Sources of occupational stress and coping strategies among nurses working in AIDS care

Identifying Patterns of Turnover Intention Among Alabama Frontline Nurses in Hospital Settings During the COVID-19 Pandemic

Introduction

Current research about frontline nurse stress and turnover intention lacks context related to rural communities’ plight in providing organizational resources during the current COVID-19 pandemic. These implications have been particularly underexamined in the United States, whose regional differences may influence how frontline nurses perceive the access and utility of organizational resources. This study investigates if anxiety and stress while working during the current COVID-19 pandemic contribute to frontline nurses’ desire to leave their current position in Alabama hospital settings.

Material and Methods

A cross-sectional survey was developed and distributed as a Qualtrics survey to frontline nurses using social media and professional contacts. A total of 111 frontline nurse respondents within May 19–June 12, 2020 were included in this study.

Results

A significant correlation was found between gender (p= 0.002), marital status (p= 0.000) and seniority (p= 0.049) on turnover intention. A nurse’s perceived anxiety and stress related to their patients’ acuity (r= 0.257, p= 0.004), their personal health as a risk factor (r= 0.507, p= 0.000), their patient assignments (r= 0.239, p= 0.01), their personal protective equipment (r= 0.412, p= 0.000), and their psychological support (r= 0.316, p= 0.001) correspond to higher turnover intention among nurses working with patients infected with COVID-19.

Conclusion

Perceived resource loss in task autonomy, PPE, and psychosocial support increased turnover intention among frontline nurses in Alabama. Research is needed to understand how intrinsic motivations and social support influence individual nurse staff’s perceptions of resource loss and job demands. Further, more research is necessary to examine the implications of rurality and place in discussing turnover intention and organizational resources across multiple health systems.

Major Stressors and Coping Strategies of Frontline Nursing Staff During the Outbreak of Coronavirus Disease 2020 (COVID-19) in Alabama

BACKGROUND

Studies suggest that nursing staff during pandemics such as H1N1 Influenza and COVID-19 exhibit higher than usual stress levels due to an increasingly overburdened healthcare system and increasing infection rates. This study aims to investigate the major stressors and coping strategies reported by nurses working directly with potentially infectious patients in Alabama, United States, during the COVID-19 pandemic.

MATERIALS AND METHODS

A cross-sectional questionnaire study was conducted with nursing staff working in hospital settings in the state. The questionnaire was completed by 109 nurses working in hospitals that treated COVID-19 patients.

RESULTS

Around 71% of the nursing staff were concerned about receiving more COVID-19 patients and exhibited heightened workload-related stress resulting from taking care of infected patients. The study found that most nurses (82%) are stressed about getting their friends and family infected. Overall, younger, less experienced nurses reported more stress levels compared to older, senior-level nurses. Findings suggest that many nurses fail to perceive protective measures as an effective coping strategy, with only 75% reporting problem-solving strategies such as hand washing and wearing a face mask, and only 60% avoiding public transportation and crowded spaces. Findings also suggest a lack of organizational support including psychiatric assistance, with no nurses reportedly seeking psychological therapy.

CONCLUSION

The COVID-19 pandemic increased the stress level of the nursing staff in Alabama. The study finds that the cases in the state of AL are still increasing dramatically, which can overwhelme the healthcare system and escalate nurse stress levels.

Self-compassion as a Stress Moderator: A Cross-sectional Study of 1700 Doctors, Nurses, and Medical Students

Objectives

Work stress is common in healthcare and reliably predicts negative outcomes, including burnout and lower quality of life (QOL). However, few studies have investigated factors that might attenuate the impact of stress on these negative outcomes. We investigated whether the tendency to be kind to the self during times of difficulty—self-compassion—might buffer the effect of work stress on outcomes.

Methods

Registered nurses (n = 801), physicians (n = 516), and medical students (n = 383) were recruited using convenience sampling in New Zealand. Following consent, participants (N = 1700) completed a survey including the Copenhagen Burnout Inventory, Satisfaction with Life Scale, and Self-Compassion Scale–Short Form.

Results

Across groups, greater work stress consistently predicted greater burnout and lower QOL, while greater self-compassion predicted lower burnout and better QOL. Self-compassion moderated the relationship between stress and burnout in nurses (albeit in the opposite direction to what had been predicted), but not in doctors or medical students.

Conclusions

While self-compassion predicted better outcomes (and may thus represent a target to enhance wellbeing), it strengthened the association between stress and burnout in nurses. How self-compassion impacts the experience of stress and its correlates and why it does so differently in different groups of professionals remains unclear.

Low provider and staff self-care in a large safety-net HIV clinic in the Southern United States: Implications for the adoption of trauma-informed care

Objective:

This mixed-methods needs assessment study examined self-care practices among providers, staff, and administrators at an HIV clinic and identified barriers and facilitators to strengthening self-care services in this setting.

Methods:

Surveys (n = 31) and qualitative interviews (n = 23) were conducted with staff, providers, and administrators at a large, safety-net HIV clinic.

Results:

Surveys indicated an overall absence of formal self-care services including resources to manage stress, opportunities to debrief, and formal mechanisms to voice concerns. Based on interviews with staff and providers, deficiencies in self-care services included support for dealing with complex patients, formal mechanisms for feedback, and time for self-care. Administrators recognized the need for more support, acknowledged that opportunities for employees to voice concerns were lacking, and felt that implementing multi-disciplinary team meetings could improve morale and reduce stress and burnout.

Conclusion:

This assessment revealed a need to enhance self-care in safety-net HIV services. Adoption of trauma-informed care, which includes activities to strengthen self-care, could reduce workplace burnout.

Coping With Imminent Death: Thematic Content Analysis on Narratives by Japanese Soldiers in World War II

Coping affects somatic and psychological outcomes. This article explores narratives in a book, Kamikaze Diaries: Reflections of Japanese Student Soldiers, which report on the ways of coping used by each kamikaze participant before and during military service. The purpose of this study is to observe the possibility of a trend in coping strategies and consider how these trends inform us about other populations facing imminent death. This study analyzed data and extracted meaning from the narratives in the book (thematic content analysis). Within the thematic content analysis, the Ways of Coping scale was used, which describes the coping strategies people use when facing problems. The most frequently used coping strategies before they entered the military were "Accept Responsibility," "Endurance/Obedience/Effort," and "Self-Control," while once in the military, they were "Accept Responsibility" and "Endurance/Obedience/Effort." All the coping strategies used by kamikaze pilots appeared to focus on the passive self, which may be the type of coping in other populations facing death.

Administrative Stressors and Islamic Coping Strategies Among Muslim Primary Principals in Malaysia: A Mixed Method Study

Principals are school leaders who experienced stress while leading their schools towards excellence. However, principals stress experiences are always ignored and least studied. This mixed-methods study investigates primary principals' stress experiences and their Islamic coping strategies used in incapacitating the stress experiences. A total of 216 Muslim primary principals across different gender, types of schools and years of experiences as school leaders responded to the administrative stress and the Islamic coping strategies items. In addition, seven primary principals were purposefully selected and interviewed in exploring their reasons of using Islamic coping strategies for their relieving process. Results discovered that primary principals experienced fairly stress level and they perceived managing students' academic achievement was the most stressor followed by managing teachers' capabilities. Although findings revealed that no significant differences in terms primary principals' demographics; male primary principals, and experienced between 6 and 10 years and positioned in schools with least students (SLS) category have slightly higher level of stress. In terms of Islamic coping strategies used by primary principals, saying dhua to Allah, performing dhikir and reciting the Yassen are selected coping approaches employed in handling their stress. From interviews, primary principals also revealed that they used Islamic religious approaches as part of meaningful activities not just to overcoming their stress but also as part of religious approaches in remembering Allah, thinking back their past mistakes as part of the Muhasabah process. Therefore, we believed that religious approaches should be taken into consideration in principals' training as it provides peaceful and treatment in managing principals' stress issue.

The Roles of Motivation and Coping Behaviours in Managing Stress: Qualitative Interview Study of Hong Kong Expatriate Construction Professionals in Mainland China

Driven by fast-growing economies worldwide, the number of international construction projects is booming, and employing expatriates has inevitably become a strategy used by construction firms. However, stress arising from expatriate assignments can lead to early return, assignment failure, and staff turnover, causing in significant losses to an organisation. Extensive research has focused on the effectiveness of coping behaviours in relation to stress. However, studies investigating the antecedents of coping are rare. The limited studies to date tend to focus on content-based motivations (identifying what), instead of on how coping behaviours can be motivated in the stress management process (identifying how). Focus on expatriate construction professionals (ECPs) is further limited. Hence, this study aims to investigate from a process theory perspective the role of motivation in the stress management process. Using a qualitative interview study approach, involving 22 in-depth interviews, this study first identifies the content of motivation, coping behaviours, performance, and stress in the context of Hong Kong ECPs working on cross-cultural projects in China; it then unveils and explains the associations between the identified variables. Based on the results, stakeholders are recommended to review pre-departure training, so as to ensure that key elements such as personal awareness of stress (cognitive, affective, and physical), expectancies of coping strategies on stress (adaptive or maladaptive), and expectancies of the influence of stress on performance are covered.

HIV health-care providers' burnout: can organizational culture make a difference?

One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p < .005, R(2) = .18). Further negative organizational culture (i.e., critical appraisal) was positively related to depersonalization (p < .005, R(2) = .18). These findings suggest that effective organizational communication interventions might protect HIV health-care providers from burnout.

Association of coping style and psychological well-being in hospital nurses

INTRODUCTION

Nursing jobs are among the occupations experiencing high levels of stress. Level of psychological well-being and coping style with stressful situations among nurses has large impact on their job performance. Limited information exists about the relationship between coping styles and psychological well-being among nurses, so the present study examined the way of coping and the level of psychological well-being as well as their relationships among nurses.

METHODS

In this correlational study, 100 nurses from Shahid Sadoughi University of Medical Sciences were selected by multi-stage random sampling in 2012. Lazarus and Folkman's coping styles and Ryff's psychological well-being Questionnaires were completed by self-report method. Collected data were entered software SPSS ver. 13 and then analyzed using Pearson correlation test.

RESULTS

The results showed EFCSwere more used  but PFCSstyle was less used with a little difference by mean (SD) of  87.91 (10.76) vs. 73.12 (12.15). Between EFCSand some psychological well-being dimensions such as purpose in life (P=0.01, r= -0.28) and personal development (P=0.03, r=-0.024), a significant negative association and between PFCSstyle and purpose in life, a significant positive relationship was found (P=0.006, r=0.31).

CONCLUSION

Considering that PFCSstyle is more effective in solving problems and job stress, as well as, the increased use of EFCSis associated with adverse health consequences, improvement of nurses' coping strategies to cope better with stressful events by skill training and promotion of nurses' psychological well-being level is recommended.

Relationship between occupational stress and coping strategy among operating theatre nurses in China: a questionnaire survey

AIM

To explore the relationship between occupational stress and coping strategies among operating theatre nurses in China.

BACKGROUND

Studies on occupational stress and burnout in nurses are common, but there is a dearth of research on the coping strategies of operating theatre nurses.

METHODS

A cross-sectional study was conducted in a typical operating theatre in China. A questionnaire survey was conducted among 70 nurses. The data were analysed using correlation and regression methods.

RESULTS

Nurses reported high stress levels in the workload and time pressure subscales. Female nurses' occupational stress was positively correlated with designation and negatively correlated with operation sets per day and night shifts. Nurses preferred self-control as a coping strategy. Active coping was positively related to resource and environmental problems, and passive coping was positively related to workload and time pressure, and to interpersonal relationship and management issues.

CONCLUSION

Nursing managers could reduce operating theatre nurses' passive coping by decreasing the stressors of workload and time pressure, and interpersonal relationships and management problems.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers could employ more nurses to reduce nurses' workload and occupational stress. In addition, managers should consider fortifying nurses' active coping strategies and training nurses in problem-solving skills.

Challenges, coping strategies, and recommendations related to the HIV services field in the HAART era: a systematic literature review of qualitative studies from the United States and Canada

Qualitative research methods have been utilized to study the nature of work in the HIV services field. Yet current literature lacks a Highly Active Anti-Retroviral Treatment (HAART) era compendium of qualitative research studying challenges and coping strategies in the field. This study systematically reviewed challenges and coping strategies that qualitative researchers observed in the HIV services field during the HAART era, and their recommendations to organizations. Four online databases were searched for peer-reviewed research that utilized qualitative methods, were published from January 1998 to February 2012, utilized samples of individuals in the HIV services field; occurred in the U.S. or Canada, and contained information related to challenges and/or coping strategies. Abstracts were identified (n=846) and independently read and coded for inclusion by at least two of the four first authors. Identified articles (n=26) were independently read by at least two of the four first authors who recorded the study methodology, participant demographics, challenges and coping strategies, and recommendations. A number of challenges affecting those in the HIV services field were noted, particularly interpersonal and organizational issues. Coping strategies were problem- and emotion-focused. Summarized research recommendations called for increased support, capacity-building, and structural changes. Future research on challenges and coping strategies must provide up-to-date information to the HIV services field while creating, implementing, and evaluating interventions to manage current challenges and reduce the risk of burnout.

Stigma, an important source of dissatisfaction of health workers in HIV response in Vietnam: a qualitative study

Background

Like in many other low- and middle-income countries, the recent development of an HIV epidemic in Vietnam has led to a growing need for prevention, treatment, care, and support services for people living with HIV (PLHIV). This puts greater demands on the national HIV services, primarily on health workers, which increases the importance of their job satisfaction and working conditions. This study describes health worker perceptions and explores the factors that influence job satisfaction and dissatisfaction of health personnel working on the HIV response in Vietnam. Spector’s job satisfaction model was used as the theoretical framework for the study design and analysis.

Methods

The study employed a qualitative design with 7 focus group discussions and 15 semi-structured interviews with health workers, purposively selected from national and provincial organizations responsible for HIV services in 5 cities and provinces in Vietnam. Data were analyzed using a hybrid approach of theory-driven and data-driven coding and theme development using qualitative analysis software.

Results

HIV services are perceived by Vietnamese health workers as having both positive and negative aspects. Factors related to job satisfaction included training opportunities, social recognition, and meaningful tasks. Factors related to job dissatisfaction included unsatisfactory compensation, lack of positive feedback and support from supervisors, work-related stress from a heavy workload, fear of infection, and HIV-related stigma because of association with PLHIV. An adjusted Spector’s model of job satisfaction for HIV service health workers was developed from these results.

Conclusion

This study confirmed the relationship between stigmatization of PLHIV and stigma experienced by staff because of association with PLHIV from families, colleagues, and society. The experiencing stigma results in additional work-related stress, low self-esteem, poor views of their profession, and lower income. The study shows the importance of actions to improve staff job satisfaction such as pay raises, supportive supervision, stress management, stigma reduction and workplace safety. Immediate actions could be the provision of more information; education and communication in mass media to improve the public image of HIV services, as well as improvement of workplace safety, therefore making health workers feel that their work is valued and safe.

[Study of stress, coping and psychosomatic health among baccalaureate nurses-to-be]

Stress is a risk factor that may endanger our quality of life and health. Certain occupational groups are particularly concerned, such as health care workers.

OBJECTIVE

The present study aimed to investigate the stress load and coping strategies of nurses as well as their psychosomatic health.

METHOD

The questionnaire survey was performed at the University of Szeged. The sample consisted of 208 nursing students (136 part-time and 72 full-time students). The self-completed questionnaire included items of psychosomatic symptoms, coping strategies and stress load.

RESULTS

Persons characterized by high level of stress and more frequent psychosomatic symptoms tended to use inadaptive ways of coping more often; whereas those with a relatively lower stress level and fewer symptoms were not characterized by a more frequent use of active ways of coping but instead a lack of the inadaptive coping strategies.

CONCLUSIONS

The authors concluded that vulnerability of the would-be baccalaureate nurses in this sample was especially high because they even used less effectively the ways of coping that otherwise aimed at both problem solving and maintaining their own health.

What qualitative research has taught us about occupational stress

While many reviews of job stress and the stressor–strain relationship have been conducted, such reviews typically focus exclusively on quantitative data. In the current paper, we review qualitative studies on occupational stress that met two criteria: (1) the studies employed qualitative methods; (2) the stressors, strains and/or coping strategies were grouped into identifiable, higher-order categories. Results indicated that the nature of the stressors experienced varied by (a) occupation, (b) country, (c) seniority and (d) gender. The review further revealed that organizational constraints, work overload and interpersonal conflict were relatively universal stressors. Anger and annoyance were the most frequently reported psychological strains in the United States and the United Kingdom, while Chinese workers exhibited tension and anxiety and Indian workers exhibited acceptance. Coping strategies also varied by gender, occupation and country. Research on gender differences suggested that, compared to men, women tended to report more interpersonal stressors. Differences in the ways in which the two types of methodologies are applied, as well as their relative strengths and weaknesses, underline the value of qualitative approaches to the study of occupational stress, especially when used in conjunction with quantitative methods in mixed-methods studies.

Iranian clinical nurses' coping strategies for job stress

OBJECTIVES

Since the existence of work-related stressors is inevitable in nurses' workplace, nurses usually use a variety of coping strategies which can be called cognitive, affective, and behavioral techniques. In this study, we aimed to explore the coping strategies employed by the Iranian clinical nurses in depth.

METHODS

This work was a qualitative study using Straus and Corbin's grounded theory approach focusing on the process of coping with job stress used by Iranian clinical nurses.

RESULTS

The results of the present qualitative study indicate that the core category was "on the route to coping" which contained six categories comprising work management, self-control, emotional, spiritual, cognitive, and interactional strategies.

CONCLUSIONS

We conclude that in nursing it is inevitable that different kinds of strategies are used to cope with the many stressors. The conceptual model emerging from the data indicate that nurses are engaged in a dynamic process of struggling to cope with job stressors. In fact, they are "on the route to coping" with the job stressors. Considering the high level of stress in the nursing profession, the findings of this study have implications for both hospital managers and Iranian clinical nurses.

How caring for persons with HIV/AIDS affects rural nurses

Prior research findings about caregiving for persons with HIV/AIDS indicate that caregiving impacts nurses in three separate domains: personal self as a nurse in practice; interactions with the nurse's family members, friends, and colleagues; and interactions with persons with HIV/AIDS. However the impact caregiving for persons with HIV/AIDS has on rural nurses has not been extensively explored. A qualitative study of rural registered nurses' experiences of caring for persons with HIV/AIDS was conducted to determine how caregiving affects registered nurses in rural areas. Content analysis was used to analyze rural registered nurses' written comments about their experiences of caring for persons with HIV/AIDS. Themes identified from the nurses' accounts of instances of caregiving were the perceived risk of acquiring the virus, a lack of concern about HIV/AIDS, and a need for ongoing continued education about the care of persons with HIV/AIDS.

Job satisfaction among intensive care nurses from the People's Republic of China

BACKGROUND

Prior research has suggested that job satisfaction is a major concern for both nurses and healthcare administrators. A variety of workplace stressors, coping strategies and demographic characteristics have been found to contribute both positively and negatively to job satisfaction. However, most of this research has been conducted in Western culture countries, leaving one to wonder if the findings are relevant in China, particularly in regard to intensive care nurses.

AIM

Therefore, the purpose of this descriptive study was to determine, in intensive care nurses from the People's Republic of China, which combination of workplace stressors, coping strategies and demographic characteristics was the best predictor of job satisfaction.

METHODS

To address these purposes, four self-report questionnaires were administered to a convenience sample of 102 intensive care nurses from four teaching hospitals located in two cities in central China.

RESULTS

The best predictors of job satisfaction were workload, years of experience in nursing, uncertainty about patients' treatment, behavioural disengagement and positive reframing.

CONCLUSIONS

The findings provide information about what factors need to be considered and addressed in the workplace to facilitate job satisfaction among Chinese intensive care nurses.

Workplace stressors, coping, demographics and job satisfaction in Chinese intensive care nurses

BACKGROUND

Prior research has suggested that certain workplace stressors, coping strategies and demographic characteristics are related to job satisfaction in nurses. Most of the research in this area has been conducted within western culture countries, with little research being carried out in Asian culture countries, especially China. It remains unclear if the findings of the research conducted in western culture countries are applicable to Chinese nurses, especially intensive care nurses.

AIMS AND OBJECTIVES

Therefore, the aims of this study were to examine, in Chinese intensive care nurses, the most often occurring workplace stressor; the most frequently used coping strategy; and the relationships among workplace stressors, coping strategies, demographic characteristics and job satisfaction.

DESIGN

The study design was a survey using four self-report questionnaires.

METHODS

One hundred and two intensive care nurses, from four hospitals located in two major cities in central China, were administered four self-report questionnaires.

RESULTS

Findings suggested that the most frequently cited workplace stressor was workload, while the most commonly used coping strategy was planning. Two hundred and twelve significant positive and negative correlations were found among the various workplace stressors, coping strategies, demographic characteristics and the different factors comprising job satisfaction.

CONCLUSIONS

These findings identify factors that need to be considered when addressing workplace stress, coping strategies and demographic characteristics as they relate to job satisfaction in Chinese intensive care nurses.

RELEVANCE TO CLINICAL PRACTICE

It is important for both hospital and nursing administrators to address factors contributing to job satisfaction, so that retention of qualified ICU nurses, within the workforce, will be facilitated.

HIV transmission risk behaviors among HIV-positive individuals: stress and coping in the aftermath of 9/11

Using case studies, this article discusses a nursing approach for working with HIV-positive clients who have experienced stress as the result of the 9/11 attack on the United States. The stress and coping framework developed by Lazarus and Folkman is used to guide nursing care.