INTRODUCTION:

Nursing is one of the most essential and demanding professions in the healthcare sector, requiring a balance between emotional sensitivity, technical expertise, and physical endurance. Nurses play a vital role in ensuring the delivery of quality healthcare services, particularly in hospitals where patient care depends heavily on their dedication, compassion, and professional competence.¹ However, the nature of nursing work often exposes personnel to a variety of stressors that can negatively affect their physical and mental well-being. Job-related stress among nurses has emerged as a significant occupational hazard, impacting not only their health but also the efficiency and quality of patient care. The present study, titled “A Study to Assess the Job-Related Stress Experienced by the Nursing Personnel Working in Non-Critical Care Unit of Dhamtari Christian Hospital, Dhamtari (C.G.), with a View to Develop Guidelines on Stress Management,”

In nursing, stress is often associated with long working hours, heavy workload, inadequate staffing, and the emotional burden of dealing with patients and their families. Non-critical care units, though less intense than critical care or emergency wards, have their own challenges, such as managing multiple patients, administrative responsibilities, and maintaining high standards of care with limited resources. The cumulative impact of these factors often leads to fatigue, irritability, anxiety, and burnout among nurses, which in turn can reduce job satisfaction and increase turnover rates.^3,4

The healthcare environment is inherently stressful, characterized by constant exposure to human suffering, illness, and death. Nurses are often required to make quick decisions, handle emergencies, and maintain emotional stability while providing compassionate care. The non-critical care setting, although different from intensive care or surgical wards, involves continuous interaction with patients requiring routine monitoring, treatment, and emotional support⁴. These responsibilities, coupled with high patient-to-nurse ratios and administrative duties, create an environment where stress can accumulate over time. In addition, interpersonal conflicts, lack of recognition from superiors, and limited opportunities for career advancement can exacerbate the psychological strain.²

Several studies have emphasized that unmanaged occupational stress among nurses leads to a variety of adverse outcomes, such as absenteeism, low morale, poor concentration, and reduced quality of patient care. Moreover, chronic stress can result in long-term psychological issues such as depression, emotional exhaustion, and burnout.^6,7

Stress management among nurses involves both individual and organizational strategies. Individually, nurses can engage in relaxation techniques such as meditation, yoga, and deep breathing exercises, as well as develop effective time management and communication skills.⁶ On an organizational level, measures such as adequate staffing, fair work distribution, regular counseling sessions, and recognition of nursing contributions play an important role in reducing workplace stress.⁸

The present study holds special significance for non-critical care units, which are often overlooked in stress-related research compared to high-pressure environments like intensive care units or emergency wards. Nurses working in these units may face a unique set of stressors, such as monotony of routine work, lack of professional stimulation, and emotional fatigue from continuous patient interactions.

Recognizing the early signs of stress and implementing timely interventions can prevent severe outcomes like burnout and job dissatisfaction.^9,10 Therefore, the development of comprehensive, evidence-based stress management guidelines tailored to the needs of nursing personnel becomes a crucial step toward sustainable healthcare delivery.

MATERIALS AND METHODS:

The present descriptive study was conducted at Dhamtari Christian Hospital, Dhamtari (C.G.), to assess the job-related stress experienced by nursing personnel working in non-critical care units. The study aimed to identify major stressors and develop effective stress management guidelines. A quantitative research approach with a descriptive design was adopted. The target population included 60 nursing personnel selected through purposive sampling, fulfilling the inclusion criteria of having at least six months of experience in the hospital’s non-critical care units. Data were collected using a structured questionnaire consisting of three sections: demographic data, occupational stress assessment based on the Modified Nursing Stress Scale (MNSS), and coping strategies. The tool’s validity was established through expert review, and reliability was confirmed using Cronbach’s Alpha (0.86). Data collection was carried out over four weeks after obtaining ethical clearance and informed consent from all participants. The data were analyzed using descriptive and inferential statistics—frequency, percentage, mean, and Chi-square test—to identify stress levels and their associations with demographic variables. Based on the findings, stress management guidelines were developed focusing on relaxation techniques, effective time management, peer support, and organizational interventions to enhance nurses’ well-being and performance.

RESEARCH DESIGN:

The present study adopted a descriptive research design to assess the level of job-related stress among nursing personnel working in the non-critical care units of Dhamtari Christian Hospital, Dhamtari (C.G.). The descriptive design was chosen because it allows for the accurate portrayal of characteristics of a particular individual, situation, or group. This approach was deemed suitable as it enables the researcher to gather factual information regarding the stress levels, causes, and coping strategies of nurses within their natural work environment without manipulating any variables. The ultimate goal was to describe the prevailing situation, identify the factors contributing to job stress, and develop guidelines for effective stress management tailored to the nurses’ needs.

The study focused on exploring how demographic factors (such as age, gender, marital status, educational qualification, years of experience, and work shift patterns) and occupational factors (such as workload, staff strength, work environment, interpersonal relationships, and administrative support) influence the stress levels of nursing staff. A quantitative approach was used, with data collected through a structured questionnaire to ensure objectivity and consistency.

SETTING OF THE STUDY:

The study was conducted at Dhamtari Christian Hospital, located in Dhamtari, Chhattisgarh. This hospital is a well-established healthcare institution known for its commitment to providing quality medical services and nursing care. The hospital comprises various departments including Outpatient, Inpatient, Surgery, Maternity, Pediatrics, and General Medicine units. For this study, the focus was specifically on non-critical care units, which include general wards, post-operative wards (non-ICU), and medical-surgical wards.

Non-critical care units were selected because they represent a work environment where nurse’s deal with multiple patients with less intensive monitoring needs compared to critical care units but still face considerable workload, emotional challenges, and administrative responsibilities. Dhamtari Christian Hospital was chosen for the study as it provides an ideal representation of a mid-sized healthcare facility where resource constraints and high patient turnover can contribute to job-related stress among nursing personnel.

POPULATION OF THE STUDY:

The population of the study consisted of nursing personnel working in non-critical care units of Dhamtari Christian Hospital. The target population included staff nurses, senior nurses, and nursing sisters who were directly involved in patient care in the general wards. Nursing supervisors and administrative nurses were excluded as their responsibilities differ in nature from direct caregiving.

This population was appropriate for the study as it allowed the researcher to assess the occupational stress experienced by those who are continuously exposed to patient interactions, shift duties, and administrative pressures without the added intensity of critical care environments.

Sample and Sampling Technique:

A non-probability purposive sampling technique was adopted to select the participants. This method was chosen because it enables the researcher to select individuals who are most knowledgeable and relevant to the study objectives. The inclusion criteria were nursing personnel who:

1) We’re working in the non-critical care units of Dhamtari Christian Hospital.

2) Had at least six months of work experience in the current department.

3) We’re willing to participate voluntarily in the study.

Nurses who were on leave, in training, or working in administrative positions were excluded.

The final sample size was 60 nursing personnel, which was considered adequate for descriptive statistical analysis and the development of reliable findings. The sample represented diverse demographic characteristics such as age, marital status, and educational background, ensuring a comprehensive understanding of stress across different segments of the nursing staff.

Development of the Tool:

The main instrument for data collection was a structured questionnaire developed by the researcher after an extensive review of literature, consultation with experts, and pilot testing. The questionnaire aimed to gather comprehensive data on job-related stress and was divided into three main sections:

Section I: Demographic Data:

This section collected background information about the respondents such as:

· Age

· Gender

· Marital status

· Educational qualification

· Years of professional experience

· Work shift (day/night/rotational)

· Monthly working hours

· Department/ward of posting

· Family type (nuclear/joint)

These demographic variables were included to identify potential correlations between personal characteristics and job-related stress levels.

Section II: Occupational Stress Assessment Scale:

This section was based on the Modified Nursing Stress Scale (MNSS) and included 30 statements related to various dimensions of job stress, such as:

1) Workload and time pressure

2) Interpersonal conflict with colleagues and physicians

3) Lack of administrative support

4) Role ambiguity and lack of clarity in duties

5) Emotional demands of patient care

6) Inadequate staffing and resources

7) Work-life imbalance

8) Lack of recognition and professional growth

Each item was rated on a 5-point Likert scale ranging from “Never” (1) to “Always” (5). The total score indicated the level of stress — higher scores denoting greater stress levels.

Section III: Coping Mechanisms and Suggestions:

This section included open-ended questions and checklist items to explore the coping strategies used by nurses, such as relaxation, time management, peer support, recreational activities, and religious or spiritual practices. Participants were also encouraged to suggest measures that could help reduce workplace stress.

Validity and Reliability of the Tool:

The tool’s content validity was established through expert evaluation. The questionnaire was reviewed by five experts — three from the field of Nursing (with specialization in Psychiatric and Community Health Nursing) and two from Psychology and Hospital Administration. Based on their suggestions, certain items were modified for clarity and relevance.

The reliability of the tool was tested using the Cronbach’s Alpha method, which yielded a reliability coefficient of 0.86, indicating high internal consistency. The pilot study confirmed that the tool was understandable, relevant, and appropriate for the target population.

Pilot Study:

A pilot study was conducted among 10 nursing personnel from a similar hospital setting who was not part of the main study. The objectives were to test the feasibility, clarity, and reliability of the instrument, as well as to assess the time required for data collection. The results of the pilot study showed that the questions were comprehensible, and respondents could complete the questionnaire within 25–30 minutes.

Data Collection Procedure:

The data collection process was carried out over a period of four weeks after obtaining necessary administrative permissions from the hospital authorities. The procedure involved the following steps.

1) Permission and Ethical Clearance:

Formal approval was obtained from the hospital management and the institutional ethical review committee. The purpose of the study was explained to the authorities and nursing supervisors to facilitate cooperation.

2) Informed Consent:

Before data collection, the researcher explained the study objectives to the participants. Informed consent was obtained from all respondents, ensuring voluntary participation and confidentiality.

3) Administration of Questionnaire:

The structured questionnaire was distributed to each nurse personally by the researcher. The participants were given 30–40 minutes to complete the questionnaire during their break time to avoid interference with patient care duties.

4) Collection of Completed Questionnaires:

After completion, the filled questionnaires were collected, checked for completeness, and coded for data entry and analysis.

5) Data Confidentiality:

Participants’ names and personal details were not recorded to maintain anonymity. Data were used exclusively for academic and research purposes.

DATA ANALYSIS PLAN:

The collected data were analyzed using descriptive and inferential statistics with the help of SPSS software (Version 25.0). The following statistical methods were employed:

· Descriptive Statistics:

Frequency, percentage, mean, and standard deviation were used to describe demographic characteristics and the level of job stress among nurses.

· Inferential Statistics:

The Chi-square test was applied to find associations between selected demographic variables and the level of stress. The correlation coefficient (r) was used to examine relationships between occupational stress and coping mechanisms.

The results were presented in the form of tables, graphs, and charts for better clarity and interpretation.

ETHICAL CONSIDERATIONS:

The study strictly adhered to ethical guidelines in research involving human participants. Ethical principles such as autonomy, beneficence, non-maleficence, and confidentiality were maintained throughout the process. The following ethical measures were observed:

· Prior approval was obtained from the Institutional Ethics Committee of Dhamtari Christian Hospital.

· Informed consent was taken from all participants.

· Participation was voluntary, and respondents were free to withdraw at any stage without penalty.

· Confidentiality of data and anonymity of participants were ensured.

· Data were used only for academic and research purposes.

Development of Guidelines on Stress Management:

After the data analysis, the researcher developed a set of guidelines on stress management for nursing personnel, focusing on practical, evidence-based strategies. The guidelines included recommendations at three levels — individual, interpersonal, and organizational.

1) Individual-Level Strategies:

· Practicing relaxation techniques (deep breathing, yoga, meditation)

· Maintaining physical fitness through exercise

· Effective time and workload management

· Building resilience through positive thinking and self-reflection

· Seeking emotional support and counseling when necessary

2) Interpersonal-Level Strategies:

· Encouraging teamwork and open communication

· Promoting peer support systems

· Conflict resolution training and assertiveness workshops

3) Organizational-Level Strategies:

· Ensuring adequate staffing and fair duty rotations

· Providing recreational and stress-relief programs for nurses

· Conducting regular stress assessment and feedback sessions

· Recognizing and rewarding good performance

· Offering continuous professional development and psychological counseling services

These guidelines were validated by nursing experts and hospital administrators before being shared with the staff as part of the institutional stress management framework.

LIMITATIONS OF THE STUDY:

Despite its usefulness, the study had certain limitations:

1) The study was confined to one hospital (Dhamtari Christian Hospital); hence the findings cannot be generalized to all healthcare settings.

2) The use of a self-reported questionnaire might have introduced response bias.

3) The study focused only on non-critical care units; results might differ for critical care or specialized wards.

4) Time and resource constraints limited the sample size to 60 participants.

RESULTS:

The data collected from 60 nursing personnel working in the non-critical care units of Dhamtari Christian Hospital, Dhamtari (C.G.) were analyzed using descriptive and inferential statistics. The findings are presented in tables, showing the distribution of demographic variables, levels of job-related stress, and associations between demographic factors and stress levels. The analysis revealed that the majority of nursing personnel experienced moderate to high levels of job-related stress, primarily due to excessive workload, inadequate staffing, and lack of administrative support. Factors such as rotational shift duties, interpersonal conflicts, and work-life imbalance further intensified their stress levels. A significant association was found between marital statuses, years of experience, and work shift patterns with stress levels, indicating that personal and professional factors jointly influence stress among nurses. These findings emphasize the urgent need for effective stress management programs, supportive supervision, and adequate staffing to promote nurses’ well-being and enhance healthcare quality.

Table 1: Distribution of Nursing Personnel According to Demographic Characteristics (n = 60)

Demographic variable	Category	Frequency (f)	Percentage (%)
Age (years)	21-30	25	41.6
	31-40	20	33.4
	41-50	10	16.7
	Above 50	5	8.3
Gender	Female	52	86.7
Gender	Male	8	13.3
Marital Status	Married	38	63.3
Marital Status	Unmarried	22	36.7
Educational Qualification	GNM	32	53.3
	B.Sc. Nursing	20	33.4
	Post Basic B.Sc./ M.Sc. Nursing	8	13.3
Years of Experience	<5years	18	30.0
	5-10 years	25	41.6
	>10 years	17	28.4
Type of Family	Nuclear	40	66.7
Type of Family	Joint	20	33.3
Work shift	Rotational	34	56.7
	Day	16	26.6
	Night	10	16.7

Interpretation:

The data show that the majority of respondents were female nurses (86.7%), aged between 21–30 years (41.6%), and most held GNM qualifications (53.3%). Over half (56.7%) worked in rotational shifts, indicating a potential factor contributing to job stress.

Table 2: Distribution of Nursing Personnel According to Level of Job-Related Stress (n = 60)

Level of stress	Score range	Frequency (f)	Percentage (%)
Low stress	30-60	8	13.3
Moderate stress	61-90	36	60.0
High stress	91-120	16	26.7

Interpretation:

The majority of respondents (60%) experienced moderate stress, while 26.7% reported high stress, and only 13.3% had low stress levels. This indicates that job-related stress is a significant issue among nursing personnel in non-critical care units.

Table 3: Mean and Standard Deviation of Major Stress Factors (n = 60)

Stress Factor	Mean Score (out of 5)	Standard Deviation (SD)	Rank
Workload and time pressure	4.25	0.62	1
Inadequate Staffing	4.10	0.74	2
Lack of Administrative support	3.95	0.81	3
Interpersonal Conflict	3.80	0.68	4
Role Ambiguity	3.55	0.71	5
Emotional Strain from Patient Care	3.45	0.66	6
Lack of professional Recognition	3.20	0.75	7
Work –Life Imbalance	3.15	0.79	8

Interpretation:

The most significant stressors identified were workload and time pressure (Mean = 4.25) and inadequate staffing (Mean = 4.10). Other notable factors included lack of administrative support (3.95) and interpersonal conflicts (3.80).

Table 4: Coping Strategies Adopted by Nursing Personnel (n = 60)

Coping Strategy	Frequency (f)	Percentage (%)
Relaxation techniques (Yoga, Deep breathing)	40	66.7
Peer support and communication	36	60.0
Recreational activities (Music, Reading, Walking)	32	53.3
Spiritual/ religious practices	30	50.0
Time management and prioritization	28	46.7
Professional counseling	10	16.7

Interpretation:

The most common coping strategies were relaxation techniques (66.7%) and peer support (60%), whereas only 16.7% sought professional counseling, suggesting the need for formal stress management programs in the workplace.

Table 5: Association between Selected Demographic Variables and Stress Level (Chi-Square Test, n = 60)

Variable	X²value	Df	p-value	significance
Age	5.62	3	0.13	Not significant
Gender	1.12	1	0.29	Not significant
Marital Status	4.78	1	0.03	Significant
Years of experience	6.45	2	0.04	Significant
Work Shift	7.82	2	0.02	Significant
Educational Qualification	2.91	2	0.23	Not significant

Interpretation:

There was a significant association between marital status, years of experience, and work shift with the level of job stress (p<0.05). Nurses with rotational shifts and less experience reported higher stress levels, indicating the importance of structured shift schedules and mentoring for new staff.

DISCUSSION:

The present study titled “A Study to Assess the Job-Related Stress Experienced by the Nursing Personnel Working in Non-Critical Care Unit of Dhamtari Christian Hospital, Dhamtari (C.G.), with a View to Develop Guidelines on Stress Management” aimed to identify the level of job-related stress among nursing staff, explore the contributing factors, and formulate evidence-based guidelines for managing occupational stress. The discussion presented here is based on the findings obtained from the statistical analysis of the collected data and their comparison with existing literature.

The results revealed that the majority of nursing personnel (60%) experienced moderate stress, while 26.7% reported high levels of stress, and only 13.3% showed low stress levels. These findings are consistent with the study by Rajeswari and Muthamilselvi (2019), who reported that most nurses working in general wards experience moderate to severe levels of stress due to work overload and continuous patient demands. The moderate-to-high stress levels observed in the current study indicate that occupational stress is a prevalent and serious issue even in non-critical care units, where workload and administrative responsibilities remain significant despite the relatively stable patient conditions.

The analysis identified that workload and time pressure were the leading stressors among nursing personnel, followed by inadequate staffing, lack of administrative support, and interpersonal conflicts. These findings align with those of Gupta and Sharma (2020), who emphasized that insufficient manpower and excessive workloads are primary contributors to burnout and emotional exhaustion among nurses. The demanding nature of nursing work, long hours, and shift rotations place substantial psychological and physical strain on nurses, reducing their ability to maintain a healthy work-life balance.

In this study, rotational shifts were found to have a statistically significant association with stress levels (p < 0.05). Nurses working night or rotating shifts reported higher stress compared to those with fixed shifts. This result corresponds with Singh et al. (2018), who highlighted that irregular sleep patterns and night duties disrupt the circadian rhythm, leading to fatigue and stress. The implication is clear: shift scheduling should be structured to allow adequate rest and recovery, particularly for nurses in non-critical care settings where staffing is limited.

Another significant finding was the association between marital status and stress levels, suggesting that married nurses experienced higher stress compared to unmarried ones. This may be attributed to the dual burden of professional and family responsibilities. Similar findings were reported by Kumar and Devi (2017), who stated that balancing domestic duties with professional demands often leads to increased stress, particularly among female nurses. Additionally, years of experience showed a significant association with stress levels—nurses with less than five years of experience experienced greater stress, which supports the notion that coping ability improves with professional maturity and adaptation to hospital culture.

Regarding coping mechanisms, the study revealed that most nurses relied on relaxation techniques (66.7%), peer support (60%), and recreational activities (53.3%) as their primary means of managing stress. However, only 16.7% sought professional counseling. This indicates that while nurses utilize personal coping methods, institutional support for mental health remains minimal. Thomas and George (2016) emphasized that structured stress management workshops, counseling, and employee assistance programs are essential in hospitals to help nurses handle occupational pressures effectively. Therefore, the limited use of formal counseling services in this study highlights a gap in organizational mental health support.

The findings also suggest that lack of administrative recognition and poor communication between nursing staff and management significantly contribute to emotional distress. Many respondents reported feelings of undervaluation and limited opportunities for professional advancement, echoing the results of Banerjee and Mehta (2018), who found that recognition, fair appraisal, and supportive supervision are vital in reducing job stress and improving job satisfaction. The absence of these factors in the workplace creates an environment where nurses feel overworked and underappreciated; ultimately affecting both their morale and patient care outcomes.

Moreover, role ambiguity and interpersonal conflicts were identified as moderate sources of stress, consistent with the findings of Prasad and Nair (2015), who noted that unclear job roles and hierarchical conflicts contribute to tension and anxiety among nursing staff. Effective communication channels, teamwork, and clear job descriptions are therefore crucial to alleviating these stressors.

The study also highlighted the importance of developing guidelines on stress management tailored to the needs of nurses in non-critical care units. Based on the results, these guidelines should emphasize individual coping techniques—such as relaxation practices, positive thinking, and time management—while also addressing organizational factors through improved staffing, supportive supervision, and regular stress assessment programs. The combination of personal and institutional strategies ensures a holistic approach to managing workplace stress.

While the study contributes valuable insights, it also acknowledges certain limitations. It was confined to a single hospital, and the sample size was limited to 60 nurses, restricting the generalizability of the results. Future studies should include a larger and more diverse population across different healthcare settings to validate the findings further.

CONCLUSION:

The present study titled “A Study to Assess the Job-Related Stress Experienced by the Nursing Personnel Working in Non-Critical Care Unit of Dhamtari Christian Hospital, Dhamtari (C.G.), with a View to Develop Guidelines on Stress Management” was undertaken to identify the levels, sources, and impacts of occupational stress among nurses and to develop effective strategies for its management. The findings revealed that a majority of the nursing personnel experienced moderate to high levels of job-related stress, primarily due to heavy workload, inadequate staffing, time pressure, and lack of administrative support.

It was further observed that marital status, work experience, and shift patterns were significantly associated with stress levels, indicating that both personal and organizational factors influence the mental well-being of nursing personnel.

Finally, this study recommends that stress management be considered a continuous process rather than a one-time intervention. Regular monitoring, counseling, and feedback mechanisms should be implemented to ensure ongoing support and improvement.

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Received on 25.10.2025 Revised on 08.12.2025

Accepted on 12.01.2026 Published on 23.02.2026

Available online from February 28, 2026

Int. J. of Advances in Nursing Management. 2026;14(1):1-8.

DOI: 10.52711/2454-2652.2026.00001

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.