Stress is a construct depicting the interrelation of individual and environment. It is the response by a individual to stressors in the environment. Selye ‘s General Adaptation Theory ( Selye, 1976 ) described stress response as biophysiologic in nature. When the individual is subjected to a stressor, a characteristic syndrome of physical reactions will happen. The emphasis construct can besides be seen as active in a holistic position of the individual. The stress response can be physical, psychological, emotional or religious in nature and is normally a combination of these dimensions. Stress, likewise, can originate from one or more dimensions and can be either internal or external.
Lazarus and Folkman ( 1984 ) viewed emphasis as a dynamic and mutual relationship between the individual and environment. In this theory, stressors can run from ruinous events to annoying incidents. However, these stressors do non arouse a emphasis response in the person until the individual appraises it as transcending the available resources.
Stress and the negative results of emphasis have been recognized as financially dearly-won to any wellness attention organisation. Negative results of occupation emphasis among nurses include unwellness, diminution in overall quality of attention, occupation dissatisfaction, absenteeism, and staff turnover ( Schwab, 1996 ) . Job stress describes the emphasis associated with the professional or work environment. Tension is created when the demands of the occupation or the occupation environment exceed the capacity of the individual to react efficaciously. Job stress varies with each work environment.
Assorted beginnings of occupation emphasis have been identified in the nursing work environment. Cohen-Mansfield ( 1995 ) divided work related stressors for nursing into three classs: the institutional degree, the unit degree and the patient degree. Leveck and Jones ( 1996 ) used four classs of stressors modeled after Hinshaw and Atwood ‘s Job Stress Scale ( JSS ) ( 1983 ) . The JSS steps competency, physical work environment, staffing, and squad regard. Other surveies have identified heavy work load, urgency of work to be performed, deceasing and decease of patients, function struggle, and deficiency of liberty in pattern, deficiency of societal support, hapless occupation tantrum, deficient cognition base, insecure workplace, and a quickly altering wellness attention environment as stressors for nurses ( Hemingway & A ; Smith, 1999 ; Tovey & A ; Adams, 1999 ; Van Servellen & A ; Topf, 1994 ) .
Job Satisfaction
Job satisfaction has been shown to be closely affected by occupation emphasis. In a metaanalysis of variables related to nurses ‘ occupation satisfaction, Blegen ( 1993 ) identified the variables of age, liberty, committedness, communicating with equals and supervisors, instruction, equity, venue of control, professionalism, acknowledgment, emphasis and old ages of experience. Blegen ‘s analysis found emphasis and committedness to hold the strongest relationship with occupation satisfaction. Irvine and Evans ( 1995 ) besides found a strong negative correlativity between emphasis and occupation satisfaction although non every bit strong as that found by Blegen. Job satisfaction has besides been negatively linked to purpose to go forth and existent turnover ( Hinshaw & A ; Atwood, 1983 ; Irvine & A ; Evans, 1995 ; Price & A ; Mueller, 1981 ) . Although occupation satisfaction is a complex concept, the strong negative correlativity to emphasize and behavioural purpose to go forth employment warrants the attending of nursing decision makers. Attention to occupation satisfiers may non be sufficient to countervail the occupation emphasis experienced by nurses therefore taking to ideas of go forthing employment.
Significance of the Study
This survey provides information to nursing decision makers, and pedagogues related to perceived occupation emphasis and occupation satisfaction of ICU nurses in SMC in Bahrain.
Understanding the relationship of occupation emphasis to occupation satisfaction will give way to nurse decision makers as to the comparative importance of cut downing emphasis or increasing other occupation satisfiers. Increased emphasis or decreased occupation satisfaction increases the likeliness of occupation hurt, absenteeism, and staff turnover. This is expensive to the organisation as overtime hours or per diem aid must be used. Tzeng ( 2002 ) suggests that decision makers should concentrate on those stressors or satisfiers over which they have the most influence to alter.
For nurses in clinical pattern, the rapid turnover of staff due to emphasize, deficiency of satisfaction, or both, reduces the quality of attention as new staff must be oriented and group coherence is weakened by changeless alterations in the group rank on a nursing unit. Increased apprehension of both emphasis and satisfaction factors will motivate nurses to take personal steps to cut down emphasis, raise their degree of expertness, and go proactively involved in bettering the working environment of their organisations ( Mee & A ; Robinson, 2003 ) .
Problem statement
What is the consequence of occupational emphasis on occupation satisfaction of ICU nurses in SMC?
Purpose of the Study
The intent of this survey is to research the relationship between occupational emphasis and occupation satisfaction of ICU nurses in SMC.
Premise
Based on literature reappraisal we assume that there are different beginnings of emphasis affect the degree of satisfaction of ICU nurses.
Hypothesiss
Job emphasis reported by ICU nurses will be reciprocally related to occupation satisfaction.
Theoretical Model
Roy Adaptation Model ( RAM ) ( Roy, 1984 ) will be used as the theoretical model for our survey. Roy viewed the individual as a holistic and complex adaptive system. In the RAM, the environment ( stimulus or stressor ) and the individual ( adaptation degree ) provided the system input. The response control processes were the get bying mechanisms, regulator subsystem ( physiologic version ) , and cognator subsystem ( cognitive & amp ; emotional assessment ) . Effecters were physiological map,
self-concept, function map, and mutuality. System end product is either version to the stimulation or uneffective response. The end product so provided feedback as the version degree of system input.
In the current survey, both external stressors associated with the occupation of nursing in the ICU environment and internal adaptative degrees of the nurses in the sample provide the system input. The nurses ‘ single header mechanisms and regulator and cognator subsystems control the psychological and emotional effecters that produce the end product of effectual or uneffective version. Job satisfaction is the index of the effectivity of version in this population of nurses.
Conceptual and Operational Definitions
Job Stress
Conceptual Definition
Gray-Toft and Anderson ( 1981 ) stated that emphasis is “ an internal cue in the physical, societal, or psychological environment that threatens the equilibrium of an person ”
Operational Definition
Stress ( independent variable ) is an internal response to stimuli or force per unit areas that challenge ICU nurse ‘s ability to accommodate or get by. This variable will be measured utilizing the Expanded Nursing Stress Scale ( ENSS ) ( see Appendices B ) developed by French, Lenton, Walter, and Eyles ( 2000 ) . This instrument is an expanded and updated version of the widely used Nursing Stress Scale ( NSS ) developed by Gray-Toft & A ; Anderson ( 1981 ) .
Job Satisfaction
Conceptual Definition
The contentment one feels when 1 has fulfilled a desire, demand, or outlook.
Operational Definition
The grade of satisfaction ( dependent variable ) single nurses feels toward their occupation. It will be measured utilizing seven points from the Price and Mueller questionnaire developed to prove the Professional Turnover Model ( Appendix C ) .
Restrictions
The survey might hold several restrictions. First, it will be limited by a little, convenience sample size. The usage of a larger sample and random sample will beef up future surveies. A 2nd restriction of the survey will be the cross-sectional design. Depending on the minute in clip during which informations will be collected, factor such as alterations in staffing could act upon a positive or negative response.
Literature Review
Kirkcaldy & A ; Martin ( 2000 ) examined the relationship between Job emphasis and satisfaction among nurses. The sample for this survey consisted of 276 nurses working at a big urban general infirmary in Northern Ireland.
A composite questionnaire was developed to garner information refering demographic inside informations, organisational stressors, personality variables, and outcome steps. In early 1996, questionnaires and a covering missive were distributed to every nurse ( N 500 ) working at the infirmary. Respondents were asked to return the completed questionnaires in pre-paid envelopes. A sum of 287 questionnaires were returned, of which merely 11 were uncomplete. This yielded a response rate of 57.4 per cent ( Kirkcaldy & A ; Martin, 2000 ) .
The consequences showed that assurance and competence in occupation function, every bit good as jobs associating to the prep interface, and organisational support and engagement appeared as the most common force per unit areas at work. Stressors such as work breaks and clip force per unit areas appear less pertinent ( Kirkcaldy & A ; Martin, 2000 ) .
Healy and McKay ( 1999 ) examined the impact of nursing work-related stressors and get bying schemes on degrees of occupation satisfaction and temper perturbation. The survey was conducted in urban and regional medical establishments in Australia.
A voluntary sample of 129 registered nurses was recruited from Melbourne metropolitan and Victorian regional establishments ( Australia ) and surveyed utilizing standardised questionnaires and open-ended inquiries. The sample consisted of 125 females and four males: 120 were division 1 nurses and nine were division 2. Their ages ranged from 20 to 59 old ages: average age was 36a8 old ages. Topographic points of employment included private infirmaries 80 nurses ( 62 % ) , public infirmaries 24 ( 11 % ) , nursing places 11 ( 9 % ) , nursing bureaus 7 ( 5 % ) , and community-based bureaus 7 ( 5 % ) . The length of nursing experience ranged from 6 months to 37 old ages with an norm of 16 old ages of experience ( Healy & A ; McKay, 1999 ) .
A Demographic Survey and five standardised questionnaires were given to the participants: ( a ) the Nursing Stress Scale ( NSS ) , ( B ) the Ways of Coping Questionnaire ( WOCQ ) , ( degree Celsius ) the Coping Humour Scale ( CHS ) , ( vitamin D ) the Job Satisfaction Scale of the Nurse Stress Index, and ( vitamin E ) the Profile of Mood States ( POMS ) ( Healy & A ; McKay, 1999 ) .
Consequences from the NSS mark indicated that `workload ‘ was the highest sensed stressor in the nurses ‘ working environment, which closely accords with the findings of two British surveies ( Tyler & A ; Cushway 1992, 1995 ) . The workload sub-scale of the NSS taps into issues originating from the physical environment, such as existent work load, unequal staffing degrees and deficient clip to finish nursing undertakings. ‘Conflict with other nurses ‘ and `lack of staff support ‘ were the least reported stressors on the NSS. The dependability coefficients obtained for the Nursing Stress Scale in this survey were higher than those reported by Gray-Toft & A ; Anderson ( 1981 ) ( entire graduated table coefficient 0.89 and sub-scales coefficients runing from 0.64 to 0.77 ) . Standard multiple arrested development was so used to analyze the extent to which the independent variable, the Nursing Stress Scale factors, explained the discrepancy in temper perturbation ( POMS tonss ) . The combined NSS factors accounted for 15 % of the discrepancy of POMS tonss ( F ( 7120 ) =E†4.16, P & lt ; 0.001 ) . However, Workload was the lone important forecaster of temper perturbation ( Healy & A ; McKay, 1999 ) .
The comparative importance of occupational and non-occupational variables in the anticipation of occupation satisfaction and psychological hurt was investigated in a study of infirmary nurses ( N = 376 ) . Perceived dealingss with the caput nurse, coworkers, doctors, and other units/departments, along with unit term of office and job/non-job struggle, were forecasters of occupation satisfaction. Personal temperament ( anxiety-trait ) , societal integrating, unit term of office, professional experience, place degree, and job/non-job struggle, along with the dealingss with the caput nurse and doctors were forecasters of psychological hurt. The dealingss with the caput nurse and doctors, every bit good as unit term of office and job/non-job struggle, were forecasters of both satisfaction and hurt. The anticipation by unit term of office is notable. Unit term of office had a negative relationship to satisfaction and a positive 1 to straiten, whereas entire experience had a negative relationship to psychological hurt and none with occupation satisfaction. The function of unit term of office in nurses ‘ affectional experiences warrants more attending in future research, along with the function of job/non-job struggle and other variables predictive of nurses ‘ satisfaction and hurt ( Decker, 1997 ) .
N. Flanagan & A ; T. Flanagan ( 2002 ) examined the relationship between occupation satisfaction and occupation emphasis in correctional nurses.
A non-experimental correlational survey was designed to mensurate occupation satisfaction and occupation emphasis in the correctional nurse population in a province prison system in the southwesterly United States. There were 493 registered nurses employed by this correctional system in 56 units or installations. A sum of 287 studies were returned, a response rate of 58 % . The typical correctional nurse in this prison system in the southwesterly United States was white ( 74 % ) , female ( 83 % ) , 46 old ages old ( SD=9.01 ) , and married ( 65 % ) , with an associate ‘s grade ( 51 % ) or unmarried man ‘s grade ( 30 % ) . On norm, these correctional nurses had been working in nursing for 16.7 old ages ( SD=9.78 ) , had been registered nurses for 14 old ages ( SD=10.50 ) , had been employed in correctional nursing for 5 old ages ( SD=4.17 ) , and had been assigned to their current installation for 3.6 old ages ( SD=3.27 ) . Correctional nurses brought a broad assortment of nursing experience to their current places ( N. Flanagan & A ; T. Flanagan, 2002 ) .
This descriptive and cross-sectional survey was conducted in April 2003, and included 180 nurses: 31 working in dialysis units, 100 in ICUs, and 49 in the most preferable wards of the same infirmaries. The survey campaigners were assessed with the usage of a questionnaire sing their socio-demographic features, work topographic points, and positions refering their dealingss with and the sentiments of their professional contacts. Other agencies of informations aggregation were the Work-Related Strain Inventory ( WRSI ) , the Maslach Burnout Inventory ( MBI ) and the Minnesota Work Satisfaction Questionnaire ( MWSQ ) . Percentage appraisals, the chi-square trial, and discrepancy analysis were used for statistical rating of the informations ; P & gt ; 0.05 was accepted as important ( Fatma, 2007 ) .
This survey confirmed some established forecasters of occupation satisfaction, work-related emphasis, and burnout and provided informations on an undiscovered country. Dialysis nurses appear to be at a reduced hazard for occupation emphasis, burnout and premature retirement from nursing, with higher degrees of occupation satisfaction. Further. the quality of relationships with physician colleagues and the sentiments of professional contacts sing the nursing profession as perceived by nurses may be related to occupation emphasis, burnout and work satisfaction ( Fatma, 2007 ) .
Design of the survey
A quantitative, descriptive, cross-sectional, non-experimental research design will be used in this survey. This design was chosen because randomisation of groups wo n’t be possible.
Sample of the survey
Nurses for this survey ( N = 30 ) will be recruited from ICU in SMC. Inclusion standards consisted of nurses who are ( a ) Registered nurses in ICU, ( B ) employed at the infirmary at least 1 twelvemonth. Exclusion standards consisted of direction forces.
These standards were chosen because the respondents would be well-oriented to the organisation, past the initial emphasis of working in a new environment, and working in similar state of affairss as they will be evaluated for the first six months. Nurses in direction places will be excluded because there are differences in stressors related to occupation duties.
Puting of the survey
The survey will take topographic point at ICU in SMC. SMC is a secondary infirmary under ministry of wellness. ICU is an intensive attention unit consists of 12 beds.
Instruments of the survey
Instruments will be used in the survey are the Expanded Nursing Stress Scale ( see Appendix B ) ( ENSS ) ( Gallic et al. , 2000 ) and seven inquiries refering to occupation satisfaction from Price and Mueller ‘s ( 1981 ) Professional Turnover questionnaire ( see Appendix C ) . Permission to utilize these instruments will be obtained.
The ENSS measured the independent variable of occupation emphasis. The ENSS is an expanded and updated alteration of the authoritative Nursing Stress Scale ( NSS ) developed by Gray-Toft & A ; Anderson ( 1981 ) . ENSS contained 57 points in nine subscales: ( a ) Death and Dying, ( B ) Conflict with Physicians, ( degree Celsius ) Inadequate Emotional Preparation, ( vitamin E ) Problems Associating to Peers, ( degree Fahrenheit ) Problems Associating to Supervisors, ( g ) Work Load, ( H ) Uncertainty Concerning Treatment, ( I ) Patients and their Families, and ( J ) Discrimination. The 57 points were arranged in a 5 point Likert response graduated table. The responses were ‘never nerve-racking ‘ ( 1 ) , ‘occasionally nerve-racking ‘ ( 2 ) , ‘frequently nerve-racking ‘ ( 3 ) , ‘extremely nerve-racking ‘ ( 4 ) , and ‘does non use ‘ ( 5 ) . ( Gallic et al. , 2000 ) .
The independent variable of occupation satisfaction will be measured utilizing seven points from the Price and Mueller ( 1981 ) Professional Turnover questionnaire.
Dependability and Validity
Instrument dependability will be calculated utilizing Cronbach ‘s coefficient alpha for the ENSS graduated table, each of the nine subscales, and the Job Satisfaction graduated table. Cogency of the instruments will be examined utilizing Content Validity. Statistician aid will be asked.
Pilot survey:
A pilot survey will be conducted on 10 nurses who will be excluded from the existent sample.
Data aggregation methods
Permission to carry on the survey will be granted by the research Technical Support Team ( see Appendix A ) . We will administer 30 information and study packages to the nurses who will run into inclusion standards. The package will be contained a missive of account for the survey ( see Appendix D ) , an Informed Consent ( see Appendix E ) , a Demographic Survey ( see Appendix F ) , the Expanded Nursing Stress Scale Survey, and the Job Satisfaction questionnaire. Participants will be asked to return the questionnaires within the following two hebdomads and to put their certain responses in the designated envelope available in the ICU. Surveys will non be numbered and respondents will be requested non to place their responses with names or initials.
Ethical Considerations
As mentioned antecedently, Permission to carry on the survey will be granted by the Research Technical Support Team. The participants will hold full account sing the survey and an informed consent will be obtained. Surveies will non be numbered and respondents will be requested non to place their responses with names or initials.
Datas analysis
Data will be analyzed utilizing both descriptive and illative statistics. Demographic information will be analyzed to place the relationship between respondent age and old ages worked in ICU. Means and standard divergences will be used to place degrees of occupation emphasis and occupation satisfaction. Statistician aid will be asked.
Timeline and budgets:
This research survey wo n’t be much. Time devouring and the cost of documents the lone cost of this research.
Aims
Duration
Introduction
28/12-1/1
Literature reappraisal
2/1 – 8/1
Methodology
9/1 – 15/1
Data aggregation procedure & A ; finalisation
16/1 – 23/1