Prevalence and determinants of work-related stress among nurses in Ethiopia: a systematic review and meta-analysis

Abstract

Work-related stress is a growing global concern among nurses, affecting professional performance and health system outcomes. In Ethiopia, evidence is fragmented. This review aimed to estimate the pooled prevalence of work-related stress among nurses in Ethiopia and identify its associated factors. We systematically searched PubMed, Embase, Scopus, Web of Science, and Google Scholar for observational studies published up to April 30, 2025. Eligible studies reporting the prevalence or determinants of work-related stress among nurses in Ethiopia. The review was conducted and reported following the PRISMA 2020 guidelines; the PRISMA 2020 Abstract Checklist is provided as Appendix 1. Two reviewers independently screened, extracted data, and assessed study quality using the JBI Critical Appraisal Checklist. A random-effects model was used to calculate pooled prevalence and adjusted odds ratios (AORs). Subgroup and sensitivity analyses were conducted. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. Thirteen studies involving 3,702 nurses across multiple Ethiopian regions were included. The pooled prevalence of work-related stress was 47.84% (95% CI: 46.28–49.41%, I2 = 93.4). Significant associated factors included shift work (AOR = 2.68), working in emergency units (AOR = 5.95), intensive care (AOR = 6.33), less than five years of experience (AOR = 4.41), and having children (AOR = 2.13). Nearly one in two nurses in Ethiopia experiences work-related stress. Occupational and personal factors contribute substantially to this burden. Interventions such as improved scheduling, support for high-risk units, and early-career mentoring are recommended. Future longitudinal and interventional studies are needed to inform workforce policy and improve nurse well-being. Not applicable.