Work satisfaction,health, and stress: A study of Dutch nurses

Abstract

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Job satisfaction and occupational stress in UK general hospital nursing staff

This study investigated factors associated with the perceptions of stress reported by nurses in a general hospital environment in the UK. The levels and sources of stress experienced by nursing staff were examined in relation to the type of ward or department, and nursing grade. The association between reported stress and job satisfaction was also examined. By means of a self-completion questionnaire survey, data were collected from 234 nurses from 24 wards in a single general hospital. The Brayfield and Rothe job satisfaction index was used to provide data for analysis. Factor analysis, analysis of variance, and Pearson product moment correlation procedures were performed on these data. The factor analysis identified two main factors concerned with sources of stress: interpersonal relations and resource problems, and dealing with death. Although there were no differences found across wards, the analyses of variance revealed that reported stress varied over different nursing grades. It was also found that job satisfaction was correlated with nursing experience and negatively related to stress.     

Psychological stress-factors and concentration of immunoglobulins and complement components in Norwegian nurses

Psychological stress produces immunological changes in animals, and increasing evidence suggests that this may also be true for humans. In the present study of 34 nurses in a busy ward of a Norwegian hospital, significant relationships have been demonstrated between die plasma levels of immunoglobulins and complement components and work-related 'stress', anxiety, and cognitive defence strategies. The main components of die work-related stress experience were role-stress and nonparticipation in decision-making.

The results indicate chat immunological parameters may perhaps be used as a psychological stress indicator, but the relationships are complex and can best be understood if individual coping and defence mechanisms are considered. Health symptoms were also examined, but these were not related to stress experience or immunological measures.     

Stress, health and the working environment of Swedish prison staff

A random stratified sample of just over 2000 was drawn from staff working in 67 different prisons in Sweden. Questionnaires on working conditions and symptoms of ill health were administered and subjects were given health examinations. Morning plasma Cortisol and gamma glutamyltransferase (g GT) levels were measured and factual information on the prisons was collected for use in the analyses.

There were differences between prisons in terms of both objective and self-reported working conditions which appeared to affect health status, physiological state and sick leave rate. Cardiovascular and hypertensive conditions were found more often among prison staff than among a large reference group made up of many different occupations. Sick leave rates among prison staff, especially those over 45 years old, were very high compared with this reference group. The situation appeared particularly difficult in prisons with a high proportion of drug abusing inmates.

The data allowed the identification of several factors which might counteract the effects of stress at work: a proactive management style, goal consensus among staff, a high degree of decision latitude, satisfaction with work performance and a supportive psychosocial climate.     

结构式团体在临床护士心理压力调解中的应用

目的探讨应用结构式团体在临床护士心理压力调解中的改善效果。方法选择临床护士60例,均为2020年06月~2020年12月间我院在册在岗内科病区护士,依据护士入科先后顺序采取分组,即前期入科护理人员30例采取自我调节方式应用心理压力,观察组为后期入科护理人员30例,采取结构式团体干预模式进行心理压力调节,对比护士不同调节方式下,情绪分值变化及对自我职业的倦怠评分、心理健康状态评分,并采取科室设计的满意度问卷展开评估。结果由自评量表结果所示,观察组护理人员在干预前焦虑、抑郁分值均无明显变化(P>0.05),干预后观察组护理人员焦虑、抑郁分值有所下降,与对照组呈鲜明对比(P<0.05)。职业倦怠量表测评结果所示,观察组护理人员情绪衰竭、工作态度、个人成就感三个维度的分值均低于对照组,差异显著(P<0.05)。由科室自我设计满意度问卷所示,观察组对自我工作满意度较高,与对照组比值差异明显(P<0.05)。两组在SCL-90量表测评下,观察组护理人员各项指标得分低于对照组(P<0.05)。结论结构式团体在临床护士心理压力的调解中的应用效果值得肯定,可改善职业倦怠感,提高工作效率。     

Impact of shift work and department type upon strain and attitudinal measures of hospital nurses

The effects of shift work (fixed versus rotating), type of hospital department (intensive care unit versus non-ICU), and job scope on stress and attitudes have been reported previously. The goal of the present study was to examine the interactive, as well as individual, impact of these variables on measures of perceived work stress, strain, work satisfaction and withdrawal intentions. Respondents in the study were nurses in a large general hospital in Israel. None of the two- or three-way interactions received empirical support. However, significant multivariate main effects for each of the three independent measures were found. The negative influence of rotating work shift compared to fixed work shift was supported. Nurses who thought that their job was more enriching were more satisfied and perceived their workload as being lower. Department type affected only burnout level; nurses in non-ICUs were lower in burnout. Several theoretical and practical possible interpretations and possible implications are presented.     

Occupational stress, and teachers in Northern Ireland

This article reports the results of a study of occupational stress undertaken with a large sample of Northern Ireland teachers, including qualified staff up to headteacher level. This study formed part of a wider interprofessional study of teachers, nurses and social workers.

The design and methods are described and demographic characteristics of the teaching sample are provided, with their views about teaching. Stressors are identified in both professional and private lives. The effects of stress as manifested through the General Health Questionnaire and the Maslach Burnout Inventory are examined and the teachers' views on various stress coping strategies are discussed.     

Dealing with shift work: Physical fitness, temperature, and napping

This paper reviews the effects of generally controllable factors such as physical conditioning, ambient temperature, and amount of prior sleep in adjustment to night work periods and shift work. One can expect a 5-10% decline in capacity for work in nocturnal work periods as compared to daytime work periods. This decreased capacity would dissipate if workers maintained a consistent sleep-wake routine for 8-16 days after moving to a new shift. Proven means for accelerating this adaptation are currently not available. The ability to perform work also declines as the length of the work period increases but depending upon individual tasks. Physical conditioning improves mood and general well-being, but no strong evidence currently indicates that conditioning increases tolerance or adjustment to shift work.

Increased ambient temperature increases the stress of work, although studies do not address heat as a factor in adjustment to shift work. While lower nocturnal temperature would be assumed to reduce heat stress during night shifts, supporting data does not exist. Studies have not addressed the negative consequences of cold stress or of rotating from night to day shifts with added heat stress.

The proper use of short sleep periods either as preparation for or as a response to a shift change can ameliorate some effects of shift rotation. Data indicate that performance on 'graveyard' shifts can be maintained close to baseline levels following true prophylactic naps while performance may decline by up to 30% when such naps are not taken. While there is evidence that naps or even rest periods without sleep are beneficial in improving mood in normal young adults, these data do not apply to 'replacement' naps. Studies of interjected naps imply that such naps do reduce sleep debt but do not imply that such naps are more beneficial than longer sleep periods. Naps appear to be most advantageous when the accumulated sleep debt is least.     

The psychosocial work environment of district nurses in Sweden

Data were collected from a stratified sample of district nurses in the greater Stockholm area on four occasions during one year using questionnaire techniques (to assess psychosocial working conditions and social networks, and self-reported health sums); as well as physiological measurement techniques. Three groups of district nurses were compared: group A, those working independently in the 'traditional' role but outside primary health care centres; group B, those working independently in the 'traditional' role but in primary health care centres; and group C, those working in the model role as part of primary health care teams. The study focused on the effects of these different work environments on the district nurse's psychological and somatic health, and their physiological state.

The data suggested that district nurses in the primary care teams (group C) had a lower objective work load than those working in the more traditional role. Despite this, they reported a less favourable balance (ratio) of work demands to decision latitude. They reported more 'problems' and 'conflicts' at work than did the other district nurses. However, such 'problems' were diminishing during the study period, which could mean that successive adaptation to the 'new' situation was occurring. The 'conflicts', on the other hand, remained. This may indicate that despite this adaptation, the district nurses in the primary care teams were struggling with their new work roles. It points to the need for organizational support during this important change process. The district nurses in group B (traditional role but in a primary health care centre) had the highest objective work load and showed physiological reactions in terms of elevated plasma cortisol levels in the morning, high systolic blood pressure and sleep disturbances.     

Health, well-being and burnout of ICU nurses on 12- and 8-h shifts

It is generally agreed that some features of shift systems can influence the extent of well-being and health problems experienced by the workers involved. Extended working days (9-12 h) have been found to aggravate some problems associated with shiftwork, especially when the work is mentally and emotionally demanding. The aim of the study was to compare measures of health, sleep, psychological and social well-being, job satisfaction and burnout of ICU nurses on 12- and 8-h shifts. The groups of subjects were matced for age, length of shiftwork experience, marital status and number of hours worked. the 12-h shift nurses, when compared to their 8-h shift colleagues, experienced more chronic fatigue, cognitive anxiety, sleep disturbance and emotional exhaustion. Job satisfaction seems to be independent of the shift duration. The nurses on 12-h shifts reported less social and domestic disruption than those on 8-h shifts. The 12-h shift nurses showed worse indices of health, well-being and burnout tan the 8-h shift nurses. It is suggested that this may be associated with their longer daily exposure to the stress of work. The increased number of rest days of 12-h shift nurses seems tobe insufficient to dissipate the adverse health and well-being effects that built up over their longer shifts.     

Stress factors among lecturers in a college of further education

This article presents some of the findings of a pilot study of sources of stress among lecturers working in a college of further education. The empirical work was carried out over a four-week period, with lecturers, chosen at random, being asked to participate using one or all of the three research methods employed: personal interviews, completing a questionnaire, and keeping a diary.

The study set out to address two broad questions. First, 'What are the experiences that can give rise to stress and, having identified them, how often do these experiences occur?' Second, 'Having identified the sources of stress, did the lecturers feel that such experiences affected their teaching, their preparation for teaching or their assessments as a result of teaching?'

The data highlighted the fact that mere were four broad problem areas or sources of stress within this college of further education and that some were seen to occur 'frequently'. However, whether such sources of stress affected actual teaching was not dear, but mere was some support for the notion that the preparation for teaching and the assessment as a result of teaching were affected.     

Stress demands on school administrators in Singapore

This study investigated the use of the Occupational Stress Indicator (OSI) on school administrators in Singapore. The sample of 223 school administrators consisted of the top management group of principals and vice-principals and the middle management group of heads of department. The school administrators reported pressure at work, and consequently, higher levels of mental and physical ill health. They had high locus of control scores, indicating low internal control over their environment. However, they also reported greater use of coping strategies and higher job satisfaction. Psychometrically, the sub-scales of sources of pressure, job satisfaction, and mental and physical ill health were found to be reliable. The items of the scales of type A, locus of control and coping skills had to be re-factor analysed for the Singaporean sample. The new factors were found to have higher reliability. When the stress and job satisfaction levels of the principals/vice-principals and heads of department were compared, the heads of department reported significantly less job satisfaction and higher levels of mental and physical ill health. They perceived less internal control in their work situation.     

Stress demands on school administrators in Singapore

Abstract

This study investigated the use of the Occupational Stress Indicator (OSI) on school administrators in Singapore. The sample of 223 school administrators consisted of the top management group of principals and vice-principals and the middle management group of heads of department. The school administrators reported pressure at work, and consequently, higher levels of mental and physical ill health. They had high locus of control scores, indicating low internal control over their environment. However, they also reported greater use of coping strategies and higher job satisfaction. Psychometrically, the sub-scales of sources of pressure, job satisfaction, and mental and physical ill health were found to be reliable. The items of the scales of type A, locus of control and coping skills had to be re-factor analysed for the Singaporean sample. The new factors were found to have higher reliability. When the stress and job satisfaction levels of the principals/vice-principals and heads of department were compared, the heads of department reported significantly less job satisfaction and higher levels of mental and physical ill health. They perceived less internal control in their work situation.     

Psychosocial stress and job satisfaction in female office employees with and without neck-shoulder symptoms

The objective of this research performed in a Finnish occupational health care setting was to describe the annual prevalence of neck and shoulder symptoms in female office employees and to test whether or not these symptoms were associated with psychosocial stress, job satisfaction and health locus of control. The subjects consisted wholly of female office employees (n = 232) at one local bank and three insurance offices, chosen on a voluntary basis. The annual prevalence of disturbing neck-shoulder symptoms among female office employees was 43.3%. An association of these symptoms with psychosomatic symptoms, poor general job satisfaction and its two subdimensions, work content and perception of the healthiness of the working environment, was noticed. The subjects with neck-shoulder symptoms had a significantly higher score of feelings of external control (fatalism) than those without symptoms. The results lead to the conclusion that neck-shoulder symptoms are common amongst female office employees. These symptoms are associated with some psychosocial stress factors and job dissatisfaction. In future, it would be important to pay attention to these factors when trying to reduce the prevalence of neck-shoulder symptoms in office work.     

Job design and levels of physical and mental strain among Australian prison officers

Over the past 15 years much has been made of the moderating influence of job discretion and support in occupations that are perceived to be high in demands. Such an effect seems to be most prevalent when subject populations are large and heterogeneous. One aim of this study was to examine the influence of subjective perceptions of these variables on strain reactions among a group of relatively homogeneous workers such as, in the present study, prison officers (n = 274). A second aim was to extend previous research and examine the joint influence of negative affectivity and perceptions of demands, discretion, and support on mental and physical well-being. It was hypothesized that those high in negative affect would be particularly strained by jobs perceived as being demanding. The hypothesized relationship between job demands, discretion and support were found to be weak and at times inconsistent. Social support, in particular, was found to have both positive and negative consequences for different aspects of well-being. Those high in negative affect were in general found to suffer lower mental well-being. More importantly, the interactive effect of negative affectivity and job demands was found to significantly predict the majority of the dependent variables used in this study. The valences of these relationships were inconsistent and are interpreted in light of Warr's (1987) vitamin model of stress.

There are several conclusions that can be drawn from the present study. Negative affectivity appears to have a truly interactive effect with job components, job demands in particular, to influence a range of variables relating to physical and mental health as well a job-related attitudes. The nature of these effects, however, suggests a dissociation in the ways that different independent variables influence a range of indices of well-being and affect. This result requires further investigation since there are important theoretical implications which will follow if the data are replicable.

In order to examine such complex effects, in addition to the need for more longitudinal studies, it is also important that standardized measures of job components are developed so that levels of stress exposure can be equated and their impact assessed across organizational settings.

Finally, the data reported in this study suggest that some effective stress management may be undertaken by adopting selection strategies which take into consideration individual characteristics. In view of the fact that individual stress management programmes are of unproven benefit (Murphy 1986, 1988) such an approach is recommended especially for those organizations which are highly constrained in the services that must be performed.     

Book reviews and books received

Stress in Health Professionals Edited by Roy Payne and Jenny Firth-Cozens (Wiley Chichester, 1987). [Pp. xxiv + 288.] £25·50. ISBN 0-471-91254-9.

Man and Accidents Offshore: An examination of the costs of stress among workers on oil and gas rigs By Valerie J. Sutherland and Cary L. Cooper (Lloyds of London Press: Colchester, 1986). [Pp. xv + 207.] £45·00. ISBN 1-85044-082-4.

Man—Computer Interaction Research Edited by F. Klix and H. Wandke (Elsevier Amsterdam, 1987). [Pp. xiii + 473.] Dfl 225. ISBN 0-444-87910-2.

Stress Management for the Healthy Type A—Theory and Practice: A skills training program By Ethel Roskies (The Guilford Press: New York and London, 1987). [Pp. 252.] £12·95. ISBN 0-89862-692-7.     

Chronic stress and chronic disease in life and work: Conceptual and methodological issues

This paper argues that the lack of strong prospective evidence linking occupational and social stress to chronic disease stems from the failure of research designs to attend sufficiently to the aetiological chronicity of such diseases. Studies of both supposedly acute stress (life events) and chronic stress in life or work must increasingly be designed to distinguish between stress which is sustained or chronic over a period of yean or even decades, and hence capable of causing a serious chronic disease, and brief or transient stress, which may produce transient or brief psychological or physiological disturbances but cannot generate major chronic disease. Prospective studies are needed which collect measures of both stress and health or disease at multiple points over an extended period of time. Measures of stress should focus more on affect (for example, feelings of pressure and tension) than on cognition (for example feelings of satisfaction). Limited existing evidence is consistent with these ideals.     

Book reviews and books received

Recent Advances in Occupational Health edited by J. M. Harrington, Edinburgh, Churchill Livingstone (1987). PP. xii + 350. £40. ISBN 0 443 03577 6.

Occupational Health and Safety in Automation and Robotics edited by Kageyu Noro, London, Taylor & Francis (1987). Pp. xviii + 437. £40·00. ISBN 0 85066 351 2.

Contemporary Ergonomics 1987 edited by E. D. Megaw, London, Taylor & Francis (1987). Pp. xi+387. £25. ISBN 0 85066 365 5, ISSN 0267 4718.

Noise and Human Efficiency Michel Loeb, Chichester, Wiley (1986). Pp. xiii+269. £28. ISBN 0 471 10287 3.

Pilots under Stress S. J. Sloan and C. L. Cooper, London, Routledge & Kegan Paul (1986). Pp. ix + 230. £20. ISBN 0 7102 0479 5.

Towards a Democratic Rationality John Fry, Aldershot, Gower (1986). Pp. xi+281. £22·50. ISBN 0 566 00761 4.     

Book reviews and books received

Managing Stress Edited by David Fontana, Leicester, BPS/London, Routledge (1989). [Pp.ix + 118.] 5.95. ISBN 0-901715-98-0 (hardback). ISBN 0-901715-97-2 (paperback).

Applying Cognitive Psychology to User Interface Design Edited by M. M. GARDINER and B. CHRISTIE, New York, John Wiley (1987). [Pp.ix+372.] A29.95. ISBN 0-471-91184-4.

Architect or Bee? The Human Price of Technology Edited by MIKE COOLEY, London, The Hogarth Press (1987). [Pp. 193.1 E5.95 (paperback). ISBN 0-701207-69-8.

Occupational Health, 2nd Edition Edited by BARRY S. LEVY and DAVID H. WEGMAN, Boston, Little Brown (Edinburgh, Churchill Livingstone) (1988). [Pp. xxv + 640.1 A24.95 (Paperback). ISBN 0-316-52247-3.

Stress Management in Work Settings Edited by LAWRENCE R. MURPHY and THEODORE F. SCHOENBORN, Washington DC, US Government Printing Office (1987). [Pp. viii+ 190.1 $9.50. DHHS (NIOSH) Publication No. 87-111.

Trends in ErgonomicslHuman Factors V Edited by FEHEVDOUN AGHAZADEH, Amsterdam, North-Holland (Elsevier), (1988). [Pp. xx + 1095.1 $208, Dfl. 395. ISBN 0-444-70442-6.

Technology and the Transfarmation of White Collar Work Edited by ROBERT E. KRAUT, New Jersey, Lawerence Erlbaum Associates (1987). [Pp. x + 281 .] A21.50. ISBN 0-89859-633-5.