Stress of Nurses working in General Wards at Teaching Hospitals in Baghdad City

Iman .A. Isaa[1]                                   Qahtan. Q. Mohammed[2]

Abstract:

Background : stress is one of the chief psychological and social difficulties that individuals and organizations suffer from both, negatively disturbing the health of the individual and his professional achievement, as well as the good running of the institution.

Objectives : a descriptive design was used to examine the levels of stress of nurses working in general wards at teaching hospitals in Baghdad City.

 Methods : correlational study; the study took place between November 16, 2020 and April 19, 2021. Using a non-random convenience sample 70 nurses from Baghdad Teaching Hospitals' general wards. The data was collected using sociodemographic,) Gender, age, marital status, number of children, nursing qualification, years of service at work, and years of experience are among the seven variables).and Work-related psychological stress scale.

Finding: No association was found between the Work-related psychological stress and gender, age, marital status, do you have children, Nursing qualification and Years of servicing nursing of staff nurses working in general wards.

Conclusion : Implementation of programs aimed at education nurses how to deal with work stress and its effects as well as enhancing the capabilities of nurses regarding Coping and problem solving strategies. The need for future research that should be directed at the effects of stress management.

Keyword: Workplace stress, general wards

 Introduction

       Workplace stress is a well-known issue that affects health-care workers (Khamisa et al., 2015). Nursing has long been known as a high-stress job (Burbeck, 2002; Greenglass, 2002). Nayomi (2016) according to their article, stress is defined as an individual's perception of expectations and the ability to cope with those demands.

       The physical and emotional effects a nurse has when her talents and resources are inadequate to cope with the demands and expectations of her profession are referred to as nursing work stress (Nakasis & Ouzouni, 2008; Brunero et al, 2006).

       Nurses, by their very nature, are exposed to a variety of stressors while completing a nursing care plan, maintaining a personal relationship, and other activities connected to their job. Nurses who endure stress in the workplace on a regular basis and do not use active coping mechanisms have a negative impact on nursing abilities as well as negative implications in their work lives (Lee et al., 2005).

       Nursing employment in a hospital setting is widely acknowledged to be extremely demanding. Many stressful situations are linked to the nursing obligations (Kirchhoff et al, 2009).

       Occupational stress in nursing is connected to increased workload, decreased levels of support, and workplace conditions, particularly psychosocial concerns. High levels of job-related stress in nurses can lead to substance misuse, depression, anxiety, decreased job satisfaction and disengagement, lower organizational loyalty, and higher desire to leave the profession, all of which can negatively affect patient care and outcomes. in management costs that are both substantial and disruptive from the organization's smooth operation (Yang, 2017; Lamont et al, 2017; Rushton et al, 2015).

Nurses face a number of physical, psychological, and social demands in the workplace. Because work stress has a negative impact on this group of employees' health and, as a result, on the quality of care provided by nurses, examining and identifying how to deal with job stress in staff nurses is critical and can help avoid unfavorable consequences (Elahi, et al., 2016).

Objectives of the Study

1.5.1.      To assess the level of Job stress in nurses working in general wards at teaching hospitals in Baghdad city.           

1.5.2.      To find out the relationship between level of Job stress among nurses with their sociodemographic characteristics.

Methodology:

To achieves stated objectives, a descriptive design was used to examine the levels of stress of nurses working in general wards at teaching hospitals in Baghdad City: correlational study; the study took place between November 16, 2020 and April 19, 2021. Consent has been granted for the questionnaire constructed from official permission granted from Baghdad Medical City Administration to ensure their agreement and to facilitate the researcher's task of entering these hospitals and meeting the nurses after explaining the purpose of the study to them and obtaining their consent. The research was carried out in Baghdad City Teaching Hospital, Using a non-random convenience sample 70 nurses from Baghdad Teaching Hospitals' general wards. The data was collected using sociodemographic,) Gender, age, marital status, number of children, nursing qualification, years of service at work, and years of experience are among the seven variables).and Work-related psychological stress scale,  This section introduces the items on the job-related stress scale; this scale has 26 items that can be used to measure job-related stress in nurses.The scale is divided into sub-domains that deal with work-related stress: 1. Workload: Items are used to represent the workload (1, 2, 3, 4, 5).2. Conflict is symbolized by the clauses (6, 7, 8, 9).3. A lack of support is exemplified by things (10, 11 and 12).4.  Uncertainty over the patient's care, as depicted by the items (13, 14, 15, 16).5.  Death and death clauses: These are the clauses that deal with death and death (17, 18, 19).6.  Clauses are used to represent organizational choices (20, 21, 22).7. Inadequate planning: indicated by clauses (23, 24, 25).8.  Section 26 represents sexual harassment. These were assessed as never stressful = 1, sometimes stressful = 2, and very stressful = 3 on a three-level Likert scale. The amount of job-related stress was calculated by splitting the overall scale score into three categories: mild, moderate, and severe. Mild = 25-37, moderate = 38-43, severe = 44-52, and very severe = 53-69 are the severity levels: severe, severe, and very severe. Face validity has determined throughout the use of panel of experts (7) Their responses revealed that they all agreed on the questionnaire's content, clarity, relevancy, and adequacy, therefore it is deemed valid after considering their suggestions and recommendations for improvement. The pilot study took place from March 14th to March 22nd, and this ten-person sample was omitted from the study's initial sample. The participants comprehended the questionnaire, and the average time needed to collect data was between (15) minutes, according to the findings of the pilot study. Cronbach's Alpha was used to measure the questionnaire's reliability, and it revealed that the questionnaire had 26 items. Cronbach's alpha was 0.84 for the Work-related psychological stress scale after excluding Sexual harassment (item 26) The Statistical Package for Social Sciences was used to examine the data (SPSS, version 26). Data was evaluated using both descriptive and inferential statistical approaches, such as the Chi-square test. The reliability of the questionnaire was determined using the correlational coefficient, and the level of statistical significance was set at 0.05. A significant relationship between job stress among nurses and their sociodemographic characteristics was discovered using the Chi-square test (X2).

Results: Table 1:Distribution Nurses according to Demographic Data

Table (1) demonstrates that female nurses worked in general (68.6 percent ) Almost all of them were female. Table (1)reveals that nurses working nurses working in general (55.7 percent) were between the ages of 40 and 49. (20- 29).. The marital status of nurses working nurses working in general (62.9 percent) was shown in Table(1). 27.1 percent of 47.1 percent of Nurses in general have no children. Table (1)reveals that the majority of Nurses in general (42.9%) reported having a diploma's degree. Table reveals that percent of Nurses working  in general 35.7 percent reported having (2-9) years of nursing experience.

Table2:Distribution of Nurses according to their Work-related Psychological Stress Scale.

Table (2): Nurses working in general wards: 24.3 percent with Mild level; 32.9 percent with Moderate level; and 21.4 percent with Sever level; and: 21.4. with very sever.

Table3:Association of Work-related psychological stress scale with selected socio-demographic variables of staff nurses working in general wards.

Work-related psychological stress scale and selected socio-demographic factors of staff nurses working in general wards were found to be associated. Table 3 shows that there is no correlation between work-related psychological stress and gender, age, marital status, whether or not you have children, nursing qualification, or years of nursing service.

Discussion of Results:

Table (1) demonstrates that female nurses worked in general (68.6 percent ) Almost all of them were female. Table (1)reveals that nurses working in general (55.7 percent) were between the ages of (20- 29).The marital status of nurses working in general (62.9 percent) was shown in Table(1). 47.1 percent of Nurses in general have no children. Table (1)reveals that the Nurses in general (42.9%) reported having a diploma's degree. Table reveals that 35.7 percent of Nurses working in general reported having (2-9) years of nursing experience. nurses in general (68.6%) were almost entirely female. This finding demonstrated that despite the fact that nurses in general were almost all female. this is considered natural. Kourakos (2017) found additional support in their findings, reporting that (75.8%) were female and (24.2%) were male. according to Abdullah, Mirza, and Othman (2018). Faremi and colleagues (2019) This descriptive design study was conducted among nurses in two hospitals, and the results revealed that 86.9% of the nurses were female. Table (1) shows General nurses have been discovered to have a higher age group) 55.7 percent of general nurses were between the ages of 20 and 29 ; This may be attributable to the Ministry of Health's plan to hire graduate nurses in general hospitals. The nurses' ages ranged from 22 to 44, which is in line with Deh et al (2017). This findings contradicted Alharbi & Hasan's (2019) finding that general nurses were slightly older than mental nurses. For example, around 45 percent of general nurses were between the ages of 30 and 39, The marital status of nurses working in general (62.9 percent) was shown in Table(1). Alharbi & Hasan (2019) discovered that the majority of the study sample in both groups was married, which supported their findings. the majority of the study sample in both groups was married, which supported their findings. 47.1 percent of Nurses in general. This result was consistent with Deh et al. (2017), who found that nearly 79.1% of the participating nurses had between one and three children, while only 20.9 percent had no children. Nurses working in general (42.9 percent) reported having a diploma's degree, according to Zaki (2016) found that none of the nurses in the study have a master's or doctoral degree, and that the bulk of them are diploma nurses, with more than half of them working as staff nurses. Table 1shows that35.7 percent of Nurses working in general reported having (2-9) years of nursing experience. This conclusion is supported by Sailaxmi, (2015), who discovered that the majority of psychiatric nurses were between the ages of 24 and 35, with work experience ranging from 2 to 10 years. nurses working in general wards have different levels of work-related psychological stress: 24.3 percent have a mild level; 32.9 percent have a moderate level.  Faremi et al.,(2019) The results of the current study show that workload is the first aspect of nurses' work that results in the highest frequency of stress due to intense daily work. With the global increase in the number of elderly people, the increasing severity of health care problems, the increasing incidence of chronic diseases and advanced technology, nurses face a variety of work-related stresses.The association between work-related psychological stress, gender, age, marital status, whether or not you have children, nursing qualifications, and years of nursing service of employees is depicted in Table 10. Nurses on general wards discovered no link between work-related psychological stress, gender, age, marital status, whether or not you have children, nursing qualifications, or years of experience. According to Abdullah and Mirza (2018), while there is no significant variation in job stress among nurses based on age, years of experience, occupation, marital status, or remuneration, there is a significant difference in education levels, preparation, gender, or hospital. Respondents' stress levels were linked to their age, marital status, workload, and educational background, according to Odonkor and Adams (2021).

Conclusions:

No association was found between the Work-related psychological stress and gender, age, marital status, do you have children, Nursing qualification and Years of servicing nursing of staff nurses working in general wards.

Recommendations:

1. Implementation of programs aimed at education nurses how to deal with work stress and its effects as well as enhancing the capabilities of nurses regarding Coping and problem solving strategies.
2. Hospitals must have nurse training programmers on how to face their pressures in effective coping methods.
3. The need for future research that should be directed at the effects of stress management.

References:

Kim and Lee (2014(Effects of Servicescape on Perceived Service Quality, Satisfaction and Behavioral Outcomes in Public Service Facilities. Journal of AsianArchitectureandBuildingEngineering13(1):125131DOI:10.3130/jaabe.13.125

Greenglass, E. R. (2002). Work stress, coping, and social support: Implications for women's occupational well-being. In D. L. Nelson & R. J. Burke (Eds.), Gender, work stress, and health (pp. 85–96). American Psychological Association. https://doi.org/10.1037/10467-006

Natasha Khamisa, Brian Oldenburg, Karl Peltzer, Dragan Ilic . Work related stress, burnout, job satisfaction and general health of nurses. Int J Environ Res Public Health. 2015 Jan 12;12(1):652-66. doi:10.3390/ijerph120100652.

R Burbeck 1, S Coomber, S M Robinson, C Todd. Occupational stress in consultants in accident and emergency medicine: a national survey of levels of stress at work. Emerg Med J. 2002 May;19(3):234-8. doi: 10.1136/emj.19.3.234.

Nayomi, W.V.P.N. (2016). Workplace stress in nursing: a literature review. “Social Statistics”, Journal of Social Statistics, 03(01), 47-53.

Nakakis K and Ouzouni C (2008). Factors influencing stress and job satisfaction of nurses working in psychiatric units, Health Science Journal; 2 (4): 183-195.

Lee D, et al. (2005) The proteasome regulatory particle alters the SAGA coactivator to enhance its interactions with transcriptional activators. Cell 123(3):423-36.

Brunero, S. Cowan, D. Garvey, A. 2006, Stress Management for Nurses. ANMF, New South Wales Nurses and Midwives Association (NSWNMA).

Kirchhoff ALC, MagnagoTSBdS, Camponogara S, Gripe RH, Tavares JP, Presets FC, et al. Condoles de tribal e characteristics sócio-demográficas relacionadas à presence de disturbers psíquicos minors me trabalhadores de enfermagem. Text Context Enform. 2009; 18:215-23.

Yang D. Stress and Burnout in Demanding Nursing Home Care: A literature review of the causes, prevention and coping strategies; [Internet] 2017 [cited 2017 Nov 17]. Available from: http://www.theseus.fi/handle/10024/1318 93

Lamont S, Brunero S, Perry L, Duffield C, Sibbritt D, Gallagher R, et al. ‘Mental health day’ sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics. J Adv Nurs 2017 May;73(5):1172–81.

Rushton CH, Batcheller J, Schroeder K, Donohue P. Burnout and Resilience Among Nurses Practicing in High-Intensity Settings. Am J Crit Care 2015 Sep;24(5):412–20.

Elahi, Mohammadi ,Akbar,Khoshknab What Strategies Do the Nurses Apply to Cope With Job Stress?: AQualitative Study Global Journal of Health Science; Vol. 8, No. 6; 2016ISSN 1916-9736 E-ISSN 1916-9744Published by Canadian Center of Science and Education.

F A Faremia, M I Olatubib, K G Adeniyic,OR Salaud (2019) Assessment of occupational related stress among nurses in two selected hospitals in a city southwestern Nigeria. International Journal of Africa Nursing Sciences 10 68–73.

Kourakos M(2017) Mental health and coping strategies among nursing staff in public health services.  Prog Health Sci 2017, Vol 7, No 2 Mental health and coping strategies among nursing staff.

M.K Abdullah, Z. M Mirza,& S.Y Othman. Assessment of Job Stress among Nurses Working in Akre Teaching Hospitals, Mosul Journal of Nursing, Vol. 6, No. 1, 2018 ( 23-33 ) www.mjn.mosuljournals.com. DOI: 10.33899/mjn.2018.160079.

S Alharbi, A Al Hasan. Occupational Stress, Coping Strategies, and Quality of Life among Nurses in General and Psychiatric Setting in Jeddah City—KSA. Open Journal of Psychiatry, 2019, 9, 124-137 http://www.scirp.org/journal/ojpsychISSN Online: 2161-7333ISSN Print: 2161-7325.

R M’Deh, F Alhalaiqa, M E AbuRuz1, G Al-Dweik1 & H Al-Akash(2017 )Perceived Stress in Nurses: A Comparative Study. Global Journal of Health Science; Vol. 9, No. 6; 2017 ISSN 1916-9736 E-ISSN 1916-9744.

Sailaxmi, G.(2015): Impact of a stress management program on stress perception of nurses working with psychiatric patients, Asian Journal of Psychiatry ,vol (14) .pp. 42–45

Rania. A. Zaki. Job Stress and Self- Efficacy among Psychiatric Nursing Working in Mental Health Hospitals at Cairo, Egypt , Journal of Education and Practice www.iiste.orgISSN 2222-1735 (Paper) ISSN 2222-288X (Online)Vol.7, No.20, 2016

Stephen T. Odonkor  , Samuel Adams. Predictors of stress and associated factors among healthcare workers in Western Ghana journal homepage: www.cell.com/heliyon Received 5 August 2020; Received in revised form 27 March 2021; Accepted 2 June 2021 2405-8440/© 2021.