Systematic review on occupational stress and its risk factors among nurses

Abstract

Introduction: occupational stress is a major challenge in nursing, with implications for workforce well-being, patient safety, and health system resilience. Nurses face multidimensional stressors, including workload, shift work, and limited resources, which may vary across global and regional contexts.Objective: This systematic review aimed to synthesize recent evidence on the prevalence, determinants, and consequences of occupational stress among nurses, with attention to universal and context-specific risk factors.Method: Guided by the PRISMA 2020 framework, a comprehensive search was conducted in PubMed, CINAHL, Scopus, and PsycINFO, covering studies published between January 2015 and March 2024. Eligible studies included nurses working in hospital or healthcare settings and assessed occupational stress using validated tools. Data extraction and quality appraisal were performed independently by two reviewers using the Joanna Briggs Institute (JBI) Critical Appraisal Tools.Results: Fifteen studies met inclusion criteria, conducted across Asia, Africa, the Middle East, and Europe. Reported prevalence of occupational stress ranged from moderate to high. Common determinants included heavy workload, shift work, inadequate staffing, role ambiguity, limited managerial support, and workplace violence. The COVID-19 pandemic further intensified stress, driven by infection risk and inadequate protective equipment. Context-specific stressors included resource shortages in low- and middle-income countries and political instability in regions such as Jordan and Palestine. Consequences included burnout, emotional exhaustion, turnover intention, and adverse effects on patient safety and care quality.Conclusion: Occupational stress among nurses remains a significant global issue with critical personal and systemic consequences. Multilevel interventions—targeting organizational support, staffing, safe workplaces, and resilience-building—are urgently required, especially in resource-limited and conflict-affected settings.