Original Research

Behind the scrubs: Psychological distress and resilience among nurses

Jennifer Chipps, Ilze Steenkamp, Anita Padmanabhanunni, Petra Brysiewicz, Amanda Cromhout
Health SA Gesondheid | Vol 30 | a2820 | DOI: https://doi.org/10.4102/hsag.v30i0.2820 | © 2025 | This work is licensed under CC Attribution 4.0
Submitted: 16 August 2024 | Published: 21 March 2025

About the author(s)

Jennifer Chipps, School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
Ilze Steenkamp, School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
Anita Padmanabhanunni, Department of Psychology, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
Petra Brysiewicz, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Amanda Cromhout, School of Nursing, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa

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.


Keywords

categories of nurses; moral distress; sources of stress; fear of COVID-19; vulnerability to disease; psychological distress; resilience

Sustainable Development Goal

Goal 3: Good health and well-being

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