Relation between depression, anxiety, and quality of life among female nurses in Shaanxi province: a cross-sectional study

Abstract

BackgroundNurses are known to work in stressful environments, which might lead to severe mental illness and impaired quality of life. However, little research has been done to address this problem in Chinese nurses. This study aimed to assess psychological distress and quality of life in Chinese nurses, and to examine the relation among these problems. MethodA cross-sectional survey was done in Shaanxi province during June to December, 2013. 1700 nurses were recruited, 1570 of whom completed questionnaires. Depression was measured with the Center for Epidemiologic Studies Depression scale, and anxiety was measured with the State-Trait Anxiety Inventory. Quality of life was assessed using the 36-item short-form health survey (SF-36). A general linear model was used to investigate whether quality-of-life measures showed significant difference among participants with different psychological symptoms after adjustment for confounding variables. The research proposal and data access were approved by the Ethics Review Committee of the Second Hospital of Xi'an Jiaotong University, Xi'an, China. Individual written assent was provided by all nurses in the study. The study dataset contained no identifying information, and all research data were kept confidential. This consent procedure was approved by the Ethics Review Committee of the Second Hospital of Xi'an Jiaotong University. Findings389 (25%) of 1570 participants had depression. 911 (58%) participants had state anxiety, whereas trait anxiety was reported in 780 (50%) participants. All subscales of SF-36 scores of nurses who had depression were significantly lower than those of nurses without depression (p=0·003). All subscales of SF-36 scores, except physical function, of the nurses with high anxiety scores were significantly lower than those of the nurses with low anxiety scores (p=0·0003). Depression was significantly associated with poor overall quality of life (β=107·874; p=0·0005) and all other seven domains of quality of life (p=0·016). Significant effects of social anxiety (β=59·760; p=0·029) and trait anxiety (β=57·908, p=0·027) were reported in overall quality of life. InterpretationDepression and anxiety are each associated with poor quality of life in nurses in Shaanxi province. Moreover, depression has more pervasive effects than anxiety on non-mental domains of nurses' quality of life. FundingNone.