A meta-analytic investigation of occupational stress and related organisational factors: is nursing really a uniquely stressful profession?

Abstract

These studies investigated relationships between occupational stressors and strain through the application of meta-analysis. In Study I, the meta-analytic procedure specified by Hunter and Schmidt (1990) was applied to 53 studies that utilised 54 independent samples of nurses (N = 14, 524) and presented 143 correlations between occupational stressors and strain. This study showed that patient care demands, workload, conflict with co-workers, lack of co-worker and supervisor support, poor leadership, role uncertainty, lack of role confidence and competence, responsibility, lack of job control, job complexity, poor physical environment, shift work, home/work conflict, lack of career prospects, and lack of professional esteem were all significantly correlated with strain. Some of the strongest effect sizes were found for workload, home/work conflict, leadership, co-worker conflict. Nursing specialisation moderated the effect sizes of professional esteem and patient care demands, such that professional esteem was more strongly related to strain in paediatric nurses than in other nurses, and the relationship between patient care demands and strain was stronger in mental health nurses than in general nurses. In Study II, archival data from various administrations of the Queensland Public Agency Staff Survey (QPASS) among nurses and public servants employed by the Queensland Government (N = 4,509) was meta-analysed. This study showed that all organisational climate variables, positive and negative work events measured by the QPASS were significantly related to individual distress at work. Organisational issues such as staff relationships, leadership, role clarity, goal congruence, and workplace morale and workplace distress were amongst those most strongly associated with distress. Employment status did not moderate any of the relationships, but the relationship between personality clashes and distress was moderated by occupation, whereby the effect size was stronger in nurses than in public servants. It was suggested that generic interventions used to improve organisational climate and decrease stress will also be of value in the nursing profession. Several avenues for further meta-analytic research in the organisational health domain were identified.