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Stress in nursing staff: a comparative analysis between intensive care units and general medicine units

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It's a current belief that stress is an outstanding feature of intensive care units, in particular within nursing staff. The aim of this study was to compare some variables belonging to stress (i.e. anxiety, depression and `Burnout' syndrome) between nurses working in intensive care units (ICUs) and general medicine units (GMUs).

Materials and methods

We studied a population of 883 nurses working in ICUs, distributed in 79 Italian hospitals (70.1 % female) and 509 nurses working in GMUs, distributed in 35 Italian hospitals (80.2 % female). We asked them to fill in a form including: 1) general data and his/her work environment; 2) different evaluation standardized scales - the Hospital Anxiety and Depression Scale, divided into anxiety (HAD A) and depression (HAD D) status 0-7 `non cases', 8-10 `doubtful cases', 11-21 `cases'; the S.T.A.I. scale, divided into acute anxiety (Y-1) and chronic anxiety (Y-2) status; the Maslach Burnout Inventory-Human Services Survey (MBI.) divided into Emotional Exhaustion (EE), ≤ 18 `low', 19-26 `average', ≥ 27 `high', Depersonalization (DP) and Personal Accomplishment (PA). We also evaluated the different reasons of anxiety through individual questions (higher value, more anxiety): A1, a critically ill patient; A2, a young patient; A3, an old patient; A4, a suicidal patient; A5, a terminal patient; A6, presence of mechanical supports; A7, relationship with patients' relatives. The comparison between the two groups was performed by the Mann-Whitney Rank Sum test and z-test; statistical significance was accepted as P<0.05.


The results, expressed as median value, with 25th and 75th percentile in brackets, are shown in Tables 1 and 2.

Table 1 also shows the proportions of nurses that had a highest value of HAD A and M.B.I. EE.


Pathologic anxiety and emotional exhaustion are more prevalent in nurses working in GMUs. Thus, contrary to a common belief, `stress' is a more distinctive peculiarity of general medicine units than intensive care units.

Table 1
Table 2

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Chiumello, D., Caironi, P., Pelosi, P. et al. Stress in nursing staff: a comparative analysis between intensive care units and general medicine units. Crit Care 4 (Suppl 1), P232 (2000).

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