Because of two years of constant epidemic control, healthcare staff in medical institutions are subjected to suffering from psychological symptoms and are prone to stress [19, 23]. In this study, we investigated the status of challenge-hindrance stress of NASSNs and determined the predictors of stress. Our findings suggest that the overall challenge-hindrance stress of NASSNs is moderately low, and the predictors affecting challenge-hindrance stress contain motivation, nursing experiences, preparedness of NASSNs and their families, working environment, and competence of emergency disposal.
NASSNs in our research reported moderately low challenge and hindrance stress, differing from the findings of other researchers at the beginning of the Covid-19 pandemic [14, 16]. This could be attributed to the consistent training in epidemiological characteristics, prevention, and treatment of the novel coronavirus pneumonia. It has been noted that healthcare staff facing the pandemic are exposed to chronic psychological stress on both themselves and their patients [25]. It has also been reported that nurses wearing protective clothing are prone to physiological discomforts such as headaches, nausea, and respiratory distress during high-intensity work; some even become fearful of their work [26]. Hence, administrators should provide a stable and safe working environment for NASSNs from a humanistic perspective and implement early psychological interventions as recommended by Pinho [27].
According to our findings, NASSNs' challenge stress scores highest in the following items, amount of responsibility, time pressures, and scope of responsibility. In contrast, their hindrance stress scored highest in the lack of job security, the amount of red tape needed, and the degree to which politics rather than performance affects organizational decisions. Challenge stress is usually considered to have a positive predictive effect on attitudes and behaviors and is beneficial to realizing potential [9, 11]. Contrary to challenge stress, hindrance stress has a negative psychological effect and requires adjustment [12]. Our study showed that challenge stress was higher than hindrance stress, indicating that NASSNs tended to perceive the stress of nucleic acid sampling work as a challenge, which could increase their sense of professional benefit and ensure the quality of the sampling task. The highest challenge stress item was the amount of responsibility, implying that NASSNs saw a high social value in the nucleic acid sampling task to detect, diagnose, and treat patients with novel coronaviruses early. The highest hindrance stress score was lack of job security, suggesting nursing administrators must strengthen occupational protection and establish a standardized sampling site and procedure. Similarly, scholars abroad and at home also argued that the stress of medical staff tended to remain stable over time due to fear of job exposure, working long hours, and barriers from institutional policy provisions [28, 29].
The most exciting finding from our analysis is that motivation, nursing experiences, preparedness of NASSNs and their families, working environment, and emergency disposal competence could predict the challenge-hindrance stress level. NASSNs who were less concerned about preparedness of themselves and families, working environment, and emergency disposal competence showed less challenge and hindrance stress. NASSNs could develop both positive and negative emotions during nucleic acid sampling. Therefore, nursing administrators should help nurses make psychological adjustments, rationalize the deployment in sampling nurse personnel, clarify the scope of job responsibilities, and strengthen the training of emergency disposal. Furthermore, when dispatching NASSNs, nursing administrators should focus on relief of pressure from their families, and strengthening humanistic care. Moreover, NASSNs motivated by personal willingness to participate in the sampling task experience less challenge stress, accords with earlier observations by Deng et al.[9]. In terms of hindrance stress, NASSNs with longer nursing experiences showed higher hindrance stress. In accordance with the present results, previous studies have also demonstrated that predictors of stress among emergency medical personnel during the COVID-19 pandemic include the fear of contracting COVID-19, a reduction in safety and security while performing emergency medical procedures, and the marginalization of patients who are not infected with COVID-19 [30].
In response to the status and predictors of NASSNs' challenge-hindrance stress reflected by our findings, the following strategies are proposed: a) Establish an emergency response system in hospitals and reserve flexible personnel for emergency disposal. b) Develop smooth communication channels between frontline nucleic acid sampling teams, regularly summarize and share experiences in prevention and control of Covid-19, and improve NASSNs' adaptability to complex clinical settings. c) Set up a psychological hotline and provide psychological counseling to staff to reduce negative emotions. d) Strengthen logistical support and increase humanistic care to alleviate health care workers' concerns about their families.