nurses of the province of quebec are practicing in a multi · nurses of the province of quebec are...

Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010

Nurses of the Province of Quebec are practicing in a multi stressor work environment

Perhaps this explains why they are showing alarming symptoms related to occupational stress

Several decades of research and discussion have been able to increase our awareness on the subject but still has not provided

us with the information required to eradicate this scourge in Quebec


Introduction

Background

Framework

Review of literature

Purpose

Method

Future oriented

Conclusion


INSUFFICIENT STAFF

Previous career

• involved with working conditions of female staff Awareness of the negative effects caused by poorworking conditions

New career

• Enduring poor working conditions

Nicole Jacob, RN. B Sc. MS UQO

RAA Boston 2010

Nursing role


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Supported by an inspirationalmanagement

… use specificknowledge to support individuals, groups, and community in managing theirhealth (Roy, 2009)

…act as leaders, and specialists, on healthpromotion-preventionissues

Nurses…

Nursing reality

ØRN:• Nurses admit that they feel stressed and

demoralized; • New graduates show signs of exhaustion and

psychological distress; • Some nurses choose to leave the profession


RAA Boston 2010

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Accounta-bility but devaluedrole

Increasednumber of patients

Lackof staff

Overtime Increa-sedworkload

Decliningbudget

Lack of manage-mentsupport

Occupational stress

• Nurses a group at high risk of occupational stress (Duxbury & Higgins, 2001; Brun, Biron, Martel & Ivers, 2002; Lemelin, Bonin & Duquette, 2009);

• Costs related to occupational stress are enormous (Berland, Natvig & Gundersen, 2007; Viens, Lavoie-Tremblay & Mayrand Leclerc, 2007; aiic, 2007);

• Main sources of occupational stress (CHSRF, 2006): – Workplace– Workforce


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Nurses facing psychological distress

Psychological distress often originates in the workplace (Duxbury & Higgins, 2001), one of the worst being the Health Facilities (Brun, Biron, Martel & Ivers, 2002; Lemelin, Bonin & Duquette, 2009);

In Quebec 85% of nurses work in hospitals (Marleau, 2009); 35% of all health professionals providing direct care to

the patients are nurses (Statistique Canada, 2006); Hospital nurses suffer 6.2 times more psychological

distress than the population in general (Brun & al., 2002);

54% of hospital nurses are showing signs of high psychological distress (Brun & al., 2002; Watson & al, 2009 );

(In one major hospital) 61% of nurses show significant symptoms of psychological distress + 4.4% need antidepressants to get through the day (Hamann, 1997);

A stressed nurse poses a threat to the health of the patient… (Berland, Natvig & Gundersen, 2007)


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Understanding the phenomenon of psychological distress among

nurses of Quebec as related to their working environment


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Coping Strategies

STIMULI

Lack of staffRESULTING

BEHAVIORS

Psychological distress

INPUT OUTPUT


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Strategies

Studies aimed atmanipulating, or

eliminating, external causes

of stress

Focal

Contextual

threatening worksituations

(jeopardizes the quality of care

provided to the population of

Quebec)

Residual(sociodémographics )

Ineffective behaviorMost nurses still show

signs of distress(CHSRF, 2006; Watson

& al., 09)

Adaptive behaviorYet, some nurses seem to have the ability to adapt…

INPUT OUTPUT


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Theory

Hardy Personality(Maddi &

Kobasa,1984)

Focalwork situations that

are perceived as a threat to their

professional ideal, values, and

expectations (« hurts because it leaves no time to care for the

patients. This was not the way I envisioned

nursing… »)

Contextual

Residual(sociodémographics )

Adaptive behavior

Nurses who possess a Hardy personnality

seem to adapt better ready for the

challenge rather than feeling like a victim

(Literature review to follow…)

INPUT OUTPUT


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2nd buffer: Hardy personnality

Innate or acquired personalitystyle

Hardy people demonstrate:Commitment

Control Challenge

(Maddi & Kobasa, 1984)

INPUT OUTPUT

1st buffer: Healthylifestyle

3rd buffer: Transforma-

tional Coping

(Ablett & al., 2007; Delmas & al., 2004; Hurst & al., 2005; Judkins & al., 2005; Lambert & al., 2007)

Research problem

• Quality of life of nurses in the workplace;

Research purpose

• Understand the impact of a Hardy Personality on psychological distress causedby occupational stress;

Results

• Seems that Hardy nurses adapt better to a multi stressor work environment;

• It is unlikely that these results may apply to nurses in Quebec…


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Research problem: Lack of data concerningthe nature of relations between the Hardy Personality and the Psychological distressof nurses in Quebec

Proposed solution: conduct a study…

To Verify the Nature of Relations betweenEach of the Concepts of the Hardy Personality and the PsychologicalDistress of Nurses of the Province of Quebec


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The choice of a research method dependsprimarily on the nature of the researchquestion…. (Lepage & Dumas, 2010)

• Research question: What is the nature of the relations betweeneach of the concepts of the Hardy Personality and the psychologicaldistress of nurses of the province of Quebec?

• Research design: predictivecorrelational


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There is an inverse relationshipbetween each of the concepts of

the Hardy Personality and the psychological distress of nurses in

the Province of Quebec


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H1: • RESEARCH

HYPOTHESIS

X • The

presenceof hardiness

-• Causes a

decrease

Y • In psychological

distress

Population• Registered Nurses in the Province of Quebec;Sample• Nurses that are working a minimum of

14hours/week in a public health institution;Sampling method• Nonprobability convenience sampling;Sample size• Recruited from 7330 email addresses;Method of data collection• Survey; Data collection tool• Self-administered questionnaire;Method of distribution• Electronic distribution via the Internet;Research process: • Cross-sectional study;


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Questionnaire = three measures + one sociodemographic sheet

• Perceived stress: Échelle des Stresseurs en Soins Infirmiers (ÉSSI) (Kérouac &Duquette, 1992) measuring the seven major sources of stress associated with threeenvironments;

• Hardy personality: Échelle des Points de Vue Personnels (Kerouac & Duquette, 1992) measuring the concepts of Commitment, Control and Challenge;

• Psychological distress: Indice de détresse psychologique (IDPESQ-14) (Préville & al., 1987) measuring depression, anxiety, anger and cognitive problems;

• Sociodemographic sheet


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2010-2011

• July: Ethics Approval Form (UQO) and Consent form;

• August: recruitment of the sample by emailing;

• September: first recall;

• October: second recall;

• September – December : data retrieval and compiling results using SPSS;

• Beginning of 2011: Submission of the ResearchPaper


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Research

Results

EvidenceNursing interventions

Feed-back


Nurse involvement in promoting hardiness could result in…

Evidence about Hardiness that would contribute to the nursing knowledge base;

Specialized courses in stress management to prepare future nurses;

Nursing interventions to help individuals, groups, and communities increase Hardiness;

A group awareness in relation to the culture of Hardiness in the workplace


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The purpose of this research is to collect data on the nature of relations between each of the concepts of the Hardy Personality

and the psychological distress of nurses in the Province of Quebec

If this research follows a familiar path, the size of the sample and the current conjuncture will justify this new approach

Let us hope that the results will enrich the nursing knowledge base and contribute to a salutogenic vision of care…

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Nicole Jacob, RN. B Sc.. MS - UQO RAA Boston 2010

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Nicole Jacob, RN. B Sc.. MS - UQO RAA Boston 2010

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