Abstract
The high level of occupational stress and burnout among nurses can lead to insomnia, anxiety, and depression. However, the actual risks for healthcare-seeking for these stress-related mental health problems among nurses are still unclear. The aim of this study was to explore the risks and influencing factors of treated anxiety, depression, and insomnia among nurses. We used claims data obtained from the 2010 National Health Insurance Research Database (NHIRD) in Taiwan. Hospital nurses who had at least 3 coded ambulatory care claims or 1 inpatient claim with a principal diagnosis of anxiety, depression, or insomnia were identified. A cohort of 46,120 nurses and 92,240 matched controls were included. All the study subjects were followed up until the onset of any of the aforementioned outcomes, death, or the end of 2012. Results showed that the adjusted hazard ratios (HRs) for treated anxiety, depression, and insomnia among all the nurses were 0.91 (95% CI, 0.88–0.95), 0.59 (95% CI, 0.55–0.63), and 1.43 (95% CI, 1.38–1.48), respectively. Furthermore, the risks of these psychiatric problems in healthcare-seeking nurses were affected by age, gender, hospital level, and job tenure. Our findings suggest that hospital nurses have lower hazards of treated anxiety and depression than the general population, although they have a higher hazard of treated insomnia. There may be undertreatment in some subgroups of nurses with different demographic and working characteristics.
Highlights
Nursing has been acknowledged to be a stressful occupation with a high prevalence of distress and stress-related burnout [1,2,3]
The high level of occupational stress and burnout among nurses can lead to behavioral health problems and psychiatric morbidity, including insomnia [4,5,6], anxiety [7,8,9,10], depression [7, 10,11,12,13,14], and substance use [15,16,17]
Compared to the general population, nurses working in medical centers had a significantly lower hazard ratios (HRs) for anxiety (0.64), while nurses working in local hospitals had a higher HR for anxiety (1.42)
Summary
Nursing has been acknowledged to be a stressful occupation with a high prevalence of distress and stress-related burnout [1,2,3]. The high level of occupational stress and burnout among nurses can lead to behavioral health problems and psychiatric morbidity, including insomnia [4,5,6], anxiety [7,8,9,10], depression [7, 10,11,12,13,14], and substance use [15,16,17]. In Taiwan, the working conditions of nurses have become exhausting and highly stressful in recent years due to heavy workloads and litigation, extended working hours and high levels.
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