Nurses in Poland and Slovakia Show Similar Stress but Different Health Habits

Nurses in Poland and Slovakia report comparable levels of perceived occupational stress, yet their day-to-day health behaviors diverge noticeably, according to a new cross-sectional comparative study published in the journal Frontiers in Public Health. The research, led by Katarzyna Tomaszewska of Państwowa Akademia Nauk Stosowanych im. ks. B. Markiewicza in Jarosławiu, Poland, together with colleagues from Polish and Slovak institutions, found that higher perceived stress went hand in hand with less favorable health behaviors in both national groups, while Slovak nurses scored significantly better on overall health behavior measures than their Polish counterparts despite experiencing similar stress levels.

The study addressed a gap that the authors identified in the occupational health literature: although occupational stress among nurses has been studied extensively and has been associated with less favorable health behaviors, comparative data on the relationship between perceived stress and health behaviors in Central European countries have been scarce. The research team set out to assess that relationship among nurses employed in healthcare institutions in Poland and Slovakia, and to examine how selected sociodemographic and occupational factors related to the variables analyzed. To capture the picture, the investigators conducted a multicenter cross-sectional survey involving 307 nurses, 145 of whom worked in Poland and 162 in Slovakia.

Participants completed three instruments: an original survey questionnaire, the Perceived Stress Scale in its PSS-10 form, and the Health Behavior Inventory, commonly abbreviated as HBI. Statistical analysis relied on the Mann-Whitney U test for between-group comparisons and Spearman's rank correlation coefficient for associations between variables, with statistical significance set at p < 0.05. On the central question of stress, the comparison produced a null result: no significant differences were found between nurses from Poland and Slovakia in perceived stress levels, with a p value of 0.551.

In other words, the two groups reported stress levels that were statistically indistinguishable. Health behaviors told a different story. Nurses from Slovakia had significantly higher scores for overall health behaviors, for positive mental attitude, and for preventive behaviors, all at p < 0.05.

The difference in the remaining category, health practices, sat at the threshold of statistical significance, with a p value of 0.049 and a Monte Carlo p value of 0.050, a result the authors treated as borderline rather than definitive. The most consistent finding emerged from the correlation analysis. In both national groups, perceived stress levels and health behaviors were significantly negatively correlated, with Spearman's rank correlation coefficients ranging from −0.179 to −0.427 and p values below 0.05.

The negative sign of these coefficients means that, within each group, nurses who perceived more stress tended to report less favorable health behaviors, while those who perceived less stress tended to report better ones. The authors concluded that higher levels of perceived stress were associated with less favorable health behaviors in both groups of nurses. The strength of the correlations deserves attention.

The study's design imposes important limits on interpretation, and the authors were explicit about them. The two national groups differed in terms of their age and length-of-service distributions, which the researchers said should be taken into account when interpreting between-group comparisons. Because a cross-sectional study captures a single moment in time, it can document associations but cannot establish whether stress causes poorer health behaviors, whether nurses with less favorable habits experience more stress, or whether both are shaped by some third factor such as workload, shift patterns, or family circumstances.

For that reason, the research team advised caution specifically about the between-country comparison. Given the cross-sectional design of the study and the sociodemographic and occupational differences between the groups, they wrote, comparisons between Poland and Slovakia should be interpreted with caution. The convergence of two results, similar perceived stress across both countries and a consistent negative stress-behavior correlation within each, points to occupational stress as a common denominator linked to how nurses in both Poland and Slovakia look after their own health.

The study, received on 24 August 2026 and accepted on 13 October 2026, is a provisional article whose final formatted version will follow, and its authors note that all claims expressed are solely those of the research team.

Subject of Research: Relationship between perceived stress and health behaviors among nurses in Poland and Slovakia

Article Title: Perceived stress and health behaviors among nurses in Poland and Slovakia: a cross-sectional comparative study

Article References: Tomaszewska, K., Majchrowicz, B., Matulníková, Ľ., Kadučáková, H., Zrubáková, K., Kłos, A., & Kowalczuk, K. (2026). Perceived stress and health behaviors among nurses in Poland and Slovakia: a cross-sectional comparative study. Frontiers in Public Health, 14, Article 1976809. https://doi.org/10.3389/fpubh.2026.1976809

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.1976809

Keywords: nurses, occupational stress, health behaviors, Perceived Stress Scale, Health Behavior Inventory, Poland, Slovakia, cross-sectional study, occupational health, preventive behaviors, Perceived, stress