Revista brasileira de enfermagem · 2026
Network analysis of depression, anxiety, and stress symptoms in Brazilian nursing workers.
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Santin Júnior Lacir José, Ribeiro Isabely Karoline da Silva, Oliveira Samuel Andrade de, Barreto Maynara Fernanda Carvalho, Oliveira Ana Carolina Gomes Martins de, Borges Mayla Rodrigues Valadão, Fernandes Sérgio Joaquim Deodato, Rocha Fernanda Ludmilla Rossi
Аннотация
OBJECTIVES: to explore the network structure of depression, anxiety, and stress symptoms among Brazilian nursing workers.
METHODS: cross-sectional study using nonprobability sampling. Participants were 4,053 nursing workers. Symptoms of depression, anxiety, and stress were assessed using the Depression Anxiety Stress Scales-21. Data were analyzed using psychological network analysis, applying a partial correlation model with LASSO regularization method. Node centrality was assessed using strength, closeness, and betweenness indices.
RESULTS: the symptoms with the highest strength centrality were "I felt that I was using a lot of nervous energy," "I was unable to become enthusiastic about anything," and "I felt I was close to panic." The symptom "I felt that I was using a lot of nervous energy" showed the highest closeness and betweenness indices.
CONCLUSIONS: the identified central symptoms may play a structuring role in the activation of other symptoms and may help guide strategies to prevent and manage psychological distress among nursing workers.
METHODS: cross-sectional study using nonprobability sampling. Participants were 4,053 nursing workers. Symptoms of depression, anxiety, and stress were assessed using the Depression Anxiety Stress Scales-21. Data were analyzed using psychological network analysis, applying a partial correlation model with LASSO regularization method. Node centrality was assessed using strength, closeness, and betweenness indices.
RESULTS: the symptoms with the highest strength centrality were "I felt that I was using a lot of nervous energy," "I was unable to become enthusiastic about anything," and "I felt I was close to panic." The symptom "I felt that I was using a lot of nervous energy" showed the highest closeness and betweenness indices.
CONCLUSIONS: the identified central symptoms may play a structuring role in the activation of other symptoms and may help guide strategies to prevent and manage psychological distress among nursing workers.