RESUMO
Background: Nurses are facing unprecedented amounts of pressure because of the ongoing global health challenges. Improving nurses' resilience to job-related stress and enhancing their strategies to cope effectively with stressors are key issues facing many health care institutions during the COVID-19 pandemic. This literature review aimed to: a) provide a thorough overview of individual-level interventions for stress management among nurses, b) identify measurement tools utilized to evaluate nurses' stress level, and c) provide the best evidence-based recommendations for future research and practice adapted to the current restrictions. Design: Systematic review. Data Sources: Studies published between January 2000 and October 2020 were retrieved from the following sources: EBSCOhost, Dortmund University Library, PubMed, Medline, Google Scholar, Applied Nursing Research, and reference lists from relevant articles. Review methods: Individual-level interventions with a control group or a placebo intervention were included in the final sample. Primary outcome was defined as a change in individual stress level or stress symptoms which were measured by objective or subjective instruments with evidence of validity. Articles published in English or German were included in the present review. Results: In total, 27 relevant studies were included into the current review. There are some indications that technology-delivered interventions with relaxation and stress management interventions comprising cognitive-behavioral components might be effective in decreasing stress among nurses and improving their well-being. Furthermore, although there were some attempts to collect objectively measured parameters for assessing the primary outcome of stress, the majority of the interventions utilized self-reported stress scales. Conclusion: A wide range of interventions are available for nurses. However, it is of utmost importance to develop and implement stress management programs that are conveniently accessible in the workplace and above all, meet the current restrictions for minimizing human contacts. To this end, innovative interventions delivered through digital technology, such as virtual reality, seem to be a promising solution for combating the detrimental impact of stress on nurses. Special attention should be also paid to applying standardized objective measurement tools to allow the assessment of sensitive physiological indices and the generalizability of scientific knowledge.
RESUMO
The theoretical framework of interactive work provides a multi-dimensional perspective on the interpersonal demands of nurses in nurse-patient interactions. It is defined by four dimensions: emotional labor directed to the self and others, cooperative work, and subjective acting. While the framework stems from qualitative research, the aim of the current study is to translate it into a quantitative scale to enable measurement of the high interpersonal demands that so often remain implicit. For this reason, we conducted an online survey study (N = 157; 130 women, 25 men, 2 divers) among professional nurses in Germany (spring 2021) to test the derived items and subscales concerning interactive work, which resulted in a 4-factor model that was verified with confirmatory factor analysis (CFA). The survey further captured additional information on established constructs concerning job-related well-being (e.g., burn out, meaningfulness), job characteristics (e.g., work interruptions, time pressure) and individual resources (coping strategies) that are supposed to correlate with interactive work demand scales for nurses (IWDS-N), to determine the quantitative nature of their relations. The results show that the subscales of the IWDS-N have adverse effects on indicators of work-related well-being. Moreover, negative job characteristics, such as time pressure, are positively correlated with subscales of the IWDS-N and are therefore problem-focused coping strategies as an individual resource. The results emphasize that a multidimensional consideration of self-regulatory processes is useful to capture the subtle and complex nature of the interactive work demands of nurses. The current study is the first that developed a quantitative, multi-dimensional measure for interactive work demands, which can help make implicit demands in service work explicit.