Occupational stress and burnout in acute care medical surgical nurses in a rural area
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Date
1994
Department
Nursing
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Abstract
The purpose of this study was to investigate stress and
burnout in acute care, medical and surgical nurses in a
rural hospital setting. The relationships between age,
level of education, years of nursing experience, marital
status, shift worked, length of the shift, and full or part
time status with stress and burnout were investigated. The
relationship between stress and burnout was also studied.
Hans Selye's General Adaptation Syndrome was the theoretical
basis for the study. The design for this study was a descriptive,
correlational one, using a convenience sample of 84
registered nurses who worked on medical and/or surgical
areas in a rural regional medical center in a mid-Atlantic
state. Participation in the study was voluntary, and
anonymity was guaranteed. The tools used in this
investigation included a demographic questionnaire, the
Nursing Stress Scale (NSS) , and the Maslach Burnout
Inventory (MBI). Spearman Rho correlation coefficients were computed to
examine the relationships between age, years of experience,
stress and burnout. The relationship between the total
stress score (NSS) and age was not significant. However, it
was found that older nurses felt that they could not share
experiences and negative feelings toward patients with their co-workers (r=.1950, p=.038). Older nurses also felt less
emotional exhaustion than younger nurses (r=-.2533, p=.010).
Statistically significant relationships were found
between stress and burnout, including moderately positive
relationships for emotional exhaustion and depersonalization
with total stress (r=.3682, p=.000 and r=.3255, p=.001
respectively). A weak significant negative correlation
existed between stress and personal accomplishment (r=.2382,
p=.016). Mann Whitney U Tests, and Kruskal-Wallis one-way
analyses of variance were used to test the differences
between full and part time status, education, shift worked,
length of the shift, and marital status with stress and
burnout. Statistical significance was not reached at the
.05 level on any of these compared differences. Multiple regression was used to explain the effect of
the demographic variables on stress and burnout. Inadequate
preparation to deal with the emotional needs of patients and
their families (Factor 3 of the NSS) was found to explain
18% of the variance in depersonalization scores (p<.Ol).
This same factor explained 27.6% of variance in personal
accomplishment scores at the p=.000 level. Inadequate
preparation, workload, and age accounted for 28.5% of the
variance in emotional exhaustion (p=.0000). Implications for nursing, including the need for staff
support groups and education in conflict resolution was suggested. Suggestions for further research, including the
effect of personality hardiness on stress and burnout, were
given.