ppt stress

04/10/2023 JHARIA Jayantee 1

Workplace stress in nursing

INTERGRATIVE LITERATURE REVIEWS AND META-ANALYSES


Presented by


Overview of study

Research topic: workplace stress in nursingBackground: as individuals differ so do their perception on stress. This leads to variation in the sources identified. Thus causing ambiguity on the preventive measures.


Literature review purpose: 1. To Identify nurses perception of workplace

stress.2. Consider the potential effectiveness of

initiatives to reduce distress.3. Identify direction for future research.


Method of research

A literature search from January 1985 to April 2003 was conducted .

key word used:nursingstressdistressstress management


job satisfactionstaff turnovercoping to identify research on sources of

stress in adult and child care nursing.

Recent (post-1997) United Kingdom Department of Health documents and literature about the views of practitioners was consulted.


Findings

1. Main sources of distress for nursesWorkloadLeadership/management styleProfessional conflictsEmotional cost of caring(but degree of impact

differs)


2. Lack of reward3. Lack of understanding how sources of stress

vary from place to place.4. Lack of predictive power of assessment tool.5. Lack of understanding of how

personal/workplace factors interact.


Working with literature

Working with Literature

Working with Literature

Find it!Find it! Manage it!Manage it! Use it!Use it! Review it!Review it!

Knowing the literature typesKnowing the

literature types

ReadingefficientlyReadingefficiently

Choosing your research topic Choosing your research topicUnderstanding the lit review’s purpose

Understanding the lit review’s purpose

Using available resourcesUsing available resourcesKeeping track of references

Keeping track of references

Developing your questionDeveloping your questionEnsuring adequate

coverageEnsuring adequate

coverage

Honing your search skills

Honing your search skills

Writing relevant annotationsWriting relevant annotations Arguing your

rationale Arguing your

rationale

Informing your work with theory

Informing your work with theory

Designingmethod

Designingmethod

Writingpurposefully

Writingpurposefully

Working on style and toneWorking on

style and tone


Introduction

Different authors have differently cited and articulate the definition of stress. Some has define stress as a demand perception response whereas others have put more emphasis on stress threshold, referring it to stress hardiness, but they also mention about the positive effects of stress. In this piece of work more accent has been given on subjective data.


The citations

Stress is usually defined from a 'demand-

perception-response' perspective ( Bartlett 1998).

Lazarus and Folkman (1984) integrated this view into a cognitive theory of stress that has become the most widely applied theory in the study of occupational stress and stress management(Lehrer & Woolfolk 1993, Rick & Perrewe 1995).


articulation of the author

The basic concept is that stress relates both to an individual's perception of the demands being made on them and to their perception of their capability to meet those demands. A mismatch will mean that an individual's stress threshold is exceeded, triggering a stress response (Clancy 8i McVicar 2002).


Identification of stressors by different authors

Major workplace stressors that impact on work satisfaction for staff nurses. Those stressors that relate to the same theme are collated, and presented pre- and post-1997, that is before and after recent policy changes in the workplace (Department of Health 1998a, 1998b, 1998c,1998d). The stressors are not listed in orderof importance.


Research questions

1. Is there commonality of sources of workplace stress for nurses?

2. Are sources of workplace stress for nurses changing?

3. Will recent organizational interventions introduced to reduce the sources of stress for nurses be effective?

A secondary question is:• What should be the directions of further research

on stress in nursing?


Ref of databases: CINAHL, MEDLINE, COCHRANEThe research was restricted to adult and child care nursing.Sample of study: sample came from a wide range of practice setting and sometime from entire hospital. Focus settings were medical surgical and intensive care. But no comparison was made between the practice areas.((Foxall et al.1990, Tyler & Ellison 1994). 100 papers and texts were consulted out of which only 21 were primary research sources.


Findings

Williams et al.(1998) have identified workloads, leadership, professional conflict and emotional demand of caring as sources of distress.Fox all et al.(1990) found that nurses working in intensive care are more at risk for distress rather than those working in medical-surgical cares.


On the other hand Payne(2001) did not find significant relationship between burnout and workload but reasons for the variations are unclear.Different studies reveals how different sources can contribute to the causes of stress. For example conflict among the members of the multidisciplinary teams or bullying. Lack of reward and shift working are also classified as stressors.


Overall discussion

Workload is seen as one of the leading stressor, thus in order to minimize it, different initiatives are being taken. For recruitment of new staffs both clinical and administrative have shown great improvement.As far as professional conflicts and harassment are concern there is no significant improvement but no deterioration is noted.


Emotional labour which was more prevalent in the years 80s has been changed to holistic care for the betterment of nurses. (Charnley 1999, Gerrish 2000) has suggested the introduction of Constructive clinical supervision, mentorship and preceptorship, underpinned by an effective leadership style, (will have a significant role to play here, especially for newly qualified nurses).


Pay and shift schedules as well as lack of reward are hindering smooth working of nurses.(Ball et al. 2002)Duffin 2001, Holyoake et al.(2002) stated that despite that police officer and teachers are compared to nurses, there is a discrepancy in the wage. While others ponder that the government is not giving enough attention to the nurse plight.


Individuality of stress perception is more of psychological problem. According to Boyle et al.(1991) it is personal stress that influence the ability to cope. But Schaefer & Moos( 1993), Jones & Johnston (2000) said that The range of possible interactions between personal and workplace sources of distress is considerable, but under-researched.


Research indicates that problem-focused coping, such as problem-solving, is the more effective of the two at preventing burnout in nurses (Ceslowitz 1989, Tyler & Cushway 1995, Simoni & Paterson1997, Healy & McKay 2000, Payne 2001. Thus, employing positive reappraisal or self-control (that is, positive emotion-focused dimensions) effectively decreases burnout(Ceslowitz 1989, Healy & McKay 2000, Payne 2001)


conclusion

Progression of stress is subjective depending upon the relationship between an individual and the environment.So stress intervention measure should focus on stress prevention for individual as well as the organisational issues.To achieve that this require further comparative studies and new tools to evaluate the intensity of individual distress.

ppt stress

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