To Explore the Impacts of Job Stress and Job Content on Anxiety, Depressive Symptoms and Self-perceived Health Status among Nurse Practitioners

• Main Authors: Chin-Huang Chen, 陳金凰
• Other Authors: Jun-Yu Fan
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/56132989942392454008

碩士 === 長庚科技大學 === 護理研究所在職專班 === 102 === Background：In 2007, Taiwan recognized the first nurse practitioners. Their practice guidelines are approved by the "nurse practitioner training program and Codex Committee". Their roles are vary between different hospitals due to diverse demands and encompass complex tasks. Thus, nurse practitioners experience heavy workloads that can result in insomnia, depression, negative affect, and abnormal endocrine reactions all of which can profoundly influence their health status. Purpose：The purposes of the study were (1) to explore the impact of job stress and job content on anxiety, depressive symptoms, and self-perceived health status among nurse practitioners and (2) to explore the relationship between variables and their related factors. Methods：This study was a descriptive cross-sectional design. A convenience sample of nurse practitioners from southwestern regional hospitals was enrolled in the study. The current study measured health using instruments including the “Taiwan Nurse Stress Checklist”, the “Chinese Version of the Job Content Questionnaire (C-JCQ)”, the “General Health Status checklist”, the “SF-36 Health Survey, Taiwanese Version,” “The Beck Anxiety Inventory-II; BAI”, “The Beck Depression Inventory-II; BDI-II” and a salivary cortisol test. Data were analyzed using SPSS Version 20.0 for Windows, and the threshold for statistical significance was set at P < .05. To analyze the data and identify the predictors and variances of work stress, anxiety symptoms, depressive symptoms, and self-perceived health status in nurse practitioners, descriptive and inferential statistics were used and included independent t-tests, paired t-tests, analysis of variance (ANOVA), repeated measures ANOVA, Pearson’s r correlation, and Hierarchical regression analysis. Results：The results showed that nurses practitioners reported moderate job stress, with "individual response" rated as the most stressful dimension. In terms of the job content, the job control of nurse practitioners was similar to nurses but they experienced higher psychological stress. Social support was provided by peers rather than by administrators. More than half of nurse practitioners presented with mild anxiety (57.8%) and symptoms of moderate to severe depression (51.2%). The more depressive symptoms nurse practitioners perceived, the poorer they reported their self-perceived health status to be, and the more of a flat slope in cortisol levels between morning and was measured indicating a slower adaptation ability for that individual. The following significant relationships were observed: the more job stress, the greater individual responses, the lower the feelings of job control, the higher the psychological burden, the lower the perceived recognition by administrators, the higher the levels of anxiety and depression symptoms, and the poorer the self-perceived health status. After adjusting covariates, the predictors of self- perceived health status were personal response and the competence subscale of job stress. Conclusion and clinical implications：Nurse practitioners are very important health providers and educators. Currently job requirements vary between different hospitals that result in a poor quality of patient care and indirectly affect the retention rate of nurse practitioners. The government and hospital managers need to consider providing a professional training program, identifying clear policy and legal norms, arranging appropriate working hours and nurse-patient ratios, providing a reasonable salary and a realistic promotion system in order to enhance the performance of nurse practitioners.