Abstract
Background: Nurses working in rural districts such as UMkhanyakude face persistent workload pressures, limited staffing and emotionally demanding patient care responsibilities. These conditions contribute to high levels of occupational stress, making workplace wellness programmes increasingly important for supporting staff well-being. Although such programmes exist within the public health system, little is known about how nurses understand them, how they perceive their usefulness and what factors influence participation in resource-constrained settings.
Aim: to assess nurses' knowledge, attitudes and perceptions of workplace wellness programmes for stress management, and to identify key organisational barriers to participation across selected healthcare facilities in the UMkhanyakude District.
Method: A quantitative descriptive cross-sectional design was used. Data were gathered from 118 nurses across eight facilities using a structured, self-administered questionnaire. A pilot study was conducted and formal data collection took place in November 2025. Questionnaires were completed during break periods to minimise disruption to service delivery. Data were analysed using descriptive statistics.
Key Findings
The findings indicated that nurses had a moderate level of knowledge regarding wellness programmes, with some variation across facilities. Overall, participants demonstrated positive attitudes towards wellness programmes and supported their expansion. Perceptions were also favourable, particularly regarding the role of wellness programmes in supporting stress management and well-being. Despite these positive views, substantial barriers to participation were reported, including workload and time constraints (72%), limited programme access (69%), and insufficient managerial or peer support. Clinic-based nurses reported higher levels of perceived barriers than hospital-based nurses, suggesting that workplace context influences access to and participation in wellness programmes.
Conclusions: Although nurses recognise the value and importance of workplace wellness programmes, their participation is hindered by structural and organisational challenges. Addressing these barriers, specifically by improving communication, ensuring equitable access and integrating protected time for participation, may strengthen engagement and enhance stress-management capacity within rural healthcare settings. Strengthening wellness initiatives is therefore essential for supporting nurse well-being and promoting sustainable, high-quality patient care.