Nurses of the Province of Quebec are practicing in a multi · Nurses of the Province of Quebec are...
Transcript of 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
Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010
Introduction
Background
Framework
Review of literature
Purpose
Method
Future oriented
Conclusion
Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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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
Nicole Jacob, RN. B Sc. MS UQO
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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)
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
Understanding the phenomenon of psychological distress among
nurses of Quebec as related to their working environment
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
Coping Strategies
STIMULI
Lack of staffRESULTING
BEHAVIORS
Psychological distress
INPUT OUTPUT
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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
Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010
(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…
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
There is an inverse relationshipbetween each of the concepts of
the Hardy Personality and the psychological distress of nurses in
the Province of Quebec
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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;
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
Research
Results
EvidenceNursing interventions
Feed-back
Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010
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
Nicole Jacob, RN. B Sc. MS UQO
RAA Boston 2010
Nicole Jacob, RN. B Sc.. MS UQO RAA Boston 2010
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