Exploring the burden of emergency care: predictors of stress-health outcomes in emergency nurses
Jef Adriaenssens
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorVeronique De Gucht
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorMargot Van Der Doef
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorStan Maes
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorJef Adriaenssens
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorVeronique De Gucht
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorMargot Van Der Doef
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorStan Maes
Jef Adriaenssens MSN RN Researcher Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands
Search for more papers by this authorAbstract
adriaenssens j., de gucht v., van der doef m. & maes s. (2011) Exploring the burden of emergency care: predictors of stress-health outcomes in emergency nurses. Journal of Advanced Nursing67(6), 1317–1328.
Aims. This paper is a report of a study that examines (1) whether emergency nurses differ from a general hospital nursing comparison group in terms of job and organizational characteristics and (2) to what extent these characteristics predict job satisfaction, turnover intention, work engagement, fatigue and psychosomatic distress in emergency nurses.
Background. The work environment and job characteristics of nurses are important predictors of stress-health outcomes. Emergency nurses are particularly exposed to stressful events and unpredictable work conditions.
Methods. This cross-sectional study (N = 254) was carried out in 15 emergency departments of Belgian general hospitals in 2007–2008 by means of the Leiden Quality of Work Questionnaire for Nurses, the Checklist Individual Strength, the Utrecht Work Engagement Scale and the Brief Symptom Inventory.
Results. Emergency nurses report more time pressure and physical demands, lower decision authority, less adequate work procedures and less reward than a general hospital nursing population. They report, however, more opportunity for skill discretion and better social support by colleagues. Work-time demands appear to be important determinants of psychosomatic complaints and fatigue in emergency nurses. Apart from personal characteristics, decision authority, skill discretion, adequate work procedures, perceived reward and social support by supervisors prove to be strong determinants of job satisfaction, work engagement and lower turnover intention in emergency nurses.
Conclusion. Emergency departments should be screened regularly on job and organizational characteristics to identify determinants of stress-health outcomes that can be the target of preventive interventions.
References
- Adali E. & Priami M. ( 2002 ) Burnout among nurses in ICU, internal medicine wards and emergency departments in Greek hospitals . ICUs and Nursing Web journal ( 11 ), 1 – 19 .
- Akerboom S. & Maes S. ( 2006 ) Beyond demand and control: the contribution of organizational risk factors in assessing the psychological well-being of health employees . Work and Stress 20 ( 1 ), 21 – 36 .
-
Bakker A.
&
Demerouti E.
(
2007
)
The Job Demands-Resources model: state of the art
.
Journal of Managerial Psychology
22
(
3
),
309
–
328
.
10.1108/02683940710733115 Google Scholar
- Blegen M.A. ( 1993 ) Nurses’ job satisfaction: a meta-analysis of related variables . Nursing Research 42 ( 1 ), 36 – 41 .
- Bradley J. & Cartwright S. ( 2002 ) Social support, job stress, health, and job satisfaction among nurses in the United Kingdom . International Journal of Stress Management 9 ( 3 ), 163 – 181 .
- Browning L. , Ryan C.S. , Thomas S. , Greenberg M. & Rolniak S. ( 2007 ) Nursing specialty and burnout . Psychology, Health & Medicine 12 ( 2 ), 248 – 254 .
- Bultmann U. , Kant I.J. , Schroer C.A. & Kasl S.V. ( 2002 ) The relationship between psychosocial work characteristics and fatigue and psychological distress . International Archives of Occupational and Environmental Health 75 ( 4 ), 259 – 266 .
- Burke R.J. & Greenglass E.R. ( 1999 ) Work-family congruence and work-family concerns among nursing staff . Canadian Journal of Nursing Leadership 12 ( 2 ), 21 – 29 .
- Coomber B. & Barriball K.L. ( 2007 ) Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: a review of the research literature . International Journal of Nursing Studies 44 ( 2 ), 297 – 314 .
- Cooper C. , Dewe P. & O’Driscoll M. ( 2001 ) Organizational Stress: A Review and Critique of Theory, Research and Applications . SAGE Publications , London .
- Crabbe J.M. , Bowley D.M. , Boffard K.D. , Alexander D.A. & Klein S. ( 2004 ) Are health professionals getting caught in the crossfire? The personal implications of caring for trauma victims . Emergency Medicine Journal 21 ( 5 ), 568 – 572 .
- De Beurs E. ( 2007 ) Handleiding bij de Brief Symptom Inventory (BSI) . Pits B.V. , Leiden, the Netherlands .
- De Beurs E. & Zitman F. ( 2005 ) De Brief Symptom Inventory (BSI): De betrouwbaarheid en validiteit van een handzaam alternatief voor de SCL-90. [The Brief Symptom Inventory (BSI): the reliability and validity of a brief alternative of the SCL-90] . Maandblad Geestelijke Volksgezondheid 61 , 120 – 141 .
- De Jonge J. & Schaufeli W. ( 1998 ) Job characteristics and employee well-being: a test of Warr’s vitamin model in health care workers using structural equation modelling . Journal of Organizational Behavior 19 , 387 – 407 .
- Demerouti E. , Bakker A.B. , Nachreiner F. & Schaufeli W. ( 2000 ) A model of burnout and life satisfaction among nurses . Journal of Advanced Nursing 32 ( 2 ), 454 – 464 .
- Derogatis L. ( 1993 ) BSI Brief Symptom Inventory. Administration, Scoring, and Procedures Manual , 4th edn . National Computer Systems , Minneapolis .
- Escriba-Aguir V. , Martin-Baena D. & Perez-Hoyos S. ( 2006 ) Psychosocial work environment and burnout among emergency medical and nursing staff . International Archives of Occupational and Environmental Health 80 ( 2 ), 127 – 133 .
- Fahlen G. , Knutsson A. , Peter R. , Akerstedt T. , Nordin M. , Alfredsson L. & Westerholm P. ( 2006 ) Effort-reward imbalance, sleep disturbances and fatigue . International Archives of Occupational and Environmental Health 79 ( 5 ), 371 – 378 .
-
Gelsema T.
,
Van der Doef M.
,
Maes S.
&
Akerboom S.
(
2005
)
Job stress in the nursing profession: the influence of organizational and environmental conditions and job characteristics
.
International Journal of Stress Management
12
(
3
),
222
–
240
.
10.1037/1072-5245.12.3.222 Google Scholar
- Gerberich S.G. , Church T.R. , McGovern P.M. , Hansen H.E. , Nachreiner N.M. & Geisser M.S. ( 2004 ) An epidemiological study of the magnitude and consequences of work related violence: the Minnesota nurses’ study . Occupational and Environmental Medicine 61 ( 6 ), 495 – 503 .
- Hart P. & Cooper C. ( 2001 ) Occupational stress: toward a more integrated framework . In Handbook of Industrial, Work and Organizational Psychology (Vol. 2: Personnel Psychology) ( N. Anderson et al. , eds ), Sage , London , pp . 93 – 114 .
- Hasselborn H. , Tackenberg P. & Müller B. ( 2003 ) Working Conditions and Intent to Leave the Profession Among Nursing Staff in Europe . NEXT – University of Wuppertal , Wuppertal .
- Havens D.S. & Aiken L.H. ( 1999 ) Shaping systems to promote desired outcomes. The magnet hospital model . The Journal of Nursing Administration 29 ( 2 ), 14 – 20 .
- Helps S. ( 1997 ) Experiences of stress in accident and emergency nurses . Accident and Emergency Nursing 5 , 48 – 53 .
- Irvine D.M. & Evans M.G. ( 1995 ) Job satisfaction and turnover among nurses: integrating research findings across studies . Nursing Research 44 ( 4 ), 246 – 253 .
- Karasek R. & Theorell T. ( 1990 ) Healthy Work: Stress, Productivity, and the Reconstruction of Working Life . Basic Books , New York .
- Kilcoyne M. & Dowling M. ( 2007 ) Working in an overcrowded accident and emergency department: nurses’ narratives . Australian Journal of Advanced Nursing 25 ( 2 ), 21 – 27 .
- Krausz M. , Sagie A. & Bidermann Y. ( 2000 ) Actual and preferred work schedules and scheduling control as determinants of job-related attitudes . Journal of Vocational Behavior 56 ( 1 ), 1 – 11 .
- Laschinger H. , Shamian J. & Thomson D. ( 2001 ) Impact of magnet hospital characteristics on nurses’ perceptions of trust burnout quality of care, and work satisfaction . Nursing Economics 19 ( 5 ), 209 – 219 .
- Maes S. , Akerboom S. , Van der Doef M. & Verhoeven C. ( 1999 ) The Leiden Quality of Work Life Questionnaire for Nurses (LQWLQ-N) . Health Psychology, Leiden University , Leiden, The Netherlands .
- McGrath A. , Reid N. & Boore J. ( 2003 ) Occupational stress in nursing . International Journal of Nursing Studies 40 ( 5 ), 555 – 565 .
- McVicar A. ( 2003 ) Workplace stress in nursing: a literature review . Journal of Advanced Nursing 44 ( 6 ), 633 – 642 .
-
Potter C.
(
2006
)
To what extent do nurses and physicians working within the emergency department experience burnout: a review of the literature
.
Australasian Emergency Nursing Journal
9
(
2
),
57
–
64
.
10.1016/j.aenj.2006.03.006 Google Scholar
- Ruggiero J.S. & Pezzino J.M. ( 2006 ) Nurses’ perceptions of the advantages and disadvantages of their shift and work schedules . Journal of Nursing Administration 36 ( 10 ), 450 – 453 .
- Sauter S. , Murphy L. , Colligan M. , Swanson N. , Hurrell J. , Scharf F. , Sinclair R. , Grubb P. , Goldenhar L. , Alterman T. , Johnston J. , Hamilton A. & Tisdale J. ( 2009 ) Stress…at Work (NIOSH) . DHHS (NIOS–) - CDC , Cincinnati .
- Schriver J.A. , Talmadge R. , Chuong R. & Hedges J.R. ( 2003 ) Emergency nursing: historical, current, and future roles . Journal of Emergency Nursing 29 ( 5 ), 431 – 439 .
- Seppälä P. , Mauno S. , Feldt T. , Hakanen J. , Kinnunen L. , Tolvanen A. & Schaufeli W. ( 2008 ) The construct validity of the Utrecht work engagement scale: multisample and longitudinal evidence . Journal of Happiness Studies 10 ( 4 ), 459 – 481 .
- Siegrist J. ( 2008 ) Chronic psychosocial stress at work and risk of depression: evidence from prospective studies . European Archives of Psychiatry and Clinical Neuroscience 258 ( suppl. 5 ), 115 – 119 .
- Van der Doef M. & Maes S. ( 1998 ) The job demand-control(-support) model and physical health outcomes: a review of the strain and buffer hypotheses . Psychology & Health 13 ( 5 ), 909 – 936 .
- Van der Doef M. & Maes S. ( 1999a ) The Leiden quality of work questionnaire: its construction, factor structure, and psychometric qualities . Psychological Reports 85 ( 3 Pt 1 ), 954 – 962 .
- Van der Doef M. & Maes S. ( 1999b ) The job demand-control (-support) model and psychological well-being: a review of 20 years of empirical research . Work and Stress 13 ( 2 ), 87 – 114 .
- Van der Doef M. & Maes S. ( 2002 ) Teacher-specific quality of work versus general quality of work assessment: a comparison of their validity regarding burnout, (psycho)somatic well-being and job satisfaction . Anxiety, Stress, and Coping 15 ( 4 ), 327 – 344 .
- Vercoulen J. , Alberets M. & Blijenberg G. ( 1999 ) De Checklist Individual Strength (CIS) . Gedragstherapie 32 , 31 – 36 .
- Wagenaar W.A. , Hudson P.T.W. & Reason J.T. ( 1990 ) Cognitive failures and accidents . Applied Cognitive Psychology 4 , 273 – 294 .
- Wagenaar W. , Groeneweg J. , Hudson P. & Reason J. ( 1994 ) Promoting safety in the oil industry . Ergonomics 37 ( 12 ), 1999 – 2013 .
- Walsh M. , Dolan B. & Lewis A. ( 1998 ) Burnout and stress among A&E nurses . Emergency Nurse 6 ( 2 ), 23 – 30 .
- Wheeler H.H. ( 1998 ) Nurse occupational stress research. 5: sources and determinants of stress . The British Journal of Nursing 7 ( 1 ), 40 – 43 .
- Yang Y. , Koh D. , Ng V. , Lee F.C. , Chan G. , Dong F. & Chia S.E. ( 2001 ) Salivary cortisol levels and work-related stress among emergency department nurses . Journal of Occupational and Environmental Medicine 43 ( 12 ), 1011 – 1018 .
- Zangaro G.A. & Soeken K.L. ( 2007 ) A meta-analysis of studies of nurses’ job satisfaction . Research in Nursing & Health 30 ( 4 ), 445 – 458 .
Citing Literature
