Citation: Vitale, E. Work Conditions of Italian Nurses and Their Related Risk Factors: A Cohort Investigatory Study. Diseases 2022, 10, 50. https:// doi.org/10.3390/diseases10030050 Academic Editor: Domenico De Berardis Received: 15 July 2022 Accepted: 1 August 2022 Published: 3 August 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). diseases Article Work Conditions of Italian Nurses and Their Related Risk Factors: A Cohort Investigatory Study Elsa Vitale Local Health Company Bari, 70124 Bari, Italy; vitaleelsa@libero.it Abstract: (1) Background: Nursing is a satisfying employment pathway, as nurses preserve lives, but it is also considered one of the most stressful care professions. Nursing is a lifesaving and highly satisfying profession, yet it is considered one of the most stressful occupations. This study aimed to assess differences in anxiety, depression and stress states among nurses according to gender, work history, shift and body mass index (BMI) characteristics. (2) Methods: An online questionnaire was addressed to all Italian nurses during May 2022, investigating anxiety, depression and stress conditions according to the Depression, Anxiety and Stress Scale-21 Items (DASS-21) and sampling characteristics, such as sex, work experience, shift and BMI values. (3) Results: A total of 408 Italian nurses answered the questionnaire. Significant differences between the following were reported: anxiety levels and work experience, since nurses employed over 6 years reported higher anxiety levels than their younger colleagues (p = 0.035); depression levels and sex (p = 0.017), as females reported higher depression levels than males; and also between depression levels and BMI levels (p = 0.003), as 5.90% of overweight and 2.50% of obese participants reported extremely severe depression. By considering stress levels according to sampling characteristics, significant differences were registered according to BMI levels (p < 0.001), as overweight subjects reported higher stress levels (7.40%) than the other subgroups. Finally, significant associations were recorded between anxiety, depression and stress conditions with sex, work experience, shift and BMI. (4) Conclusions: The data were in agreement with the current literature, indicating that nurses might take care not only of their patients but also of themselves, in both the physical and mental aspects. Keywords: anxiety; body mass index; depression; nurse; sex; shift; stress; work experience 1. Introduction Nursing is a satisfying employment pathway, as it preserving lives. On the other hand, it is also one of the most stressful care professions. Every day, nurses deal with physical and emotional situations, which are often combined with several factors, such as understaffing due to the low availability of funds in the healthcare system, heavy workloads, and the increasing utilization of sophisticated healthcare technologies [1]. Therefore, nursing is considered as the most stress-related profession in the entire healthcare system [2]. Research has highlighted that nurses are stressed and overemployed, with a poor perception of their own safety in their many working environments [3]. Stressed workers are susceptible to harm and poor health, leading to absenteeism and reduced productivity [4]. In stress con- ditions, corticosteroids regulate learning and memory processes due to a rapid alternating hypothalamic–pituitary–adrenal (HPA) axis activation and inhibition, which depend on the phase of the pulse [5,6] and are also affected by circadian rhythms [7,8]. The literature demonstrates a very strong relationship between nursing, working con- ditions and psychological conditions, such as stress, anxiety and depression [9–13], which negatively influence biological rhythms [9,10] and increase the risk of a hostile work–life balance [14,15], for example by increasing the BMI [16] and the possibility of work-related injury [17–19]. Several studies have investigated the association between employment and psychological conditions, particularly stress, anxiety and depression [20–26]. In all Diseases 2022, 10, 50. https://doi.org/10.3390/diseases10030050 https://www.mdpi.com/journal/diseases