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
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