Title: Combined and Selective Effects of Psychosocial Stressors in Nurses
1 CWERC Seminar 7 April 2008
- Combined and Selective Effects of Psychosocial
Stressors in Nurses - Rachel McNamara
2Combined selective effects of psychosocial
stressors
- Objectives
- Are additional psychosocial stressors associated
with acute ill health in addition to NOF? - Is exposure to multiple stressors associated with
a more negative outcome? - Are the effects of particular stressors
selective?
3Combined selective effects of psychosocial
stressors
- Background
- Additive selective associations between
multiple stressors health outcomes (Smith et
al., 2004) - Bullying, anxiety depression (Quine, 2001)
psychosomatic complaints (e.g. dizziness, chest
pain Mikkelsen Einarsen, 2001) - High demands/low control high effort/low reward
associated with CVD risk factors psychiatric
disorder (e.g. Kivimaki et al., 2002 Stansfeld
et al., 1998, 1999) - Link between high demands/low control high
effort/low reward comparatively minor health
complaints (Smith et al., 2004)
4Combined selective effects of psychosocial
stressors
- Additional stressors
- Bullying (e.g. persistent attempts to undermine
work) - Leader-Member Exchange (e.g. how well does your
manager recognise your potential?) - Team-Member Exchange (e.g. how well do other
members of your team recognise your potential?) - Role Conflict (e.g. I feel I have enough time to
complete my work) - Role Ambiguity (e.g. I feel certain about how
much authority I have) - Supportive Organisational Culture (e.g. being
people oriented)
5Combined selective effects of psychosocial
stressors
6Combined selective effects of psychosocial
stressors
Work stress
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _
7Combined selective effects of psychosocial
stressors
Anxiety
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Depression
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
8Combined selective effects of psychosocial
stressors
14-day symptoms
14-day LRTIs
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
9Combined selective effects of psychosocial
stressors
(plt.0001) (plt.05) JD job demand
E Intrinsic/extrinsic effort WH working
hrs/hazards
10Combined selective effects of psychosocial
stressors
Depression (plt.0001)
(plt.0001) (plt.01)
11Combined selective effects of psychosocial
stressors
- 14-day symptoms (plt.0001)
(plt.0001) (plt.01)
14-day LRTIs (plt.008)
12Combined selective effects of psychosocial
stressors
- Conclusions
- Of novel psychosocial stressors, only bullying
significantly predicted psychological well-being
acute health in addition to NOF - Exposure to multiple stressors associated with a
more negative outcome (additive influence on
health well-being) - Relationship between stressors health is
complex not simply additive - Components of NOF selectively associated with
outcomes (e.g. job demand, effort work-stress
effort, bullying and anxiety)