Stress,coping and mental well-being in hospital nurses

Previous studies on stress in nurses have demonstrated positive but low correlations between stress measures and indicators of mental distress. The present study was designed to investigate further this relationship and the extent to which it is attenuated by coping strategies. Questionnaires on sources of stress, coping strategies and health outcomes were administered to 72 nurses in one large general hospital. The results indicated that staff conflicts and workload stress increased with grade of nurse and that workload stress and organizational support and involvement differed between wards, whereas there were no differences between groups in coping strategies or mental health outcomes. Negative mental health outcomes were mainly predicted by nurses' perceptions of excessive workload and their adoption of avoidance coping strategies. The main recommendations arising from the study, therefore, were that stress-related disorders in nurses could be alleviated if sufficient resources were allocated so that excessive workloads were reduced, and if stress management programmes could be initiated so that appropriate coping strategies would be adopted.     

Stress,coping, burnout and job satisfaction in British nurses: findings from the Clinical Supervision Evaluation Project

The Clinical Supervision Evaluation Project is a study of the effectiveness of clinical supervision in nurses. As part of this evaluation, we administered the General Health Questionnaire (GHQ‐28), Maslach Burnout Inventory, Cooper's Coping Skills Scale, Minnesota Job Satisfaction Scale and a demographic checklist to 586 nurses in 23 centres. Some 18 centres were chosen from England and five from Scotland. Results show that occupational stress levels are rising in nursing. While there is now a greater focus on community nursing, this would appear to be more stressful, though also more satisfying than working in hospital settings. Nurses appear to perceive stressors differently according to their grade. Copyright © 1999 John Wiley & Sons, Ltd.     

Stress and burnout in forensic psychiatric nursing

The relevant literature suggests that all branches of the nursing profession are subject to high levels of stress and burnout. Forensic psychiatric nursing has been considered as an area of high risk, despite a paucity of literature in this area, particularly in Australia. This paper presents the findings of a research study undertaken with forensic nurses (n = 51) and designed to measure their level of stress and burnout. The Maslach Burnout Inventory (MBI) and the Nursing Stress Scale (NSS) were the instruments used. The findings indicated that relatively few forensic nurses suffered from ‘high’ levels of burnout with considerably more forensic nurses recording ‘low’ levels of burnout. On the personal accomplishment subscale, only 17 per cent recorded a ‘high’ score. Interestingly the least reported stressor was lack of staff support for nursing activities which suggests that the amount of support received may account for lower than expected levels of stress. Copyright © 2003 John Wiley & Sons, Ltd.     

Fourteen years of litigation claims in cardiothoracic surgery in the United Kingdom National Health Service

Approximately 36 400 cardiac and 23 100 thoracic operations are carried out in the United Kingdom between 2006 and 2015. National Health Service (NHS) resolution, as known as the NHS litigation authority, is one of the essential bodies of the Department of Health. Its purpose is to provide NHS expertise to resolve concerns fair and square share learning for improvement. We aim to evaluate and increase awareness of medicolegal cases in cardiothoracic surgery. Total numbers and details of claims coded by NHS resolution in cardiothoracic surgery from 2004 to 2017 were requested under the Freedom of Information Act 2000. The data provided in successful claims is further breakdown into damages paid to the claimant, defence cost, claimant cost paid and the sum of the three. In contrast, unsuccessful claims only include the defence cost. Moreover, data provided also includes further analysis of primary causes and primary injuries for Claims Closed/Settled with damages paid. There were 753 claims recorded from 2004 to 2017, of which 415 (55.11%) were successful. The number of claims has been steadily increasing since 2004, with two significant raises from 2009/10 to 2010/11 (37‐55, 48.64% raise) and 2012/13 to 2013/14 (49‐69, 40.82% raise). The mean successful claim ratio was 69.58% (range, 47.56%‐ 83.33%) There is also a steady increase in the successful ratio from 2004 to 2017. In summary, this is the first study published in relation to litigation claims on cardiothoracic surgery in the United Kingdom. The results have provided insight on claims made against cardiothoracic surgery.     

Stress and coping in clinical psychologists

Levels and sources of stress, as well as coping strategies, were assessed in 101 West Midlands clinical psychologists by means of a postal survey. As expected, GHQ caseness levels for qualified psychologists were lower than for those in training, although qualified psychologists reported that they felt as stressed as trainees. As hypothesized, women and those with less experience reported higher stress levels. Junior men reported higher stress levels than more senior men; however, no such differences were found for women. Those psychologists who were ‘cases’ were also less likely to live with a partner. As expected, the most frequently reported coping strategies were behavioural, which mostly involved talking to others, and avoidance coping was associated with a poorer mental health outcome. Factor analysis of a self-report stress survey identified seven factors; being responsible for supervising trainees accounted for the greatest variance in stress ratings. Psychologists indicated that better support from colleagues and better NHS management were the factors most likely to alleviate stress.     

Survey on the working hours and workload of public sector surgeons in Hong Kong

Introduction: The College of Surgeons of Hong Kong commissioned the Public Opinion Programme (POP) of the University of Hong Kong in April 2002 to conduct a survey on the working hours and workloads of all in‐service public sector surgeons in Hong Kong. The research instrument used, as well as the fieldwork operation and data analysis, were all conducted independently by the POP team. Methods: All in‐service public sector surgeons in Hong Kong were invited to participate in the survey from 23 to 29 September 2002, which consisted of a daily work diary and seven opinion questions on workload, work morale and quality of life. Results and Conclusions: A total of 264 of the 486 eligible surgeons participated in the survey. The average daily work hour was 10.3 h and the average weekly work hour was 72 h. A total of 45% of the respondents worked for more than 10 h everyday. In the respondents’ opinion, 60.9% claimed they were overworked, 31% were satisfied with their own morale and 51% evaluated their own quality of life as unsatisfactory.      

Work-family stress,conflict, coping,and burnout in police officers

This study examined a research model developed to understand work satisfactions and emotional and physical well-being among police officers. Data were collected from 828 men and women in police work using questionnaires completed anonymously. Although considerable diversity was present in the sample, a majority were male constables in their early careers. Five groups of predictor variables identified in previous research were considered: individual demographic and situational variables, work stressors, work-family conflict, coping responses, and psychological burnout components. Work stressors and psychological burnout were fairly consistently and significantly related to levels of self-reported work attitudes and emotional and physical well-being. Somewhat surprisingly, work-family conflict and individual coping responses were generally unrelated to measures of work attitudes and self-reported emotional and physical well-being.     

Stress in teaching: a study of occupational stress and its determinants among Italian schoolteachers

This paper presents the findings of an investigation into stress among Italian teachers conducted by means of the Teacher Stress Questionnaire elaborated by Travers and Cooper. The questionnaire was submitted to 320 southern Italy teachers drawn from a cross‐section of school types. Data were discussed in order to highlight some features of teacher stress peculiar to the Italian sample with respect to those that emerged in the British validation of the questionnaire. In this perspective a comparison was drawn between the intensity and quality of mental ill‐health, the sources of job pressure, the intensity and quality of job satisfaction and the coping strategies adopted by teachers as emerged in this study and in the British study; and between the most predictive dimensions of mental ill‐health highlighted from the present study with respect to the British study. Copyright © 2007 John Wiley & Sons, Ltd.     

Urological litigation in the UK National Health Service (NHS): an analysis of 14 years of successful claims

What’s known on the subject? and What does the study add? There are no previous studies for urology in the UK but several studies from physician insurance groups in North America. There is anecdotal evidence of common reasons for litigation, e.g. missed testicular torsion. This is the first analysis of the claims data compiled by the NHS litigation authority for the speciality of urology; it provides realistic insight into the areas and procedures of the speciality most commonly affected by litigation. The article identifies areas of high risk, both clinical and medico‐legal.

OBJECTIVES

? To present a summary of the collected data on urological litigation within the UK National Health Service (NHS). ? Knowledge of the main areas of litigation is essential for maintaining good clinical practice as well as risk management procedures in any specialty.

MATERIALS AND METHODS

? Details of all claims closed with indemnity payment pertaining to the specialty of urology as practiced by urologists, general surgeons and paediatric surgeons was obtained from the NHS Litigation Authority (NHSLA) for the years since its creation in 1995 to 2009. ? The data was then classified and analysed.

RESULTS

? In all, 493 cases were closed with indemnity payment with a total of £20 508 686.18 paid. The average payment per claim was £41 599.77. ? Most of the claims were related to non‐operative events (232), followed by postoperative events (168) and intraoperative events (92). ? The most common reason for non‐operative‐related claims was failure to diagnose/treat cancer (69), perforation/organ injury (38) was the highest intraoperative‐related claim and a forgotten ureteric stent (23) was the most frequent postoperative‐related claim. ? The five most commonly implicated procedures were ureteroscopy/ureteric stenting (45), transurethral resection of the prostate (30), nephrectomy (26), vasectomy (19) and urethral catheterisation (15).

CONCLUSIONS

? The present study once again emphasizes the importance of thorough clinical assessment, record keeping and follow‐up as well as informed consent and good communication with patients. ? Recognising the areas of highest risk and improving practice should limit future claims.     

Stress,burnout, depression and work satisfaction among UK anaesthetic trainees; a quantitative analysis of the Satisfaction and Wellbeing in Anaesthetic Training study

There is growing evidence that anaesthetic trainees experience, and may be particularly susceptible to, high levels of work stress, burnout and depression. This is concern for the safety and wellbeing of these doctors and for the patients they treat. To date, there has been no in-depth evaluation of these issues among UK anaesthetic trainees to examine which groups may be most affected, and to identify the professional and personal factors with which they are associated. We conducted an anonymous electronic survey to determine the prevalence of perceived stress, risk of burnout/depression and work satisfaction among anaesthetic trainees within South-West England and Wales, and explored in detail the influence of key baseline characteristics, lifestyle and anaesthetic training variables. We identified a denominator of 619 eligible participants and received 397 responses, a response rate of 64%. We observed a high prevalence of perceived stress; 37% (95%CI 32–42%), burnout risk 25% (21–29%) and depression risk 18% (15–23%), and found that these issues frequently co-exist. Having no children, > 3 days sickness absence in the previous year, ≤ 1 h.week⁻¹ of exercise and > 7.5 h.week⁻¹ of additional non-clinical work were independant predictors of negative psychological outcomes. Although female respondents reported higher stress, burnout risk was more likely in male respondents. This information could help in the identification of at-risk groups as well as informing ways to support these groups and to influence resource and intervention design. Targeted interventions, such as modification of exercise behaviour and methods of reducing stressors relating to non-clinical workloads, warrant further research.     

Payment by results and coding practice in the National Health Service. The importance for orthopaedic surgeons

This paper considers the new financial infrastructure of the National Health Service and provides a resource for orthopaedic surgeons. We describe the importance of accurate documentation and data collection for National Health Service hospital Trust finances and league tables, and support our discussion with examples drawn from our local audit work.     

Relationship between job burnout and occupational stress among doctors in China

The purpose of this study was to explore the status of the job burnout of doctors and the variables associated with this in China. The sample consisted of 543 doctors from three provincial hospitals in China. The Maslach Burnout Inventory‐General Survey (MBI‐GS) was used to measure burnout, and the occupational stress inventory revised edition was used to measure the two dimensions of occupational adjustment (including occupational stress and coping resources). After the statistical testing for validity and reliability of MBI‐GS with nurses in China, the participants' scores were evaluated and analysed. The main results were as follows. The scores of job burnout of the surgeon and physician were significantly higher than the others (p < 0.05). The score of exhaustion (EX) was significantly higher in the 30‐ to 40‐year age group than that in any other groups. The score of professional efficacy (PE) decreased with age, while this increased with educational status. Occupational stress was significantly positively related to all burnout dimensions (p < 0.05), while coping resources correlated negatively to all burnout dimensions. Under multilevel regression, the main significant predictors of EX were role overload, responsibility, physical environment and self‐care. The main significant predictors of cynicism were role insufficiency, role overload and responsibility, and of PE were role insufficiency, social support and rational/cognitive coping (p < 0.05). Organizational efforts aimed at reducing occupational stress and strengthening their coping resources among doctors could help prevent job burnout. Copyright © 2007 John Wiley & Sons, Ltd.     

Stress,burnout, depression and work satisfaction among UK anaesthetic trainees: a qualitative analysis of in-depth participant interviews in the Satisfaction and Wellbeing in Anaesthetic Training study

Anaesthetists experience unique stressors, and recent evidence suggests a high prevalence of stress and burnout in trainee anaesthetists. There has been no in-depth qualitative analysis to explore this further. We conducted semi-structured interviews to explore contributory and potentially protective factors in the development of perceived stress, burnout, depression and low work satisfaction. We sampled purposively among participants in the Satisfaction and Wellbeing in Anaesthetic Training study, reaching data saturation at 12 interviews. Thematic analysis identified three overarching themes: factors enabling work satisfaction; stressors of being an anaesthetic trainee; and suggestions for improving working conditions. Factors enabling work satisfaction were patient contact; the privilege of enabling good patient outcomes; and strong support at home and work. Stressors were demanding non-clinical work-loads; exhaustion from multiple commitments; a ‘love/hate’ relationship, as trainees value clinical work but find the training burden immense; feeling ‘on edge’, even unsafe at work; and the changing way society sees doctors. Nearly all trainees discussed feeling some levels of burnout (which were high and distressing for some) and also high levels of perceived stress. However, trainees also experienced distinct elements of work satisfaction and support. Suggested recommendations for improvement included: allowing contracted hours for non-clinical work; individuals taking responsibility for self-care in and out of work; cultural acceptance that doctors can struggle; and embedding wellbeing support more deeply in organisations and the specialty. Our study provides a foundation for further work to inform organisational and cultural changes, to help translate anaesthetic trainees’ passion for their work into a manageable and satisfactory career.     

护理SARS病人的护士心理健康状况与应付方式研究

目的了解参与SARS护理工作人员在高危险、高传染性、高强度工作压力下的心理健康状况及应付方式 ,为管理者制定护士心理卫生保健措施提供依据。方法采用症状自评量表 (SCL 90 )、应付方式问卷 (CSQ) ,对参与SARS工作的 96名护士 (SARS护士 )及 6 4名从事急救工作的护士和 73名普通内、外科护士进行心理健康状况及应付方式的调查。结果SARS护士心理健康状况与急救、普通护士比较 ,差异无显著性意义 ;但在应付方式上SARS护士相对优于其他护士 (除幻想因子外 ,均P <0 .0 5 ) ;6 1.4 5 %SARS护士应用成熟型应付方式 ,且心理健康状况相对优于不成熟型和混合型的SARS护士。结论SARS护士心理健康状况良好 ,大部分SARS护士采用最优应付方式。护理管理者应加强整体护理队伍心理素质训练和建立健全护士支持系统 ,提高群体应付水平。     

江苏省专科护士工作投入现状及影响因素调查分析

目的 了解江苏省省级专科护士工作投入现状及影响因素,为针对性管理提供参考。方法 采用一般资料调查问卷与专科护士工作投入量表对2 472名省级专科护士进行调查分析。结果 专科护士工作投入总均分为4.06±0.46;多元线性回归分析显示,性别、聘任方式、专科类别、工作类型、出任专科护理门诊、论文发表是专科护士工作投入的影响因素(P<0.05,P<0.01)。结论 专科护士工作投入水平较高,其影响因素较多,护理管理者应关注专科护士专业开展现况,采取针对性措施支持专科护理的有效开展,从而进一步提高专科护士的工作投入水平。     

急诊科护士职业创伤后应激障碍与应对方式的研究

目的了解急诊科护士职业创伤后应激障碍（PTSD）和应对方式水平并分析二者的相关性。方法以整群抽样法抽取长沙市7所三级综合性医院的急诊科护士193名,对其采用基本情况调查表、创伤后应激障碍自评量表（PTSD-SS）和特质应对方式问卷进行调查。结果急诊科护士PTSD-SS评分为43．40土10．87,38名（19．69％）护士PTSD-SS为阳性水平;其积极应对水平低于一般健康人群,消极应对水平高于一般健康人群（P〈0．05,P〈0．01）;PTSD与消极应对呈正相关,与积极应对呈负相关（均P〈0．01）。结论急诊科护士职业PTSD水平较高,且缺乏良好的应对机制。护理管理者应关心和爱护护士,改善急诊工作环境;急诊科护士应不断提高心理承受能力,有意识地调整自己的身心状态,以雏护和促进自身健康。     

Stress in nurses: The effects of coping and social support

Sources of stress, job satisfaction and coping were investigated in 245 general hospital nurses using standardized questionnaires. It was hypothesized that coping strategies, social support and job satisfaction would moderate or buffer the effects of the stressor on psychological distress, such that those who were lower in coping skills, social support and job satisfaction would be more reactive to stress effects. Negative main effects on mental well-being, as measured by the General Health Questionnaire, were found for workload, lack of social support, inadequate preparation, conflict with other nurses, conflict with doctors and use of avoidance coping strategies. Proposed buffering effects were investigated using multiple regression analysis to control for the main effects. Although consistently in the predicted direction, the buffering effects were found to be very small and non-significant. It was concluded that for stress in nurses the results supported a transactional model rather than an interactive model for social support and coping.     

护士长工作压力与应对方式及心理健康状况的调查分析

目的了解并分析护士长的工作压力源、应对方式与心理健康状态,为合理选拔考核护士长,有效减轻护士长工作压力并提高其心理健康水平提供依据.方法采用问卷调查法对2所大型综合性教学医院的92名护士长的工作压力源、压力应对方式和心理健康状态进行调查分析.结果低学历及任职时间10年以上的护士长有较少的工作压力源;学历层次较高的护士长多采用有计划地解决问题的应对方式,而任职时间6～10年的护士长较少采用自我控制的应对方式,护龄6～10年的护士长较多采用疏远等消极的应对方式;学历层次高、护龄在10年以上的护士长具有较好的心理健康状态.结论在选拔考核护士长时,应充分考虑其个人特点、学历背景与工作经历,并针对不同层次的护士长,采取相应的措施缓解其工作压力,提高心理健康水平,增强管理能力.     

急诊科护士职业创伤后应激障碍与应对方式的研究

目的 了解急诊科护士职业创伤后应激障碍(PTSD)和应对方式水平并分析二者的相关性.方法 以整群抽样法抽取长沙市7所三级综合性医院的急诊科护士193名,对其采用基本情况调查表、创伤后应激障碍自评重表(PTSD-SS)和特质应对方式同卷进行调查.结果 急诊科护士PTSD-SS评分为43.40±10.87,38名(19.69%)护士PTSD-SS为阳性水平;其积极应对水平低于一般健康人群,消极应对水平高于一般健康人群(P<0.05.P<0.01); PTSD与消极应对呈正相关,与积极应对呈负相关(均P<0.01).结论 急诊科护士职业PTSD水平较高.且缺乏良好的应对机制.护理管理者应关心和爱护护士,改善急诊工作环境;急诊科护士应不断提高心理承受能力,有意识地调整自己的身心状态,以雏护和促进自身健康.