Introduction
The organisational structure, work content, and environment contribute to occupational injuries [1, 2]. Occupational injuries are common among health workers; it has been a growing concern among hospital nurses in recent years. In addition to threatening nurses’ well-being, these injuries significantly impact care delivery [3, 4]. Occupational injuries arise from strains, slips, infections, broken bones and blood-borne infectious diseases and are characterised by changes in workers that cause them to diverge from their usual course of action [5‐7]. These injuries can result from biological, chemical, physical, ergonomic, psychosocial, fire or explosions, and electrical, threatening health workforces’ lives and safety.
Globally, 1 in 10 healthcare workers experience an occupational injury yearly [8]. Nurses and midwives also complain of traumatic lower back pain, strains, needle pricks, and contact with blood and other body fluids. In addition to their injuries, some nurses complain of other life-threatening severe complications such as HIV/AIDS and Hepatitis B infections [9, 10]. Again, nurses are often subjected to physical and verbal abuse by patients and their family members. Not only do nurses face immediate harm, but their psychological well-being is also negatively affected by this [11].
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A primary cause of occupational injuries among nurses is a lack of proper equipment and resources, including gloves, masks, and gowns [12, 13]. Again, nurses are often overworked and fatigued due to high workloads, long working hours, and a shortage of resources. Ahmadi et al. [14] assert that occupational injuries arise when nurses cannot cope with work stress because of workloads and daily demands. There is a sense that individuals perceive their added responsibilities and tasks as too much to handle.
In such circumstances, nurses’ decision-making abilities are impaired in clinical settings, which increases accidents and injuries [15, 16]. Occupational injuries, also decrease employee productivity and work hours and increase medical expenses [4, 17]. Occupational injuries can be costly, not just because of physical pain, but because high incidences may cause missed work days, decreased productivity, and increased healthcare expenses. It is estimated that occupational injuries alone cost the United States healthcare system between 175 and 350USD in direct and indirect costs. These costs place a financial burden on employers and employees alike [18]. As a result of injury, nurses may experience psychological distress, leading to burnout and even leaving nursing [7, 19].
Healthcare organisations in high-resourced countries have substantially reduced occupational injuries by creating an ergonomic work environment that supports nurses’ mental well-being [20, 21]. Suggestions to improve the mental well-being of nurses have been made in high-resourced countries such as China [22], Spain [23], the United Kingdom [4] and the United States [24].
Meanwhile, one of the key factors associated with increased occupational injuries among nurses in sub-Saharan Africa (SSA) is mental workload. This refers to the cognitive and psychological demands placed on individuals in their work environment. Thus, the amount of mental effort required for workers to complete tasks. It encompasses high workload, time pressure, decision-making complexity, and emotional labour [25, 26]. Numerous factors may influence mental workload, including task demands, external support, workers’ cognition, and experience. In the healthcare sector, nurses are often subjected to intense mental work demands due to the nature of their work, including patient care, documentation, multitasking, and managing critical situations [27, 28].
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As a result of mental workload, physical skills are affected, leading to fatigue and functional errors, contributing to occupational injuries [17, 29, 30]. A high mental workload can also lead to cognitive overload, impairing nurses’ ability to concentrate and make quick decisions. This, in turn, increases the risk of errors (adverse events and near misses), potentially resulting in injuries to both nurses and patients. Mental workload, by extension, can also affect the social life of nurses [31, 32].
While physical demands and workplace hazards have been extensively studied [33‐35], the influence of mental workload on occupational injuries remains relatively unexplored. Despite the lack of research on the relationship between mental workload and occupational injuries, few studies have examined individual concepts in healthcare.
Recognising the impact of high mental workload is essential for healthcare organisations to implement preventive measures and coping strategies that address nursing work’s cognitive, emotional, and physiological aspects. By reducing mental workload and providing support, the risk of occupational injuries can be minimised [36], ensuring a safer working environment for nurses and better patient outcomes. Iddrisu et al. [37] explain that individuals use several coping strategies to buffer or tolerate the impact of stressful situations. While cognitive coping strategies, such as positive reframing and cognitive restructuring, have helped nurses reframe their thoughts and perceptions in reducing stress and the mental workload [38], prioritising self-care activities such as regular exercise, adequate sleep, and healthy eating can also significantly reduce the mental workload of nurses [39].
The mental workload experienced by nurses can have profound implications for their well-being and the quality of patient care they provide. Therefore, identifying effective coping strategies is essential in reducing nurses’ mental workload and promoting their overall well-being. Thus, the study examined the association between mental workload, occupational injuries, and nurses’ coping strategies.
Methods and materials
Study design and settings
The study adopted a multi-centre cross-sectional design to examine the influence of mental workload on occupational injuries and the coping strategies used by the nursing workforce. The study was conducted in 6 hospitals in four Districts (Akuapem North, Yilo Krobo, Lower Manya Krobo and Asugyaman) in the Eastern Region of Ghana. These facilities provide preventive and curative services like maternal and child health, laboratory, and outpatient department consultation services. The six hospitals had an estimated nursing workforce of 1400 [40].
Population of the study
The target population included all nursing workforce in the six hospitals in the Eastern Region of Ghana. To be eligible for the study, participants must have worked at least 1 year in a hospital. They must have given direct care to at least one patient per shift and provided written consent.
Sampling
To achieve an 80% power, with an alpha set of 0.05 and a small effect size set at 0.04, the sample size was estimated using the G*power programme software version 3.1.9.7 [41]. The sample size was initially calculated using power estimates for five regression-analysis predictors. Three hundred ninety nurses were invited to participate in the survey; however, only 317 nurses responded (81.3%). Multi-stage sampling was used to select participants. Four [4] districts were randomly selected among 33 districts, and six hospitals were chosen for the study. A proportionate stratified sampling was used to assign a sample to each hospital [Facility A − 112, Facility B − 130, Facility C − 92, and Facility D − 56]. Participants were conveniently sampled for the study.
Instrumentation
Occupational injuries
Occupational injuries among nurses were assessed using researcher-designed questionnaires through a search of related literature on the subject [17, 42, 43]. There were six [6] items related to injuries suffered by participants in the healthcare setting, which included ‘Needle Prick Injuries’, ‘Sharps Injuries’, ‘Blood and Body Fluid Exposure’, ‘Drugs and Chemical Splash’, ‘Back pain resulting from Patient-Handling Task’ and ‘Slips and Falls’. The responses to the items were dichotomised into Yes or No. The items were scored on an individual basis. The tool was pre-tested using a facility with similar characteristics to identify culturally sensitive and wrong-worded statements before the primary data collection. All culturally sensitive questions were revised to the Ghana setting before being used. The pre-test tool showed an internal consistency of 0.85 and, therefore, fit to be used for the study. The tool is attached as a supplementary file.
Mental workload
Using the NASA Task Load Index (NASA-TLX) scale [44], the mental workload as perceived by the participants was measured. NASA-TLX assesses and conducts subjective mental workload assessments. The NASA-TLX is a six-item scale that measures how much mental demands (e.g., “thinking, deciding, calculating, remembering, looking, searching”), physical demands (e.g., “pushing, pulling, turning, controlling, activating”), temporal demands (e.g., “time pressure due to the task load”), frustration (e.g., “feeling insecure, discouraged, irritated, stressed, and annoyed”), effort (e.g., “mental and physical effort to accomplish the required tasks”), and performance (“job satisfaction and performance”) are needed to perform tasks at the workplace. We calculated the unweighted average of the six items to create the overall perceived workload score. Multi-step bipolar scales determine the ratings for all of these dimensions. Consequently, possible scores are converted to a scale of 0 to 100. The higher the rate, the greater the mental workload. Past studies reported acceptable Cronbach’s Alpha values between 0.72 and 0.89 for the scale [27, 28, 45‐47]. The validity and reliability coefficient after pre-testing this scale was 0.84.
Coping strategies
Carver’s Brief COPE scale [48] was used to measure the coping strategies used by the participants. The scale comprises 28 items and 14 subscales with two items each. The scale is measured on a 4-point Likert scale (1 = I haven’t been doing this at all, 4 = I’ve been doing this a lot). It categorises the strategies into 14 sub-scales: active coping, planning, positive reframing, acceptance, humour, self-distraction, active emotional support, venting, instrumental support, religion, substance abuse, behavioural disengagement, denial and self-blame. By adding the items and dividing them by 2, we calculated the mean score for each coping strategy. In previous studies, the scale has been reported to have good discriminant and convergent validity and a reliability score between 0.63 and 0.84 [38, 49, 50]. The scale was pre-tested and yielded a Cronbach Alpha of 0.82.
Data collection procedure
After administrative approval from the management of the various hospitals, participants were conveniently selected, and the questionnaire was distributed after the purpose of the study and instructions on how to complete the questionnaire were explained to them. Data were collected between June and September 2022.
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Data analysis
Using the Statistical Package for Social Sciences (SPSS) version 26, the data was analysed using descriptive and inferential statistics. Frequencies, percentage, mean, and standard deviation were used to assess occupational injuries, perceived mental workload and coping strategies used by participants. Pearson moment-product correlation was also used to determine the relationship among work characteristics, mental workload, and the various types of occupational injuries reported by participants. A logistic regression model was performed to determine factors related to occupational injuries. Odds ratios (OR) were calculated to assess the contribution of each factor for needle stick injuries, injuries from sharps, exposure to blood and other body fluids, exposure to drugs and chemical splashes, back pain and injuries from patient-handling tasks and slips and falls. The statistics for each group were expressed as the number of people with occupational injuries. Confounders were identified and included as covariates in the regression model. By adjusting for these variables, their influence on the predictor and outcome variables was accounted for, thereby reducing bias in the estimated effects. Analysis was conducted with a statistical significance of a p-value of 0.05.
Ethical considerations
Based on the Declaration of Helsinki, permission was obtained from the Committee on Human Research and Publication Ethics of the Kwame Nkrumah University of Science and Technology (CHRPE/AP/297/22). All the participants provided signed informed consent to participate. The principles of voluntary participation, anonymity, and confidentiality were included in this study. Thus, the respondents were made aware of their voluntary participation in the study and were informed of their free will to withdraw from the study at any moment in time.
Results
Three hundred and ninety nurses participated in this study with a response rate of 81.3% (n = 317). More than half of the participants (58.7%) were 30 years of age and below, and 72.9% of participants were females. More than 40% of the participants were diploma holders, 62.5% had clinical experience of at most 10 years, and 60.9% worked more than 40 h a week. Most participants (69.4%) worked a shift system schedule. The detailed socio-demographic characteristics are provided in Table 1.
Table 1
Socio-demographic and work characteristics
Variables | Frequency | % | |
|---|---|---|---|
Age | 30 years and below | 186 | 58.7 |
Above 30 years | 131 | 41.3 | |
Gender | Male | 86 | 27.1 |
Female | 231 | 72.9 | |
Education | Certificate | 95 | 30.0 |
Diploma | 133 | 41.9 | |
Degree | 89 | 28.1 | |
Clinical Experience | < 10 years | 198 | 62.5 |
> 10years | 119 | 37.5 | |
Hours per week | 30–40 h | 124 | 39.1 |
More than 40 h | 193 | 60.9 | |
Work Schedule | Shift system | 220 | 69.4 |
Fixed system | 97 | 30.6 | |
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Occupational injuries among nurses
Table 2 details the occupational injuries as reported by participants. At least a third of the participants have suffered an occupational injury in one way or the other. The majority of the participants reported sustaining injuries through needle pricks (73.8%), injuries from sharps (61.5%), exposure to blood and other body fluids (71.3%), and back pain and injury from patient handling tasks (69.2%) in the past year. However, only 37.7% and 33.7% of the participants had experienced exposure to drugs and chemical splashes, slips and falls, respectively, at the workplace.
Table 2
Occupational injury among nurses
Variables | Frequency | % |
|---|---|---|
Have you ever had a needle stick injury? | ||
Yes | 234 | 73.8 |
No | 83 | 26.2 |
Have you ever had an injury from sharps? | ||
Yes | 195 | 61.5 |
No | 122 | 38.5 |
Have you been exposed to blood or body fluids before? | ||
Yes | 226 | 71.3 |
No | 91 | 28.7 |
Have you had exposure to drugs and chemical splashes on the skin and mucus membranes? | ||
Yes | 120 | 37.7 |
No | 197 | 62.3 |
Have you experienced back pain and injury from patient-handling tasks? | ||
Yes | 221 | 69.2 |
No | 96 | 30.8 |
Have you ever sustained injuries from slips or falls at the workplace? | ||
Yes | 107 | 33.7 |
No | 210 | 66.3 |
Mental workload of nurses
Table 3 details the mental workload of participants. The mean (SD) of the mental workload of participants was higher as it was calculated as 80.57 (20.11). Moreover, the results of mental demand had the highest mean score of 86.56 (21.53), and temporal demand had the lowest mean score of 75.24 (19.02). All the other variables showed a higher mean for the scale: frustration (µ = 82.88, SD = 18.90), physical demand (µ = 82.40, SD = 22.47), effort (µ = 79.52, SD = 20.40), and perceived performance (µ = 76.82, SD = 18.34).
Table 3
The level of mental workload as perceived by participants
Variables | Mean | SD |
|---|---|---|
Mental demand | 86.56 | 21.53 |
Physical demand | 82.40 | 22.47 |
Temporal demand | 75.24 | 19.02 |
Perceived Performance | 76.82 | 18.34 |
Effort | 79.52 | 20.40 |
Frustration | 82.88 | 18.90 |
Total Mental Workload | 80.57 | 20.11 |
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The relationship among work characteristics mental workload and occupational injuries
Correlations among mental workload, occupational injuries, and work characteristics were examined using the Pearson moment-product correlation, as detailed in Table 4. There was a statistically significant positive correlation between mental workload and the following occupational injuries: needle pricks injuries (r = 0.552, p < 0.01); injuries through sharps (r = 0.652, p < 0.01), exposure to blood and body fluids (r = 0.177, p < 0.05), exposure to drugs and chemical splashes (r = 0.119, p < 0.05), back pain and injuries from the patient-handling task (r = 0.505, p < 0.05), and slips and falls (r = 0.657, p < 0.01). These results indicate that increased mental workload leads to a corresponding increase in the incidence of occupational injuries. Hours per week participants worked statistically correlated with mental workload (r = 0.618, p < 0.01). Thus, nurses increased weekly hours were associated with increased mental workload. Moreover, the hours per week participants worked also significantly associated with needle prick injuries (r = 0.027, p < 0.05), injuries through sharps (r = 0.210, p < 0.05), exposure to blood and body fluids (r = 0.091, p < 0.05), back pain and injuries from a patient-handling task (r = 0.483, p < 0.01), slips and falls (r = 0.561, p < 0.01).
Table 4
Correlations between mental workload, hours per week and occupational injuries
Variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
|---|---|---|---|---|---|---|---|
1. Mental workload | - | ||||||
2. Hours per week | 0.618** | - | |||||
3. Needle prick injuries | 0.552** | 0.027* | - | ||||
4. Injuries from sharp | 0.652** | 0.210* | 0.716* | - | |||
5. Exposure to blood and body fluids | 0.177* | 0.091* | 0.811* | 0.601* | - | ||
6. Exposure to drugs or chemical splashes | 0.119* | 0.145 | 0.185 | 0.230 | 0.089 | - | |
7. Back pain and injuries from patient-handling tasks | 0.505* | 0.483** | 0.248 | 0.304 | 0.033 | 0.080 | - |
8. Slips and falls | 0.657** | 0.561** | 0.008 | 0.129 | 0.028 | 0.017 | 0.734** |
Association of Work Characteristics, Mental workload and occupational injuries
As detailed in Table 5, the logistic regression results revealed factors contributing to occupational injuries (needle sticks, injuries from sharps, blood and body fluid exposure, drug and chemical splashes, back pain and injuries from patient handling, and slips and falls). These factors included mental workload, years of work experience, weekly hours, and participants’ work schedules. The comparison revealed that participants with a high mental workload (OR = 3.36; p < 0.05) had a higher risk of needle prick injuries than those with participants with a low mental workload. Regarding work experience, participants with 10 years or less experience (OR = 1.67; p < 0.05) had a comparatively higher risk of needle pricks. Moreover, working more than 40 h per week (OR = 2.52; p < 0.01) contributed more to needle pricks than working 30 to 40 h per week. A high mental workload was associated with higher odds for injuries from sharps (OR = 2.32, 95%CI = 1.06–3.54), blood and body fluid exposure (OR = 4.79, 95%CI = 3.59–5.08), drugs and chemical splashes (OR = 3.60, 95%CI = 2.01–4.64), back pains and injuries (OR = 4.72, 95% CI = 3.35–5.96) and slips and falls (OR = 1.24, 95%CI = 0.80–1.88). Work experience was associated with 82% higher odds for injuries from sharps (95% CI = 0.42–1.74). A higher hour per week by nurses was related to back pains and injuries, with each extra hour performed by nurses associated with 4.49 and 3.24 higher odds of back pain and injuries (95% CI = 2.82–6.67) and slips and falls (95% CI = 2.48–4.72) respectively.
Table 5
Logistic regression on the relationship between work characteristics, mental workload and occupational injuries
Occupational injuries | ||||||
|---|---|---|---|---|---|---|
Predictors | Needle pricks OR (95% CI) | Injuries from sharps OR (95% CI) | Blood and body fluid exposure OR (95% CI) | Drugs and chemical splashes OR (95% CI) | Back pains and injuries OR (95% CI) | Slips and falls (OR (95% CI) |
Mental Workload | ||||||
Low mental workload | 2.21 (1.84–2.62)* | 1.56 (0.58–2.96)* | 2.34 (1.96–2.72)* | 1.02 (0.82–1.24)* | 2.74 (1.66–3.89)* | 1.04 (0.62–1.34)* |
High mental workload | 3.36 (1.08–5.72)* | 2.32 (1.06–3.54)* | 4.79 (3.59–5.08)* | 3.60 (2.01–4.64)* | 4.72 (3.35–5.96)** | 1.24 (0.80–1.83)* |
Work experience | ||||||
10 years or less | 1.67 (1.02–2.88)* | 0.82 (0.42–1.74)* | 0.72 (0.52–0.96) | 0.92 (0.72–1.18) | 1.38 (0.84–1.82)* | 0.61 (0.45–0.82) |
> 10 years | 0.63 (0.36–0.92)* | 0.24 (0.08–1.82)* | 0.66 (0.48–0.84) | 0.83 (0.63–1.02) | 1.43 (0.88–2.01)* | 0.26 (0.10–0.42) |
Hours per week | ||||||
30–40 h | 1.02 (0.88–1.42)* | 0.89 (0.42–1.33)* | 1.52 (1.24–1.78) | 1.69 (1.32–1.92) | 2.13 (1.54–3.62)* | 1.34 (0.82–3.56* |
> 40 h | 2.52 (1.65–3.48)** | 1.52 (0.74–2.10)* | 2.45 (1.72–3.15) | 2.10 (1.34–3.85) | 4.49 (2.82– 6.67)* | 3.42 (2.48–4.72)* |
Work schedule | ||||||
Shift system | 1.01 (1.64–2.42) | 0.87 (0.46–1.24) | 0.82 (0.65–1.21) | 0.96 (0.88–1.64) | 2.43 (1.36–3.74)* | 0.73 (0.44–0.96) |
Fixed system | 0.57 (0.21–0.78) | 0.36 (0.20–0.46) | 0.52 (0.36–0.74) | 0.42 (0.21–0.72) | 1.64 (1.02–2.14)* | 0.43 (0.28–0.64) |
Coping strategies by participants
The results of the coping strategies used by participants at hospitals are detailed in Table 6. Active Coping and Instrumental Support were the two most used coping strategies and had a mean score of 5.9 each, while substance abuse and self-blame had the lowest mean score of 3.4 each. Meanwhile, distraction, denial, emotional support, behaviour disengagement, venting, positive reframing, planning, humour, acceptance and religion had a mean range of 4.5 to 5.6.
Table 6
The coping strategies used by participants
Coping strategies | Mean | SD |
|---|---|---|
Self-Distraction | 5.2 | 1.6 |
Active Coping | 5.9 | 1.4 |
Denial | 5.3 | 1.4 |
Substance abuse | 3.4 | 1.5 |
Active Emotional Support | 5.6 | 1.4 |
Behaviour Disengagement | 5.0 | 1.4 |
Venting | 5.5 | 1.5 |
Instrumental Support | 5.9 | 1.4 |
Positive reframing | 5.3 | 1.6 |
Self-blame | 3.4 | 1.3 |
Planning | 4.5 | 1.4 |
Humour | 5.1 | 1.3 |
Acceptance | 5.5 | 1.3 |
Religion | 5.4 | 1.9 |
Discussion
In the healthcare industry, occupational injuries among nurses are a significant concern. Several factors can increase the risk of nurses suffering an injury. In the study, occupational injuries and emotional workload were assessed, along with coping strategies used by nurses in hospitals.
Many healthcare professionals, especially nurses, suffer occupational injuries. Similar to studies in SSA countries [8, 13, 51], the incidence of occupational injuries was high. However, compared to the global pooled prevalence [9, 52, 53], the incidence was higher in this study. This high incidence may be related to the nature of nurses’ jobs, as they deal with patients frequently and perform most procedures using sharps, such as phlebotomy, intravenous needle insertion, and injections [9]. By implementing occupational health and safety programmes in healthcare organisations, the incidence of this problem will be reduced. Additionally, such programmes could reduce injury incidence and improve healthcare workers’ health and safety.
Mental workload levels were high among most nurses in the present study. This is consistent with the findings of studies conducted on nurses working in critical care areas such as emergency departments (EDs) and intensive care units [ICUs] [27, 50], in which most clinical tasks are performed by nurses [46]. The findings suggest that nurses’ workload increased significantly with an increasing number of patients and unfavourable scheduling due to the stressful nature of their jobs. Nurses in other units or care settings may have different workload levels than ICUs and EDs.
This study agrees with Rostami et al. [30] and Bagheri et al. [17], who found a link between mental workload and occupational injuries. Their findings suggested that nurses in demanding work environments may suffer from fatigue and a lack of situational awareness, leading to needle pricks [17], injuries from sharps [54], exposure to blood and body fluids [55], back pain and injuries when lifting and transferring patients [56, 57]. These positions were consistent with the findings of this study. Therefore, a high mental workload may lead to compromised physical abilities and reduced situational awareness, increasing injury risk. The reason may also be due to high cognitive demands, which may minimise attention, increase distractions, and increase the risk of accidents. However, it has been argued that physical workload and organisational support may significantly impact occupational injury occurrence among nurses [7, 53].
Occupational injuries are more likely to occur among nurses who work more than the required number of hours per week, indicating considerable exposure to potential injuries. The risk of nurse injury has also been increased by working long hours [58, 59]. In light of these results, it is vital to have a prevention policy for nurses logging extra hours, even if they are voluntary.
Nurses’ physical and psychological well-being are often adversely affected by the demanding nature of their jobs. Effective coping strategies, however, can alleviate nurses’ mental workload, improving the overall quality of patient care [60, 61]. Healthcare organisations generally employ adaptive and maladaptive coping methods to deal with stress and its effects on employees and the organisation [62]. Through adaptive coping, individuals use formulated strategies that focus either on the problem or their emotional response to it to cope with the workload. On the other hand, others use maladaptive approaches through avoidance strategies, such as denial and self-blame [63]. The finding from this study was in line with the range of coping strategies as recommended by Carver Brief COPE intervention; maladaptive strategies such as substance abuse, self-blame, and denial were less common. This study confirmed that adaptive coping strategies are preferable to maladaptive strategies [64]. It may result from nurses’ training and work orientation toward emotions. Most participants used cognitive coping techniques such as positive reframing and cognitive restructuring to reframe their thoughts and perceptions, reducing stress and mental workload [65]. Like Isa et al. [66], nurses frequently used problem-oriented strategies, such as active coping.
In contrast, the least used interventions in this study, such as substance abuse and disengaged behaviour, have been popular in several studies [38, 67]. Though avoidance-oriented behaviour does not address the cause of stress, it can reduce stress in the short term and minimise its severity. It is appropriate to temporarily overcome stress when the work environment is fast and stressful.
Implication for nursing management
Healthcare managers can reduce mental work demand on nurses by ensuring appropriate nurse-to-patient ratios and staffing levels. Nurses can concentrate on their tasks more and make fewer errors due to reduced mental demands. A comprehensive training program should also be implemented to equip nurses with the necessary skills to cope with mental workloads. As part of this process, they can learn techniques to manage stress, make decisions, and prioritise tasks, which will help them better deal with the challenges they face every day.
Meanwhile, to ensure nurses can cope effectively with the mental work demands, it is essential to implement strategies that promote their overall well-being and maintain a healthy work-life balance. This can be done through nurses prioritising self-care at the workplace by ensuring they get enough restorative sleep, maintaining a nutritious diet, engaging in regular exercise, and practising mindfulness techniques. By taking care of their physical and mental health, nurses can better manage the mental demands of their work.
Again, creating a supportive work environment is vital for reducing the mental work demand on nurses. Healthcare managers should encourage teamwork, open communication, and a culture that values and supports the well-being of nurses. This includes opportunities for debriefing and support sessions, where nurses can openly discuss their challenges and seek guidance from their peers.
While healthcare managers need to provide access to stress reduction techniques such as relaxation exercises, meditation programs, and counselling services, promoting work-life balance is equally necessary to reduce the mental work demand on nurses. Nurse managers should establish policies encouraging nurses to take breaks, utilise their leave time, and maintain healthy work-life integration. By ensuring nurses have time for self-care, hobbies, and spending quality time with loved ones, they will be better equipped to handle the mental demands of their profession and consequently help reduce occupational accidents.
Conclusion
Mental work demands influence occupational injuries suffered by nurses in hospital settings. Understanding the relationship between mental work demands and occupational injuries is crucial for developing effective strategies to reduce risk and improve nurses’ safety and well-being. By addressing staffing levels, optimising the work environment, and providing adequate training and support, healthcare organisations can mitigate mental work demands. Through such measures, healthcare organisations can take proactive steps to reduce mental work demands and the risk of occupational injuries for nurses. This will create safer working conditions for nurses.
Limitation
Despite the multi-centre approach to data collection, responses were not evenly distributed across the settings. Nevertheless, there was confidence in the generalizability given the representation across the hospitals. Given that self-report data can result in social desirability bias, this may be a study limitation. Using validated tools with high reliability in the data collection and stratified sampling overcame this. Again, convenience sampling may limit the generalisability of the results, as the sample may not accurately represent the broader population, potentially introducing selection bias. Efforts were made to include participants from diverse socio-demographic and job backgrounds. Generalisations and interpretation of the data should be done with caution. Future research should consider a qualitative study to provide well-grounded evidence of the adverse effects of perceived workload on occupational injuries.
Acknowledgements
The authors sincerely thank all the participants in the study.
Declarations
Ethics approval and consent to participate
Based on the Declaration of Helsinki, permission was obtained from the Committee on Human Research and Publication Ethics of the Kwame Nkrumah University of Science and Technology (CHRPE/AP/297/22). All the participants provided signed informed consent to participate. The principles of voluntary participation, anonymity, and confidentiality were included in this study. Participants were also informed of their free will to withdraw from the study at any moment.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
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