Stress among nurses is still perceived as a challenge experienced by the nursing profession. Several studies have shown the negative impact of stress on both nurses and patients. However, little is known about the factors influencing stress among nurses in Rwanda. Aim: The overall aim of the study was to explore the factors contributing to nurses’ stress and related coping strategies used by nurses in the University Teaching Hospital of Butare (UTHB), Rwanda. Methods: The researcher used a non-experimental, descriptive study to explore the factors contributing to nurses’ stress and related coping strategies used by nurses in the University Teaching Hospital of Butare, Rwanda. This study was informed by a stress and coping theoretical framework. A questionnaire was used to collect the demographic characteristics of participants, while nurses’ stressors were assessed using the questionnaire of nurse’s stressors previously developed by Bianchi. The ways of coping were evaluated using the ways of coping elaborated by Folkman & Lazarus. A convenient sampling of 85 registered nurses, working at UTHB, participated in this study. Permission to conduct the study was requested and obtained from the University of KwaZulu-Natal Ethics Committee, the Kigali Health Institute -Institutional Review Board and the management of UTHB. The data was analysed using the Statistical Package for Social Sciences (SPSS), version 15, and was summarized using descriptive statistics. The results were presented in tables and graphs. Results: The findings of the study revealed that registered nurses at UTHB face a variety of stressors such as shortages of staff and materials, facing death and dying, dissatisfaction with the work environment, work overload and time spent on bureaucratic activities. It was shown that consequences of stress vis-à-vis registered nurses could be low quality of care, job dissatisfaction and burnout syndrome. Among the major strategies of coping with stress, registered nurses have indicated problem solving, social support and accepting responsibility. This study indicates that stress can be prevented and managed by using vi nursing strategies such as team work, effective communication improving work conditions and fostering the managerial nursing strategies in working unit. Conclusion: Drawing from these findings, it can be inferred that nurses’ stressors need to be addressed in order to create a working environment conducive to high quality of care and also to enhance nursing staff morale, satisfaction, motivation and retention. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Introduction: It was previously established that mental health workers in Rwanda experience secondary traumatic stress when working with trauma survivors. The effects of secondary traumatic stress can be serious and permanent in mental health workers when working with traumatized clients. It interferes with mental health worker’s ability to do their work effectively. Aim: This study aimed to explore STS and to develop an intervention model to manage secondary traumatic stress in mental health workers in Kigali, Rwanda. Methodology: This study was carried out into five cycles using action research approach. In the first cycles of the study a quantitative design was used to explore secondary traumatic stress in mental health workers in Rwanda. For this cycle, the particular aim was to determine the extent of the secondary traumatic stress in mental health workers in Rwanda. A total of 180 participants were selected using convenience sampling to be part of the quantitative study. In the second cycle of the study a qualitative design was used to explore mental health workers’ experiences of secondary traumatic stress. For this cycle 30 unstructured interviews were conducted. The third cycle aimed at developing the model to manage secondary traumatic stress. Action research approach was used in this phase. Experts from mental health services involved in the study were asked to participate in the study based on their availability as research team members. The fourth cycle of the study consisted of implementing the model in one mental health service and the fifth cycle consisted evaluation of the implementation of the model after six weeks period. The main aim of this cycle was an observation of the model implantation. Results: A diagrammatical model to manage secondary traumatic stress was developed by mental health professionals. In the model development cycle of the study, it emerged that there are very strong concurrence between the findings from experts in mental health care system and literature in terms of what needs to be included in the intervention model to manage secondary traumatic stress in mental health workers in Rwanda. The key elements to include in the model were based on preventive, evaluative and curative strategies to manage secondary traumatic stress in mental health workers in Rwanda. During the evaluation of the implementation, it emerged that participant noticed a change in coping strategies when facing the stressful incident in the practice. Recommendations: include an emphasis on more psychological support for mental health professional in their workplace and for more concrete aids such as supervision, guidelines on stress management on workplace, education on secondary traumatic stress management and implementation of counseling service for mental health workers. Conclusion: The model developed in the present study outlined different ways to manage STS at the individual, social and organizational levels. There is a need to translate the interventions to manage STS into active ongoing coping activities to be conducted at the individual, group and organizational levels. Organizational responses, such as creating a supportive organizational culture that acknowledges the potential for secondary traumatic stress, may help mental health workers to deal with workplace related secondary traumatic stress. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2010.