Severe pneumonia with novel pathogens, also called COVID-19, caused a pandemic in Taiwan as well as in the rest of the world in May 2021. Nurses are under great stress when caring for critically ill patients with COVID-19. This study aimed to explore the perceived stress and coping behaviors of nurses caring for critically ill patients with COVID-19 using a mixed-methods approach. We recruited 85 nurses from a special intensive care unit (ICU) of a medical center in Taiwan between May and June 2021. To gather data, we used a questionnaire on basic characteristics, the perceived stress scale (PSS-14), and the brief coping orientation to problems experienced inventory (B-COPE), then conducted a qualitative interview. The results showed that the average perceived stress level among nurses was 25.4 points, and most of them perceived moderate stress. The top three coping behaviors practiced by the nurses were active coping, planning, and acceptance. Nurses who received less perceived support from their friends or families and who had shorter working experience in nursing had significantly higher stress levels. The qualitative results revealed that the nurses’ perceived stress came from fear, worry, and the increased burden caused by caring for critical patients with COVID-19. Coping behaviors included rest, seeking support, and affirmative fighting. Based on these findings, it is suggested that the support nurses receive from their families is an important predictor of perceived stress. Therefore, it is suggested that nurses be provided with more support in dealing with stress caused by caring for critical patients with COVID-19 in special ICUs.

Background: Nurses working in acute and critical care settings, including general wards, intensive care units and emergency departments, are exposed to high job demands that increase the risk of stress and burnout. Self‐efficacy has been identified as an important psychological resource that may buffer these effects; yet limited evidence has explored its mediating role in clinical nursing practice. Aim: To examine the association relationships between perceived stress, self‐efficacy, and burnout among hospital nurses and to test the mediating role of self‐efficacy, with subgroup analysis across demographic and work‐related factors. Study Design: A cross‐sectional design was conducted through quota sampling to recruit registered nurses from a medical centre in Taiwan between July and October 2020. Data were collected using a self‐report questionnaire including demographic and work‐related characteristics, the Perceived Stress Scale, the General Self‐Efficacy Scale and the Burnout Scale. Descriptive analyses and mediation with bootstrapping were used to test the indirect effect of self‐efficacy, with stratified analyses for subgroups. Results: Of the 395 nurses invited, 380 completed the survey, yielding a response rate of 96.2%. Higher perceived stress was significantly associated with lower self‐efficacy, which in turn increased burnout. Mediation analysis confirmed that self‐efficacy played a significant indirect role in the stress–burnout pathway. The mediating effect was particularly evident among nurses aged over 40 years and those working day shifts, groups often holding leadership or supervisory responsibilities in acute and critical care environments. Conclusions: Self‐efficacy is a key psychological mechanism linking stress to burnout among nurses in acute and critical care settings. This study adds evidence that reinforcing self‐efficacy may reduce vulnerability to burnout, particularly among senior and supervisory nurses. Relevance to Clinical Practice: Interventions designed to reduce perceived stress while enhancing self‐efficacy, such as resilience training, simulation‐based education and mentorship programmes may help mitigate burnout, improve nurse retention and support well‐being in high‐intensity clinical settings.

Nurses’ readiness for disaster response is influenced by stress, self-efficacy, and family support. Understanding these mediating roles is crucial fo