Work stress among nurses engaged in palliative care on general wards.

OBJECTIVE: The objective of the present study was to elucidate the work stress among nurses engaged in palliative care on general wards. The relationship between nurses' psychological characteristics and stress was the particular focus of this study in order to clarify the actual stress situation. METHODS: Nurses with ≥3 years of experience in palliative care on general wards were surveyed with respect to their personal characteristics, work stress using a scale created by the authors, the Profile of Mood States (POMS) short version, and the Coping Inventory for Stressful Situations (CISS). Correlations between each derived variable and stress were tested. Variables found to be significant were set as independent variables, and multiple regression analysis was performed with overall stress as the dependent variable. RESULTS: A total of 402 nurses participated. The questionnaire response rate was 68.2%, with a valid response rate of 59.7%. The analysis involved 240 participants (96.7% female participants; mean age, 36.2 years old). Tension-Anxiety (POMS), Fatigue (POMS), Confusion (POMS), and Emotion-Oriented Coping (CISS) were the significant variables. On multiple regression analysis with these four variables, the coefficient of determination was R(2) = 0.103, and the coefficient of determination adjusted for degrees of freedom was R(2) = 0.087. Fatigue (POMS) (ß = 0.179, p < 0.05) and Emotion-Oriented Coping (CISS; ß = 0.197, p < 0.05) were found to be significantly related to stress among nurses providing palliative care on general wards. CONCLUSIONS: The stress among nurses engaged in palliative care on general wards can be predicted by the degree of 'fatigue' and 'emotion-oriented coping'. Mechanisms to address these issues are needed.

Creation of a questionnaire to measure stress among nurses engaged in palliative care on general wards.

PURPOSE: This study was conducted to create a questionnaire that measures stress among nurses engaged in palliative care on general wards. METHODS: Nurses with at least 3 years of experience involved in palliative care on a general ward in six facilities in Japan were the subjects from September 7 to October 4, 2004. A draft questionnaire on stress factors and conditions of stress in nurses engaged in end-of-life care was created, and question items and content meaning were revised to produce 32 question items, with a four-point Likert scale for the responses. Two pretests were conducted. Internal validity was investigated and resulted in 31 question items. Factor analysis using the principal factor method (Varimax rotation) was performed, and Cronbach's coefficient alpha was used to evaluate internal consistency and check reliability. RESULTS: The survey response rate was 94%, with a valid response rate of 98%. Analysis was conducted using responses from 269 participants, of whom 98.9% were female, with a mean age of 35.4 years. The mean length of experience as a nurse was 13.6 years, and the mean length of experience in cancer nursing was 8 years. Results of factor analysis produced eigenvalues of 5.260-1.558 and a cumulative proportion of 58.032%. After two items were deleted, six stress-related factors were identified; their alpha coefficients were 0.753 to 0.912, ensuring high reliability. CONCLUSIONS: The questionnaire developed had high internal validity and high reliability, and it can thus serve as a first stage in elucidating stress among nurses engaged in palliative care on general wards.