Ghanei Gheshlagh Reza, Mukhtar Madiha, Asmat Kainat, Sharafi Simin
Lahore School of Nursing, The University of Lahore, Lahore, Pakistan.
Nursing Department, Biruni University, Istanbul, 34010, Turkey.
BMC Nurs. 2025 Mar 31;24(1):347. doi: 10.1186/s12912-025-02985-2.
Occupational stress in the nursing profession is higher than in many other occupations, significantly impacting nurses' physical and mental health, job satisfaction, and the quality of patient care. It often leads to burnout and the decision to leave the profession. Various studies conducted in Pakistan have reported different findings. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of occupational stress among nurses in Pakistan.
Databases such as Scopus, Medline, Web of Science, EMBASE, and CINAHL were searched, including studies published from 2000 to September 2024. The screening process, article selection, data extraction, and quality assessment were all conducted independently by two authors. Any disagreements were resolved through consultation. Heterogeneity among studies was assessed using the I² statistic and Cochran's Q test. Subgroup analysis based on the study location (city) was performed. The relationship between occupational stress prevalence and publication year and sample size was evaluated using meta-regression. Publication bias was assessed using funnel plots and the Egger test. All analyses were conducted using a random-effects model with Stata software version 17.
Eleven studies with a sample size of 1636 participants were included. The prevalence of mild, moderate, and severe occupational stress was 16% (95% CI: 10-21), 48% (95% CI: 36-61), and 30% (95% CI: 20-41) respectively. The prevalence of mild occupational stress was highest in other cities, moderate stress was most common in Lahore, and severe stress was more prevalent in Karachi. No significant relationship was found between occupational stress prevalence and publication year or sample size. Publication bias for mild and severe occupational stress was significant, but the trim-and-fill analysis showed no impact on the results. Sensitivity analysis confirmed the stability of the findings.
This meta-analysis estimates the high prevalence of occupational stress among nurses in Pakistan, with moderate stress being most common. Differences in stress levels between cities may be influenced by local factors. Despite publication bias, the results remain stable and reliable, emphasizing the need for addressing occupational stress to enhance nurse well-being and patient care quality.
护理行业的职业压力高于许多其他职业，对护士的身心健康、工作满意度以及患者护理质量产生重大影响。这常常导致职业倦怠和离职的决定。巴基斯坦进行的各种研究报告了不同的结果。因此，本系统评价和荟萃分析旨在估计巴基斯坦护士职业压力的合并患病率。
检索了Scopus、Medline、Web of Science、EMBASE和CINAHL等数据库，纳入2000年至2024年9月发表的研究。筛选过程、文章选择、数据提取和质量评估均由两位作者独立进行。任何分歧都通过协商解决。使用I²统计量和Cochran's Q检验评估研究之间的异质性。基于研究地点（城市）进行亚组分析。使用meta回归评估职业压力患病率与发表年份和样本量之间的关系。使用漏斗图和Egger检验评估发表偏倚。所有分析均使用Stata软件17版的随机效应模型进行。
纳入了11项研究，样本量为1636名参与者。轻度、中度和重度职业压力的患病率分别为16%（95%CI：10 - 21）、48%（95%CI：36 - 61）和30%（95%CI：20 - 41）。轻度职业压力的患病率在其他城市最高，中度压力在拉合尔最常见，重度压力在卡拉奇更普遍。未发现职业压力患病率与发表年份或样本量之间存在显著关系。轻度和重度职业压力的发表偏倚显著，但剪补法分析显示对结果无影响。敏感性分析证实了研究结果的稳定性。
本荟萃分析估计巴基斯坦护士职业压力患病率较高，其中中度压力最为常见。城市之间压力水平的差异可能受当地因素影响。尽管存在发表偏倚，但结果仍然稳定可靠，强调需要解决职业压力以提高护士的幸福感和患者护理质量。
