An examination of the relationship between personal and contextual variables and occupational stress-related depression in nurses.

Abstract

The issue of occupational stress in nurses is significant because it has been associated with absenteeism, burnout and turnover among nurses. This study was an attempt to illuminate the occupational stress experience of workers in general with a focus upon nurses as subjects. Consequently, this research evaluated multiple contributory components to this stress process. Further, consideration of the fit between this stress-coping-depression model and General Systems Theory was another major focus of this study. The independent variables of daily hassles, occupational stress, primary stress appraisal, coping strategies, social support, repression and extraversion were measured in an attempt to determine their combined and singular influence upon the dependent variable of professional depression. These variables were measured by means of a paper-and-pencil self-report inventory of questionnaires mailed to a random sample of six hundred registered nurses in the state of Arizona. Analyses of returned questionnaires consisted of regression analyses of a causal model of the above noted variables. The findings indicate that emotion-focused coping strategies, especially escape avoidance and distancing strategies, demonstrated the most consistently significant effect upon depression for the total sample as well as for all of the demographic subgroups. The next most significant variable measured in this study was that of social support. This variable demonstrated an inverse relationship to depression and thereby appears to provide protection from depression when an individual is exposed to external stressors. External stressors, especially the daily hassles subscales of work, and time pressures, were also significantly related to increased depression in most of the analyses. Occupational stress, on the other hand, as measured revealed a statistically significant relationship to depression for only two subsamples of the study population, charge nurse/clinical specialists and nurses who had worked in nursing longer than 20 years. In regard to stress appraisal, the aspects of threat and stressfulness both revealed significant relationships. The appraisal of threat was significantly related to depression while stressfulness revealed influences upon both external stressors of daily hassles and occupational stress as well as upon depression.