Post-Traumatic Stress Disorder among Nurses Who Provided Care for Patients with COVID-19 in Sri Lanka: A Descriptive Cross-Sectional Study

Background: Nurses, as front-line health workers, faced significant psychological health challenges during the COVID-19 pandemic, which led to post-traumatic stress disorder (PTSD). This study assessed the prevalence of PTSD and its associated factors among nurses at the end of the third wave of COVID-19 in Sri Lanka. 
Methods: A descriptive cross-sectional study was conducted among 384 nurses working in state sector hospitals in Sri Lanka from 18th August 2021 to 17th October 2021. A convenience sample of nurses who provided care to patients with COVID-19 for at least one week was included. Data were collected using a self-administered questionnaire comprising the Sinhala version of “Impact of Event Scale” and the Sinhala version of “Depression Anxiety and Stress Scale-21”. Data analysis involved descriptive statistics, Chi-square tests, and Mann-Whitney U-tests, with significance set at p<0.05. The ethical committee of the Faculty of Medicine, University of Colombo, Sri Lanka, approved the study.   
Results: From the invited nurses, 66.9% (n=257) completed the survey. Most of the participants (89.5%) were female, and 44% were aged between 36-45 years. The prevalence of the PTDS manifestations among nurses was 40.10%. Depression, anxiety, stress (p<0.001), marital status (p=0.03), information acquisition (p=0.02), psychological well-being (p=0.005), and death of a family member due to COVID-19 (p=0.04) were significantly associated with the manifestation of PTSD. 
Conclusions: A substantial proportion of Sri Lankan nurses experienced PTSD during the COVID-19 pandemic, with personal factors, inadequate mental well-being, and stress emerging as major contributing factors. These findings highlight the urgent need for mental health support systems and targeted interventions to address the psychological and social needs of front-line nursing staff in future healthcare crises.