“Coping is Not Enough”: Rethinking Nurse Wellbeing Interventions During Health Emergencies
1
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
The wellbeing of healthcare workers has long been a concern in low- and middle-income countries (LMICs), and the COVID-19 pandemic exacerbated existing challenges. Nurses experienced significant physical, mental, and psychosocial strain during the peak of the pandemic. Many wellbeing interventions in LMIC settings emphasise individual coping strategies and resilience; however, the extent to which these factors protect against burnout during large-scale health emergencies remains uncertain. This study examined the relationship between coping, resilience, general health, and burnout among South African nurses during the peak of COVID-19.
METHODS:
A cross-sectional study was conducted using online self-administered questionnaires among nurses working in six purposively and conveniently sampled hospitals across three South African provinces. Validated instruments were used to measure burnout, coping strategies, resilience, mental health, physical health, and symptoms of anxiety and depression. Univariable and multivariable linear regression analyses were performed to identify factors associated with burnout.
RESULTS:
A total of 139 nurses participated, the majority of whom were female (97.4%), with a median age of 43.3 years and a median professional experience of 12 years. Burnout scores differed significantly between nursing staff and nursing management (p = 0.028). In univariable analyses, burnout was significantly associated with coping strategies, resilience, mental health, physical health, anxiety and depression symptoms, and occupational role (p < 0.05). However, in the multivariable model, coping strategies were no longer significantly associated with burnout. Instead, burnout remained significantly associated with resilience, mental health, physical health, and anxiety and depression symptoms.
CONCLUSIONS:
Findings indicate that coping strategies alone are insufficient to mitigate burnout among nurses during health emergencies in LMIC contexts. Mental and physical health emerged as more critical determinants of burnout, highlighting the need to move beyond coping-focused approaches toward holistic, system-level mental health and wellbeing interventions to support nurses during future public health crises.
The wellbeing of healthcare workers has long been a concern in low- and middle-income countries (LMICs), and the COVID-19 pandemic exacerbated existing challenges. Nurses experienced significant physical, mental, and psychosocial strain during the peak of the pandemic. Many wellbeing interventions in LMIC settings emphasise individual coping strategies and resilience; however, the extent to which these factors protect against burnout during large-scale health emergencies remains uncertain. This study examined the relationship between coping, resilience, general health, and burnout among South African nurses during the peak of COVID-19.
METHODS:
A cross-sectional study was conducted using online self-administered questionnaires among nurses working in six purposively and conveniently sampled hospitals across three South African provinces. Validated instruments were used to measure burnout, coping strategies, resilience, mental health, physical health, and symptoms of anxiety and depression. Univariable and multivariable linear regression analyses were performed to identify factors associated with burnout.
RESULTS:
A total of 139 nurses participated, the majority of whom were female (97.4%), with a median age of 43.3 years and a median professional experience of 12 years. Burnout scores differed significantly between nursing staff and nursing management (p = 0.028). In univariable analyses, burnout was significantly associated with coping strategies, resilience, mental health, physical health, anxiety and depression symptoms, and occupational role (p < 0.05). However, in the multivariable model, coping strategies were no longer significantly associated with burnout. Instead, burnout remained significantly associated with resilience, mental health, physical health, and anxiety and depression symptoms.
CONCLUSIONS:
Findings indicate that coping strategies alone are insufficient to mitigate burnout among nurses during health emergencies in LMIC contexts. Mental and physical health emerged as more critical determinants of burnout, highlighting the need to move beyond coping-focused approaches toward holistic, system-level mental health and wellbeing interventions to support nurses during future public health crises.
| eISSN: | 2654-1459 |
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