Prevalence of depression, anxiety, and stress among Iranian nurses during the COVID-19 outbreak and their related factors

Background: Psychological disorders such as stress, anxiety, and depression are emerging challenges in healthcare systems. These disorders are recognized as very common problems among the nursing staff. Over the past two years of the COVID-19 pandemic, nursing staff has been exposed to the highest risk of psychological disorders. This study aimed to examine the prevalence of depression, anxiety, and stress among Iranian nurses during the COVID-19 pandemic and to analyze the potential factors associated with each mental disorder. Methods: A cross-sectional and web-based survey was conducted between September 15 and December 15, 2020 among 1135 Iranian nurses working in public hospitals. Stress, anxiety, and depression were measured using the Depression Anxiety Stress Scale-21 Items (DASS-21) during the COVID-19 pandemic. A logistic regression analysis was performed to identify the predictors of depression, anxiety, and stress. Results: The prevalence of stress, anxiety, and depression was 75.6%, 79.2%, and 59.1%, respectively, among nurses. The results of the multivariable logistic regression analysis indicated that potential factors contributing to stress included female gender (odds ratio [OR] = 1.52), younger age (OR = 0.48), and work overload (OR = 1.73). Female gender (OR = 1.56), younger age (OR=0.27), and lower levels of education (OR = 0.50) were associated with high levels of anxiety. Also, lower education (OR=0.56), longer working hours (OR = 1.81), and working in intensive care units (OR = 1.67) significantly predicted a higher risk of depression symptoms in nurses. Conclusion: The present results showed that stress, anxiety, and depression were common among nurses working in public hospitals during the COVID-19 pandemic. Preventive measures, such as psychological interventions, are suggested to reduce the risk of stress, anxiety, and depression among nurses; the identification of risk factors may also allow for more targeted interventions. There is an urgent need for diverse implementation strategies at all levels to reduce the psychological impact of the pandemic such as social support and psychological support in the workplace