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Occupational stress among hospital nurses in Gaza-Palestine

Al Hajjar, Bashir

[Thesis]. Manchester, UK: The University of Manchester; 2013.

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Abstract

Background: Occupational stress in nursing is common worldwide; with rates of 9.20%-68.0% of nurses suffering from stress being reported in the worldwide literature. This thesis reports an investigation into stress among hospital nurses in Gaza Strip-Palestine. The purpose of this study was to determine the prevalence of occupational stress among hospital nurses in Gaza-Palestine and explore possible causal occupational stressors. Method: A quantitative survey design was employed, with a self-administered questionnaire pack being the data collection technique. Data were collected on psychological distress (GHQ-12), depression (SLC-D), sources of stress (NSS), trauma (IES-R) and demographic variables. Open questions were used to enable participants to describe their experiences of stressful events and enable the researcher to collect more in-depth information regarding some aspects of the stress domains. Data were analysed by SPSS using a variety of descriptive and inferential statistical methods: T-test, one way ANOVA and logistic regression were employed.Sample: The study population is the entire cohort of nurses who were working in the 16 hospitals in Gaza (1801 nurses; 985 males) during the period August 2009 through March 2010. Because of difficulties in access, only 1500 were able to receive questionnaire packs and 1133 were completed and returned (response rate=75.53%). Results: The results of this study revealed a high prevalence of psychological distress (63%, GHQ-12 cut-off=6), depression (59.7%, SCL-D cut-off=1.5) and trauma (69.4%, IES-R cut-off=35). The most severe occupational stressors were: ‘Not enough staff to adequately cover the unit’, ‘Lack of drugs and equipments required for nursing care’ and ‘Unpredictable staffing and scheduling’ respectively. The most frequent occupational stressors were: ‘Not enough staff to adequately cover the unit’, ‘Watching a patient suffer’ and ‘Lack of drugs and equipments required for nursing care’ respectively. As subscales, ‘Workload’ and ‘Death and dying’ were the most frequent and severe occupational stressors.Psychological distress was significantly associated with gender, age, experience, night shifts and extra-work. Depression was significantly associated with gender, hospital type, age, night shifts, experience and marital status. Severity of occupational stressors was significantly associated with age, night shifts, specialisation and qualifications. Frequency of occupational stressors was significantly associated with hospital type, experience specialisation and night shifts. Finally, trauma was significantly associated with hospital type, experience and night shifts. The predictors of psychological distress caseness (GHQ-12) were: depression caseness, uncertainty about treatment (severity), experience and qualifications of nurses. Protective factors were: extra work and experience of more than 15 years. Conclusion: Being a nurse in Gaza hospitals appears to be a stressful experience. More attention should be focused to develop an effective programme to reduce stress levels among Palestinian nurses in Gaza.

Bibliographic metadata

Type of resource:
Content type:
Form of thesis:
Type of submission:
Degree type:
Doctor of Philosophy
Degree programme:
PhD Nursing
Publication date:
Location:
Manchester, UK
Total pages:
289
Abstract:
Background: Occupational stress in nursing is common worldwide; with rates of 9.20%-68.0% of nurses suffering from stress being reported in the worldwide literature. This thesis reports an investigation into stress among hospital nurses in Gaza Strip-Palestine. The purpose of this study was to determine the prevalence of occupational stress among hospital nurses in Gaza-Palestine and explore possible causal occupational stressors. Method: A quantitative survey design was employed, with a self-administered questionnaire pack being the data collection technique. Data were collected on psychological distress (GHQ-12), depression (SLC-D), sources of stress (NSS), trauma (IES-R) and demographic variables. Open questions were used to enable participants to describe their experiences of stressful events and enable the researcher to collect more in-depth information regarding some aspects of the stress domains. Data were analysed by SPSS using a variety of descriptive and inferential statistical methods: T-test, one way ANOVA and logistic regression were employed.Sample: The study population is the entire cohort of nurses who were working in the 16 hospitals in Gaza (1801 nurses; 985 males) during the period August 2009 through March 2010. Because of difficulties in access, only 1500 were able to receive questionnaire packs and 1133 were completed and returned (response rate=75.53%). Results: The results of this study revealed a high prevalence of psychological distress (63%, GHQ-12 cut-off=6), depression (59.7%, SCL-D cut-off=1.5) and trauma (69.4%, IES-R cut-off=35). The most severe occupational stressors were: ‘Not enough staff to adequately cover the unit’, ‘Lack of drugs and equipments required for nursing care’ and ‘Unpredictable staffing and scheduling’ respectively. The most frequent occupational stressors were: ‘Not enough staff to adequately cover the unit’, ‘Watching a patient suffer’ and ‘Lack of drugs and equipments required for nursing care’ respectively. As subscales, ‘Workload’ and ‘Death and dying’ were the most frequent and severe occupational stressors.Psychological distress was significantly associated with gender, age, experience, night shifts and extra-work. Depression was significantly associated with gender, hospital type, age, night shifts, experience and marital status. Severity of occupational stressors was significantly associated with age, night shifts, specialisation and qualifications. Frequency of occupational stressors was significantly associated with hospital type, experience specialisation and night shifts. Finally, trauma was significantly associated with hospital type, experience and night shifts. The predictors of psychological distress caseness (GHQ-12) were: depression caseness, uncertainty about treatment (severity), experience and qualifications of nurses. Protective factors were: extra work and experience of more than 15 years. Conclusion: Being a nurse in Gaza hospitals appears to be a stressful experience. More attention should be focused to develop an effective programme to reduce stress levels among Palestinian nurses in Gaza.
Thesis main supervisor(s):
Thesis co-supervisor(s):
Thesis advisor(s):
Language:
en

Institutional metadata

University researcher(s):

Record metadata

Manchester eScholar ID:
uk-ac-man-scw:189872
Created by:
Al Hajjar, Bashir
Created:
18th March, 2013, 05:11:48
Last modified by:
Al Hajjar, Bashir
Last modified:
10th April, 2013, 11:06:06

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