patients in a Vietnamese tertiary hospital.

Methods: A cross-sectional survey was conducted among all clinical nurses (184 nurses) at a tertiary hospital in Vietnam from March 15 to April 15, 2021. A questionnaire was used for collecting data. Data analysis was done by descriptive statistics, bivariate and multivariate logistic regressions. Risk factors were identified by adjusted odds ratio with 95% confidence interval and P values less than 0.05.

Results: The survey was completed by 89.7% (165/184) of clinical nurses. Most participants were female (85.5%) and ≤ 40 years old (97.6%). Overall, participants reported a medium stress level with an Extended Nursing Stress Scale (ENSS) mean score of 1.79 points, and 32.1% had occupational stress. Prevalence of occupational stress among participants caring for COVID-19 patients (34.0%) was not statistically significant difference with that among those who did not (29.4%). Nurses' occupational stress in emergency and intensive care units (50.0%) was substantially higher than that in the other departments (11.7%). The most stressors for participants were difficulties connected to inadequate emotional preparedness, patients and families, and death and dying, with subscale mean scores of 1.97, 1.88, and 1.88 points, respectively. In multivariate analysis, working at an emergency and intensive care unit (OR 4.97), usually or more frequently feeling heavy duty for patients (OR 3.17), and income decrease (OR 3.03) were risk factors associated with occupational stress.

Conclusion: One-third of clinical nurses at a tertiary hospital experienced occupational stress, with highest rate occurred at emergency and intensive care units. Nurses' working conditions at emergency and intensive care units should be essentially addressed to improve nurses' occupational stress.