Cureus · 2026
Prevalence of Stress and Perceived Contributing Factors Among Healthcare Workers at a District Health Center in Vietnam: A Mixed-Methods Study.
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Luu Oanh, Phan Xuan, Ha Nguyet, Hua Thuy
Аннотация
BACKGROUND: Psychological stress among healthcare workers (HCWs) is a growing concern in primary care settings, yet data from such facilities in Vietnam remain limited. This study aimed to estimate the prevalence of stress and explore perceived contributing factors among HCWs at a regional health center, a primary healthcare facility (formerly a district health center) in Vietnam.
METHODS: A convergent mixed-methods study was conducted among all 167 HCWs at the Long Dat Medical Center in Ba Ria-Vung Tau Province, Vietnam, in 2025. The quantitative component used a self-administered questionnaire including the Depression, Anxiety and Stress Scale-21 Items (DASS‑21) stress subscale; stress severity was categorized as normal (0-14), mild (15-18), moderate (19-25), severe (26-33), and extremely severe (≥34). The qualitative component consisted of seven in-depth interviews and one focus group, analyzed thematically around individual, family-related, and health-facility-related factors.
RESULTS: The mean DASS-21 stress score was 5.34 ± 6.31 (range 0-28). Overall, 74.8% (n=125) of HCWs had normal stress levels, while 11.4% (n=19) had mild, 11.4% (n=19) moderate, and 2.4% (n=4) severe or extremely severe stress, indicating that 25.2% (n=42), approximately one in four, experienced elevated stress symptoms. The most frequently reported manifestations were difficulty relaxing and feeling a high level of nervous energy. Qualitative findings showed that stress was driven by the interaction of financial strain, caregiving responsibilities, workload, and role overload, inadequate infrastructure and supplies, perceived imbalance between effort and remuneration, and tensions in workplace relationships, with family and collegial support acting as partial buffers.
CONCLUSIONS: About one in four HCWs at this primary healthcare facility experienced elevated stress, highlighting stress as an important workforce health issue rather than a marginal problem. Interventions should combine routine stress screening and targeted support for at-risk staff with organizational measures to improve working conditions, clarify roles, optimize workload and staffing, and strengthen fair and transparent incentive and support mechanisms.
METHODS: A convergent mixed-methods study was conducted among all 167 HCWs at the Long Dat Medical Center in Ba Ria-Vung Tau Province, Vietnam, in 2025. The quantitative component used a self-administered questionnaire including the Depression, Anxiety and Stress Scale-21 Items (DASS‑21) stress subscale; stress severity was categorized as normal (0-14), mild (15-18), moderate (19-25), severe (26-33), and extremely severe (≥34). The qualitative component consisted of seven in-depth interviews and one focus group, analyzed thematically around individual, family-related, and health-facility-related factors.
RESULTS: The mean DASS-21 stress score was 5.34 ± 6.31 (range 0-28). Overall, 74.8% (n=125) of HCWs had normal stress levels, while 11.4% (n=19) had mild, 11.4% (n=19) moderate, and 2.4% (n=4) severe or extremely severe stress, indicating that 25.2% (n=42), approximately one in four, experienced elevated stress symptoms. The most frequently reported manifestations were difficulty relaxing and feeling a high level of nervous energy. Qualitative findings showed that stress was driven by the interaction of financial strain, caregiving responsibilities, workload, and role overload, inadequate infrastructure and supplies, perceived imbalance between effort and remuneration, and tensions in workplace relationships, with family and collegial support acting as partial buffers.
CONCLUSIONS: About one in four HCWs at this primary healthcare facility experienced elevated stress, highlighting stress as an important workforce health issue rather than a marginal problem. Interventions should combine routine stress screening and targeted support for at-risk staff with organizational measures to improve working conditions, clarify roles, optimize workload and staffing, and strengthen fair and transparent incentive and support mechanisms.