Investigating stress effect patterns in hospital staff nurses: results of a cluster analysis.

A comprehensive and reliable assessment of work stress, burnout, affective, and physical symptomatology was conducted with 260 hospital nurses. As previous attempts to categorize nursing stress and burnout by ward type have yielded inconsistent results, an alternative method for grouping nursing stress effects was sought. Cluster analysis was chosen as it offers a statistically sound means of delineating natural groupings within data. Sets of questionnaires measuring burnout, work stressors, and physical and emotional symptomatology were sent to all staff nurses at a large university hospital. Of 709 nurses employed there, a total of 260 nurses returned completed questionnaire packets. These nurses were separated into two equal groups using random sampling procedures. Cluster analysis of this data revealed groupings which were based on nursing stressors (particularly workload and conflict with physicians), social support, and patient loads. These cluster-analytic findings were replicated on both samples, and validated using data not used in the original cluster analysis. Results suggest that the effects of stress have more to do with the characteristics of the work environment and overall workload than with the degree of specialization on the unit. Results also suggest that intraprofessional conflict (i.e. with other nurses) is less psychologically damaging than is interprofessional conflict (i.e. conflict with physicians). Findings are discussed with respect to the burnout process and possible interventions.

[1]  R. Cattell The Scree Test For The Number Of Factors. , 1966, Multivariate behavioral research.

[2]  K. Parkes,et al.  Psychologic stress in intensive care unit and non-intensive care unit nursing: A review of the past decade. , 1982, Heart & lung : the journal of critical care.

[3]  Seymour Sudman,et al.  Asking Questions: A Practical Guide to Questionnaire Design.@@@The Design and Understanding of Survey Questions. , 1982 .

[4]  M. Lorr Cluster analysis for social scientists , 1938 .

[5]  J. Anderson,et al.  Stress among hospital nursing staff: its causes and effects. , 1981, Social science & medicine. Part A, Medical sociology.

[6]  R. Gorsuch,et al.  Social Support, Personality, and Burnout in Nurses , 1994 .

[7]  S. Hobfoll Conservation of resources. A new attempt at conceptualizing stress. , 1989, The American psychologist.

[8]  J. Hillhouse,et al.  Evaluating a simple model of work stress, burnout, affective and physical symptoms in hospital nurses , 1996 .

[9]  R K Blashfield,et al.  Propositions regarding the use of cluster analysis in clinical research. , 1980, Journal of consulting and clinical psychology.

[10]  R. Harris,et al.  Reviewing nursing stress according to a proposed coping‐adaption framework , 1989, ANS. Advances in nursing science.

[11]  H. Valdimarsdottir,et al.  Depression, burnout, and perceptions of control in hospital nurses. , 1993, Journal of consulting and clinical psychology.

[12]  D. Cross,et al.  Stress, coping behaviors, and recommendations for intensive care and medical surgical ward registered nurses. , 1985, Research in nursing & health.

[13]  S. Jackson,et al.  The Measurement of experienced burnout , 1981 .

[14]  A. Guppy,et al.  Job satisfaction and occupational stress in UK general hospital nursing staff , 1991 .

[15]  G. Larsson,et al.  A review and critique of psychological approaches to the burn-out phenomenon. , 1990, Scandinavian journal of caring sciences.

[16]  A. Duquette,et al.  Factors related to nursing burnout: a review of empirical knowledge. , 1994, Issues in mental health nursing.

[17]  P. Dewe Investigating the frequency of nursing stressors: a comparison across wards. , 1988, Social science & medicine.

[18]  D. Cox,et al.  Differential effectiveness of electromyograph feedback, verbal relaxation instructions, and medication placebo with tension headaches. , 1975, Journal of consulting and clinical psychology.

[19]  S. Jurs,et al.  Relationships among Burnout, Death Anxiety, and Social Support in Hospice and Critical Care Nurses , 1991, Psychological reports.

[20]  P. Tyler,et al.  Sources of stress and dissatisfaction among nurses in four hospital environments. , 1989, The British journal of medical psychology.

[21]  D. Chiriboga,et al.  Stress and burnout among critical care and medical surgical nurses: a comparative study. , 1986, CCQ. Critical care quarterly.

[22]  E. Ogus Burnout and Coping Strategies: A Comparative Study of Ward Nurses , 1992 .

[23]  Blake E. Ashforth,et al.  A meta-analytic examination of the correlates of the three dimensions of job burnout. , 1996, The Journal of applied psychology.

[24]  J. Ducette,et al.  Stress in ICU and non-ICU nurses. , 1985, Nursing research.