How Do Nurses Manage their Health under Multiple Crises? A Cross-Sectional Observational Study

Background: Nurses are at the frontline of healthcare, particularly during crises such as pandemics, disasters, and socio-political conflicts. These situations place significant physical and psychological demands on nurses, potentially affecting their health and well-being. Limited data exist on the specific health outcomes experienced by nurses under crisis conditions. Lebanon has witnessed in the past years unprecedented economic crisis, the COVID pandemic and the third largest explosion in history. Objective: The study aims to: 1) determine the prevalence of non-communicable diseases, depression and related risk factors among Lebanese nurses; 2) identify the nurses’ attitudes and practices of health promotion; and 3) determine factors associated with depressive symptoms in the sample. Methods The study design was descriptive cross sectional. A convenience national sample of 885 working nurses was recruited. Data were collected through online survey on nurses’ personal and family health history, bio-behavioral risk factors, depressive symptoms measured by the Patient Health Questionnaire-9, practices and attitudes towards health promotion, work conditions and demographic characteristics. Descriptive statistics, bivariate and multivariable linear regression analyses were done. Results: Majority of the nurses were females, aged 30-49 years, married and worked in hospitals. The most frequent health conditions were low back pain and depression. More than one third of the sample screened positive for depression. The nurses did not meet the recommendations for healthy eating, physical activity, smoking and health screening. They reported confidence in assuming healthy lifestyle and ability to counsel their patients. PHQ-9 scores were significantly associated with age, marital status, health indicators and health promotion variables, number of hours worked per week and frequency of night shifts. The multivariable regression showed that older age, being confident in assuming healthy lifestyle, positive health perception, and longer hours of sleep predicted lower scores on PHQ-9 whereas history of depression predicted higher scores. Conclusions: The findings raise concern about the prevalence of depressive symptoms and low back pain among nurses, their unhealthy lifestyle and the negative association of depressive symptoms with their perceived health and lifestyle. Occupational health promotion programs are recommended to ensure nurses can function to their full capacity and maintain their health.