Sudan Journal of Medical Sciences · Published 2026-06-30 · DOI 10.18502/sjms.v21i2.20305
Background: Occupational stress is highly prevalent among nurses and negatively impacts care quality and workforce retention. This study aimed to explore stressors and coping mechanisms of nurses in Saudi general hospital settings using a mixed-methods design. Methods: A mixed-methods approach was used in this study, with a total of 150 nurses completing a structured survey (quantitative component), and 18 nurses providing qualitative open-ended responses. Quantitative data were collected using a 20-item questionnaire adapted from validated instruments, including items derived from the Nursing Stress Scale (NSS) and the Brief COPE inventory. Qualitative data were obtained through open-ended questions exploring lived experiences. Results: Frequent stressors included inadequate staffing (68%), heavy workload (62%), and conflicts with physicians (47%). Nurses commonly used emotion-focused (66%) and problem-focused coping (58%), while avoidant coping was least frequent (72% “a little bit”). Stress correlated positively with avoidant coping (r = 0.27, P = 0.001) and weekly hours (r = 0.21, P = 0.009), but negatively with years of experience (r = –0.21, P = 0.010). Problem- and emotion-focused coping were strongly related (r = 0.82, P < 0.001). Regression showed stress predicted avoidant coping (β = 0.27, R² = 0.074), and years of experience negatively predicted stress (β = –0.20, P = 0.017; R² = 0.066). Qualitative themes included workload pressure, emotional strain, reliance on support, and spirituality, with some contradictions between survey and narratives on avoidant coping. Notably, although avoidant coping was the least commonly endorsed overall, nurses experiencing higher stress levels showed greater reliance on whatever avoidant strategies they did employ, suggesting that even infrequent avoidant behavior may intensify proportionally under greater occupational burden. Conclusion: Nurses face multiple stressors that affect well-being and patient care. The integration of quantitative and qualitative findings underscores the need for institutional stress management programs and supportive policies to enhance coping and retention.
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Alrasheadi, B. (2026). Stressors and Coping Mechanisms of Nurses in Saudi General Hospital Settings: A Mixed-Methods Study. Sudan Journal of Medical Sciences. https://doi.org/10.18502/sjms.v21i2.20305