job stress

SPELL INTERNSHIP -1 SUMMER DISSERTATION PRESENTATION

ON

“A STUDY ON JOB STRESS AMONG NURSES”

IN

OWAISI HOSPITAL AND RESEARCH CENTER

By Syeda Uzma Sultana Hall No. 107709676016

INTRODUCTION Stress is a normal, universal human experience and a routine

part of our lives. An unavoidable effect of living, it is an especially complex phenomenon in modern technological society. It is a feature of life which can be both protective and harmful. Unfortunately "stress" is too often viewed in a negative context when, in fact, it enables us to cope with change.

Symptoms of stress can be physical and psychological. There could be changes in ordinary behavior patterns, such as changes in eating habits, decreased personal hygiene, withdrawal from others and prolonged silences. It has been linked to coronary heart disease, psychosomatic disorders, and various other mental and physical problems

INTRO CONTINUE….. Definitions of Stress Stress is a word derived from the Latin word ‘stringere’,

meaning to draw light, and was used in the 17th century to describe hardships or affliction. The term stress originated in the field of engineering and refers to any external force directed at some physical object. Many writers in psychology and physiology have adopted this engineering convention, stress being the external agent or stimulus, and strain being the resultant effect.

The Longman Dictionary of Psychology (1984) defines stress as “a state of physical or psychological strain which imposes demands for adjustment upon the individual.”

Occupational Stress:

In the modern work environment, physical hazards and demands have been reduced, whereas other forms of stress that are psychological in nature, caused by aspects like a very high work place, competition, and has considerably increased. These new trends are likely to involve an increased risk of work-related stress due to work overload, role conflicts and lack of time for rest and recovery.

Occupational stress in the work place includes relatively enduring or chronic stressors such as role conflict, role ambiguity, role overload, interpersonal conflict with a co-worker, and frequently recurring daily hassles at work, pressures of work such as fear of job loss, blocked ambition or work overload also have an effect on home life. This is particularly relevant for dual career couples or in cases where one partner may be experiencing financial difficulties or life crisis

There are a variety of factors intrinsic to the job which are potentially stressful and which have been linked to poor physical and mental health. These include poor working conditions, shift work, long hours, travel, risk and danger, person-job mismatch, new technology, and work overload, both of a qualitative and qualitative in nature. Three critical factors are major sources of potential stress: 1) role ambiguity, 2) role conflict, and 3) the degree of responsibility for others.

In India at present, the work situation has under gone profound changes. In the modern work environment, physical hazards and demands have been reduced, where as psychological stress, caused by a very high work pace, competition, and efficiency and by successive readjustment to organizational changes, has increased.

RESEARCH METHODOLOGY OBJECTIVE To find out factors causing job stress among nurses. To understand the influence of Socio-Demographic

variables if any on job stress. To study the impact of stress on work performance. To suggest stress relieving mechanism.

Purpose of study: The present study was undertaken to find out the

degree of stress in nurses working in Owaisi Hospital. This would give the idea regarding the extent of stress levels in nurses and what are the various factors which are responsible for it.

Research Design:

1. Descriptive Study: Descriptive Research involves surveys and fact-finding enquiries of different kinds. The major purpose of this research is description of the state of affairs as it exists at present.

2. Quantitative Approach: Qualitative approach to research is concerned with subjective assessment of attitudes, opinions and behavior.

3. Qualitative Approach: It is based on the measurement of quantity or amount. It is applicable to phenomena that can be expressed in terms of quantity.

SAMPLE PLAN : Sampling Design:

Convenience sampling: o It refers to the collection of information from

members of the population who are conveniently available to provide it.

Sampling Unit:

Here sample unit is (OWAISI HOSPITAL) Nurses, Santosh Nagar, Hyderabad.

Sampling Size: 50 Nurses are selected by using convenience sampling method

from different wards of the unit.

Methods of Data Collection:

PRIMARY DATA: Here is the Questionnaires method using Likert type of scaling.

Description of the tools used: Data for the study was collected using: Socio-demographic data sheet. Nurse Stress Scale

Source of Data Collection:

Nurses of Owaisi Hospital are the source of data collection.

Data Analysis Technique:

Data analysis is done by using SPSS

ANALYSIS AND INTERPRETATION

Sociodemographic particulars of the Respondents:

Age No of Patients

Percentage Mean Standard Deviation

22 or Younger

18 36

1.92 1.027

23 – 25 25 50

26 – 29 3 6

30 -34 1 2

35 – 39 3 6

GenderNo of Patients

Percentage Mean Standard Deviation

Female 49 98 1.02 0.141

Male 1 2

Marital Status

Single 39 78 1.22 0.418

Married 11 22

Educational Qualification

B.Sc Nursing 38 76

1.52 0.974ANM 1 2

GNM 8 16

Inter 3 6

SocioDemographic Variables

No of Patients Percentage Mean Standard Deviation

Duration of Service in Current Job

Less than 6 Months

12 242.28 1.051

6 Months - 1 Year

18 36

2 Year - 5 Year

17 34

6 Year - 10 Year

1 2

11 Year - 15 Year

1 2

15 above 1 2

Residential Status(Living with Family)

Yes 27 460.540 0.503

No 23 54

Type of Family

Yes 43 861.14 3.51

No 7 14

Total 50 100

One Fourth of Nurses (25 %) are in the Age group of 23 - 25.

Majority are female Nurses (98 %) than the male nurses.

Nearly 80 % of the Respondents are Single.

More than one third Nurses i.e (76 %) respondents are B.SC (Nursing)

others are GNM ,ANM and Inter .

More than One fourth of the total sample (34 %) had 2 – 5 yrs of work Experience.

More than half of the Nurses i.e (54 %) were Living with the family.

Majority of the Nurses (82%) belongs to the nuclear Families.

FREQUENCY DISTRIBUTION OF DEATH AND DYING (PATIENT RELATED)

Stress Scale

Performing procedures that patients experience as painful

Feeling Helpless in the case of a patient who fails to improve.

Death of Patient. Physician not being present when patient dies.

No % No % No % No %

Never StressFull

10 20 3 6 7 14 5 10

Occasionally StressFull

32 64 25 50 18 36 8 16

Frequently StressFull

8 16 12 24 6 12 10 20

Extremely Stressfull - -

10 20 19 38 27 54

Total 50 100 50 100 50 100 50 100

Mean 1.96 2.58 2.74 3.18

Standard Deviation

0.605 0.883 1.121 1.044

Physician(s) not being present when a patient dies is perceived as most stressful here(3.18)

FREQUENCY DISTRIBUTION OF WORKLOAD

Stress Scale

Have to work through breaks.

Too many non-nursing task required, such as clerical work.

Not enough staff to adequately cover the unit

Not enough time to complete all of your nursing task.

No % No % No % No %

Never Stressful

13 26 10 20 5 10 7 14

Occasionally Stressful

16 32 19 38 14 28 19 38

Frequently Stressful

10 20 9 18 5 10 13 26

Extremely Stressful

11 22 12 24 26 52 11 22

Total 50 100 50 100 50 100 50 100Mean 2.38 2.46 3.04 2.56

Standard Deviation

1.105 1.073 1.106 0.993

Rated Frequency Stressful at (3.04) is “Not enough Staff to adequately cover the Unit”. These factors received the highest ratings from the sample nurses

FREQUENCY DISTRIBUTION OF SUPERVISOR STRESSORS

Stress Scale

Conflict with supervisor.

Lack of Support from immediate supervisor

Criticism from nursing administration.

Being held accountable for thing over which you have no control.

No % No % No % No %

Never Stressful

14 28 7 14 16 32 9 18


24 28 19 38 15 30 13 26


8 16 12 24 10 20 11 22

Extremely Stressful

14 28 12 24 9 18 17 34

Total 50 100 50 100 50 100 50 100Mean 2.44 2.58 2.24 2.72

Standard Deviation

1.181 1.012 1.098 1.126

“Being held accountable for thing over which you have no control” was perceives as stressful (2.72) by sample of nurses.

FREQUENCY DISTRIBUTION OF PEERS STRESSORS

Stress Scale

Difficulty in working with particular nurse

Lack of Opportunity to share experience /feeling with other personnel.

Lack of Opportunity to express to other personnel on the unit your negative feeling towards patients.

No % No % No %

Never Stressful

28 56 26 52 23 46


9 18 18 36 20 40


6 12 4 8 20 40

Extremely Stressful

7 14 2 4 5 10

Total 50 100 50 100 50 100Mean 1.84 1.64 1.72

Standard Deviation

1.113 0.802 0.809

Difficulty in working with particular nurse is perceived as stressful (1.84).

FREQUENCY DISTRIBUTION OF UNCERTAINTY CONCERNING TREATMENT

Stress Scale

Fear of mistaking in treating a patient.

Feeling Inadequately trained for what you have to do

A physician not being present in a medical emergency.

No % No % No %

Never Stressful

35 70 15 30 3 6


14 28 20 40 14 28


1 2 6 12 11 22

Extremely Stressful - -

9 18 22 44

Total 50 100 50 100 50 100

Mean 1.32 2.18 3.04

Standard Deviation

0.513 1.063 0.989

Rate Frequency Stressful at (3.04)” Physician not being present when in a medical Emergency”.

FREQUENCY DISTRIBUTION OF PATIENT FAMILY STRESS

Stress Scale

Patient’s family making unreasonable demand.

Being Blamed for anything that goes wrong.

No % No %

Never Stressful 4 8 5 10Occasionally Stressful

11 22 9 18


19 38 9 18

Extremely Stressful

16 32 27 54

Total 50 100 50 100Mean 2.94 3.16

Standard Deviation

0.935 1.057

“Being Blamed for anything that goes wrong” Rated frequency is (3.16) perceived as more stressful.

CHI –SQUARE TEST Chi- Square was used for finding the dependent and independent

variables. Here Chi Square is used to know whether Socio-Demographic

variables is dependent on other factors or it is independent. Null Hypothesis and Alternative Hypothesis is used.

Null Hypothesis (H0) –Age & Patient’s Related Stress are Independent.

Alternative Hypothesis (H1) –Age & Patient Related Stress are dependent.

Result: Age & patient’s Related Stress is dependent. As the Chi Square value is greater than the Chi Square-α Value.

CHI SQUARE RESULTS WHICH ARE STATISTICALLY SIGNIFICANT. Variables Analyzed Chi

Square P - value

Subscale “Death and Dying” with “Age” 60.892 <0.05

Subscale “Workload” with “Age” 38.083 <0.05

Subscale “Supervisor Stress” with “Age” 4.083 >0.05Subscale “Peers Stress” with “Age” 55.083 <0.05

Subscale “ Uncertainty concerning Treatment” with “ Age”

41.917 <0.05

Subscale “Patient family Stress” with “ Age” 49.250 <0.05

“Gender” with Subscale “Death and Dying” 25.314 <0.05

“Gender” with Subscale “Workload” 25.471 <0.05

“Gender” with Subscale “Supervisor Stress” 2.882 >0.05

“Gender” with Subscale “Peers Stress” 25.00 <0.05

“Gender” with Subscale “ Uncertainty concerning Treatment”

16.059 <0.05

“Gender” with Subscale “Patient family Stress” 25.157 <0.05

Variables Analyzed Chi Square

P- value

“Marital Status” with Subscale “Death and Dying” 34.279 <0.05

“Marital Status” with Subscale “Workload” 28.115 <0.05

“Marital Status” with Subscale “Supervisor Stress” 3.721 >0.05

“Marital Status” with Subscale “Peers Stress” 33.623 <0.05

“Marital Status” with Subscale “ Uncertainty concerning Treatment”

23.787 <0.05

“Marital Status” with Subscale “Patient family Stress” 32.443 <0.05

Subscale “Death and Dying” with “Educational Qualification”.

37.263 <0.05

Subscale “Workload” with “Educational Qualification”. 24.105 <0.05

Subscale “Supervisor Stress” with “Educational Qualification”.

2.000 >0.05

Subscale “Peers Stress” with “Educational Qualification”.

44.526 <0.05

Subscale “Uncertainty concerning Treatment” with “Educational Qualification”.

27.895 <0.05

Subscale “Patient family Stress” with “Educational Qualification”.

31.053 <0.05


P - value

“Duration Of Service” with Subscale “Death and Dying”.

62.912 <0.05

“Duration Of Service” with Subscale “Workload” 32.737 <0.05

“Duration Of Service” with Subscale “Supervisor Stress”.

1.158 >0.05

“Duration Of Service” with Subscale “Peers Stress”.

68.386 <0.05

“Duration Of Service “with Subscale “Uncertainty concerning Treatment”.

40.737 <0.05

“Duration of Service” with Subscale “Patient family Stress”..

45.649 <0.05

Subscale “Death and Dying” with “Residential Status”.

25.296 <0.05

Subscale “Workload” with “Residential Status”. 11.963 <0.05

Subscale “Supervisor Stress” with “Residential Status”.

4.259 >0.05

Subscale “Peers Stress” with “Residential Status” 10.667 <0.05

Subscale “ Uncertainty concerning Treatment” with “Residential Status”

5.148 <0.05

Subscale “Patient family Stress” with “Residential Status”

18.185 <0.05


P - value

“Type of Family” with Subscale “Death and Dying”

29.807 <0.05

“Type of Family” with Subscale “Workload”

26.579 <0.05

“Type of Family” with Subscale “Supervisor Stress”

1.877 >0.05

“Type of Family” with Subscale “Peers Stress”

32.754 <0.05

“Type of Family” with Subscale “ Uncertainty concerning Treatment”

17.035 <0.05

“Type of Family” with Subscale “Patient family Stress”

24.193 <0.05

The Sub scale “Death and Dying (Patient Related)” was Statistically Significant for all the Sociodemographic Variables. (Age, Gender, marital Status, Educational Qualification, Duration of Service, Residential Status and Type of Family).

The Subscale “Workload Related” was Statistically

Significant for all the Sociodemographic Variables. Age, Gender, marital Status, Educational Qualification, Duration of Service, Residential Status and Type of Family).

The Subscale “Supervisor Related Stress” was Statistically

Not Significant for all the Sociodemographic Variables. . (Age, Gender, marital Status, Educational Qualification, Duration of Service, Residential Status and Type of Family).

The Subscale “Peers Related Stress” was Statistically Significant for all the Sociodemographic Variables. Age, Gender, marital Status, Educational Qualification, Duration of Service, Residential Status and Type of Family).

Subscale “Uncertainty concerning Treatment with patient” was Statistically Significant for all the Sociodemographic Variables. Age, Gender, marital Status, Educational Qualification, Duration of Service, Residential Status and Type of Family).

The Subscale “Patient’s Family Related” was Statistically

Significant for all the Sociodemographic Variables. Age, Gender, marital Status, Educational Qualification, Duration of Service, Residential Status and Type of Family).

MAIN FINDINGS OF STUDY Physician(s) not being present when a patient dies

is perceived as most stressful in case of patient related stress.

“Not enough Staff to adequately cover the Unit”.

These factors received the highest ratings from the sample nurses. This stress is related to the workload and it is one of the highest rated subscale when compare to the other related subscales.

“Being held accountable for thing over which you have no control” was perceives as stressful in case of supervisor related stress.

Difficulty in working with particular nurse is perceived as stressful .As their opinion and way of dealing with the patient is different.

“Being Blamed for anything that goes wrong” Rated frequency is (3.16) perceived as more stressful. Nursing managers should be particularly look at causes of problems to solve them rather than “assigning blame”.

By observing all values of mean, it is seen that in all

the subscales, more stress is by the Workload, Uncertainty Concerning Treatment with Patient and Patient’s Family related.

Socio-demographic variables such as age, gender,

marital status, educational qualification, residential status, Type of Family, were statistically significant in Owaisi Hospital in relation to the subscales as shown by the Chi Square, except in case of Supervisor Related Stress it is not Significant.

It is found that there is impact of stress on work

performance as more stress is due to the workload and they are unable to complete their nursing task due to the stress.

SUGGESTIONS Share your worries with family and friends. Increased knowledge helps to alleviate fears – clear up

any misconceptions and give yourself the tools and resources to cope.

Don’t be too hard on yourself. Worry does not solve anything, try to confront your

problems and make plans to solve them. Set realistic goals. Exercise regularly and eat healthily. Practice relaxation techniques.

Have fun with your family and friends, think positive and enjoy new experiences.

CONCLUSION “Workload” to be a significant source of stress

identified by most respondents.

It is known that staffing patterns in hospitals throughout the India have been dramatically impacted because of the critical nursing shortage and the advancing age of the current nursing workforce.

“Patient’s Family Related ” was the second highest in terms of the total mean score, Chi Square results for variables such as gender, marital status, educational qualification, residential status and Type of family were statistically significant in relation to subscale “Patient’s Family related”.

The main reason for this stress is Patent’s family making unreasonable demand and Blaming for the things that goes wrong.

job stress

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