Stress and Coping in Nurses Taking Care of People Living with HIV in Hunan, China: A Descriptive Qualitative Study

Chen Pan; Honghong Wang; Minzhen Chen; Yu Cai; Peihuan Li; Changgen Xiao; Qiuping Tang; Deborah Koniak-Griffin

doi:10.2147/NDT.S341151

Stress and Coping in Nurses Taking Care of People Living with HIV in Hunan, China: A Descriptive Qualitative Study

Neuropsychiatr Dis Treat. 2022 Feb 17:18:303-315. doi: 10.2147/NDT.S341151. eCollection 2022.

Authors

Chen Pan¹, Honghong Wang², Minzhen Chen³, Yu Cai¹, Peihuan Li⁴, Changgen Xiao⁵, Qiuping Tang¹, Deborah Koniak-Griffin⁶

Affiliations

¹ Department of Clinical Psychology, The Third Xiangya Hospital of Central South University, Changsha, People's Republic of China.
² Department of Fundamental Nursing, Xiangya School of Nursing, Central South University, Changsha, People's Republic of China.
³ Department of AIDS, The First Hospital of Changsha, Changsha, People's Republic of China.
⁴ College of Resources of Environment, Hunan Agricultural University, Changsha, People's Republic of China.
⁵ Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, People's Republic of China.
⁶ School of Nursing, University of California Los Angeles, Los Angeles, CA, USA.

Abstract

Background/purpose: Nurses engaged in the care of people living with HIV (PLWH) are commonly exposed to workplace stress. This study aimed to explore the stress experiences and coping strategies among nurses taking care of PLWH in China.

Methods: Nurses were recruited from the AIDS department of a public, general, third-grade class-A hospital, which has the largest HIV care department in the Hunan Province of China. Thirty-three nurses working in the AIDS Department were recruited in this qualitative study. Eight nurses participated in a focus group and 25 nurses underwent in-depth individual interviews aimed at characterizing the nurse's feelings and struggles with stress during caregiving for PLWH. The interviews were audio-recorded, transcribed verbatim, anonymized, and imported into NVivo 8.0 software. The data were coded and subjected to thematic analysis.

Results: Concerns about occupational exposure, heavy workload, mental health problems and risk behaviors of patients, and discrimination towards nurses caring for PLWH were the four main sources of stress. The negative impact of stress included problems with emotion regulation, somatic health and sleep, and work performance. Some participants also reported a positive impact of work stress on their mental health. Using personality strengths, problem-solving, help-seeking, concealing and avoiding/suppression were common coping strategies employed by nurses caring for PLWH.

Conclusion: Our findings help characterize the stress experienced by nurses caring for PLWH in the Chinese cultural context, and may inform specific interventions to help manage stress and promote mental health of nurses.

Keywords: HIV; coping; job burnout; nurses; stress.

Grants and funding

This research was supported by the Natural Science Foundation of Hunan Province (grant no. 2020JJ4845), Changsha Science and Technology Bureau (grant no. kq1901127), and NIH-FIC Fogarty International Center (grant # D43 TW009579). The study sponsors did not participate in any study activity including study design; data collection, management, analysis, and interpretation; report writing; the decision to submit the report for publication; and will have no ultimate authority over any of these activities.