Nurses' representations of the perceived causes of work-related stress: a network drawing approach

Abstract

This paper reports a study, involving a network drawing approach, that examined how nurses perceive the interrelationship between causes of workplace stress. Network analysis originated in sociology as a method of examining the relationship between people, objects or events. It has recently been adapted to examine participants' perceptions of the relationships between causes of a phenomenon, either by asking participants to complete a grid rating the strength of all the possible links between causes or by getting them to draw a diagram of the links that they think are important. The network drawing technique, in which participants are asked to draw a diagram indicating perceived causal links between nominated causes of stress and also to indicate the strength of these links, was employed in this study. The causes of stress were taken from a previous study in which nurses kept a diary for one week detailing stressful events and their causes. There were 48 participants in the present study and the main results confirmed the importance of staffing levels and inadequate support as perceived direct causes of stress. The study also revealed the importance of indirect links between staffing levels and other causes of stress. The networks illustrate how direct and mediating causes of stress are connected and lie largely outside nurses' control. The results are discussed in relation to other recent work on the causes and experience of stress by nursing staff.