M.Cur. (Psychiatric Mental Health Nursing) / Injuries suffered by nursing personnel as a result of aggression by mental health care users are on the increase. The psychiatric nurses and assistant nurses working in a psychiatric institution may suffer physical trauma, which gets healed over time with proper treatment, but the emotional scars are not attended to, hence some of the psychiatric nurses and assistant nurses working in a psychiatric institution do not cope. The impact of this trend is enormous and it is reflected in the health care service. The main purpose of this research study is to explore and describe the experiences of psychiatric nurses and assistant nurses who have been exposed to aggression by mental health care users while working in a psychiatric institution, in order to formulate guidelines to promote the mental health of these psychiatric and assistant nurses to. A qualitative, exploratory, descriptive and contextual research design was utilised in this study. There were two phases to the research, whereby phase one included the description and exploration of experiences of nurses who have been exposed to aggression by mental health care users in a public psychiatric hospital in Gauteng. In phase two, guidelines were formulated to promote the mental health of the nurses in this context. A purposive sampling method was used, since it provides information-rich cases for in-depth study. One-on-one in-depth phenomenological interviews were utilised to gather data. Lincoln and Guba’s approach to trustworthiness was adopted, and I employed the services of an independent coder - an experienced psychiatric nursing specialist - to assist. Thereafter a consensus discussion was held. Ethical principles were adhered to throughout the study. The findings of the research were discussed in the light of literature relevant to this research study and similar studies will be used to verify the findings. Tesch’s method of data analysis was utilised in analysing the data of this research study. The findings revealed that participants experience significant emotional distress as a result of both verbal and physical aggression by mental health care users. Aggressive behaviour was recognised by the participants as being the outcome of interplay between numerous interactional and contextual factors. Participants may at times, experience conflict between their job mandate – to care for the mental health care users – and their need for personal safety. This often results in a sense of ambivalence towards those they care for, as well as towards their job. The participants were of the opinion that they should be offered counselling or debriefing services by management after exposure to aggressive incidents in order to recuperate from the anxiety-provoking situation they encountered. They also mentioned that they do not receive enough training in handling aggressive mental health care users, hence at times they feel demotivated. Guidelines to facilitate the mental health of nursing personnel who have been exposed to aggression by mental health care users, were formulated and recommendations were made to psychiatric nursing practice, psychiatric nursing education and psychiatric research. Evaluation of the study was done and the role of an advanced psychiatric nurse in mobilising resources to facilitate the mental health of psychiatric nurses and assistant nurses working in a psychiatric institution who have been exposed to aggression by mental health care users, was outlined.

The focus of this study was to investigate work-family conflict, social support and gender ideologies of professional/registered nurses in the South African context, specifically within the Cacadu District (Eastern Cape). The study had four aims: (a) to investigate the construct validity of the measuring instrument, (b) to investigate the relationship between social support provided by family and family interference with work (FIW), (c) to ascertain the influence of shift work on perceived work-family conflict, and lastly, (d) to determine whether there is a difference between the number of children in households and nurses’ perceptions of work-family conflict. A quantitative research design was used in the study. The sample (N = 106) was taken from five district hospitals in the Cacadu District, Eastern Cape. The measuring instrument consisted of three scales, namely the Multi-dimensional Work-Family Conflict Scale (Carlson, Kacmar, & Williams, 2000), the Social Support Questionnaire (Sarason, Sarason, Shearin, & Pierce, 1987), and an adapted Gender Ideology Scale (Tsai, 2008). The results indicated that the construct validity of the Multi-dimensional Work-Family Conflict scale was satisfactory. However, analysis of the Social Support Questionnaire and Gender Ideology scales both suggested that these scales have not been validated for use with diverse samples outside the contexts in which they were developed. The results also indicated that there is a relationship between social support provided by families and behaviour-based family interference with work. Additionally, there appeared to be a difference between the shifts worked by nurses and their perceived work-family conflict, except for strain-based work interference with family. And lastly, the only significant difference between the number of children in the household and work-family conflict was reported for strain-based work interference with family. The implications of the results for future research suggest the importance of developing and validating work-family conflict, social support and gender ideology scales that are dependent on the context of the research. In so doing, the constructs of the scale are made meaningful. Additionally, the findings provide preliminary evidence of tailoring work-family initiatives that address the needs of the nursing profession and the context of healthcare institutions

The complex environment of an intensive care unit is associated with a considerable amount of stress. Intensive care nurses are confronted daily with increasing work demands, emanating from the growing numbers of critically-ill patients; the introduction of highly sophisticated technologies in the intensive care environment; increasing competition between health care institutions; increased work loads; and limited career opportunities caused by, among other things, budget cuts by the government (Janssen, De Jonge & Bakker, 1999:1360). Research has shown that such stressors can result in mental, physical and behavioural stress reactions among nurses (Demerouti, Bakker, Nachreiner and Schaufeli, 2000:454). The objective of this study is to explore and describe registered nurses’ perceptions of factors causing stress in intensive care environments of state hospitals. The main purpose of the study is to develop guidelines for a stress management programme, to assist registered nurses to cope with the stressors in an intensive care environment. The research design is placed within a quantitative, explorative and descriptive contextual framework. Validity and reliability in testing and evaluating the research questionnaire are discussed, as well as the ethical and legal considerations relating to this research study. Findings of the research study will be utilized to assist the researcher in developing guidelines for a stress management programme to assist registered nurses in coping with stress in an intensive care environment

Critical care nursing is a vital and significant part of health care provision to critically ill patients. It is a specialty area of nursing that requires registered nurses who are highly motivated, knowledgeable and skilled to provide optimal care to critically ill patients. These patients are nursed in a complex environment consisting of specialised equipment (such as ventilators, defibrillators, intravenous pumps, and cardiac monitors) that is not found in any other field of nursing. Collegial support and an adequate registered nurse: patient ratio is vital in critical care units in order to provide optimal quality care to critically ill patients. However, an understaffed work environment, the demands of critical care nursing and other work-related problems, such as conflict with physicians, inadequate remuneration packages and an increased workload can cause serious distress and dissatisfaction amongst registered nurses in this specific environment (Carayon & Gürses, 2005:287). The objectives of this study therefore are to explore and describe the experiences of registered nurses of their work environment in a critical care unit and to make recommendations that will assist registered nurses working in a critical care unit. A qualitative, explorative, descriptive and contextual research design will be utilised. Data will be collected by means of semi-structured interviews and analysed according to the framework provided by Tesch (in Cresswell, 2003:192). Purposive sampling will be used to select a sample of registered nurses working in a critical care environment. Guba’s model (in Krefting, 1991) will be utilised to verify data and to ensure trustworthiness of the study. Ethical considerations will be adhered to throughout the study. Once data has been analysed, recommendations will be made that will assist registered nurses working in a critical care unit.

The literature has indicated that nurses perceive more occupational stressors than do other professional groups. HIV is a new stressor which has impacted on society, in particular on people caring for HIV/AIDS patients. The availability of antiretroviral treatment (ART) which is accessible at wellness clinics has improved the quality of life of people with HIV and greatly prolonged the lives of many infected people. Wellness clinics are out-patient clinics where HIV positive patients receive their ART. This study has explored and described the occupational stressors perceived by nurses working in wellness clinics in Nelson Mandela Bay. The study was conducted using a qualitative research approach. Convenience sampling was used consisting of voluntary registered female nurses. The data were collected by means of semi-structured interviews. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using Tech’s method. The nurses who participated in this study reported their perceptions of occupational stressors in wellness clinics where they worked. The occupational stressors perceived by the nurses included the working environment, interpersonal relationships and the organizational structure. However, they also reported that they experienced satisfaction from their jobs despite the perceived stressors.

The purpose of this study was to describe staff nurses' perceptions of their power bases in their work environment. Power, the capacity to set conditions, make decisions and take action that influences others, is an increasingly important issue within the nursing profession. In the nursing literature, nurses have been encouraged to consider the power to influence nursing care as an attainable goal and a necessary element in the change process. Empowering staff nurses may become a strategy for coping with the nursing manpower shortage. However, research about nursing power has focused on the nurse manager and little is written about staff nurses' perception of their power. A grounded theory research design was used to collect and analyze data. Data were collected through interviews of nine staff nurses in a 369 bed British Columbia community hospital. A comparative content analysis was used to analyze the data. The findings showed that the staff nurse participants were able to recognize certain factors in their work environment that impacted on their sense of power. The nature of nurses' work and the communication of information were found to be the most significant factors. The communication of information was perceived to positively influence nurses' sense of power, while the nature of nurses' work was found to limit nurses' sense of power. Nurses' lack of control over client care was found to contribute to a sense of powerlessness and was linked to units using team nursing. The eight power bases outlined in Randolph's framework, were useful as a basis for describing the staff nurses' perceptions of their organizational power bases. The staff nurses studied were found to have the most affinity for referent, expert, information, and connection power bases. These nurses were found to have the least affinity for reward, coercion, legitimate, and resource power bases. Primary nursing was found to enhance legitimate power while team nursing was found to enhance connection power. The source of power most frequently mentioned by the nurse participants was personal power in relation to oneself. This did not fit into Randolph's framework and was not well defined. This has implications for nursing since support for the professional nature of nurses' work was found to strenghthen nurses' sense of personal power. Knowledge about the perceptions described by the subjects in this investigation provides information to assist nurses' to identify power bases that they may not recognize. As well, increased understanding about staff nurses' perceptions of power should enable nursing administration to identify strategies for retaining nurses and enhancing client care. / Applied Science, Faculty of / Nursing, School of / Graduate

There is alleged to be a severe nursing shortage in Canada. While the shortage is attributed in large part to fiscal restraint in the hospital sector in the early 1990s, there are competing claims addressing why nursing employment levels changed over this period. Supply-side proponents argue that deteriorating working conditions and stagnant wages led nurses to voluntarily leave the profession, province, or country for better employment prospects. Demand-side proponents argue that hospitals reduced staff levels in response to a decline in inpatient utilization. There is also considerable disagreement on what impact, if any, reduced nursing employment levels had on access to hospital care. However, while there is no shortage of anecdotal evidence and plausible rhetoric, the debate is being carried out in a largely data-free environment. This thesis attempts partially to fill this void. Part I of this thesis examines trends in the nursing employment level in Canada over the hospital restructuring period. Results indicate that the number of nurses employed in hospitals decreased significantly during the cut-backs period and that the decrease was particularly severe among young nurses. The employment level is decomposed into three separate components for each age group: the change in the potential supply of nurses, the change in the employment rate of this group and the change in the likelihood that an individual will work in the nursing profession conditional on being employed. Results indicate that the third factor is most important. To determine whether the observed shift toward non-nursing employment was voluntary, an occupational sector choice model is developed and the pattern of nursing wages, non-nursing wages, and hospital expenditure (a proxy for demand) is examined. The evidence strongly suggests that the reduction in the nursing employment level in hospitals during the downsizing period was a result of a decrease in the demand for nursing labour and did not represent voluntary movement out of the nursing sector. That the decrease in demand primarily affected young nurses appears to reflect the influence of seniority in the highly unionized nursing sector. / Arts, Faculty of / Vancouver School of Economics / Graduate

No description available.

This study investigated relationships among and between psychological hardiness, coping style, and burnout in 101 female hospital nurses. The third generation (50-item) hardiness scale, scored by the revised scoring procedure, was used to measure hardiness and its components. The Maslach Burnout Inventory was used as the measurement for burnout. Coping style was assessed by the COPE Inventory. The components of hardiness, commitment, control, and challenge, were hypothesized to be negative predictors of emotional exhaustion and depersonalization and positive predictors of personal accomplishment. In addition, hardiness and its components were postulated to be positively related to adaptive coping styles and negatively related to maladaptive coping styles. Emotional exhaustion and depersonalization were thought to be related positively to maladaptive coping styles and negatively related to adaptive coping styles. Personal accomplishment was thought to be positively related to adaptive coping style and negatively related to maladaptive coping style. Simple and multiple regressions were used.

The problem of this study was to determine whether or not the variables locus of control, perceived anxiety, anxiety proneness, nursing experience and intensive care experience were better than chance predictors of job stress in intensive care nurses. The study was conducted using 200 volunteer nurses (RN's) who worked in the Intensive Care Units of two major hospitals in a large metropolitan area. All subjects were administered Spielberger's State-Trait Anxiety Inventory, Rotter Internal-External Locus of Control Scale and the Nursing Stress Scale as well as a demographic questionnaire. Multiple Regression Analysis was used to determine the predictive value of the characteristic variables to job stress and to determine the most efficient predictive model possible using these variables.