Feelings, Stress, and Adaptation Strategies of Nurses against COVID-19 in Guayaquil

  • Joicy Anabel Franco Coffré Universidad de Guayaquil
  • Patricia de los Ángeles Leví Aguirre Universidad de Guayaquil
Keywords: Stress, psychological, nurses, coronavirus infections, risk factors, pandemics, cross-sectional studies, Ecuador


Objective. To explore the feelings, stress factors, and adaptation strategies of nurses during the COVID-19 pandemic in Guayaquil, Ecuador.

Methods. A cross-sectional, descriptive quantitative study, conducted through the application of a 52-item questionnaire with four sections (feelings, perceived stress, stress-reducing factors, and adaptation strategies). The study population was 227 nursing professionals from “Hospital General del Guasmo Sur” of the Ministry of Public Health, who worked during the peak of the pandemic from March to May 2020. The sample comprised 155 nurses who voluntarily
accepted to participate. The study received 127 complete questionnaires for analysis.

Results. The data showed the priority of humanist feelings and professional duty for these nurses, mostly young (59% under 35 years of age and with the professional exercise of three and fewer years), against the fear of contagion and the stress of strenuous work. They also revealed the great importance for them of the institutional support, recognition to the staff, and strict organization of safe care, like strategies for coping with this difficult experience.

Conclusion. The COVID-19 pandemic represented for nurses from Guayaquil a great professional and emotional challenge. Health services and society could consider these findings to avoid burning out nurses and their professional desertion.

= 1763 veces | PDF
= 770 veces| HTML INGLES
= 19 veces| HTML ESPAÑOL
= 645 veces| VIDEO
= 0 veces|


Download data is not yet available.

Author Biographies

Joicy Anabel Franco Coffré, Universidad de Guayaquil

Nurse, Master’s. Assistant Full-Time Professor. Email: joicy.francoc@ug.edu.ec

Patricia de los Ángeles Leví Aguirre, Universidad de Guayaquil

Nurse, Master’s of Science. Principal Professor (Retired). Email: songuest@yahoo.com


(1) Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, Zhang LJ. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology. 2020; 296(2):E15-E25.

(2) Guerrero S. Coronavirus en Ecuador: una opinión desde la Academia. La Granja [Accepted version]. 2020 [cited 2020 May 17]; 32(2). Available from: https://lagranja.ups.edu.ec/pdf/granja/COVID_esp.pdf

(3) Hallo A, Rojas A, Hallo C. Perspective from Ecuador, the Second Country with More Confirmed Cases of Coronavirus Disease 2019 in South America: A Review. Cureus. 2020; 12(3);e7452.

(4) Bajaña I. Incidencias del COVID-19 en Ecuador. Question/Cuestión. 2020; 1(May):e321.

(5) Riesgos Ecuador [Internet]. Coronavirus Ecuador – información verificada de la llegada del COVID-19 al país. 2020 [cited 2020 May 15], [about 20 screens]. Available from https://www.coronavirusecuador.com/galeria-multimedia/

(6) Inca GP, Inca AC. Evolución de la enfermedad por coronavirus (COVID-19) en Ecuador. La Ciencia al Servicio de la Salud y la Nutrición [Internet]. 2020 [cited 2020 May 15]; 11(1). Available from: https://bit.ly/3iF4Ikb

(7) Levin J. Mental Health Care for Survivors and Healthcare Workers in the Aftermath of an Outbreak. Psychiatry of Pandemics. 2019: 127–41.

(8) Lazarus RS, Folkman S. Estrés y procesos cognitivos. Barcelona: Martínez Roca; 1986.

(9) Huang L, Xu F Ming, Liu H Rong. Emotional responses and coping strategies of nurses and nursing college students during COVID-19 outbreak. medRxiv [Preprint]. [posted 2020 March 8; cited 2020 May 16]; [17 p.]. Available from: https://doi.org/10.1101/2020.03.05.20031898

(10) Xu M, Zhang Y, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Psychological status survey of first clinical first-line support nurses fighting against pneumonia caused by a 2019 novel coronavirus infection. 护理研究. 2020; (3):368-70. Available from: https://bit.ly/31Q8nFX

(11) Hoseinabadi T Kakhki S, Teimori G, Nayyer S. Burnout and its influencing factors between front-line nurses and nurses from other wards during the outbreak of Coronavirus Disease (COVID-19) in Iran. Invest. Educ. Enferm. 2020; 38(2):e03.

(12) Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y, Zhuang Q. Psychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 2020 During the Outbreak of Coronavirus Disease 2019 (COVID‐19) in Hubei, China. Med. Sci. Monit. 2020: e924171.

(13) Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare Workers Emotions, Perceived Stressors and Coping Strategies During a MERS-CoV Outbreak. Clin. Med. Res. 2016; 14(1):7-14.

(14) Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ 2020; 368:m1211.

(15) Tzeng HM, Yin CY. Nurses’ fears and professional obligations concerning possible human-to-human avian flu. Nurs. Ethics. 2006; 13(5):455-70.

(16) Liu Y, Aungsuroch Y. Work stress, perceived social support, self‐efficacy and burnout among Chinese registered nurses. J. Nurs. Manag. 2019; 27(7):1445–53.

(17) Feng MC, Wu HC, Lin HT, Lei L, Chao CL, et al. [Exploring the Stress, Psychological Distress, and Stress-relief Strategies of Taiwan Nursing Staffs Facing the Global Outbreak of COVID-19]. Hu Li Za Zhi. 2020; 67(3):64-74. Chinese.

(18) Koh D, Lim MK, Chia SE, Ko SM, Qian F, et al. Risk perception and impact of Severe Acute Respiratory Syndrome (SARS) on work and personal lives of healthcare workers in Singapore: what can we learn? Med. Care. 2005; 43(7):676-82.

(19) Mo Y, Deng L, Zhang L, Lang Q, Liao C, Wang N, et al. Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic. J. Nurs. Manag. 2020; 28(5):1002-9.

(20) Maben J, Bridges J. COVID‐19: Supporting nurses’ psychological and mental health. J. Clin. Nurs. 2020; 29(15-16): 2742-50.

(21) Fernandez PR, Lord H, Halcomb PE, Moxham PL, Middleton DR, Alananzeh DI, et al. Implications for COVID-19: a systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. Int. J. Nurs. Stud. 2020:103637.

How to Cite
Franco CoffréJ. A., & Leví AguirreP. de los Ángeles. (2020). Feelings, Stress, and Adaptation Strategies of Nurses against COVID-19 in Guayaquil. Investigación Y Educación En Enfermería, 38(3). https://doi.org/10.17533/udea.iee.v38n3e07