Post-pandemic anxiety among nurses and midwives: the role of intolerance of uncertainty, chronic conditions, and professional experience

BACKGROUND: Although healthcare systems have largely stabilized following the COVID-19 pandemic, the long-term psychological adaptation of nurses and midwives remains insufficiently understood. Persistent exposure to uncertainty and individual health-related vulnerabilities may contribute to sustained anxiety beyond the acute crisis phase. AIM: This study aimed to assess levels of state anxiety, trait anxiety, and intolerance of uncertainty among nurses and midwives in the post-pandemic period, and to examine whether intolerance of uncertainty, chronic health conditions, and professional experience are associated with elevated trait anxiety. METHODS: A cross-sectional analytical study was conducted among 1,201 nurses and midwives working in public hospitals in Albania. Participants were selected through stratified random sampling, and data were collected from March 2024 to May 2025 using a structured questionnaire adapted into Albanian, including the State-Trait Anxiety Inventory (STAI) and the 12-item Intolerance of Uncertainty Scale (IUS-12). Descriptive and inferential analyses, including group comparisons, correlation analyses, and multiple linear regression, were performed using SPSS. Statistical significance was set at p < 0.05. RESULTS: Participants reported moderate levels of state anxiety (M = 2.15, SD = 0.90), trait anxiety (M = 2.40, SD = 0.86), and intolerance of uncertainty (M = 2.64, SD = 1.01). Trait anxiety was positively correlated with intolerance of uncertainty (r = 0.46, p < 0.001) and state anxiety (r = 0.52, p < 0.001). Participants reporting chronic health conditions had higher trait anxiety than those without chronic conditions (M = 2.57 vs. 2.35, p < 0.001). In multiple linear regression, intolerance of uncertainty, chronic health conditions, and lower professional experience remained independently associated with trait anxiety; the model explained 26.5% of the variance in trait anxiety (adjusted R² = 0.262, p < 0.001). CONCLUSION: Nurses and midwives continue to experience moderate levels of anxiety and intolerance of uncertainty in the post-pandemic period, suggesting that psychological adaptation may involve stabilization rather than full recovery. The findings highlight the role of both individual vulnerability and professional context in shaping long-term emotional outcomes and underscore the need for sustained, targeted interventions to support healthcare workforce wellbeing.