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      Behind the scrubs: Psychological distress and resilience among nurses

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          Abstract

          Background

          Nurses are exposed to high levels of stress in the workplace. During the coronavirus disease 2019 (COVID-19) pandemic, levels of stress were exacerbated, impacting on nurses’ mental health.

          Aim

          The aim of the study was to investigate psychological distress and resilience, and how nurses with different levels of education responded to stress.

          Setting

          The study was conducted in three hospitals (a psychiatric hospital, a general district hospital and a dedicated COVID-19 hospital) in the Western Cape province, South Africa.

          Methods

          A survey was conducted with frontline nurses ( N = 167 [71.8%]) in three hospitals in the Western Cape using six validated self-administered scales.

          Results

          Respondents reported high levels of moral distress related to time (3.42/6, ± 1.6) and protection during COVID-19 (1.3/3, ± 0.7). Mild-to-moderate levels of fear of COVID-19 (19.4/35, ± 8.2) and a moderate perception of vulnerability to disease (60.7/105, ± 19.9) contributed to nurses’ stress. High levels of psychological distress, especially during COVID-19 compared to current levels (27.2 vs 18.8; W = 8.9, p = < 0.001), with high levels of resilience (73.2/88, ± 17.9) were reported. Enrolled nurses reported significantly higher levels of stress during the pandemic.

          Conclusion

          Post COVID-19, there was reduction in the respondents who reported severe levels of psychological distress, highlighting the impact of the pandemic on nurses’ mental health and the need to build resilience.

          Contribution

          This study enhances understanding of the factors that result in psychological distress in nurses and how nurses with different levels of education respond to stress.

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          Most cited references44

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          Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

          Highlights • At least one in five healthcare professionals report symptoms of depression and anxiety. • Almost four in 10 healthcare workers experience sleeping difficulties and/or insomnia. • Rates of anxiety and depression were higher for female healthcare workers and nursing staff. • Milder mood symptoms are common and screening should aim to identify mild and sub-threshold syndromes.
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            The Fear of COVID-19 Scale: Development and Initial Validation

            Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.
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              Short screening scales to monitor population prevalences and trends in non-specific psychological distress

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                Author and article information

                Journal
                Health SA
                Health SA
                HSAG
                Health SA Gesondheid
                AOSIS
                1025-9848
                2071-9736
                21 March 2025
                2025
                : 30
                : 2820
                Affiliations
                [1 ]School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
                [2 ]Department of Psychology, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
                [3 ]School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
                Author notes
                Corresponding author: Jennifer Chipps, jchipps@ 123456uwc.ac.za
                Author information
                https://orcid.org/0000-0002-7895-4483
                https://orcid.org/0009-0004-3262-2717
                https://orcid.org/0000-0001-7733-7486
                https://orcid.org/0000-0001-6258-1603
                https://orcid.org/0000-0002-0008-8212
                Article
                HSAG-30-2820
                10.4102/hsag.v30i0.2820
                11966667
                40183027
                6f85a3f2-9412-488d-88a3-b2dec0bf7e84
                © 2025. The Authors

                Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.

                History
                : 16 June 2024
                : 27 January 2025
                Funding
                Funding information Research reported in this publication received funding from Cape Higher Education Consortium (CHEC) (2022) - City of Cape Town (CCT)- Resilience for Inclusive Development and the South African Medical Research Council with funds received from the Department of Science and Innovation (2023).
                Categories
                Original Research

                categories of nurses,moral distress,sources of stress,fear of covid-19,vulnerability to disease,psychological distress,resilience

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