INTRODUCTION:

Stress can be defined as any type of change that causes physical, emotional, or psychological strain. Stress is your body's response to anything that requires attention or action. Everyone experiences stress to some degree.

The way you respond to stress, however, makes a big difference to your overall well-being.¹Healthcare workers, particularly nurses, are at risk for developing psychological distress as a result of direct contact with patients and the increasing work demand during the pandemic. A study on the psychological experience of nursing officers caring COVID-19 patients in AIIMS, Jodhpur showed that nursing officers caring Covid-19 patients are experiencing mental and emotional distress at initial stage of duty. As days passed participants used coping strategies and understand the new era of situation.²

The doctors, Nurses and other health care providers are at frontline in this covid-19 pandemic, are exposed to tremendous occupational stressors that render them liable for occupational burnout due to workload, lack of medical professionals and infrastructure. The COVID-19 pandemic had a massive impact on healthcare systems and health care workers across the globe leading to increasing the risks of psychological distress in health care professionals³

In the recent years work environment is given importance and organizations are keen to know how stress and burnout affect nurses’ work, health and life. Efforts had been made to identify the stressful situations affecting nurses and to recognize the early signs of stress to burnout so that adverse health effects and nurse turnover can be avoided⁴

The investigators, on their extensive review of literature has come across many studies in India that have been done among the medical practitioners and students in relation to stressduring Covid-19. Student Nurses are likely to experience stress due to heavy syllabus, new environment, new friends and dealing with myriad of various issues. They also encounter a number of challenges in their life, therefore their whole college life is unveiled by challenges which in turn causes stress and if not dealt with, can hamper their academic performance⁵

Proper stress management is incredibly difficult to achieve since parents do not have the time to adequately care for their children. Most people assume that stress can only be caused by a traumatic event, but the fact is that tension may also be caused by a good experience. There are numerous causes of student stress that can lead to stress in a student's life, including misbehavior between the student and the teacher, which can lead to increased tension and stress. A lack of parental engagement also led in attacks on all pupils⁶

The role of nurse is dynamic, diverse and complex thus, emphasizing the nurse to high levels of work-related stress which decisive impact general wellbeing, and organizational outcomes. Nursing stress is known to be an important predictor of turnover intention in nurses at hospitals. Although nurses experience various sources of stress across work environment, culture, and generations, little is known about the stress factors affecting turnover intention in nurses⁷

COVID 19 has resulted in unprecedented times for the world. It has impacted all the individuals in one or the other way. However, the most affected have been the healthcare professionals across the globe. A study by Anchal Gupta (2022), collected data from 112 individuals who are working on COVID 19 vaccine development in healthcare sector in India, to understand the relationship between perceived stress from coronavirus and burnout with the mediating role of resilience by developing a path model. The study has also attempted to examine the significant difference in stress, resilience and burnout based on COVID 19 infection subgroups. The results of the study revealed a significant difference in resilience of those who have already been infected against those who have not been infected yet. Further, the analysis reported a positive relationship between perceived stress and burnout with a significant mediating effect of resilience among the healthcare professionals during the time of pandemic⁸

Stress management programme should be incorporated into the curriculum by nursing training institutions with the aim of empowering them with coping resources as they enter the nursing profession so that the percentage of burnout can be reduced to a greater extent^9,10

The paucity of research within this field has spearheaded the need for the study. Because of the critical role nurses play in caring Covid-19 patients, this descriptive study was undertaken to assess their stress during Covid-19.

MATERIALS AND METHODS:

A quantitative non experimental research approach with a descriptive design was used to conduct the study. The study was conducted among Nursing officers who cared /are caring for Covid 19 in Government Medical College Hospital, Thiruvananthapuram. Convenience sampling technique was used to recruit the subjects. Data were collected during February 2022. Tool used for the study includessocio personal profile which include age, gender, marital status, type of family, habitat, course studied, duration of experience, area of last Covid duty, Covid-infection status and vaccination status. Stress among Nursing officers was assessed using standardized tool, Perceived stress scale by Sheldon Cohen. It is a measure of the degree to which situations in one’s life are appraised as stressful. It consists of 10 items with 5 point rating and a maximum of 40 and minimum of 0. The technique used were self-reporting. PSS scores are obtained by reversing responses (eg. 0=4, 1=3, 2=2, 3=1, 4=0) to the 4 positively stated items (items 4, 5, 7 and 8) and then summing across all scale items.

The ethical clearance for conducting the study was obtained from Institutional Ethics Committee, Govt. College of Nursing, Thiruvananthapuram. Participants were informed of the study aims and the involvement procedures including their right to withdraw from the study at any time or stage without any penalty. Informed consent was obtained from all study participants. Confidentiality and anonymity were maintained whereby names or identifiers were not disclosed. Socio demographic variables and stress level were presented with appropriate descriptive statistics. Chi square test was used to find out association between stress and sociodemographic variables. The statistical software SPSS for windows (version 20.0) was employed for the analysis of data.

RESULTS:

Socio-demographic characteristics n=140

Variables	f	%
Age in years
20-30	54	38.57
31-40	79	56.42
41-50	6	4.28
51-60	1	0.71
Gender
Male	24	17.1
Female	116	82.9
Course studied
GNM	30	21.4
BSc. Nursing	65	46.4
PBBSc. Nursing	23	16.4
MSc. Nursing	22	15.7
Duration of experience
<1yr	11	7.9
1-5yr	72	51.4
5-10yr	36	25.7
11years and above	21	15
Area of last Covid duty
Casualty	29	20.7
ICU	50	35.7
OP	18	12.9
Ward	43	30.7
Have you been affected by Covid?
Yes	117	83.6
No	23	23
Whether you got infection following duty hours?
Yes	94	67.1
No	46	32.9
Frequency of Covid duty
Once in a month	40	28.6
Twice in a month	56	40
Thrice in a month	23	16.4
Others	21	15
Get updated training on Covid-19 care from your hospital authority
Yes	110	78.6
No	30	21.4
Completed both doses of Covid vaccine
Yes	134	95.7
No	6	4.3

Majority of the participants were in the age group 31-40 years, 82.9% of the participants were female, majority studied BSc Nursing course (46.4%), majority have 1-5years of experience (51.4%), about 50 participants (35.7%) done their Covid duty in ICU, 83.6% were affected by Covid-19, 67.1% were infected with Covid-19 following duty hours, 40% participants responded that they got Covid duty twice in a month, 110 participants (78.6%) got updated training on Covid-19 care from their hospital authority and 95.7% of participants completed both doses of Covid vaccine.

Level of stress among Nursing officers n=140

Majority (76%) of the participants had moderate stress and 12% are having mild and severe stress respectively.

· Study showed that there was a statistically significant association (p< 0.05) between in service training on covid19 care and stress level of nursing officers.

DISCUSSION:

In the present study, 76% of participants had moderate stress. 12% of participant had severe stress and 12 % of participant had mild stress. Participants with moderate stress are vulnerable to severe stress.

In comparison study tilted ‘Prevalence and predictors of stress, anxiety and depression among health workers managing Covid-19 pandemic in India showed a prevalence of health care providers with high level as 3.7% and woman had approximately two times the increased odds of developing moderate or high level stress.¹¹

In the present study, we found a significant association between stress of nursing officers during covid19 and the availability of in service training on care of patients with Covid19 (p<0.05)

The study has the following implications in the field of Nursing

· There is a need to implement stress reduction activities for nursing officers who are caring for Covid-19 patients.

· Clinical instructors can use this study findings in their clinical teaching sessions to prepare students to cope up with stress in their future work-life.

The job stress significantly influences the job satisfaction among the staff nurses and there is subjectivity and individual differences in the experience of stress. Identifying stress at the earliest and paying attention to manage and overcome it may have an impact on their personal life and professional outcome in terms of quality of service and patient care^12,13

CONCLUSION:

The purpose of the study was to assess the stress among nursing officers during Covid -19 in Government Medical college Thiruvananthapuram. It was found that majority of the Nursing officers are having moderate stress. Nurses who are the front line care givers plays a very significant role in monitoring and giving direct patient care. It is the nurses who facilitate coping for patients and their families. Hence their mental well-being is having significant impact on the patient care. The findings of the study demonstrated the need for stress reduction program for nursing officers.

CONFLICT OF INTEREST:

The authors have no conflict of interest regarding this study.

ACKNOWLEDGMENTS:

The authors would like to thank the Principal, faculty members of Govt. College of Nursing, Thiruvananthapuram and the Chief Nursing Officer and Nursing officers of Govt. Medical College Hospital, Thiruvananthapuram for their kind help and co-operation.

REFERENCES:

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10. Sasmita Das, Prasanna Baby. Correlation between Organizational Stress and Job Satisfaction among Registered Nurses in Selected Hospital. Asian J. Nur. Edu. & Research. 2014; 4(1): 45-49.

11. Wilson W, Raj JP, Rao S, Ghiya M, Nedungalaparambil NM, Mundra H, Mathew R. Prevalence and predictors of stress, anxiety, and depression among healthcare workers managing COVID-19 pandemic in India: a nationwide observational study. Indian Journal of Psychological Medicine. 2020;42(4):353-8.

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13. Sasmita Das, Prasanna Baby. Impact of Work Related Stress on Burnout among I.C.U Nurses: A Literature Review. Asian J. Nur. Edu. and Research. 2013; 3(2): 101-106.

Received on 06.04.2023 Modified on 17.05.2023

Int. J. Nur. Edu. and Research. 2023; 11(3):193-196.

DOI: 10.52711/2454-2660.2023.00044