Frontline Nurses’ Stress, Sleep Quality, and Temperament During the COVID-19 Pandemic: An Intervention Study using Resilience Training and Comics Programs

Abstract

Introduction: There are rising worries regarding stress among frontline nurses during COVID-19 worldwide, especially in Iran. The purpose of this study, first, is to assess stress and other physiological indicators of stress. Then, we investigated the effect of cognitive intervention on the stress level of frontline nurses.

Material & Methods: In this study, we assessed stress, depression, anxiety, temperament, PSQI, and salivary cortisol levels among 120 voluntary nurses in a military hospital in Tehran, Iran, during COVID-19 (Wave V) using a cognitive intervention, stress level changes were investigated in the following.

Results: Surprisingly, on the first and 28th day, most participants reported stress and anxiety at a normal level in (p > 0.05). There was a significant difference between the control and intervention groups regarding the salivary cortisol level (p < 0.0001) and the severity of depression in DASS-21 (p = 0.0196) on the 28th day. More than eighty percent of nurses reported poor sleep quality. In the general temperament, most participants showed a warm and temperate temperament, while in the brain temperament, the majority exhibited a warm and dry.

Conclusion: The results showed that participants did not have stress and anxiety. At the same time, we noticed a reduction in salivary cortisol and depression levels after the intervention using our cognitive-behavioral therapy technique. Also, subjects showed poor sleep quality. The majority of participants had warm and dry brain temperaments.