Stress, shift work and substance use among nurses: A single-centre experimental study

Journal title MISSION
Author/s Gloria D'Angelo, Isabella Baglioni, Chiara Gatti, Stefano Marcelli, Jasmine Eddhima
Publishing Year 2026 Issue 2026/74
Language Italian Pages 15 P. 16-30 File size 0 KB
DOI 10.3280/mis74-2026oa22627
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Introduction: Burnout is a form of chronic work-related stress characterised by emotional exhaustion, detachment and reduced fulfilment. It can lead to dysfunctional coping mechanisms, such as self-medication for stress, anxiety and insomnia. In the healthcare sector, access to medication can contribute to addiction, posing risks to both healthcare professionals and patients. This study investigates coping mechanisms and addiction among healthcare professionals.

Materials and methods: This cross-sectional study was conducted from 12 January to 13 March 2026 at the Local Health Authority (AST) in Ascoli Piceno. The survey involved a sample of 174 nurses using a questionnaire comprising a sociodemographic section and the ASSIST test, ensuring their privacy.

Results: The sample was predominantly female (75%), with high heterogeneity (90%) in the reasons for leaving the profession. Although 80% reported strong family support, 59% experienced critical environmental stress and 20% had difficulty separating their private life from work. This is associated with smoking habits: daily use in 37% and cravings in 28%, with moderate risk.

Discussions: Significant gender differences emerged, in line with the Glass Escalator Theory and the biological-hormonal component.

Conclusions: The ASSIST test identifies tobacco as the most prevalent substance, followed by sedatives, with moderate risk. The study highlights the need for prevention, organisational support and the reduction of stigma.

Keywords: Nurses;Burnout;ASSIST tool;Coping;Mental health;Patient safety

  1. Bagnasco A., Dasso N., Rossi S., Timmins F., Watson R., Aleo G., Catania G., Zanini M., & Sasso L. (a cura di) (2020). A cross-sectional multisite exploration of Italian paediatric nurses’ reported burnout and its relationship to perceptions of clinical safety and adverse events using the RN4CAST@IT-Ped. J Adv Nurs, 76(8): 2072-2081.
  2. Becker J.B., & Chartoff E. (a cura di) (2018). Sex differences in neural mechanisms mediating reward and addiction. Neuropsychopharmacology, 44(1): 166-183.
  3. Bleidorn W., Arslan R.C., Denissen J.J.A., Rentfrow P.J., Gebauer J.E., Potter J., & Gosling S.D. (a cura di) (2015). Age and gender differences in self-esteem – A cross-cultural window. Journal of Personality and Social Psychology, 111(3): 396-410.
  4. Deng J., Wang P., Tian X., Li K., Yang L., & Ding S. (a cura di) (2024). Turnover intention and its influencing factors among male nurses in China: a national-scale descriptive study. BMC Nurs, 14, 23(1): 833.
  5. Dunn D. (a cura di) (2005). Substance abuse among nurses: Defi ning the issue. AORN Journal, 82(4): 573-596.
  6. Ettore E. (a cura di) (1992). Women and Substance Use. Favretto G.
  7. (a cura di) (1994). Lo stress nelle organizzazioni. Bologna: il Mulino.
  8. Federazione Nazionale Ordini Professioni Infermieristiche [FNOPI] (a cura di) (2023). Studio BENE: burnout, intenzione di lasciare e sicurezza delle cure. I primi dati. -- Disponibile al sito: <a href="https://www.fnopi.it/2023/12/13/studio-bene-burnout/">https://www.fnopi.it/2023/12/13/studio-bene-burnout/</a>. Consultato il 10/02/2026.
  9. Federazione Nazionale Ordini Professioni Infermieristiche [FNOPI] (a cura di) (2024). Le donne puntano sull’Infermieristica: in Italia sono il 76% degli iscritti. Fnopi. -- Disponibile al sito: <a href="https://www.fnopi.it/2024/03/08/8-marzo-infermiere-3/">https://www.fnopi.it/2024/03/08/8-marzo-infermiere-3/</a>. Consultato il 30/03/2026.
  10. Giorgi F., Mattei A., Notarnicola I., Petrucci C., & Lancia L. (2018). Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study. J Adv Nurs., Mar, 74(3): 698-708. Doi: 10.1111/jan.13484.
  11. Istituto Nazionale per l’Assicurazione contro gli Infortuni sul Lavoro [INAIL] (a cura di) (2022). La gestione dello stress lavoro correlato: strumenti e metodologie di intervento nel settore sanitario. -- Disponibile al sito: <a href="https://www.inail.it/portale/it/inail-comunica/news/notizia.2025.05.piattaforma-inail-per-lavalutazione-e-gestione-del-rischio-stress-lavoro-correlato.html">https://www.inail.it/portale/it/inail-comunica/news/notizia.2025.05.piattaforma-inail-per-lavalutazione-e-gestione-del-rischio-stress-lavoro-correlato.html</a>. Consultato il 15/02/2026.
  12. Istituto Superiore di Sanità (a cura di) (2003). La tutela della salute della donna. Rapporti ISTISAN. Istituto Superiore di Sanità. -- Disponibile al sito: <a href="https://www.iss.it/documents/20126/955767/0328.1109159497.pdf/21abdeec-641dd883-0309-a739bf2ee3b9?t=1575578494070">https://www.iss.it/documents/20126/955767/0328.1109159497.pdf/21abdeec-641dd883-0309-a739bf2ee3b9?t=1575578494070</a>. Consultato il 15/02/2026.
  13. Kling K.C., Hyde J.S., Showers C.J., & Buswell B.N. (a cura di) (1999). Gender differences in self-esteem: A meta-analysis. Psychological Bulletin, 125(4): 470-500.
  14. Maslach C., & Leiter M.P. (a cura di) (2016). Understanding the burnout experience: some comparative transitions. Current Directions in Psychological Science, 25(2): 103-111.
  15. Ministero della Salute (a cura di) (2024). I servizi per le tossicodipendenze in Italia: i dati del 2023. -- Disponibile al sito: <a href="https://www.salute.gov.it/new/it/news-e-media/notizie/iservizi-le-tossicodipendenze-italia-i-dati-del-2023/">https://www.salute.gov.it/new/it/news-e-media/notizie/iservizi-le-tossicodipendenze-italia-i-dati-del-2023/</a>. Consultato il 15/02/2026.
  16. Munro C.A., McCaul M.E., Wong D.F., Oswald L.M., Zhou Y., Brasic J., Kuwabara H., Kumar A., Alexander M., Ye W., & Wand G.S. (a cura di) (2006). Sex differences in striatal dopamine release in healthy adults. Biol Psychiatry.
  17. Söderberg M., Härenstam A., Rosengren A., Schiöler L., Olin A., Lissner L., Waern M., & Torén, K. (a cura di) (2014). Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population. BMC Public Health, 14(1), 605.
  18. Williams C.L. (a cura di) (1992). The Glass Escalator: Hidden Advantages for Men in the “Female” Professions. Social Problems. -- Disponibile al: <a href="https://xyonline.net/sites/xyonline.net/files/Williams%2C%20The%20Glass%20Escalator%201992.pdf">https://xyonline.net/sites/xyonline.net/files/Williams%2C%20The%20Glass%20Escalator%201992.pdf</a>. Consultato il 30/03/2026.
  19. World Health Organization [WHO] a cura di (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. 289-292. -- Disponibile al sito: <a href="https://cdn.who.int">https://cdn.who.int</a> /media/docs/default-source/classification/other classifications/9241544228_eng.pdf. Consultato il 15/02/2026.
  20. Young V. (a cura di) (2011). The secret thoughts of successful women: Why capable people suffer from the impostor syndrome and how to thrive in spite of it. Crown Business.

Gloria D'Angelo, Isabella Baglioni, Chiara Gatti, Stefano Marcelli, Jasmine Eddhima, Stress, shift work and substance use among nurses: A single-centre experimental study in "MISSION" 74/2026, pp 16-30, DOI: 10.3280/mis74-2026oa22627