Work Stressors and Their Relationship with Depression, Anxiety, Stress, and Job Satisfaction Among Nurses in Ecuador, Peru, and Paraguay

Background Nurses working in hospital environments face a high workload and constant exposure to stressful situations, making them vulnerable to psychological disorders such as anxiety, depression, and stress, as well as reduced job satisfaction. Previous studies have demonstrated that work stressors can deteriorate psychological well-being and lower the quality of patient care, impacting both patient safety and nurse retention. However, there is limited research addressing this issue in Ecuador, Peru, and Paraguay, highlighting the need to investigate how work stressors influence nurses' mental health and job satisfaction in these countries. Objective To analyze the relationship between work stressors and levels of anxiety, depression, stress, and job satisfaction among nurses in Ecuador, Peru, and Paraguay. Methods A cross-sectional study with an explanatory design was conducted using structural equation modeling. A total of 300 nurses from public hospitals in Lima (Peru), Guayaquil (Ecuador), and Paraguay participated in the study. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess mental health, the SL-SPC scale measured job satisfaction, and the Nursing Stress Scale identified work-related stressors. Results The structural model demonstrated an acceptable fit (CFI = 0.914, RMSEA = 0.049, SRMR = 0.078), confirming the hypotheses: work stressors showed a positive relationship with stress (β = 0.53, p