An Assessment of Anxiety, Depression, and Coping Strategies among Nurses: A Case of Pumwani Maternity Hospital, Nairobi, Kenya

Abstract

Frontline healthcare workers, particularly nurses in high-stress environments such as maternity hospitals, are highly vulnerable to psychological distress due to demanding workloads, emotional exhaustion, and limited institutional support. This study assessed the prevalence of anxiety and depression, identified factors contributing to psychological distress, explored coping strategies, and examined the relationship between anxiety, depression, and coping mechanisms among nurses at Pumwani Maternity Hospital, Nairobi, Kenya. A descriptive cross-sectional design employing a mixed-methods approach was utilized. Data were collected from 93 respondents through a researcher-developed questionnaire comprising both quantitative and qualitative items. Quantitative data were analyzed using descriptive statistics, Spearman correlation, and regression analysis, while qualitative data were analyzed thematically. The study revealed a high prevalence of depression and anxiety among nurses. According to the Beck’s Depression Inventory, the majority of respondents experienced mild to moderate depressive symptoms, while results from the Generalized Anxiety Disorder (GAD-7) scale showed that most nurses reported mild to severe anxiety. Qualitative findings indicated that the main contributors to anxiety and depression included heavy workload, staff shortages, delayed salaries, inadequate resources, poor management support, and financial and family pressures. These factors were compounded by the emotionally demanding nature of maternity nursing, which often involves critical and distressing patient situations.Findings further showed that nurses employed a range of coping mechanisms, predominantly adaptive strategies such as planning, acceptance, teamwork, prayer, and emotional support, although some also resorted to maladaptive approaches such as self-blame and withdrawal. Correlation and regression analyses demonstrated a significant positive relationship between anxiety and depression, as well as between these psychological conditions and coping strategies, indicating that emotional distress strongly influences coping behavior. The study concluded that while nurses at Pumwani Maternity Hospital exhibit resilience through various coping mechanisms, their mental health is adversely affected by institutional and personal stressors. It recommends that the hospital management and the Ministry of Health establish comprehensive mental health support systems, including regular psychological screening, counseling services, stress management training, and improved working conditions. Strengthening institutional and social support frameworks is essential to enhance nurses’ psychological well-being, reduce burnout, and improve the quality of maternal healthcare services