PREDICTORS OF PSYCHOLOGICAL DISTRESS IN MEDICAL-SURGICAL AND CRITICAL CARE NURSES (WORK, SOCIAL SUPPORT, COPING, STRESS).

Description

The purposes of this cross-sectional predictive study were to: identify stressors, support systems, and coping strategies of Medical-Surgical and Critical Care Nurses (N = 544); determine differences between the two study groups; and, investigate the predictors of psychological distress in these two groups of nurses. The data were gathered using the Nurse Stress Project Questionnaire, consisting of 11 separate instruments, and eight were utilized for the present study. The major finding in work setting included significant differences in type of shift, work pressure, and the presence of demanding patients. Medical-Surgical Nurses worked fewer nights, experienced more work pressure, and worked with more demanding patients compared to Critical Care Nurses (CCU). The two study groups perceived their work stressors differently. Using a qualitative categorization technique to describe the stressor data, the Medical-Surgical Nurses indicated that management of the unit was the greatest source of stress whereas CCU nurses identified interpersonal relationships. Using an item designed to identify sources of work support, both groups of nurses indicated they depended on co-workers for support more than on supervisors, friends, or spouses. The coping strategies instrument revealed differences in coping behaviors used by the two groups. Medical-Surgical Nurses were more likely to employ anticipated coping as a strategy whereas CCU nurses tended to use emotional avoidance and emotional responses more frequently. Findings of the study sample relative to psychological distress measures of anxiety and depression indicated that there were no significant differences. However, there were significant differences on the burnout scales. Emotional exhaustion was experienced more often by Medical-Surgical Nurses. Two hierarchical set multiple regressions were run to predict psychological distress in the total nurse group. A higher percent of explained variance was accounted for in burnout (40%) than was accounted for in anxiety and depression (23%). The common predictors were: work pressure, the presence of demanding patients, occupational insecurity, and the use of emotion-focused coping strategies. Nurses who utilized fantasized actions such as wishing things were different, and conflicted behaviors such as sleeping more than usual, were also more anxious, depressed, and burned-out.

Subjects