Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
A STUDY TO ASSESS THE JOB RELATED STRESS AND ITS COPING PATTERN AMONG STAFF NURSES WORKING IN CRITICAL CARE UNIT IN A SELECTED HOSPITAL IN BANGALORE.
synopsis Proforma for Registration of subject for
dissertation
Mr. GIRISHA H.B
PSYCHIATRIC NURSING
I YEAR M.SC NURSING
SRI SHARADA COLLEGE OF NURSING,
UTTARAHALLI, BANGALORE -61.
SRI SHARADA COLLEGE OF NURSING
BANGALORE
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1 / NAME OF THE CANDIDATE AND ADDRESS / Mr. GIRISHA H B1ST YEAR M.Sc. NURSING
SRI SHARADA COLLEGE OF NURSING
#42-45 UTTARAHALLI MAIN ROAD,
UTTARAHALLI.
BANGALORE-560061.
2 / NAME OF THE INSTITUTION / SRI SHARADA COLLEGE OF NURSING
#42-45 UTTARAHALLI MAIN ROAD,
UTTARAHALLI.
BANGALORE-560061.
3 / COURSE OF THE STUDY AND SUBJECT / M.Sc. NURSING 1 YEAR
PSYCHIATRIC NURSING
4 / DATE OF ADMISSION TO THE COURSE / 04– 06 – 2012
5 / TITLE OF TOPIC / ”A STUDY TO ASSESS THE JOB RELATED STRESS AND ITS COPING PATTERN AMONG STAFF NURSES WORKING IN CRITICAL CARE UNIT IN A SELECTED HOSPITAL IN BANGALORE.”
6. BRIEF RESUME OF THE INTENDED STUDY
INTRODUCTION
For us who nurse, our nursing is a thing which, unless we are making progress every year, every month, every week, take my word for it, we are going back... Florence nightingale
According to the World Health Organization, the main determinants of health include the social and economic environment, the physical environment and the person's individual characteristics and behaviors. Generally the context in which an individual lives is of great importance on his life quality and health status. The social and economic environment are key factors in determining the health status of individuals given the fact that higher education levels are linked with a higher standard of life as well as a higher income. Generally, people who finish higher education are more likely to get a better job and therefore are less prone to stress by comparing to individuals with low education levels. The example set by the family as well as the relationship with friends and family can have a great impact on one's general health. Nonetheless, genetics may play a role in the manner in which people cope with stress. In daily life failure to which represents with many emotional reactions may be as anxiety, fear, aggression or violence etc.1
Health research plays a major roll in advancing science, in providing solution for health problems and can contribute to growth, development equity, global security and fight against poverty. The massive imbalance in health research funding and output in terms of populations addressed has been referred to as 10/90 gap. Mental and Neurological Disorders are responsible for 13% of behavior related disorder for another third of the global burden of disease. Despite the evidence, mental health is a more neglected area within public health
Anger is a normal human emotion that is crucial for individual growth and is a present in all relationship. When handled appropriately and expressed assertively, anger is positive creative force that leads to problem solving and productive change. When channeled inappropriately and expressed as verbal aggression or physically aggression, anger is a destructive and potentially life force. Physical aggression is also called assault or violent. It is important to note that most violent individual is not psychiatrically ill. It is commonly associated with psychotic disorder, such as delirium, drug intoxication or withdrawal, central nervous system disorder etc.4 Hence aggression can be defined as verbal aggression which could be demanding or argumentative, shouting, yelling or screaming, swearing or using abusive language, other things includes generally in a bad mood irritable or quick to fly off handle critical, sarcastic or derogatory, saying someone is incompetent impatience or anger if something does not suit him /her or for that matter being angry with him/her are also included. 7
Workplace stress has long been recognized as a challenge for the nursing profession .stress is perceived when environmental demands exceed the individual resources .role –stress occurs through perceived mismatch between the expectations of the role and the accomplishment. Lazarus considered stress as the transaction involving individual and his or her environment.
There is growing body of research about stress in nursing in addition to some general indications. For example, occupational mortality figures in early 1980s indicated that the suicide rate for female nurses was significantly higher than national average. 3
6.2 NEED FOR THE STUDY:
Job life is one of the important parts of our daily lives which cause a great deal of stress. Due to the competitive nature of the job environment most of the people in the world are spending their time for job related work purpose resulting ignore the stressor those one influencing their work and life. Usually people are more worry about their outcome of work that can even affect the and relatives)
The working environment of intensive care unit nurse is constant source of stress researches have described CCU as stressful environment because of the complex nature of patient’s health problems requiring an intensive use of very sophisticated technology.2
Nurses not only have to cope with sophisticated technology but also regularly face ethical dilemmas concerning issues of patient care management .the changes in health care delivery has also created new nursing roles and responsibilities and has also contributed to source of stress.
Stress occurs when nurses try to manage patients nursing care within the scope of nursing stress also occurs when there is a constant desire to achieve only the best Studies have also shown that high level of stress can affect the competence and job performance of nurse. Nurses working in environments where verbal and physical aggression is prevalent are more likely to experience the effects of stress.4
Nurses as one of the professional service of tend to be exposed to extreme workloads. Their works are generally characterized by having a high contagious potential, being labor-intensive, having an overwhelming. Job shifting and experiencing malicious complicated and dynamic occurrences under strict time pressures. Studies have generally revealed that continuously excessive working loads tend to lower their job satisfaction and deteriorate in turnover intentions.
Previous research has also indicated that the source among CCU nurses is more organization in nature .organizational stressors could be physical, psychological and social in nature. Nurses working in environments where verbal and physical aggression is prevalent are more likely to experience the effects of stress. The other determinants causing the stress in CCU nurse could be due to increased job demand, nursing shortages, overload of work, and lack of support from colleagues a lot of paperwork and high expectations from the superior. 5
6.2 REVIEW OF LITERATURE
A study was conducted on working in ICU different hospitals in Palma demallorca descriptive and factors analysis about causal and emotional factors to work stress in ICU nursing staff. The importance of accurate measurements. Such emotional are divided into seven factors which explain 65.31% of the variance and define states of personal satisfaction, depersonalization, and anxiety low self esteem. The results corroborates previous research findings on work stress provide a simplified tool for assessing this and show the need to quantify the degree of such manifestations in the assessments.12
A study was conducted on workplace stressors coping, demographic and job satisfaction in Chinese intensive care nurses in department of nursing in tongji medical school, huazhong university of science and technology wuhan, china. It remains unclear is the findings of the research conducted in western culture countries are applicable to Chinese nurses .the study design used administered four self report questionnaires. The results suggested that the almost frequently cites workplace stressor was workload, while the most commonly used coping strategy was planning. Two hundred and twelve significant positives and negative correlations were found among the various workplace stressors, coping strategies, demographic characteristics and the different factors comprising job satisfaction.13
A study was conducted on job stress and the coping of ICU nurses in college of nursing, pusan national university, busan koren. The data was accumulated from 206 ICU nurses services at least more than one year in 500 order hospitals during the period of three months. The averages job stress was 2.96% -95 points, which was 2.55-23points, for the prevention of job stress, every effort is required to analysis the causes of stress caused by job circumstances and to pose an appropriates solution. Mean which, job stress, needs to be controlled using, a solution for the central problem, and search for social support.14
A study was to identify and analyses professional stressors, evaluate the level of stress in nurses in intensive care units and assess the correlation between the perception of stress and psychological and somatic symptoms or disease shown by nurses. The research, design as a cross sectional study, was carried out in the intensive care units in health centers, in Serbia. The sample population encompassed 1000 nurses; expanded nursing stress scale was used as the research instrument. In view of permanent, escalation of professional stressors, creating a supporting working environment is essential for positive health outcomes, prevention of job related diseases and better protection of already ill nurses.15
A study was conducted on registered nurses stress in intensive care units in Australia perspective this is describe a study of stressors and coping mechanisms in different grades of registered nurses in intensive care unit. The research demonstrated that significant correlation existed between relating what and when to report clinical patient changes and relating theory to practices. The findings conforms that environmental stressors are the major stressors in ICU and demonstrates that sound knowledge and assessment skills are important factors in reducing perceived stress.16
A study was conducted on a comparative study on the effectives of professionalization on German and America intensive care nurses in a German us American comparative study of 13 ICU nurses each analyzes what effects a higher degree of professionalism has on every day nursing practice. Using the data of structured interviews, dimension of job perception and aspects of coping capability with stress in regard to patient care and relation with physician of both nursing groups are compared. The results show that US American nurses often refer to cognitive, aspects of being in control of a situation and emphasize their professional part. 17
A study was conducted on reviewing nursing stress according to a proposed coping adaption framework in seton Hall University, college of nursing, south orange, newjersey. Is stress is a common problem for nurses, who in intensive care units, stress coping theory is useful in analyzing ineffective coping and its outcome. This study show compares stress among nurses in ICU to stress in non ICU nurses. Effects of stresses, such as nursing dissatisfaction and the loss of nurses to the profession will discuss .Research and commentaries, regarding stress in ICU nurses, non ICU nurses will be reviewed. Areas for future research will be presented.18
A study was conducted on ICU nurses coping measures response to work-load stressors. Stress is an integral part of every workplace. The environment of an intensive care unit exposes critical care nurses to nurses to a proportionately greater amount of work-related stress than most occupations. Several components contributing to stress as well as coping measures are discussed.19
A study was conducted on critical care nurses, ethical decision making and stress. In school of nursing, university of Pittsburgh, Pennsylvania. USA .this cross-sectional study examines the relationship between selected aspects of ethical decision-making stress and selected characteristics, sixty one critical care nurses completed the nurses’ ethical decision making –ICU questionnaires and the health professions stress inventory. Finding revealed that nurses who selected the patient advocacy model had significantly higher nurses’ autonomy scores, that perceived anxiety had a negative association with nurses’ autonomy, and that workplace restrictions and stress were related.20
A study was designed to investigate the sources of job stress and the adopted coping strategies of nurses who were working in an accident and emergency department in Shiraz University Iran. In their descriptive survey university of medical science ninety emergency ward nurses from there large teaching hospital. The date was collected through a self administration questionnaire to identify the sours of job stress and nurse’s profile and Lazarus standard questionnaires to determine the types of coping strategies. The result was a respondent was women 86.7% between 23-50 years old with less than 5 year of experience.56.7%. The following stressors were identified. Problem related to physical environment, workload dealing with patients or their relatives and handling their anger, being exposed to health safety hazards lack of support by nursing administrations, absence of the corresponding physician in the emergency room and lack of equipment, generally was issued.21
STATEMENT OF THE PROBLEM
“A STUDY TO ASSESS THE JOB RELATED STRESS AND ITS COPING PATTERN AMONG STAFF NURSES, WORKING IN CRITICAL CARE UNIT IN A SELECTED HOSPITAL IN BANGALORE.”
6.3 OBJECTIVES
6.3.1 To assess job related stress among staff nurses working in critical care unit.
6.3.2 To assess the coping pattern of staff nurses working in critical care unit.
6.3.3 To find correlation between jobs related stress and coping pattern among staff nurses.
6.3.4 To find association between jobs related stress and coping pattern with selected demography variables
6.4 RESEARCH HYPOTHESIS
H1: There is a significant correlation between job related stress and coping pattern.
H2: There is a significant association between job related stress and level of coping.
6.5 VARIABLES:
Dependent Variable:
Job related stress and coping pattern among staff nurses working in critical care unit.
6.6 OPERATIONAL DEFINITIONS
6.6.1 Assess: Assess refers to the verbal response to know the job related stress and coping pattern
6.6.2 Critical care units: Critical care unit is a departmental unit that focuses on caring for patients who have critical and life threatening conditions. In this study it refers to medical intensive care units, surgical intensive care units.
6.6.3 Staff nurses: They are the registered nurses who provide care to patients with serious conditions in intensive care environments.