A Daily Diary Approach to the Examination of Chronic Stress, Daily Hassles and Safety Perceptions in Hospital Nursing
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Stress is a significant concern for individuals and organisations. Few studies have explored stress, burnout and patient safety in hospital nursing on a daily basis at the individual level. This study aimed to examine the effects of chronic stress and daily hassles on safety perceptions, the effect of chronic stress on daily hassles experienced and chronic stress as a potential moderator.
Utilising a daily diary design, 83 UK hospital nurses completed three end-of-shift diaries, yielding 324 person days. Hassles, safety perceptions and workplace cognitive failure were measured daily, and a baseline questionnaire included a measure of chronic stress. Hierarchical multivariate linear modelling was used to analyse the data.
Higher chronic stress was associated with more daily hassles, poorer perceptions of safety and being less able to practise safely, but not more workplace cognitive failure. Reporting more daily hassles was associated with poorer perceptions of safety, being less able to practise safely and more workplace cognitive failure. Chronic stress did not moderate daily associations. The hassles reported illustrate the wide-ranging hassles nurses experienced.
The findings demonstrate, in addition to chronic stress, the importance of daily hassles for nurses’ perceptions of safety and the hassles experienced by hospital nurses on a daily basis. Nurses perceive chronic stress and daily hassles to contribute to their perceptions of safety. Measuring the number of daily hassles experienced could proactively highlight when patient safety threats may arise, and as a result, interventions could usefully focus on the management of daily hassles.
KeywordsNursing Chronic stress Patient safety Daily hassles Diary methods
We would like to thank the nurses who completed the questionnaires and made this study possible. The study was funded by the University of Leeds and Bradford Institute for Health Research (PhD Studentship).
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the University of Leeds School of Psychology Ethics Committee in February 2013. Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
- 2.Moustaka Å, Constantinidis TC. Sources and effects of work-related stress in nursing. Health Sci J. 2010;4:210–6.Google Scholar
- 3.Carayon P, Gurses AP. Nursing workload and patient safety—a human factors engineering perspective. In: Hughes R, editor. Patient safety and quality: an evidence–based handbook for nurses [internet]. Rockville: Agency for Healthcare Research and Quality; 2008. [cited 2016 January 10]. Available from http://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/CarayonP_NWPS.pdf. Google Scholar
- 7.Royal College of Nursing. Guidance on nurse staffing levels in the UK. London: RCN; 2010.Google Scholar
- 8.Royal College of Nursing. Mandatory nurse staffing levels. London: RCN; 2012.Google Scholar
- 30.Jennings B. Work stress and burnout among nurses: role of the work environment and working conditions. In: Hughes R, editor. Patient safety and quality: an evidence–based handbook for nurses [internet]. Rockville: Agency for Healthcare Research and Quality; 2008. [cited 2016 January 10]. Available from http://www.ncbi.nlm.nih.gov/books/NBK2676/?report=reader.Google Scholar
- 36.Ferguson E. The use of diary methods in clinical and health psychology. In: Miles J, Gilbert P, editors. A handbook of research methods in clinical and health psychology. Oxford: Oxford University Press; 2005.Google Scholar
- 37.O’Connor DB, Ferguson E. Stress and stressors. In: Benyamini Y, Johnston M, Karademas EC, editors. Assessment in health psychology. Göttingen/Boston: Hogrefe; 2016. p. 104–18.Google Scholar
- 54.Schulz P, Schlotz W, Becker P. Trierer Inventar zum chronischen Stress (TICS) [Trierer Inventory of Chronic Stress]. Gottingen: Hogrefe; 2004.Google Scholar
- 55.Schulz P, Schlotz W. Trierer Inventar zur Erfassung von chronischem Streß (TICS): Skalenkonstruktion, teststatistische Überprüfung und Validierung der Skala Arbeitsüberlastung [The Trier Inventory for Chronic Stress (TICS): scale construction, statistical testing and validation of the scale work overload]. Diagnostica. 1999;45(1):8–19. doi: 10.1026//0012-1918.104.22.168.
- 56.Sorra JS, Nieva VF. Hospital survey on patient safety culture. AHRQ Publication No. 04-0041. Rockville, MD: Agency for Healthcare Research and Quality, September 2004. (Available from: http://www.ahrq.gov/qual/hospculture; accessed January, 2016).
- 61.Raudenbush SW. HLM 6: Hierarchical linear and nonlinear modeling. Scientific Software International; 2004.Google Scholar
- 62.Bryk AS, Raudenbush SW. Hierarchical linear models. Newbury Park: Sage; 1992.Google Scholar
- 65.Griffin MA. Interaction between individuals and situations: using HLM procedures to estimate reciprocal relationships. J Manage. 1997;23(6):759–73.Google Scholar
- 66.Hofmann DA. An overview of the logic and rationale of hierarchical linear models. J Manage. 1997;23(6):723–44.Google Scholar