Identifying the causes of nurses' stress: A survey of New Zealand nurses

Abstract

A nationwide survey of 2500 general and obstetric nurses identified five potential sources of stress. These included work overload, difficulties relating to other staff, the difficulties involved in nursing the critically ill, concerns over the treatment of patients, and dealing with difficulty or helplessly ill patients. These findings support earlier work which suggested that a number of stressful situations are commonly encountered by all nurses. In terms of intervention strategies these results point to a number of important issues which are discussed in this paper. They include the difficulties and conflicts inherent in the nurses' role, the multidimensional nature of the different stressors, aspects of the work environment which give rise to different stressors and the relationship between stressors.     

Individual and organizational strategies for coping with organizational change

Abstract

During times of significant change to organizations in strategies and structures, employees can experience high levels of stress as their jobs, areas of responsibility and roles also change. Yet research is curiously silent about how people react to organizational change, especially towards promoting healthy responses to change. As a first step to outlining areas for future research this paper considers a range of individual and organizational strategies that may be effective in reducing employee stress and related problems. Prior to the implementation of these strategies, however, organizations must empower employees to adopt the role of change agent and encourage them to take action to solve the problems that stress them. At the individual level, employees can respond to the stress created by organizational change by using problem- and emotion-focused strategies. Also important in coping with change are the personal resources of employees, including a sense of hardiness, beliefs about having control over their work environment, and the availability of social supports within and outside the organization. Although few organizations fully acknowledge their role in helping employees cope with change, there are a number of initiatives that organizations can pursue. Several strategies are discussed in relation to communication, leadership, job-related tasks and stress management programmes.     

Individual and organizational strategies for coping with organizational change

During times of significant change to organizations in strategies and structures, employees can experience high levels of stress as their jobs, areas of responsibility and roles also change. Yet research is curiously silent about how people react to organizational change, especially towards promoting healthy responses to change. As a first step to outlining areas for future research this paper considers a range of individual and organizational strategies that may be effective in reducing employee stress and related problems. Prior to the implementation of these strategies, however, organizations must empower employees to adopt the role of change agent and encourage them to take action to solve the problems that stress them. At the individual level, employees can respond to the stress created by organizational change by using problem- and emotion-focused strategies. Also important in coping with change are the personal resources of employees, including a sense of hardiness, beliefs about having control over their work environment, and the availability of social supports within and outside the organization. Although few organizations fully acknowledge their role in helping employees cope with change, there are a number of initiatives that organizations can pursue. Several strategies are discussed in relation to communication, leadership, job-related tasks and stress management programmes.     

Changing work environments: Innovative coping responses to occupational stress

To what degree do individuals adapt their work environments in response to occupational stress? The research reported below addresses this question through a qualitative questionnaire survey that assesses the extent to which innovation is used as a stress coping strategy amongst health care professionals (community and hospital nurses, administration workers and paramedics; N = 333). Overall, 32% of these workers reported a coping response subsequently coded as innovative, and significant between-occupational group differences in the frequency of usage were found. Overwork, procedural difficulties and dealing with others were the stressors eliciting the greatest number of innovative coping responses. The study indicated that such responses were perceived as an effective and important way of dealing with occupational stress. It is concluded that stress management programmes that encourage individuals to change workplace factors through innovation, would be a worthwhile addition to interventions that emphasize individual adaptation to stressful work environments.     

The relationship of organizational and social coping resources to employee coping behaviour: A longitudinal analysis

Research on the determinants of coping behaviour has focused primarily on stressor-specific influences and on personal attributes and skills that serve as coping resources. However, coping resources can also include aspects of the organizational and social environment. This study investigates the role of supportive work relationships and of participation and influence in decision-making in determining the coping behaviour of employees in a manufacturing plant. Since the relationships between worksite coping resources and employee coping behaviours may be causally reciprocal, longitudinal models were analysed to sort out causal priorities. Results showed that organizational and social coping resources did influence subsequent coping behaviour. Perceiving oneself to have influence over decision-making at work predicted increases in active, problem-solving coping attempts and decreases in resignation in response to worksite stressors. Also, employees who perceived their co-workers and supervisors to be supportive were more likely to increase their mobilization of that support when faced with worksite stress. In addition, the use of certain employee coping behaviours influenced subsequent levels of participation in decision-making, as well as the quality of relationships with co-workers and supervisors.     

The relationship of organizational and social coping resources to employee coping behaviour: A longitudinal analysis

Abstract

Research on the determinants of coping behaviour has focused primarily on stressor-specific influences and on personal attributes and skills that serve as coping resources. However, coping resources can also include aspects of the organizational and social environment. This study investigates the role of supportive work relationships and of participation and influence in decision-making in determining the coping behaviour of employees in a manufacturing plant. Since the relationships between worksite coping resources and employee coping behaviours may be causally reciprocal, longitudinal models were analysed to sort out causal priorities. Results showed that organizational and social coping resources did influence subsequent coping behaviour. Perceiving oneself to have influence over decision-making at work predicted increases in active, problem-solving coping attempts and decreases in resignation in response to worksite stressors. Also, employees who perceived their co-workers and supervisors to be supportive were more likely to increase their mobilization of that support when faced with worksite stress. In addition, the use of certain employee coping behaviours influenced subsequent levels of participation in decision-making, as well as the quality of relationships with co-workers and supervisors.     

Individual strategies for coping with stress at work: A review

This paper discusses some of the conceptual and methodological issues involved in the study of coping. It focuses on individual coping with work and work-related problems, and adopts a transactional framework for the definition of the key concepts of stress, appraisal and coping. It identifies and reviews 17 recent papers which are representative of the coping literature, as defined by the scope of the paper. What it draws out of this review largely concerns issues of measurement, and four particular issues are flagged as important for future research. It concludes that there is a need for more and more adequate studies, particularly in relation to the classification and modelling of coping, and that the adequacy of those future studies should be partly judged in terms of how well they deal with the issues raised here.     

Cognitive therapy and behavioural coping in the management of work-related stress: An intervention study

Transactional models of stress emphasize the importance of cognitive appraisal of potential stressors in the determination of the stress response. This appraisal can be modified by the use of techniques normally associated with cognitive therapy. The contribution of a specifically cognitive component when intervening in work-related stress has not been well evaluated to date. This research seeks to determine the effectiveness of stress management training in the treatment of the work-related effects of stress by comparing the role of modifying dysfunctional cognitions with the teaching of appropriate behavioural coping strategies. Participants were allocated to one of two intervention conditions or to a waiting list control group. Those in the intervention conditions received group stress management either with the focus on delivering cognitive therapy techniques or with the focus on behavioural coping skills. Measures of general health were taken at the beginning and end of intervention and at 3-month follow-up. Participants in the cognitive therapy groups who were reporting symptoms of general ill-health at the start of the intervention showed a significant improvement at follow-up. Cognitive therapy appears to have been an effective intervention in work-related stress. Those in the behavioural group showed a smaller but still clinically effective improvement. Results are discussed in terms of methodological issues and implications for future research. It is suggested that changes in cognitive appraisal may need to be developed.     

政府干预下突发事件舆情传播规律与控制决策

通过对突发事件背景下的舆情传播进行多案例研究,界定了群众类型和政府干预作用,并分析了各类群众间的状态转移关系.然后,通过借鉴SEIR传染病模型的构造思路,结合舆情传播的实际特点,建立了政府干预下的舆情传播控制系统,进而运用平均场方法给出了系统的微分方程组模型.进一步,通过研究模型的平衡点和稳定性,得到了政府所应选择的管控方向,并以2011年东日本大地震事件中的舆情传播为例进行了验证.最后,基于该案例,通过设计多个情景,考查了政府的不同应急决策关注点对群众行为的影响,给出了应急方案的制定策略.     

The availability of personal and external coping resources: Thier impact on job stress and employee attitudes during organizational restructuring

This study examines the relationships among personal coping resources, social support, external coping resources, job stressors and job strains in a sample of 110 American Telephone and Telegraph employees undergoing a major organizational restructuring. The study expanded on a model suggested by Ashford (1988) by defining another category of coping resources that employees may draw upon to deal with the stressors and strains which occur during major organizational changes. External coping resources were defined as those which provided employees with a sense of 'vicarious control' in stressful situations. Results indicated that personal coping resources, social support and external coping resources had a direct effect upon job stressor and strain levels. No 'buffering' effect of these coplng resources was found. Hierarchical regression analyses indicated that external coping resources added to the prediction of job stressors and strains even when pertonal coping resources and social support were entered first into the prediction questions.     

Job stress,burnout and substance use among urban transit operators: The potential mediating role of coping behaviour

Abstract

Urban transit operators, compared to other occupational groups, have higher rates of mortality and morbidity. A major risk factor is the highly stressful objective environment. This study used structural equation modelling to test a model hypothesizing that transit operators’ coping behaviours in responding to daily job hassles mediate the associations of work stress with burnout and substance use. The study sample consisted of 1231 transit operators who participated in the San Francisco MUNI Health and Safety Study. The results showed a direct and strong association between transit operators’ daily job stress and symptoms of occupational burnout even when a series of controls and coping behaviours were considered. In addition, use of “disengage-deny” and escapist strategies to cope with job stress was positively associated with burnout; the job stress–burnout association was partially mediated through such coping practices. Daily job stress was related to substance use only indirectly and mediated through burnout and use of “disengage-deny” and escapist coping strategies. “Disengage-deny” coping strategies might help reduce substance use whereas escapist coping strategies might increase such use. Overall, our findings suggest that coping behaviour may be an important correlate of transit operators’ ill health. Interventions enabling healthy coping behaviours may help reduce health risks for this occupational group.     

Power motivation, illness, coping strategies and psychological stress in police trainees

Research suggests that there are substantial differences in the ways in which people cope with strcss, and that certain coping strategies buffer the degree of psychological and physical illness resulting from stress. Furthermore, personality, the situational context and subjective appraisal of the situation are believed to mediate coping behaviour and its effectiveness. The present investigation reports the results of two studies of the relationship between coping behaviour and the personality disposition need for power, taking into account the environment and the subject's appraisal of the situation. Highly power-motivated individuals were hypothesized to utilize emotion-focused coping strategies more than problem-focused coping strategies, to find the training environment stressful and anxietyprovoking, and to report more illness, than low power-motivated individuals. A 19-wcck policc academy training programme was used to measure these relationships in 34 police trainees. Thc results did not support all hypotheses. Findings are discussed with reference to sample characteristics, training intensity, and the empirical work in this area.     

Power motivation,illness, coping strategies and psychological stress in police trainees

Abstract

Research suggests that there are substantial differences in the ways in which people cope with strcss, and that certain coping strategies buffer the degree of psychological and physical illness resulting from stress. Furthermore, personality, the situational context and subjective appraisal of the situation are believed to mediate coping behaviour and its effectiveness. The present investigation reports the results of two studies of the relationship between coping behaviour and the personality disposition need for power, taking into account the environment and the subject's appraisal of the situation. Highly power-motivated individuals were hypothesized to utilize emotion-focused coping strategies more than problem-focused coping strategies, to find the training environment stressful and anxietyprovoking, and to report more illness, than low power-motivated individuals. A 19-wcck policc academy training programme was used to measure these relationships in 34 police trainees. Thc results did not support all hypotheses. Findings are discussed with reference to sample characteristics, training intensity, and the empirical work in this area.     

The New Zealand government approach to stress and fatigue

Abstract

Self-control involves inhibiting undesired behaviours and emotions, and it can be particularly relevant in the service sectors. Recent theoretical developments in cognitive and social psychology suggest that the demands on an individual of exercising self-control have an effect as a source of stress at work. In turn, burnout could be associated with being unable to meet those demands. It was expected that cognitive control deficits, as assessed by a questionnaire measure of self-reported failures in perception, memory, and action, would function as a vulnerability factor in the relationship between self-control demands and indicators of job strain. Data from 630 staff members of a German municipal administration revealed significant main effects of both self-control demands and cognitive control deficits on the burnout dimensions of emotional exhaustion and depersonalization. Both predictors were positively related to burnout. In addition, the results provided clear evidence of the vulnerability hypothesis of cognitive control deficits. By way of contrast, musculoskeletal complaints did not reflect similar main and interactive effects of self-control demands and cognitive control deficits. The requirements for self control in the service sector are expected to increase as the sector expands, and the practical implications for this are discussed.     

Musculoskeletal discomfort and work-related stress in New Zealand dentists

There has been little research into the stressors, psychological distress and musculoskeletal symptoms experienced by dentists. The present study was carried out among a random sample of New Zealand dentists (N=413). The present study aimed to identify the severity of work psychosocial stressors, examine the occurrence of musculoskeletal discomfort and psychological disturbance, and determine relationships between these factors. The average age of the dentists was 43 years, with 74% being male. The annual prevalence of symptoms in both the lower back or neck was 63%, with 49% experiencing symptoms in the shoulders. Older dentists were no more likely to suffer musculoskeletal discomfort than younger dentists. The highest ranking dentistry-specific work-related stressor was 'patients having a medical emergency' with 78% scoring this stressor very highly. Dentists scored mental demands as the highest general work-related stressor. One-fifth of the dentists scored highly for psychological disturbance, which was very similar to the general population. Dentists with high scores for dentistry-specific work-related stressors were more likely to have evidence of psychological disturbance. The relationships between psychological disturbance and musculoskeletal discomfort needs to be taken into account when considering any multidisciplinary approach to prevention.     

Musculoskeletal discomfort and work-related stress in New Zealand dentists

Abstract

There has been little research into the stressors, psychological distress and musculoskeletal symptoms experienced by dentists. The present study was carried out among a random sample of New Zealand dentists (N=413). The present study aimed to identify the severity of work psychosocial stressors, examine the occurrence of musculoskeletal discomfort and psychological disturbance, and determine relationships between these factors. The average age of the dentists was 43 years, with 74% being male. The annual prevalence of symptoms in both the lower back or neck was 63%, with 49% experiencing symptoms in the shoulders. Older dentists were no more likely to suffer musculoskeletal discomfort than younger dentists. The highest ranking dentistry-specific work-related stressor was ‘patients having a medical emergency’ with 78% scoring this stressor very highly. Dentists scored mental demands as the highest general work-related stressor. One-fifth of the dentists scored highly for psychological disturbance, which was very similar to the general population. Dentists with high scores for dentistry-specific work-related stressors were more likely to have evidence of psychological disturbance. The relationships between psychological disturbance and musculoskeletal discomfort needs to be taken into account when considering any multidisciplinary approach to prevention.     

Stress,coping and problem solving

Abstract

This paper outlines the developing consensus on the nature of stress. It offers a definition of stress as a psychological state derived from the person's appraisal of their ability to cope with the demands which are made of them. The paper then examines the concept of coping and explores its role in stress theory. It contrasts two different approaches to the study of coping: the classification of coping strategies, and the investigation of the process of coping—coping as ‘problem solving’. The paper focuses on the latter and in doing so it describes the nature of rational models of problem solving, considering their utility and application to stress management.     

The relationship of work stressors, coping and social support to psychological symptoms among female secretarial employees

A conceptual framework is advanced that assumes that psychological symptoms emerge within multiple contexts, such as the workplace, and are influenced by the interplay of individual and situational risk and protective factors over time. This framework was utilized to examine the impact of work and work-family role stressors, coping, and work-related social support on psychological symptoms among 239 female, secretarial employees in the USA, using both cross-sectional and longitudinal structural equation models. Work stressors and avoidance coping were viewed as risk factors, and active coping and social support as protective factors. Work stressors contributed substantially to increased symptoms, primarily through a direct pathway in the cross-sectional model, but also indirectly to both Time 1 and Time 2 symptoms (4 months later) via pathways through active and avoidance coping. In both models, avoidance coping also predicted increased symptoms. Avoidance coping also served to partially mediate the relationship between work stressors and symptoms in the cross-sectional model, but not in the longitudinal model. Active coping was related to fewer psychological symptoms in both models, thereby reducing the negative effect of work stressors on symptoms. Likewise, work-related social support served an indirect protective function by contributing to lower levels of reported work stressors and greater use of active coping. Work stressors but not active coping mediated the relationship between social support and symptoms. Implications for future research and workplace interventions are discussed.     

The measurement of coping with stress: Construct validity of the ways of coping checklist and the cybernetic coping scale

Though numerous Measures of coping have been presented in the literature, procedures used to evaluate the construct validiy of these measures are incomplete, and few studies have examined multiple measures using data from the same sample, This study presents a comparative evaluation of the construct validity of the Ways of Coping Checklist (WCCL; Lazarus and Folkman 1984) and the Cybernetic Coping Scale (CCS; Edwards 1991), based on confirmatory factor analyses of data from 116 MBA students. Results provided moderate support fot the CCS and weak suport fot the WCCL. Recommendations for the use of the WCCL and CCS are offered, and procedures for the development of coping measures are discussed.