Relationship between Depression, Anxiety, Stress and Coping Strategies among Nurses Working in General Wards of Selected Hospitals in Southern Province, Sri Lanka

Abstract

Background: Nursing is a stressful profession due to its inherent complex demands, high expectations, and greater responsibilities. Owing to these characteristics, nurses working in clinical settings are prone to experience high degree of depression, anxiety, and stress leading to poor job performance and diminished quality of life. Nevertheless, in view of providing effective patient care, nurses need to cope with numerous adverse emotional states. Objective: To assess the relationship between depression, anxiety, stress and coping strategies among nurses working in general wards of four selected hospitals in Southern Province, Sri Lanka. Methods: A descriptive cross-sectional study was conducted in four selected hospitals in the Southern Province with 300 conveniently recruited nurses. Participants completed validated Depression, Anxiety and Stress Scale-21 (DAS-21) and Coping Inventory for Stressful Situations 21 (CISS-21) along with socio-demographic questionnaire. Data were analysed by descriptive statistics and Pearson’s correlation tests. Results: The mean(±SD) age of participants was 34.55±3.80 years with the majority were female (n=277, 92.3%) and married (n=161, 53.7%). The mean(±SD) work experience was 8.22±3.79 years (range: 1-16). The mean(±SD) depression, anxiety and stress scores were 11.11±6.04 (range: 8-25), 10.32±6.38 (range: 9-34) and 12.69±6.65 (range: 8-25), respectively. The mean (±SD) scores of task-oriented coping, emotional-oriented coping and avoidance-oriented coping were 14.54±2.51 (range: 0-28), 16.17±3.09, (range: 0-30) and 14.27±2.47 (range: 0-34), respectively. Task-oriented coping was negatively correlated with anxiety (r=-0.18, p=0.011) whereas emotional-oriented coping was negatively correlated with anxiety (r=-0.19, p=0.008) and depression (r=-0.16, p=0.024). No adverse emotional state correlated with avoidance-oriented coping. Conclusions: Nurses experience mild levels of depression, anxiety, and stress due to multiple work tasks and use task-oriented and emotional-oriented coping as effective strategies to tackle emotional disturbances encountered in the clinical setting. Hence, providing a conducive work environment assists nurses to counteract negative emotional states using effective coping strategies which in turn promote quality nursing care. Keywords: Anxiety, Coping strategies, Depression, Nursing, Stress 43