Prevalence of Mental Health Problems Among Female Nurses in Public Sector Hospitals Faisalabad An Exploratory Study

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Journal of Professional & Applied Psychology Brief Research Report

Prevalence of Mental Health Problems among Female Nurses in Public Sector Hospitals
Faisalabad: An Exploratory Study

Faiza Anwar1, Riffat Sadiq2, Saira Khan3


Abstract
The objective of the present study was to explore the prevalence and severity of mental health
problems (i.e., Depression, Anxiety, Stress, Anger and Hostility) among female nurses working in
public sector hospitals situated in Faisalabad. In this regard, the sample of 306 participants (female
nurses) was selected from public sector hospitals situated in Faisalabad. Personal Information
Sheet, Depression, Anxiety, Stress Scale-21 (DASS-21), and the subscales of Anger and Hostility
(AQ) were used for the data collection. Data analysis was done through Statistical Package for
Social Sciences (SPSS, v22). Of the 306 participants, about 73.8% nurses reported significant
depression, 80.7% nurses experienced significant anxiety, 84.9% nurses reported significant stress,
83.3% participants reported significant anger, while 81.3% reported significant hostility.
Approximately, 64.15% nurses experienced moderate depression, 33.19% reported severe level of
anxiety and 61.92s % nurses reported moderate level of stress. Female nurses of public sector
hospitals suffered from significant mental health problems (i.e., depression, anxiety, stress, anger
and hostility) which are deleterious not only for the professional growth of nurses but for the
patient’s welfare as well. Addressing mental health status of nurses will enable them to cope up
with personal and work related issues.
Keyword: Anger, Anxiety, Depression, Hostility, Mental health, Nurses, Stress
Received: 10 February 2022; Revised zeal. Nursing involves handling and caring of
Received: 07 March 2022; Accepted: 07 variety of patients suffering from mild to
March 2022 chronic physical/psychological ailment. As a
result, nursing, in some setting, is allied with
1
Visiting Lecturer, Department of Applied stressful conditions.
Psychology, Government College With this frequent job stress, nurses develop
University, Faisalabad, Pakistan. significant psychological and physical
2
Assistant Professor/Incharge, Department of problems. Previous studies have evinced
Applied Psychology, Government College nurses to be experiencing significant
Women University, Faisalabad, Pakistan. depression, anxiety and stress (Cheung &
3
Assistant Professor, Department of Applied Yip, 2015; Maharaj et al., 2019), somatic
Psychology, Government College Women symptoms, depression, social dysfunction
University, Faisalabad, Pakistan. and anxiety as well (Swapnil et al., 2016;
Tajver et al., 2015). The ratio of
Corresponding Author Email: psychological illnesses was higher among
[email protected] nurses engaged with dialysis, eye, medical,
Introduction gynecological wards and emergency as well
The profession of nursing is foremost (Shakya et al., 2012).
significant profession in the health sector. A cross-sectional survey indicated the
Nurses assume full time caregiving disorder of anxiety and depression among
responsibilities with sufficient devotion and nurses (Perry et al., 2015). Nurses engaged
This article is distributed under the terms of the Creative Commons Attribution Non Commercial
4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-
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the original work is attributed as specified.
© Copyright: The Authors (2022)
Mental Health Problems in Female Nurses Anwar et al.

with Tertiary Care Hospitals in Pakistan Method


experienced severe burnout and poor quality Having approval from the Ethical Review
of life (Naz et al., 2016). Nurses of same Committee at Government College Women
hospital also reported mild to severe level of University, Faisalabad, this exploratory study
depression as well (Ali et al., 2018). was done on the nurses of public sector
Researchers proved moderate to severe level hospitals. For that purpose, a list of female
of everyday stress among nurses irrespective nurses (sampling frame) was obtained from
of their demographics which further impaired each hospital to determine the population size
their personal and professional and that was 1295. Following formula was
responsibilities (Badil et al., 2017). Age, computed to determine the present sample
gender, level of hospital and job tenure are size (Yamane, 1967):
likely to make ground for significant
depression, anxiety and insomnia among n=N/1 + N (e) 2
nurses (Huang et al., 2018). n=1295/1+1295(0.05)2
Mental health of nurses indeed is influential n= 1295
for patients besides their own professional 1+1295*0.0025
performance. Quality of patient care depends n=1295
on how the professional own’ health is. 4.23
Stressful work and working condition n=306.14
negatively influence patient’s safety (Berland
et al., 2008). It is an eminent fact that nurses In that way, at least 306 female nurses were
cannot possibly attend the needs of patients, randomly selected from five different public
if their own mental health is unstable. sector hospitals working in Faisalabad.
Psychological problems among nurses may Afterwards, permission was taken from the
result in errors at work also, obviously administration of all hospitals respectively to
deleterious for one’s life. Previous studies collect the data from nurses. Then, in
show that stress lead to medical errors, non- individual meeting, consent was also taken
compliance and negligence on the part of from the female nurses verbally and as well
nurses that may further put patient’s life at as in written form. First, self-constructed
risk (Babu et al., 2015). To be boisterous at semi-structured brief interview form was
work, nurses need to be mentally stable. administered on participants that ruled out
Furthermore, nurses who strive to cope with basic information such as: age, educational
environmental and work related problems level, marital status, no. of family
may prevent themselves from developing members/children, family system, head of the
mental health issues. In the light of existing family, residential area, duration of job, duty
literature, the present study has specific shift, and duty hours.
objectives as mentioned below: Other instruments included Urdu Versions of
1. To examine the presence of mental DASS-21 that comprised of 21 items and
health problems among female nurses three subscales (Depression, Anxiety and
of public sector hospitals. Stress). All subscales have 7 items
2. To determine the prevalence and respectively which are scored on 4-points
severity of the mental health likert scale ranged from [Did not apply to me
problems (i.e., Depression, Anxiety, at all =0, applied to me to some degree or for
Stress, Anger and Hostility) among some of the time=1, applied to me to a
nurses of public sector hospitals in considerable degree or for a good part of
Faisalabad. time=2, applied to me very much or most of

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Mental Health Problems in Female Nurses Anwar et al.

time=4]. The reliability of the Urdu version uncharacteristic nor characteristic of me=3,
of Depression subscale is (α =.0.84), of somewhat characteristic of me=4, extremely
Anxiety is (α =.0.86), of Stress is ((α =.0.83) characteristic of me=5]. Reliability of Urdu
and of full scale is (0.93) as reported by version of Anger is (α =.88), whereas of
(Aslam & Kamal, 2017). Hostility is α =.75 (Shafique & Sadiq, 2019).
Urdu Versions of Anger (7-items) and Every participant was given sufficient time to
Hostility (8-items), subscales of Aggression answer each questionnaire selected for the
Questionnaire, were used. Items of both present research. After completing data
subscales are scored on five point likert scale collection procedure, scoring was done in
[Extremely uncharacteristic of me =1, order to statistically analyze the data using
somewhat uncharacteristic of me=2, neither SPSS Version 22.0.

Results
Table 1
Summary of Demographic Characteristics of the Participants (N=306)
Characteristics Frequencies Percentages
Age Range f %
21-30 279 91.18, (M= 24.94; SD= 3.67716)
31-40 27 8.82
Education
BS Nursing 237 77.45
General Nursing 69 22.55
Marital Status
Single 219 71.57
Married 87 28.43
Family System
Nuclear 180 58.82
Joint 126 41.18
Socio-economic Status
Lower 19 6.20
Middle 287 93.7
Duration of Job
1-10 222 72.55
11-20 84 27.45
Duty Hours
6 hours 238 77.78
Above 6 hours 68 22.22
Duty Shift
Morning 127 41.50
Evening 111 36.27
Monthly Income
25-35 43 14.05
36-45 57 18.6
46-55 139 45.4
56-65 67 21.8

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Mental Health Problems in Female Nurses Anwar et al.

Descriptive statistics (frequencies family (93.79%) and were living in nuclear


/percentages) was computed to present family system (58.82%).
demographic information obtained from the Duration of job of most of the nurses
participants of the present study. Results (72.54%) was in the range of 1 to 10 years.
(Table-1) have revealed that the majority of About 77.77% spent at least six hours at duty
participants (91.17%) were falling in the age or work, while 41.50% were paying duty in
range of 21 to 30 years with mean age (M= the morning shift at the time of data
24.94; SD= 3.67716). About 77.45% had the collection. Majority (45.42%) nurses were
degree of BS nursing. Most of the nurses being paid 46 to 55 thousands per month for
(71.56%) were single, with middle class the services.

Table 2
Prevalence of Mental Health Problems in Nurses (N=306)
Nurses
Mental Health ________________________________________________
Problems Yes No
f % f %
Depression 226 73.8 80 26.1
Anxiety 247 80.7 59 19.2
Stress 260 84.9 46 15.03
Anger 255 83.3 51 16.6
Hostility 249 81.3 57 18.6

Further analysis was done pertaining to the anxiety, while 19.2% reported normal
mental health problems experienced by the anxiety. About 84.9% nurses reported
participants of the present study. Results significant stress and 15.03% reported
(Table-2) have depicted that among 306 normal stress in their life. Amidst all, about
participants; about 73.8% nurses reported 83.3% participants reported significant
significant depression, whereas 26.1% anger, while 16.6% reported normal anger.
reported normal depression. Approximately, About 81.3% reported significant hostility
80.7% nurses experienced significant and 18.6% reported normal hostility.

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Mental Health Problems in Female Nurses Anwar et al.

Table 3
Severity of Depression, Anxiety and Stress in Nurses (N=306)
Mental Health f %
Problems
Depression
Mild 51 22.5
Moderate 145 64.1
Severe 26 11.5
Extremely Severe 4 1.76
Anxiety
Mild 31 12.5
Moderate 73 29.5
Severe 82 33.1
Extremely Severe 61 24.6
Stress
Mild 161 61.9
Moderate 89 34.2
Severe 8 3.07
Extremely Severe 2 0.76

Level of depression, anxiety and stress was moderate anxiety, 24.69% reported
also calculated. It is shown by the results extremely severe anxiety, while 12.55%
(Table-3) that majority nurses (64.15%) reported mild level of anxiety.
experienced moderate depression, 22.56% Approximately 61.92% nurses reported
experienced mild depression, 11.5% moderate level of stress, 34.23% reported
experienced severe depression and 1.76% mild stress, 3.07% reported severe stress and
experienced extremely severe depression. 0.76% reported extremely severe stress in
Regarding anxiety, about 33.19% reported life.
severe level of anxiety, 29.55% reported

Discussions (Khodadadi et al., 2016) and middle income


The present study addressed the mental groups (Gong et al., 2014) accounted for
health status of female nurses engaged with depressive symptomatology in nurses. Job
public sector hospitals in Faisalabad. The requirements along with personal or
obtained findings indicated the significant environmental problems might become the
proportion of mental health problems among source of depression among nurses in the
participants (Table-2). Further analysis present study.
revealed that majority of the nurses In the present study, majority of the nurses
experienced moderate level of depression reported severe anxiety (Table-3). A previous
(Table-3). It is supported by a previous study study also demonstrated the significant
that documented registered nurses anxiety in nurses of tertiary care hospitals in
experiencing depression as twice in South India (Shajan & Nisha, 2019). Nurses,
comparison to other professionals (Brandford of the present study, might remained worried
& Reed, 2016). Various factors including job owing to their current life circumstances,
demands/characteristics and working which seemed to them as uncontrollable.
condition (Gelsema et al., 2005), duty shifts When one does not feel capable enough to

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Mental Health Problems in Female Nurses Anwar et al.

control or handle painful stimuli, he or she health status of nurses may enable them to
becomes anxious. Uncontrollable feelings manage personal and as well as work related
regarding environmental issues and future issues. It can also strengthen the nurse-patient
social and economic concerns might cultivate relationships in health care setting.
anxiousness among nurses of the present
study. Limitations and Recommendations
Most of the nurses also experienced moderate Some significant limitations of the present
level of stress (Table- 3). The present study were noted. First, the study explored
research findings are also supported by the prevalence of mental health problems in
previous researches that revealed medium the absence of causing factors. Role of
level of stress in nurses (Najimi et al., 2012; demographics was not estimated in the
Kshetrimayum et al., 2019). Role of job connection of mental health problem at all.
dissatisfaction (Maharaj et al., 2019), Only female nurses were focused ignoring
pollution, time pressure and long hours are male nurses completely. Mental health of
evident in determining stress among nurses male nurses is equally important to be
(Kane, 2009). In hospital setting, nurses are addressed.
exposed to distinct stimulus which requires Hence, in the light of these limitations, all
timely management. Simultaneous handling future researchers are recommended to
of multiple tasks might propagate the stress examine the reasons of developing mental
level among nurses in the present study. health problems among both male and female
Nurses of the present study also reported nurses in Pakistan. In this regard, mental
significant anger (Table-2). It is further health of nurses working in public and private
supported by previous research that pointed sector hospitals can be compared. More
out three different kinds of anger expression details pertaining to the mental health
among nurses in Korea (Han et al., 2015). problems among nurses will help in
Probably, nurses of the present study got implementing preventive measures. Stability
frustrated owing to personal and work related of mental health prevents medical errors at
problems (i.e., insufficient pay, duty shifts work, ensure quality of services for patients
and patient’s demand or handling) that and as well as utilization of positive coping
provoked more anger in them. and skills on the part of nurses both at work
Significant hostility was also noted among and home.
female nurses of the present study (Table-2).
A previous study elaborated the nurse-nurse Contribution of Authors
hostility within clinical setting (Hutchinson Faiza Anwar: Conceptualization,
& Jackson, 2013). Perhaps, nurses might not Methodology, Investigation, Data Curation
cope well with negative experiences in living Riffat Sadiq: Supervision, Methodology,
and working environment, as a result, they Writing -Original Draft, Writing - Review &
harbored negative feelings and emotions Editing
leading to hostility among them. Saira Khan: Formal Analysis, Writing-
Conclusion Original Draft
Female nurses of public sector hospitals
experience significant depression, anxiety, Conflict of Interest
stress, anger and hostility which may impede The authors declared no conflict of interest.
their professional growth. Owing to various Source of Funding
mental health problems, they are unable to The authors stated no source of funding.
handle patients effectively. Adequate mental

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Mental Health Problems in Female Nurses Anwar et al.

References Cheung, T., & Yip, P.S. F. (2015).


Ali, A., Rasheed, A., Naz, S., & Siddiqui, Depression, anxiety and symptoms
M.A. (2018). A study of depression of stress among Hong Kong nurses:
and associated factors among nurses a cross-sectional
working in Tertiary Care Hospitals study. International Journal of
in Karachi. Isra Medical Journal, Environmental Research and Public
10(3): 138- Health, 12(9): 11072-11100. doi:
142.https://www.researchgate.net/p 10.3390/ijerph120911072
ublication/326199295 Gelsema, T.I., van der Doef, M., Maes, S.,
Aslam, N., & Kamal, A. (2017). Akerboom, S., Verhoeven, C.
Translation, Validation and (2005). Job Stress in the Nursing
Effectiveness of Depression, Profession: The Influence of
Anxiety and Stress Scale (DASS-21) Organizational and Environmental
in assessing psychological distress Conditions and Job
among flood affected individuals. Characteristics. International
Journal of Pakistan Psychiatric Journal of Stress Management,
Society, 14(4): 16-20. 12(3), 222-240.
http://www.jpps.com.pk/article/151 https://doi.org/10.1037/1072-
98028712310- 5245.12.3.222
Babu, G.R., Sathyanarayana, T.N., Gong, Y., Han, T., Chen, W., Dib, H.H.,
Ketharam, A., Kar, S.B., & Detels, Yang, G., Zhuang, R., Chen, Y.,
R. (2015). Perceived occupational Tong, X., Yin, X., & Lu, Z. (2014).
stressors and the health software Prevalence of Anxiety and
professionals in Bengaluru, India. Depressive Symptoms and Related
The Qualitative Report, 20 (3):314- Risk Factors among Physicians in
35.https://www.researchgate.net/pu China: A Cross-Sectional Study.
blication/280632226 PLoS One, 9(7): e103242.
Badil, Shah, H., Ali, S.A., & Siddiqui, M. A. https://doi: 10.1371/journal.pone.01
(2017). Severity of stress in nurses 03242
everyday life in Karachi, Pakistan. Han, A., Won, J., Kim, O., & Lee, S. E.
Journal of Liaquat University of (2015). Anger expression types and
Medical and Health Science, interpersonal problems in nurses.
16(01):62-7. doi: Asian Nursing Research, 36(2): 1-
10.22442/jlumhs.171610508 10. https://doi:
Berland, A., Natvig, G.K., & Gundersen, D. 10.1016/j.anr.2015.04.001
(2008). Patient safety and job- Huang, C. L., Wu, M. P., Ho, C. H., &
related stress: A focus group study. Wang, J. J. (2018). Risks of treated
Intensive and Critical Care Nursing, anxiety, depression, and insomnia
24(2):90-7. doi: among nurses: A nationwide
10.1016/j.iccn.2007.11.001 longitudinal cohort study. PLoS One,
Brandford, A. A., & Reed, D. B. (2016). 25,13(9):e0204224.doi:
Depression in registered nurses: A 10.1371/journal.pone.0204224
state of the Science. Workplace Hutchinson, M., & Jackson, D. (2013).
Health and Safety, 64(10):488-511. Hostile clinician behaviors in the
https://doi.org/10.1177/2165079916 nursing work environment and
653415. implications for patient care: A

JPAP, 3(1), 108-116 https://doi.org/10.52053/jpap.v3i1.93 114


Mental Health Problems in Female Nurses Anwar et al.

mixed-methods systematic review. Association, 66(5):532-6.


Bio Medical Central Nursing, https://www.jpma.org.pk/article-
12- 25.https://doi.org/10.1186/1472- details/7734
6955-12-25 Perry, L., Lamont, S., Brunero, S.,
Kane, P. P. (2009). Stress causing Gallagher, R., & Duffield, C.
psychosomatic illness among nurses. (2015). The mental health of nurses
Indian Journal of Occupational and in acute teaching hospital settings: A
Environmental Medicine, 13(1):28- cross-sectional survey. Bio Medical
32.http://www.ijoem.com/article.as Central Nursing, 14(15):3-8. doi:
p?issn=0019-5278 10.1186/s12912-015-0068-8
Khodadadi, E., Hosseinzadeh, M., Shafique, S., & Sadiq, R. (2019).
Azimzadeh, R., Fooladi, M. (2016). Aggression and physical health in
The relation of depression, anxiety married women. Journal of
and stress with personal Postgraduate Medical Institute,
characteristics of nurses in hospitals 33(4): 319-23.
of Tabriz, Iran. International https://jpmi.org.pk/index.php/jpmi/a
Journal of Medical Research and rticle/view/2418
Health Science, 5,140-148. Shajan, A., Nisha, C. (2019). Anxiety and
https://www.researchgate.net/public Depression among nurses working in
ation/308969364 a tertiary care hospital in South
Kshetrimayum, N., Bennadi, D., & Siluvai, India. International Journal of
S. (2019). Stress among staff nurses: Advances in Medicine, 6(5):1611-
A hospital-based study. Journal of 1615.https://www.researchgate.net/
Nature and Science of Medicine, 2, publication/336034298
95-100. Swapnil, B., Harshali, R., & Snehal, C.
https://doi.org/10.4103/JNSM.JNS (2016). Prevalence of low mental
M_24_18 health among nurses in medical
Maharaj, S., Lees, T., & Lal, S. (2019). intensive care units. International
Prevalence and risk factors of Journal of Contemporary Medical
depression, anxiety, and stress in a Research, 3(8):2444-
cohort of Australian nurses. 2447.https://www.ijcmr.com/upload
International Journal of s/7/7/4/6/77464738/ijcmr_846_aug_
Environmental Research and Public 17.pdf
Health,16(1): 61. doi: Shakya, D. R., Lama, S., & Shyangwa, P. M.
10.3390/ijerph16010061 (2012). Psychological problems
Najimi, A., Goudarzi, A.M., & Sharifirad, among nursing staff in a hospital.
G. (2012). Causes of job stress in JNMA Journal of Nepal Medical
nurses: A cross-sectional study. Association, 52(187):102-10.
Iranian Journal of Nursing and https://pubmed.ncbi.nlm.nih.gov/23
Midwifery Research, 17(4): 301– 591168/
305.https://pubmed.ncbi.nlm.nih.go Tajver, A., & Saraji, G. N. (2015).
v/23833631/ Ghanbarnejad A, Omidi L,Hosseini
Naz, S., Hashmi, A.M., & Asif, A. (2016). SS, Abadi SSA. Occupational stress
Burnout and quality of life in nurses and mental health among nurses in a
of a tertiary care hospital in Pakistan. medical intensive care unit of a
Journal of Pakistan Medical general hospital in Bandar Abbas in

JPAP, 3(1), 108-116 https://doi.org/10.52053/jpap.v3i1.93 115


Mental Health Problems in Female Nurses Anwar et al.

2013. Electro Physician, 7(3):1108-


1113. doi: 10.14661/2015.1108-
1113.
Yamane, T. (1967). Statistics: An
Introductory Analysis, 2nd Ed.
Harper and Row.

JPAP, 3(1), 108-116 https://doi.org/10.52053/jpap.v3i1.93 116

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