Occupational stress and self-rated health among nurses

Occupational Stress Monitoring Using Biomarkers and Smartwatches: A Systematic Review

This article presents a systematic review of the literature concerning scientific publications on wrist wearables that can help to identify stress levels. The study is part of a research project aimed at modeling a stress surveillance system and providing coping recommendations. The investigation followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In total, 38 articles were selected for full reading, and 10 articles were selected owing to their alignment with the study proposal. The types of technologies used in the research stand out amongst our main results after analyzing the articles. It is noteworthy that stress assessments are still based on standardized questionnaires, completed by the participants. The main biomarkers collected by the devices used in the selected works included: heart rate variation, cortisol analysis, skin conductance, body temperature, and blood volume at the wrist. This study concludes that developing a wrist wearable for stress identification using physiological and chemical sensors is challenging but possible and applicable.

DNA damage, salivary cortisol levels, and cognitive parameters in a nursing team

In a cross-sectional study of women in a nursing team at a university hospital in southern Brazil, we studied DNA damage, salivary cortisol levels, and cognition. DNA damage was measured in blood leukocytes with the comet assay and the micronucleus test. Salivary cortisol levels were determined upon waking, 30 min later, and at bedtime. Cognition was evaluated according to the Stroop, Digit span and Word span tests. Cortisol levels on waking up were associated negatively with the number of years the employee worked at the institution and positively with the DNA damage in comet assay. Cognitive scores were lower when the cortisol levels were low at awakening and high at bedtime; and were associated positively with educational level. Cortisol status may influence overall health as well as essential work skills, such as attention.

Self-rated health and general procrastination in nurses: a cross-sectional study

Introduction

nurses are responsible for taking care of the health of the general public. Nurses´ own health is among the important factors affecting the quality of patient care. Self-Rated Health (SRH) is one of the indicators used extensively in health research for the assessment of the health status of individuals. The present study was conducted to evaluate self-rated health and its relationship with general procrastination in nurses.

Methods

the present cross-sectional study was conducted in 2019 on 305 Iranian nurses selected by stratified random sampling. The relationship of self-rated health with procrastination was determined using an ordinal logistic regression analysis after adjustments for personal and occupational factors.

Results

self-rated health was poor/bad in 11.3% of the nurses, fair in 23.7%, good in 34.3% and excellent in 30.7%. After adjustments for personal and occupational factors, a significant relationship was observed between procrastination and self-rated health (OR=0.95; 95%CI 0.92, 0.98).

Conclusion

the results showed an unfavorable health status in nurses. Given the significant relationship between procrastination and poor self-rated health in nurses, it is essential to consider this relationship for improving nurses´ health.

Factors associated with occupational stress among nursing professionals in health services of medium complexity

OBJECTIVE

To analyze the factors associated with occupational stress among nursing workers in health services of medium complexity.

METHODS

Epidemiological, cross-sectional, exploratory study. A randomly selected sample of 126 nursing professionals from medium complexity services in three cities in the state of Bahia (Santo Antônio de Jesus, Feira de Santana and Itabuna) was investigated. Data were collected in 2011 and 2012. The demand-control model proposed by Karasek was used to assess occupational stress. Simultaneous analysis of occupational stressors was performed using Poisson regression with robust variance.

RESULTS

The prevalence of occupational stress among nursing professionals was 77%. Occupational stress was associated with the professional category of nursing technician (p=0.01).

CONCLUSION

The data indicates a concerning situation of exposure to occupational stressors, which requires coping strategies in order to protect the health of the worker.

Occupational stress among emergency and urgent care nurses at a public hospital in Teresina, Piaui, Brazil

BACKGROUND

The number of emergency and urgent care providers with occupational stress is quite large and is a source of concern for hospital managers. Nurses are the professional category most affected among workers exposed to occupational stress.

OBJECTIVE

To investigate the level of occupational stress among emergency and urgent care nurses at a public hospital in Teresina, Piaui, Brazil, by means of the Bianchi Stress Questionnaire.

METHODS

Cross-sectional descriptive study conducted from November 2016 through January 2017 at a public emergency and urgency care hospital in Teresina. The sample comprised 20 nurses allocated to the department red, yellow, green and stabilization zones. Data were collected by means of the Bianchi Stress Questionnaire (BSQ), fed to a database and processed using software Statistical Package for the Social Sciences version 23.0. Analysis consisted of descriptive statics.

RESULTS

Participants were predominantly female (75%) within age range 31 to 40 years old (65%); most had graduated 6 to 10 years earlier (60%), 90% had attended graduate education and 70% had worked at the department for more than 6 years. The global stress score ranged from 2.4 to 5.25, mean 3.46; the highest stress level corresponded to BSQ domain A. Conclusion: Interpersonal relationships in emergency and urgent care departments might be a cause of occupational stress among workers.

Perception of nurse managers about the functionally-readapted worker

OBJECTIVE

To understand the perception of nurse managers about the functionally-readapted worker.

METHODS

Descriptive study with qualitative approach, whose data were collected in from November 2016 to April 2017, through interviews with 14 nurse managers of a university hospital. The content analysis analysis was applied to interpret the speeches.

RESULTS

The reports converged into three categories, which revealed the impact on the management of the nursing staff, the management of the limitations of the readapted worker, and the regular follow-up planning for him.

FINAL CONSIDERATIONS

Nurse managers are clear that readapted workers need special attention, so that their potentialities mat be maximized, respecting the workers' limitations. Readapted workers must be encouraged to resume their self-esteem, identity, autonomy, and feel socially included.

Burnout Syndrome in Physicians-Psychological Assessment and Biomarker Research

Background and objectives: Burnout is a syndrome typically occurring in work environments with continuous and chronic stress. Physicians are at increased risk for burnout, as a result of 24-h work, delayed work–life balance gratification, and the challenges associated with patient care. The aim of the present study was to evaluate the psychological parameters of burnout symptoms in relation to biomarkers of stress among physicians with different medical specialties. Materials and methods: A total of 303 physicians were contacted as potential participants. A comparison group of 111 individuals working outside medicine was used as a control to verify the results. The physicians were specialists in internal medicine, general surgery, pathology, and primary care. Serum cortisol, salivary cortisol, adrenocorticotropic hormone (ACTH), insulin (IRI), and prolactin levels were analyzed by chemiluminescence enzyme immunoassay (Access 2, Beckman Coulter). Fasting glucose in serum and glycated hemoglobin (HbA1C) in whole blood were measured using the automatic analyzer AU 480 Beckman Coulter system. Symptoms of burnout were measured with the Maslach Burnout Inventory (MBI). Results: The group with burnout presented significantly higher levels of serum and saliva cortisol, ACTH, prolactin, fasting glucose, and HbA1C compared with the control group. The correlation analysis between biomarkers showed a positive correlation with moderate strength between serum and saliva cortisol (r = 0.516, p = 0.01),as well as serum and saliva cortisol with ACTH (r = 0.418; r = 0.412, p = 0.01) and HbA1C (r = 0.382; r = 0.395, p = 0.01). A weak positive correlation was found between serum and saliva cortisol with prolactin (r = 0.236; r = 0.267, p < 0.01) and glucose (r = 0.271; r = 0.297, p < 0.01). In the multiple logistic regression model, saliva cortisol, HbA1C, and age were significantly associated with burnout (chi-square = 16.848, p < 0.032). Conclusion: Our findings demonstrated the interest of exploring biomarkers of stress related to burnout in health professionals.

Trabalho de alta exigência entre professores:associações com fatores ocupacionais conforme o apoio social

Resumo Objetivou-se verificar fatores ocupacionais associados ao trabalho de alta exigência entre professores da educação básica e se as associações variavam conforme o apoio social. Estudo transversal com 842 professores da rede estadual de ensino de um município do Sul do Brasil. Informações ocupacionais foram obtidas por meio de entrevistas. Dados sociodemográficos e o Demand Control Support Questionnaire faziam parte de um questionário autorrespondido. Realizou-se análise de regressão logística com cálculo das razões de odds e intervalos de confiança de 95%. Associaram-se ao trabalho de alta exigência a carga horária > 40 horas/semana, ter sofrido violência na escola e percepções negativas quanto ao equilíbrio entre a vida profissional e pessoal, remuneração e quantidade de alunos em sala de aula. Após análise estratificada, carga horária e percepção negativa quanto à quantidade de alunos por sala foram significativas apenas no grupo de menor apoio social. Trabalho de alta exigência está associado a condições específicas de trabalho docente e o apoio social pode atuar como moderador de efeito em algumas dessas associações.

Risks of illness in the work of the nursing team in a psychiatric hospital

Objective:

To analyze the risks of illnesses related to the work context of nursing workers in a psychiatric hospital.

Method:

Cross-sectional and quantitative study, developed in a psychiatric hospital with 74 nursing workers. The Work Context Assessment Scale was used to measure the risks of illness at work. Descriptive analyzes were performed with mean and standard deviation. To test the reliability of the data, the Cronbach’s alpha test was used. The correlation between the factors of the work context was tested using the Spearman correlation coefficient.

Results:

The organization of work was considered serious, social-professional relationships were considered satisfactory and working conditions were considered severe for risks of illness at work. The repetitiveness of tasks, work conditions that pose risks to safety, inadequate furniture and physical structure of the workplace, and the existence of noise in the work environment were indicated as severe risks to workers’ health.

Conclusion:

The factor working conditions is the one that contributes the most to illness among nursing workers.

Mediating the role of work engagement between personal resources (self-efficacy, the big five model) and nurses’ job performance

Purpose

The purpose of this paper is to examine the mediating role of work engagement (vigor and dedication) between personal resources (self-efficacy and Big Five model) and job performance (task and contextual) rated by supervisor.

Design/methodology/approach

A sample of 364 nurses and their supervisors was used. Structural equation modeling with Amos-17 was used to obtain model fit with path significance of work engagement as mediator between personal resources and job performance.

Findings

The results found support for the proposed conceptual claim and confirm that work engagement with the two-factor model (vigor and dedication) mediates the relationship between personal resources (self-efficacy and Big five model) and with multidimensional construct of job performance (task and contextual performance) rated by the supervisor.

Originality/value

Past researches have never tested the two-factor model of work engagement (vigor and dedication) as mediating variable between personal resources (self-efficacy and big five model) and job performance rated by the supervisor.

Sleep and biological parameters in professional burnout: A psychophysiological characterization

Professional burnout syndrome has been described in association with insomnia and metabolic, inflammatory and immune correlates. We investigated the interest of exploring biological parameters and sleep disturbances in relation to burnout symptoms among white-collar workers. Fifty-four participants with burnout were compared to 86 healthy control participants in terms of professional rank level, sleep, job strain (Karasek questionnaire), social support, anxiety and depression (HAD scale). Fasting concentrations of glycaemia, glycosylated hemoglobin (HbA1C), total-cholesterol, triglycerides, C-reactive protein (CRP), thyroid stimulating hormone (TSH), 25-hydroxyvitamin D (25[OH]D), and white blood cell (WBC) counts were assessed. Analysis of variance and a forward Stepwise Multiple Logistic Regression were made to identify predictive factors of burnout. Besides reporting more job strain (in particular job control p = 0.02), higher levels of anxiety (p<0.001), and sleep disorders related to insomnia (OR = 21.5, 95%CI = 8.8–52.3), participants with burnout presented higher levels of HbA1C, glycaemia, CRP, lower levels of 25(OH)D, higher number of leukocytes, neutrophils and monocytes (P<0.001 for all) and higher total-cholesterol (P = 0.01). In particular, when HbA1c is > 3.5%, the prevalence of burnout increases from 16.6% to 60.0% (OR = 4.3, 95%CI = 2.8–6.9). Strong significant positive correlation existed between HbA1C and the two dimensions (emotional exhaustion and depersonalization (r = 0.79 and r = 0.71, p<0.01)) of burnout. Models including job strain, job satisfaction, anxiety and insomnia did not predict burnout (p = 0.30 and p = 0.50). However, when HbA1C levels is included, the prediction of burnout became significant (P = 0.03). Our findings demonstrated the interest of sleep and biological parameters, in particular HbA1C levels, in the characterization of professional burnout.

Job satisfaction in an oncology nursing team

ABSTRACT Objective: to identify the level of attributed, perceived and real job satisfaction of oncology nursing professionals and analyze the relationships between the levels of satisfaction among these workers. Method: a descriptive, quantitative cross-sectional study was conducted using the Index of Work Satisfaction (IWS) to evaluate the nursing team, nurses and technicians/auxiliaries. A total of 348 workers answered the questionnaire, of which 216 were fully completed and considered for the IWS calculation. Results: Autonomy was considered the most important item in attributed satisfaction for the nursing team and nurses. Salary was valorized most by the technicians/auxiliaries. For perceived satisfaction, Professional Status was the most important for all workers. Regarding real satisfaction, Interaction was the most important for the nursing team and technicians/auxiliaries; while the nurses valorized Autonomy. The nurses presented the greatest job satisfaction. Conclusion: a discrepancy was observed in job satisfaction among the oncology nurses, indicating the importance of further quantitative research.

Organizational culture of a psychiatric hospital and resilience of nursing workers

Objective:

to analyze the organizational culture of a psychiatric hospital and identify the capacity of resilience of nursing workers.

Method:

quantitative research. For data collection, were used the Brazilian Instrument for Evaluation of Organizational Culture (IBACO - Instrumento Brasileiro para Avaliação da Cultura Organizacional) and the Resilience Scale (RS).

Results:

participants reported the existence of centralization of power and devaluation of workers, despite recognizing the existence of collaboration at work and practices for improving interpersonal relations. In relation to the capacity of resilience, 50% of workers showed high level, and 42.9% a medium level of resilience. The correlation tests revealed negative values between the IBACO and RS domains, indicating that the lower the appreciation of individuals in the institution, the greater their capacity of resilience.

Conclusion:

the organizational values reflect the work organization model in the institution that devalues the workers' needs and requires greater capacity of resilience.

Stress among nursing undergraduate students of a Brazilian public university

OBJECTIVES

To determine the level of stress among students of an undergraduate course in nursing of a Brazilian public university.

METHODS

Cross-sectional study involving 111 students who responded to the 30 item questionnaire of Costa and Polak for the Assessment of Stress among Nursing Students, with Likert type response options of 0-3 (0 = I have not experienced the situation; 1 = I do not feel stressed with the situation; 2 = I feel a little stressed with the situation, and 3 = I feel very stressed with the situation).

RESULTS

Participants were predominantly single (82.9%), female (83.8%), young adults (mean 23.3 years) and performing some kind of paid work (76.6%). The main stressors were related to the lack of time for: leisure activities (2.6); spending time with family members (2.5) and; completion of extracurricular activities (2.3). The highest levels of stress among students were found in the domains of professional training (52.2%), professional communication (33.3%) and time management (32.4%).

CONCLUSIONS

The majority of the students presented low levels of stress in the general activities of the course, however, the activities related to time management, especially time for academic activities and social and family life, were identified as permanent stress factors during the graduation course.

The Impact of Arts Activity on Nursing Staff Well-Being: An Intervention in the Workplace

Over 59 million workers are employed in the healthcare sector globally, with a daily risk of being exposed to a complex variety of health and safety hazards. The purpose of this study was to investigate the impact of arts activity on the well-being of nursing staff. During October-December 2014, 115 nursing staff working in a hospital, took part in this study, which lasted for 10 weeks. The intervention group (n = 56) took part in silk painting activities once a week. Data was collected using socio-demographic questions, the Warwick-Edinburgh Mental Well-Being Scale, Short Form-36 Health Survey questionnaire, Reeder stress scale, and Multidimensional fatigue inventory (before and after art activities in both groups). Statistical data analysis included descriptive statistics (frequency, percentage, mean, standard deviation), non-parametric statistics analysis (Man Whitney U Test; Wilcoxon signed-ranks test), Fisher's exact test and reliability analysis (Cronbach's Alpha). The level of significance was set at p ≤ 0.05. In the intervention group, there was a tendency for participation in arts activity having a positive impact on their general health and mental well-being, reducing stress and fatigue, awaking creativity and increasing a sense of community at work. The control group did not show any improvements. Of the intervention group 93% reported enjoyment, with 75% aspiring to continue arts activity in the future. This research suggests that arts activity, as a workplace intervention, can be used to promote nursing staff well-being at work.

[Rural workers' health in Brazil]

Workers' health is a central theme in public health surveys, but the specificity of work activities should be considered. This study aimed to analyze the health of rural workers in Brazil that perform both agricultural and non-agricultural work, based on self-rated health and self-reported diseases. The Brazilian National Household Sample Survey (PNAD 2008) was used, incorporating information from the complex sampling plan. Agricultural workers 18 years or older were selected, stratified according to those with and without non-agricultural work. Logistic regression was performed for self-rated health, and odds ratios were calculated for self-reported diseases. Exclusive agricultural work decreased the odds of reporting good health and increased the odds of reporting back pain, high blood pressure, and arthritis/rheumatism. Exclusive agricultural workers reported more diseases and worse living conditions. Self-rated health was generally better in workers with non-agricultural occupations.

[Pleasure-suffering indicators of nursing work in a hemodialysis nursing service]

OBJECTIVE

To measure the pleasure and suffering indicators at work and relate them to the socio-demographic and employment characteristics of the nursing staff in a hemodialysis center in southern Brazil.

METHOD

Quantitative research, with 46 workers. We used a self-completed form with demographic and labor data and the Pleasure and Suffering Indicators at Work Scale (PSIWS). We conducted a bivariate and correlation descriptive analysis with significance levels of 5% using the Epi-Info® and PredictiveAnalytics Software programs.

RESULTS

Freedom of Speech was considered critical; other factors were evaluated as satisfactory. The results revealed a possible association between sociodemographic characteristics and work, and pleasure and suffering indicators. There was a correlation between the factors evaluated.

CONCLUSION

Despite the satisfactory evaluation, suffering is present in the studied context, expressed mainly by a lack of Freedom of Speech, with the need for interventions to prevent injury to the health of workers.

Loneliness and self-rated health among church-attending African Americans

OBJECTIVES

To explore relations between loneliness and self-rated health among African-American adults of diverse ages.

METHODS

Associations between loneliness and self-rated health were investigated using covariate-adjusted linear regression models. Perceived social support was examined as a moderator. The potential indirect effects of stress and/or depressive symptoms were examined using nonparametric bootstrapping procedures.

RESULTS

Greater loneliness was associated with poorer self-rated health (p = .008), and social support did not moderate. Stress and depressive symptoms yielded significant indirect effects in single and multiple mediator models (p values ≤ .05).

CONCLUSIONS

Loneliness may contribute to poorer health among African Americans. Results suggest that greater stress and depressive symptoms might underlie these associations, but longitudinal studies are needed to assess causal relations.