Person-environment imbalance in an occupational setting : a comparative study of nursing stress in several hospital wards : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology

The present study had three major objectives; (1) the development of a model in which to view nursing stress in terms of basic processes which underlie behaviour; (2) assessment of the levels of nursing stress in several hospital wards, including Oncology; (3) definition of the relationship of personality to the levels of perceived stress amongst nurses. A general information processing model of behaviour, based on the central role of imbalance in process, was developed as the appropriate context in which to understand occupational stress. The sources of stress in nursing, identified in the literature, were reviewed in terms of this model. Data reported here were obtained with a questionnaire designed to measure perceived frequency and stressfulness of job events, presence and stressfulness of job conditions, propensity to leave the job, role conflict, frequency and degree of satisfaction from a variety of sources, and other variables including a number of possible moderators of stress. Indices of stress were derived from these data and from standard measures of well-being, state anxiety and depression. The personality variables extraversion-introversion, neuroticism, trait anxiety, self esteem and locus of control were measured. Scores for stressfulness of events and job conditions respectively were factor analysed and individual factor scores obtained. Wards were compared on a number of the above variables. Few of the events or job conditions were perceived as very stressful on average, with only job conditions related to work load rated as very stressful. Although scores of frequency and stressfulness of each event were not significantly correlated, individuals reporting high frequencies tended to also give high stress scores. Differences between wards in reported frequency of events were generally consistent with the speciality of wards involved. However, Women's Medical showed a general elevation of scores on most items relative to other wards, and on stress indices, particularly depression. Factor analysis of stressfulness scores with two factors for both events and job conditions respectively revealed in both cases a factor which was heavily loaded on by administrative items and which also correlated strongly with measures of depression. Scores on personality tests did not differ significantly between wards, although neuroticism, trait anxiety and self esteem correlated to similar degrees with a number of stress indices and appeared to be measuring the same trait. Extraversion-introversion and locus of control were not correlated significantly with stress. The results do not support the prevalent view that nurses in Oncology and Intensive Care wards suffer high levels of stress compared with nurses in other wards. The methodology used in this and similar types of study is critically discussed in light of the present results, and the relevance of personality variables to stress is discussed in relation to the present findings