Occupational stress, psychological distress, physical symptoms, and their interrelationships among frontline nurses caring for COVID-19 patients in Japan

Abstract

This study aimed to identify occupational stress, psychosomatic symptoms, psychological distress, and their correlations among frontline nurses during and after the first peak of the coronavirus disease 2019 (COVID-19) outbreak in Japan. Sixteen frontline nurses, aged 25 to 52 years, working in a ward with COVID-19 patients participated in this study. Two months after the peak of the first wave of the COVID-19 outbreak in Japan, the COVID-19-related occupational stress scale (COS; questionnaire items: fear of infection and increased workload) and physical symptom scale (PS; questionnaire items: gastrointestinal symptoms, pain, appetite loss, and insomnia) were assessed. The degree of general psychological distress was evaluated using the 6-item Kessler Scale (K6). Simultaneously, participants were asked to recall their condition during the peak period of the first wave and rate it using the same scale. K6 was positively correlated with COS and PS during the peak period (rs = 0.574, P = .020 and rs = 0.587, P = .017, respectively). Increased workload was positively correlated with the K6 score both during and after the peak period (rs = 0.869, P < .001 and rs = 0.732, P = <.001, respectively) and was positively correlated with insomnia during the peak period (rs = 0.498, P < .05). The COS, PS, and K6 scores during the peak period were significantly higher than those after the peak period. Psychological distress at the peak was associated with PS and occupational stress. An increased workload during peak periods can cause psychological distress and insomnia. The occupational stress, PS, and psychological distress of nurses working in COVID-19 wards improved after the peak of COVID-19.

Differences in the presentation of COVID-19-related psychosocial stress and general psychological distress and the relation between the number of care days and these symptoms among Japanese ward staff working exclusively with COVID-19 and support staff

“…Prior research in Japan on the relation between workload and general psychological distress has shown that a too few holidays have an adverse impact on depressive symptoms [ 11 ]. Also, our previous report showed a positive correlation between increased workload and K6 in Japanese healthcare workers during the first wave of the COVID-19 epidemic [ 6 ].…”

“…Research has also shown that occupational stress, such as from an increased workload, is greater in healthcare workers treating COVID-19 patients and that these occupational stress factors are associated with psychological distress [ 5 ]. Furthermore, our previous study of frontline nurses found that COVID-19-related occupational stress and psychological distress were associated with increased workload and physical symptoms (particularly insomnia) during the first wave of the COVID-19 outbreak in Japan [ 6 ].…”

The impact of organizational justice on psychological distress among Chinese public hospitals nurses: A cross-sectional study

“…[5,6] Multiple factors are associated with psychological distress among nurses, such as workload stressors, fear of COVID-19, low job satisfaction, exposure to bullying, and sleep disturbance. [7][8][9][10][11] But few studies have examined the relationship between organizational justice and psychological distress in nurses.…”

Lessons learned during the health crisis caused by COVID-19 in the work of the nursing professional: A systematic review

“… Stefanowicz-Bielska et al, 2022), psychological well-being disturbance(Nishihara et al, 2022;Ali et al, 2023), mental and physical illness(Stefanowicz-Bielska et al, 2022), increased occupational risks to personal safety(Huff et al, 2023), and negative emotional reactions…”