Mental health of Portuguese nurses in 2024: what has changed since 2017? A cross-sectional observational comparative study.

Background: Nurses' mental health has become an increasingly pressing concern worldwide because of its impact on health systems, patient health outcomes, job satisfaction, and workforce attrition. Aim: This study updates and compares findings from a national survey initially conducted in 2017 to assess the mental health of Portuguese nurses and examine associations with socio-professional variables. Methods: This cross-sectional observational study was expanded to include 1894 nurses working in hospitals, primary care, and other settings. The General Health Questionnaire-24 was used to assess mental health perception. Results: Results indicate a substantial decline in mental health perceptions across all indicators compared with 2017. Participants reported more negative assessments of overall mental health, with notable increases in somatic symptoms, anxiety and insomnia (the most affected domain), social dysfunction, and severe depression. Moreover, participants reported increased use of psychotropic drugs. Protective factors identified include specialised training, increased time off (particularly weekends), and engagement in sports or hobbies. Conclusions: Being the largest group in Portugal's healthcare workforce, and reflected globally, nurses play a pivotal role in the health system. Their mental well-being directly impacts patient care quality and safety. These findings support the implementation of targeted strategies to safeguard nurses' mental health and enhance healthcare delivery.