# Health status, health behavior and perceived stress of nursing staff in Germany: a scoping review

## TL;DR

This review examines the health, behaviors, and stress levels of German nursing staff, highlighting gaps in research and the need for better support.

## Contribution

The study provides a comprehensive scoping review of nursing staff health in Germany, identifying key research gaps and intervention needs.

## Key findings

- Nursing staff face high work-related stress and significant health risks, especially mental health issues.
- Research on physical health and health behaviors of nurses is limited compared to mental health studies.
- Supportive work environments and team cohesion are protective factors for nurse well-being.

## Abstract

In view of increasing work-related burdens resulting from staff shortages, demographic changes, and high physical and psychological demands, there is a growing need for an understanding of the health status of nursing staff in Germany. The aim of this review is to consolidate existing knowledge on nurses’ health, health behaviors, and subjective stress perceptions to highlight existing research gaps, and to provide impetus for the development of future health-promoting interventions.

To analyze the research field, a scoping review was conducted following the JBI methodology. The systematic literature search was carried out using CINAHL, PubMed, and CareLit- databases and was supplemented by searches of the preprint servers OpenGrey and MedRxiv. In addition, a targeted supplementary search for relevant publications was also conducted on selected pertinent websites.

A total of 11,006 titles and abstracts were screened, of which 150 full texts were reviewed, resulting in the inclusion of 90 studies. The literature predominantly focused on nurses’ mental health. Physical health and health-related behaviors were examined less frequently. Results consistently indicate a high burden of morbidity and substantial work-related stress, which have significant implications for individual well-being, professional performance, and long-term retention in the nursing profession. These challenges have been further intensified by the COVID-19 pandemic. Protective factors such as team cohesion and recognition have emerged repeatedly, highlighting the importance of supportive work environments. Although some interventions have demonstrated short-term improvements in mental health outcomes, robust evidence of long-term effects and physical health promotion remains limited.

Nursing staff are exposed to a wide range of health risks and high work-related burdens. Despite a broad body of research, substantial gaps remain - particularly regarding health behaviors and physical health. Future research requires longitudinal, comparative studies, and a structured, nursing-specific health monitoring system. In practice, comprehensive strategies that combine individual-level interventions with structural improvements in the work environment are needed.

Open Science Framework 10.17605/OSF.IO/HX9ZM.

Not applicable.

The online version contains supplementary material available at 10.1186/s12912-025-04282-4.