Iranian nurses report moderate stigma around occupational stress and burnout

A cross-sectional study of 250 nurses working in six university-affiliated hospitals in Kashan, Iran, found moderate stigma surrounding occupational stress and burnout on average. The researchers measured stigma with the Stigma of Occupational Stress Scale for Nurses, which has a theoretical range of 12 to 84, and found a mean total score of 48.13, with a 95% confidence interval of 46.96 to 49.31. Perceived stigma from other people had the highest average subscale score, while personal stigma had the lowest. Among the demographic and occupational variables examined, a history of psychiatric medication was the only factor retained in an exploratory regression model, but it explained just 1.8% of the variation in total stigma.

The study, published in BMC Psychology as an early-access version, was conducted in 2025 and designed to assess occupational stress and burnout stigma among hospital nurses and identify potential predictors. Participants were selected through proportionate stratified random sampling from six university-affiliated hospitals in Kashan. Data came from a demographic and occupational questionnaire, the 21-item Depression, Anxiety, and Stress Scale, and the SOSS-N. The researchers used descriptive statistics and exploratory stepwise multiple linear regression in SPSS version 27. Because the design was cross-sectional, the findings describe associations in the sampled population rather than demonstrating cause and effect, and the authors cautioned that the medication-history result requires particular care.

Psychiatric disorder history was associated with total stigma in the univariable analysis, with a p value of 0.048, while psychiatric medication history was associated at p = 0.032. In the final exploratory stepwise model, medication history was the only retained variable. Nurses reporting that history scored an average of six points lower on the total stigma scale than the model’s reference group, with an unstandardized coefficient of −6.00, a 95% confidence interval of −11.48 to −0.53, a standardized coefficient of −0.136, and p = 0.032. However, only 12 of the 250 participants, or 4.8%, reported psychiatric medication use. The overall model was highly limited in explanatory power, with R² = 0.018 and an adjusted R² of 0.014.

These results suggest that the measured individual and occupational characteristics provided little help in accounting for differences in nurses’ reported stigma. The moderate average score and the especially high mean for perceived other stigma indicate that the issue was not confined to nurses’ attitudes toward themselves. The authors concluded that stigma surrounding occupational stress and burnout was moderate on average, with perceived other and perceived structural stigma showing the highest mean scores. They also emphasized that the small subgroup with psychiatric medication history, the cross-sectional design, and the low variance explained make the regression finding insufficient to establish a broader relationship. The study therefore identifies a measurable pattern of stigma among the Kashan hospital nurses sampled, but not its causes or changes over time.

Subject of Research: Occupational stress and burnout stigma among hospital nurses in Kashan, Iran

Article Title: Stigma of occupational stress and burnout: The role of lived experience with treatment in Iranian nurses

Article References: Pouyan, M., Tagharrobi, Z., & Zare, M. (2026). Stigma of occupational stress and burnout: The role of lived experience with treatment in Iranian nurses. BMC Psychology. https://doi.org/10.1186/s40359-026-05562-7

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05562-7

Keywords: nurses, occupational stress, burnout, workplace stigma, Iran, Kashan, psychiatric medication, cross-sectional study, health care workers, Stigma, occupational, stress