Security-Related Occupational Stress and Its Impact on Mental Health and Job Performance among Community Health Nurses: A Scoping Review

Background: Community health nurses (CHNs) occupy the front line of primary and preventive care, delivering services in clinics, schools, homes, and other community settings where exposure to security-related occupational stressors is increasingly documented. Such stressors include workplace violence and abuse, biological and chemical threats, unsafe home-visit environments, and organizational security gaps. Objective: To map and synthesize the available evidence on the nature, scope, and consequences of security-related occupational stress among CHNs, with a specific focus on its impact on mental health and job performance. Methods: A scoping review was conducted following the Arksey and O’Malley five-stage framework, enhanced by Levac and colleagues, and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Four databases (PubMed, CINAHL, Scopus, and Web of Science) were searched for peer-reviewed publications between 2014 and 2024. Two reviewers independently screened titles, abstracts, and full texts against predefined eligibility criteria. Data were extracted using a standardized charting form and synthesized thematically. Results: A total of 28 studies met the inclusion criteria. Security-related stressors were categorized into four thematic domains: workplace violence and verbal abuse (reported by 38–72% of CHNs across studies), biological and chemical exposure risks, unsafe home-visit and community environments, and organizational security gaps. Mental health consequences included anxiety (prevalence 19–44%), depression (17–39%), burnout (22–51%), post-traumatic stress symptoms (8–23%), and sleep disturbance. Job performance outcomes comprised reduced productivity, increased turnover intention (24–46%), medical errors, absenteeism, and diminished quality of care. Conclusion: Security-related occupational stress is a pervasive and multi-dimensional phenomenon among CHNs, with significant adverse effects on mental health and job performance. Targeted organizational policies, security training, psychological support systems, and strengthened legislative protection are urgently needed to safeguard this essential workforce.