Occupational stress in nurses in psychiatric institutions in Taiwan

Investigating association between job stress dimensions and prevalence of low back pain among hospital nurses

BACKGROUND

There are a few studies conducted on job stress dimensions and their relationship with Low Back Pain (LBP) among Iranian nurses.

OBJECTIVE

The aim of the current study was to investigate the association between job stress dimensions assessed via Demand-Control-Social Support (DCS) and Effort-Reward Imbalance (ERI) models and prevalence of LBP among Iranian hospital nurses.

METHODS

In this cross-sectional study, 495 randomly selected nurses of Shiraz University of Medical Sciences (SUMS) participated. Demographic/occupational questionnaire, the Persian version of the Job Content Questionnaire (P-JCQ) and the Persian version of the ERI Questionnaire (P-ERIQ) were used for data collection. Data were analyzed by SPSS software (version 19) using descriptive statistics, independent sample t-test, and logistic regression.

RESULTS

The LBP prevalence was found to be 69.9%. The means±standard deviations of job stress dimensions were obtained as follows: decision latitude: 64.67±6.82, physical job demands: 15.52±2.6, social support: 23.18±3.65, psychological job demands: 38.02±4.98, effort: 8.73±2.62, reward: 23.12±5.31, over-commitment: 12.25±3.09, and effort-reward ratio: 0.86±0.3. The findings revealed that the work experience (OR = 1.56), psychological job demands (OR = 1.082), and effort-reward ratio (OR = 3.43) were predictors for LBP among the study population.

CONCLUSION

The prevalence rate of LBP among studied nurses was high. About half of nurses had high psychological demands, low decision latitude and low social support. Based on the effort-reward ratio, nurses had experienced high level of stress. Interventional programs and coping strategies for reduction of work-related stress and, subsequently, prevention of LBP are recommended among hospital nurses.

Nurses' work-related stress and associated factors in governmental hospitals in Harar, Eastern Ethiopia: A cross-sectional study

Introduction

Work-related stress causes poor quality of nursing care and increases the risk of medical errors. Research evidence is so limited to nurses’ work-related stress in eastern Ethiopia. Therefore, this study aimed to assess work-related stress and associated factors among nurses working in governmental hospitals in Harar, Eastern Ethiopia.

Methods

Institution-based quantitative cross-sectional study was conducted among 367 nurses from 15^th to 30^th March, 2015. Simple random sampling technique was applied to recruit study participants. Data were collected using structured self-administered questionnaire. Descriptive statistics, bivariate and multivariate logistic regressions were carried out. The statistical association was declared using adjusted odds ratio at 95% confidence interval (CI) and P-value of less than 0.05.

Results

A total of 398 study participants were involved in the study, and the response rate was 92.2% (367/398). More than half of 202(55%) of the participants were males. One third (33.8%, n = 124) of study participants’ age ranged between 26 to 34 years. The prevalence of work-related stress in the current study was 66.2%. Nurses, who reared child (AOR = 2.1, 95% CI: 1.2, 3.7), working in intensive care units (AOR = 4.5, 95% CI: 1.4, 17.7), work on rotation (AOR = 2.5, 95% CI: 1.4, 4.4), and nurses who had a chronic medical illness (AOR = 2.6, 95% CI: 1.2, 5.7) were significantly associated with nurses’ work-related stress.

Conclusion

Two-thirds of nurses who were working at government hospitals had work-related stress. Work-related stress was associated with child-rearing, working units, work on rotation, and chronic medical illness. We suggested the hospital's administration, and other concerned stakeholders should design a strategy to undertake necessary measures such as hiring more nurses to minimize workload and rescheduling work shift to alleviate work-related stress among nurses.

Exploring Perceptions of the Work Environment among Psychiatric Nursing Staff in France: A Qualitative Study Using Hierarchical Clustering Methods

Most studies on workers’ health are based on non-specific models of occupational stress, thereby limiting the understanding and research on efficient interventions. This qualitative approach aimed to explore the structure of resources and constraints in the working environment of nurses in a deliberately open approach. Semi-structured interviews were conducted with 37 nurses working in closed and open inpatient psychiatric wards in a French university hospital. The data were statistically analyzed using a hierarchical clustering method. Our model highlighted a systemic structure, describing the interactions, including patients, nurses, doctors, and managers in a specific material, communicational, and organizational environment. The results show a discursive structure organized around dimensions pertaining to “environment”, “patients”, “medical-care group”, and “the individual”. Our model showed interest in an interdisciplinary approach that encompasses occupational medicine and social psychology.

Validation of the Job Content Questionnaire among hospital nurses in Vietnam

Objectives

The aim of this study was to examine the reliability and validity of the Job Content Questionnaire (JCQ) in Vietnamese among hospital nursing staff.

Methods

The 22‐items version of the JCQ was used. This includes four scales: (a) psychological demands (5 items); (b) job control (9 items); (c) supervisor support (4 items); and (d) coworker support (4 items). All 1258 nurses in a general hospital in Vietnam, excluding 11 who were due to retire, were invited to complete the cross‐sectional survey. The internal consistency reliability was estimated using Cronbach's α. Construct validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations between the JCQ scores and DASS 21 and overtime work.

Results

In total, 949 (75%) of the 1258 eligible nurses completed the survey. Cronbach's α values demonstrated acceptable internal consistency in two scales (supervisor support α = .87; coworker support α = .86), while Cronbach's α was below the acceptable threshold of 0.70 for job control (α = .45) and job demand (α = .50). EFA assuming a four‐factor structure showed a factor structure that was almost identical to the original JCQ, with two items loading on other scales. The subscales of depression, anxiety, and stress response of DASS 21 and the subscales of JCQ were significantly correlated, as expected.

Conclusion

The results suggest that the JCQ in Vietnamese can be used with some reliability and validity for examining psychosocial work environment among nurses. Further studies should be done to confirm and expand our findings in a variety of occupational groups and in other Asian low‐ and middle‐income countries.

Factores psicosociales, estrés psicológico y burnout en enfermería: un modelo de trayectorias

Introducción: El personal de enfermería se enfrenta cotidianamente a diferentes eventos asociados al estrés, factores psicosociales y otros mecanismos que afectan su salud mental. Objetivo: Evaluar la correlación entre la demanda psicológica, el control laboral, el apoyo social, el estrés psicológico, y las dimensiones del Síndrome de Burnout (ilusión por el trabajo, desgaste psíquico, indolencia y culpa), en un modelo de trayectorias en enfermeras mexicanas. Metodología: Estudio transversal, observacional, analítico, conducido en 357 profesionales de enfermería de Morelos, México, seleccionados por conveniencia. Los datos fueron colectados empleando tres cuestionarios, la Escala de Estrés Percibido, el Cuestionario del Contenido del Trabajo y el Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo. Los programas SPSS 19 y LISREL 8.3 fueron empleados para el procesamiento y modelaje de los datos. Resultados: En el modelo de trayectorias, se especificó como variable mediadora de los factores psicosociales y de las dimensiones del Síndrome de Quemarse por el Trabajo (SQT), al estrés psicológico. Los índices de ajuste fueron aceptables. Se encontraron altos niveles de apoyo social, control laboral e ilusión por el trabajo; grados moderados de demanda psicológica y estrés psicológico; y bajos niveles de desgaste psíquico, indolencia y culpa. Conclusión: Implicaciones para la disciplina, se propone implementar estrategias de intervención efectivas para mantener en el personal de enfermería bajos niveles de demandas psicológicas, altos niveles de control laboral, altos niveles de apoyo social, y niveles moderados de estrés, para prevenir, el SQT.

The correlation between occupational stress, coping strategies, and the levels of psychological distress among nurses working in mental health hospital in Jordan

PURPOSE

Psychiatric nurses encounter variety of demanding and stressful events such as dealing with aggressive patients, and hostile. This study purposed to assess workplace stress, coping strategies, and psychiatric distress among psychiatric nurses.

DESIGN AND METHODS

A descriptive explanatory design was employed. One hundred and nineteen psychiatric nurses were recruited in the study and data were collected in the period between June and September 2017.

FINDINGS

The results showed that participants experienced moderate level of occupational stress and psychiatric distress. In addition, they utilized different coping mechanism.

PRACTICE IMPLICATIONS

Stress management techniques program is very effective in helping psychiatric nurse to deal with occupational stress which might influence their wellbeing. Moreover, this program assists them to use more effective coping strategies as problem solving.

Combining group psychotherapy and yoga exercises improves quality of life in mental health professionals: a controlled randomized clinical trial

Purpose

This study aims to investigate the effects of combining 12-week group psychotherapy with yoga exercises on stress perception and quality of life in mental health professionals.

Design/methodology/approach

This study was a parallel-arm randomized controlled trial, in which the participants was unaware of which group was the experimental one. Participants involved in our research were assigned to two groups of separate treatment that followed for three months group psychotherapy combined with yoga program for stress management or usual stress coping strategies.

Findings

The findings did not reveal a significant difference in stress perception assessed in the two groups either before or after intervention but reveal a significant difference in the quality of life in the two groups before and after the psycho behavioral interventions.

Originality/value

The findings did not reveal a significant difference in stress perception assessed in the two groups either before or after intervention but reveal a significant difference in the quality of life in the two groups before and after the psycho behavioral interventions.

Occupational stress, coping strategies, and psychological-related outcomes of nurses working in psychiatric hospitals

AIMS

Psychiatric nurses experience a wide range of stressful events, evolving from the care of violent, aggressive patients, recurrent relapse, and poor prognosis of mental disorders. The aim of the study was to assess workplace stress, coping strategies, and levels of depression among psychiatric nurses.

METHODS

A descriptive correlation design was conducted on psychiatric nurses working in mental health settings Port-Said, Egypt. Data were collected from 70 nurses at a mental health hospital.

RESULTS

The results revealed that psychiatric nurses had moderate levels of work-related stress and depression, and exhibiting different coping strategies. Stress and depression are prevalent among psychiatric nurses.

CONCLUSIONS

Implementing programs aimed at teaching them how to deal with stress at work and improving their coping strategies and problem-solving skills are recommended.

The impact of shift work and organisational climate on nurse health: a cross-sectional study

BACKGROUND

The negative effects of shift work schedules, specifically night and rotating shifts, have been widely reported. However, little is understood whether particular aspects of the organisational environment, related to specific shifts, may influence the negative impact of shift work. This study investigated the variation in organisational climate and health outcomes across shift work schedules (day, night, rotating).

METHODS

This cross-sectional study involved nursing staff (n = 108) who were all registered nurses from two Melbourne health services. There were slightly more nursing staff that participated from one health service (n = 56) than the other health service (n = 52). Nursing staff completed a survey on either paper form or online which comprised of: demographic characteristics, organisational climate (work environment scale) and health outcomes (general health questionnaire).

RESULTS

The study found that organisational climate factors and health outcomes differed across shift types. Rotating shift staff exhibited significantly higher coworker cohesion scores when compared to night staff. Night staff reported significantly greater levels of physical comfort within their work environment than rotating staff. Overall, supervisor support emerged as a significant predictor of health outcomes such as somatic complaints, social dysfunction and overall distress. Task orientation was also shown to significantly predict levels of social dysfunction.

CONCLUSIONS

Findings suggest that interventions with a focus on enhancing the organisational climate, focused in increasing supervisor support, may mitigate the potential negative health outcomes experienced by shift workers.

TRIAL REGISTRATION

Not applicable to this study.

The Work Ability of Hong Kong Construction Workers in Relation to Individual and Work-Related Factors

The shortage in Hong Kong of construction workers is expected to worsen in future due to the aging population and increasing construction activity. Construction work is dangerous and to help reduce the premature loss of construction workers due to work-related disabilities, this study measured the work ability of 420 Hong Kong construction workers with a Work Ability Index (WAI) which can be used to predict present and future work performance. Given the importance of WAI, in this study the effects of individual and work-related factors on WAI were examined to develop and validate a WAI model to predict how individual and work-related factors affect work ability. The findings will be useful for formulating a pragmatic intervention program to improve the work ability of construction workers and keep them in the work force.

Mental Health Nurse's Exposure to Workplace Violence Leads to Job Stress, Which Leads to Reduced Professional Quality of Life

Professional quality of life (ProQOL) reflects how individuals feel about their work as helpers. Psychiatric ward nurses cope with significant psychological and physical challenges, including exposure to verbal and physical violence. This study was based on two aspects of ProQOL, the positive compassion satisfaction, and the negative compassion fatigue, with the aim of investigating the relation of ProQOL to job stress and violence exposure at a large mental health center. Data were collected from 114 mental health nurses (49/63 M/F) who completed a self-administered questionnaire examining violence exposure, ProQOL, and job stress. The results showed that during the last year, almost all nurses (88.6%) experienced verbal violence, and more than half (56.1%) experienced physical violence. Only 2.6% experienced no violence. ProQOL was not associated with violence exposure but was reduced by work stress and by previous exposure to violence; nurses who perceived their work as more stressful had lower satisfaction from their work. In conclusion, although most mental health nurses are exposed to physical and verbal violence, their ProQOL is more related to job stress than to workplace violence (WPV). Hospital managements should conduct work stress reduction intervention programs and promote strategizes to reduce WPV. Further exploration of (a) factors affecting ProQOL and (b) the effect of violence coping workshops on ProQOL is warranted.

Psychological symptoms among hospital nurses in Taiwan: a cross sectional study

Background

A considerable number of studies have identified the risk factors attributable to job-related stress among nurses. However, studies investigating psychological symptoms among hospital nurses is still lacking, especially in Taiwan, where the average patient to nurse ratio is among the highest in the world. This study aimed to investigate the potential role of self-rated health status, self-reported diseases, and utilization of occupational health checks in psychological symptoms among Taiwanese nurses.

Methods

A cross-sectional design was conducted from September through December 2013. Data were collected through online self-administered questionnaire among 697 registered nurses in seven regional hospitals governed by the Taipei City Government.

Results

Nurses with fair or poor self-rated health, lower education, <30 years of age, and low back pain were more likely to suffer from psychological symptoms. A trend toward significance was also noticed for those aged 30–39. Importantly, low back pain was the most common disease among nurses in self-reported diseases and half of the nurses reported not utilizing the occupational health examination for the last 5 years.

Conclusions

To alleviate or prevent the psychological symptoms, psychosocial support, and awareness program on prevention of occupational injuries should be offered to nurses younger than 39 years old and having lower educational levels. Moreover, underutilization of occupational health examination among nurses deserves more attention.

Electronic supplementary material

The online version of this article (doi: 10.1186/s12905-017-0460-5) contains supplementary material, which is available to authorized users.

A cross-sectional study on the prevalence and associated risk factors for workplace violence against Chinese nurses

OBJECTIVES

The purpose of the present study was to explore the characteristics of workplace violence that Chinese nurses at tertiary and county-level hospitals encountered in the 12 months from December 2014 to January 2016, to identify and analyse risk factors for workplace violence, and to establish the basis for future preventive strategies.

DESIGN

A cross-sectional study.

SETTING

A total of 44 tertiary hospitals and 90 county-level hospitals in 16 provinces (municipalities or autonomous regions) in China.

METHODS

We used stratified random sampling to collect data from December 2014 to January 2016. We distributed 21 360 questionnaires, and 15 970 participants provided valid data (effective response rate=74.77%). We conducted binary logistic regression analyses on the risk factors for workplace violence among the nurses in our sample and analysed the reasons for aggression.

RESULTS

The prevalence of workplace violence was 65.8%; of this, 64.9% was verbal violence, and physical violence and sexual harassment accounted for 11.8% and 3.9%, respectively. Frequent workplace violence occurred primarily in emergency and paediatric departments. Respondents reported that patients' relatives were the main perpetrators in tertiary and county-level hospitals. Logistic regression analysis showed that respondents' age, department, years of experience and direct contact with patients were common risk factors at different levels of hospitals.

CONCLUSIONS

Workplace violence is frequent in China's tertiary and county-level hospitals; its occurrence is especially frequent in the emergency and paediatric departments. It is necessary to cope with workplace violence by developing effective control strategies at individual, hospital and national levels.

The Effect of Job Demand-Control-Social Support Model on Nurses' Job Satisfaction in Specialized Teaching Hospitals, Ethiopia

Background

The job demand-control-social support model has been widely studied in western countries but has not been theoretically addressed on health workers of sub-Saharan African countries. Therefore, this study investigates the relationship between Job Demand-Control-Support Model and job satisfaction in specialized teaching hospitals in Ethiopia.

Method

A cross-sectional survey was conducted from September 2014 to May 2015 in three public specialized teaching hospitals in Ethiopia. Among 1371 nurses, 360 were selected as sample. Data was collected using Job Content Questionnaire and Job Satisfaction Survey Questionnaire. After the data was collected, it was analyzed using SPSS version16.0 statistical software. The results were analyzed using of descriptive statistics followed by inferential statistics on the variables.

Results

The result revealed that control variables (gender, age, educational qualification, and work experience) accounted for a significant increment explaining 2.1 percent of the variance in job satisfaction. Job demand and social support together explained 24.5 percent of job satisfaction. Job demand(β=−0.152; p<0.01) had significant but negative relationship with job satisfaction and social support (β=0.458; p<0.01) had significant and positive relationship with job satisfaction. On the other hand, job control (β=0.042; p>0.05) did not have a significant relationship with job satisfaction. Furthermore, there was no straight three-way interaction effect among job demand, job control and social support (β=0.05, p>0.05).

Conclusion

Job demand and social support are related to nurses' job satisfaction, but job control neither related to nor moderated the relationship between job demands and job satisfaction. Furthermore, there was no joint three-way interaction effect among job demand, job control and social support.

Job stress and burnout in the care staff of Leros PIKPA Asylum 25 years after the first Deinstitutionalisation and Rehabilitation Greek Project

Aims and method To identify correlates between burnout and job stress of care staff at Leros PIKPA Asylum. Forty-nine asylum employees were assessed by Maslach's Burnout Inventory, a sociodemographic questionnaire, the Perceived Stress Scale and the Job Content Questionnaire. Results Emotional exhaustion is related negatively to social support (P = 0.010, r = -0.362). Lack of job achievements is related positively to overall job responsibility (P = 0.040) and negatively to lack of job satisfaction (r = -0.430). Depersonalisation was negatively associated with support from superiors (P = 0.036). Employees with high levels of perceived stress reported higher levels of fatigue (P = 0.050). Positive associations of perceived stress with depression (P = 0.011) and sleep problems (P<0.001) were also detected. Positive correlation was found between monthly salary and lack of sense of personal achievement (P = 0.020). Clinical implications It is necessary to address these issues through staff education and stress management.

Practice manager expectations of new graduate registered nurses in Australian general practice: a national survey

Practice managers are often involved in the employment of practice nurses and are likely to have a significant role in future transition programs in general practice. Therefore, the aim of the study was to explore practice managers' expectations of new graduate registered nurses working in general practice. A nation-wide web-based electronic survey distributed by the Australian Association of Practice Management was used to collect demographic data and practice managers' expectations of new graduate nurses directly transitioning into general practice in their first year of practice. The sample was broadly representative of the Australian state and territory population numbers. Respondents were predominantly female with postgraduate qualifications. The findings of this study highlight that practice managers who currently work with practice nurses would be supportive of graduate registered nurses in general practice in their first year with preceptor support. The results of this study have important implications for nursing workforce development and it is recommended that such initiatives are widely introduced with appropriate financial support.

Association of Psychosocial Work Hazards With Depression and Suboptimal Health in Executive Employees

OBJECTIVES

This study aims to investigate whether psychosocial work-related hazards, measured by workplace justice and employment insecurity, are associated with depression and suboptimal health status in Taiwan's executive-level employees.

METHODS

There were 365 executives who have received a series of cardiovascular health examinations, blood sampling, and self-reported questionnaires, which included the psychosocial work-related hazards and the CES-D scale. Suboptimal health status was defined as the presence of dyslipidemia or prediabetes.

RESULTS

Executive-level employees perceived lower workplace justice and higher employment insecurity and had a significantly higher risk of depression (CES-D scores ≥16 or ≥23). However, workplace justice was identified as a significant determinant factor that was negative for dyslipidemia but protective for prediabetes.

CONCLUSION

This study supports the fact that psychosocial work-related hazards can independently contribute to the risk of developing depression, prediabetes, and dyslipemia in executives.

Exposure of mental health nurses to violence associated with job stress, life satisfaction, staff resilience, and post-traumatic growth

Workplace violence towards health workers in hospitals and in mental health units in particular is increasing. The aim of the present study was to explore the effects of exposure to violence, job stress, staff resilience, and post-traumatic growth (PTG) on the life satisfaction of mental health nurses. A descriptive, cross-sectional design was used. The sample consisted of mental health nurses (n = 118) working in a large mental health centre in Israel. Verbal violence by patients was reported by 88.1% of the nurses, and 58.4% experienced physical violence in the past year. Physical and verbal violence towards nurses was correlated with job stress, and life satisfaction was correlated with PTG and staff resilience. Linear regression analyses indicated that life satisfaction was mainly affected by PTG, staff resilience, and job stress, and less by exposure to verbal and physical violence. The present study is the first to show that, although mental health nurses are frequently exposed to violence, their life satisfaction is affected more by staff resilience, PTG, and job stress than by workplace violence. Therefore, it is recommended that intervention programmes that contribute to PTG and staff resilience, as well as those that reduce job stress among mental health nurses, be explored and implemented.

Impact of Job Satisfaction on Greek Nurses' Health-Related Quality of Life

Background

Employee job satisfaction and its relationship with health and quality of life has been an issue of major concern over the past decades. Nurses experience difficult working conditions that affect their job satisfaction, health, and quality of life.

Methods

A cross-sectional study was undertaken in three general hospitals and their respective health centers. Stratified random sampling by level of education was used, and 508 nurses and nursing assistants were included. A self-administered anonymous questionnaire, which included the Measure of Job Satisfaction, the 36-item Short Form Health Survey, as well as demographic details, education, and work conditions data, was used.

Results

Greek nurses were found to be dissatisfied with their job according to the total score of the job satisfaction scale, although personal satisfaction and satisfaction with support had had higher scores. Their general health was reported as average, because of physical and mental health problems, low vitality, low energy, and increased physical pain. Multivariate linear regression analysis revealed that males and those wishing to stay in the job had higher physical and mental health. Increased job satisfaction was related to increased physical and mental health.

Conclusion

Although Greek nurses are not satisfied with their work, those with high levels of job satisfaction had better health-related quality of life. The findings suggest that improvement of the work environment would contribute to a healthier and more satisfied nursing workforce.

Effects of Yoga on Stress, Stress Adaption, and Heart Rate Variability Among Mental Health Professionals--A Randomized Controlled Trial

BACKGROUND

Mental health professionals experiencing work-related stress may experience burn out, leading to a negative impact on their organization and patients.

AIM

The aim of this study was to examine the effects of yoga classes on work-related stress, stress adaptation, and autonomic nerve activity among mental health professionals.

METHODS

A randomized controlled trial was used, which compared the outcomes between the experimental (e.g., yoga program) and the control groups (e.g., no yoga exercise) for 12 weeks. Work-related stress and stress adaptation were assessed before and after the program. Heart rate variability (HRV) was measured at baseline, midpoint through the weekly yoga classes (6 weeks), and postintervention (after 12 weeks of yoga classes).

RESULTS

The results showed that the mental health professionals in the yoga group experienced a significant reduction in work-related stress (t = -6.225, p < .001), and a significant enhancement of stress adaptation (t = 2.128, p = .042). Participants in the control group revealed no significant changes. Comparing the mean differences in pre- and posttest scores between yoga and control groups, we found the yoga group significantly decreased work-related stress (t = -3.216, p = .002), but there was no significant change in stress adaptation (p = .084). While controlling for the pretest scores of work-related stress, participants in yoga, but not the control group, revealed a significant increase in autonomic nerve activity at midpoint (6 weeks) test (t = -2.799, p = .007), and at posttest (12 weeks; t = -2.099, p = .040).

LINKING EVIDENCE TO ACTION

Because mental health professionals experienced a reduction in work-related stress and an increase in autonomic nerve activity in a weekly yoga program for 12 weeks, clinicians, administrators, and educators should offer yoga classes as a strategy to help health professionals reduce their work-related stress and balance autonomic nerve activities.

Extent, Nature, and Risk Factors of Workplace Violence in Public Tertiary Hospitals in China: A Cross-Sectional Survey

Using a cross-sectional survey design from 11 public tertiary hospitals (a specialist hospital, four Chinese medicine hospitals, and six general hospitals) in the urban areas of Heilongjiang, we determined the nature of workplace violence that medical staff have encountered in Chinese hospitals and identified factors associated with those experiences of violence. A total of 1129 health workers participated. The specialist hospital had the highest prevalence of physical violence (35.4%), while the general hospitals had the highest prevalence of non-physical violence (76%). Inexperienced medical staff (p < 0.001) were more likely to suffer non-physical violence than physical violence in Chinese medicine hospitals compared to experienced staff. Medical units (p = 0.001) had a high risk of non-physical violence, while surgical units (p = 0.005) had a high risk of physical violence. In general hospitals, staff with higher levels of anxiety about workplace violence were more vulnerable to both physical violence (1.67, 95% CI 1.36–2.10) and non-physical violence (1.309, 95% CI 1.136–1.508) compared to those with lower levels of anxiety, while rotating shift workers had a higher odds of physical violence (2.2, 95% CI 1.21–4.17) and non-physical violence (1.65, 95% CI 1.13–2.41) compared to fixed day shift workers. Thus, prevention should focus not only on high-risk sections of hospitals, but also on the nature of the hospital itself.

Exploratory study of factors influencing job-related stress in Japanese psychiatric nurses

This study explored the factor structure of psychiatric nurses' job-related stress and examined the specificity of the related stressors using the job stressor scale of the Brief Job Stress Questionnaire (BJSQ). The stressor scale of the BJSQ was administered to 296 nurses and assistant nurses. Answers were examined statistically. Exploratory factor analysis was performed to identify factor structures; two factors (overload and job environment) were valid. Confirmatory factor analysis was conducted to examine the two-factor structure and found 11 items with factor loadings of >0.40 (model 1), 13 items with factor loadings from 0.30 to <0.40 (model 2), and 17 items with factor loadings from 0.20 to <0.30 (model 3) for one factor; model 1 demonstrated the highest goodness of fit. Then, we observed that the two-factor structure (model 1) showed a higher goodness of fit than the original six-factor structure. This differed from subscales based on general workers' job-related stressors, suggesting that the factor structure of psychiatric nurses' job-related stressors is specific. Further steps may be necessary to reduce job-related stress specifically related to overload including attention to many needs of patients and job environment including complex ethical dilemmas in psychiatric nursing.

Differences in job stress experienced by female and male Japanese psychiatric nurses

In psychiatric nursing, female nurses tend to spend more time building rapport with patients and developing cooperative working relationships with colleagues; they encounter more sexual harassment by patients. In contrast, male nurses respond to aggressive patients and tend to resist physically caring for female patients; they encounter more physical and verbal assault from patients. These gender differences might result in differences in job-related stress. We quantitatively examined gender differences in psychiatric nurses' job stress. The Psychiatric Nurse Job Stressor Scale and the Stress Reaction Scale of the Brief Job Stress Questionnaire were administered to 159 female and 85 male Japanese psychiatric nurses. The results indicated that female nurses had significantly higher stress levels than males related to psychiatric nursing ability, attitude towards nursing, and stress reactions of fatigue and anxiety. Moreover, the factors affecting stress reactions differed somewhat between sexes. In particular, male nurses reported that greater irritability was affected by patients' attitudes. Their anxiety and somatic symptoms were affected by their attitude towards nursing, and depressed mood was affected by psychiatric nursing ability. Knowledge of these differences can lead to better mental health-care interventions for psychiatric nurses.

Work-related stress and associated factors among nurses working in public hospitals of Addis Ababa, Ethiopia: a cross-sectional study

Work-related stress is a pattern of reactions to work demands unmatched to nurses' knowledge, skills, or abilities; these challenges exceed their ability to cope, resulting in burnout, turnover, and low quality patient care. An institution-based cross-sectional study of 343 nurses was conducted in public hospitals of Addis Ababa in 2012. Data were collected by pretested and self-administered questionnaires using a nursing stress scale. One hundred twenty-one (37.8%) (95% confidence interval: 34.3 to 39.1) nurses reported experiencing occupational stress. Significant associations were found between nurses' stress and gender, work shift, illness, marital status, and worksite or unit. Prevalence of work-related stress was higher than expected and opportunities exist for stake holders to design stress reduction and management programs for nurses.

Psychosocial work environment, stress factors and individual characteristics among nursing staff in psychiatric in-patient care

The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics--Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience--are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff's perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.

Job stress and intent to stay at work among registered female nurses working in Thai hospitals

OBJECTIVES

Job stress is one of the factors that increase the likelihood of turnover. Intent to leave work is one of the most accurate predictors of turnover. This cross-sectional study was created to evaluate the intent of nurses working at hospitals to continue working and to determine the relationship between job stress and intent to stay at work.

METHODS

The subjects were 514 female hospital nurses aged 21-58 years old, who had worked full time at the study hospitals for at least 1 year. Data were collected using a self-administered questionnaire, which included sections on demographic characteristics, the Thai version of the Job Content Questionnaire (JCQ), and intent to stay at work. Multiple regression analysis was used to identify factors related to intent to stay at work.

RESULTS

The prevalences of high job strain and low intent to stay at work were 17.5 and 22.4%, respectively. The mean (SD) scores of the nurses for psychological job demand, decision latitude, workplace social support, and intent to stay at work were 33.5 (4.4), 70.7 (6.9), 23.8 (2.8), and 14.6 (2.9), respectively. Multiple regression analysis indicated that intent to stay at work was significantly correlated with only supervisor support among the nurses with high-strain jobs and with coworker support in nurses with active jobs.

CONCLUSIONS

The findings suggest that different job types need different sources of social support in the workplace. Proactive steps by nurse managers to increase workplace social support might lead to an increase in intent to stay and reduce nursing turnover in hospitals and possibly other settings.

Exploration of the burnout syndrome occurrence among mental health nurses in Cyprus

Nurses' work-related stress might be associated with psychiatric symptoms, leading to altered professional attitudes. The aim of this study was to explore the levels of burnout and associations with anxiety and depressive symptoms among Greek-Cypriot psychiatric-mental health nurses (PMHNs). A descriptive correlational design with cross-sectional comparisons was applied. A sample of 226 PMHNs was used. Participants reported low levels of burnout. However, 10% of them manifested clinically significant anxiety and depressive symptoms. Emotional exhaustion and depersonalization were associated with depressive (r=0.562, p<0.0001, and r=0.616, p<0.0001, respectively) and anxiety (r=0.394, p<0.0001, and r=0.448, p<0.0001, respectively) symptoms. Further research investigating the biological aetiopathology of these psychological alterations is warranted.

Greek-Cypriot mental health nurses' professional satisfaction and association with mild psychiatric symptoms

The present descriptive correlational study aims to explore among Greek-Cypriot mental health nurses (MHNs) the level of professional satisfaction, potential differences with regard to vocational characteristics, and associations with anxiety and depressive symptoms. A random sample of 225 Greek-Cypriot MHNs employed in hospital and community settings completed Hamilton's Anxiety Scale, Beck's Depression Inventory, and Stamps's Index of Work Satisfaction. Moderate levels of overall professional satisfaction of 4.38 (±0.58) were detected. Work experience was positively correlated with satisfaction from payment (τ = 0.230, P < 0.0001). Men seemed to be more satisfied with organizational policies (P = 0.0043) and performed tasks (P = 0.027) than women. Nurses working in psychiatric clinics of general hospitals experienced higher levels of professional satisfaction in general, and more satisfaction from organizational policies, autonomy, and task requirements than nurses working in community settings, substance misuse programs, and community mental health centres (P = 0.001). Nurses working in acute/admission settings were the less satisfied, compared to nurses working in rehabilitation wards (P = 0.017). Professional satisfaction was associated with anxiety (τ = 0.280, P < 0.0001) and depressive (τ = 0.246, P < 0.0001) symptoms. Greek-Cypriot MHNs seem to get moderate satisfaction from their work, whilst professional satisfaction is associated with their psychological well-being. Targeted managerial interventions and longitudinal research are warranted.

The effect of job strain on psychological morbidity and quality of life in military hospital nurses in Taiwan: a follow-up study

This study investigated changes in job strain in female nurses serving in a military hospital system being restructured and the effect of these changes on psychological morbidity and quality of life (QOL). Questionnaire surveys were sent twice to 618 nurses working in three military hospitals in southern Taiwan at the beginning and at follow up a half year later. A Job Content Questionnaire was used to divide subjects into high and low strain groups. The General Health Questionnaire and the WHO QOL Questionnaire were used to assess psychological morbidity and QOL. Four hundred eighteen nurses completed the study. Initially, the high strain group had a greater prevalence of psychological morbidity and lower QOL than the low strain group. At follow up, high strain group did not have a greater prevalence of psychological morbidity, though significant differences in QOL remained. Job control and social support directly affected the QOL (B=0.42, p<0.001; B=0.41, p=0.038, respectively) and the psychological demand affected directly on psychological morbidity (B=0.12, p<0.001). Job control and psychological demand are different aspects in job strain to impact the psychological morbidity and QOL in nurses working in military hospitals in Taiwan.

Anxiety symptoms among Chinese nurses and the associated factors: a cross sectional study

BACKGROUND

Nurses are an indispensable component of the work force in the health care system. However, many of them are known to work in a stressful environment which may affect their mental well-being; the situation could be worse in rapidly transforming societies such as China. The purpose of this study was to investigate anxiety symptoms and the associated factors in Chinese nurses working in public city hospitals.

METHODS

A cross-sectional survey was performed for Chinese nurses in public city hospitals of Liaoning Province, northeast China. Seven hospitals in different areas of the province were randomly selected for the study. The Zung Self-Rating Anxiety Scale was used to measure anxiety symptoms. Effort-reward imbalance questionnaire and Job Content Questionnaire were used to assess the work stressors. Univariate analysis and stepwise multivariate logistic regression analysis were used to identify the factors associated with anxiety symptoms.

RESULTS

All registered nurses in the seven city hospitals, totaling 1807 registered nurses were surveyed. Of the returned questionnaires, 1437 were valid (79.5%) for analysis. Utilizing the total raw score ≥ 40 as the cut-off point, the prevalence of anxiety symptoms in these nurses was 43.4%. Demographic factors (education, chronic disease and life event), lifestyle factors (regular meals and physical exercise), work conditions (hospital grade, job rank, monthly salary, nurse-patient relationships, job satisfaction and intention of leaving), job content (social support and decision latitude), effort-reward imbalance and overcommitment were all significantly related to the anxiety symptoms. Multivariate logistic regression analysis showed main factors associated with anxiety symptoms were lower job rank (OR 2.501), overcommitment (OR 2.018), chronic diseases (OR 1.541), worse nurse-patient relationship (OR 1.434), higher social support (OR 0.573), lower hospital grade (OR 0.629), taking regular meals (OR 0.719) and higher level of job satisfaction (OR 0.722).

CONCLUSIONS

A large proportion of Chinese nurses working in public city hospitals had anxiety symptoms, which warrants immediate investigation and intervention from the hospital administrators. Meanwhile, results of the study suggest that proper counseling, promotion of healthy lifestyle behavior and improvements to the social environment in the work place may be helpful toward reducing or preventing the anxiety symptoms.

Factors and symptoms associated with work stress and health-promoting lifestyles among hospital staff: a pilot study in Taiwan

BACKGROUND

Healthcare workers including physicians, nurses, medical technicians and administrative staff experience high levels of occupational stress as a result of heavy workloads, extended working hours and time-related pressure. The aims of this study were to investigate factors associated with work stress among hospital staff members and to evaluate their health-promoting lifestyle behaviors.

METHODS

We conducted a cross-sectional study from May 1, 2010 to July 30, 2010 and recruited 775 professional staff from two regional hospitals in Taiwan using purposive sampling. Demographic data and self-reported symptoms related to work-related stress were collected. Each subject completed the Chinese versions of the Job Content Questionnaire (C-JCQ) and The Health-Promoting Lifestyle Profile (HPLSP). Linear and binary regression analyses were applied to identify associations between these two measurements and subjects' characteristics, and associations between the two measurements and stress symptoms.

RESULTS

Self-reported symptoms of work-related stress included 64.4% of subjects reporting nervousness, 33.7% nightmares, 44.1% irritability, 40.8% headaches, 35.0% insomnia, and 41.4% gastrointestinal upset. C-JCQ scores for psychological demands of the job and discretion to utilize skills had a positive correlation with stress-related symptoms; however, the C-JCQ scores for decision-making authority and social support correlated negatively with stress-related symptoms except for nightmares and irritability. All items on the HPLSP correlated negatively with stress-related symptoms except for irritability, indicating an association between subjects' symptoms and a poor quality of health-promoting lifestyle behaviors.

CONCLUSIONS

We found that high demands, little decision-making authority, and low levels of social support were associated with the development of stress-related symptoms. The results also suggested that better performance on or a higher frequency of health-promoting life-style behaviors might reduce the chances of hospital staff developing stress-related symptoms. Our report may contribute to the development of educational programs designed to encourage members of high stress groups among the hospital staff to increase their health-promoting behaviors.

Stress of Conscience among psychiatric nursing staff in relation to environmental and individual factors

The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress of Conscience. We conclude that Mastery and Control at Work seemed to work as protective factors, while Sense of Moral Burden and perceptions of Angry and Aggressive Behavior made the nursing staff more vulnerable to Stress of Conscience. Future research should investigate whether measures to increase the level of perceived control and being part of decision making will decrease the level of Stress of Conscience among the staff.

Investigating the impact of psychosocial risks and occupational stress on psychiatric hospital nurses' mental well-being in Japan

A cross-sectional survey was conducted, with the aim to examine what stressors in the workplace and demographic factors were associated with signs and symptoms of poor well-being among psychiatric nurses. A structured questionnaire was distributed to nurses within six psychiatric hospitals in Japan. Information was collected on demographic information, work characteristics and two dimensions of well-being: feeling uptight and emotional exhaustion. Three hundred and sixty-one questionnaires were completed by participants. High rates of emotional exhaustion in psychiatric nurses were found to be predicted by young age, high psychological demands paired with low social support in the workplace, job strain (a proxy to occupational stress) and job strain paired with low social support. In addition, high rates of being tense/uptight were associated with high psychological job demand, low psychological job control, low social support in the workplace, high job strain and high job strain paired with low social support. The current study has found evidence of significant relationships between demographic factors and several work and organizational stressors and poor mental health among Japanese psychiatric nurses.

Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil

OBJECTIVES

Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers.

METHODS

We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis.

RESULTS

In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL.

CONCLUSION

The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

Occupational stress, social support, and quality of life among Jordanian mental health nurses

Occupational stress affects physical and mental health of mental health nurses. This study measured levels of occupational stress and identified the variables that are associated with occupational stress among Jordanian mental health nurses. A descriptive design was conducted, using self-report questionnaires and demographic characteristics. Data were collected from 181 mental health nurses who were recruited from all mental health settings in Jordan. Jordanian mental health nurses showed high levels of occupational stress regarding "client-related difficulties," "lack of resources," and "workload." The highest level of social support as indicated by these Jordanian mental health nurses was from a spouse/partner followed by colleagues. Regarding quality of life (QOL), physical health scores were higher than mental health scores. Occupational stress correlated significantly and negatively with QOL-physical scores, QOL-mental scores, and social support scores, and correlated positively with being physically assaulted, verbally assaulted, and the respondent having the intention to leave his or her current job. Social support, QOL-mental scores, verbal assault, ward type, and intention to leave the current job were the best predictors of occupational stress among Jordanian mental health nurses. Mental health nurses are under significant occupational stress levels; therefore, comprehensive interventions aimed at minimizing the risk of occupational stress and improving social support and quality of life among mental health nurses are needed.