Expanded Nursing Stress Scale Research Articles

ASSESSMENT OF WORKPLACE DIFFICULTIES FACED BY NURSES WORKING IN TERTIARY CARE HOSPITAL

Occupational stress among nurses in government hospitals is a significant concern, impacting individual well-being and patient care quality. This study aimed to assess the prevalence of stress and its contributing factors among nurses in three government hospitals. This study aimed to evaluate the prevalence of stress among nurses in government hospitals and identify the factors contributing to their stress levels. A cross-sectional study involved 400 nurses from tertiary care Hospital. Demographic and workplace data were collected using a self-administered questionnaire, and stress levels were assessed using the Modified Expanded Nursing Stress Scale (ENSS). Most participants were female (70%) and aged between 25 and 35 (55%). Sixty per cent of nurses held a Bachelor's degree, and 40% had a diploma in nursing. Heavy workload was the most common stressor reported (70%), followed by long working hours (60%) and poor working relationships (45%). Binary logistic regression analysis revealed that female nurses were 1.5 times more likely to experience stress than males (p < 0.05). Nurses working more than 40 hours per week had a 1.3 times higher likelihood of experiencing stress (p < 0.05), and those with less than six years of job experience were 1.8 times more likely to report stress (p < 0.05). The study highlights a high prevalence of stress among nurses in government hospitals, primarily attributed to heavy workloads, long working hours, and poor working relationships. Addressing these factors through targeted interventions is crucial to improving the well-being of nurses and enhancing patient care quality.

Validity and reliability of the Indonesian version of Expanded Nursing Stress Scale (ENSS) as a job-stress assessment tool for nurses

Validity and reliability of the Indonesian version of Expanded Nursing Stress Scale (ENSS) as a job-stress assessment tool for nurses

Occupational Stress of Pediatric Emergency Nurses in Greece During the COVID-19 Pandemic.

During the COVID-19 pandemic, numerous studies have shown the high prevalence of occupational stress (OS) of health workers, affecting the quality of health care provided. To date, there is no study regarding OS of emergency care pediatric nurses working in Greece. This study aimed to examine the pediatric nurses' OS working in tertiary public hospitals in Greece. In this cross-sectional study, a total of 104 pediatric nurses were recruited randomly from summer 2020 to summer 2021. The Expanded Nursing Stress Scale (ENSS), which consists of 59 items grouped into nine categories, was used to assess nurses OS. The overall OS mean score was 141.04 (SD = 33.48), indicating mild stress. Among nine categories, pediatric nurses were more stressed about patients and families (mean = 22.83, SD = 5.71), as well as death and dying (mean = 19.33, SD = 5.22), whereas they were less stressed about discrimination (mean = 4.21, SD = 4.09) and problems with peer support (mean = 12.11, SD = 4.58). Sex, age, and shifts did not correlate with OS. Borderline correlation was present between age and inadequate emotional preparation for less experienced nurses (p = 0.047), while higher educated pediatric nurses were more stressed because of workload than lower educated pediatric nurses (p = 0.044). Greek pediatric nurses suffered mild OS during the COVID-19 pandemic. There is a great need for further research and implementation of supportive sustainable programs aimed to the minimization of OS and the optimization of health care provided during and after the COVID-19 pandemic.

HUBUNGAN STRES KERJA DENGAN KUALITAS KEHIDUPAN KERJA PERAWAT DI RSUD dr. R. GOETENG TAROENADIBRATA PURBALINGGA

Introduction: Quality of work life is something that a person achieves in his work. When workers' needs fulfilled, it will have a positive impact on increasing organizational productivity. Work stress, in this case, is an environmental change that causes tension that excessively affects physical and psychological conditions. The aim of this research is to understand the relationship between work pressure and the quality of work life that occurs among nurses who work at RSUD dr. R. Goeteng Taroenadibrata Purbalingga.
 Methods: Quantitative method with a cross sectional approach. The respondents in this study were 96 nurses who met the inclusion criteria. This research uses a probability sampling method that has been adjusted proportionally with the stratified random sampling technique. The reference used in this research is the Expanded Nursing Stress Scale and Quality of Work Life. The statistical analysis used is the Spearman Rank test.
 Result: The results obtained from data collection shown that the work stress experienced by nurses was mostly in the moderate category (62.5%), and the quality of work life of the nurses was mostly in the high category (53.1%). The result of the overall data analysis is that there is a relationship between work stress and the quality of work life for nurses with a p value of 0.026 (p<a).
 Conclusion: There is a relationship between work stress and the quality of work life for nurses at RSUD dr. R. Goeteng Taroenadibrata Purbalingga.

Occupational Stress and Professional Quality of Life Among Community Health Nurses During the COVID-19 Pandemic.

Purpose: This study aimed to identify the correlation between occupational stress and professional quality of life (Pro-QOL) among community nurses during the pandemic COVID-19. Design: This study was conducted with a correlational design of 120 community health nurses. The research sample was obtained using a nonprobability purposive sampling technique following the research inclusion criteria. Expanded Nursing Stress Scale and Pro-QOL were used in this study. The research hypothesis: there is a correlation between occupational stress and the Pro-QOL of community health nurses. Methods: Pearson's correlation coefficient was used to analyze the correlation between occupational stress and Pro-QOL. Findings: The results of correlation analysis showed that there was a statistically significant positive correlation between occupational stress and Pro-QOL. Despite being in a difficult situation due to the pandemic and vulnerable to occupational stress, nurses significantly had high compassion satisfaction. Conclusions: Occupational stress affects nurses' Pro-QOL, it can be considered for public healthcare organizations to promote healthcare workers' well-being. Mobilizing the existing workforce, changing work patterns, support from colleagues and supervisors, clear communication of directives, and precautionary measures can reduce psychiatric symptoms.

The Cross-Cultural Adaptation and Validation of the Polish Version of the Expanded Nursing Stress Scale Tool

Background. Nursing is considered one of the most stressful occupational groups. Work-related stress is a major health risk for workers worldwide. Therefore, it is critical to continually monitor nurses’ stress levels based on important aspects of nurses’ work identified as stressors. Methods. A total of 331 nurses participated. The cross-cultural adaptation of the instrument was carried out based on six of the seven steps proposed: forward translation of ENSS, comparison of the two translated versions, blind back translation, comparison of the two back-translated versions of ENSS, pilot testing of the prefinal version of ENSS, and full-psychometric testing of the prefinal version of the translated instrument. The reliability of the scales was estimated using Cronbach’s alpha and McDonald’s omega internal consistency coefficients. Results. The results indicate that each of the distinguished subscales is unique, but at the same time, they are all related to each other as different dimensions of stress. Conclusions. The Polish version of the ENSS tool is a valid and reliable tool for assessing the level of stress experienced by nurses.

Self-Perceived Work Stress between Emergency Department Nurses and General Wards Nurses

Background: Nursing profession is a very stressful profession and mounting evidence indicates that it may be on the rise in death and dying, conflict with physicians, inadequate emotional preparation, problems relating to peers, problems relating to supervisors, workload, uncertainty concerning treatments, 8) patients and families and, discrimination especially among nurses who work in emergency department nursing. The current study aimed to assess self-perceived work stress between emergency department nurses' (ED) and general wards nurses (GW). Method: The study was conducted by selecting a non-probability (purposive) sample. Ninety six nurses included in the current study; (48) work in emergency department and (48) in general ward. By interviewing each nurse, we prepared a draft of 57 items within nine domain (Expanded Nursing Stress Scale) questionnaire. Results: The assessment of stress was moderate for both ED nurses and GW nurses with mean of scores (2.00 and 2.47) respectively. The mean difference was high statistically significant (p-value <0.0001). Conclusion: ED nurses reported a high level of occupational stress compared to GW nurses.

Occupational stress and coping strategies of the nursing staff of a Public University Hospital during the COVID-19 pandemic

Background & Aim: Nursing staff are exposed to high-stress levels daily due to the demanding work environment. This study examined nursing staff occupational stress and coping mechanisms during the COVID-19 pandemic.‎
 Methods & Materials: A cross-sectional study with a sample of 108 nursing staff was carried out. The Expanded Nursing Stress Scale (ENSS), the Brief Coping Orientation to Problems Experienced (Brief COPE) Scale, and constructed questions were used for data collection. Data were analyzed using chi-square (χ2), Pearson methods, and Multiple linear regression analysis. Statistical significance was determined at p-value ≤ 0.05.
 Results: Overall Occupational stress was assessed with a mean score of 146.8 (SD±35.3). In Brief COPE Scale, a higher mean was assessed for “social support - information seeking” and lower for “substance use” or “withdrawal” (p<0.001). A significant difference in response distributions was observed regarding their degree of concern or fear about COVID-19 (p<0.01). Increased levels of Overall Occupational Stress (ENSS) were associated with higher levels of BCOPE. Emotional Focus and Venting and Diffusion of Emotions (β=5.15, p=0.026), younger age of the participants (β=-5.78, p=0.033), years of working in the healthcare sector (β=14.46, p=0.004) or the highest fear/concern about being infected and infecting their patients (β=6.22, p=0.032).
 Conclusion: Nursing staff experienced moderate levels of occupational stress, while challenges raised by the pandemic were handled through seeking social support, positive reframing and acceptance, taking protective measures, and turning to religion. Developing meaningful administrative and educational strategies for staff empowerment and resilience may reduce anxiety and occupational stress for nurses.

Emotional Intelligence And Nurses’ Occupational Stress

Nurses are health workers dealing with patients, dealing with patients whose illnesses vary and work demands can be a strong source of stress for nurses at work, so emotional intelligence is needed. The purpose of this study was to determine the relationship between emotional intelligence and the level of occupational stress of nurses at the X Hospital Lamongan. This study used a cross-sectional method with a correlational analytic design using a cluster sampling technique to get 43 respondents. Research data was taken using a closed questionnaire for emotional intelligence and an ENSS (Expanded Nursing Stress Scale) questionnaire to measure occupational stress. This research showed that the emotional intelligence of nurses had high, 23 nurses (53.5%) and almost the majority of nurses had moderate occupational stress, 23 nurses (53.5%). This study used the Spearman rank test with a value of p= 0,000 and obtained a value of rs= 0,581, which means there is a relationship between emotional intelligence and occupational stress of nurses at the X Hospital Lamongan. Based on the research, it is hoped that nurses can add insight and knowledge regarding emotional intelligence so that it is not affected by occupational stress and nursing care providers in accordance with SOP (Standard Operating Procedures).

Psychosocial Problems among Psychiatric Nurses for Caring Patients with Mental Disorders during the COVID-19 Pandemic.

COVID-19 has a negative effect on the psychological well-being of psychiatric nurses. Thus, examining the psychosocial response of nurses is important for preventing more serious mental health problems and disruption of the quality of nursing care. This study aimed to evaluate the psychosocial problems of nurses who provided nursing care to patients with mental health disorders during the COVID-19 pandemic. A quantitative study with a cross-sectional design was conducted. The 101 nurses at Central Mental Health Hospital who provide nursing care to patients with mental health disorders were recruited through consecutive sampling. The instruments used were the demographic questionnaire, the Expanded Nursing Stress Scale, Zung Self-Rating Anxiety Scale, and The Connor-Davidson Resilience Scale 25. Univariate and bivariate analyses were used to process the data. The mean score of 45.1 (±24.3) was obtained for the ENSS; around 97% of nurses have a work stress score below the average, 4.95% have mild-moderate anxiety, and 28.7% have a low level of resilience. Work stress and contact frequency, work stress and gender, anxiety and contact frequency, as well as resilience and contact frequency all correlated significantly (p value <0.05). The Pearson test showed a significant positive correlation between work stress and anxiety (p: 0.002, r: 0.299). However, there was no significant correlation between anxiety and resilience (p: 0.643, r: 0.47), nor between work stress and resilience (p: 0.643; r: 0.47). Psychosocial disorders that psychiatric nurses face include occupational stress, mild-moderate anxiety, and low resilience. The government can create specific infection control guidelines for the mental health setting, and hospital management or ward leaders can also provide support to psychiatric nurses to increase resilience in reducing psychosocial problems.

Occupational stress and associated factors among nurses working at public hospitals of Addis Ababa, Ethiopia, 2022; A hospital based cross-sectional study.

By its very nature, the nursing profession involves a lot of stress. Working in this field includes interacting with individuals who are already under a great deal of stress. Workplace stress affects the quality of services provided and also causes staff burnout, departure, and absenteeism. This study is to determine occupational stress and associated factors among nurses working at public hospitals, Addis Ababa, Ethiopia, 2022. An institutional based cross sectional study was conducted among 422 nurses working at public hospitals from March 1 to April 1/2022. Simple random sampling technique was used to select public hospitals. The calculated sample size was allocated proportionally to each hospital based on the number of nurses. Finally, systematic sampling method was used to approach the study participants. The data was collected by using a self-administered structured questionnaire (Expanded Nursing Stress Scale). The collected data was entered by Epi-data version 3.1 and analyzed by SPSS version 23. Descriptive analysis such as frequency distribution and measure of central tendency and variability (mean and standard deviation) was computed to describe variables of the study. Binary logistic regression was used to assess associations between dependent and independent variables. The degree of associations was interpreted using odds ratio (OR) and 95% confidence interval (CI) and statically significance at value of p < 0.05. The result was presented using text, tables, and graphs. The study finding showed that 198 (47.8%) of nurses were occupationally stressful. Factors significantly associated with occupational stress among nurses were having children (no: AOR = 0.46, 95% CI: 0.22, 0.96) and work shift (rotating: AOR = 2.89, 95% CI: 1.87, 4.45). In this study, job stress affected over half of the nurses. The presence of children and respondents' work shifts were personal characteristics that were significantly linked to job stress. Therefore based on this result the government policy makers, different stakeholders and hospitals need to collaborate to reduce nurses job related stress.

Investigating the impact of written emotion disclosure on the level of occupational stress among intensive care nurses.

The present study was conducted with the aim of determining the impact of rewriting pleasant events on the level of occupational stress in Intensive Care Unit (ICU) nurses. This is a quasi-experimental research conducted on nurses working in the intensive care units of Imam Khomeini and Golestan hospitals in Ahvaz, from July to November 2021. Seventy-six nurses were selected based on the inclusion criteria, and were then randomly assigned to the intervention and the control groups. The nurses' demographic information form and the Expanded Nursing Stress Scale (ENSS) were used to collect data. In the intervention group, the technique of rewriting pleasant events was used for 8 weeks, at least once a week. The data was analyzed with SPSS V20. No significant difference in the demographic characteristics was observed between the intervention and the control groups (p > 0.05). The pre-intervention occupational stress of the nurses in the intervention and the control groups were reported to be 173.86 ± 26.75 and 173.05 ± 24.47, respectively, showing no statistically significant difference (p = 0.89). After the intervention, the occupational stress scores were 134.21 ± 16.09 and 172.36 ± 24.33, respectively, showing a significant difference between the two groups (p < 0.001). Considering the impact of rewriting pleasant events on the level of occupational stress of ICU nurses, it is recommended that nursing managers and nurses plan training programs for nurses in this area, and encourage other nurses to do so, too. It is also suggested to implement this intervention on the nurses of other wards as well.

Nurse Staffing Factors, Fatigue, and Work-related Stress among Emergency Department Nurses During COVID-19 Pandemic

Aims : This study aimed to examine the relationship between nurse staffing factors, fatigue, and stress among emergency department (ED) nurses during pandemic. Design : Descriptive, correlation, and cross sectional approach. Methods : Using cross-sectional design, a total of 113 ED nurses in Indonesia selected by convenience sampling completed the survey on the Fatigue Severity Scale (FSS) and the Expanded Nursing Stress Scale (ENSS). Data analysis included descriptive statistics and bivariate analysis. Results : Nurse staffing factors were not significantly associated with stress (r = -0.07-0.16, p &gt; 0.05). Fatigue correlated with the domain of death and dying (r = 0.19, p &lt; 0.05), problems relating to supervisors (r = 0.19, p &lt; 0.05), workload (r = 0.26, p &lt; 0.01) and patients/families (r = 0.25, p &lt; 0.01), and overall stress (r = 0.21, p &lt; 0.05). Conclusions : The more severe fatigue the emergency nurses suffered, the worse stress they experienced. The workload and rotation of nurses during pandemic should be readjusted in accordance with current hospital situation. Identification of basic needs during the pandemic such as ensuring the supply of personal protective equipment (PPE) may help to reduce stress and to maintain the service quality in ED. Organizing counseling programs and support group through online meetings can help nurses to share their difficulties and experiences and to prevent them from feeling isolated.

Prevalence of Job Stress and Presenteeism among Nurses in Hospitals of Hafr Al-Batin City, Saudi Arabia

Currently, both job stress and presenteeism are critical problems. Job stress carries enormous costs for healthcare workers and nurses in terms of overall wellbeing, presenteeism, and turnover, which in turn affect the quality of patient healthcare services. The objectives of this research were to uncover the extent of presenteeism and job stress among nurses in hospitals in Hafr Al-Batin, a city in the Kingdom of Saudi Arabia. A descriptive, correlational, cross-sectional study was conducted. The study sample included 146 nurses working in Hafr Al-Batin hospitals. Data were collected from May to June 2020. For analysis, the researcher used two tools, the Expanded Nursing Stress Scale (ENSS) and the Stanford Presenteeism Scale-6 (SPS-6). The data was subsequently analyzed by descriptive statistics and Spearman’s correlation coefficient. Study results showed that the mean values of job stress and presenteeism were both high. Furthermore, there was a relationship between the overall presenteeism and overall job stress experienced among staff nurses. The results of this research would aid both nursing administrators and hospital managers in designing effective strategies to reduce job stress and manage presenteeism among staff nurses in the hospitals of Hafr Al-Batin.

B Vitamins, work-related stress and emotional mental disorders: a cross-sectional study among nurses in Indonesia.

AimThe aim of this study was to examine the relationship between intake of vitamins B1, B6, B9 and B12 with emotional mental disorders among nurses in Indonesia.DesignThis cross‐sectional study included nurses who have worked at least six months at a private hospital in Indonesia from March to April 2021.MethodsWe used the Food Frequency Questionnaire, Self‐Reporting Questionnaire 20 and the Expanded Nursing Stress Scale questionnaire to assess the B‐vitamin intake, emotional mental disorders and work‐related stress.ResultsOf 80 interviewed nurses, 8.8% experienced severe work‐related stress, and 22.5% had emotional mental disorders. Most nurses had inadequate intake of vitamins B1 and B9 but had adequate intake of vitamins B6 (72.5%) and B12 (56.3%). Emotional mental disorders are more probably to occur in nurses with less intake of vitamins B6 and B12, with respective aOR of 20.06, 95% CI 4.14–97.09 (p < .001) and 4.49, 95% CI 1.19–16.83 (p = .026).

Association between Occupational Stress and Psychopathological Symptoms Among Nurses in Cardiovascular Hospital During COVID-19 Pandemic

Introduction: Occupational stress is known to be one of the factors that are often found in nursing professionals. Occupational stress can affect a person both physically and mentally. Moreover, the COVID-19 pandemic has brought additional workload for healthcare professionals, including nurses. This study aimed to analyze the association between occupational stress and psychopathological symptoms among nurses in Cardiovascular Hospital during the Covid-19 pandemic. Methods: This cross-sectional study involved 108 nurses in Cardiovascular Hospital X. Samples were taken by simple random sampling based on inclusion and exclusion criteria. Occupational stress was assessed by Expanded Nursing Stress Scale (ENSS) and psychopathological symptoms were assessed by Symptom Checklist 90 (SCL-90). Results: The mean ENSS total score was 88,17 ± 32,24 (maximum score of ENSS was 228). 19,4% of nurses had psychopathological symptoms. Somatization, obsessive-compulsive, and psychoticism had higher t-score values than other SCL-90 subscales. There was a strongly significant association between occupational stress and psychopathological symptoms (p&lt;0,001). Conclusion: Its highly recommend early diagnosis and prompt treatment for psychopathological symptoms among nurses. Monitor and evaluation of occupational stress and psychopathology in nurses are recommended as periodic medical check-up program in hospital.

Comparing the Effect of Resilience Skills Training and Metacognitive Therapy on Job Stress in Nurses: An Experimental Study.

Nursing is one of the stressful professions. The work-related stressful factors have affected the physical and mental health of nurses seriously. This study aimed to compare the effect of resilience skills training and metacognitive therapy on nurses' job stress. This experimental study was conducted on 54 nurses working in intensive care units and the emergency department of Valiasr Hospital, Birjand, Iran, in 2018. Selected participants were allocated via permuted block randomization into three groups: resilience skills training, metacognitive therapy, and control (n = 18 for each group). Both resilience and metacognitive therapy programs were held in eight sessions of 45-mintraining classes twice a week. The control group received no intervention. The data were collected using a demographic characteristics form and the Expanded Nursing Stress Scale (ENSS) before, immediately after, and one month after the intervention. The data were analyzed using Chi-square, Fisher's exact test, Analysis of Variance (ANOVA), and repeated measures ANOVA in the Statistical Package for Social Science (SPSS) software. Job stress significantly decreased in both resilience (F2,51 = 123.5, p < 0.001) and metacognitive therapy (F2,51= 29.2, p = 0.002) groups over time. However, this decrease was not significantly different between the two groups (p > 0.05). Also, the control group's job stress mean score increased over time (F2,51 = 9.35, p < 0.001). The findings suggest that both resilience skills training and metacognitive therapy can reduce the job stress of emergency and intensive care nurses. Therefore, it is recommended that both programs be taken into account by managers to reduce nurses' job stress.

Fear of COVID-19, Nurse’s Stress, and Health Care Behaviors toward Elderly People

Abstract: Elderly people are the most vulnerable group for high morbidity and mortality from Covid-19 and need high effort to meet their health needs. As nurses are at the front of fighting this pandemic in all geriatric settings, they have faced stress and fear of corona which can affect the provided elderly care. Therefore, this study aimed to explore nurses' fear of Covid-19 and stress, and their relations to health care behaviors towards elderly people. Research design: A cross-sectional research design was conducted on 185 nurses from ten governorates of Egypt, who completed an online questionnaire distributed through Google forms from September 2020 to February 2021. Tools: Demographic characteristics, added to, three research instruments were used: (1) The Expanded Nursing Stress Scale (ENSS), (2) The Fear of COVID-19 Scale (FCV-19S), and (3) The Caring Behaviors Inventory (CBI). Results indicated that 41.0 % of the studied nurses had a mild level of fear of COVID-19. Besides, there was a significantly positive association between nurses' Fear of COVID-19 and stress (r=.77, p

Effect of anuloma and viloma pranayama on stress of nurses

Background: Nurses are an integral component of the health care delivery system. Nurses encounter a variety of stressors while discharging their duties. Mind-body interventions are beneficial in stress-related mental and physical disorders. Yogic breathing is a unique method for influencing psychological and stress-related disorders. Aim: To evaluate the effect of Anuloma and Viloma Pranayama on stress among nurses. Method and Materials: A pre experimental one group pretest posttest design was adopted for study. 296 female nurses were selected using nonprobability purposive sampling technique. Modified Expanded Nursing Stress Scale (ENSS) was used to measure the stress of clinical nurses. The pre test stress level was evaluated on the day 1 and then the CD of video-assisted intervention on anuloma and viloma pranayama was distributed among participants and were instructed to perform anuloma and viloma pranayama for six months and post test stress level was evaluated on day 180. Result: Result revealed that major nursing stress factors causing stress to the participants were economical and professional growth stressors, direct patient care, patient and family stressors and workload stressors, caused significantly higher stress among participants. Overall mean pre-test stress value was 106.12 ± 26.34, while the mean post-test stress value was 70.48 ± 15.18. After the intervention, a statistically significant decrease in the stress level was seen in nurses and the difference was found to be statistically significant (P<0.05). Conclusion: The video-assisted intervention of anuloma and viloma pranayama used in this study was effective in reducing stress of clinical nurses.

Investigate Stressors Levels and Identify Coping Strategies of Frontline Nurses during the COVID-19 in Sharjah Primary Health Center—A Quantitative Research Study

During the COVID-19 Epidemic, nurses are usually informed of emotional exhaustion, increased workloads, and uncertainty, leading to burnout. Consequently, psychological health initiatives are essential to support nurses during a pandemic. This project aims to investigate the stress levels and identify the Coping Strategies of Nurses during the COVID-19 Epidemic in Sharjah Primary Health Center, as they are always at the front line of this epidemic. The nature of their work, they are mainly infected and spread the virus amongst colleagues and family. The target population is nurses working in Sharjah primary health centers, and the number sample is 230. The researcher sent the survey through the link. And in this research, we used two instruments which include the Expanded Nursing Stress Scale and The Coping Strategies Scale (CSS). This study shows that the most stressful factor is related to workload, especially related to unpredictable staffing and scheduling. On the other hand, the most coping strategies were those that were associated with Meaning-focused Coping Strategies, especially believing that valuable lessons can learn from undesirable experiences.