Relationship between Emotional Labor and Job-Related Stress among Hospital Nurses

Abstract

To clarify the effects of factors of emotional labor, defined as the suppression of own emotions to better maintain other peoples' emotional conditions, on job-related stress responses among hospital nurses, the relationship between emotional labor and job-related stress was analyzed. A self-reported questionnaire was distributed among 147 nurses of five hospitals in Japan. Complete answers were collected from 123 nurses (83.7%, 107 females and 16 males). Emotional labor was assessed by the Emotional Labor Inventory for Nurses (ELIN) (26 items), which consisted of five subscales, i.e., "suppressed expression," "surface adjustment," "deep adjustment," "exploring and understanding" and "expression on caring." Job-related stress was evaluated using the Brief Job Stress Questionnaire (BSQ) consisting of 57 items. Stepwise multiple regression analysis was performed to examine the relationships of stress responses (BSQ) with ELIN and job stressors (BSQ). Subjects working in an inpatient department showed significantly higher total ELIN scores than those working in an outpatient department. The stepwise multiple regression analysis showed the following: Scores on "anger" and "fatigue" in BSQ positively related to "suppressed expression" scores in ELIN; those on "anxiety" positively related to "deep adjustment" scores; and those on "depression" positively related to "surface adjustment" scores. Similarly, scores on negative stress responses (BSQ) such as "anger," "fatigue," "anxiety," "depression," and "somatic stress responses" positively related to scores on job stressors (BSQ), e.g., physical work load, whereas "vigor" scores positively related to "job worthwhileness" in BSQ. The aspects of "suppressed expression," "deep adjustment," and "surface adjustment" of emotional labor seem to be the major occupational stressors for nurses, as well as job-related stressors measured by BSQ. Working in an inpatient department appears to be a potent stressor for nurses.