|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 1 | Page : 84-86
Perceived stress and coping strategies among the married staff nurses working in ward setting of selected hospitals in Mangalore, India
PJ Shiji, Sonia Karen Liz Sequera, Simi Mary Mathew
Department of Community Health Nursing, Father Muller College of Nursing, Mangalore, Karnataka, India
|Date of Web Publication||21-Jan-2016|
Sonia Karen Liz Sequera
Lecturer, Department of Community Health Nursing, Father Muller College of Nursing, Mangalore, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shiji P J, Sequera SK, Mathew SM. Perceived stress and coping strategies among the married staff nurses working in ward setting of selected hospitals in Mangalore, India. Muller J Med Sci Res 2016;7:84-6
|How to cite this URL:|
Shiji P J, Sequera SK, Mathew SM. Perceived stress and coping strategies among the married staff nurses working in ward setting of selected hospitals in Mangalore, India. Muller J Med Sci Res [serial online] 2016 [cited 2023 Mar 21];7:84-6. Available from: https://www.mjmsr.net/text.asp?2016/7/1/84/174671
Stress is experienced when demands made on us outweigh our resources.  Stress that is not well managed will bring negative consequences not only to an employee, but also to the organization.  Nurses in India face different stressful events. They are the backbone of the medical system and act as the first line of patient medical care. Nursing is, by its nature, an occupation subject to a high degree of stress. Workload, leadership or management style, professional conflict, and emotional cost of caring have been the main sources of stress in nursing.  A study conducted in India, to assess the job stress, revealed that 63% of the nurses experienced severe stress and 37% experienced moderate stress.  Another study conducted in Karnataka revealed that 60% experienced low stress, 38% moderates stress, and 2% severe stress. There was also significant association between stress and professional qualification, marital status, and area of work. Additional sources of stress include financial and economic factors and conflict between work and family roles.  Study conducted to determine the coping strategies among nurses in Benin City revealed that 90% avoided unnecessary stress, altering the situation, and 94% managed their time better, adjusted to the standard and attitude. 
Since the investigators are nurses, thanks for their sharing of personal experiences while working with their colleagues in the wards. They have found nurses face a lot of stress due to various reasons. With this background, this study was undertaken with the objective of assessing the perceived stress level and the coping strategies among married staff nurses in a selected hospital of Mangalore, Dakshina Kannada.
A descriptive study, cross-sectional in design, was employed to research the stress and coping strategies among married staff nurses. A purposive sampling technique was used. The study was performed at a selected hospital of Mangalore. The tool was developed after an intensive review of literature, consultation, and discussion with experts and was based on the personal experience of the researcher. A blueprint was prepared, which showed the distribution of items according to the content areas. Tools of data collection consisted of a baseline proforma; a stress-rating scale that consisted of 40 items; a 4-point scale with the responses as "never" (N), "sometimes" (S), "often" (O), and "always" (A); and a coping strategy checklist consisting of 30 items, "yes" or "no" type. The validity and reliability of the tool were ascertained. The tool was pretested. Ethical clearance was obtained from the concerned institution. The investigator conducted a pilot study at a private hospital from 19 May till 22 May 2014 on 5 married staff nurses, who satisfied the inclusion and exclusion criteria. The main study was conducted on 40 married staff nurses of ward settings from 26 May till 6 June 2014. Informed consent was obtained from the subjects and the confidentiality was assured. The demographic pro forma, stress rating scale, and coping strategies checklist were administered to the subjects. The inclusion criteria included married staff nurses working in ward settings. Nurses working in critical setup were excluded from the study.
The data were analyzed using descriptive and inferential statistics. A majority of the subjects had moderate stress (75%), whereas few (25%) had mild stress. Professional problem (61.67%) was found to be a major stressor among nurses, followed by personal problem (57.81%) and psychological problem (49.23%).
[Table 1] shows area-wise mean, standard deviation, and mean percentage of stress level. The mean percentage stress score was higher in the professional area (61.67%) than in the areas of personal problem (57.81%) and psychological problem (49.23%). The overall mean percentage of stress score is moderate (54.38%).
|Table 1: Area-wise range of score, mean, standard deviation, and mean percentage level of stress among married staff nurses (N = 40)|
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Most of the married staff nurses (80%) used coping strategies at a moderate level, few of them used high-level coping strategies (12.5%), followed by low-level coping strategies (7.5%).
The data presented in [Table 2] show that majority (80%) of the married staff nurses had moderate-level coping strategies and 12.5% of them had high-level coping, and only 7.5% of the married staff nurses had low-level coping strategies to cope up with stress.
|Table 2: Frequency and percentage distribution of the level of coping strategies among married staff nurses (N = 40)|
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[Table 3] shows that mean percentage scores of coping level of married staff nurses was highest in the area of confrontive coping (64.4%), least in the area of escape avoidance (36%). The overall mean percentage of coping level is moderate (55.08%).
|Table 3: Area-wise range of score, mean, standard deviation, and mean percentage level of coping strategies among married staff nurses (N = 40)|
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There was a significant negative relationship between stress and coping strategies as depicted by the Karl Pearson correlation coefficient (r = -0.459, >0.325 tabled value). There was no association between perceived stress level and coping strategies with the sample characteristics.
Out of the 40 staff nurses selected, the majority were in the age group of 25-30 years and most of them (92.5%) were Christians. More than half (65%) completed their general nursing and midwifery and rest (52.5%) were working as senior staff. Half of the subjects worked 40 h per week and most of them (45%) worked more than 40 h per week. Majority of the nurses (75%) live in a nuclear family, and most of them (75%) did not attend any stress management sessions. More than half (58%) were working for more than 4 years in the institution.
| Discussion|| |
Majority (75%) of the subjects had moderate stress and none revealed severe stress whereas, 80% nurses used moderate coping strategies in the working area. The results of the investigation indicated that the majority of the married staff nurses had moderate level of stress and coping strategies.
Professional problem was found to be a major source of stress among the staff nurses followed by the personal problems and psychological problems. It may be due to the added responsibilities of the married life that in turn may contribute to the stress at work. There is lot of anger and resentment in the family because of job. Majority stated that long working hour and frequent night duties causes lot of stress. Staff shortage was also one of the causes for stress, and it is also difficult to meet daily expenses with the present income. They also reported that balance between work and family was difficult to maintain. It was also noticed that they are not able to express or communicate their problem with others. These factors, along with compromised training received, could be major determinants of this finding. Nurses witness suffering of the patients every day and sometimes death of the patients whom they have cared for. They also deal with patients who do not improve in spite of providing maximum possible care and treatment. All these may result in more stress. As there is acute shortage of nurses in majority of the hospitals in India, nurses face problems due to increased workload. They are unable to complete their tasks in time and have inadequate time to meet emotional needs of the patients, unpredictable staffing may be there, and in most of the hospitals nurses have to do too many nonnursing tasks such as clerical work. The least reported stressors were perceived lack of staff support and inadequate preparation to deal with emotional needs of patients and their families.
The present study throws light on the coping strategies used by the staff nurses in their work area. Some of the methods used for coping included planful problem solving (62%), confrontive coping (64%), self-control (61%), and seeking social support (66%). Other ways included escape/avoidance (36%) and accepting responsibility (45%).
Some of the findings of this study support the information available from the existing studies. A study conducted in Malaysia to determine the job stress and coping mechanisms among 160 nursing staff of public sector revealed that the major contributor of job stress was heavy workload (64%), repetitive work (73%), and poor working environment (67%). Coping mechanism used were hobbies, leisure activities (68%), having close friends to confine (71%), and spiritual thoughts (62%). 
A study conducted in Nigeria among staff nurses to determine the occupational stress and management strategies revealed that a major cause of stress was poor salary (82%), handling large number of patient alone, lack of incentives (83%), and job insecurity. 
The studies discussed reveal that stress is a part of everyday life for nurses in the health-care industry. The negative influence of job-related stress on nurses and hospitals is manifested through absence, unhealthiness, staff conflict, depression, staff turnover, and inferior service. This will have a negative impact on an employee and organizational effectiveness. Significant number of nurses experience stress, which may diminish nursing care quality. Dual roles of the nurses after marriage could be one of the contributing factors for married nurses to have more stress and less coping. Nurses make efforts to create positive meaning by focusing on personal growth and make efforts to seek informational support, tangible support, and emotional support. Stress management programs and coping techniques for nurses are very important. Excessive workload requires attention from the management especially because safe work environments are legally required. Reducing the effect of environmental stressors such as workload, staffing, and assisting nurses to balance priorities may be effective interventions. Attempts to deal with the sources of stress and their consequences need to be made at individual, interpersonal, and organizational levels. 
Further studies with a better methodology are required to draw definite conclusions. The study could be replicated on a larger sample using random selection for generalizing the findings. The present study can be used as a baseline to plan and implement programs, which in turn would contribute to the quality care of patients in the health industry.
Financial Support and Sponsorship
Conflicts of Interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]