Occupational stress, coping strategies, and mental health among clinical nurses in hospitals: a mediation analysis

Abstract

Objective: This study aimed to examine the relationship between occupational stress and mental health among clinical nurses, focusing on the mediating role of coping strategies.

Methods: A cross-sectional survey was conducted among 600 clinical nurses from tertiary hospitals in Hangzhou, China. Data were collected using the Chinese Nurses' Work Pressure Source Questionnaire, the Symptom Checklist-90 (SCL-90), and the Coping Strategies Scale. Mediation analysis was performed using Bootstrap to test the hypothesized mediating effects.

Results: The results showed that occupational stress was positively associated with mental health issues (β = 0.42, p < 0.01), and coping strategies partially mediated this relationship (indirect effect = 0.18, 95% CI [0.11, 0.27]). Nurses in high-stress departments (e.g., surgery and ICU) reported significantly higher SCL-90 scores than the national norm (p < 0.05).

Conclusion: The findings suggest that positive coping strategies can mitigate the adverse effects of occupational stress on mental health. Interventions targeting coping skills training may improve nurses' well-being and reduce burnout.

Keywords: clinical nurses; mental health status; nurses; psychological stress reduction model; reduction model.

Figure 1

Mediation analysis model. This figure illustrates the relationships between occupational stress (X), coping strategies (M), and mental health (Y). The direct effect from occupational stress to coping strategies is β = 0.34, and the effect from coping strategies to mental health is β = 0.28. The indirect effect of occupational stress on mental health through coping strategies is also depicted with an indirect effect size of β = 0.18 (95% CI [0.11, 0.27]), accounting for 42% of the total effect.