Bakgrund Inom hälso- och sjukvården är sjuksköterskan den som ansvarar för omvårdnadsarbetet. När arbetsmiljön är påverkad av stress ges sämre förutsättningar att utföra omvårdnad korrekt och patientsäkert. Trots att patientsäkerhet bland annat definieras av skydd mot vårdskada drabbas över 100 000 patienter per år av vårdskador i Sverige. Detta genererar ekonomiska konsekvenser för samhället men skadar även patienters förtroende för vården. Syfte Syftet var att beskriva sjuksköterskors upplevelse av arbetsrelaterad stress och dess påverkan på patientsäkerheten. Metod Designen som användes var en strukturerad litteraturstudie med inslag av den metodologi som används vid systematiska översikter. Resultat I resultatet framkom tre teman: arbetsmiljö, säkerhet och sjuksköterskors upplevelse. Utifrån teman framkom sedan sex subteman: arbetsrelaterad stress, organisation, risker i arbetet, patientsäkerhet, hälsoeffekter och otillfredsställelse. Slutsats För att kunna bedriva en säker vård krävs en arbetsbelastning som är anpassad efter tillgängliga resurser. Sjuksköterskor är i behov av stöd i sitt arbete för att kunna ge personcentrerad och patientsäker vård. För att ge sjuksköterskor förutsättningar att utföra ett bra arbete bör en större förståelse kring hur stress påverkar individen uppmärksammas. / Background Within health care, the nurse is the person responsible for the nursing work. When the work environment is affected by stress, poorer conditions are provided to perform nursing care correctly and patient-safely. Despite the fact that patient safety is defined, amongother things, by protection against health care injuries, over 100,000 patients per year suffer from health care injuries in Sweden. This generates financial consequences for society but also damages patients' trust in care. Aim The aim was to describe nurses' experience of work-related stress and its impact on patient safety. Method The design used was a structured literature study with elements of the methodology used in systematic reviews. Results The results revealed three themes: work environment, safety and nurses' experience. Based on the themes, six subthemes emerged: work-related stress, organization, risks at work, patient safety, health effects and dissatisfaction. Conclusions In order to provide safe care, a workload that is adapted to the available resources is required. Nurses need support in their work to be able to provide person-centred and patient-safe care. In order to give nurses the conditions to do a good job, attention should be paid to a greater understanding of how stress affects the individual.

Bakgrund: Arbetsrelaterad stress är ett fenomen som finns i ett flertal olika yrken. Stress har genom historien påverkat oss människor på olika sätt, både fysiskt och psykiskt.  Studier visar att vård- och omsorgsyrken är riskyrken för stressrelaterad psykisk ohälsa, psykiatriska diagnoser och för sjukfrånvaro.  Syfte: Syftet med studien är att beskriva sjuksköterskors upplevelser av arbetsrelaterad stress. Metod: Studien är en litteraturöversikt baserad på åtta kvalitativa artiklar. Databassökning genomfördes i databaserna PubMed och CINAHL. Analysen genomfördes enligt Fribergs femstegsmodell. Resultat: I analysprocessen framkom tre huvudkategorier och tretton subkategorier. Huvudkategorierna var “verksamhetsrelaterade stressfaktorer”, “professionsrelaterade stressfaktorer” och “patient-och anhörigrelaterade stressfaktorer.” Arbetsrelaterad stress visade sig ge konsekvenser för sjuksköterskor, patienter samt vårdorganisationer i allmänhet.  Konklusion: Litteraturstudiens resultat visade på att många olika arbetsrelaterade faktorer samverkade och bidrog till stress. Faktorerna påverkade sjuksköterskorna negativt och resulterade i att de inte hann med sina uppgifter, att de upplevde fysisk och mental utmattning samt att de upplevde att patientsäkerheten påverkades negativt. / Background: Work-related stress is a phenomenon that can be found in several different occupations. Throughout history, stress as affected us in many different ways, both physically and psychologically. Studies show that care professions are known risk professions when it comes to stress-related mental illness, psychiatric disorders and sick leave.  Aim: The aim of the study is to describe nurses' experiences of work-related stress. Methods: The study is a literature review based on eight qualitative articles. Database searches was conducted in PubMed and CINAHL. The analysis process was conducted according to Fribergs’ five-step model. Results: The analysis revealed three main categories and thirteen subcategories. The main categories were “organizational-related stressors”, "profession-related stress factors", and "patient-and relative related stressors.” Work-related stress was shown to affect nurses, patients and care organizations in general. Conclusion: The study showed that different work-related factors interact and contribute to stress. The factors affected the nurses negatively and led to them not having time to complete their tasks, to them experiencing physical and mental exhaustion and to the perception that patient safety was negatively affected.

Bakgrund: Den upplevda arbetsrelaterade stressen bland sjuksköterskor på sjukhus är ett stort problem i hela världen och påverkar sjuksköterskors hälsa samt medför stora risker. Andra typer av konsekvenser kan vara att kvaliteten på omvårdnaden försämras.  Syfte: Att beskriva erfarenheter av arbetsrelaterad stress och utbrändhet bland sjuksköterskor som arbetar på sjukus Metod: Litteraturstudien innefattade tio kvalitativa studier. Vid databassökningen användes Pubmed och Cinahl. Fribergs femstegsmodell användes vid analysprocessen för att analysera studierna.  Resultat: Analysen resulterade i tre kategorier och åtta subkategorier. De tre kategorierna var: 'Att efterfråga tydlighet i vårdstrukturen', 'Känsla av otillräcklighet' och 'Att patientsäkerheten hotas på grund av arbetsbelastningen'. Konklusion: Arbetsrelaterad stress och utbrändhet orsakas av många olika faktorer, allra främst på grund av en bristande organisation. Förbättringsförslag inom det aktuella områden är att utveckla organisationen samt förbättra prioriteringar gällande upplägget av ekonomin. Exempel på förbättringar organisationen kan ordna är teambuildning, tillräckligt med utrustning på plats, fokus på personalvård och tydligare ledarskap. Allt detta bidrar till en bättre arbetsmiljö för sjuksköterskorna men även till en bättre patientvård. / Background: The experience of burnout and work-related stress among nurses at hospitals are a big problem all around the world and affects nurses' health and entails big risks. Consequences of this are that the quality of care can deteriorate.  Aim: To describe experiences of work-related stress and burnout among nurses working in hospitals.  Methods: The literature study is based on ten qualitative studies. Pubmed and Cinahl were used as database search. Friberg's five-step model was used in the analysis process to analyze the studies.  Results: The analysis resulted in three categories and eight subcategories. The three categories were: To demand clarity in the care structure', 'The feeling of inadequate' and 'Patient safety is threatened due to the excessive workload'. Conclusion: Work-related stress and burnout is caused by many different factors, a big reason is an inadequate organization. Suggestions for improvement in this area are to develop the organization and improve priorities regarding the economy. Examples of improvements that the organization can do are teambuildning, enough equipment, focus on the staffcare and clearer leadhership. All this can improve the work environment for the nurses and the patient care.

Forskningsfrågor: 1. Vilka proaktiva åtgärder använder arbetsgivare i förebyggande syfte för att undvika utvecklingen av negativ stress på arbetsplatsen? 2. Vilka reaktiva åtgärder använder arbetsgivare för att hantera redan utvecklad arbetsrelaterad stress hos sina medarbetare?  Syfte: Undersöka de praktiska åtgärder som arbetsgivare använder för att hantera arbetsrelaterad stress. Därmed eftersträvar denna studie till att bidra med en ackumulerad samling av konkreta förslag på åtgärder som kan användas praktiskt i olika arbetsrelaterade sammanhang. Metod: Kvalitativ metod med en abduktiv forskningsansats. Datainsamling genom djupgående semistrukturerade intervjuer som genomfördes en och en. Den primära respondentgruppen var arbetsgivare.  Slutsats: Praktiska åtgärder på proaktiv och reaktiv stresshantering sammanfattas enligt studien genom fyra teman: kommunikation, kunskap, ledarskap och företagskultur. Genom regelbunden kommunikation kan symtom på stress upptäckas i tid och tillsammans med medarbetaren hitta en lösning för återhämtning. Genom planering kan onödig stress undvikas. Kunskap om stress och verktyg för hantering kan med fördel undvika utvecklingen av stress. Förslag på gott ledarskap i stresshanteringssyfte kan handla om närvaro och att visa att man som ledare finns där för att hjälpa medarbetare som drabbas av stress. En öppenhet kring dialoger om stress kan ha betydelse för hur stress kan undvikas och hanteras. En företagskultur som främjar gemenskap i kombination med en öppenhet om stress, kan hjälpa medarbetare att våga be om hjälp när stress upplevs på arbetsplatsen. / Research questions: 1. What proactive measures do employers use preventively to avoid the development of negative stress in the workplace? 2. What reactive measures do employers use to manage already developed negative work-related stress in their employees? Purpose: Investigate the practical measures employers use to manage work-related stress. Thus, this study strives to contribute with an accumulated of concrete proposals for measures that collection can be used practically in various work-related contexts. Method: Qualitative method with an abductive research approach. Data collection through in-depth semi-structured interviews conducted one on one. The primary respondent group was employers. Conclusion: Practical measures on proactive and reactive stress management are summarized according to the study through four themes: communication, knowledge, leadership and corporate culture. Through continuous communication, symptoms of stress can be detected in time and together with the employee, find a solution for recovery. Through planning, unnecessary stress can be avoided. Knowledge of stress and tools for management can advantageously avoid the development of stress. Suggestions for good leadership for stress management purposes can be about presence and showing that you as a leader are there to help employees who are affected by stress. An openness about dialogues about stress can have an impact on how stress can be avoided and managed. A corporate culture that promotes community, combined with an openness about stress, can help employees dare to ask for help when stress is experienced in the workplace.

Syftet med studien är att undersöka hur det sociala stödet från chef och kollegor tar sig uttryck, samt dess betydelse för medarbetare vid återgången till arbetet efter en långtidssjukskrivning på grund av arbetsrelaterad stress. Fokus ligger på medarbetarnas upplevelser av det sociala stödet vid återgången, och därför läggs inget vidare fokus på själva sjukskrivningen. Studien har en kvalitativ metodansats där resultatet grundar sig på sju semistrukturerade intervjuer. Vidare har ett hermeneutiskt förhållningssätt i kombination med en abduktiv förståelseansats tillämpats. För att analysera resultaten har teorier och tidigare forskning om socialt stöd, stress och utmattning, kollegialt stöd samt arbetsgivarens stöd använts, där House kategorisering av socialt stöd utgör en central del. Även Habermas teori om system och livsvärld inkluderades för att ge ett ytterligare perspektiv. Resultaten betonar vikten av alla typer av stöd, men där emotionellt och instrumentellt stöd framstår som särskilt viktiga. Vidare varierade både utformningen och källan till stödet, där avsaknaden av socialt stöd var en viktig erfarenhet kopplat till både hur det tog sig uttryck och betydelsen av det. / The purpose of this study is to investigate the significance of social support from managers and colleagues for individuals returning to the workplace after a period of sick leave due to work-related stress. The emphasis is on employees’ experiences of social support as they return and therefore no additional focus is directed toward the sick leave itself. This study is based upon a qualitative research approach with seven semi-structured interviews. A hermeneutic approach combined with an abductive understanding approach has been applied. To analyze the results, theories and previous research on social support, stress and burnout, collegial support, and manager support were studied, with House's categorization of social support being central. Also included is Habermas theory about systems and lifeworld for additional perspective. The results highlight the weight of various types of support, with emotional and instrumental support being of greater importance. Both the design and the source of support varied, and absence of support was an important experience tied to its manifestation and signification.

According to statistics, a significant increase in sickness has occurred in the public sector in recent decades in Sweden. Human therapeutic professions is the area where the illness is most prevalent. The purpose of this study was through a qualitative method and hermeneutic approaches explore how conscious six social workers in the social services are on stress and how they cope with it. Further it investigates and analyzes how these results affect their daily work. One important result due to stress is that the social workers ability to treat their clients is impaired and they are less able to be empathetic. Inadequacy in the work environment leads to a sense of insufficiency by social workers, and a reduced quality of life. This despite the fact that they express a variety of coping strategies. The conclusion of the study shows that due to high demands, a lack of control over ones work and lack of support from management, social workers have a sense of inadequacy.

The aim of this essay was to identify how social workers experience and handle work related stress in order to understand how stress can be handled on an individual level. The study was based on a qualitative study and used semi-structured interviews. Interviews with professionals showed that stress mainly occur in absence of control. Social workers use social support and structure their work to reduce demands, to handle stress. The professionals also believe that limits and distance in work is key. Social workers use these different strategies to handle stress, yet some of the issues is adjusted within the organisation. Various organizational factors may contribute or prevent a burnout. In conclusion although the professionals can form their work situation by using these techniques to reduce stress, some problems will remain because it is controlled within the organisation. Keywords: Social worker, work related stress, burnout, social services, work situation.

Det finns många läkare som arbetar deltid, sjukskrivs eller byter jobb på grund av ett påfrestande arbetsmiljö. Syftet med min studie är att identifiera läkarens upplevelse av arbetsrelaterad stress inom vårdcentral. Metoden som valdes är en kvalitativ metod där jag använder halvstrukturerade intervjuer. Två kategorier och fyra subkategorier av upplevelse av arbetsrelaterad stress hos läkare identifierades: faktorer som påverkar stress i arbetet, egna strategier för stresshantering, tidsbrist, ledarskap, brister i organisatorisk och social arbetsmiljö, upplevelse av krav och förväntningar. Informanterna upplevde att deras stress orsakades av brister i den organisatoriska och sociala arbetsmiljön. Läkarens arbete kan förstås påverkas negativt av upplevd stress. Arbetsrelaterad stress kan påverka negativt läkarens bedömningsförmåga vilket ställer patienterna i risk för felbedömningar. / There are many doctors who work part-time, are laid off or change jobs because of a stressful work environment. The purpose of my study is to identify the physician's experience of work-related stress in a health center. The method chosen is a qualitative method where I used semi-structured interviews. Two categories and four subcategories of high of work-related stress were identified: factors affecting stress at work, own strategies for stress management, lack of time, leadership, deficiencies in organizational and social work environment, demands and expectations. It was found that the respondents experienced stress was caused by problems in the organizational and social work environment. The physician's work can be adversely affected by high stress. Work-related stress can adversely affect the physician's judgment, which puts patients at risk of misjudgment.

The psychological and physiological effects of work-related stress on law enforcement causes high morbidity and mortality rates and rates of alcoholism, substance abuse, domestic violence, and suicide higher than the national average. The purpose of this explanatory sequential mixed-methods study was to examine whether work-related stress experienced by child sexual exploitation (CSE) and child sexual abuse (CSA) investigators differ from that of other duty assigned subgroups. I used Karasek's job demands-control model as the theoretical framework for this study. I conducted the study within a medium sized law enforcement agency in eastern Washington State. The sample in the quantitative study consisted of 27 law enforcement officers from 17 duty-assigned subgroups who completed McCreary and Thompson's Operational Police Stress Survey (PSQ-Op) and Organizational Police Stress Questionnaire (PSQ-Org). The sample in the qualitative study consisted of 7 law enforcement officers who answered 5 researcher developed questions during a telephone interview. Descriptive statistics, a Pearson's correlation analysis, and linear regression analysis of the PSQ-Op and PSQ-Org revealed no significant difference in reported work-related stress experienced within the duty-assigned subgroups, revealing no correlative difference of stress experienced by CSE and CSA investigators and the other duty assigned subgroups due to job demands and job control. Content analysis of the qualitative interviews revealed themes that supported the finding of the quantitative study. The findings of this study support the need for law enforcement leaders to take preemptive measures to mitigate the effects of work-related stress on all law enforcement officers.

<p>The main purpose of this thesis was to evaluate and test the Job Stress Survey (JSS, Spielberger, 1991; Spielberger & Vagg, 1999), a self-report instrument which assesses workplace stress. In the thesis a thorough evaluation is made of JSS scales and items, and the relations to health, particularly musculoskeletal complaints. The aim of Study I was to evaluate the factor structure and the psychometric properties of a Swedish version of the JSS. The instrument was distributed to medical service personal and metal industry workers (n=1186). Factor analyses demonstrated a good resemblance between the present version and the American original version. The results also showed that the internal consistencies, as well as the test-retest reliabilities of the scales are high, and the concurrent validity are good. Study II examined work-related stress measured by JSS for the subgroups of gender, industry workers and medical service personnel, and special attention was given to the problem of differential item functioning (DIF) on these subgroups. The main findings were that both gender and occupation has a substantial impact on specific sources of work-related stress assessed by JSS scales and individual items. The result of the DIF analyses showed no item bias in the gender subgroup, but for the occupational subgroups there where items showing DIF in two of the scales. These items do not jeopardize the conclusions made on scale level since the number of items showing DIF are too few to make an impact on the overall result on the different scales. In Study III the relation between self-reported stress and health, particularly musculoskeletal problems were examined longitudinally in two metal industry factories. Results showed high levels of stress and musculoskeletal complaints in these factories and significant and strong relationships between the JSS scales and musculoskeletal, as well as psychosocial ratings. Lack of Organizational Support was found to be more related to musculoskeletal pain than Job Pressure. Longitudinal differences were found between the factories and between different types of musculoskeletal complaints. The general conclusions from the studies are that the present version of JSS shows a good resemblance with the American original, and that JSS is a useful instrument for studying relationships between stress and health.</p>