The relationship between nurses' stress and nurse staffing factors in a hospital setting

Occupational Stress in United Kingdom Audiologists

PURPOSE

Occupational stress is known to have detrimental effects on health care professionals worldwide. This study aimed to address a research gap by investigating sources and levels of occupational stress in U.K. audiologists.

METHOD

A mixed-methods cross-sectional design and convenience sampling were utilized. The study used the Audiologist Occupational Stress Questionnaire (AOSQ) and an audiological working practices questionnaire. The study included 100 registered U.K. audiologists.

RESULTS

The research revealed that over a third of participants reported experiencing moderate or higher levels of occupational stress. Pediatric audiologists and those with a high daily patient load reported significantly higher stress scores than other specialties and those seeing fewer patients per day. Identified sources of stress for U.K. audiologists included clinical demands and time constraints, staffing issues, leadership in the workplace, and equipment availability. Reported impacts of stress encompassed mental health issues, fatigue, social life disruptions, and physical health concerns.

CONCLUSIONS

The research validated the use of the AOSQ in a U.K. setting, and the findings provided insights into the sources and levels of occupational stress experienced by U.K. audiologists, supporting existing research on occupational stress in audiologists in other countries. The identification of consistent stress themes across the literature underscores the need for targeted support and interventions to ensure the well-being of audiologists and empower them in maintaining their pivotal role in health care.

Perceived Stress Among Nurses at a Tertiary Care Teaching Hospital in Saudi Arabia During the COVID-19 Pandemic

BACKGROUND

The stress level of nurses, especially frontline staff, directly impacts their physical and mental health as well as work efficiency. However, few studies have been conducted to understand the stress level of nurses related to the coronavirus disease 2019 (COVID-19) pandemic.

AIM

The aim of this study is to assess the level of perceived stress among nurses at a tertiary care teaching hospital (King Abdulaziz University Hospital, Jeddah) in Saudi Arabia during the COVID-19 pandemic.

METHODS

A cross-sectional survey-based descriptive study involved 1044 nurses working at a tertiary care/teaching hospital in Saudi Arabia. The Perceived Stress Scale (PSS) was used to assess nurses' stress levels. The study was conducted in July 2021 by selecting clinical nurses from different nursing units. Considering the current situation of social isolation, an online cross-sectional survey using Google Forms was used. Data analysis was performed using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States).

RESULTS

Out of 1044 nursing professionals, 93 (8.9%) reported experiencing low levels of stress, 915 (87.6%) reported moderate levels of stress, and 36 (3.4%) reported high perceived stress during the COVID-19 pandemic. The study found that gender (p=0.001) and nationality (p=0.016) had significant effects on stress levels. The three major causes of stress identified by the nurses were workload, lack of resources, and fear of contracting COVID-19.

CONCLUSION

Job-related stress continues to be an issue in the nursing workforce. The effects of stress experienced by nurses impact job satisfaction and retention, which, in turn, can affect the quality of patient care. This study highlights that nurses in a tertiary care (COVID care) teaching hospital in our setting often experience stress and anxiety during the pandemic. It is worth noting that this is the first study conducted to understand the level of stress perceived by nursing staff during the COVID-19 pandemic in our current study setting. The findings indicate that a considerable number of nurses experienced moderate levels of stress during COVID-19, which can have implications for patient care. Recognizing and understanding the job-related stressors of nurses can help nurse leaders implement more effective strategies aimed at reducing nurses' stress and subsequently improving patient outcomes.

Workload In Neonatology (WORKLINE): Validation and feasibility of a system for measuring clinician workload integrated into the electronic health record

OBJECTIVE

The purpose of the study was to validate WORKLINE, a NICU specific clinician workload model and to evaluate the feasibility of integrating WORKLINE into our EHR.

STUDY DESIGN

This was a prospective, observational study of the workload of 42 APPs and physicians in a large academic medical center NICU over a 6-month period. We used regression models with robust clustered standard errors to test associations of WORKLINE values with NASA Task Load Index (NASA-TLX) scores.

RESULTS

We found significant correlations between WORKLINE and NASA-TLX scores. APP caseload was not significantly associated with WORKLINE scores. We successfully integrated the WORKLINE model into our EHR to automatically generate workload scores.

CONCLUSION

WORKLINE provides an objective method to quantify the workload of clinicians in the NICU, and for APPs, performed better than caseload numbers to reflect workload. Integrating the WORKLINE model into the EHR was feasible and enabled automated workload scores.

Factors Associated with Job Stress among Hospital Nurses: A Meta-Correlation Analysis

This study aims to investigate research trends concerning job stress among hospital nurses. Articles about job stress among hospital nurses published in English from 2008 to 2018 were searched. In the first search, 2673 articles were extracted from the MEDLINE, EMBASE, KoreaMed, KERIS, KISS, KISTI, and KMbase databases. Altogether, 154 articles were used in the systematic review and meta-analysis. Thirty-nine variables were explored regarding job stress. Among the major variables, insufficient job control, personal conflict, and burnout had a positive correlation. In contrast, intention to stay, job satisfaction, and personal accomplishment had a negative correlation. In the meta-analysis conducted in relation to a specific conceptual framework, the negative-outcome factors showed significant positive correlations with job stress, whereas the positive-outcome factors showed significant negative correlations with job stress. This study identified factors associated with job stress in nurses through a meta-correlation analysis, and the overall correlation coefficient was relatively high at 0.51. Job factors and moderators had significant meta-correlation coefficients. These results can be utilized in clinical practice and research to help develop intervention programs to relieve job stress among nurses.

Job experience as a buffer against incivility: a daily diary study

Purpose

Incivility is pervasive in organisational settings, particularly in healthcare, and is associated with negative employee outcomes. The aim of this study was to analyse the relationships between experienced incivility, sleep quality and emotional outcomes, positioning sleep quality as a mediator. Additionally, the protective role of tenure and the unique effects of incivility from different sources were examined.

Design/methodology/approach

This study used a daily diary longitudinal design using self-report questionnaires with 92 nurses of varying tenure.

Findings

This research demonstrates that experiencing incivility negatively impacts sleep quality, which, in turn, increases surface acting and emotional exhaustion. Furthermore, the negative relationship between incivility and sleep quality is attenuated among nurses who have longer tenure.

Practical implications

These findings are helpful in developing targeted practical practices, such as incivility interventions and mentorship programs to reduce the incidence and impact of incivility.

Originality/value

This study draws upon theories of self-regulation and emotion regulation to examine how incivility diminishes self-control resources, leading to negative outcomes. This study also positions job tenure as a buffer against incivility and examines the differential impact of different sources of incivility.

Non-specific Low Back Pain Among Nurses in Qassim, Saudi Arabia

Introduction

Non-specific low back pain (LBP) is a complex and multifactorial health problem. Evidence has shown that LBP is an important occupational hazard and nurses are particularly at high risk. While several studies have addressed the prevalence of LBP worldwide, the prevalence of LBP in Saudi Arabia remains unclear. In this study, we aimed to estimate the prevalence and associated factors of LBP among nurses in the Qassim region, Saudi Arabia.

Methods

This was a multicenter cross-sectional study carried out in four major public hospitals in the Qassim region. A total of 323 nurses were recruited through a two-stage sampling method. A previously validated questionnaire was used to gather data. The main outcome measures were; LBP prevalence during working life, demographic factors, lifestyle factors, work-related factors, and psychological factors. Multivariable logistic regression analysis was used to determine factors independently associated with LBP. 

Results

The study showed that LBP prevalence was 65.6% (n=212). Over one-third of the study, participants sought treatment for LBP (n=82, 38.7%). Age and the type of ward were found significantly associated with LBP [adjusted odds ratios (aOR): 0.39; 95% confidence interval (CI): 0.19, 0.77; p value=0.007] & (aOR: 0.36; 95% CI: 0.15, 0.86; p-value =0.02), respectively. However, gender, working hours, number of patients, stress, and smoking were not identified as LBP risk factors in this study.

Conclusion

The findings of this study suggest that LBP is a highly prevalent occupational health problem among nurses in Qassim. Young nurses 20-30 years are more likely to suffer from LBP, while nurses working in the general surgery wards have a lower risk for LBP in this study. On-the-job training is essential particularly for new and young nurses on proper body mechanics when mobilizing patients or lifting heavy equipment. In addition, there is a need for evidence-based interventions to improve the workplace environment for nurses in hospitals in order to lower LBP prevalence.

Post-traumatic Stress and Related Factors Among Hospital Nurses during the COVID-19 Outbreak in Korea

COVID-19 is an ongoing worldwide infectious disease pandemic. The purpose of this study was to investigate post-traumatic stress and related factors among hospital nurses during the COVID-19 outbreak. The subjects of this study were 300 nurses who worked in three general hospitals that operated National Designated Isolation Unit (NDIU) wards during the COVID-19 outbreak. Self-reporting questionnaires were used to collect data on post-traumatic stress, general characteristics, and work-related information. The average post-traumatic stress score was 20.68 ± 19.5 points and 36.7% of participants were at high risk of post-traumatic stress disorder (PTSD). The odds ratio (OR) for PTSD was higher for nurses who worked in the NDIU ward (OR = 16.31, 95% CI = 3.79-70.32), who responded that nurse staffing was poor (OR = 3.03, 95% CI = 1.01-9.10), and who responded that they experienced COVID-19 symptoms (OR = 3.83, 95% CI = 1.89-7.75). Total 36.7% of nurses were at risk of PTSD and the factors related to PTSD were the work department, nurse staffing, and experiencing COVID-19 symptoms. These results could be used to manage PTSD and provide psychological support of nurses during infectious disease epidemics, such as COVID-19.

The nurses' occupational stress components and outcomes, findings from an integrative review

AIM

To identify, evaluate and summarize the components, factors and outcomes of nurses' occupational stress published between 2009-2019.

DESIGN

Integrative literature review.

METHODS

A literature search was conducted on PubMed, CINAHL and PsycINFO databases for articles published in English, between 2009-2019.

RESULTS

The review included 132 studies. Most studies were conducted in the Confucian Asia and Anglo countries, but a growing number of studies were done in other countries. Almost all studies used a quantitative design, and changes in the use of scales indicated an increasing attention to career-related components. Factors were categorized into sociodemographic, work environment and personal resources. Sociodemographic factors were inconsistent across countries. Outcomes were categorized into health status, capability, affective and behavioural responses to work, and organizational performance with generally consistent results. Model validation studies showed the non-linear or non-direct associations between stress and outcomes.

Comparison of Psychological and Physiological Stress in NICU Nurses: Effects of Unit Design and Shift

BACKGROUND

Effects of unit design and shift worked on stress in neonatal intensive care unit (NICU) nurses have not been fully studied.

PURPOSE

To compare stress in NICU nurses who work in single-family room (SFR) or open bay (OBY) units and on nonrotating day or night shift.

METHODS

Full-time registered nurses (RNs) (n = 72) from a 42-bed SFR and a 131-bed OBY NICU participated in this comparative cross-sectional study. The Nurse Stress Scale (NSS) and within-shift repeated salivary cortisol levels were used to measure stress. The relationship between NSS score and salivary cortisol level was examined using multiple linear regression. Salivary cortisol levels of day versus night shift were compared with mixed-effects linear models.

RESULTS

NSS scores were similar for SFR and OBY units (P = .672) and day versus night shift (P = .606). Changes in cortisol level over time (P = .764) and final cortisol level (P = .883) for SFR versus OBY were not significantly different after controlling for shift. Salivary cortisol level of day-shift nurses decreased significantly over time compared with night-shift nurses (P < .001). The final cortisol level was significantly higher for night-shift compared with day-shift nurses (P < .001).

IMPLICATIONS FOR PRACTICE

Psychological (NSS) and physiologic (salivary cortisol) stress of NICU nurses is similar in established SFR and OBY units. Cortisol levels are higher at the end of shift in nurses who work night shift and may reflect increased physiologic stress.

IMPLICATIONS FOR RESEARCH

Strategies are needed for reducing stress in NICU nurses who work night shift.

Perceived stress, self-compassion and job burnout in nurses: the moderating role of self-compassion

BACKGROUND

Job burnout is more prevalent among nurses than other medical team members and may have adverse effects on the mental and physical health of both nurses and their patients.

AIMS

To evaluate the associations between job burnout as a dependent variable with perceived stress and self-compassion as independent variables, and test the buffering role of self-compassion in the link between perceived stress and job burnout in nurses.

METHODS

This is a cross-sectional study with a convenience sampling method. A total of 150 nurses from four hospitals in Tehran, Iran participated in this study and completed three questionnaires, namely the Perceived Stress Scale, the Self-Compassion Scale and the Copenhagen Burnout Inventory.

RESULTS

Partial least square-structural equation modelling showed greater levels of perceived stress associated with greater levels of job burnout (β = 0.795, p < 0.001), and greater levels of self-compassion associated with lower levels of job burnout (β = -0.512, p < 0.001) in nurses. The results of the interaction-moderation analysis showed that self-compassion diminished the effect of perceived stress on job burnout in nurses.

CONCLUSIONS

The results of this study not only showed a significant association between perceived stress and job burnout in nurses, but also increased our understanding about the buffering role of self-compassion in the link between perceived stress and job burnout in nurses.

Transitional Shock of Multi-Nationality Newly Graduate Nurses in Kuwait

Introduction

The transitional period of newly graduate nurses became more stressful, different coping mechanisms are essential. Therefore, effective coping with transition-related stress and anxiety is important for the life and professional of those nurses.

Objectives

To examine the transitional shock through assessing the occupational stress and coping mechanism of multi-nationality newly graduate nurses in Kuwait.

Methods

A descriptive correlational design was used to identify the occupational stress of the newly graduate nurses (NGNs) and their coping mechanisms during the transitional period to their professional life. All the NGNs were recruited. The total number of participants was 152 nurses.

Results

Highly significant correlations on almost all stress domains with p-values P < 0.01. We found that "Death and dying" was ranked as the highest stressor with a mean score of 6.20, followed by "uncertainty concerning treatment" with a mean score of 5.59, and in the "Inadequate preparation" was the least stressor with a mean score of 1.64.

Conclusion

"Religious coping" was the highest-ranked coping mechanism. In conclusion, NGNs have to adjust quickly to the new practical atmosphere encountered in the health care settings by using the proper coping mechanisms techniques.

Impact of COVID-19 outbreak on nurses' mental health: A prospective cohort study

OBJECTIVES

To evaluate variations in nurses' sleep quality and symptoms of depression, anxiety and stress during the COVID-19 outbreak, and to evaluate whether the presence of potential risk factors influenced these symptoms over time.

METHODS

This prospective cohort study surveyed nurses three times - surveying personal factors, working conditions, family dynamics, and attitude towards COVID-19 - between March 31 and May 4, 2020. Nurses' mental health was assessed through Depression Anxiety Stress Scales - short version (DASS-21); their sleep quality was assessed through a 5-point Likert scale question.

RESULTS

Nurses' sleep quality and symptoms of depression, anxiety and stress presented a positive variation over the COVID-19 outbreak. The only factors which are directly related to the COVID-19 outbreak and that were associated with the positive variation in nurses' symptoms of depression, anxiety and stress were the fear to infect others and the fear to be infected (higher fear of being infected or to infect someone corresponded to increased symptoms of depression, anxiety and stress).

CONCLUSIONS

Although the COVID-19 outbreak seems to have had an immediate impact on nurses' mental health, a psychological adaptation phenomenon was also observed. Future research should focus on assessing nurses' symptoms of depression, anxiety and stress, after the COVID-19 pandemic, in order to compare and contrast the findings with the results of our study.

Validity and reliability of the Turkish version of the General Work Stress Scale

AIM

To test the validity and reliability of the Turkish version of the General Work Stress Scale.

BACKGROUND

Nursing is one of the most stressful professions. The primary measure that should be taken to ensure that nurses can cope with stress is determining their stress levels.

METHOD

The General Work Stress Scale was translated into Turkish via back-translation. Its reliability and validity were analysed via item analyses, content and construct validities, exploratory and confirmatory factor analyses, Cronbach's alpha and Spearman-Brown reliability coefficients. Average and standard deviations of the scale items and the overall scale were calculated.

RESULTS

The study was conducted with 276 nurses. The Cronbach's alpha of the whole scale was 0.91, and the Spearman-Brown reliability coefficient was 0.89. According to the resulting one-dimensional structure, the factor loadings of the scale items were between 0.67 and 0.82, and this structure alone explained 58.72% of the total variance. The confirmatory factor analysis revealed perfect and good-fit indices (χ² /df = 1.96; RMSA = 0.06; CFI = 0.99; IFI = 0.99; GFI = 0.97; RMR = 0.04; NFI = 0.99). The mean total score was 2.55 ± 0.87, while the items' means ranged from 2.10 ± 1.15 to 3.33 ± 1.13.

CONCLUSION

The Turkish version of the General Work Stress Scale is a valid and reliable tool for assessing nurses' general work stress. Nurses largely feel that their work makes them so stressed that they wish they had a different job. The items with high means suggest opportunities for improvement.

IMPLICATIONS FOR PRACTICE

The nurses or nursing services and units with low or high stress levels can be determined with the General Work Stress Scale. If necessary, measures aimed at eliminating or reducing the negative effects of those nurses or nursing services and units with high stress levels can be taken in a timely manner.

Public Sector Workers' Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale

OBJECTIVES

Given that Argentinian public-sector workers are highly exposed to stressful conditions, and that the psychometric properties of the widely used Perceived Stress Scale (PSS) should be evaluated in different settings, this work aimed to compare the psychometric properties of the Latin American Spanish PSS-10 and PSS-4 and to identify the optimal scale for stress assessment.

METHODS

A sample of 535 participants was randomly divided into 2 groups to evaluate dimensionality by exploratory and confirmatory factor analyses. The reliability of both scales was also evaluated. Convergent validity was estimated using the Executive Complaints Questionnaire, the average variance extracted, and the composite reliability. Discriminant validity was based on the correlation with the Utrecht Work Engagement Scale and the phi-square correlation between the components.

RESULTS

The factor analyses supported bidimensionality of the PSS-10 (stress and coping), which showed a better fit than the PSS-4. Moreover, the reliability of the PSS-10 was higher, whereas the PSS-4 did not achieve adequate values of internal consistency. The PSS-10 was also correlated significantly with all validation scales, and presented proper internal convergent and divergent validity.

CONCLUSIONS

The PSS-10 is a reliable and structurally valid instrument to measure perceived stress and coping in a Latin American Spanish-speaking population with high work demands, and the findings of this study expand our knowledge on the geographical and sociocultural applicability of the PSS.

Empathy levels among nursing students: A comparative cross-sectional study

AIM

Empathy is a crucial component of the nurse-patient relationship, but knowledge is lacking as to when empathy develops during nursing education. The aim of the present study was to compare empathy levels at different stages of undergraduate nursing education and different master's nursing programmes.

DESIGN

The design was a comparative cross-sectional study.

METHODS

A total of 329 participants in Sweden, comprised of nursing students in their second and sixth semesters in an undergraduate nursing programme as well as master's nursing students, rated their own empathy using the Jefferson Scale of Physician Empathy.

RESULTS

Students in their sixth semester in an undergraduate nursing programme expressed more empathy than did students in their second semester and master's nursing students. Among the five master's programmes, public-health nursing students expressed the most empathy and intensive-care nursing students the least.

Development and validation of an instrument to measure stress among older adult nursing students: The Student Nurse Stressor-15 (SNS-15) Scale

AIMS AND OBJECTIVES

To report the development, testing and validation of an instrument to assess the stressors experienced by student nurses during their older adult clinical placements.

BACKGROUND

The world's population of older adults is accelerating rapidly, with associated increased healthcare demands and a growing need for skilled nursing staff. However, this sector fails to attract adequate numbers of nursing graduates which is leading to a significant gap between nursing supply and demand. Older adult care is considered to be less attractive than other specialties and accompanied by more sources of stress.

DESIGN

A quantitative design was used.

METHODS

Data were collected from a cohort of Irish student nurses (n = 242) completing older adult clinical placements as part of their undergraduate degree. Exploratory and confirmatory factor analysis examined the instrument's underlying latent structure. Discriminant validity was investigated using a confirmatory factor analysis model with covariates. STROBE guidelines for cross-sectional studies informed reporting of this paper's research.

RESULTS

Factor analyses identified two factors relating to "Knowledge and Workload" and "Resources," which were assessed by nine and six items, respectively. Discriminant validity analyses found a significant relationship between age and the workload and knowledge factor, and between year of programme and the resources factor. The new instrument was labelled the Student Nurse Stressor-15 (SNS-15) Scale.

CONCLUSIONS

The SNS-15 contained some overlap with stressors from extant general student nurse stress instruments and a number of unique stressors encountered in older adult care. Future research directions are discussed.

RELEVANCE TO CLINICAL PRACTICE

The SNS-15 may assist stakeholders in nurse education and practice with the development of undergraduate degree programmes and clinical placements, and ultimately, in improving patient care and student retention.

The Impact of a Stress Management Program on the Stress Response of Nurses in Neonatal Intensive Care Units: A Quasi-Experimental Study

This study was conducted with the aim to determine the effect of a stress management program on the response to stress by nurses working in neonatal intensive care units. This quasi-experimental study was conducted on 70 nurses in Iran. The nurses were assigned to the 2 groups: experimental and control groups, with each group comprising 35 participants. The McNamara education program was used for nurses in the experimental group. The response to stress in both groups was reviewed pre- and postintervention and 8 weeks after the intervention using the Stress Response Inventory. The 2 groups had no significant differences in terms of stress response preintervention (t = 0.668, P = .506). The mean scores in the experimental group were higher preintervention than those obtained postintervention, and the difference between them was significant. These findings indicate that the program has led to stress reduction in the experimental group.

Nurses' Moral Distress, Burnout, and Intentions to Leave: An Integrative Review

Moral distress has been widely addressed across the nursing profession and within other disciplines. Forensic nurses are a vital part of the nursing profession as they care for complex patients who may suffer physically and psychologically. However, forensic nurses' moral distress in the context of caring for victims of violence has not been addressed. This integrative review of the literature reveals the consequences of moral distress on the nursing workforce particularly regarding nurses' burnout and intentions to leave their jobs. Turnover contributes to the country's critical shortage of nurses, which affects the quality of care patients receive and increases the costs for healthcare institutions.

Perceived job stress among community nurses: A multi-center cross-sectional study

AIM

China is reforming its health care system, which aimed to strengthen primary health care through building community health centers (stations) and assigning a "gate-keeper" role to primary care providers. Community nurses play a key role in the reform. Little is known about the level of job stress among community nurses. Thus, this study aims to explore the level of perceived job stress and its influencing factors among community nurses.

METHOD

A cross-sectional design was used to conduct a survey with 1015 nurses from 56 community health centers in Sichuan province. Job stress was measured by the Community Nurses Stress Scale. Data were collected between March and November 2015.

RESULTS

Community health nurses in China perceived high levels of job stress. The job stress was related to nurses' individual characteristics and work environments. Permanently employed nurses, shift workers, and those older than 45 years age and with less training related to community nursing and involvement in childcare were more likely to experience high levels of stress.

CONCLUSION

Reform is required of the community nursing personnel system, and development of continuing education programs and stress-alleviating measures to reduce community nurses' job stress. The results of this study favour future advanced practice community health nursing practice and education.

Work-related stress among nursing staff working in government hospitals and primary health care centres

AIM

Work-related stress (WRS) in the nursing working environment is prevalent and significantly affects the performance of nurses and organizations. Poor nursing and administrative performance affects the delivery of safety and quality patient care. Thus, this study aims to compare the sources and factors of stress among nurses from hospitals and primary health care centres.

METHODS

A cross-sectional study was conducted in five government hospitals and four sectors of primary health care centres in Saudi Arabia. Through a survey, the Nursing Stress Scale was completed by 347 nurses from February to March 2016.

RESULTS

Workload is perceived as the most common source of WRS, whereas inadequate preparation is regarded as the least. Other major sources are conflicts with physicians and nurses in primary centres and the lack of support and uncertainty concerning treatment in hospitals. The nurses' age, marital status, nationality, and job position are the significantly identified factors that contribute to stress.

CONCLUSION

Overall, the sources and factors of WRS significantly vary with nurses' working environment. Hence, understanding the perception of nurses towards their working environment can be a strategic basis in modifying policies in occupational stress management.

A Daily Diary Approach to the Examination of Chronic Stress, Daily Hassles and Safety Perceptions in Hospital Nursing

PURPOSE

Stress is a significant concern for individuals and organisations. Few studies have explored stress, burnout and patient safety in hospital nursing on a daily basis at the individual level. This study aimed to examine the effects of chronic stress and daily hassles on safety perceptions, the effect of chronic stress on daily hassles experienced and chronic stress as a potential moderator.

METHOD

Utilising a daily diary design, 83 UK hospital nurses completed three end-of-shift diaries, yielding 324 person days. Hassles, safety perceptions and workplace cognitive failure were measured daily, and a baseline questionnaire included a measure of chronic stress. Hierarchical multivariate linear modelling was used to analyse the data.

RESULTS

Higher chronic stress was associated with more daily hassles, poorer perceptions of safety and being less able to practise safely, but not more workplace cognitive failure. Reporting more daily hassles was associated with poorer perceptions of safety, being less able to practise safely and more workplace cognitive failure. Chronic stress did not moderate daily associations. The hassles reported illustrate the wide-ranging hassles nurses experienced.

CONCLUSION

The findings demonstrate, in addition to chronic stress, the importance of daily hassles for nurses' perceptions of safety and the hassles experienced by hospital nurses on a daily basis. Nurses perceive chronic stress and daily hassles to contribute to their perceptions of safety. Measuring the number of daily hassles experienced could proactively highlight when patient safety threats may arise, and as a result, interventions could usefully focus on the management of daily hassles.

Relationship between stress-related psychosocial work factors and suboptimal health among Chinese medical staff: a cross-sectional study

OBJECTIVES

The study aimed to develop and validate a model to measure psychosocial factors at work among medical staff in China based on confirmatory factor analysis (CFA). The second aim of the current study was to clarify the association between stress-related psychosocial work factors and suboptimal health status.

DESIGN

The cross-sectional study was conducted using clustered sampling method.

SETTING

Xuanwu Hospital, a 3A grade hospital in Beijing.

PARTICIPANTS

Nine hundred and fourteen medical staff aged over 40 years were sampled. Seven hundred and ninety-seven valid questionnaires were collected and used for further analyses. The sample included 94% of the Han population.

MAIN OUTCOME MEASURES

The Copenhagen Psychosocial Questionnaire (COPSOQ) and the Suboptimal Health Status Questionnaires-25 were used to assess the psychosocial factors at work and suboptimal health status, respectively. CFA was conducted to establish the evaluating method of COPSOQ. A multivariate logistic regression model was used to estimate the relationship between suboptimal health status and stress-related psychosocial work factors among Chinese medical staff.

RESULTS

There was a strong correlation among the five dimensions of COPSOQ based on the first-order factor model. Then, we established two second-order factors including negative and positive psychosocial work stress factors to evaluate psychosocial factors at work, and the second-order factor model fit well. The high score in negative (OR (95% CI)=1.47 (1.34 to 1.62), P<0.001) and positive (OR (95% CI)=0.96 (0.94 to 0.98), P<0.001) psychosocial work factors increased and decreased the risk of suboptimal health, respectively. This relationship remained statistically significant after adjusting for confounders and when using different cut-offs of suboptimal health status.

CONCLUSIONS

Among medical staff, the second-order factor model was a suitable method to evaluate the COPSOQ. The negative and positive psychosocial work stress factors might be the risk and protective factors of suboptimal health, respectively. Moreover, negative psychosocial work stress was the most associated factor to predict suboptimal health.

Exploratory study on resilience and its influencing factors among hospital nurses in Guangzhou, China

Background

Currently, building resilience in nurses is recognized as an important factor that helps maintain their health and stay in their profession; thus, identifying which factors can help them build resilience is necessary.

Methods

A cross-sectional survey design was used, and 1356 nurses from 11 general hospitals in Guangzhou, China, were assessed using the Chinese version of the Conner–Davidson Resilience Scale, the General Self-Efficacy Scale, the Simplified Coping Style Questionnaire, and the Job Stress Scale of Chinese nurses. The demographic characteristics of participants were also gathered.

Results

The mean total score of nurses' resilience is 59.99 (SD 13.59), which was significantly lower (P < 0.001) than that of the general people in China. The regression analysis affirmed that the factors which influence the resilience of nurses include self-efficacy, coping style, job stress, and education level (R² = 49.4%, P < 0.001).

Conclusion

Nurses had low resilience. They could not effectively cope with job challenges and recover from adversity. Strengthening self-efficacy, choosing active coping, decreasing job stress, and enhancing educational training can effectively improve their resilience.

Occupational Stress Experienced by Nurses Working in a Greek Regional Hospital: A Cross-sectional Study

Background:

Occupational stress is both psychologically and physically challenging and may lead to high rates of absenteeism, burnout, and turnover. Nursing is considered as one of the most stressful and demanding professions. This study aims to measure perceived stress levels among nurses in a Greek public general hospital.

Materials and Methods:

A cross-sectional study was conducted. A total of 157 nurses and nursing assistants took part. A self-administered questionnaire including sociodemographics and Expanded Nursing Stress Scale (ENSS) for stress assessment was used. Analysis was performed using Statistical Package for the Social Sciences version 20.0.

Results:

Total stress mean(SD) score ranged in medium levels [136.27 (47.80)]. The most stressful situations were dealing with death and dying [18.29 (5.59)]; patients' and their families' demands [20.90 (7.12)], and uncertainty concerning treatment [22.19 (9.07)]. Discrimination [4.40 (4.25)] and conflicts with peers [12.07 (5.10)] provoked less stress. There was a statistically significant relationship between age and total stress (F = 4.23, p < 0.001) and all distinct stressors. Nurses between 30 and 34 years expressed higher stress in all cases except patients' and their families' demands stressor. Those nurses who were divorced expressed higher stress in death and dying subscale (F = 2.93, p = 0.035). Nursing assistants expressing higher stress as far as workload (t = −2.40, p = 0.017), conflicts with physicians (t = −2.19, p = 0.033), and problems with peers (t = −2.63, p = 0.009) were concerned, compared to nurses.

Conclusions:

The findings of the study are in line with other researchers' findings concerning stressors among nursing personnel in Greece. Appropriate measures for the prevention and management of specific stressors must therefore be taken.

Subjective and Objective Measurement of Neonatal Nurse Practitioner Workload

BACKGROUND

Neonatal nurse practitioner (NNP) workload is not well studied, and metrics specific to NNP practice are lacking. Factors such as changes in resident duty hours, increasing neonatal intensive care unit admissions, and a shortage of NNPs contribute to NNP workload. Increased workload has been shown to be detrimental to providers and can affect quality of care.

PURPOSE

This study quantified NNP workload using a subjective workload metric, the NASA Task Load Index, and a newly developed objective workload metric specific to NNP practice.

METHODS

The NNP group at a level IV academic medical center was studied. The sample included 22 NNPs and 47 workload experiences.

RESULTS

A comparison of scores from the NASA Task Load Index and objective workload metric showed a moderate correlation (r = 0.503). Mental demand workload scores had the highest contribution to workload. Feelings of frustration also contributed to workload.

IMPLICATIONS FOR PRACTICE

The NASA Task Load Index can be utilized to measure the workload of NNPs. The objective workload metric has potential to quantify NNP workload pending further validation studies and is a simple, straightforward tool.

IMPLICATIONS FOR RESEARCH

Additional research is needed regarding NNP workload and methods to quantify workload. Larger studies are needed to validate the objective workload metric.

Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction

There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork.

Predictors of occupational burnout among nurses: a dominance analysis of job stressors

AIMS AND OBJECTIVES

To quantitatively compare dimensions of job stressors' effects on nurses' burnout.

BACKGROUND

Nurses, a key group of health service providers, often experience stressors at work. Extensive research has examined the relationship between job stressors and burnout; however, less has specifically compared the effects of job stressor domains on nurses' burnout.

DESIGN

A quantitative cross-sectional survey examined three general hospitals in Jinan, China.

METHOD

Participants were 602 nurses. We compared five potential stressors' ability to predict nurses' burnout using dominance analysis and assuming that each stressor was intercorrelated.

RESULTS

Strong positive correlations were found between all five job stressors and burnout. Interpersonal relationships and management issues most strongly predicted participants' burnout (11·3% of average variance).

CONCLUSION

Job stressors, and particularly interpersonal relationships and management issues, significantly predict nurses' job burnout.

RELEVANCE TO CLINICAL PRACTICE

Understanding the relative effect of job stressors may help identify fruitful areas for intervention and improve nurse recruitment and retention.

Job Demands, Engagement, and Turnover Intentions in Polish Nurses: The Role of Work-Family Interface

Background: Poland has lower ratios of employed registered nurses per 1,000 inhabitants than the EU average. Polish nurses work under miserable conditions without assisting personnel, and they reconcile their professional demands with responsibilities for their families; 96% of them are women.

Rationale/Aims: This study uses Hobfoll’s conservation of resources (CORs) theory to explain the role of various resources in the improvement of work conditions in the nursing profession. Work-family conflict (WFC) and family work conflict (FWC) threaten to deplete nurses’ resources. This paper set out to (1) examine the extent to which perceived job demands (workload and interpersonal conflicts at work) and engagement (vigor, dedication, and absorption) are associated with turnover intentions (the intention to leave the present workplace and the intention to leave the nursing profession); (2) attempt to determine whether levels of WFC and FWC moderate these associations.

Design/Method: This study comprised 188 female registered nurses. The inclusion criterion was to live with a partner and/or have children.

Results: WFC was moderately related to FWC. Hierarchical regression analyses showed that only high job demands and low vigor were significantly associated with turnover intentions. WFC was experienced more intensively than FWC. Job demands, vigor, dedication, and turnover intentions had a strong effect on WFC, while absorption had a strong effect on FWC. However, levels of WFC and FWC did not significantly moderate these associations.

Originality/Conclusion: The study produces new knowledge by examining a constellation of job demands, work engagement and WFC, which reflect the management of personal resources. Results from such a constellation in nurses from countries with a post-transformational economic system have not previously been discussed in the light of COR theory. Most importantly, we conclude that WFC does not intensify turnover intentions.

Relationship among perceived stress, anxiety, depression and craniocervical pain in nursing professionals under stress at work

Abstract Introduction: The appearance and evolution of some clinical pain conditions may be influenced by stress and other psychosocial factors. Face, head and cervical muscles may increase their activity and tension in the presence of stress, leading to craniocervicomandibular pain in individuals exposed to stress. Objective: To assess the relationship among perceived stress, anxiety, depression and craniocervicomandibular pain in nursing professionals under stress at work. Materials and Methods: Forty-three women under stress at work, according to the Job Stress Scale (JSS), were assessed by the Perceived Stress Scale (PSS), the Hospital Anxiety and Depression Scale (HADS), pressure pain threshold, measured by algometry, and muscle sensitivity to hand palpation of the masticatory and cervical muscles. Results: A low moderate level of perceived stress was found in 62.79% of the sample, anxiety in 11.63% and depression in 9.30%. The psychosocial scales correlated with each other. No correlation was found between pressure pain threshold and perceived stress, anxiety and depression. The level of pain to hand palpation correlated with the perceived stress scores. Conclusion: Pressure pain threshold was not influenced by the psychosocial factors assessed. Pain intensity to hand palpation, however, was higher as the perception of stress increased.

The importance of monitoring nurses' workplace satisfaction of nurses for the well-being of all employees in nursing

Introduction: Work is an important constituent of an individual’s life since the experience of work influences well-being and health. The well-being of employees is an important issue in the work environment. The aim was to examine the relationship between satisfaction in the workplace and the well-being of employees in nursing. Methods: Quantitative research based on a cross-sectional study was used, with 640 employees in nursing from eight Slovenian hospitals participating in the study. A structured survey questionnaire was administered. The relationship between psychological well-being and workplace satisfaction was analysed with correlation and linear regression analysis. Results: The workplace satisfaction (x = 3.69, s = 1.13) and well-being ( x=161.27, s = 55.19) of employees in nursing are at a middle level. With the correlation analysis we established that well-being statistically significantly correlates with workplace satisfaction (r = 0.611, p < 0.001). Workplace satisfaction explains 42 % of the total variability of well-being of employees in nursing. Discussion and conclusion: It is necessary for every health care organization to take care of its employees' workplace satisfaction and well-being. Health care organizations can be successful and achieve their organisational objectives if their employees are satisfied with their work and have a high level of well-being.

Critical Review on Suicide Among Nurses

Background: Research shows that there is a high prevalence of suicide among nurses. Despite this, it has been 15 years since the last literature review on the subject was published. Aim: The aim of this article is to review the knowledge currently available on the risk of suicide among nurses and on contributory risk factors. Method: A search was conducted in electronic databases using keywords related to prevalence and risk factors of suicide among nurses. The abstracts were analyzed by reviewers according to selection criteria. Selected articles were submitted to a full-text review and their key elements were summarized. Results: Only nine articles were eligible for inclusion in this review. The results of this literature review highlight both the troubling high prevalence of suicide among nurses as well as the persistent lack of studies that examine this issue. Conclusion: Considering that the effects of several factors related to nurses' work and work settings are associated with high stress, distress, or psychiatric problems, we highlight the relevance of investigating work-related factors associated with nurses' risk of suicide. Several avenues for future studies are discussed as well as possible research methods.

An investigation into the Professional Quality of Life of dietitians working in acute care caseloads: are we doing enough to look after our own?

BACKGROUND

The development of compassion fatigue (CF) has been described across a variety of acute care caseloads in some health professions. The present study was undertaken to determine whether dietitians working in these caseloads also experience CF.

METHODS

A voluntary, anonymous survey incorporating the Professional Quality of Life tool was developed in an online format, and was e-mailed to dietitians working in public acute care settings.

RESULTS

Eighty-seven completed surveys were returned. Average rates of compassion satisfaction (CS) and burnout and low rates of secondary traumatic stress (STS) were reported. Dietitians in high-risk workloads reported higher levels of STS than those with low-risk workloads (χ2 = 5.4, P = 0.02). Differences in STS were found between those practising in paediatric compared to adult caseloads (χ2 = 16.6, P < 0.01). Dietitians in smaller facilities reported higher STS (χ2 = 10.6, P < 0.01) and lower CS (P = 0.05) than larger facilities. Working for >5 years as a dietitian was associated with higher rates of STS and burnout than in those working for <5 years (χ2 = 7.9, P = 0.05 and χ2 = 3.8, P = 0.05, respectively). Those who perceived greater levels of support reported lower rates of burnout (r(s) = -0.41, P < 0.01) and higher rates of CS (r(s) = 0.39, P < 0.01) than those not feeling supported. All dietitians reported undertaking self-care practices; however, up to 24% reported practices that may represent maladaptive coping methods.

CONCLUSIONS

Although the present study suggests dietitians experience a good professional quality of life, vulnerable areas were identified, suggesting the need for additional support in some areas of dietetic practice.

Nurses' Experiences of Nonpatient Factors That Affect Nursing Workload: A Study of the PAONCIL Instrument's Nonpatient Factors

In the RAFAELA patient classification system, the professional assessment of optimal nursing care intensity level (PAONCIL) instrument is used to assess the optimal nursing intensity level per unit. The PAONCIL instrument contains an overall assessment of the actual nursing intensity level and an additional list of central nonpatient factors that may increase or decrease the total nursing workload (NWL). The aim of this cross-sectional study was to assess and determine which nonpatient factors affect nurses' experiences of their total NWL in both outpatient settings and hospitals, as captured through the PAONCIL instrument. The data material consisted of PAONCIL questionnaires from 38 units and 37 outpatient clinics at 11 strategically selected hospitals in Finland, and included nurses' answers (n = 1307) to the question of which factors, other than nursing intensity, affect total NWL. The methods for data analyses were qualitative content analyses. The nonpatient factors that affected nurses' experiences of total NWL are "organization of work," "working conditions," "self-control," and "cooperation." The actual list of nonpatient factors in the PAONCIL instrument is to a reasonable extent relevant, but the list should be improved to include nurses' actual working conditions and self-control.

Factors Affecting Job Satisfaction of Immigrant Korean Nurses

PURPOSE

An increasing number of foreign-born nurses are working in the United States. Nurses' job satisfaction is a critical issue for quality patient care. The purpose of this study was to examine factors affecting the job satisfaction of immigrant Korean nurses.

DESIGN

We used a cross-sectional mailed survey design. A convenience sample (n = 105) of members of the Greater New York Korean Nurses Association currently working or had previously worked in the United States completed the questionnaires. We used hierarchical regression to test the effects of acculturation and life satisfaction on job satisfaction.

RESULTS

Most participants were female (n = 98, 93.3%) aged 27 to 70 years (mean = 52.27 years, SD = 10.67). In the regression model, life satisfaction, self-esteem, and perceived stress predicted job satisfaction (F = 5.127, p < .001) and explained 44.5% of the variance of job satisfaction.

DISCUSSION AND CONCLUSION

U.S. nurses need to gain insight into factors influencing job satisfaction in Korean nurses to promote retention and quality care.

A comparison of burnout among oncology nurses working in adult and pediatric inpatient and outpatient settings

PURPOSE/OBJECTIVES

To investigate differences in burnout among oncology nurses by type of work setting, coping strategies, and job satisfaction.

DESIGN

Descriptive.

SETTING

A metropolitan cancer center.

SAMPLE

A convenience sample of 74 oncology nurses.

METHODS

Participants completed a demographic data form, the Nursing Satisfaction and Retention Survey, and the Maslach Burnout Inventory.

MAIN RESEARCH VARIABLES

Burnout, coping strategies, job satisfaction, and oncology work setting (inpatient versus outpatient and adult versus pediatric).

FINDINGS

The participants most often used spirituality and coworker support to cope. Emotional exhaustion was lowest for youngest nurses and highest for outpatient RNs. Personal accomplishment was highest in adult settings. Job satisfaction correlated inversely with emotional exhaustion and the desire to leave oncology nursing.

CONCLUSIONS

The findings support that the social context within the work environment may impact emotional exhaustion and depersonalization, and that demographics may be more significant in determining burnout than setting.

IMPLICATIONS FOR NURSING

The findings raise questions of whether demographics or setting plays a bigger role in burnout and supports organizational strategies that enhance coworker camaraderie, encourage nurses to discuss high-stress situations, and share ways to manage their emotions in oncology settings.

KNOWLEDGE TRANSLATION

Spirituality and coworker relationships were positive coping strategies among oncology nurses to prevent emotional exhaustion. Nurses who rely on supportive social networks as a coping mechanism have lower levels of depersonalization. Age was inversely related to emotional exhaustion.

Emotional intelligence and affective intensity as life satisfaction and psychological well-being predictors on nursing professionals

The goal of this study was to examine the relationship between perceived emotional intelligence (PEI), affective intensity, life satisfaction, and psychological well-being in a sample of nursing professionals. Studies conducted in nursing have shown that emotional intelligence is a skill that minimizes the negative stress consequences. PEI was measured by the Trait Meta-Mood Scale, which includes the emotional attention, clarity and repair subscales. Affective intensity was measured by Larsen's Affective Intensity Scale. To analyze this relationship, we observed the impact of PEI and affective intensity on life satisfaction and psychological well-being, while controlling the sociodemographic variables. The correlation analyses showed significant relationships between the subscales of these variables. Clarity showed positive relationships with some psychological well-being dimensions. Affective intensity subscales presented relationships with life quality and different subscales of psychological well-being. Regression analyses indicated that repair is the only life satisfaction predictor. Moreover, clarity, some affective intensity dimensions, and sociodemographic variables are the main predictors of psychological well-being. The results confirmed the importance of repair on life quality and psychological well-being. Programs to improve nursing professionals' PEI are needed to increase their psychological well-being and life satisfaction.

Psychometric analysis of the Short-Form Chinese Health and Safety Executive's Management Standards Indicator Tool among nurses in Taiwan

The purpose of the study was to develop a Short-Form Chinese version of the Health and Safety Executive's Management Standards Indicator Tool that can be used to measure work-related stress among nurses in Taiwan. Three subscales (supportive climate, role perception, and workload) were developed from an exploratory factor analysis. The three-factor confirmatory factor analysis indicated that the model fit the data well. The evidence based on convergent validity was supported by a significant correlation between the Short-Form Chinese version of the Health and Safety Executive's Management Standards Indicator Tool and the job satisfaction subscale of the Chinese Patient Safety Attitude Questionnaire. Cronbach's α values demonstrated internal item consistency for the Short-Form Chinese version of the Health and Safety Executive's Management Standards Indicator Tool.

Stressors of dual-qualification nursing teachers in the ChengDu-ChongQing economic zone of China--a qualitative study

Nursing and teaching are considered risk professions with high levels of stress and burnout. Dual-qualification nursing teachers (DQNT) are nurses who both teach and practise. These nurses face additional stress. This study explored the stressors of DQNT in the Chengdu-Chongqing Economic Zone of China. This qualitative study used in-depth, open-ended interviews. The interview responses were analysed using a grounded theory approach. The participants in this study included 21 DQNT from 5 teaching hospitals in the Chengdu-Chongqing Economic Zone of China. The results indicated that heavy workload, personal safety, inadequate pay, role overload, and poor working environment are stressors of DQNT. Furthermore, Chinese DQNT face violence from patients and students. The study provides a theoretical basis to help DQNT to cope with stress.

Organisational change stressors and nursing job satisfaction: the mediating effect of coping strategies

AIM

To examine the mediating effect of coping strategies on the consequences of nursing and non-nursing (administrative) stressors on the job satisfaction of nurses during change management.

BACKGROUND

Organisational change can result in an increase in nursing and non-nursing-related stressors, which can have a negative impact on the job satisfaction of nurses employed in health-care organisations.

METHOD

Matched data were collected in 2009 via an online survey at two time-points (six months apart).

RESULTS

Partial least squares path analysis revealed a significant causal relationship between Time 1 administrative and role stressors and an increase in nursing-specific stressors in Time 2. A significant relationship was also identified between job-specific nursing stressors and the adoption of effective coping strategies to deal with increased levels of change-induced stress and strain and the likelihood of reporting higher levels of job satisfaction in Time 2.

CONCLUSIONS

The effectiveness of coping strategies is critical in helping nurses to deal with the negative consequences of organisational change.

IMPLICATIONS FOR NURSING MANAGEMENT

This study shows that there is a causal relationship between change, non-nursing stressors and job satisfaction. Senior management should implement strategies aimed at reducing nursing and non-nursing stress during change in order to enhance the job satisfaction of nurses.

Occupational stress and turnover intention: implications for nursing management

BACKGROUND

The main purpose of this study was to explore the status of occupational stress among hospital nurses in Isfahan, Iran. It also aimed to examine the relationship between nurses' occupational stress and their intention to leave the hospital.

METHODS

The study employed a cross-sectional research design. A validated questionnaire was used to collect data from 296 nurses. Respondents were asked to rate the intensity of 30 common occupational stressors using a five-point scale.

RESULTS

A third of hospital nurses rated their occupational stress high. The major sources of stress were inadequate pay, inequality at work, too much work, staff shortage, lack of promotion, job insecurity and lack of management support. More than 35% of nurses stated that they are considering leaving the hospital, if they could find another job opportunity. Occupational stress was positively associated with nurses' turnover intentions.

CONCLUSION

Hospital managers should develop and apply appropriate policies and strategies to reduce occupational stress and consequently nurses' turnover intention.