Indian Journal of Private Psychiatry

Register      Login

VOLUME 16 , ISSUE 2 ( July-December, 2022 ) > List of Articles


A Cross-sectional Study of Psychological Distress, Coping Strategies, Concerns, and Perceived Needs among Nurses Working in a Dedicated COVID-19 Center

HN Pratibha, S Sourabh, Sushmitha Kota, Shankar Kumar

Keywords : Anxiety, Depression, Nurses, Psychological

Citation Information : Pratibha H, Sourabh S, Kota S, Kumar S. A Cross-sectional Study of Psychological Distress, Coping Strategies, Concerns, and Perceived Needs among Nurses Working in a Dedicated COVID-19 Center. Ind J Priv Psychiatry 2022; 16 (2):61-66.

DOI: 10.5005/jp-journals-10067-0117

License: CC BY-NC 4.0

Published Online: 31-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Context: Nurses presented with highest levels of occupational stress and resulting distress when compared to other healthcare workers, which could be due to nurses spending more time than doctors with patients with frequent rotations of duties and direct contact of the nurses with the patients. Most studies have focused on psychological distress among nurses in the coronavirus disease-2019 (COVID-19) pandemic. We in addition wanted to explore their concerns, factors which could possibly mitigate their distress in addition to studying coping strategies used by them and its association with psychological distress which was the aim of the present study. Settings and design: It was a cross-sectional study using convenient sampling where snowballing technique was used to contact 100 frontline nurses working for a dedicated COVID-19 care center. Materials and methods: The study tools included were socio-demographic questionnaire, Depression Anxiety Stress Scale 21 (DASS 21), Brief COPE scale, and a list of concerns and perceived needs which could mitigate distress which was sent using google forms to participants after obtaining informed consent from each participant. Statistical analysis used: Descriptive data were tabulated using percentages. Statistical analysis was conducted using Chi-square test for categorical variables, t-test for continuous variables, and Spearman correlation for correlations. Results: Our study had 100 participants, of which 43 (43%) were males and 57 (57%) were females. Majority of them were married (60%) and living with family (77%). The predominant concern was death due to COVID-19 infection. Nurses in the study reported that factors such as family support, working as a team and positive attitudes of colleagues, recognition of work by management could possibly help in mitigating distress. Those with high stress had significantly higher fear of death due to COVID-19 infection (p = 0.001). We found a significant association between high emotion focused and avoidant type of coping with higher stress (p = 0.0001) and high problem-focused coping with lower stress (p = 0.0013). Conclusion: The results of the present study highlight the need to better understand psychological distress and coping strategies among nurses providing care to COVID-19 patients. Administration should establish a system to support nurses and monitor their psychological health.

PDF Share
  1. Bahar A, Koçak HS, Bağlama SS, et al. Can psychological resilience protect the mental health of healthcare professionals during the COVID-19 pandemic period? Dubai Med J 2020;3(4):133–139. DOI: 10.1159/000510264.
  2. Saini RK, Chaudhary S, Raju MS, et al. Caring for the COVID warriors: a healthcare's perspective in the challenging times. Ind Psychiatry J 2020;29(2):355–356. DOI: 10.4103/ipj.ipj_167_20.
  3. Bozdag F, Ergun N. Psychological resilience of healthcare professionals during COVID-19 pandemic. Psychol Rep 2021;124(6):2567–2586. DOI: 10.1177/0033294120965477.
  4. Dong L, Bouey J. Public mental health crisis during COVID-19 pandemic, China. Emerg Infect Dis 2020;26(7):1616–1618. DOI: 10.3201/eid2607.200407.
  5. Gupta N, Luthra A, Shailaja B, et al. Impact of COVID-19 pandemic on mental health of health-care workers in a tertiary care teaching and dedicated COVID-19 hospital. Ind Psychiatry J 2021;30(Suppl.1):S56–S62. DOI: 10.4103/0972-6748.328790.
  6. Javadekar A, Javadekar S, Chaudhury S, et al. Depression, anxiety, stress, and sleep disturbances in doctors and general population during COVID-19 pandemic. Ind Psychiatry J 2021;30(Suppl. 1):S20–S24. DOI: 10.4103/0972-6748.328783.
  7. Pooja V, Khan A, Patil J, et al. Burnout and resilience in doctors in clinical and preclinical departments in a tertiary care teaching and dedicated COVID-19 hospital. Ind Psychiatry J 2021;30(Suppl. 1):S69–S74. DOI: 10.4103/0972-6748.328792.
  8. Vagni M, Maiorano T, Giostra V, et al. Coping with COVID-19: emergency stress, secondary trauma and self-efficacy in healthcare and emergency workers in Italy. Front Psychol 2020;11:566912. DOI: 10.3389/fpsyg.2020.566912.
  9. Sampaio F, Sequeira C, Teixeira L. Impact of COVID-19 outbreak on nurses’ mental health: a prospective cohort study. Environ Res 2021;194:110620. DOI: 10.1016/j.envres.2020.110620.
  10. Pappa S, Ntella V, Giannakas T, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun 2020;88:901–907. DOI: 10.1016/j.bbi.2020.05.026.
  11. Gloster AT, Rhoades HM, Novy D, et al. Psychometric properties of the depression anxiety and stress scale-21 in older primary care patients. J Affect Disord 2008;110(3):248–259. DOI: 10.1016/j.jad.2008.01.023.
  12. Carver CS. You want to measure coping but your protocol's too long: consider the brief. Int J Behav Med 1997;4(1):92–100. DOI: 10.1207/s15327558ijbm0401_6.
  13. García FE, Barraza-Peña CG, Wlodarczyk A, et al. Psychometric properties of the Brief-COPE for the evaluation of coping strategies in the Chilean population. Psicol Refl Crít 2018;31:22. DOI: 10.1186/s41155-018-0102-3.
  14. Velickovic K, Rahm Hallberg I, Axelsson U, et al. Psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) in a non-clinical population in Sweden. Health Qual Life Outcomes 2020;18(1):132. DOI: 10.1186/s12955-020-01383-3.
  15. Da Rosa P, Brown R, Pravecek B, et al. Factors associated with nurses emotional distress during the COVID-19 pandemic. Appl Nurs Res 2021;62:151502. DOI: 10.1016/j.apnr.2021.151502.
  16. Kang L, Ma S, Chen M, et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: a cross-sectional study. Brain Behav Immun 2020;87:11–17. DOI: 10.1016/j.bbi.2020.03.028.
  17. Hu D, Kong Y, Han Q, et al. Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: a large-scale cross-sectional study. Lancet 2020;24:100424. DOI: 10.1016/j.eclinm.2020.100424.
  18. Southwick SM, Vythilingam M, Charney DS. The psychobiology of depression and resilience to stress: implications for prevention and treatment. Annu Rev Clin Psychol 2005;1:255–291. DOI: 10.1146/annurev.clinpsy.1.102803.143948.
  19. Rose S, Hartnett J, Pillai S. Healthcare worker's emotions, perceived stressors and coping mechanisms during the COVID-19 pandemic. PLoS One 2021;16(7):e0254252. DOI: 10.1371/journal.pone.0254252.
  20. Xu J, He Y. Psychological health and coping strategy among survivors in the year following the 2008 Wenchuan earthquake. Psychiatry Clin Neurosci 2012;66(3):210–219. DOI: 10.1111/j.1440-1819.2012.02331.x.
  21. Lazarus RS, Folkman S. Stress, appraisal and coping. 1984. Available from:
  22. Phua DH, Tang HK, Tham KY. Coping responses of emergency physicians and nurses to the 2003 severe acute respiratory syndrome outbreak. Acad Emerg Med 2005;12(4):322–328. DOI: 10.1197/j.aem.2004.11.015.
  23. Ho CS, Chee CY, Ho RC. Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic. Ann Acad Med Singap 2020;49(3):155–160. PMID: 32200399.
  24. Sim K, Chan YH, Chong PN, et al. Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease. J Psychosom Res 2010;68(2):195–202. DOI: 10.1016/j.jpsychores.2009.04.004.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.