Prevalence and determinants of work-related stress among nurses in Ethiopia: a systematic review and meta-analysis

Abstract

Background: Work-related stress is a growing global concern among nurses, affecting professional performance and health system outcomes. In Ethiopia, evidence is fragmented. This review aimed to estimate the pooled prevalence of work-related stress among nurses in Ethiopia and identify its associated factors. Methods: We systematically searched PubMed, Embase, Scopus, Web of Science, and Google Scholar for observational studies published up to April 30, 2025. Eligible studies reporting the prevalence or determinants of work-related stress among nurses in Ethiopia. The review was conducted and reported following the PRISMA 2020 guidelines; the PRISMA 2020 Abstract Checklist is provided as Appendix 1. Two reviewers independently screened, extracted data, and assessed study quality using the JBI Critical Appraisal Checklist. A random-effects model was used to calculate pooled prevalence and adjusted odds ratios (AORs). Subgroup and sensitivity analyses were conducted. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. Results: Thirteen studies involving 3,702 nurses across multiple Ethiopian regions were included. The pooled prevalence of work-related stress was 47.84% (95% CI: 46.28–49.41%, I2 = 93.4). Significant associated factors included shift work (AOR = 2.68), working in emergency units (AOR = 5.95), intensive care (AOR = 6.33), less than five years of experience (AOR = 4.41), and having children (AOR = 2.13). Conclusion: Nearly one in two nurses in Ethiopia experiences work-related stress. Occupational and personal factors contribute substantially to this burden. Interventions such as improved scheduling, support for high-risk units, and early-career mentoring are recommended. Future longitudinal and interventional studies are needed to inform workforce policy and improve nurse well-being. Clinical trial number: Not applicable.