NURSING IN THE CRUCIBLE OF STRESS AND UNMASKING STRATEGIES FOR RESILIENCE & WELL-BEING: A BIBLIOMETRIC AND SYSTEMATIC LITERATURE REVIEW
Abstract
This study aims to examine the stress levels of nurses in Asian nations, comprehend the coping strategies they use, and evaluate the efficacy of stress management programs. By combining bibliometric analysis with a systematic literature review and a mixed-methods approach, the study reveals a significant prevalence of stress among nurses in Asian nations, which is attributed to a complex interplay of intrinsic and extrinsic causes. Nurses use various coping strategies, including self-care routines, mindfulness exercises, and social support. According to the systematic literature review, stress management techniques such as technology-based solutions, mindfulness training, and cognitive-behavioral techniques have the potential to lower stress levels among Asian nurses. These findings highlight the significance of individualized stress management approaches that take into account environmental and cultural characteristics, with digital technology that incorporates cognitive-behavioral components emerging as a feasible intervention route. This study underscores the pressing need to address nursing stress in Asian nations and advances our understanding of nursing stress across national, cultural, and geographic barriers.
Keyword : nursing stress, coping mechanisms, stress management interventions, Asian countries, mindfulness, healthcare workforce, cultural factors.
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Aguilera, G. (2011) ‘HPA axis responsiveness to stress: Implications for healthy aging’, Experimental Gerontology, 46(2–3), pp. 90–95. Available at: https://doi.org/10.1016/j.exger.2010.08.023. Akyurek, G., Avci, N. and Ekici, G. (2022) ‘The effects of “Workplace Health Promotion Program” in nurses: A randomized controlled trial and one-year follow-up’, Health Care for Women International, 43(9), pp. 980–996. Available at: https://doi.org/10.1080/07399332.2020.1800013. Alharbi, J., Jackson, D. and Usher, K. (2020) ‘Personal characteristics, coping strategies, and resilience impact on compassion fatigue in critical care nurses: A cross-sectional study’, Nursing and Health Sciences, 22(1), pp. 20–27. Available at: https://doi.org/10.1111/nhs.12650. Alkhawaldeh, J.M. et al. (2020) ‘Stress management training program for stress reduction and coping improvement in public health nurses: A randomized controlled trial’, Journal of Advanced Nursing, 76(11), pp. 3123–3135. Available at: https://doi.org/10.1111/jan.14506. Babapour, A.R., Gahassab-Mozaffari, N. and Fathnezhad-Kazemi, A. (2022) ‘Nurses’ job stress and its impact on quality of life and caring behaviors: a cross-sectional study’, BMC Nursing, 21(1). Available at: https://doi.org/10.1186/s12912-022-00852-y. Bakker, E.J.M. et al. (2020) ‘Improving the mental health of student and novice nurses to prevent dropout: A systematic review’, Journal of Advanced Nursing. Blackwell Publishing Ltd, pp. 2494–2509. Available at: https://doi.org/10.1111/jan.14453. De Bellis, N. (2009) Bibliometrics and citation analysis: from the Science citation index to cybermetrics. Scarecrow Press. Berardo, L. et al. (2021) ‘Assessment of burnout prevention and wellness programs for US-based neurosurgical faculty and residents: A systematic review of the literature’, Journal of Neurosurgery. American Association of Neurological Surgeons, pp. 392–400. Available at: https://doi.org/10.3171/2020.6.JNS201531. Bernburg, M., Groneberg, D.A. and Mache, S. (2019) ‘Mental Health Promotion Intervention for Nurses Working in German Psychiatric Hospital Departments: A Pilot Study’, Issues in Mental Health Nursing, 40(8), pp. 706–711. Available at: https://doi.org/10.1080/01612840.2019.1565878. Bosma, H. et al. (1997) ‘Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study’, British Medical Journal, 314(7080), pp. 558–565. Available at: https://doi.org/10.1136/bmj.314.7080.558. Carver, C.S., Scheier, M.F. and Weintraub, J.K. (1989) Assessing Coping Strategies: A Theoretically Based Approach, Journal of Personality and Social Psychology. Chang, H.E. and Cho, S.-H. (2021) ‘The Influence of Social Support on the Relationship between Emotional Demands and Health of Hospital Nurses: A Cross-Sectional Study †’. Available at: https://doi.org/10.3390/healthcare. Cheetham, S. et al. (2021) ‘Education and training for preventing sharps injuries and splash exposures in healthcare workers’, Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd. Available at: https://doi.org/10.1002/14651858.CD012060.pub2. Cocchiara, R.A. et al. (2020) ‘Tai chi and workplace wellness for health care workers: A systematic review’, International Journal of Environmental Research and Public Health, 17(1). Available at: https://doi.org/10.3390/ijerph17010343. Delgado, C. et al. (2017) ‘Nurses’ resilience and the emotional labor of nursing work: An integrative review of empirical literature’, International Journal of Nursing Studies. Elsevier Ltd, pp. 71–88. Available at: https://doi.org/10.1016/j.ijnurstu.2017.02.008. Dervis, H. (2019) ‘Bibliometric analysis using bibliometric an R package’, Journal of Scientometric Research, 8(3), pp. 156–160. Available at: https://doi.org/10.5530/JSCIRES.8.3.32. Devebakan, N. (2019) ‘The Relationship Between Burnout and Perceived Stress: A sample of Healthcare Workers’, Psychiatry and Behavioral Sciences, (0), p. 1. Available at: https://doi.org/10.5455/pbs.20190213030150. Dincer, B. and Inangil, D. (2021) ‘The effect of Emotional Freedom Techniques on nurses’ stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial’, Explore, 17(2), pp. 109–114. Available at: https://doi.org/10.1016/j.explore.2020.11.012. Duarte, I. et al. (2020) ‘Burnout among Portuguese healthcare workers during the COVID-19 pandemic’, BMC Public Health, 20(1). Available at: https://doi.org/10.1186/s12889-020-09980-z. Dyrbye, L.N. et al. (2022) ‘Physicians’ Experiences with Mistreatment and Discrimination by Patients, Families, and Visitors and Association with Burnout’, JAMA Network Open, 5(5), p. E2213080. Available at: https://doi.org/10.1001/jamanetworkopen.2022.13080. Edwards, D. and Burnard, P. (2003) ‘A systematic review of stress and stress management interventions for mental health nurses’, Journal of Advanced Nursing, pp. 169–200. Available at: https://doi.org/10.1046/j.1365-2648.2003.02600.x. European Agency for Safety and Health at Work. (2013) Annual report 2012. Publications Office. Ghawadra, S.F. et al. (2020) ‘The effect of mindfulness-based training on stress, anxiety, depression and job satisfaction among ward nurses: A randomized control trial’, Journal of Nursing Management, 28(5), pp. 1088–1097. Available at: https://doi.org/10.1111/jonm.13049. Gollwitzer, P.M. et al. (2018) ‘Promoting the self-regulation of stress in health care providers: An internet-based intervention’, Frontiers in Psychology, 9(JUN). Available at: https://doi.org/10.3389/fpsyg.2018.00838. Herman, J.P. et al. (2016) ‘Regulation of the hypothalamic-pituitary- adrenocortical stress response’, Comprehensive Physiology, 6(2), pp. 603–621. Available at: https://doi.org/10.1002/cphy.c150015. Hoedl, M. et al. (no date) ‘Influence of nursing staff working hours on the stress level during the COVID-19 pandemic: a cross-sectional online survey Short running title: Working hours and stress List of all authors Influence of nursing staff working hours on the stress level during the COVID-19 pandemic: a cross-sectional online survey’. Available at: https://doi.org/10.1101/2020.08.12.20173385. Hsieh, H.F. et al. (2020) ‘The effects of biofeedback training and smartphone-delivered biofeedback training on resilience, occupational stress, and depressive symptoms among abused psychiatric nurses’, International Journal of Environmental Research and Public Health, 17(8). Available at: https://doi.org/10.3390/ijerph17082905. Hwang, W.J. and Jo, H.H. (2019) ‘Evaluation of the effectiveness of the mobile app-based stress-management program: A randomized controlled trial’, International Journal of Environmental Research and Public Health, 16(21). Available at: https://doi.org/10.3390/ijerph16214270. Johnston, D. et al. (2016) ‘Stressors, Appraisal of Stressors, Experienced Stress and Cardiac Response: A Real-Time, Real-Life Investigation of Work Stress in Nurses’, Annals of Behavioral Medicine, 50(2), pp. 187–197. Available at: https://doi.org/10.1007/s12160-015-9746-8. Joseph, B. and Joseph, M. (2016) ‘The health of the healthcare workers’, Indian Journal of Occupational and Environmental Medicine. Medknow Publications, pp. 71–72. Available at: https://doi.org/10.4103/0019-5278.197518. Labrague, L.J. et al. (2017) ‘A literature review on stress and coping strategies in nursing students’, Journal of Mental Health. Taylor and Francis Ltd, pp. 471–480. Available at: https://doi.org/10.1080/09638237.2016.1244721. Labrague, L.J. et al. (2018) ‘Examining stress perceptions and coping strategies among Saudi nursing students: A systematic review’, Nurse Education Today. Churchill Livingstone, pp. 192–200. Available at: https://doi.org/10.1016/j.nedt.2018.03.012. Lai, J. et al. (2020) ‘Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019’, JAMA Network Open, 3(3). Available at: https://doi.org/10.1001/jamanetworkopen.2020.3976. Landsbergis, P.A., Schnall, P.L. and Picketing, T. (1992) The Patterning of Psychological Attributes and Distress by ‘Job Strain’ and Social Support in a Sample of Working Men 1, Journal of Behavioral Medicine. Lary, A., Borimnejad, L. and Mardani-Hamooleh, M. (2019) ‘The Impact of a Stress Management Program on the Stress Response of Nurses in Neonatal Intensive Care Units: A Quasi-Experimental Study’, Journal of Perinatal and Neonatal Nursing, 33(2), pp. 189–195. Available at: https://doi.org/10.1097/JPN.0000000000000396. Lee, E.K. and Kim, J.S. (2020) ‘Nursing stress factors affecting turnover intention among hospital nurses’, International Journal of Nursing Practice, 26(6). Available at: https://doi.org/10.1111/ijn.12819. Lin, L. et al. (2019) ‘The Effects of a Modified Mindfulness-Based Stress Reduction Program for Nurses: A Randomized Controlled Trial’, Workplace Health and Safety, 67(3), pp. 111–122. Available at: https://doi.org/10.1177/2165079918801633. Lu, H. et al. (2012) ‘Job satisfaction among hospital nurses revisited: A systematic review’, International Journal of Nursing Studies, pp. 1017–1038. Available at: https://doi.org/10.1016/j.ijnurstu.2011.11.009. Mandal, S. et al. (2021) ‘Effect of Structured Yoga Program on Stress and Professional Quality of Life Among Nursing Staff in a Tertiary Care Hospital of Delhi—A Small Scale Phase-II Trial’, Journal of Evidence-Based Integrative Medicine, 26. Available at: https://doi.org/10.1177/2515690X21991998. Maran, D.A. et al. (2022) ‘Animal-Assisted Intervention and Health Care Workers’ Psychological Health: A Systematic Review of the Literature’, Animals. MDPI. Available at: https://doi.org/10.3390/ani12030383. Mohammad, K.I. et al. (2020) ‘Personal, professional and workplace factors associated with burnout in Jordanian midwives: A national study’, Midwifery, 89. Available at: https://doi.org/10.1016/j.midw.2020.102786. Muriithi, J.W. and Kariuki, P.W. (2020) Article no.AJRNH.58208 Original Research Article Muriithi and Kariuki, Asian Journal of Research in Nursing and Health. Available at: http://www.sdiarticle4.com/review-history/58208. Orly, S. et al. (2012) ‘Are cognitive-behavioral interventions effective in reducing occupational stress among nurses?’, Applied Nursing Research, 25(3), pp. 152–157. Available at: https://doi.org/10.1016/j.apnr.2011.01.004. Panari, C. et al. (2019) ‘Emotional exhaustion among healthcare professionals: The effects of role ambiguity, work engagement, and professional commitment’, Acta Biomedica, 90, pp. 60–67. Available at: https://doi.org/10.23750/abm.v90i6-S.8481. Park, J.H. et al. (2022) ‘The effectiveness of e-healthcare interventions for the mental health of nurses: A PRISMA-compliant systematic review of randomized controlled trials’, Medicine (United States). Lippincott Williams and Wilkins, p. E29125. Available at: https://doi.org/10.1097/MD.0000000000029125. Pino, O. and Rossini, G. (2012) ‘Perceived Organizational Stressors and Interpersonal Relationships as Predictors of Job Satisfaction and Well-Being among Hospital Nurses’, International Journal of Psychology and Behavioral Sciences, 2(6), pp. 196–207. Available at: https://doi.org/10.5923/j.ijpbs.20120206.02. Poghosyan, L. et al. (2010) ‘Nurse burnout and quality of care: cross-national investigation in six countries.’, Research in nursing & health, 33(4), pp. 288–298. Available at: https://doi.org/10.1002/nur.20383. Pollock, A. et al. (2020) ‘Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review’, Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd. Available at: https://doi.org/10.1002/14651858.CD013779. do Prado, J.M., Kurebayashi, L.F.S. and da Silva, M.J.P. (2018) ‘Experimental and placebo auriculotherapy for stressed nurses: Randomized controlled trial’, Revista da Escola de Enfermagem, 52. Available at: https://doi.org/10.1590/S1980-220X2017030403334. Reith, T.P. (2018) ‘Burnout in United States Healthcare Professionals: A Narrative Review’, Cureus [Preprint]. Available at: https://doi.org/10.7759/cureus.3681. Riva, G. et al. (2020) ‘COVID Feel Good—An Easy Self-Help Virtual Reality Protocol to Overcome the Psychological Burden of Coronavirus’, Frontiers in Psychiatry, 11. Available at: https://doi.org/10.3389/fpsyt.2020.563319. Scheier, M.F., Weintraub, J.K. and Carver, C.S. (1986) ‘Coping With Stress. Divergent Strategies of Optimists and Pessimists’, Journal of Personality and Social Psychology, 51(6), pp. 1257–1264. Available at: https://doi.org/10.1037/0022-3514.51.6.1257. Schneiderman, N., Ironson, G. and Siegel, S.D. (2005) ‘Stress and health: Psychological, behavioral, and biological determinants’, Annual Review of Clinical Psychology, pp. 607–628. Available at: https://doi.org/10.1146/annurev.clinpsy.1.102803.144141. Serrano-Ripoll, M.J. et al. (2020) ‘Impact of viral epidemic outbreaks on the mental health of healthcare workers: a rapid systematic review and meta-analysis’, Journal of Affective Disorders, 277, pp. 347–357. Available at: https://doi.org/10.1016/j.jad.2020.08.034. Slatyer, S. et al. (2018) ‘Nurse Experience of Participation in a Mindfulness-Based Self-Care and Resiliency Intervention’, Mindfulness, 9(2), pp. 610–617. Available at: https://doi.org/10.1007/s12671-017-0802-2. Soliman, M. et al. (2021) Scientific output of the European Journal of Tourism Research: A bibliometric overview and visualization, Journal of Tourism Research Citation. Spoorthy, M.S. (2020) ‘Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review’, Asian Journal of Psychiatry. Elsevier B.V. Available at: https://doi.org/10.1016/j.ajp.2020.102119. Szabo, S., Tache, Y. and Somogyi, A. (2012) ‘The legacy of Hans Selye and the origins of stress research: A retrospective 75 years after his landmark brief “letter” to the Editor# of Nature’, Stress, 15(5), pp. 472–478. Available at: https://doi.org/10.3109/10253890.2012.710919. Taylor, H. et al. (2022) ‘Health Care Workers’ Need for Headspace: Findings From a Multisite Definitive Randomized Controlled Trial of an Unguided Digital Mindfulness-Based Self-help App to Reduce Healthcare Worker Stress’, JMIR mHealth and uHealth, 10(8). Available at: https://doi.org/10.2196/31744. Teixeira, C.A.B. et al. (2015) ‘Occupational stress among nursing technicians and assistants: Coping focused on the problem’, Investigacion y Educacion en Enfermeria, 33(1), pp. 28–34. Available at: https://doi.org/10.17533/udea.iee.v33n1a04. Todd, C.M. and Decry-Schmitt, D.M. (1996) Factors Affecting Turnover Among Family Child Care Providers: A Longitudinal Study, Early Childhood Research Quarterly. Valérie, D. and Pierre, A.G. (2010) ‘Bibliometric idicators: Quality masurements of sientific publication’, Radiology, pp. 342–351. Available at: https://doi.org/10.1148/radiol.09090626. Verma, S. and Gustafsson, A. (2020) ‘Investigating the emerging COVID-19 research trends in the field of business and management: A bibliometric analysis approach’, Journal of Business Research, 118, pp. 253–261. Available at: https://doi.org/10.1016/j.jbusres.2020.06.057. Wang, W., Kong, A.W.M. and Chair, S.Y. (2011) ‘Relationship between job stress level and coping strategies used by Hong Kong nurses working in an acute surgical unit’, Applied Nursing Research, 24(4), pp. 238–243. Available at: https://doi.org/10.1016/j.apnr.2009.09.003. Wazqar, D.Y. et al. (2017) ‘An integrative review of the influence of job strain and coping on nurses’ work performance: Understanding the gaps in oncology nursing research’, International Journal of Nursing Sciences. Chinese Nursing Association, pp. 418–429. Available at: https://doi.org/10.1016/j.ijnss.2017.09.003. Wen, B.M. (1998) ‘Stress, adaptation, and disease allostasis and allostatic load’, Annals of the New York Academy of Sciences, 840, pp. 33–44. Available at: https://doi.org/10.1111/j.1749-6632.1998.tb09546.x. W.J, N. et al. (2021) ‘Mahamantra chanting as an effective intervention for stress reduction among nursing professionals—A randomized controlled study’, Advances in Integrative Medicine, 8(1), pp. 27–32. Available at: https://doi.org/10.1016/j.aimed.2020.05.007. Xu, J. et al. (2020) ‘Psychological status of surgical staff during the COVID-19 outbreak’, Psychiatry Research. Elsevier Ireland Ltd. Available at: https://doi.org/10.1016/j.psychres.2020.112955. Yang, J., Tang, S. and Zhou, W. (2018) ‘EFFECT OF MINDFULNESS-BASED STRESS REDUCTION THERAPY ON WORK STRESS AND MENTAL HEALTH OF PSYCHIATRIC NURSES’, Psychiatria Danubina, 30(2), pp. 189–196. Available at: https://doi.org/10.24869/psyd.2018.189. Zeller, J.M. et al. (2013) Mindfulness Interventions to Reduce Stress Among Nursing Personnel An Occupational Health Perspective, WORKPLACE HEALTH & SAFETY •. Zhang, S. et al. (2020) ‘A cross-sectional study of job burnout, psychological attachment, and the career calling of Chinese doctors’, BMC Health Services Research, 20(1). Available at: https://doi.org/10.1186/s12913-020-4996-y. Zhang, Y. et al. (2020) ‘Stress, Burnout, and Coping Strategies of Frontline Nurses During the COVID-19 Epidemic in Wuhan and Shanghai, China’, Frontiers in Psychiatry, 11. Available at: https://doi.org/10.3389/fpsyt.2020.565520. Singh, R. K., & Jain, M. (2017). Efficacy of self-management techniques in reducing perceived occupational stress among nursing staff. Indian Journal of Positive Psychology, 8(3), 360-365. Tully, S., Tao, H., Johnson, M., Lebron, M., Land, T., & Armendariz, L. (2023). Gratitude Practice to Decrease Stress and Burnout in Acute-Care Health Professionals. The Online Journal of issues in Nursing, 28.