Occupational stress and psychological wellbeing among critical care nurses in private hospitals in Somalia: a national cross-sectional study

Abstract

Background Critical care nurses operate in some of the most demanding environments within the health system, and their psychological wellbeing is closely tied to patient outcomes and workforce sustainability. Somalia's fragile healthcare system, marked by persistent resource shortages and limited regulation, presents additional pressures that may elevate stress among ICU nurses. However, evidence from the Somali context has been lacking. This study examined the relationship between occupational stress and psychological wellbeing among critical care nurses working in private intensive care units across Somalia. Methods A nationwide cross-sectional survey was conducted among all 134 eligible critical care nurses employed in the ICUs of 13 private hospitals. Data were collected using a structured online questionnaire that included demographic characteristics, the Perceived Stress Scale (PSS-10), and a modified version of Ryff's Psychological Wellbeing Scale. Descriptive statistics were used to summarize participant characteristics. Pearson correlation assessed the relationship between stress and wellbeing, and multiple linear regression identified predictors of psychological wellbeing. Results Most participants reported moderate stress (64.9%), while nearly one-third experienced high stress. Overall psychological wellbeing was moderate, with the highest scores observed in purpose in life and positive relations. No significant correlation was found between perceived stress and psychological wellbeing (r = −0.077, p = 0.377). Regression analysis showed that female nurses had significantly lower psychological wellbeing (p = 0.001), while nurses with chronic illnesses reported higher wellbeing (p = 0.042). Other demographic and work-related variables showed no significant associations. Conclusion Critical care nurses in Somalia reported moderate occupational stress alongside moderate psychological wellbeing, with no significant association observed between the two variables. Gender disparities and the unexpected association between chronic illness and psychological wellbeing highlight the complexity of psychological outcomes in this setting. Strengthening staffing, improving working conditions, and implementing targeted psychological support services may help support the wellbeing of this vital workforce.