Influence Of Work Related Stress Towards Nursing Care Of Patients Amongst Selected Nurses At The Lautech Teaching Hospital, Ogbomoso

Project and Seminar Material for Nursing (Science)

Influence Of Work Related Stress Towards Nursing Care Of Patients Amongst Selected Nurses At The Lautech Teaching Hospital, Ogbomoso


Abstract


Work stress of nurses has been widely researched, for example in specific health care units — intensive care, specific conditions — cancer. Personal characteristics like emotional involvement and depersonalization of patients are also suggested as stressors for nurses. In Nigeria the Department of Health has made a number of changes since 2014. One of the changes involved the restructuring of the different departments to unify the fragmented health services. No comparison study was found for professional and trainee nurses. The objectives of this study were to determine the influence of work related stress towards nursing care of patients amongst selected nurses.

A cross-sectional survey design was used. A random sample of professional nurses (N = 980) and enrolled (N = 800) nurses were used. The NSI was developed as measuring instrument and administrated together with a biographical questionnaire. Descriptive statistics and inferential statistics were used to analyse the data.

Five internally consistent factors were extracted. The first factor was labelled Stress: Patient Care. It relates to stress because of the care nursing staff provide to patients. The second factor was labelled Stress: Job Demands, and refer to the demands associated with the work of the nurse. The third factor indicated a lack of support in the organization as well as from supervisors and colleagues, and was labelled Stress: Lack of Support. The fourth factor was labelled Stress: Staff Issues, because it included item loadings on things like shortage of staff, and fellow workers not doing their job. The fifth factor contains items concerning working hours, especially overtime, and was labelled Stress: Overtime.

The results indicated that a difference in stress levels exists between professional and trainee nurses. Professional nurses’ severity for the different stressors are higher on all five the extracted factors than those of the trainee nurses. The sources of work stress for professional and trainee nurses were almost the same. One source of stress for professional nurses that the trainee nurses did not experience is management of staff. Professional nurses (compared with trainee nurses) obtained practically significant higher scores on two stressors, namely stress because of making a mistake when treating a patient and stress because of disagreement with medical practitioners or colleagues concerning the treatment of a patient. Recommendations for future research were made.


Table of Content


Chapter One

1.0 Introduction

  • 1.1 Background to the Study
  • 1.2 Statement of Problem
  • 1.3 Objectives of the Study
  • 1.4 Research Questions
  • 1.5 Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Definition of Terms

Chapter Two

2.0 Literature Review

  • 2.1 Conceptual Review
  • 2.2 Theoretical Framework
  • 2.2.1 Transactional Model
  • 2.2.2 Health Realization or Innate Model
  • 2.3 Stress Management Strategies
  • 2.4 Empirical Studies
  • 2.5 Summary of Literature Review

Chapter Three

3.0 Methodology

  • 3.1 Research Design
  • 3.2 Research Setting
  • 3.3 Target Population
  • 3.4 Sampling
  • 3.5 Sampling Technique
  • 3.6 Instruments for Data Collection
  • 3.7 Validity of Instrument
  • 3.8 Reliability of Instrument
  • 3.9 Method of Data Collection
  • 3.10 Method of Data Analysis

Chapter Four

4.0 Results and Discussion

  • 4.1 Results
  • 4.2 Discussion

Chapter Five

5.0 Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendations
  • References
  • Appendix

Chapter One


1.0 Introduction

1.1 Background to the Study

Stress refers to physical or mental overexertion. It is a form of pressure or adverse influences and circumstances that disturbs the natural physiological balance of the body. Stress imposes unusual demands on an organism. Stress occurs when there are demands on the person which task or exceed the person‟s adjustive resources.

On the other hand, stressor constitutes of things that causes stress (i.e. factors that causes stress). Some conditions such as military combat, imprisonment, natural disasters (such as flood and fire, disabling injuries, incapacitating illness, terminal illness such as advanced cancer, or death of a loved one) are all regarded as universal stressors. Many environmental situations are not stressful for everyone and reactions to such stressors depend on the kind of person one is, for example, being evaluated in examinations. Generally, stimuli that cause stress are called stressor.

They include emotional crisis, physical trauma, infection, physical restraint, extremes of heat or cold, etc.
Stress management involves the skill of controlling, directing or planning stress. Stress management strategies scales up an individual‟s psychological response to stress which is referred to as „stress reaction‟. Stress reaction often involves or stimulates behavioral attempts to deal with the stressor or with stress itself. Information or knowledge about stress, adopting correct attitude towards it and possession of skills in stress management among undergraduates (of any university) is very important for healthy, happy life and produces conducive environment for scholarship.

There have been many studies [1-4], which reported strong relationship between stress and undergraduates academic performance. Some individuals are more sensitive to some stressors than others, so the person‟s characteristics and behavior patterns must be looked at to determine their vulnerability to stress.

The experience of stress in human beings is universal, but there are also marked individual differences in how stress is experienced. According to Altmaier [5], stress has been known “to be the fuel the body uses to meet the challenges of our fast-paced modern life, although for others, it is the aversive by- product of such a life.” Stress has been associated with major life events, daily life hassles, and changes in life. Stress is created by excessive environmental and internal demands that need constant effort and adjustment.

The transition of moving to university and leaving home can be an added stressor for an undergraduate nurse. There are many first-year nurses who deal with being home-sick, whether it is mild and self-limiting or profound, creating grief and anxiety. There is a loss of control for nurses who are attending school and have to adapt to a different climate, new language, behavior, and social customs. The changes and transition are stressful for nurses because of this new environment. Fisher [2], notes that undergraduate nurses who are passive and mildly depressed prior to leaving home have been found to be those most likely to show raised level of homesickness following the move to university.

Many people recognize that stress comes in the form of negative tension that is caused by someone or something. Those who recognize stress as negative tension fail to realize that stress can generate a positive reaction to a stimulus. The positive reaction of stress can drive individuals to achieve and to test their potential to its fullest.

Stress can be a positive aspect of learning. According to Robert and White [6], if nurses experience stress as a challenge, they can exhibit an increased capacity to learn. Many experiences distress rather than challenges which can lead nurses to feel threatened and helpless.

Health work may reflect some of the high level of stress that undergraduate nurses have reported. For instance, most undergraduate nurses experience grade pressures that cause them to have problems with stress. Too much stress can interfere with a nurse‟s preparation, concentration and performance. Yet, positive stress can be helpful to nurses by motivating them out of weak performance.

Schafer [7] had observed that when individuals fall short of their own or others‟ expectations in schools, job, athletics or any other activity, one risks both external and internal costs, threat to academic or career prospects, disapproval, rejection, humiliation, guilt, and a low to the self-esteem. Thus, fear of failure can help motivate the nurses to prepare and perform well, yet, sometimes fear of failure can become extreme, which then creates unnecessary stress.

One of the main causes to academic stress is test anxiety. Most undergraduate nurses seem to emotionally vulnerable to examinations related stress. Increased anxiety from tests has a debilitating effect on their performance. When information generated by worrying about the test reduces the capacity available for performing the tasks, the result is that performance breaks down and the result becomes self-confirming [2].


1.2 Statement of Problem

Some of the effects nurses have from the stressors can be characterized by a lack of overt skills in handling a stressful situation. This can be marked also by poor performance or avoidance because nurses lack the skill to deal with these stressors. Stress management techniques usually filter out some of the stress and equip individuals to cope with stress situations.

There are a variety of coping skills that can be used to help nurses with stress. One of the first ways to begin coping and managing stress is, knowing what ones physical and emotional limits are in order to eliminate negative stress that may occur in life. This is also applicable to nurses. He or she needs to identify the cause of the stress. As noted by Greenberg and Valetutti [4] a strong psychological adjustment on the part of an individual is known to effectively help offset the dysfunctional effects of stress. The coping skills selected by an individual or a nurse to stress situation need to be techniques that are available and ought to be among one of the best coping skills that meet such needs.

As applicable to other Hospitals, nurses of Lautech, Ogbomoso also encounter some level of stress as they attend to their daily schedules as nurses.. Against the above background, it is important to investigate the subject Influence of work related stress towards nursing care of patients amongst selected nurses at the lautech teaching hospital, ogbomoso.


1.3 Objectives of the Study

The main purpose of this study is to assess Influence of work related stress towards nursing care of patients amongst selected nurses at the lautech teaching hospital, ogbomoso., Osun state. Specifically, the following objectives will guide the study;

  1. To investigate the most common sources of stress among nurses in Lautech, Ogbomoso
  2. To determine the effects of stress on nurses in Lautech, Ogbomoso
  3. To identify the most preferred stress management practices to reduce stress among nurses in Lautech, Ogbomoso

1.4 Research Questions

The following questions were formulated to guide the study based on the research objectives;

  1. What are the most common sources of stress among nurses in Lautech, Ogbomoso?
  2. What are the effects of stress on nurses in Lautech, Ogbomoso?
  3. What are the most preferred stress management practices to reduce stress among nurses in Lautech, Ogbomoso?

1.5 Hypothesis

HO1: There is no significant relationship between knowledge and practice of stress management among nurses in Lautech, Ogbomoso, Osun state


1.6 Significance of the Study

This study will be of great significance to the schools, nurses and the health seactor. From the findings of this study, nurses would be provided adequate information to enable deal successfully with challenges of stress and burnout. It will also be relevant to the nurses by providing more insight that could influence the formulation and implementation of policies that will ensure maximum support for nursesin academic settings. Information from this study will fill the gap on the body of knowledge related to stress management, and also contribute to the existing knowledge on the concerned issues.


1.7 Definition of Terms

Stress:

Is a feeling of emotional or physical tension, often resulting as a reaction to a challenge or demand, such as among nurses due to academic or anxiety related factors

Stress Management:

Refers to a wide spectrum of techniques and psychotherapies aimed at controlling a person’s level of stress, especially chronic stress, usually for the purpose of and for the motive of improving everyday functioning, in this case among the nurses.

Stress Management Practices:

These refers to the strategies that nurses in Lautech, Ogbomosoadopt to manage the stress associated.


1.8 Organization of study

This work is organized in to five chapters. The first chapter provides the introduction and background to the problem. The second chapter gives an overview of the literature. The third chapter highlights the research methods used during data collection exercise. The fourth chapter provides the discussion of the findings and the fifth chapter gives conclusion and recommendations from the study.


Chapter Five


5.0 Summary, Conclusion and Recommendation

5.1 Summary

The primary objective of the influence of work related stress towards nursing care of patients amongst selected nurses. A qualitative descriptive survey design and 120 nurses were used. A questionnaire was developed according to the objectives of the study to guide in the generation of information. Socio-demographic characteristics of the respondents and the research question were analyzed using simple frequency and percentage. Results revealed that the sources of stress among nurses were shown to include health work and activities (95.5%), role-based challenges and task execution (93.2%), changing nature of relationship with other people (79.5%), work calendar and tests (84.1%), and home and school interface (87.5%). From the findings, the effects of stress on nurseswere shown to include headache (56.2%), anger (70.7%), tiredness (69.0%), low self-esteem (50.0%), being absent more than usual (75.9%), loss of concentration (84.5%), poor interpersonal relationship (73.9%), and eating disorder (62.5%). From the findings, the most preferred stress management practices were building group norms of cooperation not competition (94.8%), indulging in hobbies, leisure activities, recreation (93.1%), planning instead of responding to pressure (84.9%), build satisfactory relationship with lecturers (85.9%), and developing peer support (80.7%).


5.2 Conclusions

The following conclusions with regard to the specific objectives are made:

Stress and its effects on professional and trainee nurses. In the literature of stress concerning nurses, a large number of stressors received attention. The research concentrated on between one and three stressors at a time, and in a specific unit/ward, e.g. intensive care (Le Blanc, De Jonge, De Rijk & Schaufeli, 2011; Couden, 2012), psychiatric or mental wards (Erasmus; Poggenpoel, & Gmeiner, 1998; Humpel, & Caputi, 2011; Levert, Lucas, & Ortlepp, 2010), general nurses (Yip, 2011). A few comparison studies between different wards/units were found e.g. emergency department and general ward nurses (Yang, Koh, Lee, Chan, Dong, & Chia, 2011), general and mental nurses (Tummers, Janssen, Landeweerd, & Houkes, 2011), urban and rural nurses (Wilkens, & Beale, 2011). No comparisons for stressors were find for professional and enrolled nurse.

Different levels of stress for professional and trainee nurses. The research clearly indicates that a difference in stress levels exists between professional and trainee nurses. Professional nurses’ severity for the different stressors are higher on all five the extracted factors than those of the trainee nurses.

Different sources of work stress. The sources for work stress for professional and trainee nurses are almost the same. One source of stress for professional nurses that the trainee nurses did not experience, is management of staff.
Internal consistency and construct validity of the Nursing Stress Indicator. The alpha coefficients of the five extracted factors of the NSI are highly acceptable to the guideline of O,70 (Nunnaly & Bernstein, 2014). The values can be considered high and thus explain a large portion of the variance in the different scales (Clark & Watson, 2015). The mean inter-item correlation coefficients are in the recommended range (0, confirming the internal consistency of the factors of the NSI. This satisfactory internal consistency points to the utility of the instrument used in the research.


5.3 Recommendations

The following recommendations were made based on the findings of the study;

  1. Nurses should be informed in advance of what difficulties they might face and encourage them to develop their own strategies to achieve personal goals during the influx of patients.
  2. The hospital management should add stress management skills into the routine or through seminars and workshops or through interactive session between the nurse and the hospital authorities to enlighten and educate on stress management.
  3. Improving hospital mental services and organizing peer counseling and self-help group can be of help in managing stress.
  4. The hospital management should create a friendly management / nurses’ relationships

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Frequently Asked Questions


How does occupational stress affect the health of nurses?

According to the main hypotheses, occupational stress leads to the deterioration of nurse’s physical and mental health status, while it is negatively affecting the adoption of good practices concerning nurses’ caring behaviors.

How common is work-related stress in nursing?

Work-related stress exists among the public and in all occupation, but it is far more important in professions that deal with people’s health. Job stress among health professionals and health care staff, especially nurses, is very prevalent.

How does stress affect caregiving behavior in nurses?

Nursing is perceived as a strenuous job. Although past research has documented that stress influences nurses’ health in association with quality of life, the relation between stress and caring behaviors remains relatively unexamined, especially in the Greek working environment, where it is the first time that this specific issue is being studied.

Do personal relationships affect job stress among nurses?

About the area of personal relationships affecting job stress, it was found that these factors have little effect on job stress among nurses. Among individual factors, unresolved conflicts with staffs in other units and problems with patients were the least effective factors in this regard. 

How does occupational stress affect nursing behaviors?

According to the main hypotheses, occupational stress leads to the deterioration of nurse’s physical and mental health status, while it is negatively affecting the adoption of good practices concerning nurses’ caring behaviors.

What are the physical health impacts of nurse stress?

Physical Health Impacts of Nurse Stress 1 A weakened immune system 2 Insomnia and daytime fatigue 3 Respiratory problems including shortness of breath 4 High blood sugar

Is nursing a stressful job?

According to the American Institute of Stress, stress is a major factor in up to 80 % of all work-related injuries and 40 % of workplace turnovers [2]. Nursing is perceived as a strenuous job with high and complicated demands.

When did occupational stress become an occupational hazard?

Nevertheless, stress has been regarded as an occupational hazard since the mid-1950s.4In fact, occupational stress has been cited as a significant health problem.5–7Work stress in nursing was first assessed in 1960 when Menzies8identified four sources of anxiety among nurses: patient care, decisionmaking, taking responsibility, and change.

How common is job stress in nurses?

The research findings indicated that the majority of sample communities, about 87.5% of men and 94.6% of women have normal stress. In total, 3.2% of nurses do not have job stress and 93.1% have normal job stress and 3.7% have intense job stress (Table 1). Table 1 Frequency of job stress levels Open in a separate window

Where does nurse stress come from?

Understanding where nurse stress comes from is one of the most important steps in addressing it. A number of underlying factors contribute to the stressors associated with this job. Nursing requires high levels of skill: The nursing profession calls for the constant use of high-level skills and technical acumen.

How to deal with nurse stress in the workplace?

Another important way to deal with nurse stress in the workplace is to take time for self-care. Specifically, nurses can set aside time to recharge following especially long shifts or grueling work weeks. This may mean sleeping late, enjoying a leisurely walk or sipping tea while reading a good book.

What are the side effects of stress in nursing?

For nurses and their organization, job stress is very expensive and its side effects become clear in the form of tiredness, harsh behavior, anxiety, increase of blood pressure, lack of self-confidence, lack of job satisfaction, decrease in efficiency.[ 8, 9] According to the studies, stress in nurses can cause depression,…

How does stress affect caring behaviors in nurses?

Although past research has documented that stress influences nurses’ health in association with quality of life, the relation between stress and caring behaviors remains relatively unexamined, especially in the Greek working environment, where it is the first time that this specific issue is being studied.

How does occupational stress affect caregiving behavior?

Therefore, occupational stress may be considered as a predictor for the adoption of caring behaviors. High degrees of stress may add to suboptimal care, increased rates of safety breaches, and higher frequency in errors in everyday clinical practice [25–27].

How does occupational stress affect nurses’ health-related quality of life?

The impact of occupational stress on nurses’ caring behaviors and their health related quality of life Occupational stress affects nurses’ health-related quality of life negatively, while it can also be considered as an influence on patient outcomes.

What is caregiver stress and how can you avoid it?

Caregiver stress — the emotional and physical stress of caregiving — is common. People who experience caregiver stress can be vulnerable to changes in their own health. Risk factors for caregiver stress include: Living with the person you are caring for

Do nurses get stressed at work?

Nurses, just like any other employees can experience job stress. Stress is a normal part of life. Some stress can motivate you to stay alert and do your best. However, excessive and prolonged stress can be detrimental to one’s health (Khamisa et al., 2015).

Is there a positive relationship between workplace relationships and job stress?

More evidence of the positive connection between workplace relationships and job stress was recorded by Reference [81], who stated that the absence of support from the working environment scored higher for teaching hospitals and, thus, nurses in teaching hospitals reported a higher level of stress when compared to nurses in non-teaching hospitals.

How do social impact and job stress interact in nursing?

Additionally, there was a significant coefficient describing the positive interaction of social impact and job stress. A potential clarification could be that nurses who realize the impact they have on others put more effort and time toward preserving this aim. As a result, they reported a lower level of job stress or exhaustion.

What are the main nurses’ occupational stressors?

The main nurses’ occupational stressors were poor doctor’s attitude, posting in busy departments (emergency/ICU), inadequate pay, too much work, and so on. Thus, hospital managers should initiate strategies to reduce the amount of occupational stress and should provide more support to the nurses to deal with the stress. 

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