Document Type : Original Article


1 Department of Occupational Health and Safety, School of Public Health, Qazvin University of Medical Science, Qazvin, Iran

2 Social Determinants of Health Research Center, Research Institute for Prevention of Non Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran



Background: High mental workload can negatively affect nurses’ mental and physical health, quality of life, and workability. Therefore, the present study aimed to determine the relationship between mental workload and the workability among nurses.
Methods: Using the multi-stage sampling method, the researchers selected 142 nurses working in Qazvin hospitals in Covid-19 patient care units to participate in a cross-sectional descriptive study. Data collection tools included a demographic information questionnaire, the NASA Workload Index, and Workability Index. Data were analyzed by independent t-test, Pearson correlation coefficient, and ANOVA in SPSS software.
Results: The mean age of participants was 31.3±6.1 years, and the work experience mean was 7.6±5.8 years. The results showed a high mental workload (80.4±13.4) and moderate workability (31.8±7.3). The number of nurses’ shifts per month was negatively correlated with workability (P=0.032). ICU nurses had the highest mental workload score and the lowest workability score. Also, workability there was a significant negative correlation between mental workability and workload (r=-0.579 & P<0.001).
Conclusion: A reverse correlation was observed between mental workload and workability. To improve the performance and mental health of nurses, frequent training programs and management interventions should be practiced.


  1. Destiani W, Mediawati AS, Permana RH. The mental workload of nurses in the role of nursing care providers. Journal of Nursing Care. 2020;3(1). doi: 10.1177/0018720820904237.
  2. Bakhshi E, Mazloumi A, Hoseini SM. Relationship Between Mental Fatigue and Mental Workload Among Nurses. Zahedan Journal of Research in Medical Sciences. 2019;21(1). doi: 10.5812/zjrms.83082.
  3. Abbasi M, Zakerian A, Kolahdouzi M, Mehri A, Akbarzadeh A, Ebrahimi MH. Relationship between workability index and cognitive failure among nurses. Electronic physician. 2016;8(3):2136. doi: 10.19082/2136. PMC4844480.
  4. Gheysarzadeh A, Sadeghifard N, Safari M, Balavandi F, Falahi S, Kenarkoohi A, et al. Report of five nurses infected with severe acute respiratory syndrome coronavirus 2 during patient care: case series. Elsevier; 2020. p. 100694.
  5. Sarsangi V, Salehiniya H, Hannani M, Marzaleh MA, Abadi YS, Honarjoo F, et al. Assessment of workload effect on nursing occupational accidents in hospitals of Kashan, Iran. Biomedical Research and Therapy. 2017;4(8):1527-40. doi: 10.15419/bmrat.v4i08.226.
  6. Madadzadeh M, Barati H, Ahmadi Asour A. The association between workload and job stress among nurses in Vasei hospital, Sabzevar city, Iran, in 2016. Journal of Occupational Health and Epidemiology. 2018;7(2):83-9. doi: 10.29252/johe.7.2.83.
  7. Nasirizad Moghadam K, Reza Masouleh S, Chehrzad MM, Kazemnezhad Leili E. The mental workload and its correlated factors in nurses working in intensive care units. Journal of Holistic Nursing And Midwifery. 2019;29(2):82-9. doi: 10.32598/JHNM.29.2.82.
  8. Buselli R, Corsi M, Baldanzi S, Chiumiento M, Del Lupo E, Dell'Oste V, et al. Professional quality of life and mental health outcomes among health care workers exposed to Sars-Cov-2 (Covid-19). International journal of environmental research and public health. 2020;17(17):6180. doi: 10.3390/ijerph17176180.
  9. Nikeghbal K, Kouhnavard B, Shabani A, Zamanian Z. Covid-19 effects on the mental workload and quality of work life in Iranian nurses. Annals of Global Health. 2021;87(1). doi: 10.5334/aogh.3386. 34434715
  10. Arnetz JE, Goetz CM, Sudan S, Arble E, Janisse J, Arnetz BB. Personal protective equipment and mental health symptoms among nurses during the COVID-19 pandemic. Journal of occupational and environmental medicine. 2020;62(11):892-7. doi: 10.1097/JOM.0000000000001999.
  11. Sampaio F, Sequeira C, Teixeira L. Nurses’ mental health during the Covid-19 outbreak: a cross-sectional study. Journal of occupational and environmental medicine. 2020;62(10):783-7. doi: 10.1097/JOM.0000000000001987.
  12. Arnetz JE, Goetz CM, Arnetz BB, Arble E. Nurse reports of stressful situations during the COVID-19 pandemic: Qualitative analysis of survey responses. International journal of environmental research and public health. 2020;17(21):8126. doi: 10.3390/ijerph17218126
  13. Ghanbary Sartang A, Ashnagar M, Habibi E, Sadeghi S. Evaluation of Rating Scale Mental Effort (RSME) effectiveness for mental workload assessment in nurses. Journal of Occupational Health and Epidemiology. 2016;5(4):211-7. doi: 10.18869/acadpub.johe.5.4.211.
  14. Soewardi H, Kusuma S, editors. Workload Analysis and Improvement of the Nurses Duty in the Hospital. IOP Conference Series: Materials Science and Engineering; 2019: IOP Publishing.
  15. Sandianto S, Tualeka AR, Indriani D. The effect of workload on the job stress of nurses in outpatient Care Unit of Public Hospital Surabaya, Indonesia. Indian Journal of Public Health Research & Development. 2018;9(1):80-4.
  16. Ghanavati FK, Choobineh A, Keshavarzi S, Nasihatkon AA, Roodbandi ASJ. Assessment of mental workload and its association with workability in control room operators. La Medicina del lavoro. 2019;110(5):389. doi: 10.23749/mdl.v110i5.8115. PMCID: PMC7810018.
  17. Rypicz Ł, Witczak I, Rosińczuk J, Karniej P, Kołcz A. Factors affecting workability index among polish nurses working in hospitals–A prospective observational survey. Journal of Nursing Management. 2021;29(3):468-76. doi: 10.1111/jonm.13192.
  18. Yang X, Zhang Y, Li S, Chen X. Risk factors for anxiety of otolaryngology healthcare workers in Hubei province fighting coronavirus disease 2019 (COVID-19). Social psychiatry and psychiatric epidemiology. 2021;56(1):39-45. doi: 10.1007/s00127-020-01928-3.
  19. Hoonakker P, Carayon P, Gurses AP, Brown R, Khunlertkit A, McGuire K, et al. Measuring workload of ICU nurses with a questionnaire survey: the NASA Task Load Index (TLX). IIE transactions on healthcare systems engineering. 2011;1(2):131-43. doi: 10.1080/19488300.2011.609524.
  20. Hart SG, Staveland LE. Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research. Advances in psychology. 52: Elsevier; 1988. p. 139-83.
  21. Abbasi M, Farhang Dehghan S, Fallah Madvari R. Interactive effect of background variables and workload parameters on the quality of life among nurses working in highly complex hospital units: A cross-sectional study. 2019.
  22. Aprilia TD, Somantri I, Mirwanti R. Nurses’ Mental Workload in Critical Care Rooms and Emergency Department. Journal of Nursing Care. 2019;2(3). doi: 10.24198/jnc.v2i3.20372.
  23. Mohammadi M, Mazloumi A, Zeraati H. Designing questionnaire of assessing mental workload and determine its validity and reliability among ICUs nurses in one of the TUMS’s hospitals. Journal of School of Public Health and Institute of Public Health Research. 2013;11(2):87-96.
  24. Mokarami H, Kalteh HO, Marioryad H. The effect of work-related and socio-demographic factors on Workability Index (WAI) among Iranian workers. Work. 2020;65(1):137-43. doi: 10.3233/WOR-193066.
  25. Adel M, Akbar R, Ehsan G. Validity and reliability of workability index (WAI) questionnaire among Iranian workers; a study in petrochemical and car manufacturing industries. Journal of occupational health. 2019;61(2):165-74. doi: 10.1002/1348-9585.12028. PMC6499439
  26. Haufe S, Kahl KG, Kerling A, Protte G, Bayerle P, Stenner HT, et al. Employers With Metabolic Syndrome and Increased Depression/Anxiety Severity Profit Most From Structured Exercise Intervention for Workability and Quality of Life. Frontiers in Psychiatry. 2020;11:562. doi: 10.3389/fpsyt.2020.00562.
  27. Mazloumi A, Kazemi Z, Eivazlou M. Validation and reliability study of farsi version of workability index questionnaire. Journal of School of Public Health and Institute of Public Health Research. 2014;12(1):61-74.
  28. Ebrahimi H, Jafarjalal E, Lotfolahzadeh A, Kharghani Moghadam SM. The effect of workload on nurses’ quality of life with moderating perceived social support during the COVID-19 pandemic. Work. 2021(Preprint):1-9. doi: 10.3233/WOR-210559.
  29. Nasirizad Moghadam K, Chehrzad MM, Reza Masouleh S, Maleki M, Mardani A, Atharyan S, et al. Nursing physical workload and mental workload in intensive care units: Are they related? Nursing Open. 2021. doi: 10.1002/nop2.785.
  30. Tubbs-Cooley HL, Mara CA, Carle AC, Gurses AP. The NASA Task Load Index as a measure of overall workload among neonatal, paediatric and adult intensive care nurses. Intensive and Critical Care Nursing. 2018;46:64-9. doi: 10.1016/j.iccn.2018.01.004.
  31. Arghami S, Kamali K, Radanfar F. Task performance induced work load in nursing. Journal of Occupational Hygiene Engineering. 2015;2(3):45-54.
  32. Pourteimour S, Yaghmaei S, Babamohamadi H. The relationship between mental workload and job performance among Iranian nurses providing care to COVID‐19 patients: A cross‐sectional study. Journal of Nursing Management. 2021. doi: 10.1111/jonm.13305.
  33. Almenyan AA, Albuduh A, Al-Abbas F. Effect of Nursing Workload in Intensive Care Units. Cureus. 2021;13(1). doi: 10.7759/cureus.12674.
  34. Heyam DF, Besher G, Nesreen A-K. Workability index of shift working hospital nurses in Jordan. The open nursing journal. 2018;12:116. doi: 10.2174/1874434601812010116. PMCID: PMC6040208
  35. Chiu M-C, Wang M-JJ, Lu C-W, Pan S-M, Kumashiro M, Ilmarinen J. Evaluating workability and quality of life for clinical nurses in Taiwan. Nursing outlook. 2007;55(6):318-26. doi: 10.1016/j.outlook.2007.07.002.
  36. Abbasi M, Zakerian A, Akbarzade A, Dinarvand N, Ghaljahi M, Poursadeghiyan M, et al. Investigation of the relationship between workability and work-related quality of life in nurses. Iranian Journal of Public Health. 2017;46(10):1404. PMCID: PMC5750353.