Stress, burnout, and depressive symptoms among nurses in a Lebanese academic medical center: a cross-sectional wellness needs assessment.

BACKGROUND: Nurses experience elevated levels of stress, burnout, and depressive symptoms, which can be intensified during periods of prolonged organizational and national strain. Academic medical centers operating under sustained system pressures may be particularly affected. This study aimed to assess perceived stress, burnout, and depressive symptoms among nurses and to identify priority well-being intervention topics and preferred delivery modes to inform targeted support. METHODS: A cross-sectional survey was conducted among full-time registered and managerial nurses at a Lebanese academic medical center as part of a quality improvement initiative. Approximately 600 nurses were invited via institutional email; 103 initiated the survey. Standardized English-language instruments were used, including the Perceived Stress Scale (PSS-10), the Maslach Burnout Inventory–General Survey 9-item version (MBI-GS9), the Single-Item Burnout Scale (SIBS), and the Patient Health Questionnaire-2 (PHQ-2). Wellness intervention needs were assessed using structured rating and preference items. Descriptive statistics, Pearson correlations, independent t-tests, Kruskal–Wallis tests, and multivariable linear regression analyses were performed. RESULTS: Moderate perceived stress was reported by 60% of respondents, and high stress by 33%. Mean emotional exhaustion was 10.9 ± 5.8, with 40.0% in the highest tertile; mean depersonalization was 4.2 ± 5.2, with 43.5% in the highest tertile. 33.3% screened positive for risk of major depressive disorder (PHQ-2 ≥ 3). Perceived stress was significantly correlated with emotional exhaustion (r = .48, p < .001) and depressive symptoms (r = .53, p < .001) but not with depersonalization (r = .08, p = .48). In multivariable regression analysis, perceived stress (β = 0.513, p < .001) and having children (β = −0.274, p = .008) were significant predictors of emotional exhaustion. Burnout prevention (66.2%), mindfulness (64.8%), and physical activity (62.5%) were the most prioritized interventions; Kruskal–Wallis testing showed significantly greater preference for burnout prevention among nurses with higher stress levels (p = .012). CONCLUSION: Our findings suggest that in high-demand academic healthcare settings, perceived stress functions as a central driver of emotional exhaustion and psychological distress. Systematically integrating nurse-informed wellness interventions, particularly stress-reduction and burnout-prevention strategies, into organizational quality improvement efforts may meaningfully strengthen nurse well-being and mitigate burnout over time.