Mental Health of Peruvian National Hospital Nurses during COVID-19: Depression, Stress, Anxiety and Coping Mechanisms

Introduction: The COVID-19 pandemic created extraordinary challenges for healthcare systems worldwide, with nurses bearing the brunt of the crisis. In Peru, which experienced one of the highest mortality rates globally, nurses worked under extreme conditions including prolonged shifts, resource shortages, and constant exposure to infection. Objective: This study evaluated the psychological impact of COVID-19 on Peruvian nurses, measuring depression, anxiety, and stress levels, while identifying effective coping mechanisms. Methods: We conducted a quantitative, descriptive, cross-sectional study involving 311 nurses from three major Peruvian hospitals (Cayetano Heredia Hospital, Daniel Alcides Carrión Hospital, and Dos de Mayo National Hospital). Participants were selected based on their frontline COVID-19 care experience. Mental health was assessed using the validated DASS-21 scale (showing excellent reliability: depression α=0.92, anxiety α=0.79, stress α=0.89), while coping strategies were evaluated with the COPE-28 inventory (with avoidant coping showing lower reliability at α=0.45, noted as a study limitation). Data collection occurred via online surveys during the peak pandemic months. Results: Findings revealed alarming mental health impacts: 47.9% of nurses experienced anxiety, 30.5% depression, and 19% stress. Problem-focused coping strategies (e.g., active planning) and emotion-focused approaches (e.g., positive reframing) correlated with better outcomes (r = 0.150-0.276, p < 0.01). Younger nurses and those with less experience showed greater vulnerability. Conclusions: The study demonstrates the pandemic's severe psychological toll on Peruvian nurses, with anxiety being most prevalent. While adaptive coping strategies provided some protection, the results underscore the urgent need for institutional mental health support programs. Future research should explore longitudinal effects and specific interventions.