Distress Tolerance and Factors Affecting It among Nurses Working in the COVID-19 Intensive Care Unit
Abstract
Background: Nurses, as professionals in the caring profession, try to perform safe and effective nursing interventions all the time and support patients to achieve the most favorable treatment outcomes. Nowadays, one of the important and international issues in nursing is distress tolerance. This study aimed to determine distress tolerance and affecting it among nurses working in the COVID-19 intensive care unit.
Methods: This study is cross-sectional. The sample consisted of 128 nurses working in the intensive care unit. A non-randomized convenience sampling method was used to select the samples based on the inclusion criteria. The data collection instruments included two questionnaires: a demographic characteristics questionnaire and a standardized distress tolerance questionnaire. The data were analyzed using SPSS software version 25, employing both descriptive and inferential statistical tests.
Results: The mean age of the samples was 34.95 ± 6.77 years. The highest scores of distress tolerance subscales included appraisal (17.89±3.62), tolerance (8.97±2.60), absorption (8.83±2.30), and regulation (2.25 ±8.39), respectively. The statistical test of linear regression showed that service history and shift work have a significant power to predict nurses' distress tolerance.
Conclusion: The distress tolerance of nurses working in the ICU units was low. Factors such as service history and shift work influence their distress tolerance. Accordingly, it is necessary to plan to improve nurses' distress tolerance.
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[16] Takhayori M, Fakhri M, Hasanzadeh R. The mediating role of cognitive emotion regulation in the relationship between object relationships and emotional distress tolerance in nursing students of Tehran University. Iran J Med Educ. 2021; 21(0):297-307.
[17] Hodaei NA, Ahadi B, Farah Bijari A. Relationship between personality traits and coping styles with distress tolerance during coronavirus outbreak. Shenakht J Psychol Psychiatry. 2022;8(6):37-49. Available from: http://shenakht.muk.ac.ir/article-1-1252-fa.html
[18] Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020; 88:901-7.
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[20] Taghizadeh F, Hassannia L, Moosazadeh M, Zarghami M, Taghizadeh H, Dooki AF, et al. Anxiety and depression in health workers and general population during covid-19 epidemic in IRAN: A web-based cross-sectional study. MedRxiv. 2020.
[21] Mirhosseini SH, Nouhi Sh, Janbozorgi M, Mohajer HA, Naseryfadafan M. The role of spiritual health and religious coping in predicting death anxiety among patients with coronavirus (Persian). Stud Islam Psychol. 2020;14(26):29-42. Available from: http://islamicpsy.rihu.ac.ir/article_1776_en.html
[22] Gillespie BM, Chaboyer W, Wallis M. The influence of personal characteristics on the resilience of operating room nurses: a predictor study. Int J Nurs Stud. 2009; 46(7):968-76.
[23] Melnyk BM, Hsieh AP, Tan A, Teall AM, Weberg D, Jun J, et al. Associations Among Nurses' Mental/Physical Health, Lifestyle Behaviors, Shift Length, and Workplace Wellness Support During COVID-19: Important Implications for Health Care Systems. Nurs Adm Q. 2022; 46(1):5-18.
[24] Sirati Nir M, Karimi L, Khalili R. The Perceived Stress Level of Health Care and Non-Health Care in Exposed to COVID-19 Pandemic. IJPCP. 2020; 26 (3):294-305. Available from: http://ijpcp.iums.ac.ir/article-1-3217-fa.html
[25] Du J, Dong L, Wang T, Yuan C, Fu R, Zhang L, et al. Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan. Gen Hosp Psychiatry. 2020; 63:1-9.
[26] Allsopp K, Brewin CR, Barrett A, Williams R, Hind D, Chitsabesan P, et al. Responding to mental health needs after terror attacks. BMJ. 2019; 366: l4828.
[27] Amin S. The psychology of coronavirus fear: are healthcare professionals suffering from corona-phobia? Int J Healthcare Manag. 2020; 13(3):249–56.
[28] Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020; 88:901–7.
[29] Zvolensky MJ, Vujanovic AA, Bernstein A, Leyro T. Distress tolerance: Theory, measurement, and relations to psychopathology. Curr Dir Psychol Sci. 2010; 19(6):406-10.
[30] Falavarjani MF, Yeh CJ. Optimism and distress tolerance in the social adjustment of nurses: examining resilience as a mediator and gender as a moderator. J Res Nurs. 2019; 24(7):500-12.
[31] Abd El Salam RM, El Kholy SEH. Factors Associated with Distress Tolerance among Community Dwelling Older Adults. Alex Sci Nurs J. 2017; 19(2):37-56.
[32] Saksvik‐Lehouillier I, Bjorvatn B, Hetland H, Sandal GM, Moen BE, Magerøy N, et al. Individual, situational and lifestyle factors related to shift work tolerance among nurses who are new to and experienced in night work. J Adv Nurs. 2013; 69(5):1136-46.
[33] Burch JB, Tom J, Zhai Y, Criswell L, Leo E, Ogoussan K. Shiftwork impacts and adaptation among health care workers. Occup Med. 2009; 59(3):159-66
[34] Winwood PC, Winefield AH, Lushington K. Work-related fatigue and recovery: the contribution of age, domestic responsibilities and shiftwork. J Adv Nurs. 2006; 56(4):438-49.
[35] Ansari Shahidi M, Tat M, Badrizadeh A, Maleki S. The role of ethical intelligence and professional value in predicting nurses'resilience. Yafteh. 2018; 20(3):77-86.
[36] Gillespie BM, Chaboyer W, Wallis M. The influence of personal characteristics on the resilience of operating room nurses: a predictor study. Int J Nurs Stud. 2009; 46(7):968-76.
[37] Afshari D, Nourollahi-darabad M, Chinisaz N. Psychosocial Factors Associated with Resilience Among Iranian Nurses During COVID-19 Outbreak. Front Public Health. 2021; 9:714971.
[2] Azizmohammadi S, Rakebi N, Kamran Koochesfehani S, Asadi H. Role of self-compassion and distress tolerance in the social health of female household heads (Persian). Middle East J Disabil Stud. 2019; 9:56. Available from: http://jdisabilstud.org/article-1-1462-en.html
[3] Bardeen JR, Fergus TA, Orcutt HK. Examining the specific dimensions of distress tolerance that prospectively predict perceived stress. Cogn Behav Ther. 2017; 46(3):211-23.
[4] Grulke N, Larbig W, Kächele H, Bailer H. Distress in patients undergoing allogeneic haematopoietic stem cell transplantation is correlated with distress in nurses. Eur J Oncol Nurs. 2009;13(5):361-7.
[5] Jackson J. Commentary: Optimism and distress tolerance in the social adjustment of nurses: examining resilience as a mediator and gender as a moderator. J Res Nurs. 2019; 24(7):513-4.
[6] Pouraboli B, Esfandiari S, Ramezani T, Miri S, Jahani Y, Sohraby N. Effectiveness of their teaching skills to reduce stress job psychological empowerment of nursing staff in intensive care units in the center of Shiraz Shahid Rajaee 1392. J Clin Nurs Midwifery. 2016; 5(1):23-35.
[7] Waldron HA. Occupational health practice: Butterworth-Heinemann; 2013.
[8] Pashaee S, Lakdizaji S, Rahmani A, Zamanzadeh V. Priorities of caring behaviors from critical care nurse’s viewpoints. Prev Care Nurs Midwifery J. 2014; 4(1):65-73.
[9] Kushali AN, Hajiamini Z, Ebadi A, Khamseh F, Rafieyan Z, Sadeghi A. Comparison of Intensive Care Unit and General Wards Nurse's Emotional Reactions and Health Status. Adv Nurs Midwifery. 2013; 23(80):15-23.
[10] Liu C-Y, Yang Y-z, Zhang X-M, Xu X, Dou Q-L, Zhang W-W, et al. The prevalence and influencing factors in anxiety in medical workers fighting COVID-19 in China: a cross-sectional survey. Epidemiol Infect. 2020;148.
[11] Arnetz JE, Goetz CM, Arnetz BB, Arble E. Nurse Reports of Stressful Situations during the COVID-19 Pandemic: Qualitative Analysis of Survey Responses. Int J Environ Res Public Health. 2020; 17(21):8126.
[12] Kang L, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav Immun. 2020, 87, 11–17.
[13] Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020; 3(3):e203976 .
[14] Varghese A, George G, Kondaguli SV, Naser AY, Khakha DC, Chatterji R. Decline in the mental health of nurses across the globe during COVID-19: A systematic review and meta-analysis. J Glob Health. 2021 Apr 10; 11:05009. J Glob Health. 2021; 11:05009.
[15] Shams J, Azizi A, Mirzaei A. Correlation between distress tolerance and emotional regulation with students smoking dependence. Hakim Journal. 2010 Apr 10;13(1):11-8.
[16] Takhayori M, Fakhri M, Hasanzadeh R. The mediating role of cognitive emotion regulation in the relationship between object relationships and emotional distress tolerance in nursing students of Tehran University. Iran J Med Educ. 2021; 21(0):297-307.
[17] Hodaei NA, Ahadi B, Farah Bijari A. Relationship between personality traits and coping styles with distress tolerance during coronavirus outbreak. Shenakht J Psychol Psychiatry. 2022;8(6):37-49. Available from: http://shenakht.muk.ac.ir/article-1-1252-fa.html
[18] Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020; 88:901-7.
[19] Kaveh M, Davari-tanha F, Varaei S, Shirali E, Shokouhi N, Nazemi P, et al. Anxiety levels among Iranian health care workers during the COVID-19 surge: A cross-sectional study. MedRxiv. 2020.
[20] Taghizadeh F, Hassannia L, Moosazadeh M, Zarghami M, Taghizadeh H, Dooki AF, et al. Anxiety and depression in health workers and general population during covid-19 epidemic in IRAN: A web-based cross-sectional study. MedRxiv. 2020.
[21] Mirhosseini SH, Nouhi Sh, Janbozorgi M, Mohajer HA, Naseryfadafan M. The role of spiritual health and religious coping in predicting death anxiety among patients with coronavirus (Persian). Stud Islam Psychol. 2020;14(26):29-42. Available from: http://islamicpsy.rihu.ac.ir/article_1776_en.html
[22] Gillespie BM, Chaboyer W, Wallis M. The influence of personal characteristics on the resilience of operating room nurses: a predictor study. Int J Nurs Stud. 2009; 46(7):968-76.
[23] Melnyk BM, Hsieh AP, Tan A, Teall AM, Weberg D, Jun J, et al. Associations Among Nurses' Mental/Physical Health, Lifestyle Behaviors, Shift Length, and Workplace Wellness Support During COVID-19: Important Implications for Health Care Systems. Nurs Adm Q. 2022; 46(1):5-18.
[24] Sirati Nir M, Karimi L, Khalili R. The Perceived Stress Level of Health Care and Non-Health Care in Exposed to COVID-19 Pandemic. IJPCP. 2020; 26 (3):294-305. Available from: http://ijpcp.iums.ac.ir/article-1-3217-fa.html
[25] Du J, Dong L, Wang T, Yuan C, Fu R, Zhang L, et al. Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan. Gen Hosp Psychiatry. 2020; 63:1-9.
[26] Allsopp K, Brewin CR, Barrett A, Williams R, Hind D, Chitsabesan P, et al. Responding to mental health needs after terror attacks. BMJ. 2019; 366: l4828.
[27] Amin S. The psychology of coronavirus fear: are healthcare professionals suffering from corona-phobia? Int J Healthcare Manag. 2020; 13(3):249–56.
[28] Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020; 88:901–7.
[29] Zvolensky MJ, Vujanovic AA, Bernstein A, Leyro T. Distress tolerance: Theory, measurement, and relations to psychopathology. Curr Dir Psychol Sci. 2010; 19(6):406-10.
[30] Falavarjani MF, Yeh CJ. Optimism and distress tolerance in the social adjustment of nurses: examining resilience as a mediator and gender as a moderator. J Res Nurs. 2019; 24(7):500-12.
[31] Abd El Salam RM, El Kholy SEH. Factors Associated with Distress Tolerance among Community Dwelling Older Adults. Alex Sci Nurs J. 2017; 19(2):37-56.
[32] Saksvik‐Lehouillier I, Bjorvatn B, Hetland H, Sandal GM, Moen BE, Magerøy N, et al. Individual, situational and lifestyle factors related to shift work tolerance among nurses who are new to and experienced in night work. J Adv Nurs. 2013; 69(5):1136-46.
[33] Burch JB, Tom J, Zhai Y, Criswell L, Leo E, Ogoussan K. Shiftwork impacts and adaptation among health care workers. Occup Med. 2009; 59(3):159-66
[34] Winwood PC, Winefield AH, Lushington K. Work-related fatigue and recovery: the contribution of age, domestic responsibilities and shiftwork. J Adv Nurs. 2006; 56(4):438-49.
[35] Ansari Shahidi M, Tat M, Badrizadeh A, Maleki S. The role of ethical intelligence and professional value in predicting nurses'resilience. Yafteh. 2018; 20(3):77-86.
[36] Gillespie BM, Chaboyer W, Wallis M. The influence of personal characteristics on the resilience of operating room nurses: a predictor study. Int J Nurs Stud. 2009; 46(7):968-76.
[37] Afshari D, Nourollahi-darabad M, Chinisaz N. Psychosocial Factors Associated with Resilience Among Iranian Nurses During COVID-19 Outbreak. Front Public Health. 2021; 9:714971.
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How to Cite
1.
Dehghani Firoozabadi M, Mirzaee S, Shamsi A. Distress Tolerance and Factors Affecting It among Nurses Working in the COVID-19 Intensive Care Unit. Arch Anesth & Crit Care. 2025;.
