Dr Adelaide Ansah Ofei Ghana. Stress and coping strategies among nurse managers at three hospitals, Eastern Region, Ghana

Transcription

1 D Adelaide Ansah Ofei Ghana Stess and coping stategies among nuse manages at thee hospitals, Easten Region, Ghana

2 STRESS AND COPING STRATEGIES AMONG NURSE MANAGERS AT THREE DISTRICT HOSPITALS IN THE EASTERN REGION, GHANA. Adelaide Maia Ansah Ofei (PhD, MPhil, MBA, BA, RM, RN, FWACN, FGCNM) College of Health Sciences School of Nusing and Midwifey 2018

3 Outline of Pesentation Intoduction Poblem statement Objectives Methods Results Conclusion

4 Intoduction Stess is a common phenomena especially, pofessionals who expeience high levels of stess due to thei complex and multifacetted oles and esponsibilities such as nuses and nuse manages (Hadwick, 2010; Johansson et al., 2013). Stess occus when an individual s capabilities, needs and esouces ae misaligned to the equiements of the job (Gandi et al., 2011). Stess may cause nuse manages to display negative behavious towads thei subodinates; affecting the oveall expeience of staff which may incease ate of tunove (Mokoka et al., 2010). Coping with stessful events is complex, highly dynamic and is diected towad modeating the impact of events in an individual s physical, social and emotional functioning (Chang and Chan, 2015; Miyata et al., 2015)

5 Poblem Statement Nuse Manages should have a sound mind to be able to manage oganizational esouces available, to enable maximize pefomance. Nuse Manages ae faced with esouce constaints, inadequate staffing, and staff attitude but ae expected to enhance delivey of high quality of sevices and have a sound family life. This expose nuse manages to high levels of stess Stess contibutes to oganizational inefficiency, high staff tunove, sickness absenteeism, deceased quality and quantity of cae, inceased costs of health cae, and deceased job satisfaction (Shiey, 2009). Slide 5

6 Objective of the study Exploe causes of stess among nuse manages in thee selected distict hospitals Exploe the types of stess expeience by nuse manages Exploe the coping stategies used by nuse manages fo stess.

7 Methods A desciptive coss-sectional design. Sample size using Yamane s (1967) fomula; with a magin of eo of 5%, confidence inteval of 95% and a population of 52 nuse manages fom the thee hospitals, the sample size calculation was 46. Sampling technique dispopotionate statified sampling technique to select 45 nuse manages fom the thee facilities simple andom sampling to select 15 nuse manages fom each hospital.

8 Methods Reliability validation of the questionnaie by colleagues who have woked many yeas as nuse manages on the wad and an expet in nusing management. Intenal consistency of the questionnaie was tested using Conbach alpha; causes of stess (.78), types of stess (.89), coping (.86). Validity of the study was ensued by the constuction of standadized questionnaie elevant to the objectives of the study and fomulation of questions that equied appopiate esponse fom espondents. Pilot study at the Univesity of Ghana hospital using 10 nuse manages. Analysis was done using both desciptive (fequencies, pecentages) infeential statistics (Peason coelation, linea egession). Slide 8

9 Results Table 1: Socio-Demogaphic Chaacteistics of Vaiables NMs Hospital Age goups Hosp. A Hosp. B Hosp. C < 31 yeas 3 (27.3%) 5 (45.5%) 3 (27.3%) 11 (24.4%) yeas 8 (33.3%) 7 (29.2%) 9 (37.5%) 24 (53.3%)* yeas 3 (75.0%) 0 (0%) 1 (25.0%) 4 (8.9%) yeas 1 (20.0%) 2 (40.0%) 2 (40.0%) 5 (11.1%) > 61 yeas 0 (0.0%) 1 (100.0%) 0 (0.0%) 1 (2.2%) Maital Status Single 2 (20.0%) 4 (40.0%) 4 (40.0%) 10 (22.2%) Maied 12 (36.4%) 10 (30.3%) 11 (33.3%) 33 (73.3%)* Sepaation 0 (0.0%) 1 (100.0%) 0 (0.0%) 1 (2.2%) Widow 1 (100.0%) 0 (0.0%) 0 (0.0%) 1 (2.2%) Religious Affiliation Chistian 15 (34.1%) 14 (31.8%) 15 (34.1%) 44 (97.8%)* Taditional 0 (0.0%) 1 (100.0%) 0 (0.0%) 1 (2.2%) Designation DDNS 1 (25.0%) 2 (50.0%) 1 (25.0%) 5 (8.9%) PNO 1 (50.0%) 1 (50.0%) 0 (0.0%) 2 (4.4%) SNO 3 (42.9%) 3 (42.9%) 1 (14.3%) 7 (15.6%) NO 4 (33.3%) 2 (16.7%) 6 (50.0%) 12 (26.7%) SSN 6 (30.0%) 7 (35.0%) 7 (35.0%) 20 (44.4%)* Gende Male 4 (26.7%) 5 (33.3%) 3 (20.0%) 12 (26.7%) Female 11 (33.3%) 10 (30.3%) 12 (36.4%) 33 (73.3%)* Total

10 Table 2: Causes of Stess among NMs RESPONSES CAUSES OF STRESS N YES NO 1. Woking with incompetent staff (64.4%) 15 (33.3%) 2. Lack of beak peiod duing shifts (95.6%)*** 2 (4.4%) 3. Long woking hous (82.2%) 8 (17.8%) 4. Family issues (62.2%) 17 (37.8%) 5. Heavy wokload (88.9%) 5 (11.1%) 6. Belief system (51.1%) 21 (46.7%) 7. Poo communication system (77.8%) 10 (22.2%) 8. Poo oganization climate hostile envionment (64.4%) 16 (35.6%) 9. Inadequate suppot fom management (93.3%)** 3 (6.7%) 10. Poo woking condition (91.1%)* 4 (8.9%) 11. Inadequate esouces to wok with (91.1%)* 4 (8.9%) 12. Poo cultue within the oganization (62.2%) 17 (37.8%) 13. Lack of incentives fo ovetime (88.9%) 5 (11.1%) 14. Inadequate delegation of esponsibilities (68.9%) 13 (28.9%) 15. Unfiendly elationships among team membes (60.0%) 18 (40.0%) 16. Death and dying (42.2%) 23 (51.1%) 17. Staff shotage (97.8%)*** 1 (2.2%) 18. Conflicts with physicians (64.4%) 16 (35.6%)

11 Table 3: Tests of Between-Subjects Effects between Causes of Stess and Socio-demogaphic Chaacteistics Dependent vaiable Sum of Squaes df Mean Squae F R 2 Independent Vaiable Age Goup Heavy wokload Poo woking conditions Inadequate esouces to wok with Lack of incentives fo ovetime Independent vaiable Religious Affiliation Lack of incentives fo ovetime Lack of beak peiod duing shift Independent vaiable Designation Poo woking conditions Inadequate esouces to wok with Staff shotage Family issues Independent Vaiable Hospital Belief system Unfiendly elationships among team membes

12 Table 4: Types of Stess among NMs TYPES OF STRESS 1.PHYSICAL STRESS RESPONSES N Yes No No esponse Headache (78.3%) 8 (17.8%) 1 (2.2%) Weight loss/gain (67.4%) 11 (23.9% 3 (6.7%) Anxiety (63.0%) 14 (30.4%) 2 (4.4%) Insomnia (50.0%) 20 (43.5%) 2 (4.4%) Fatigue (82.6%) 4 (8.7%) 3 (6.7%) Incease blood pessue (52.2%) 18 (39.1%) 5 (11.1%) Backache (73.9%) 8 (17.4%) 3 (6.7%) Diabetes 45 9 (19.6%) 29 (60.0%) 7 (15.5%) Othes 45 8 (17.4%) 4 (8.7%) 33 (73.3%) 2.EMOTIONAL STRESS Ange (65.2%) 12 (26.1%) 3 (6.7%) Ove eaction (67.4%) 11 (23.9%) 3 (6.7%) Fustation (84.8%) 4 (8.7%) 2 (4.4%) Othes 45 7 (15.2%) 5 (10.9%) 33 (73.3%) Total Fogetfulness (54.3%) 18 (39.1%) 2 (4.4%) 3.PSYCHOLOGICAL STRESS Lack of concentation (67.4%) 13 (28.3%) 1 (2.2%) Withdawal (37.0%) 23 (50.0%) 5 (11.1%) Memoy loss (32.6%) 25 (54.3%) 5 (11.1%) Othes 45 6 (13.0%) 6 (13.0%) 33 (73.3%)

13 Table 5: Coelation between Types of Stess and Socio-demogaphic chaacteistics Type of Stess Dependent Vaiable Age Maital status Rank Unit Gende Physical Headache Weight loss/weight gain Anxiety Insomnia Fatigue Inceased blood pessue -.402** * Backache Diabetes Emotional Ange Ove eaction Fustation.398** Fogetfulness Psychological Lack of concentation Withdawal Memoy loss

14 Table 6: Coping Stategies of Stess among NMs Coping Stategies N YES NO No Response Beak time (68.9%) 14 (31.1%) 0 (0.0%) Relaxation (82.2%) 8 (17.8%) 0 (0.0%) Meditation (64.4%) 14 (31.1%) 2 (4.4%) Delegation of wok/ duties (80.0%) 7 (15.6%) 2 (4.4%) Execise (73.3%) 10 (22.2%) 2 (4.4%) Taking of dugs (33.3%) 26 (57.8%) 4 (8.9%) Time management (86.7%) 4 (8.9%) 2 (4.4%) Expess you feelings instead of bottling (91.1%) 3 (6.7%) 1 (2.2%) them up Accept the things you can t change (88.9%) 4 (8.9%) 1 (2.2%) Eating excessively 45 4 (8.9%) 37 (82.2%) 4 (8.9%) Acknowledging you sphee of influence (73.3%) 9 (20.0%) 3 (6.7%) Giving up/ slow down (46.7%) 22 (48.8%) 2 (4.4%)

15 Summay of Results Majoity (44.4%) of the NMs ae SSN Majo causes of stess among nuse manages in the distict ae: Staff shotage (97.8%), lack of beak peiod duing shifts (95.6%), inadequate suppot fom management (93.3%), poo woking conditions (91.1%) inadequate esouces (91.1%), heavy wokloads (88.9%) and lack of incentives fo ovetime (88.9%) Manageial chaacteistics that pedict stess ae: Age heavy wokloads (F = 2.809, p <.05, R 2 =.219), inadequate esouces to wok with (F = 3.840, p <.05, R 2 =.277), lack of incentives fo ovetime (F = 2.976, p <.05, R 2 =.229), and poo woking conditions (F = 3.840, p <.05, R 2 =.277). Designation family issues (F = 3.099, p <.05, R2 =.267). Hospital belief system (F = 3.806, p <.05, R 2 =.175), and unfiendly elationships among team membes (F = , p <.05, R 2 =.171).

16 Types of Stess among Nuse Manages Physical stess Fatigue (82.6%), headache (78.3%), backache (73.9%) and weight loss/gain (67.4%) Emotional stess Fustation (84.8%), ove eaction (67.4%) and ange (65.2) Psychological stess lack of concentation (67.4%). Physical stess negative coelation between age and inceased blood pessue (-.402) and positive coelation between ank and inceased blood pessue (.345) Emotional stess positive coelation between age and fustation (.398).

17 Coping Stategies of Stess among Nuse Manages Key stategies expession of thei feelings instead of bottling them up (91.1%), accepting the things that can t be changed (88.9), time management (86.7%), elaxation (82.2%) and delegation of duties (80.0%) Least stategy eating excessively is the least mechanism (8.9%)

18 Conclusion Woking as a nuse manage in all the thee hospitals is associated with stess which if not caefully attended to, can educe effectiveness and efficiency of the units. Most of the NMs ae SSN; it can be concluded that thei stess is mainly due to thei limited knowledge in wad management. NMs should matue in age and pactice as well as knowledge and expeience to cope bette with the challenges that confont the nuse manage position. Hospitals should ensue adequate esouces, pope staffing pactices, and peiodic taining to enable the esilience nuse manages need to manage the challenges of the unit and educe stess.

19 Thank You Slide 19