Combined and Selective Effects of Psychosocial Stressors in Nurses

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CWERC Seminar 7 April 2008

• Combined and Selective Effects of Psychosocial
  Stressors in Nurses
• Rachel McNamara

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Combined 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?

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Combined 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)

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Combined 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)

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Combined selective effects of psychosocial
stressors
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Combined selective effects of psychosocial
stressors
Work stress
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _
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Combined selective effects of psychosocial
stressors
Anxiety
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Depression
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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Combined selective effects of psychosocial
stressors
14-day symptoms
14-day LRTIs
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
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Combined selective effects of psychosocial
stressors

• Work stress (plt.0001)

(plt.0001) (plt.05) JD job demand
E Intrinsic/extrinsic effort WH working
hrs/hazards
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Combined selective effects of psychosocial
stressors

• Anxiety (plt.0001)

Depression (plt.0001)
(plt.0001) (plt.01)
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Combined selective effects of psychosocial
stressors

• 14-day symptoms (plt.0001)

(plt.0001) (plt.01)
14-day LRTIs (plt.008)
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Combined 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)