1.4.3 Determinants of affect in working nurses: Contribution of effort reward imbalance, demand and control and clinical concerns (105)
Martyn Jones, Senior Lecturer in Nursing, School of Nursing and Midwifery, University of Dundee, Dundee, Scotland, United Kingdom Co authors: Derek Johnston, Sharon McCann, Lorna McKee m.c.jones@dundee.ac.uk
Abstract:
Background:
Stress and its putative consequences of inefficiency, absenteeism and illness is a major problem in the NHS. A small pilot study using computerised ecological momentary assessment, Johnston, Beedie & Jones (2006) showed that variations in Effort Reward Imbalance (ERI, Siegrist, 1996) and Demand and Control (DC, Karasek 1979) related to a simple 1 item scale of stress experienced.
Aims:
We report on a similar study using a larger sample and more comprehensive measurement clinical concerns and affect.
Methods:
Sixty-eight randomly selected nurses in a large district general hospital in England in 2006 completed individual computerised behavioural diaries. Diaries measured demand, control, reward and 5 scales measuring negative and 4 measuring positive affect. Results were analysed using multilevel modelling (MlwiN). Nurses reported on the range of clinical situations faced by trained nurses. These free text responses where subjected to content analysis.
Results:
Nurses averaged 19.8 diary entries over 3 shifts. ERI: Negative affect increased with effort, reduced with reward and effort and reward interacted as predicted so that high effort and low reward was particularly unpleasant. Positive affect related only to increasing as reward DC: Negative affect increased with demand, reduced with control and demand and control interacted so that high demand and low control was associated with most negative affect. Positive affect only related to increasing control Stressful clinical situations: Trained nurses reports included delays in patient care, violent patients, bullying by staff, staff and bed shortages.
Discussion:
The affect of nurses at work relates systematically and in case of negative affect, predictably, to effort/demand, reward and control. The stressful clinical situations reported by nurses have relevance for the patient safety agenda.
Conclusion:
Affect may be improved and health and working life improved by procedures that reduce demand and increase control and reward.
Recommended reading list:
- Johnston , D., Beedie, A., & Jones, M. (2006). Using Computerized Ambulatory Diaries for the Assessment of Job Characteristics and Work-Related Stress in Nurses. Work and Stress, 20(2), 163-172
- Karasek, R. A. (1979). Job Demands, Job Decision Latitude and Mental Strain: Implications for Job Redesign. Administrative Science Quarterly, 24, 285-308
- Siegrist, J. (1996). Adverse Health Effects of High-Effort/Low Reward Conditions. Journal of Occupational Health Psychology, 1(1), 27-41
Source of funding: Other
Amount in £ Sterling: 100,001 - 500,000
Biography:
Dr Martyn Jones is a Senior Lecturer in School of Nursing and Midwifery, University of Dundee and Associate Director of the Social Dimensions of Health Institute in Universities of Dundee and St Andrews. Dr Jones researches the effect of the work environment on the well-being and performance of student and trained nurses and has published in the past on scale development, models of stress and stress management intervention. He is currently researching the impact of the healthcare environment to nurse well-being and patient safety using behavioural diaries. Dr Jones is lead investigator on a £1 million collaborative award to raise research capacity and capability in Nurses, Midwives and Allied Health Professions. He is a co-ordinating applicant from University of Dundee in a Scottish Consortium working on a £2.5M research programme of “Enhancing Self-Care” in a range of ill-health contexts.