Nurses’ stress and resilience before and after evaluation for hospital accreditation

Rhoden, Deise Juliana; Dezordi, Cátia Cristiane Matte; Husein, Raida Ahmad Musa Mheisen; Barbosa, Dulce Aparecida; Treviso, Patrícia; Colet, Christiane de Fátima; Stumm, Eniva Miladi Fernandes

doi:10.1590/0034-7167-2020-1341

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (03) • 2022 • https://doi.org/10.1590/0034-7167-2020-1341 copy

Nurses’ stress and resilience before and after evaluation for hospital accreditation

Estrés y resiliencia de enfermeros antes y después de la evaluación para acreditación de hospitales

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze and compare levels of stress and resilience in nurses before and after the assessment for maintenance of the Hospital Accreditation Certification.

Methods:

quantitative, observational, and longitudinal research, with 53 nurses from a philanthropic hospital, in the Rio Grande do Sul. Data collected in two stages, March, and July 2019, before the assessment visit and 60 days after, using the Bianchi Stress Scale and Resilience Scale. Descriptive and analytical statistics were employed.

Results:

the majority of participants showed an average stress level before and after the evaluation. The highest stress scores were related to Domains E (coordination of unit activities) and C (activities related to personnel administration). In both moments of the study, the participants had medium and high resilience.

Conclusions:

managing people, processes, and assistance are stressful activities in the Accreditation process and increase the nurses’ stress levels.

Descriptors:
Nurse Administrators; Professional Burnout; Psychological Resilience; Hospital Accreditation; Hospital Nursing Service

Bianchi Stress Scale Domains	Period of collection	Level of stress
Bianchi Stress Scale Domains	Period of collection	Low n (%)	Medium n (%)	High n (%)
A - Relationship with other units and supervisors	BA	40 (75.5)	13 (24.5)	-
A - Relationship with other units and supervisors	AA	37 (69.8)	15 (28.3)	1 (1.9)
B - Activities related to the proper functioning of the unit	BA	34 (64.2)	18 (34.0)	1 (1.9)
	AA	28 (52.8)	23 (43.4)	2 (3.8)
C - Activities related to personnel administration	BA	15 (28.3)	34 (64.2)	4 (7.5)
C - Activities related to personnel administration	AA	18 (34.0)	29 (54.7)	6 (11.3)
D - Nursing care provided to the patient	BA	21 (39.6)	32 (60.4)	-
D - Nursing care provided to the patient	AA^* * For two (3.8%) nurses, all domain scores were 0 (not applicable); BA - before assessment for Accreditation; AA - after Accreditation assessment.	22 (41.5)	26 (49.1)	3 (5.7)
E - Coordination of the unit's activities	BA	12 (22.6)	39 (73.6)	2 (3.8)
E - Coordination of the unit's activities	AA	12 (22.6)	38 (71.7)	3 (5.7)
F - Working conditions for the performance of nurses' activities	BA	22 (41.5)	31 (58.5)	-
	AA	25 (47.2)	25 (47.2)	3 (5.7)

Bianchi Stress Scale Domains		Descriptive Statistics							Wilcoxon's t-test p value
Bianchi Stress Scale Domains		LL	UL	Medium	SD	Q1 (25%)	Md (50%)	Q3 (75%)	Wilcoxon's t-test p value
A	AA	1.00	5.22	2.32	1.05	1.50	2.13	3.06	0.021
A	DA	1.00	6.33	2.62	1.17	1.88	2.33	3.28
B	AA	1.00	6.00	2.90	1.34	1.75	2.67	4.00	0.152
B	DA	1.00	6.33	3.13	1.47	1.83	3.00	4.08
C	AA	1.40	7.00	3.92	1.35	2.82	4.00	4.82	0.591
C	DA	1.00	6.50	3.81	1.39	2.73	3.60	5.00
D	AA	1.14	5.67	3.30	1.28	2.13	3.47	4.33	0.853
D	DA	1.20	6.20	3.37	1.22	2.53	3.33	4.07
E	AA	1.43	6.75	3.82	1.12	3.25	3.88	4.46	0.806
E	DA	1.14	7.00	3.75	1.17	3.13	3.88	4.38
F	AA	1.14	5.75	3.31	1.08	2.69	3.17	4.07	0.862
F	DA	1.50	6.14	3.37	1.27	2.23	3.14	4.15

Bianchi Stress Scale Domains	BSS Domains BA with AA domains		Resiliency BA with BSS BA		Resilience AA with BSS BA
Bianchi Stress Scale Domains	R	p	R	p	R	p
A - Relationship with other units and supervisors	0.564	0.000^* * Correlation significant for p < 0.01; BA - before assessment for Accreditation; AA - after Accreditation assessment; BSS - Bianchi Stress Scale.	-0.052	0.712	-0.096	0.494
B - Activities related to the adequate functioning of the unit	0.656	0.000^* * Correlation significant for p < 0.01; BA - before assessment for Accreditation; AA - after Accreditation assessment; BSS - Bianchi Stress Scale.	0.031	0.824	0.037	0.791
C - Activities related to personnel administration	0.584	0.000^* * Correlation significant for p < 0.01; BA - before assessment for Accreditation; AA - after Accreditation assessment; BSS - Bianchi Stress Scale.	0.144	0.303	-0.011	0.935
D - Nursing care provided to the patient	0.616	0.000^* * Correlation significant for p < 0.01; BA - before assessment for Accreditation; AA - after Accreditation assessment; BSS - Bianchi Stress Scale.	-0.035	0.804	-0.072	0.613
E - Coordination of the unit's activities	0.414	0.002^* * Correlation significant for p < 0.01; BA - before assessment for Accreditation; AA - after Accreditation assessment; BSS - Bianchi Stress Scale.	-0.037	0.791	-0.147	0.294
F - Working conditions for the performance of nurses' activities	0.479	0.000^* * Correlation significant for p < 0.01; BA - before assessment for Accreditation; AA - after Accreditation assessment; BSS - Bianchi Stress Scale.	-0.144	0.304	-0.263	0.057

Bianchi Stress Scale Domains	Period of collection		Resilience
Bianchi Stress Scale Domains	Period of collection		Low n (%)	Medium n (%)	High n (%)
A - Relationship with other units and supervisors	BA	Low	6 (11.2)	23 (43.4)	11 (20.8)
		Medium	2 (3.8)	8 (15.1)	3 (5.7)
		High	-	-	-
	AA	Low	7 (13.2)	18 (34.0)	12 (22.6)
		Medium	3 (5.7)	5 (9.4)	7 (13.2)
		High	-	1 (1.9)	-
B - Activities related to the adequate functioning of the unit	BA	Low	5 (9.4)	20 (37.7)	9 (17.0)
		Medium	3 (5.7)	10 (18.9)	5 (9.4)
		High	-	1 (1.9)	-
	AA	Low	5 (9.4)	11 (20.8)	12 (22.6)
		Medium	5 (9.4)	11 (20.8)	7 (13.2)
		High	-	2 (3.8)	-
C - Activities related to personnel administration	BA	Low	4 (7.5)	8 (15.1)	3 (5.7)
		Medium	4 (7.5)	20 (37.7)	10 (18.9)
		High	-	3 (5.7)	1 (1.9)
	AA	Low	5 (9.4)	4 (7.5)	9 (17.0)
		Medium	4 (7.5)	17 (32.1)	8 (15.1)
		High	1 (1.9)	3 (5.7)	2 (3.8)
D - Nursing care provided to the patient	BA	Low	5 (9.4)	9 (17.0)	7 (13.2)
		Medium	3 (5.7)	22 (41.5)	7 (13.2)
		High	-	-	-
	AA	Low	3 (5.9)	9 (17.6)	10 (19.6)
		Medium	7 (13.7)	12 (23.5)	7 (13.7)
		High	-	2 (3.9)	1 (2.0)
E - Coordination of the unit's activities	BA	Low	4 (7.5)	4 (7.5)	4 (7.5)
		Medium	4 (7.5)	25 (47.2)	10 (18.9)
		High	-	2 (3.8)	-
	AA	Low	3 (5.7)	5 (9.4)	4 (7.5)
		Medium	6 (11.3)	17 (32.1)	15 (28.3)
		High	1 (1.9)	2 (3.8)	-
F - Working conditions for the performance of nurses' activities	BA	Low	5 (9.4)	11 (20.8)	6 (11.3)
		Medium	3 (5.7)	20 (37.7)	8 (15.1)
		High	-	-	-
	AA	Low	4 (7.5)	10 (18.9)	11 (20.8)
		Medium	5 (9.4)	12 (22.6)	8 (15.1)
		High	1 (1.9)	2 (3.8)	-

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[1] Corresponding author: Deise Juliana Rhoden E-mail: deise.jr@hotmail.com