Consensus on Coping Mechanisms towards Occupational Stress among Psychiatric Nurses using Modified Delphi Technique

Introduction: Occupational stress is a significant issue in healthcare, particularly in the field of psychiatric nursing. Nurses working in psychiatric settings are often exposed to unique stressors, including managing aggressive behaviours, dealing with complex mental health cases, and navigating emotionally charged situations. These stressors can lead to physical, emotional, and psychological strain, ultimately impacting job performance, patient care, and overall well-being. Coping strategies enable nurses to manage the demands of their roles, maintain their mental health, and provide high quality care to patients. Aim: This study aimed to obtain experts’ consensus on the use of coping mechanisms toward occupational stress among psychiatric nurses in the Eradah Complex and Mental Health, Riyadh, Saudi Arabia. Materials and Methods: This qualitative study was conducted at the Eradah Complex and Mental Health, Riyadh, Saudi Arabia. A three-step modified Delphi panel process, with statements to score in each round, was used to obtain expert consensus on coping mechanisms towards occupational stress among psychiatric nurses. Literature reviews were used to develop statements about coping mechanisms toward occupational stress. Recruited Delphi process psychiatric nurses and faculty rated the extent of their agreement with the statements over three rounds (round 1-3: email survey). Criteria for consensus were applied. Data were collected between September 2024 and December 2024 using an online questionnaire consisting of 110 coping mechanisms developed based on an in depth literature review and statements generated from expert psychiatric nurses and faculty members’ survey. Finally, 42 coping statements were achieved consensus. Analysis rules determined whether a statement progressed to the next round and the level of agreement deemed consensus. Measures of central tendency (mean, median) and variability {Interquartile Range (IQR), cut-off point ≥75%} were reported back to help panellists assess their previous responses in the context of those of the overall group. Results: Three rounds of Delphi surveys were conducted, and consensus was reached at ≥75% agreement from the experts. In round 1, 35 experts reached full consensus on 49 out of the 110 coping mechanisms, while 61 coping mechanisms reached partial consensus. Suggestion from the experts led to reframing of some features, and the 49 revised features were sent to the experts in the second round. In round 2, a total of 42 coping mechanisms reached full consensus, while seven coping mechanisms reached partial consensus. In round 3, all the 42 features reached full consensus based on ≥75% agreement from all the experts. Conclusion: This study highlights the multifaceted nature of coping mechanisms for occupational stress among psychiatric nurses and academics. By implementing these findings, healthcare organisations can create a more supportive environment that enhances the well-being and resilience of psychiatric nurses, ultimately improving patient care outcomes.