Skip to main content

Advertisement

SpringerLink
Log in

The prevalence of nursing staff stress on adult acute psychiatric in-patient wards

A systematic review

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Concerns about recent changes in acute in-patient mental healthcare environments have led to fears about staff stress and poor morale in acute in-patient mental healthcare staff.

Aim

To review the prevalence of low staff morale, stress, burnout, job satisfaction and psychological well-being amongst staff working in in-patient psychiatric wards.

Method

Systematic review.

Results

Of 34 mental health studies identified, 13 were specific to acute in-patient settings, and 21 were specific to other non-specified ward-based samples. Most studies did not find very high levels of staff burnout and poor morale but were mostly small, of poor quality and provided incomplete or non-standardised prevalence data.

Conclusions

The prevalence of indicators of low morale on acute in-patient mental health wards has been poorly researched and remains unclear. Multi-site, prospective epidemiological studies using validated measures of stress together with personal and organizational variables influencing staff stress in acute in-patient wards are required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Adali E, Priami M, Evagelou H, Mougia V, Ifanti M, Alevizopoulos G (2003) Burnout in psychiatric nursing personnel in Greek hospitals. Eur J Psychiatry 17(3):173–181

    Google Scholar 

  2. Adkins CL (1995) Previous work experience and organizational socialization: longitudinal examination. Acad Manage J 38(3):839–862

    Google Scholar 

  3. Barton J, Folkhard S (1991) The response of day and night nurses to their work schedules. J Occup Psychol 64:207–218

    Google Scholar 

  4. Berg A, Hallberg IR (1999) Effects of systematic clinical supervision on psychiatric nurses' sense of coherence, creativity, work-related strain, job satisfaction and view of the effects from clinical supervision: a pre-post test design. J Psychiatr Ment Health Nurs 6(5):371–381

    Article  CAS  PubMed  Google Scholar 

  5. Borril CS, Wall TD, West MA, Hardy GE, Shapiro DA, Haynes CE, Stride CB, Woods D, Carter AJ (1998) Stress among staff in NHS trusts. University of Sheffield, Sheffield

    Google Scholar 

  6. Brown D, Carson J, Fagin L, Bartlett H, Leary J (1994) Coping with caring. Nurs Times Nov 9–15;90(45) Mental Health Nursing: 53–5

    Google Scholar 

  7. Burroughs H, Chew-Graham CA, Richards D, Baldwin B, Burns A, Morley M, Roberts C (2004) “We rob off the in-patient unit”: a qualitative study of the recruitment of CPNs by Mental Health Trusts. Prim Care Psychiatry 9(2):63–66

    Google Scholar 

  8. Callaghan P (1991) Organisation and stress among mental nurses. Nurs Times 87(34):50

    CAS  PubMed  Google Scholar 

  9. Carson J, Fagin L (1996) Stress in mental health professionals: a cause for concern or an inevitable part of the job? Int J Soc Psychiatry 42(2):79–81

    CAS  PubMed  Google Scholar 

  10. Carson J, Fagin L, DeVilliers N, O’Malley P (1997) Stress and fitness in ward-based mental health nurses. J Clin Nurs 6(5):419–420

    Article  CAS  PubMed  Google Scholar 

  11. Carson J, Leary J, DeVilliers N, Fagin L, Radmall J (1995) Stress in mental health nurses: comparison of ward and community staff. Brit J Nurs 4(10):579–582

    CAS  Google Scholar 

  12. Carson J, Cavagin J, Bunclark J, Maal S, Gournay K, Kuipers E, Holloway F, West M (1999) Focus. Effective communication in mental health nurses: did social support save the psychiatric nurse? NT Res 4(1):31–42

    Google Scholar 

  13. Carson J, Cooper C, Fagin L, West M, McElfatrick S, DeVilliers N, O’Malley P, Holloway F (1996) Research in brief. Coping skills in mental health nursing: do they make a difference? J Psychiatr Ment Health Nurs 3(3):201–202

    CAS  PubMed  Google Scholar 

  14. Chalder G, Nolan PW (2000) A comparative study of stress among forensic and acute mental health nurses. Br J Forensic Pract 2(3):24–29

    Google Scholar 

  15. Corrigan PW (1994) Differences between clinical and nursing inpatient staff: implications for training in behaviour therapy. J Behav Ther Exp Psychiatry 25(4):311–316

    Article  CAS  PubMed  Google Scholar 

  16. Corrigan PW, McCracken SG, Kommana S, Edwards M, Simpatico T (1996) Staff perceptions about barriers to innovative behavioral rehabilitation programs. Cogn Ther Res 20(5):541–551

    Article  Google Scholar 

  17. Corrigan PW, McCracken SG, Edwards M, Kommana S, Simpatico T (1997) Staff training to improve implementation and impact of behavioral rehabilitation programs. Psychiatr Serv 48(10):1336–1338

    CAS  PubMed  Google Scholar 

  18. Corrigan PW, Williams OB, McCracken SG, Kommana S, Edwards M, Brunner J (1998) Staff attitudes that impede the implementation of behavioral treatment programs. Behav Modif 22(4):548–562

    CAS  PubMed  Google Scholar 

  19. Department of Health (2000) Mental health national service framework: workforce planning, education and training underpinning programme: interim report by the Workforce Action Team. Department of Health, London

    Google Scholar 

  20. Devlin AS (1992) Psychiatric ward renovation: staff perception and patient behavior. Environ Behav 24(1):66–84

    Google Scholar 

  21. Donat DC (2001) Impact of behavioral knowledge on job stress and the perception of system impediments to behavioral care. Psychiatr Rehabil J 25(2):187–189

    CAS  PubMed  Google Scholar 

  22. Donat DC, Neal B, Addleton R (1991) Situational sources of stress for direct care staff in a public psychiatric hospital. Psychiatr Rehabil J 14(4):76–81

    Google Scholar 

  23. Edwards D, Burnard P (2003) A systematic review of stress and stress management interventions for mental health nurses. J Adv Nurs 42(2):169–200

    Article  CAS  PubMed  Google Scholar 

  24. Fagin L, Brown D, Bartlett H, Leary J, Carson J (1995) The Claybury Community Psychiatric Nurse Stress Study: is it more stressful to work in hospital or the community? J Adv Nurs 22(2):347–358

    Article  CAS  PubMed  Google Scholar 

  25. Fagin L, Carson J, Leary J, De Villiers N, Bartlett H, O'Malley P, West M, McElfatrick S, Brown D (1996) Stress, coping and burnout in mental health nurses: findings from three research studies. Int J Soc Psychiatry 42(2):102–111

    CAS  PubMed  Google Scholar 

  26. Farrell GA, Dares G (1999) Nursing staff satisfaction on mental health unit. Aust N Z J Ment Health Nurs 8(2):51–57

    Article  CAS  PubMed  Google Scholar 

  27. Gigantesco A, Picardi A, Chiaia E, Balbi A, Morosini P (2003) Job satisfaction among mental health professionals in Rome, Italy. Community Ment Health J 39(4):349–355

    Article  PubMed  Google Scholar 

  28. Goodykoontz L, Herrick CA (1990) Evaluation of an inservice education program regarding aggressive behavior on a psychiatric unit. J Contin Educ Nurs 21(3):129–133

    CAS  PubMed  Google Scholar 

  29. Healthcare Commission (2004) The national audit of violence (2003–2005). Final report. Healthcare Commission, London

    Google Scholar 

  30. Humpel N, Caputi P (2001) Exploring the relationship between work stress, years of experience and emotional competency using a sample of Australian mental health nurses. J Psychiatr Ment Health Nurs 8(5):399–403

    Article  CAS  PubMed  Google Scholar 

  31. Ito H, Eisen SV, Sederer LI, Yamada O, Tachimori H (2001) Factors affecting psychiatric nurses' intention to leave their current job. Psychiatr Serv 52(2):232–234

    Article  CAS  PubMed  Google Scholar 

  32. Kunkler J, Whittick J (1991) Stress-management groups for nurses: practical problems and possible solutions. J Adv Nurs 16(2):172–176

    CAS  PubMed  Google Scholar 

  33. Levert T, Lucas M, Ortlepp K (2000) Burnout in psychiatric nurses: contributions of the work environment and a sense of coherence. S Afr J Psychol 30(2):36–43

    Google Scholar 

  34. Long CG, Blackwell CC, Midgley M (1990) An evaluation of two systems of in-patient care in a general hospital psychiatric unit. II: measures of staff and patient performance. J Adv Nurs 15(12):1436–1442

    CAS  PubMed  Google Scholar 

  35. McElfatrick S, Carson J, Annett J, Cooper C, Holloway F, Kuipers E (2000) Assessing coping skills in mental health nurses: is an occupation specific measure better than a generic coping skills scale? Pers Individ Differ 28(5):965–976

    Article  Google Scholar 

  36. Maslach C, Jackson SE (1986) Maslach burnout inventory manual, 2nd edn. Consulting Psychologists, Palo Alto

    Google Scholar 

  37. Mistral W, Hall A, McKee P (2002) Using therapeutic community principles to improve the functioning of a high care psychiatric ward in the UK. Int J Ment Health Nurs 11(1):10–17

    Article  PubMed  Google Scholar 

  38. Munro L, Rodwell J, Harding L (1998) Assessing occupational stress in psychiatric nurses using the full job strain model: the value of social support to nurses. Int J Nurs Stud 35:339–345

    Article  CAS  PubMed  Google Scholar 

  39. Muscroft J, Hicks C (1998) A comparison of psychiatric nurses' and general nurses' reported stress and counselling needs: a case study approach. J Adv Nurs 27(6):1317–1325

    Article  CAS  PubMed  Google Scholar 

  40. NHS Centre for Reviews and Dissemination (2001) Undertaking systematic reviews of research on effectiveness: CRD report 4, 2nd edn. University of York, York

    Google Scholar 

  41. Prosser D, Johnson S, Kuipers E, Szmukler G, Bebbington P, Thornicroft G (1996) Mental health, ‘burnout’ and job satisfaction among hospital and community-based mental health staff. Br J Psychiatry 169(3):334–337

    CAS  PubMed  Google Scholar 

  42. Prosser D, Johnson S, Kuipers E, Dunn G, Szmukler G, Reid Y, Bebbington P, Thornicroft G (1999) Mental health, “burnout” and job satisfaction in a longitudinal study of mental health staff. Soc Psychiatry Psychiatr Epidemiol 34(6):295–300

    Article  CAS  PubMed  Google Scholar 

  43. Robey K, Ramsland SE, Castelbaum K (1991) Alignment of agency and personal missions: an evaluation. Adm Policy Ment Health 19(1):39–45

    Article  Google Scholar 

  44. Robinson JR, Clements K, Land C (2003) Workplace stress among psychiatric nurses: prevalence, distribution, correlates and predictors. J Psychosoc Nurs 41(4):33–41

    Google Scholar 

  45. Rossberg JI, Eiring O, Friis S (2004) Work environment and job satisfaction. A psychometric evaluation of the Working Environment Scale-10. Soc Psychiatry Psychiatr Epidemiol 39:576–580

    CAS  PubMed  Google Scholar 

  46. Rothwell N, McManus P, Higgon J (1997) Evaluation of moving an acute psychiatric ward from a psychiatric hospital to a general hospital setting. Psychiatr Bull R Coll Psychiatr 21(10):636–639

    Google Scholar 

  47. Sainsbury Centre for Mental Health (1998) Acute problems. A survey of the quality of care in acute psychiatric wards. The Sainsbury Centre for Mental Health, London

    Google Scholar 

  48. Sainsbury Centre for Mental Health (2004) Acute Care 2004. The Sainsbury Centre for Mental Health, London

    Google Scholar 

  49. Secretaries of Health, Social Security, Wales and Scotland (1989) Caring for people: community care for the next decade and beyond. HMSO, London

    Google Scholar 

  50. Severinsson E, Hummelvoll JK (2001) Factors influencing job satisfaction and ethical dilemmas in acute psychiatric care. Nurs Health Sci 3(2):81–90

    Article  CAS  PubMed  Google Scholar 

  51. Shepherd G, Muijen M, Cooney M (1996) Residential care in hospital and in the community—quality of care and quality of life. Br J Psychiatry 168(4):448–456

    CAS  PubMed  Google Scholar 

  52. Smoot SL, Gonzales JL (1995) Cost-effective communication skills training for state hospital employees. Psychiatr Serv 46(8):819–822

    CAS  PubMed  Google Scholar 

  53. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE). JAMA 283:2008–2012

    Article  CAS  PubMed  Google Scholar 

  54. Stuart GW, Worley N, Morris JA Jr, Bevilacqua JJ (2000) Role utilization of nurses in public psychiatry. Adm Policy Ment Health 27(6):423–441

    Article  CAS  PubMed  Google Scholar 

  55. Sullivan PJ (1993) Occupational stress in psychiatric nursing. J Adv Nurs 18(4):591–601

    Article  CAS  PubMed  Google Scholar 

  56. Tummers GE, Janssen PP, Landeweerd A, Houkes I (2001) A comparative study of work characteristics and reactions between general and mental health nurses: a multi-sample analysis. J Adv Nurs 36(1):151–162. Erratum in J Adv Nurs 2002 May;38(3):319

    Article  CAS  PubMed  Google Scholar 

  57. Tyson GA, Lambert G, Beatie L (2002) The impact of ward design on the behaviour, occupational satisfaction and well-being of psychiatric nurses. Int J Ment Health Nurs 11(2):94–102

    Article  PubMed  Google Scholar 

  58. Wall TD, Bolden R et al (1997) Minor psychiatric disorder in NHS trust staff: occupational and gender differences. Br J Psychiatry 171:519–523

    Article  CAS  PubMed  Google Scholar 

  59. Williams S, Michie S, Pattani S (1998) Improving the health of the NHS workforce: report on the partnership of the NHS workforce. The Nuffield Trust, London

    Google Scholar 

Download references

Acknowledgements

The research was funded by a grant from the UK Department of Health, Service Development and Organization research programme. The views expressed in this paper are those of the authors and not of the Department of Health. No conflicts of interest are declared, and no ethical approval was required.

Author information

Authors and Affiliations

  1. Dept. of Health Sciences, University of York, Seebohm Rowntree Building, University Road, Heslington, York, YO10 5DD, UK

    David A. Richards PhD, BSc(Hons), RN

  2. School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK

    Penny Bee PhD, BSc(Hons)

  3. Psychological Therapies Research Centre, University of Leeds, Leeds, UK

    Michael Barkham PhD, MA, MSc, BEd & Jane Cahill MA

  4. Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK

    Simon M. Gilbody MRCPsych, DPhil, MMedSci, MDChB, BSc(Hons)

  5. Centre for Reviews and Dissemination, University of York, York, UK

    Julie Glanville MSc, PGDip, BA

Authors
  1. David A. Richards PhD, BSc(Hons), RN
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Penny Bee PhD, BSc(Hons)
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Barkham PhD, MA, MSc, BEd
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simon M. Gilbody MRCPsych, DPhil, MMedSci, MDChB, BSc(Hons)
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jane Cahill MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Julie Glanville MSc, PGDip, BA
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Richards, D.A., Bee, P., Barkham, M. et al. The prevalence of nursing staff stress on adult acute psychiatric in-patient wards. Soc Psychiat Epidemiol 41, 34–43 (2006). https://doi.org/10.1007/s00127-005-0998-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-005-0998-7

Key words

Search

Navigation