Occupational stress of professional and enrolled nurses in South Africa
Aucamp, Johanna Maria
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Occupational stress of nurses has been widely researched, for example in specific health care units - intensive care, specific conditions - cancer. Personal characteristics like emotional involvement and depersonalisation of patients are also suggested as stressors for nurses. In South Africa the Department of Health has made a number of changes since 1994. One of the changes involved the restructuring of the different departments to unify the fragmented health services. No comparison study was found for professional and enrolled nurses. The objectives of this study were to determine the construct validity and internal consistency of the Nursing Stress Indicator (NSI) and to identify differences between occupational stressors of professional and enrolled nurses. A cross-sectional survey design was used. An random sample of professional nurses (N = 980) and enrolled (N = 800) nurses of seven of the nine provinces of South Africa were used. The NSI was developed as measuring instrument and administrated together with a biographical questionnaire. Descriptive statistics and inferential statistics were used to analyse the data. Five internally consistent factors were extracted. The first factor was labelled Stress: Patient Care. It relates to stress because of the care nursing staff provide to patients. The second factor was labelled Stress: Job Demands, and refer to the demands associated with the work of the nurse. The third factor indicated a lack of support in the organisation as well as from supervisors and colleagues, and was labelled Stress: Lack of Support. The fourth factor was labelled Stress: Staff Issues, because it included item loadings on things like shortage of staff, and fellow workers not doing their job. The fifth factor contains items concerning working hours, especially overtime, and was labelled Stress: Overtime. The results indicated that a difference in stress levels exists between professional and enrolled nurses. Professional nurses' severity for the different stressors are higher on all five the extracted factors than those of the enrolled nurses. The sources of occupational stress for professional and enrolled nurses were almost the same. One source of stress for professional nurses that the enrolled nurses did not experience is management of staff. Professional nurses (compared with enrolled nurses) obtained practically significant higher scores on two stressors, namely stress because of making a mistake when treating a patient and stress because of disagreement with medical practitioners or colleagues concerning the treatment of a patient. Recommendations for future research were made.