Work related stress, burnout, job satisfaction and general health of South African nurses

Abstract

Nurses have been found to experience higher burnout levels compared to other health professionals owing to the nature of their work. High burnout levels among nurses have been attributed to their stressful working environments. Prolonged exposure to work related stress leading to burnout has negative consequences for job satisfaction and general health of nurses. This has wider implications on the health system, such as high turnover rates and compromised patient care. A systematic review was conducted to determine the evidence base concerning the relationship between work related stress, burnout, job satisfaction and general health of nurses. A comprehensive search identified 85 articles (of which 70 were included in the review). Findings demonstrated a significant gap in research focusing on the relationship between work related stress, burnout, job satisfaction and general health of nurses in developing countries, such as South Africa. This evidence gap underpinned the aim of this thesis, which was to study the relationships between work related stress, burnout, job satisfaction and general health among South African nurses over time. This aim was achieved by conducting a study investigating these relationships at baseline and one year later. An evaluation of recruitment methods and measurement tools among South African nurses revealed that issuing reminders in addition to face to face recruitment strategies improved response rates by 10%. Nurses were divided into three groups differentiated by method of recruitment to determine the most successful strategy for increasing response rates. This was an important study for this thesis, as nursing research is often characterised by lower response rates and there is little evidence to inform how best to improve response rates among nurses in developing contexts. The abovementioned recruitment methods were then utilised to recruit nurses from two private and two public hospitals in the Gauteng province of South Africa. A total of 895 nurses participated in the study at baseline and 277 of these individuals were followed up with a year later. Findings showed that although stress related to security risks in the workplace predicts job satisfaction as well as general health, stress related to patient care and nursing shortages better predict job satisfaction and general health over time. Burnout better predicts job satisfaction than general health over time. The significance of this thesis is that it provides empirical evidence explaining the nature of relationships over time between work related stress, burnout, job satisfaction and general health of nurses in a developing context. This is particularly important in the context of a country such as South Africa, where the health system is characterised by high job demands and staffing issues. With limited research informing interventions towards improving the burdened health system, this study can underpin the development of appropriate policy and its implementation in addressing work related stress, burnout and job satisfaction in order to improve the health and wellbeing of nurses. This can be achieved by designing interventions that are aimed at creating better working environments, which will improve job satisfaction and reduce the negative impact of burnout on nurses’ health, thereby enabling quality nursing practice and patient care.