This document outlines a proposed study to compare stress levels among nurses working in psychiatric versus multispecialty hospitals in Bangalore, India. It notes that nurses experience various workplace stressors and are at high risk for stress and burnout. The study aims to identify the sources and extent of stress in these settings to inform strategies for supporting nurses' health and reducing absenteeism. It will utilize validated scales to assess stress levels and correlates among nurses to determine if they differ between hospital types. The results could help hospitals acknowledge and address chronic workplace stress impacting nurses.
Nature and scope of meantal health nursing - Presented By Mohammed Haroon Ra...Haroon Rashid
Subject - Mental Health Nursing and topic is Nature and Scope of Mental health nursing , Presented by Mohammed Haroon Rashid, Basic B.Sc Nursing 3rd Year in Florence College of Nursing
Computer assisted learning,Computer assisted learning describes is to conveys a vast amount of information in a very short period of time.
It is a powerful method of reinforcing concepts and topics first introduced to students through textbook and discussion in classroom .
Hisrorical evelotion and trends in nursing researchdeepakkv1991
AS AN NURSE THIS IS MY CONTRIBUTION TO ALL MY FELLOW NURSES SO THAT THEY GET AN OPPORTUNITY TO UNDERSTAND AND LEARN ABOUT THE HISTORICAL DEVELOPMENT OF NURSING AND FUTURE TRENDS IN NURSING.
Descriptive statistics offer nurse researchers valuable options for analysing and pre-senting large and complex sets of data, suggests Christine Hallett
it explain about definition of supervisior, faculty and dual position. role of faculty and supervisior and characteristics of faculty and supervisior. different hospital who started concept of dual position. advantages and disadvantages of dual position.
DIFFERENT MODELS OF COLLABORATION BETWEEN NURSING EDUCATION AND SERVICEMental Health Center
DIFFERENT MODELS OF COLLABORATION BETWEEN NURSING EDUCATION AND SERVICE- By Bivin, J.B., & Reddemma, K. (2010). Department of Nursing, National Institute of Mental Health and Neurosciences, Bangalore.
Nature and scope of meantal health nursing - Presented By Mohammed Haroon Ra...Haroon Rashid
Subject - Mental Health Nursing and topic is Nature and Scope of Mental health nursing , Presented by Mohammed Haroon Rashid, Basic B.Sc Nursing 3rd Year in Florence College of Nursing
Computer assisted learning,Computer assisted learning describes is to conveys a vast amount of information in a very short period of time.
It is a powerful method of reinforcing concepts and topics first introduced to students through textbook and discussion in classroom .
Hisrorical evelotion and trends in nursing researchdeepakkv1991
AS AN NURSE THIS IS MY CONTRIBUTION TO ALL MY FELLOW NURSES SO THAT THEY GET AN OPPORTUNITY TO UNDERSTAND AND LEARN ABOUT THE HISTORICAL DEVELOPMENT OF NURSING AND FUTURE TRENDS IN NURSING.
Descriptive statistics offer nurse researchers valuable options for analysing and pre-senting large and complex sets of data, suggests Christine Hallett
it explain about definition of supervisior, faculty and dual position. role of faculty and supervisior and characteristics of faculty and supervisior. different hospital who started concept of dual position. advantages and disadvantages of dual position.
DIFFERENT MODELS OF COLLABORATION BETWEEN NURSING EDUCATION AND SERVICEMental Health Center
DIFFERENT MODELS OF COLLABORATION BETWEEN NURSING EDUCATION AND SERVICE- By Bivin, J.B., & Reddemma, K. (2010). Department of Nursing, National Institute of Mental Health and Neurosciences, Bangalore.
The presentation describes in brief the patients need, expectations and how to develop the patient care and feedback system to obtain maximum patient satisfaction.
ASSESS THE LEVEL OF STRESS IN NURSES OFFICESS RELATED TO JOB STATISFACTION AT...SachinKumar945617
INTRODUCTION & REVIEW OF LITERATURE OF ASSESS THE LEVEL OF STRESS IN NURSES OFFICESS RELATED TO JOB STATISFACTION AT VARIOUS HOSPITAL
IF U WANT TO MAKE YOUR RESEACRH, PROJECT, PPT ETC CONTACT ME ON
EMAIL SACHINGONE220@GMAIL.COM
The Impact of Burnout syndrome on Nurse Workers .docxrtodd33
The Impact of Burnout syndrome on Nurse Workers !1
The Impact of Burnout Syndrome on Psychosocial Wellbeing, Expected Outcomes, Self-efficacy,
Turnover, and Interest in Career of Nurse Workers.
Olajumoke Omiyale
Aspen University
Author Note
Essentials of Nursing Research N494
Dr. Keshea Britton
Date of Submission February 11, 2020
Burnout Among Nurses !2
Background
Burnout is a very common condition across the world and especially in the nursing
career. It's the reduction in the energy and zeal of nurses manifesting in form of being
emotionally exhausted, lacking motivation, feeling frustrated, fatigued, and low reaction time
which reduces individuals' output and work efficacy in general. Burnout has been strongly
attributed to the deficit in the number of healthcare professionals, a concern that goes way to be a
matter of global importance. The rapidly changing healthcare landscape that brings a paradigm
shift to increased demand for healthcare services in the world population has come with its
challenges. Although experts associate the change to improvement in the quality of life for which
people become capable of seeking healthcare services, the move has placed a lot of pressure on
not only the healthcare systems but particularly on the workforce (Mudallal, Othman, & Al
Hassan, 2017). However, governments have not moved at a similar pace to address these
pressures, leaving the mantle on the health institutions and professionals. To be specific, nurses,
as well as other healthcare providers, are left with a large number of patients to takes care of, a
number that keeps on increasing day after day, keeping them on the run all the time. The absolute
result of this healthcare environment is burning or wearing out, which without doubt minimizes
the efficacy of the nurse’s output.
The working environment for which the nurse staff doesn't match the care demand
culminated by poor leadership creates unattractive working conditions. Indeed, WHO reports
indicate that shortages of nurses would nationally and internally interfere with the efforts to
health and well being of the world population. Where staff shortage exists, human resources are
Burnout Among Nurses !3
overstretched, working conditions become poor and unbearable, work becomes increasingly
hazardous to the health of the nurse- they get no rest, become stressed, productivity decrease
with the poor patient outcome which add up to the trauma of the workers. They end up losing
interest in their job, become highly dissatisfied, burnout and increase the chances of quitting the
job. In return, the turnover of nurses affects the quality of healthcare services offered because of
a lack of expertise and increasing the workload burden on the remaining staff (Sobral, et. al,
2018). .
The Impact of Burnout syndrome on Nurse Workers !1
The Impact of Burnout Syndrome on Psychosocial Wellbeing, Expected Outcomes, Self-efficacy,
Turnover, and Interest in Career of Nurse Workers.
Olajumoke Omiyale
Aspen University
Author Note
Essentials of Nursing Research N494
Dr. Keshea Britton
Date of Submission February 11, 2020
Burnout Among Nurses !2
Background
Burnout is a very common condition across the world and especially in the nursing
career. It's the reduction in the energy and zeal of nurses manifesting in form of being
emotionally exhausted, lacking motivation, feeling frustrated, fatigued, and low reaction time
which reduces individuals' output and work efficacy in general. Burnout has been strongly
attributed to the deficit in the number of healthcare professionals, a concern that goes way to be a
matter of global importance. The rapidly changing healthcare landscape that brings a paradigm
shift to increased demand for healthcare services in the world population has come with its
challenges. Although experts associate the change to improvement in the quality of life for which
people become capable of seeking healthcare services, the move has placed a lot of pressure on
not only the healthcare systems but particularly on the workforce (Mudallal, Othman, & Al
Hassan, 2017). However, governments have not moved at a similar pace to address these
pressures, leaving the mantle on the health institutions and professionals. To be specific, nurses,
as well as other healthcare providers, are left with a large number of patients to takes care of, a
number that keeps on increasing day after day, keeping them on the run all the time. The absolute
result of this healthcare environment is burning or wearing out, which without doubt minimizes
the efficacy of the nurse’s output.
The working environment for which the nurse staff doesn't match the care demand
culminated by poor leadership creates unattractive working conditions. Indeed, WHO reports
indicate that shortages of nurses would nationally and internally interfere with the efforts to
health and well being of the world population. Where staff shortage exists, human resources are
Burnout Among Nurses !3
overstretched, working conditions become poor and unbearable, work becomes increasingly
hazardous to the health of the nurse- they get no rest, become stressed, productivity decrease
with the poor patient outcome which add up to the trauma of the workers. They end up losing
interest in their job, become highly dissatisfied, burnout and increase the chances of quitting the
job. In return, the turnover of nurses affects the quality of healthcare services offered because of
a lack of expertise and increasing the workload burden on the remaining staff (Sobral, et. al,
2018). .
FACTORS CAUSING STRESS AMONG FEMALE DOCTORS (A COMPARATIVE STUDY BETWEEN SELE...Editor Jacotech
It is an important task of working women to handle two
important tasks. Balancing these two roles at home and
work is very challenging task and causes stress at different
levels. Different dimension of working women’s life
involves in evolving the stress in working women’s life.
These stresses cause the imbalance at the front of and
handling family responsibility. In the current scenario,
doctors face many stressors that are peculiar to the medical
profession and doctors are required to have more
competencies than before in diagnosis ongoing
management of medical conditions. This means increased
responsibilities which may contribute to stress. Stress
experienced at work can have adverse outcomes for the
well-being of individual employees and organization as
whole. My study is focusing on identifying the factors
causing stress among female doctors working for public
and private hospitals and their stress levels associations
with respect to sector. A sample of 300 female doctors
from urban area participated in this study. Out of this, 150
each are from public and private hospitals respectively. A
self-made standardized tool was administered based on five
point scale. Results indicates that the values were found to
be 0.000 in all the cases except, psychosomatic problems
(0.004) which is lesser than (0.05) p-value resulting into
rejection of null hypotheses , consequently revealing an
association between sector of female doctors and stress due
to workload, working condition, physical exertion,
emotional exhaustion, job security, organizational support,
work family conflict, family adjustment, task demands,
psychosomatic problems, patient’s expectation and working
hours.
Objective: The aim of the study was to identify level of stress among nurses according to their job status. Background: Stress is highly associated with nursing profession. This stress is caused by several factors both personal and organizational such as educational level, gender, nature of work environment and work overload etc. These factors directly or indirectly expose nurses to a considerable level of stress. If a nurse works at two places, their stress level will predictably be much higher than that of those who work at a single place. Methodology: Quantitative analytical cross-sectional study design was applied in a private tertiary care hospital at Peshawar, Pakistan. Study population included all nurses working in the mentioned hospital. Universal sampling technique was used for double jobber nurses, while convenient sampling technique was used for single jobber nurses. An adopted questionnaire was used for data collection. Chi-square test was applied to analyze the data. Result: Among double jobber nurses, 23.33% had severe, 63.34% had moderate, and 13.33% had mild level of stress. On the other hand, there was no severe level of stress among single jobbers; only 20% had moderate and 80% had mild level of stress. Conclusion: The current study identified that level of stress was higher in double jobber nurses as compared to single jobber nurses. The study would have been more generalizable if more tertiary care hospitals were included for data collection.
NURSING STREE JHGJHS JBJHS JHBFJSH JHBHJ JHBFFHJ HJJHHBJHHDFJH JHFHJDS FGSDF GDFGDFG DFGDSFG DFGDFSG DFGDSFG DSFG DFG DFG DFG DFG DSG SDFG DFG D FGD SG DFG DG ETS GFDF GDSF G SDGFDF GD FG G SDG SD FGH DFG SD GDSF G DFS GDS G DFGTHYTR ERT ER Y ERT ER T EY ERT WERWE Y ERR Y ERR T ERY ET Y ETY ERT ETY RT Y TY TR RTY E RTER T E TE RT ETY R T ER T ER TR ER RT T TY YT RT Y TY EY YT T ERY T Y RTY ER Y ER
Below, I have two discussion posts from 2 of my classmates and I ne.docxtangyechloe
Below, I have two discussion posts from 2 of my classmates and I need one response for each post. Response must be at least 7 sentences and should contain 2 citations in APA style, thank you.
Student 1
Nursing shortages are not a new concept. As the Baby boomers age and more nurses retire, nurses' needs will intensify (American Association of Colleges of Nursing [AACN], 2021). The nursing industry is expected to increase 7% by 2029, with an estimated 175,900 RN openings each year through 2029 (AACN, 2021). Nursing shortages are multifactual. Nursing shortage factors include: nursing school enrolment is not growing with the demand, a significant portion of nurses are nearing retirement age, and insufficient staffing driving nurses to leave the profession (AACN, 2021). One area, in particular, that is sensitive to nursing shortages, and retention is correctional nursing. "Retention of nursing staff is more complex in a correctional facility" (Chafin & Biddle, 2013). One study noted only 20% of the nurses remained employed after three-years at this particular facility (Chafin & Biddle, 2013).
In a correctional facility, the primary focus is given to security, with healthcare being second. Providing care within a correctional setting is very different than a hospital setting. Facility security is always the focus and drive. How a nurse interacts with patients (inmates) within a facility is vastly different from a non-correctional environment. Being overly friendly or nice can wreak havoc and be deemed "over familiarizing" with inmates or been seen as a weakness by inmates creating a safety concern (Walsh, 2009). The correctional setting comes with its inherent dangers and stressors, leading to nurses' high turnover.
The prison I was formerly employed with has significantly reduced nurses due to terminations and resignments. As an employee with the Michigan Department of Corrections, a nurse can be pulled from any facility to fill the needs of another facility at any given time of which has recently happened. Marquette Branch Prison is to have nine registered nurses in total, and right now, they only have four RNs employed there. The facility has tried to offer signing bonuses to retain RNs. They have changed some procedures to make it safer for the nursing staff, such as correctional escorts when going to the cells, and have reached out to contract agencies to secure nurses. However, none of these measures have led to success. As the shortage increases, the remaining nurses are forced to work more overtime in an already demanding and stressful environment leading to an even faster turnover and increased safety concerns.
Living in a rural area already stresses the number of nurses available, and trying to recruit and retain nurses within the correctional system proves to be an even harder strain. Correctional nursing is a unique field of nursing with many added stressors. As long as there is a need for healthcare, the nursing shortage topi.
Association of an Educational Program in Mindful Communication With Burnout, ...DAVID MALAM
Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians.
The consequences of burnout among practicing physicians include not only poorer quality of life and lower quality of care but also a decline in the stability of the physician workforce.
There has been a major decrease in the percentage of graduates entering careers in primary care in the last 20 years, with reasons related to burnout and poor quality of life. This trend, coupled with attrition among currently practicing physicians, have already had a significant effect on patient access to primary care services.
Replacing physicians who leave practice is expensive:
estimates are $250 000 or more per physician. Even though the problem of burnout in physicians has been recognized for years, there
have been few programs targeting burnout before it leads to personal or professional impairment and very little data exist about their effectiveness.
METHODS
Study Population
All primary care physicians in the Greater Rochester, New York, community
(N=871) were invited to participate in the program through a series of mailed and electronic communications from the Monroe County Medical Society to individual physicians and local health care organizations, with follow-up telephone calls from the investigators.
JOB SATISFATION AND NURSE PATIENT RATIO24Table of Contents.docxchristiandean12115
JOB SATISFATION AND NURSE PATIENT RATIO
24
Table of Contents
Chapter 1: Introduction1
Background of the Problem1
Problem Statement1
Purpose of the Study1
Nature of the Study1
Significance of the Study1
Research Questions1
Hypotheses1
Brief Review of the Literature2
Conceptual Framework2
Assumptions, Limitations, and Delimitations2
Definition of Terms3
Conclusion3
Chapter 2: Literature Review4
Historical Development of the Topic4
Contemporary Perspectives4
Historical Development of the Theory4
Importance of the Study and Implication for Practice4
Directions for Future Research5
Summary5
Chapter 3: Research Method6
Research Design6
Appropriateness of Design6
Procedure6
The Role of the Researcher6
Research Questions6
Hypotheses6
Population and Sample6
Geographic or Virtual Location6
Instrumentation6
Data Collection6
Data Analysis7
Human Participants and Ethics Precautions7
Validity and Reliability7
Contribution to Social, Practice, or Organizational Change7
Summary7
Chapter 4: Results8
General Description of the Participants8
Research Questions8
Sample Size8
Pilot Tests8
Data Collection8
Unit of Analysis and Measurement8
Data Analysis8
Coding and Codebook Generation8
Qualitative Results8
Results of Hypothesis Tests9
Between Group Differences9
Outliers9
Validity and Reliability9
Summary9
Chapter 5: Discussion, Conclusions, and Recommendations10
Ethical Dimensions10
Limitations10
Overview of the Population and Sampling Method10
Data Collection and Analysis10
Summary of Findings10
Explanation of Findings10
Recommendations11
Reflecting Upon the Study11
Suggestions for Future Research11
Implications for Social, Practice, or Organizational Change11
Conclusions11
References12
Appendix A: Tables13
Appendix B: Figures15
Table of Tables
Table A1: This is an Example APA Table in Appendix A and Uses the APA Table
Title Style14
Table of Figures
Figure B1. This is an example APA figure using the APA Caption Style. Neo meets the Architect while seeking the Source.16
JOB SATISFATION AND NURSE PATIENT RATIO
i
Chapter 1: Introduction
Fatigue in nurses have been a factor that has always come with very many consequences in the medical world such as poor decision making that has not only led to negligence in the hospital but also inappropriate administration of prescribed medicine leading to, at worst, death of patients. We are to see how nurse’s fatigue relates to job satisfaction and nurse to patient ratio.
Background of the Problem
Nurses who are dissatisfied in their jobs always lack mental strength or the motivation for that matter to endure the ever-demanding requirements that are accompanied by the nursing career. This lack of interest of interest may make them work without much care in their job which results to dissatisfaction among patients (Chang, Chiu, Lin, & Lee,2009). Nurse to patient ratio has been a major topic of focus among stakeholders of healthcare institutions. An appropriate nurse to patient ratio is required to see that healthca.
Perceived Stress, Ways of Coping and Care Giving Burden among Family Caregive...iosrjce
Addressing perceived stress, ways of coping and care giving burden among family caregivers are
highly relevant in the current scenario in terms of prevention of mental illness and promotion of mental health of
people engaged in the care of their family member with schizophrenia. A community prevalence study
conducted by the IMHANS, Kerala estimated that 3.2 lakh people in the State suffer from schizophrenia (THE
HINDU, May 25, 2006).
Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi1TatianaMajor22
Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi:10.3390/ijerph10062214
International Journal of
Environmental Research and
Public Health
ISSN 1660-4601
www.mdpi.com/journal/ijerph
Review
Burnout in Relation to Specific Contributing Factors and Health
Outcomes among Nurses: A Systematic Review
Natasha Khamisa
1,2,
*, Karl Peltzer
3,4,5
and Brian Oldenburg
2,6
1
School of Health Sciences, Department of Public Health, Monash South Africa, 144 Peter Road,
Roodepoort, Johannesburg 1725, South Africa
2
Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Melbourne 3800,
Australia; E-Mail: [email protected]
3
Human Science Research Council, 134 Pretorius Street, Pretoria 0002, South Africa;
E-Mail: [email protected]
4
University of Limpopo, University Street, Turfloop, Sovenga, Polokwane 0727, South Africa
5
ASEAN Institute for Health Development, Mahidol University, Salaya 73170, Thailand
6
Monash Alfred Hospital Campus, Level 3 Burnet Tower, 89 Commercial Road, Melbourne 3004,
Australia
* Author to whom correspondence should be addressed; E-Mail: [email protected];
Tel.: +27-11-950-4450.
Received: 1 March 2013; in revised form: 16 May 2013 / Accepted: 24 May 2013 /
Published: 31 May 2013
Abstract: Nurses have been found to experience higher levels of stress-related burnout
compared to other health care professionals. Despite studies showing that both job
satisfaction and burnout are effects of exposure to stressful working environments, leading
to poor health among nurses, little is known about the causal nature and direction of these
relationships. The aim of this systematic review is to identify published research that has
formally investigated relationships between these variables. Six databases (including
CINAHL, COCHRANE, EMBASE, MEDLINE, PROQUEST and PsyINFO) were
searched for combinations of keywords, a manual search was conducted and an
independent reviewer was asked to cross validate all the electronically identified articles.
Of the eighty five articles that were identified from these databases, twenty one articles
were excluded based on exclusion criteria; hence, a total of seventy articles were included
in the study sample. The majority of identified studies exploring two and three way
relationships (n = 63) were conducted in developed countries. Existing research includes
OPEN ACCESS
Int. J. Environ. Res. Public Health 2013, 10 2215
predominantly cross-sectional studies (n = 68) with only a few longitudinal studies (n = 2);
hence, the evidence base for causality is still very limited. Despite minimal availability of
research concerning the small number of studies to investigate the relationships between
work-related stress, burnout, job satisfaction and the general health of nurses, this review
has identified some contradictory evidence for the role of job satisfaction. This emphasizes
the nee ...
Int. J. Environ. Res. Public Health 2013, 10, 2214-2240; doi1
Comparative
1. A COMPARATIVE STUDY TO ASSESS THE LEVEL OF STRESS
AMONG STAFF NURSES WORKING IN PSYCHIATRIC AND
MULTISPECIALITY HOSPITAL IN BANGALORE”.
M.Sc Nursing Dissertation Protocol submitted to
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.
By
MS.JINCY .M.VARGHESE
M.Sc NURSING 1ST
YEAR
2010-2012
Under the Guidance of
HOD, Department of Psychiatric Nursing
Nightingale College of Nursing
Guruvanna Devara Mutt
Near Binnyston garden
Bangalore –23.
2. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE,
KARNATAKA
CURRICULAM DEVELOPMENT CELL
CONFORMATION FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
Registration number :
Name of the candidate : Ms.Jincy.M.Varghese
Address : Guruvanna Devara Mutt, Near Binnyston
Garden, Magadi Road, Bangalore-23
.
Name of the institution : Nightingale College of Nursing
Course of study and subject : M.Sc Nursing in psychiatric nursing.
.
Date of admission to course : 20-05-2010
Title of the topic : A Comparative Study To Assess The Level Of Stress
Among Staff Nurses Working In Psychiatric And
Multispeciality Hospitals At Bangalore.
Brief resume of the intended work : Attached
Signature of the student :
Guide Name :Ms Archana R
.
Remarks of the guide :
Signature of the guide :
Co-guide name :
Signature of co-guide :
HOD name :Mr MohanaKrishnan
Signature of HOD :
Principal Name : Mrs.Jayakadambari
Principal Mobile No : 09886367287
Principal E-mail ID : nightingale_principal@rediffmail.com
Remarks of the Principal :
Principal signature :
3. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE.
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1 NAME OF THE CANDIDATE
AND ADDRESS
MS. JINCY.M.VARGHESE,
I YEAR M.Sc. NURSING,
NIGHTINGALE COLLEGE OF
NURSING,
GURUVANNADEVARA,MUTT
BINNYSTON GARDEN,
MAGADI ROAD
BANGALORE-560023
2 NAME OF THE INSTITUTION NIGHTINGALE COLLEGE OF
NURSING,
GURUVANNADEVARA,
MUTT BINNYSTON GARDEN,
MAGADI ROAD
BANGALORE-560023
3 COURSE OF STUDY AND
SUBJECT
M.SC NURSING IN PSYCHIATRIC
NURSING
4 DATE OF ADMISSION TO THE
COURSE 20-05-2010
5 TITLE OF THE TOPIC:
A COMPARATIVE STUDY TO ASSESS THE LEVEL
OF STRESS AMONG STAFF NURSES WORKING IN
PSYCHIATRIC AND MULTISPECIALITY HOSPITALS AT
BANGALORE
4. 6.0
BRIEF RESUME OF THE INTENDED WORK:
INTRODUCTION
“Give your stress wings and let it fly away”.
~Terri Guillemets
Stress is a term in psychology and biology, first
coined in the biological context in the 1930s, which has in more recent decades become
commonly used in popular parlance. It refers to the consequence of the failure of an
organism – human or animal – to respond appropriately to emotional or physical threats,
whether actual or imagined.1.
Stress symptoms commonly include a state of
alarm and adrenaline production, short-term resistance as a coping mechanism, and
exhaustion, as well as irritability, muscular tension, inability to concentrate and a variety
of physiological reactions such as headache and elevated heart rate.
Chronic stress can significantly affect many of the body's
immune systems, as can an individual's perceptions of, and reactions to, stress. The term
psychoneuroimmunology is used to describe the interactions between the mental state,
nervous and immune systems, as well as research on the interconnections of these
systems. Immune system changes can create more vulnerability to infection, and have
been observed to increase the potential for an outbreak of psoriasis for people with that
skin disorder2.
Stress is a subjective phenomenon based on individual perceptions,
producing positive (eustress) and negative (distress) perspectives. The workplace for
nurses provides a multiplicity of sources of stress. There are differences in the
perceptions of nurses in different workplaces, and even between individuals in the same
workplace. Progression along the continuum from eustress to distress is subjective,
depending upon the relationship between an individual and their environment. Thus,
whilst there is recognition that workload, leadership style, professional relationships, and
emotional demands are the most frequently reported major factors that cause workplace
5. distress for staff nurses3.
The concept of stress in the workplace is of great importance in
health care and especially nurse are generally considered a high risk group regarding
work stress and burnout. This syndrome has been a major concern in the field of
occupational health and healthcare worker, particularly those caring for patients suffering
from serious illness Stress affecting nurses across the globe has been convincingly
documented in the literature for more than 40 years. Nurses. environment include an
enclosed atmosphere, time pressures, excessive noise or undue quiet, no second chance,
unpleasant sights and sounds, and long standing hours4.
Nurses are trained to deal with these factors but chronic
stress takes a toll when there are additional stress factors like home stress, conflict at
work, inadequate staffing, poor teamwork, inadequate training, and poor supervision.
Stress is known to cause emotional exhaustion in nurses and lead to negative feelings
toward those in their care5.
In the absence of doctors, nurses are on the front line and
have to face verbal abuse from patients and relatives for issues that may not be directly
connected to their work. Physical violence and aggressiveness is also on the rise in
patients and their relations. Demanding patients and their relatives can cause conflict and
lead to more stress. Patient’s expectations from nurses are sometimes unreasonable and
they tend to be aggressive. No training is given to them to deal with confrontation6
.
It is important to identify the extent and sources of stress
in a healthcare organization to find stress management strategies to help the individual
and the environment. Stress in nurses affects their health and increases absenteeism,
attrition rate, injury claims, infection rates, and errors in treating patients. Unless the
healthcare setups acknowledge the problem and taken preemptive steps to tackle the
growing menace of chronic stress, personnel costs will keep rising and add to the already
soaring costs of care. Nurses’ absenteeism, turnover, and sickness significantly increase
the cost of employment in healthcare units7.
6. 6.1
NEED FOR STUDY
Stress and burnout are concepts that have sustained the interest
of nurses and researchers for several decades. These concepts are highly relevant to the
workforce in general and nursing in particular. Many studies of stress in nurse in
developed countries have shown chronic stress as a major contributor to suicide or
suicidal thoughts, smoking, excessive coffee consumption, and alcohol intake.5
A moderate level of stress or Eustress is an important
motivating factor and is considered normal and necessary. If stress is intense,
continuous, and repeated, it becomes a negative phenomenon or Distress which can lead
to physical illness and psychological disorders. Nurses are the backbone of any
healthcare unit. The pressures of overtime and long working hours create a work personal
life imbalance, which begins to affect the health of the employees.7
Lack of professional respect and recognition by authorities and
doctors is the major cause of stress among nurses in India. Poor relationship with
physicians was related to stress, which is seen as the most important reason for nurses
leaving hospitals. Lack of autonomy, poor participation in patient care due to lack of
sufficient knowledge and empowerment deprives them from job satisfaction. Nurses in
India are mainly from the lower economic strata and have low educational qualifications.
Their main motivators are salary and benefits to support their home and maintain a
decent standard of living. Shortage of staff makes them easily succumb to increasing
their pay package by doing excessive hours of overtime at the expense of their health.
They have limited access to claims and compensation for occupational hazards.7
Changes in health care systems, including the international
shortage of nursing staff, have implications on role stress felt by nurses, especially by
nursing managers. In a review of 68 articles on nurses' role stress, the most frequently
identified stressors were workload, role conflict, ambiguity, and lack of support (Chang,
Hancock, Johnson, Daly, & Jackson, 2005). Stress leads to job dissatisfaction, burnout,
and absenteeism; also, negatively impacts patients (Aiken et al., 2001; Lee & Henderson,
1996).8
7. Vicarious trauma and burnout are serious manifestations of workplace
stress. Both can have substantial consequences for health care professionals, health
services, and consumers. a study examining the prevalence, distribution, correlates, and
predictors of vicarious trauma and burnout among Registered Psychiatric Nurses (RPNs).
A survey was distributed to all practicing RPNs in Manitoba, Canada (N = 1,015). The
survey contained the Maslach Burnout Inventory, the Traumatic Stress Institute Belief
Scale The RPNs were found to be experiencing high levels of emotional. Stress
experienced by RPNs, as well as strengths on which to build, clearly are evident in the
study results. Strategies for reduction in workplace stress may benefit psychiatric nurses,
clients, and health services9
.
Nurses are responsible for creating the environment in which
nursing is practiced and patient care is given, it is important to explore interventions that
will reduce the stress and burnout experienced by nurses. By reducing the stressful nature
of the nurses’ work, nurse could be more satisfied in their positions. This role
satisfaction, in turn, could lead to improve the work environment for staff nurses.10
From the above reviews and investigators experience during
working in hospital investigator felt the need to assess and compare the level of stress
among nurses working in psychiatric and multi specialty hospitals for establishing the
existence and extent of work stress in nurses in a hospital setting, identifying the major
sources of stress, and finding the incidence of illness related to stress.
Stress is like an iceberg. We can see one-eighth of it above, but what about
what’s below?”
8. 6.2 REVIEW OF LITERATURE
INTRODUCTION
Review of literature is a key step in the research process. The typical
purpose of analyzing a review of existing literature is to generate questions and to
identify what is known and what is unknown about the topic. The major goals of review
of literature are to develop a strong knowledge base to carry out research and non
research scholarly activity.
In this present study to have in-depth information in the selected problem
the researcher has reviewed 8 literatures ranging from 2000 to 2010 studies and articles
which are chosen from books, journal article and internet publication.
In this study, the review of literature is presented under the following headings:
• Section –A: Studies related to stress among nurses working in psychiatric
hospital.
• Section –B: Studies related to stress among nurses working in multispecialty
hospitals.
• Section–C: Studies related to comparison between stress among nurses
working in psychiatric and multispeciality hospitals.
.
9. STUDIES RELATED TO STRESS AMONG NURSES WORKING IN
PSYCHIATRIC HOSPITAL.
A study was conducted by Bai JY and Suh MJ. In 1999 “to
measure the degree of work stress perceived by clinical nurses working in psychiatric
ward”. The survey method was used and the subjects of this study consisted of 135
psychiatric nurses from 7 university hospitals and 4 provincial general hospitals. The
results of study were summarized as follow. The degree of perceived stress among
psychiatric nurses was considerably high (4.32 out of 6.00). Among the stressors,
inadequate staffing (5.04), hospital administration problems (4.7) and the conflict of
nurse-patient relationship were identified as the stress factors with high rank of degree
of stress. The relationship between several stress factors and some of the demographic
and the job-related variables were significantly identified.11
A study was conducted by Sherring S and Knight D. in
2009 “to describe burnout among mental health nurses” the study involved a
questionnaire survey of all 475 mental health nurses working at a city NHS Trust. A
deeper understanding of burnout within the Trust was developed, with statistically
significant relationships showing that nurses experiencing burnout were more likely to
take sick leave and to be considering leaving their jobs or the NHS. Levels of burnout
experienced were significantly related to academic qualifications, the frequency and
adequacy of clinical supervision, feeling supported and valued at work and feeling
involved in decision making and changes. Nurses who have higher-level academic
qualifications and who feel supported and valued at work have lower levels of
burnout.12
A study was conducted by McLeod T. in 2007 to “examines the findings of
a research study on the levels and sources of stress among community psychiatric
nurses” CPNs working with the severely mentally ill reported higher caseloads, less
training, lack of respect and understanding of their role by others and the need for more
supervision and support. Forty per cent of CPNs were found to be stressed according to
the General Health Questionnaire (GHQ 28). While there is debate about where CPNs
should focus their interventions and which clients should be prioritized, it appears that
working with the severely mentally ill is less attractive and more stressful to CPNs.13
A study was conducted by Robinson JR, Clements K,
10. Land C. in 2003 “to assess workplace stress among psychiatric nurses”. A survey was
distributed to all practicing RPNs in Manitoba, Canada (N = 1,015). The survey
contained the Maslach Burnout Inventory, the Traumatic Stress Institute Belief Scale
The RPNs were found to be experiencing high levels of emotional exhaustion (i.e., high
burnout) and even higher levels of personal accomplishment (i.e., low burnout). Stress
experienced by RPNs, as well as strengths on which to build, clearly are evident in the
study results. Strategies for reduction in workplace stress may benefit psychiatric
nurses, clients, and health services. 14
A study was conducted by Richards DA, Bee P, Barkham
M, in 2006 “To review the prevalence of low staff morale, stress, burnout, job
satisfaction and psychological well-being amongst staff working in in-patient
psychiatric wards”. Systematic review. Of 34 mental health studies identified, 13 were
specific to acute in-patient settings, and 21 were specific to other non-specified ward-
based samples. Most studies did not find very high levels of staff burnout and poor
morale but were mostly small, of poor quality and provided incomplete or non-
standardised prevalence data. The prevalence of indicators of low morale on acute in-
patient mental health wards has been poorly researched and remains unclear. Multi-site,
prospective epidemiological studies using validated measures of stress together with
personal and organizational variables influencing staff stress in acute in-patient wards
are required. 15
A study was conducted by Nolan G, Ryan D. In 2008 “to
explore the experience of stress among psychiatric nursing students undertaking their
'internship' or final year”. A questionnaire was administered to all 28 students in the
intern year in conjunction with the 28-item version of the General Health
Questionnaire. Approximately 48% of respondents reported levels of stress above the
threshold score as described by Goldberg (1978), indicating levels of distress unlikely
to remit without intervention. Interview data suggested that the main sources of stress
during the intern year were associated with relationships in the clinical environment;
clinical workload; matching competence and responsibility; and simultaneous clinical
and academic demands. 16
STUDIES RELATED TO STRESS AMONG NURSES WORKING IN
11. MULTISPECIALTY HOSPITAL.
A study was conducted by DePew CL, Gordon M, Yoder
LH, Goodwin CW. In 1999The “to determine whether the personality trait of
hardiness is a predictor of burnout” Forty-nine registered nurses working in 7 special
care units completed the Tedium Burnout Scale, the Nursing Stress Scale, and the
Hardiness Test. Results indicate that burnout, stress, and hardiness had a significant
relationship (P < .001). Hierarchical multiple regression analysis indicated that
hardiness alone accounted for 35% of burnout variance (P < .05) and that the addition
of stress had no effect. However, in this study, nurses from the Burn Intensive Care
Unit had the highest burnout and stress scores and the lowest hardiness scores of nurses
from the 7 units. This study confirms findings by a previous study that hardiness is a
predictor of burnout but is not a buffer in the stress-burnout relationship. 17
A study was conducted by Watson P, Feld A. in 2006 to “Assess stress
and burnout among nurses in a multispecialty hospital”. High stress and staff turnover
in a multispecialty paediatric area. Fifty-four percent (n = 14) of the paediatric nurses
completed a questionnaire booklet that included demographic data, the Burnout
Inventory. Results indicated levels of burnout and distress comparable with larger
studies. Conflict with doctors was the major source of stress, followed by workload,
inadequate preparation in dealing with the emotional needs of patients and their
families and death and dying. Conflict with doctors has not previously been identified
as the major source of stress. However, workload and death and dying are commonly
identified as sources in the literature. Suggestions for further research and the low
response rate are discussed. 18
A study was conducted by Jaracz K, Górna K,
Konieczna J. in 2005 to “evaluate professional burnout among multispeciality hospital
nurses” A study sample consisted of 227 nurses from general medical, neurological and
psychiatric hospital wards. A set of 3 questionnaires was used, including Maslach
Burnout Inventory (MBI), Coping Inventory for Stressful Situations (CISS) and
Subjectively Perceived Stresss (SPS).Average and high level of burnout in the
emotional exhaustion (EE), depersonalisation (D) and personal accomplishment (PA)
was present at 71%, 39.8% and 77% of nurses respectively. A significantly higher level
of burnout was noted in the subgroup of general medical nurses. The level of stress
influences the professional burnout among nurses. There is a diversity in the level of
12. burnout depending on the specialization at work, which is not accompanied by a similar
diversity in the subjectively perceived stress. 19
A study was conducted by Adachi H, Inoue M, Inaba R,
Iwata H. in 1999 to assess “Mental health and stress coping among specialty hospital
nurses”. A self-administrated questionnaire including questions on nursing work, the
General Health Questionnaire (GHQ) as well as the Stress and Stress Coping
questionnaire (SSCQ) was used. The subjects of this study were 225 female nurses. The
results obtained were as follows, either of the following determinants was related to
negative mental health: experience of 1-2 years; working in the operating room or in-
patient department. 2) The subjects whose working experience was < 5 years or > or =
10 years had higher scores in the SSCQ. These findings suggest that because working
conditions have a negative influence on mental health, educational system for both
inexperienced and experienced nurses is needed to develop an effective stress-coping
style in medical institutions. 20
A study was conducted by Han K, Kim NS, Kim JH, Lee
KM. in 2004 to “identify the factors influencing Symptoms of Stress among hospital
staff nurses”. Data was collected by questionnaires from 249 hospital staff nurses in
three multi specialty Hospital. The score of the symptoms of stress showed a
significantly positive correlation with the score of work stress (r=.22, p=.00). The most
powerful predictor of symptoms of stress was social support and the variance explained
was 16%. A combination of social support, ways of coping, and work stress account for
32% of the variance in symptoms of stress among hospital staff nurses. This study
suggests that social support, ways of coping, self efficacy, hardiness, and work stress
are significantly influencing factors on symptoms of stress among hospital staff nurses.
21
STUDIES RELATED TO COMPARISON BETWEEN STRES AMONG
NURSES WORKING IN PSYCHIATRIC AND MULTISPECIALTY
13. HOSPITAL.
A study was conducted by Hughes H, Umeh K. in 2005 to
“assess stress differentials between psychiatric nurses (PNs) and general nurses” It was
expected that PNs would report different (higher) stress levels than GNs given PNs'
lower levels of social support. A questionnaire was completed and returned by 73
nurses at several public hospitals in England. Multivariate analysis of variance showed
that social support moderated stress differentials between PNs and GNs, albeit not as
anticipated; the latter group reported significantly higher and lower stress levels when
social support was low and high, respectively. This interaction was applicable to both
the quality and quantity of social support. Overall, the benefits of social support seemed
to accrue primarily to GNs. Implications of these findings for the developments of
stress-reduction interventions are considered.22
A study was conducted by Yada H, Abe H, Omori H, Ishida Y,
Katoh T. to 2009 to “identify stressors (causes of stress) for psychiatric department
nurses, and to compare the differing stress variables and levels of stress encountered in
the acute ward and the recuperation ward”. The study uses a brief work stress
questionnaire and then asks 24 questions relating to the particular stresses that nurses in
a psychiatric department may encounter and the length of time they are exposed to
them. Answers were obtained from 36 nurses and associate nurses in two psychiatric
departments. The results of this analysis show that the factor scores for recuperation
ward nurses were significantly higher than those for nurses from acute ward, and in all
factors in the subscale "Stressors among Nurses in Psychiatric Department", indicating
that nurses in recuperation ward had high levels of stress. 23
A study was conducted by Pryjmachuk S, Richards DA. in
2007 to describe “Mental health nursing students differ from other nursing students” A
cross-sectional survey of all nursing students on the department's roll (n = 1362), using
a range of self-report measures bound together in a 'questionnaire pack', was
undertaken. The findings revealed that mental health nurses were notably different from
the other three branches in terms of the quantity and characteristics of the sources of
stress they faced, the levels of stress they experienced, and the ways in which they
coped. These differences were largely advantageous to the students' well-being and
speculations are made as to whether the concept of 'hardiness'- especially its focus on a
sense of being in control - plays a role in explaining the findings.24
14. 6.3
A study was conducted by Snelgrove SR. in 1999 to
“Assess occupational stress and job satisfaction: a comparative study”. This study
examines self-reported stress and job satisfaction of health visitors (n = 68), district
nurses (n = 56) and community psychiatric nurses (n = 19) in one health authority in the
UK. The levels and sources of stress and satisfaction were examined in relation to
speciality. Stress levels were assessed using The General Health Questionnaire-12. The
results showed that levels of stress were a function of occupation with significant
variation between groups. Health visitors yielded the highest stress scores and lowest
job satisfaction scores. indications were that all three groups were dissatisfied with
supervisory relationships. Recommendations include more creative and supportive
supervisory relationships, such as clinical supervision. 25
A study was conducted by Lyons JS, Hammer JS,
Johnson N, Silberman M. in 2001 to “compare of levels of occupational stress across
multiple units of a multi specialty hospital”. Using a scale designed to measure a four-
component model of occupational stress in medical environments, the results indicated
that a significant amount of the variation in this measure was accounted for by the unit
on which the respondent worked. There were no significant differences across levels of
employment (e.g., house staff, nurse clinician, registered nurse, licensed practical nurse,
clerk). 2
STATEMENT OF PROBLEM:
“A COMPARATIVE STUDY TO ASSESS THE LEVEL
OF STRESS AMONG STAFF NURSES WORKING IN
PSYCHIATRIC AND MULTISPECIALITY HOSPITALS AT
BANGALORE ”
OBJECTIVES OF THE STUDY
1. To assess the level of stress among the nurses working in psychiatric hospital.
15. 6.4
6.5
2. To assess the level of stress among nurses working in multispecialty hospital.
3. To compare the level of stress among nurses working in psychiatric and
multispecialty hospital.
4. To associate the level of stress among nurses working in psychiatric and
multispecialty hospital with their selected demographic variables (sex, age.
qualification,working area,working hours)
HYPOTHESIS
1. H1: There will be a significant difference in level of stress between the nurses
working in psychiatric and multispeciality hospitals
2. H2- There will be a significant association between the level of stress of study
subjects with their selected demographic variables (sex,
age.qualification,working area,working hours)
OPERATIONAL DEFINITIONS:
ASSESS
In present study word Assess refers to Measure the level stress among nurses
working in psychiatric and multispecialty hospital by using rating scale.
16. 6.6
STRESS:
In present study word Stress refers to an emotional disturbance experience by the
nurses working in psychiatric and multispecialty hospital. It can be categorized into
three.
o Mild Stress : score on rating scale less than 50 %
o Moderate Stress: score on rating scale less than 50-75 %
o Severe Stress: score on rating scale more than 75 %
NURSES:
In present study word nurse refers to a qualified nurse having certification of state
nursing council completed a minimum of Diploma certificate that are eligible to impart
care to clients either in hospitals or community
• MULTISPECIALTY HOSPITAL
In present study word Multispecialty hospital refers to an institution that provides
medical, surgical, psychiatric and all other specialty care and treatment for the sick or
the injured.
• PSYCHIATRIC HOSPITAL:
In present study word psychiatric hospital refers to an institution that provides
psychiatric care and treatment for the mentally disabled patient.
17. 6.7
6.8
6.9
7.0
ASSUMPTIONS
There will be increased level of stress among nurses working in
psychiatric and multispecialty hospital.
DELIMITATIONS:
Study is limited to 60 samples.
The study is limited only to assess the level of stress.
PROJECTED OUTCOME
The present study will help the staff nurses to gain an awareness regarding
their level of stress and there by necessitates research regarding the reduction of
stress level among staff nurses in future.
MATERIALS AND METHODS
7.1 SOURCE OF DATA
Nurses working in psychiatric and multispecialty hospitals in selected Hospital
at Bangalore.
7.1.1 RESEARCH DESIGN
The research design adopted for this study is pre-experimental design.
RESEARCH APPROACH
The research approach is descriptive.
7.1.2 SETTING:.
The study will be conducted in selected psychiatric and multispecialty hospitals at
Bangalore
7.1.3 POPULATION
18. 7.2
7.3
The population selected are staff nurses.
METHOD OF DATA COLLECTION
7.2.1 SAMPLING PROCEDURE
The Sampling Technique adopted for this study is Non Probability –
convenient sampling technique
.
7.2.2 SAMPLE SIZE
The sample size is 60.
7.2.3 INCLUSION CRITERIA
1. All age groups of nurses working in psychiatric and multispecialty hospital.
2 Nurses who can able understand and read either Kannada or English
7.2.4 EXCLUSION CRITERIA:
1. Nurses who are not willing to participate in study.
2. Nurses who are not present at the time of study.
7.2.5 INSTRUMENT INTENDED TO BE USED
SELECTION OF TOOL
This consist of two parts :
PART 1 :consist of demographic variables such as sex,education age,religion, area of
working.
PART 2: Rating scale will be used to assess the level of stress.
SCORING PROCEDURE
SCORING INTERPRETATION:
Level of knowledge Range
19. 7.4
7.5
7.6
7.7
Mild Stress : score on rating scale less than 50 %
Moderate Stress: score on rating scale less than 50-75%
Severe Stress: score on rating scale more than 75 %
DATA COLLECTION METHOD
Prior permission will be obtained from the Nursing
Superintendent and Ward In- charge before conducting the study.Consent will be
taken from the staff nurses . Data will be collected within 4 weeks.
PILOT STUDY
6 samples will be selected and study will be conducted to find out the feasibility.
DATA ANALYSIS PLAN
The data obtained will be analyzed in view of the objectives of the
study using descriptive and inferential statistics.
The plan for data analysis is as follows: -
• Frequencies and percentage of distribution will be used to
analyze the demographic data.
• Mean, Median and Mode, Standard deviation is used for
assessing the stress scores.
• Chi-square test to find out the association between the level of
stress with selected demographic variables. The significant
findings will be experienced in tables, figures and graph.
20. DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTION TO BE CONDUCTED ON PATIENTS OR
OTHER HUMANS OR ANIMALS?
- No-
HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM
YOUR INSTITUTION?
YES, Ethical clearance will be been obtained from the research
committee of Nightingale college of nursing.
Consent will be taken from the hospital and permission will be taken
from the study subjects before the collection of data.
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25. 9. SIGNATURE OF THE CANDIDATE
10. REMARKS OF THE GUIDE
11. NAME AND DESIGNATION OF
11.1 GUIDE
11.2 SIGNATURE
11.3CO-GUIDE
11.4SIGNATURE
11.5 HEAD OF DEPARTMENT
11.6 SIGNATURE
12 12.1 REMARKSOF THE PRINCIPAL
12.2 SIGNATURE