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