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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 22  |  Issue : 2  |  Page : 215-220

Review of studies on stress, job satisfaction and resilience among nursing professionals


1 Research Scholar, Department of Business Administration, Faculty of Management Studies and Research, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
2 Professor, Department of Business Administration, Faculty of Management Studies and Research, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
3 Professor & Program Director- Ph.D, All India Management Association – Centre for Management Education, New Delhi, India

Date of Submission09-Feb-2021
Date of Decision26-Jul-2021
Date of Acceptance09-Nov-2021
Date of Web Publication10-Dec-2021

Correspondence Address:
Mrs. Shikha Sharma
C-8, 260A, 1st Floor, Keshav Puram, Lawrence Road, Delhi - 110 035
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijcn.ijcn_16_21

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  Abstract 


Nursing profession is quite stressful. Numerous studies had been carried out to identify the stress, job satisfaction and resilience among nursing professional. The aim of this study is to collate the available literature on the relationship among role stress, job satisfaction and resilience among nursing professionals. Electronic databases (CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles and Proquest) were searched using the various combinations of keywords: nursing stress, nurse resilience and job satisfaction. In addition to electronic databases, manual searches were also undertaken in various nursing journals including the Journal of Advanced Nursing, the International Journal of Nursing Practice and the International Journal of Nursing Studies. A total of eight descriptive and descriptive-correlational studies published in English were included, and data are presented in a narrative summary. The findings revealed a negative relationship between nursing stress and job satisfaction and reported a mediating role of resilience in the relationship. The degree of role stress, resilience level and job satisfaction varied among different demographics and work settings. Workload and staffing inadequacy were reported as the major stressors for nursing professionals. A high level of job satisfaction was attributed to the presence of intrinsic and extrinsic rewards in the profession and the resilient nature of nursing professionals played a pivotal role in managing the level of stress and increases the level of satisfaction among them. Within the limitations of the study such as the lack of literature including all three constructs of the study and methodological constraints of multiplicity of instruments, it was noted that nursing professionals are often stressed due to heavy workload and demanding work conditions, express job dissatisfaction, they try to adjust to the conditions by being resilient. This imposes a persistent need for the health-care system to strategize and ensure the management of workload, sufficient staffing and adequate training for nursing professionals to ensure the delivery of quality health care. A very limited number of studies have examined the role of resilience in the relationship between role stress and job satisfaction. Furthermore, no studies in the Asian context have previously been conducted.

Keywords: Job satisfaction, nursing professionals, resilience, role stress


How to cite this article:
Sharma S, Talib P, Singh G. Review of studies on stress, job satisfaction and resilience among nursing professionals. Indian J Cont Nsg Edn 2021;22:215-20

How to cite this URL:
Sharma S, Talib P, Singh G. Review of studies on stress, job satisfaction and resilience among nursing professionals. Indian J Cont Nsg Edn [serial online] 2021 [cited 2022 May 28];22:215-20. Available from: https://www.ijcne.org/text.asp?2021/22/2/215/332200




  Introduction Top


Stress, job satisfaction and personality variables have been reported to have strong correlation with each other in the field of occupational psychology. Nurses constitute the largest proportion of health-care workers throughout the world and play a vital role in the health care system of any country. The nursing profession is stated to be demanding career worldwide,[1],[2],[3] and the detrimental consequences of stress among nurses have been extensively studied.[4],[5],[6],[7] Furthermore, job satisfaction among nursing professionals is reported to have the positive outcomes of work performance, intention to stay, professional commitment and quality of care directly or indirectly.[8],[9] In addition, the role of personality variables in influencing actions and the way nursing professionals respond to a work situation has been acknowledged. Stressors can be different in diverse work situations but some nursing professionals possess personality trait of being resilient that enable them to deal with stressors at work, recuperate swiftly and perform better than others and enhances their level of job satisfaction. Multidimensionality of the concept of resilience, inconsistent research results and presence of multiple factors influencing stress and job satisfaction among nursing professionals require a deeper and evident understanding of the relationship among these variables.

Role stress among nursing professionals is ubiquitous, stressors such as work overload, witnessing death and dying situations, and personal inadequacy and lack of knowledge about the treatment[2],[10],[11],[12] have been identified in studies. Lazarus and Folkman 1984 identified stress as a mismatch between the perception of an individual towards the demand being posed and the individual's perception about the capability to meet those demands.[13] This mismatch is referred to as a breach of an individual's stress threshold and will trigger a stress response.[14]

Job satisfaction is referred to as a positive feeling about one's job as an outcome of an individual's perception and evaluation of his/her work.[15] Job satisfaction among nursing professionals is influenced by a variety of factors including intrinsic and extrinsic factors prevailing in the work environment. Nurses experience stress when their requirements at workplace are not met and stress is a predictor of job dissatisfaction and negatively effects job performance.[16]

Resilience as a personality characteristic has been identified in the literature as an important factor shielding against adversity and stress among nursing professionals, helping them to cope up with challenges at the workplace while maintaining mental well-being and psychological health.[17],[18],[19],[20]

The protective role of resilience during stressful events encountered by nursing professionals has been identified by numerous studies.[17],[18],[19],[20] Resilience not only plays a protective role but is also identified as a factor that strengthens the feeling of satisfaction among nursing professionals.[21],[22],[23],[24]

Comprehending the relationship between role stress, job satisfaction and resilience among nursing professionals may help policy-makers, health-care managers and nursing supervisors in formulating appropriate strategies to reduce role stress; promote job satisfaction and enhance resilience among nursing professionals. Subsequently, health-care managers may ensure the delivery of quality health care to patients along with improved productivity and better performance by the nursing professionals.

Aim

This study aims to discuss the available nursing literature on role stress, job satisfaction and resilience among nursing professionals. Specifically, the study aims to identify (1) major role stressors among nurses, (2) factors leading to job satisfaction and (3) the role of resilience in the relationship of role stress and job satisfaction.


  Methodology Top


Researches conducted between 2005 and 2019 reporting role stress, job satisfaction and resilience among nursing professionals were reviewed. The study was carried out with a focus on identifying major stressors, factors determining job satisfaction and the role of resilience in building the relationship between the variables.

Search strategy

Electronic databases of Scopus, Science Direct, PsycInfo, PsycArticles and Proquest were searched for the literature as a vast number of journals on nursing research are available within these. Various combinations of keywords: Nursing stress, resilience and job satisfaction were used to search relevant literature. To ensure a rigorous and comprehensive search of the literature, additionally manual search in Journal of Advanced Nursing, the International Journal of Nursing Practice and the International Journal of Nursing studies was done.

Inclusion and exclusion criteria

A theoretical approach to literature search was adopted due to methodological differences in studies. The PRISMA approach [Figure 1] was used as a search algorithm in the present study that resulted in the identification of eight studies [Table 1] of prospective pertinence to this review. Each article was reviewed concerning the following criteria for the inclusion: (1) Published in the English language and (2) Both quantitative and qualitative researches that assesses role stress, job satisfaction and resilience among nursing professionals.
Figure 1: PRISMA approach

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Table 1: Major studies on relationship between stress, job satisfaction and resilience

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Studies with sample unit other than nurses and/or resultants other than role stress, job satisfaction and resilience together were not considered in the final review.

Design and sample size

The majority of the studies reviewed were cross-sectional and used a descriptive design of research with a sample size that ranged from 94 to 454. Seven studies were quantitative among which six were descriptive in nature[19],[22],[23],[25],[26],[27] and one study used a longitudinal descriptive design.[27] In addition, one systematic review study[28] was also reviewed.


  Results Top


Multiplicity of instruments

A variety of instruments were utilised by studies to assess the level of stress and to identify major stressors including the Nursing Stress Scale;[30] Korean Style Job Stress Measurement; Perceived Stress Scale;[31] Perceived Job Stress Question;[32] Perceived Stress Questionnaire[33] and Korean Occupational Stress Scale Short Form.[34]

Multiple instruments were used to measure job satisfaction among Nursing professionals including the Job Satisfaction Scale,[35] Work Quality Index, and Oxford Happiness Inventory.[36]

The majority of studies utilised the Connor Davidson Resilience Scale (RISC) developed by Campbel-sills and Stein[37] to measure resilience among nursing professionals. In addition to this, some studies also used the Hardiness Scale[38] and 14-item RISC[39] to measure the personal characteristic that enables nursing professional to adjust with adverse situations at work.

The interrelationship between stress, job satisfaction and resilience among nursing professionals

Judkins and Rind explored the relationship between role stress, job satisfaction and hardiness among home care nurses from Texas, USA. The study reported a significant inverse relationship between stress and hardiness and embraced the positive relationship between control or resilience with job satisfaction. However, the study reported an insignificant relationship between role stress and job satisfaction.[24]

Another study propounded a model of stress resiliency where resilience predicted physiological empowerment, personal and situational stress. Further, stress and psychological empowerment leads to job satisfaction and finally affects intention to stay in the presence of various demographics variables. Stress and psychological empowerment mediated the relationship between stress resiliency and job satisfaction.[23]

A study based at Korea examined the association between resilience, occupational stress and job satisfaction among 433 nurses working in University hospital, Jin-Ju. The study highlighted a significant positive correlation between resilience and job satisfaction; an inverse relationship between resilience and occupational stress. The study also reported an inverse relationship between occupational stress and job satisfaction.[19]

Abdollahi et al. investigated the mediating role of hardiness in relationship of perceived stress and happiness. The study supported that hardiness enables an individual to cope up with adversities and stressful conditions. The study reported that perceived stress and happiness are inversely correlated and the relationship is mediated by hardiness among nurses in Tehran.[25]

An Israel-based study on mental health nurses focusing on the impact of staff resilience, job stress and workplace violence on satisfaction. The study reported a positive relationship between resilience and satisfaction. The study reported that, resilience and stress are the major factors affecting the level of satisfaction, whereas workplace violence plays a minor role.[26]

Lanz and Bruk-Lee examined the moderating effect of resilience in the relationship between workplace stressors of workload and interpersonal conflict with job satisfaction. The study identified work based and social stressors from the emotion-centred model of occupational stress. The study reported that interpersonal conflict and workload predicts burnout, turnover intention and self-reported injury, respectively.[28]

A study was conducted on 194 infection control nurses from general hospitals in Korea to examine the association between the variables of role stress, job satisfaction and resilience. The study identified lack of job autonomy and job requirement as major stressors and reported a negative correlation of job stress with both resilience and job satisfaction.[27]

A systematic review of resilience among nurses with associated personal and work-related factors reviewed 38 articles and identified a negative correlation between resilience and job demand factors of stress, Post-Traumatic Stress Disorder, burnout and conflicts. The study also indicated that resilience has a positive correlation with various job resources and outcomes of coping, self-efficacy and job satisfaction. The study concluded that resilience could be used to attenuate the job demand factors of emotional exhaustion and stress and can enhance the positive job outcomes of employee engagement and job satisfaction.[29]


  Discussion Top


It is evident from the review that studies investigating stress, job satisfaction and resilience among nurses mainly used quantitative designs to study the relationship between the variables. Only one study[29] had a qualitative synthesis of systematic review to study the relationship of nurse resilience with job demand factors of stress, burnout, emotional exhaustion and job resources of job satisfaction, self-efficacy and social support. It is also worth noting that only one study[28] used longitudinal research design keeping in mind the existence of variability in the level of stress across time.[13] The current review underlines the need for longitudinal studies to identify the changes in levels of stress, resilience and job satisfaction over time. Furthermore, the changes in the relationship among these three variables need to be explored across time and various demographics.

Furthermore, the findings of studies cannot be generalised as a majority of studies reviewed utilised sample limited either to only one geographic area or to one category of nurses. Therefore, including a sample from other sites and capturing responses from different categories of nurses working in different speciality departments may provide a generalised result. In addition, in most of the studies, the sample size was not determined using power analysis; hence, the conclusions may not be valid for generalisation.

The reviewed studies utilised multiple instruments to investigate stress, resilience and job satisfaction among nurses. Instruments used in studies were having different content, structure, and items, which makes the comparison among studies difficult. This review most importantly highlights the need for developing consistent instruments to measure stress and resilience so that comparison and contrast among studies and results can be accomplished and conclusions can be drawn.

Nevertheless, the review of studies suggests that nurses throughout the world experience stress though stressors may vary in varied situations and locations. Further, most studies reported that nurses encountered multiple stressors such as workload, dealing with death and dying situations, caring for patients, lack of autonomy at work and lack of resources. In addition, resilience was recognised as an aid that could enable nurses to cope up with adversities at work and enhance their inner strength to bounce back from a negative outlook. The association between role stress and job satisfaction is well-researched in literature, but the role of resilience in reducing stress and enhancing job satisfaction needs more exploration as most of the studies suggested training and approaches to increase resilience among nurses.

The positive role of factors such as social support, general well-being and happiness was reported and highlighted by several studies. However, the presence of some undetermined non-work-related factors predicting stress and satisfaction among nurses has been acknowledged in the review of studies. Further researches can be carried out to explore these factors affecting role stress and job satisfaction. Resilience among nurses has been reported as a major intervention that might help to cope with stressful events at the workplace and upsurges satisfaction among them. The review highlighted the need for further understanding and exploration of the role of resilience among nurses and stresses the development of a consistent instrument to measure resilience. [Table 1] shows the summary of reviewed literature.

Implications for nursing

The review affirms the detrimental effect of stress on level of job satisfaction among nursing professionals. Furthermore, the mediating effect of resilience in the inverse relationship of stress and job satisfaction has been noted. Insights from this review offer directions for health-care managers, nurse educators and health-care administrators to formulate requisite strategies to reduce stress and increase job satisfaction among nursing professionals. Nurse educators and trainers should incorporate resilience training to strengthen the coping capacity of nurses so that they can deal with prevailing adversities at work. Interventions to increase resilience will help reduction in stress levels and will upsurge the level of satisfaction among them. Policies and strategies in this regard will help health-care administrators to better understand the issues of nursing shortage, migration and turnover in the nursing industry and ameliorate the quality of health care provided to patients.


  Conclusion Top


A variety of stressors including heavy workload, dealing with death and dying situations, resource inadequacy and violence at work place have been identified by studies. Resilience has been acknowledged as a characteristic that might help manage and reduce the level of stress. The review affirms the positive impact of resilience on job satisfaction and provides directions for future researches to explore the mediating effect of resilience. Future research needs to examine the relationship between role stress, job satisfaction and resilience among nursing professionals in Asian settings and different work environments. The impact of the relationship between role stress, job satisfaction and resilience on nursing turnover is another domain where research needs to be conducted to strategise on the problem of nursing shortage throughout the world. This review also buttresses the need for future researches exploring the effect of changing demographic profile of nurses globally.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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