Persistent Psychological Distress and Shifting Subjective Burden Among Hospital Nursing Professionals During the...

The coronavirus disease 2019 (COVID-19) pandemic has imposed substantial psychological and physical burdens on nursing professionals, particularly in Asia, where anxiety, depression, and burnout are common. In Japan, stigma may intensify distress, highlighting the need to assess symptoms and perceived workload. However, most studies were conducted at a single time point and cannot show how these burdens differ across changing infection rates, policies, and vaccination status.

To compare psychological distress and subjective work-related burden among three independent samples of Japanese hospital nursing professionals during the COVID-19 pandemic.

A repeated cross-sectional survey was conducted during three pandemic phases, with an independent sample at each: December 2020 (pre-vaccination), July 2022 (seventh infection wave), and November 2023 (post-reclassification). Web-based surveys were administered at 138 hospitals in one Japanese prefecture. Psychological distress was measured using the K6 scale and subjective mental and physical burden using one original item each. Differences among waves were examined using one-way analysis of variance, effect sizes (η²), and Steel-Dwass post hoc comparisons.

A total of 4,194 participants were analysed. Psychological distress and subjective burden differed significantly among waves, although effect sizes were small (η² = .008-.012). Mean K6 scores were higher in July 2022 than in December 2020 or November 2023. The proportion with psychological distress (K6 ≥ 5) ranged from 59.3% to 67.9%, and that with severe distress (K6 ≥ 13) from 14.1% to 23.9%. Mental burden was highest in December 2020 and lowest in November 2023; physical burden showed the opposite pattern. In 2020, participants with COVID-19 care experience reported higher distress, but no such difference was observed in 2022 or 2023.

Sustained psychological support for nursing professionals remains essential beyond acute crises. Tailored interventions should address mental strain and cumulative physical fatigue to strengthen workforce resilience.