DOI QR코드

DOI QR Code

Measuring and Evaluating the Work-Related Stress of Nurses in Saudi Arabia during the Covid-19 Pandemic

  • Bagadood, May H. (Faculty of Nursing, Umm Al-Qura University) ;
  • Almaleki, Deyab A. (Faculty of Education, Umm Al-Qura University)
  • Received : 2022.03.05
  • Published : 2022.03.30

Abstract

Prior to the emergence of Covid-19, Saudi Arabia (SA) had never faced the challenge of dealing with a global pandemic. Significantly, the current crisis has impacted all industries and sectors in the country, including the healthcare system, and has led to an emphasis on human life being more precious and valuable than economic profit. This study focuses on the impact of Covid-19 on the health of nurses, including their quality of life, during 2020. Understanding the position of the nursing profession during the pandemic, including the most effective methods of preventing work-related stress is important. Information was acquired through an online survey method (i.e. self-completion), known as the Expanded Nursing Stress Scale (ENSS), which was distributed to nurses in all regions of SA. It was found that the main aspects impacting nurses' work-related stress include gender, employment type, training, and dealing with infected patients. In addition, they highlight that such stress plays a substantial role in patient safety and nurses' satisfaction at work, as well as the future survival of organizations. The emergence of Covid-19 as a novel infectious disease has increased nurses' uncertainty and work-related stress. The results of this research will provide insights into the views of both nurses and their managers, in order to identify the main indicators of stress.

Keywords

References

  1. Aiello, A., Young-Eun Khayeri, M., Raja, S., Peladeau, N., Romano, D., Leszcz, M., Maunder, R. G., Rose, M., Adam, M. A., & Pain, C. (2011). Resilience training for hospital workers in anticipation of an influenza pandemic. Journal of Continuing Education in the Health Professions, 31(1), 15-20. https://doi.org/10.1002/chp.20096
  2. Alghamdi, M. G., Topp, R., & AlYami, M. S. (2018). The effect of gender on transformational leadership and job satisfaction among Saudi nurses. Journal of Advanced Nursing, 74(1), 119-127. https://doi.org/10.1111/jan.13385
  3. Alomari, A., Wilson, V. J., Davidson, P. M., & Lewis, J. (2015). Families, nurses and organisations contributing factors to medication administration error in paediatrics: A literature review.
  4. Alsahafi, A. J., & Cheng, A. C. (2016). Knowledge, attitudes and behaviours of healthcare workers in the Kingdom of Saudi Arabia to MERS coronavirus and other emerging infectious diseases. International Journal of Environmental Research and Public Health, 13(12), 1214. https://doi.org/10.3390/ijerph13121214
  5. Alsayed, S., & West, S. (2019). Exploring acute care workplace experiences of Saudi female nurses: Creating career identity. Saudi Critical Care Journal, 3(2), 75. https://doi.org/10.4103/sccj.sccj_11_19
  6. Alsubaie, S., Temsah, M. H., Al-Eyadhy, A. A., Gossady, I., Hasan, G. M., Al-Rabiaah, A., Jamal, A. A., Alhaboob, A. A., Alsohime, F., & Somily, A. M. (2019). Middle East Respiratory Syndrome Coronavirus epidemic impact on healthcare workers' risk perceptions, work and personal lives. The Journal of Infection in Developing Countries, 13(10), 920-926. https://doi.org/10.3855/jidc.11753
  7. American Nurses Association (ANA) (2017). Who Will Be There? Ethics, the law, and a nurse's duty to respond in a disaster. Retrieved on April 2020 from https://www.nursingworld.org/~4af058/globalassets/docs/ana/ethics/who-will-be-there_disaster-preparedness_2017.pdf
  8. Anderson, R. M., Heesterbeek, H., Klinkenberg, D., & Hollingsworth, T. D. (2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic? The Lancet, 395(10228), 931-934. https://doi.org/10.1016/s0140-6736(20)30567-5
  9. Assadi, T., Sadeghi, F., Noyani, A., SeidAbadi, A. M., & Yekesadat, S. M. (2019). Occupational Burnout and Its Related Factors Among Iranian Nurses: A Cross-Sectional Study in Shahroud, Northeast of Iran. Open Access Macedonian Journal of Medical Sciences, 7(17), 2902-2907. PubMed. https://doi.org/10.3889/oamjms.2019.744
  10. Awajeh, A. M., Issa, M. R., Rasheed, A. M., & Faisal Amirah, M. (2018). Burnout among Critical Care Nurses in King Saud Medical City (KSMC). Journal of Nursing & Care, 07(02), 1-5. https://doi.org/10.4172/2167-1168.1000450
  11. Awan, A., Afzal, M., Majeed, I., Waqas, A., & Gilani, S. A. (2017). Assessment of knowledge, attitude and practices regarding occupational hazards among Nurses at Nawaz Sharif Social Security Hospital Lahore Pakistan. Saudi Journal of Medical and Pharmaceutical Scinces, 3(6), 622-630.
  12. Bai, Y., Yao, L., Wei, T., Tian, F., Jin, D.-Y., Chen, L., & Wang, M. (2020). Presumed asymptomatic carrier transmission of COVID-19. Jama, 323(14), 1406-1407. https://doi.org/10.1001/jama.2020.2565
  13. Bener, A., & Al-Khal, A. (2004). Knowledge, attitude and practice towards SARS. The Journal of the Royal Society for the Promotion of Health, 124(4), 167-170. https://doi.org/10.1177/146642400412400408
  14. Berdahl, J. L., Cooper, M., Glick, P., Livingston, R. W., & Williams, J. C. (2018). Work as a masculinity contest. Journal of Social Issues, 74, 422. https://doi.org/10.1111/josi.12289
  15. Brooks, S. K., Dunn, R., Amlot, R., Rubin, G. J., & Greenberg, N. (2017). Social and occupational factors associated with psychological wellbeing among occupational groups affected by disaster: A systematic review. Journal of Mental Health, 26(4), 373-384. https://doi.org/10.1080/09638237.2017.1294732
  16. Brooks, S. K., Dunn, R., Amlot, R., Rubin, G. J., & Greenberg, N. (2018). A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. Journal of Occupational and Environmental Medicine, 60(3), 248-257. https://doi.org/10.1097/JOM.0000000000001235
  17. Campbell, P., Torrens, C., Pollock, A., & Maxwell, M. (2018). A Scoping Review of Evidence Relating to Communication Failures That Lead to Patient Harm. Glasglow Caledonia Univeristy, Glasglow.
  18. Cassiani-Miranda, C. A., Campo-Arias, A., Tirado-Otalvaro, A. F., Botero-Tobon, L. A., Upegui-Arango, L. D., Rodriguez-Verdugo, M. S., Botero-Tobon, M. E., Arismendy-Lopez, Y. A., Robles-Fonnegra, W. A., & Nino, L. (2020). Stigmatisation associated with COVID-19 in the general Colombian population. International Journal of Social Psychiatry, 0020764020972445.
  19. Centers for Disease Control and Prevention (CDC) (2017). Reducing Stigma. Retrieved on April 2020 from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/reducing-stigma.html#t3
  20. Chanpa, N. B., Kotecha, I., Kumar, P., Tiwari, D. S., Vasavada, D. A., & Bhatt, R. B. (2020). Stigma and discrimination among doctors toward health-care staff working at COVID-19 sites. Archives of Mental Health, 21(2), 77. https://doi.org/10.4103/AMH.AMH_48_20
  21. Chatterjee, S., & Kagwe, M. (2020). Health workers are the frontline soldiers against COVID-19. Let's protect them. Africa Renewal. Https://Www.Un.Org/Africarenewal/Web-Features/Coronavirus/Health-Workers-Are-Frontline-Soldiers-against-Covid-19-Let% E2, 80.
  22. Chen, W.-K., Cheng, Y.-C., Chung, Y.-T., & Lin, C.-C. (2005). The impact of the SARS outbreak on an urban emergency department in Taiwan. Medical Care, 168-172.
  23. Choi, S. (2013). Demographic diversity of managers and employee job satisfaction: Empirical analysis of the federal case. Review of Public Personnel Administration, 33(3), 275-298. https://doi.org/10.1177/0734371X12453054
  24. Cohen, B., Hyman, S., Rosenberg, L., & Larson, E. (2012). Frequency of patient contact with health care personnel and visitors: Implications for infection prevention. The Joint Commission Journal on Quality and Patient Safety, 38(12), 560-565. https://doi.org/10.1016/s1553-7250(12)38073-2
  25. Dalri, R. de C. de M. B., Silva, L. A. da, Mendes, A. M. O. C., & Robazzi, M. L. do C. C. (2014). Nurses' workload and its relation with physiological stress reactions1. Revista Latino-Americana de Enfermagem, 22, 959-965. https://doi.org/10.1590/0104-1169.3292.2503
  26. Dekker, S. W., & Schaufeli, W. B. (1995). The effects of job insecurity on psychological health and withdrawal: A longitudinal study. Australian Psychologist, 30(1), 57-63. https://doi.org/10.1080/00050069508259607
  27. Eagly, A. H., & Karau, S. J. (2002). Role congruity theory of prejudice toward female leaders. Psychological Review, 109(3), 573. https://doi.org/10.1037/0033-295X.109.3.573
  28. Elbejjani, M., Abed Al Ahad, M., Simon, M., Ausserhofer, D., Dumit, N., Abu-Saad Huijer, H., & Dhaini, S. R. (2020). Work environment-related factors and nurses' health outcomes: A cross-sectional study in Lebanese hospitals. BMC Nursing, 19(1), 1-11. https://doi.org/10.1186/s12912-020-00485-z
  29. Elston, J. W., Cartwright, C., Ndumbi, P., & Wright, J. (2017). The health impact of the 2014-15 Ebola outbreak. Public Health, 143, 60-70. https://doi.org/10.1016/j.puhe.2016.10.020
  30. French, S. E., Lenton, R., Walters, V., & Eyles, J. (2000). An empirical evaluation of an expanded nursing stress scale. Journal of Nursing Measurement, 8(2), 161-178. https://doi.org/10.1891/1061-3749.8.2.161
  31. Gorbach, C., Blanton, L., Lukawski, B. A., Varkey, A. C., Pitman, E. P., & Garey, K. W. (2015). Frequency of and risk factors for medication errors by pharmacists during order verification in a tertiary care medical center. American Journal of Health-System Pharmacy, 72(17), 1471-1474. https://doi.org/10.2146/ajhp140673
  32. Greenhalgh, L., & Rosenblatt, Z. (1984). Job insecurity: Toward conceptual clarity. Academy of Management Review, 9(3), 438-448. https://doi.org/10.5465/AMR.1984.4279673
  33. Grissom, J. A., Nicholson-Crotty, J., & Keiser, L. (2012). Does my boss's gender matter? Explaining job satisfaction and employee turnover in the public sector. Journal of Public Administration Research and Theory, 22(4), 649-673. https://doi.org/10.1093/jopart/mus004
  34. Hossain, M. A., Jahid, M. I. K., Hossain, K. M. A., Walton, L. M., Uddin, Z., Haque, M. O., Kabir, M. F., Arafat, S. Y., Sakel, M., & Faruqui, R. (2020). Knowledge, attitudes, and fear of COVID-19 during the Rapid Rise Period in Bangladesh. PloS One, 15(9), e0239646. https://doi.org/10.1371/journal.pone.0239646
  35. Huang, H., Zhao, W.-J., & Li, G.-R. (2020). Knowledge and Psychological Stress Related to COVID-19 Among Nursing Staff in a Hospital in China: Cross-Sectional Survey Study. JMIR Formative Research, 4(9), e20606-e20606. PubMed. https://doi.org/10.2196/20606
  36. Huang, L., Lei, W., Xu, F., Liu, H., & Yu, L. (2020). Emotional responses and coping strategies in nurses and nursing students during Covid-19 outbreak: A comparative study. PloS One, 15(8), e0237303. https://doi.org/10.1371/journal.pone.0237303
  37. Huang, L., Xu, F., & Liu, H. (2020). Emotional responses and coping strategies of nurses and nursing college students during COVID-19 outbreak. MedRxiv.
  38. Johansson, T., & Wennblom, G. (2017). In female supervisors male subordinates trust!? An experiment on supervisor and subordinate gender and the perceptions of tight control. Journal of Management Control, 28(3), 321-345. https://doi.org/10.1007/s00187-017-0248-7
  39. Joseph, B., & Joseph, M. (2016). The health of the healthcare workers. Indian Journal of Occupational and Environmental Medicine, 20(2), 71. https://doi.org/10.4103/0019-5278.197518
  40. Khalid, A., Younas, M. W., Khan, H., Khan, M. S., Malik, A. R., Butt, A. U. A., & Ali, B. (2021). Relationship between knowledge on COVID-19 and psychological distress among students living in quarantine: An email survey. AIMS Public Health, 8(1), 90-99. PubMed. https://doi.org/10.3934/publichealth.2021007
  41. Khalid, I., Khalid, T. J., Qabajah, M. R., Barnard, A. G., & Qushmaq, I. A. (2016). Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clinical Medicine & Research, 14(1), 7-14. https://doi.org/10.3121/cmr.2016.1303
  42. Kim, Y. (2018). Nurses' experiences of care for patients with Middle East respiratory syndrome-coronavirus in South Korea. American Journal of Infection Control, 46(7), 781-787. https://doi.org/10.1016/j.ajic.2018.01.012
  43. Kompier, M., Ybema, J., Janssen, J., & Taris, T. (2009). Employment Contracts: Cross-sectional and Longitudinal Relations with Quality of Working Life, Health and Well-being. Journal of Occupational Health, 51, 193-203. https://doi.org/10.1539/joh.L8150
  44. Kurtessis, J. N., Eisenberger, R., Ford, M. T., Buffardi, L. C., Stewart, K. A., & Adis, C. S. (2017). Perceived organizational support: A meta-analytic evaluation of organizational support theory. Journal of Management, 43(6), 1854-1884. https://doi.org/10.1177/0149206315575554
  45. Labrague, L. J., De los Santos, J. A. A., & Fronda, D. C. (2021). Perceived COVID-19-associated discrimination, mental health and professional-turnover intention among frontline clinical nurses: The mediating role of resilience. International Journal of Mental Health Nursing, 30(6), 1674-1683. https://doi.org/10.1111/inm.12920
  46. Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., & Li, R. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976-e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
  47. Lazzerini, M., & Putoto, G. (2020). COVID-19 in Italy: Momentous decisions and many uncertainties. The Lancet Global Health, 8(5), e641-e642. https://doi.org/10.1016/s2214-109x(20)30110-8
  48. Liu, C., Spector, P. E., & Shi, L. (2008). Use of both qualitative and quantitative approaches to study job stress in different gender and occupational groups. Journal of Occupational Health Psychology, 13(4), 357. https://doi.org/10.1037/1076-8998.13.4.357
  49. Liu, X., Kakade, M., Fuller, C. J., Fan, B., Fang, Y., Kong, J., Guan, Z., & Wu, P. (2012). Depression after exposure to stressful events: Lessons learned from the severe acute respiratory syndrome epidemic. Comprehensive Psychiatry, 53(1), 15-23. https://doi.org/10.1016/j.comppsych.2011.02.003
  50. Maunder, R. G., Lancee, W. J., Mae, R., Vincent, L., Peladeau, N., Beduz, M. A., Hunter, J. J., & Leszcz, M. (2010). Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: A randomized trial of the optimal dose of training. BMC Health Services Research, 10(1), 1-10. https://doi.org/10.1186/1472-6963-10-1
  51. McEachan, R., Taylor, N., Harrison, R., Lawton, R., Gardner, P., & Conner, M. (2016). Meta-analysis of the reasoned action approach (RAA) to understanding health behaviors. Annals of Behavioral Medicine, 50(4), 592-612. https://doi.org/10.1007/s12160-016-9798-4
  52. Medina Fernandez, I. A., Carreno Moreno, S., Chaparro Diaz, L., Gallegos-Torres, R. M., Medina Fernandez, J. A., & Hernandez Martinez, E. K. (2021). Fear, Stress, and Knowledge regarding COVID-19 in Nursing Students and Recent Graduates in Mexico. Investigacion y Educacion En Enfermeria, 39(1), e05. PubMed. https://doi.org/10.17533/udea.iee.v39n1e05
  53. Memish, Z. A., Al-Tawfiq, J. A., Makhdoom, H. Q., Al-Rabeeah, A. A., Assiri, A., Alhakeem, R. F., AlRabiah, F. A., Al Hajjar, S., Albarrak, A., & Flemban, H. (2014). Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: A prospective descriptive study. Clinical Microbiology and Infection, 20(5), 469-474. https://doi.org/10.1111/1469-0691.12562
  54. Miconi, D., Li, Z. Y., Frounfelker, R. L., Venkatesh, V., & Rousseau, C. (2021). Socio-cultural correlates of self-reported experiences of discrimination related to COVID-19 in a culturally diverse sample of Canadian adults. International Journal of Intercultural Relations, 81, 176-192. https://doi.org/10.1016/j.ijintrel.2021.01.013
  55. Moradi, Y., Baghaei, R., Hosseingholipour, K., & Mollazadeh, F. (2021). Challenges experienced by ICU nurses throughout the provision of care for COVID-19 patients: A qualitative study. Journal of Nursing Management, 29(5), 1159-1168. https://doi.org/10.1111/jonm.13254
  56. Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., & Samami, E. (2016). Communication barriers perceived by nurses and patients. Global Journal of Health Science, 8(6), 65. https://doi.org/10.5539/gjhs.v8n6p65
  57. Nunes, R. de L. S., de Camargo Silva, A. E. B., de Lima, J. C., Carvalho, D. E., Bernardes, C. A., Sousa, T. P., Gimenes, F. R. E., & Pires, A. C. A. C. (2021). Factors influencing the patient safety climate in intensive care units: Cross-sectional study. BMC Nursing, 20(1), 1-8. https://doi.org/10.1186/s12912-020-00515-w
  58. Oboho, I. K., Tomczyk, S. M., Al-Asmari, A. M., Banjar, A. A., Al-Mugti, H., Aloraini, M. S., Alkhaldi, K. Z., Almohammadi, E. L., Alraddadi, B. M., & Gerber, S. I. (2015). 2014 MERS-CoV outbreak in Jeddah-A link to health care facilities. New England Journal of Medicine, 372(9), 846-854. https://doi.org/10.1056/NEJMoa1408636
  59. Padilha, K. G., Barbosa, R. L., Andolhe, R., Oliveira, E. M. de, Ducci, A. J., Bregalda, R. S., & Secco, L. M. D. (2017). Nursing workload, stress/burnout, satisfaction, and incidents in a trauma intensive care unit. Texto & Contexto-Enfermagem, 26.
  60. Robertson, E., Hershenfield, K., Grace, S. L., & Stewart, D. E. (2004). The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. The Canadian Journal of Psychiatry, 49(6), 403-407. https://doi.org/10.1177/070674370404900612
  61. Sena, B. (2017). Professionalization without autonomy: The Italian case of building the nursing profession. Professions and Professionalism, 7(3), e1900-e1900. https://doi.org/10.7577/pp.1900
  62. Shih, F.-J., Gau, M.-L., Kao, C.-C., Yang, C.-Y., Lin, Y.-S., Liao, Y.-C., & Sheu, S.-J. (2007). Dying and caring on the edge: Taiwan's surviving nurses' reflections on taking care of patients with severe acute respiratory syndrome. Applied Nursing Research, 20(4), 171-180. https://doi.org/10.1016/j.apnr.2006.08.007
  63. Singh, S. K. (2009). Leveraging emotional intelligence for managing executive's job stress: A framework. Indian Journal of Industrial Relations, 255-264.
  64. Sinha, D., Narvekar, S., & Sinha, S. (2021). Interplay of Gender and Executive Stress: A Review. FROM THE EDITOR'S DESK, 40.
  65. So, W. K., Chan, S. S., Lee, A. C., & Tiwari, A. F. (2004). The knowledge level and precautionary measures taken by older adults during the SARS outbreak in Hong Kong. International Journal of Nursing Studies, 41(8), 901-909. https://doi.org/10.1016/j.ijnurstu.2004.04.004
  66. Srivastava, A., & Singh, A. (1981). Manual of the occupational stress index. Department of Psychology, Banaras University, Varanasi.
  67. Stirling, B., Hatcher, J., & Harmston, J. (2017). Communicating the changing role of a nurse in an epidemic: The example of the MERS-CoV outbreak in Saudi Arabia. Journal of Healthcare Communications, 2(03), 10-4172.
  68. Sun, N., Wei, L., Shi, S., Jiao, D., Song, R., Ma, L., Wang, H., Wang, C., Wang, Z., & You, Y. (2020). A qualitative study on the psychological experience of caregivers of COVID-19 patients. American Journal of Infection Control, 48(6), 592-598. https://doi.org/10.1016/j.ajic.2020.03.018
  69. Trammell, P., Janet P., Joseph, P., Nataria T., & Harriger, P., Jennifer A. (2021). Racial and ethnic minority disparities in COVID-19 related health, health beliefs and behaviors, and well-being among students. Journal of American College Health, 1-7.
  70. Vasli, P., & Dehghan-Nayeri, N. (2016). Emergency nurses' experience of crisis: A qualitative study. Japan Journal of Nursing Science, 13(1), 55-64. https://doi.org/10.1111/jjns.12086
  71. Virtanen, M., Kivimaki, M., Joensuu, M., Virtanen, P., Elovainio, M., & Vahtera, J. (2005). Temporary employment and health: A review. International Journal of Epidemiology, 34(3), 610-622. https://doi.org/10.1093/ije/dyi024
  72. Virtanen, P., Janlert, U., & Hammarstrom, A. (2011). Exposure to temporary employment and job insecurity: A longitudinal study of the health effects. Occupational and Environmental Medicine, 68(8), 570. https://doi.org/10.1136/oem.2010.054890
  73. World Health Organization (WHO) (n.d.). Occupational health: Stress at the workplace. Retrieved on April 2020 from https://www.who.int/occupational_health/topics/stressatwp/en/
  74. World Health Organization (WHO) (2007).The Contribution of Nursing and Midwifery in Emergencies. Retrieved on April 2020 from https://www.who.int/hac/events/2006/nursing_consultation_report_sept07.pdf
  75. World Health Organization (WHO) (2018). Mental health: strengthening our response. Retrieved on April 2020 from https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
  76. World Health Organization-1 (WHO-1) (2020). Mental health and psychosocial considerations during the COVID-19 outbreak. Retrieved on April 2020 from https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
  77. World Health Organization-2 (WHO-2) (2020). Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Retrieved on April 2020 from https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)
  78. Zhao, C., Chang, Q., Zhang, X., Wu, Q., Wu, N., He, J., & Zhao, Y. (2019). Evaluation of safety attitudes of hospitals and the effects of demographic factors on safety attitudes: A psychometric validation of the safety attitudes and safety climate questionnaire. BMC Health Services Research, 19(1), 1-11. https://doi.org/10.1186/s12913-018-3827-x