Factors associated with nurses emotional distress during the COVID-19 pandemic

Background: Nurses are among the frontline healthcare workers directly impacted by the burden of the coronavirus disease of 2019 (COVID-19) pandemic. This study aimed to examine the prevalence of emotional distress and the associated factors among nurses practicing in South Dakota during the COVID-19 pandemic. Methods: An online survey was conducted among practicing, licensed nurses in South Dakota during the pandemic (July 2020 - August 2020). Emotional distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). Logistic regression models were performed to examine the association of emotional distress and the three DASS-21 subscales with: sociodemographic and work environment factors (e.g., work setting, job satisfaction, number of COVID-19 cases seen at the facility, preparedness, concerns with worsening pre-exiting mental health conditions due to the pandemic, and contracting the illness). Results: Among 1505 participants, overall emotional distress was reported by 22.2%, while anxiety, depression and stress were 15.8%, 14.5% and 11.9%, respectively. Factors associated with moderate to severe emotional distress, depression, anxiety, and stress were as follows: concerns for worsening of pre-existing mental health conditions, job dissatisfaction, encountering higher number of COVID-19 cases at one's work facility, feeling unprepared for the pandemic, and concern for contracting the illness (all p < 0.05). Conclusions: Our study suggests a high prevalence of emotional distress among nurses and highlights the factors associated with emotional distress during the COVID-19 pandemic. Promoting appropriate support is imperative to reduce nurses' emotional distress and promote psychological well-being during the COVID-19 world health crisis and in future pandemics.