Occupational stress and self-rated health among nurses

This is a cross-sectional study undertaken through the administration of a self-administered questionnaire in a sample of 134 health professionals, using the brief version of the Job Stress Scale. Descriptive analyses of the socio-demographic, health and work variables were undertaken, as was multivariate analysis through unconditional logistic regression for adjustment of the association between job stress and poor self-rated health, in accordance with potential confounding variables, with a level of significance of 5%.

RESULTS:

70% of the interviewees were classified as passive workers or as with high strain. Poor self-rated health was significantly greater among health professionals with high demand and low control, compared to those with low strain, after adjusting for co-variables.

CONCLUSIONS:

Low control, allied with low demand, can serve as a demotivating factor, contributing to the increase in professional dissatisfaction. It is recommended that institutions should adopt a policy of planning and managing human resources so as to encourage the participation of health professionals in decision-making, with a view to reducing job stress among nurses.

Health Status; Burnout, Professional; Occupational Health; Nursing

Variable/Category		n	%
Sex
	Female	93	69.9
	Male	40	30.1
Age range (years)
	< 35	53	40.2
	35 to 44	41	31.1
	= 45	38	28.8
Race
	White	82	61.2
	Mixed/Black	52	38,8
Educational level
	Up to senior high school complete	96	71.6
	Completed university	18	13.4
	Post-graduate	20	15.0
Per capita income (MS)
	< 1.5	69	53.9
	1.5 to 3.4	43	33.6
	= 3.5	16	12.5
Marital situation
	Married	88	65.7
	Single	24	17.9
	Divorced/separated/widowed	22	16.4
Diagnosis of chronic illness
	Yes	60	44.8
	No	74	55.2
Self-rating of health state
	Positive	104	77.6
	Negative	30	22.4
Time in institution
	< 5 years	56	42.7
	5 to 10 years	26	19.8
	> 10 years	49	37.4
Years doing night shift
	< 5 years	38	30.2
	= 5 years	88	69.8
Overtime, in on-call shifts/weekã
	< 12 h	12	9.3
	12 to 36 h	100	77.5
	>36 h	17	13.2
Job satisfaction
	Satisfied	98	74.8
	Not satisfied	33	25.2
Satisfaction with life
	Satisfied	115	88.5
	Not satisfied	15	11.5
Social support
	High	65	48.9
	Low	68	51.1
Demand score
	High	57	42.5
	Low	77	57.5
Control score
	High	40	29.9
	Low	94	70.1
Stress at work
	Low strain	26	19.4
	Active work	14	10.4
	Passive work	51	38.1
	High strain	43	32.1

Variables/Categories		Low strain		Active work		Passive work		High strain		p
Variables/Categories		n	%	n	%	n	%	n	%	p
Sex
	Female	18	19.4	6	6.5	40	43.0	29	31.2	0.084
	Male	8	20.0	8	20.0	11	27.5	13	32.5	0.084
Age range (years)
	< 35	10	18.9	6	11.3	14	26.4	23	43.4	0.005
	35 to 44	9	22.0	8	19.5	14	34.1	10	24.4	0.005
	= 45	7	18.4	0	0.0	23	60.5	8	21.1
Race
	White	19	23.2	7	8.5	30	36.6	26	31.7	0.491
	Mixed/black	7	13.5	7	13.5	21	40.4	17	32.7	0.491
Educational level
	Senior high school	17	17.7	8	8.3	41	42.7	30	31.3	0.182
	Completed university	4	22.2	1	5.6	7	38.9	6	33.3
	Post-graduate	5	25.0	5	25.0	3	15.0	7	35.0
Per capita income (MS)
	< 1.5	13	18.8	8	11.6	27	39.1	21	30.4	0.267
	1.5 to 3.4	6	14.0	4	9.3	21	48.8	12	27.9
	= 3.5	3	18.8	2	12.5	2	12.5	9	56.3
Marital situation
	Married	18	20.5	11	12.5	39	44.3	20	22.7	0.077
	Single	4	16.7	1	4.2	6	25.0	13	54.2
	Divorced/separated/ widowed	4	18.2	2	9.1	6	27.3	10	45.5
Diagnosis of chronic illness
	No	18	24.3	12	16.2	19	25.7	25	33.8	0.003
	Yes	8	13.3	2	3.3	32	53.3	18	30.0	0.003
Time in the institution
	<5 years	13	23.2	10	17.9	16	28.6	17	30.4	0.136
	5 to 10 years	4	15.4	3	11.5	10	38.5	9	34.6
	>10 years	9	18.4	1	2.0	24	49.0	15	30.6
Years doing on-call night shifts
	< 5 years	10	26.3	7	18.4	9	23.7	12	31.6	0.044
	= 5 years	16	18.2	5	5.6	38	43.2	29	33.0	0.044
Extra hours, on-call/week
	<12h	4	33.3	2	16.7	4	33.3	2	16.7	0.783
	12 to 36 h	18	18.0	11	11.0	37	37.0	34	34.0
	>36 h	4	23.5	1	5.9	6	35.3	6	35.3
Satisfaction with work
	Satisfied	23	23.5	11	11.2	37	37.8	27	27.6	0.029
	Not satisfied	1	3.0	3	9.1	13	39.4	16	48.5	0.029
Satisfaction with life
	Satisfied	21	18.3	13	11.3	47	40.9	34	29.6	0.129
	Not satisfied	2	13.3	1	6.7	3	20.0	9	60.0	0.129
Social support
	High	18	27.7	6	9.2	27	41.5	14	21.5	0.022
	Low	8	11.8	8	11.8	23	33.8	29	42.6	0.022

Variables/Categories		Self-rated health				p
		Positive		Negative
		n	%	n	%
Sex
	Female	72	77.4	21	22.6	0.741
	Male	32	80.0	8	20.0	0.741
Age range (years)
	< 35	41	77.4	12	22.6	0.604
	35 to 44	34	82.9	7	17.1
	= 45	28	73.7	10	26.3
Race
	White	68	82.9	14	17.1	0.063
	Mixed/black	36	69.2	16	30.8	0.063
Educational level
	Senior high school	73	76.0	23	24.0	0.682
	Completed university	14	77.8	4	22.2
	Post-graduate	17	85.0	3	15.0
Per capita income (MS)
	< 1.5	55	79.7	14	20.3	0.643
	1.5 to 3.4	31	72.1	12	27.9
	= 3.5	12	75.0	4	25.0
Marital situation
	Married	70	79.5	18	20.5	0.355
	Single	16	66.7	8	33.3
	Divorced/separated/widowed	18	81.8	4	18.2
Diagnosis of chronic illness
	No	82	86.3	13	13.7	0.000
	Yes	22	57.9	16	42.1	0.000
Time in institution
	< 5 years	43	76.8	13	23.2	0.934
	5 to 10 years	20	76.9	6	23.1
	>10 years	39	79.6	10	20.4
Years spent doing on-call night shifts
	< 5 years	30	78.9	8	21.1	0.730
	= 5 years	67	76.1	21	23.9
Overtime in on-call shifts/week
	<12 h	8	66.7	4	33.3	0.622
	12 to 36 h	79	79.0	21	21.0
	> 36 h	13	76.5	4	23.5
Satisfaction with work
	Satisfied	80	81.6	18	18.4	0.033
	Not satisfied	21	63.6	12	36.4
Satisfaction with life
	Satisfied	94	81.7	21	18.3	0.002
	Not satisfied	7	46.7	8	53.3
Social support
	High	57	87.7	8	12.3	0.009
	Low	47	69.1	21	30.9

Model	Demand-control quadrants	OR	CI 95%
Model 1 ? Not adjusted	Low strain	1	-
	Active work	2.000	0.250 ? 15.991
	Passive work	2.571	0.513 ? 12.892
	High strain	7.846	1.638 ? 37.589
Model 2 = Model 1 + Age + Chronic illness	Low strain	1	-
	Active work	2.366	0.286 ? 19.584
	Passive work	2.038	0.391 ? 10.630
	High strain	7.119	1.439 ? 35.213
Model 3 = Model 2 + Satisfaction with work	Low strain	1	-
	Active work	2.034	0.241 ? 17.192
	Passive work	1.517	0.279 ? 8.232
	High strain	5.297	1.028 ? 27.299
Model 4 = Model 3 + Social Support	Low strain	1	-
	Active work	1.713	0.199 ? 14.772
	Passive work	1.271	0.225 ? 7.177
	High strain	4.303	0.814 ? 22.734

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Mariza Miranda Theme Filha Escola Nacional de Saúde Pública Rua Leopoldo Bulhões, 1480, sala 813 Bairro Manguinhos CEP: 21041-210, Rio de Janeiro, RJ, Brasil E-mail: marizatheme@hotmail.com