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Gender differences among cancer nurses' stress perception and coping: An Italian single centre observational study

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Rosario Caruso at University of Milan
Rosario Caruso
Daniela Miazza at University of Pavia
Daniela Miazza
Francesca Gigli Berzolari
Francesca Gigli Berzolari
Francesca Gigli Berzolari
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Anna Maria Grugnetti at Policlinico San Matteo Pavia Fondazione IRCCS
Anna Maria Grugnetti
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Abstract

Objectives: The literature on gender differences in stress perception and coping has been produced diverse results, and there is a shortage of studies on this topic among cancer nurses. For this reason, the aim of this study was to describe the gender differences related to cancer nurses' stress perception and coping. Methods: This study had a cross-sectional design, using a secondary data analysis on dataset (sample = 126 cancer nurses, 74% females). The stress perception and the coping strategies were assessed using Burnout Potential Inventory (BPI) and Health Profession Stress and Coping Scale, nurses' version (HPSCS). Results: Female cancer nurses perceived more stress from personal attacks than males. Indeed, female over 45 years had a significant higher perception of stress, but they used the request for social support (functional coping) as a coping strategy more than males. Conclusions: Our results could help to clearly understand what are the main gender differences in coping and in perceiving stress among Italian cancer nurses, and to incentive more research.
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G Ital Med Lav Erg 2017; 39:2, 93-99 © PI-ME, Pavia 2017
ISSN 1592-7830 MEDICINA DEL LAVORO
Rosario Caruso1, Daniela Miazza3, Francesca Gigli Berzolari2, Anna Maria Grugnetti3, Danuta Lichosik4,
Cristina Arrigoni3
Gender differences among cancer nurses’ stress perception
and coping: an Italian single centre observational study
1Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Italy
2Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Italy
3Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Italy
4IEOEDUCATION, School of Robotic Surgery, European Institute of Oncology, Milan, Italy
Introduction
Nursing is often defined as a stressful profession (1),
due to nurses require to face with different kind of stres-
sors, mainly coming from the delivery of their care, which
have to be emphatic, cultural sensitive and proficient (2),
and from their working environment (3). The literature
shows how cancer nurses are particularly exposed to the
burnout risk (4-6), because they could tend to empathize
with patients’ losses, leading cancer nurses to a feeling of
futility or failure in their care (7). In this context, cancer
nurses’ coping strategies play a paramount role to opti-
mize the nursing answering to the stressors and to improve
their educational needs (8, 9).
Although many studies describe the relationships be-
tween burnout, coping strategies and their working envi-
ronment in the cancer nursing field (2, 3, 5, 6), there is a
shortage of studies aimed to deeply understand the gender
differences related to cancer nurses’coping and stress per-
ception. A clearest understanding related to cancer nurses’
gender differences on how they cope with stressors and
how they percept them, could have a significant influence
to improve stress management education and implementa-
tion (8), especially in the Italian context where the ratio
between male and female nurses is proximally 3:7 (10).
Background
Caring for cancer patients could play as a trigger to de-
velop work related stress, which can result in nurses
burnout (5). According to Maslach, Schaufeli and Leiter,
the burnout is given from an inability to effectively
manage the chronic stress, and it is usually expressed by
three different manifestations: (a) the emotional exhaus-
tion, (b) the depersonalisation, and (c) the reduced per-
sonal accomplishment (11). Researchers have hypothe-
sized that personality traits (12) and self-efficacy (13)
could contribute to burnout, and the same burnout have an
effect on nurses’ behaviours (14, 15). However, burnout is
the edge of a wide range of stressful situations, which is
often considered as the result of a mismatch among the
nurses’ capacity to find internal and external resources and
their stress perception (16).
ABSTRACT. The literature on gender differences in stress
perception and coping has been produced diverse results,
and there is a shortage of studies on this topic among cancer
nurses. For this reason, the aim of this study was to describe
the gender differences related to cancer nurses’ stress perception
and coping. This study had a cross-sectional design, using a
secondary data analysis on dataset (sample = 126 cancer nurses,
74% females). The stress perception and the coping strategies
were assessed using Burnout Potential Inventory (BPI) and
Health Profession Stress and Coping Scale, nurses’ version
(HPSCS). Female cancer nurses perceived more stress from
personal attacks than males. Indeed, female over 45 years had
a significant higher perception of stress, but they used the
request for social support (functional coping) as a coping
strategy more than males. Our results could help to clearly
understand what are the main gender differences in coping
and in perceiving stress among Italian cancer nurses,
and to incentive more research.
Key words: coping, gender difference, oncology, nursing, stress.
RIASSUNTO. La letteratura sulle differenze di genere
nella percezione dello stress e nell’adozione di meccanismi
di coping ha prodotto risultati poco consistenti, inoltre
vi è una lacunosità di studi nell’ambito oncologico.
Per questa ragione, l’obiettivo di questo studio era descrivere
le differenze di genere degli infermieri di oncologia nel
fronteggiare lo stress (coping) e nel percepirlo. Lo studio
aveva un disegno trasversale ed ha usato l’approccio di analisi
secondaria su dataset (campione = 126 infermieri di oncologia;
74% sesso femminile). La percezione dello stress e le strategie
di coping sono state valutate tramite il Burnout Potential
Inventory (BPI) e il questionario Health Profession Stress and
Coping Scale, versione per infermieri (HPSCS). Le infermiere
di oncologia percepiscono maggiore stress rispetto agli uomini
relativamente all’area degli attacchi personali. Inoltre,
le infermiere over-45 anni hanno una percezione di stress
significativamente più alta rispetto agli uomini, ma usano
maggiore richiesta di supporto sociale (coping funzionale)
come strategia di fronteggiamento. I nostri risultati
potrebbero essere utili per comprendere meglio quali siano
le principali differenze di genere degli infermieri di oncologia
italiani nel fronteggiare lo stress e nel percepirlo, oltre che
ad incentivare ulteriori studi.
Parole chiave: coping, differenza di genere, oncologia,
infermieristica, stress.
98 G Ital Med Lav Erg 2017; 39:2
emotion exhaustion than men also as a consequence of in-
dividuals stereotypes (30).
The third hypothesis was quite totally confirmed. Fe-
male cancer nurses over 45 years had a higher perception
of nine ‘killer jobs’ situations, and even their overall BPI
score was higher than males. These results suggest to
build up a sound supportive policy to help aging women
to find the right internal and external resources, especially
when their role begin to change within both their family
and society. Another interesting data is that the younger
female nurses perceived more personal attacks than older
colleagues. This aspect should be deeply investigated to
understand what kind of attacks they perceive and by
whom.
The results did not confirm the last hypothesis, though
they are interesting due to female nurses seem to better use
the social support coping strategy than males. Social sup-
port should became a real nursing competence (31), due to
it can enhance resilience to stress, help protect against de-
veloping trauma-related psychopathology, and decrease
the functional consequences of trauma-induced disorders
(32). It is reasonable to consider for future researches the
potential role of social support as a positive predictor of
nurses’ self-efficacy (13), behaviours (14, 15), and com-
petence (31, 33).
This study had also some limits. Firstly, the data col-
lection was cross-sectional, for this reason could not have
any information about stability of the investigated phe-
nomena. Secondly, the sample is referred to a single
Italian cancer centre, for this reason the results should be
generalizable with caution. Moreover, the moderate dis-
placement of gender distribution in our sample could have
an influence on the analysis, however it is in line with the
Italian nurses’ gender distribution.
Conclusion
To the best of our knowledge, this was the first study
aimed to describe the gender differences related to
cancer nurses’ stress perception and coping in the Italian
context. The literature on gender differences in stress
perception and coping has been produced diverse results
(29). Our study results could boost some important re-
flections on management, preventing the genesis of mis-
information, or non-evidence-based organisational deci-
sion making.
Moreover, our results could help to clearly understand
what are the main gender differences in coping and in per-
ceiving stress among cancer nurses. These results should
be used to build up tailored preventive programs for the
stress management, considering the highlighted gender
peculiarities. This topic is strategic even because the
deeper comprehension of those differences in facing with
stressors could help the managers and educators to prevent
the distress situations (e.g. burnout, emotional fatigue),
hypnotizing an effect on nurses’ turnover or intention to
live. Future researches are needed to deeply study the phe-
nomena and to test the effectiveness of the preventive
stress management policy.
Acknowledgments
The authors would to acknowledge all the nurses who have partici-
pated to this study.
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Aim: The aim of the study was to compare the associations between workplace violence and patient safety behaviour between male and female nursing interns. Design: A cross-sectional survey. Methods: A cross-sectional survey was carried out at three general hospitals in Shandong Province in China to collect data from 466 nursing interns. We evaluated the associations between workplace violence and patient safety behaviours in men and women using multiple linear regressions. Results: Sex moderated the association between workplace violence and patient safety behaviour (B = 1.046, [SE = 0.477]; p = 0.029). Among male nursing interns, there was a significant association between workplace violence and patient safety (B = -1.353, 95% CI [-2.556, -0.151]; p = 0.028). In male nursing interns, verbal violence and sexual violence were significantly negatively associated with patient safety (B = -1.569, SE = 0.492, p = 0.002; B = -45.663, SE = 5.554, p < 0.001). No significant association was found in female nursing interns. Patient or public contribution: This study did not have a patient or public contribution.
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... These results, suggesting that the support for emotional exhaustion followed by support for depersonalization are highly needed, could be explained by the higher female rates within the nursing profession, as a previous meta-analysis showed that emotional exhaustion levels tend to be higher among females, while depersonali-zation tends to be higher in males (56). However, as our narrative synthesis on the risk factor of burnout showed, the sex-related differences in burnout are still uncertain and should be addressed by specific research projects (57). ...
Burnout and post-traumatic stress disorder in frontline nurses during the COVID-19 pandemic: a systematic literature review and meta-analysis of studies published in 2020
Article
Full-text available
  • Dec 2021
Background and aim: Burnout and post-traumatic stress disorder (PTSD) among frontline nurses working with COVID-19 patients during the initial phase of the pandemic (2020) have been described by several studies. Therefore, this study aimed to systematically synthesize evidence regarding burnout and PTSD among nurses engaged in the frontline during the COVID-19 pandemic, highlighting their risk and protective factors. Methods: A systematic review was performed (PROSPERO: CRD42021227939), searching literature published in 2020 on Pubmed, Scopus, CINAHL, and PsycInfo. We quantitatively pooled means of included studies measuring burnout and PTSD with the same tools. Results: Twenty-five studies were included in this review. Seven (3766 nurses) were included in the meta-analysis for estimating means of depersonalization and emotional exhaustion assessed using the Maslach Burnout Inventory, respectively: 7,40 (95%CI=6,00-8,80) and 22,82 (95%CI=19,24-26,41). Likely, 12 studies were used to estimate two pooled means for PTSD, one for six studies adopting the Impact of Event Scale-Revised (1551 nurses), and six adopting the PTSD Scale for DSM-5 (8547 nurses). The main risk and protective factors of both outcomes were female sex and younger age, work-related variables, and physical and mental factors, such as concerns, skin lesions from wearing personal protective equipment. Conclusions: This systematic review portrayed the situation described in literature during 2020 on nurses' burnout and PTSD during the COVID-19 pandemic. Although the outcomes' levels described in the included studies are diverse, the broad situation appears alarming, and supportive multi-level strategies, considering individual and system-level, should be planned to decrease the described worsening scenario within the clinical settings avoid middle and long-term negative consequences.
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... Future research can triangulate findings by collecting quantitative data on psychological wellbeing, moral distress, coping, and other outcome variables like a sense of coherence. Overall, our findings could serve as a starting point for future research focusing on psychological support for HCWs, taking into account differences related to gender (12,32), age, health system organisations (20,(33)(34)(35), different levels of competencies (36)(37)(38)(39) and values (40,41). ...
Experiences of healthcare providers from a working week during the first wave of the COVID-19 outbreak
Article
Full-text available
  • Oct 2021
Background and aim of the work: The delivery of care to patients with COVID-19 enhanced many psychological issues among healthcare workers (HCWs), exacerbating the risk of burnout and compromising the efficacy and quality of services provided to patients. In this context, the peculiarities regarding professional roles in delivering care to patients with COVID-19 might reflect daily lived experiences that could impact psychological outcomes in specific professional groups. However, daily lived experiences considering different groups of HCWs have been poorly investigated, especially with a longitudinal qualitative study. Accordingly, our study aims firstly to longitudinally explore perceptions and experiences of HCWs about their daily working life during the initial COVID-19 outbreak, highlighting the specific lived experiences of physicians, nurses, radiology technicians, and healthcare assistants. Methods: A longitudinal qualitative content analysis was conducted to analyse the comments and quotations made on a daily diary lasting seven days by physicians, nurses, radiology technicians, and healthcare assistants during the first wave of the COVID-19 outbreak. According to Elo and Kyngäs recommendation, the data analysis process was developed in three main phases: preparation, organising, and reporting. Results: Four main generic categories emerged by data analysis: 'Clinical practice in COVID-19 patients'; 'The importance of relationship'; 'Navigating by sight'; and 'Good always pays off'. Several differences emerged from the sentences of the HCWs, which require further investigation. Conclusions: Understanding the profession-specific experiences of the involved HCWs in facing the challenges of the COVID-19 pandemic is key for boosting reflections, research, and actions to adequately support each professional group.
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... New studies also confirm gender differences in coping strategies, although contradicting previous findings. Caruso et al. (2017) note women use request for social support (negative coping) as a coping strategy more than males, whereas Shimanoe et al. (2015) report men use more positive coping strategies and women employ mainly negative coping strategies. However, Menéndez-Espina, et al. (2019) found that women implement a greater number of coping strategies, with more positive results for psychological health. ...
Work-Family Conflict, Coping Strategies and Burnout: A Gender and Couple Analysis
Article
Full-text available
  • Mar 2021
Despite the amount of research on family-work conflict and burnout, there persist questions about their relations and which coping strategies are the most effective. In this paper we address this issue from a gender perspective with a sample of 131 dual-earner couples developing both individual and couple analyses. The results at the individual level yield gender differences when each of the two burnout components is explained. The main predictor of emotional exhaustion is work-family conflict while family-work conflict is the main predictor of depersonalization, especially for men. Regarding coping strategies, behavioural coping is negatively related to male depersonalization. However, behavioral and emotional coping increases both burnout dimensions in women, particularly if family-work conflict is high. At couple level, findings confirm the relationship between conflicts and burnout and the moderating role of behavioural coping to explain emotional exhaustion.
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Coping strategies at the frontline of care: Comparisons between Covid‐19 and non‐Covid‐19 units' nurses and the role of moderator variables
Article
Introduction: Relatively few studies focused on the coping strategies adopted by the healthcare workers during the second phase of the pandemic. The present study compared the coping strategies between Italian nurses working in Covid-19 and in other units and it explored whether socio-demographic and work-related variables moderate the relation between the type of unit and coping strategies. Methods: A web-based questionnaire that included sociodemographic and work-related questions and the Coping Orientation to Problem Experienced—New Italian Version-25 item was administered. Moderation effects between variables and coping strategies were analyzed using generalized linear models. Results: 253 nurses participated. Nurses who worked in a Covid-19 unit had significantly lower scores on Avoidance Strategies subscale and higher scores on Positive Attitude and Social Support subscales than nurses working in other units. Discussion: Gender differences emerged only on the social support coping dimension, with women being more likely to adopt social support than men. No association between the type of unit and the other coping strategies was found. Conclusion: Nurses working in Covid-19 units showed better coping strategies than their colleagues: this suggests that support interventions aimed to promote coping strategies should be offered also to Covid-19-free units' nurses.
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Nursing students' clinical competencies: a survey on clinical education objectives
Article
Full-text available
  • May 2017
Background: Developing clearly defined competencies and identifying strategies for their measurement remain unfortunately a critical aspect of nursing training. In the current international context, which continues to be characterised by deep economic crisis, universities have a fundamental role to play in redefining the educational goals to respond to the expectations of certain geographical areas of interest, as underscored in the Bologna Process (Joint Declaration of the European Ministers of Education Convened in Bologna 19 June 1999). Design and aim of study: The aim of this observational study was to examine the clinical learning context of nursing students using a tool developed by a team of teachers for the analysis of clinical learning. Methods: Redefinition of the clinical learning objectives with reference to the competencies set out in the questionnaire validated by Venturini et al. (2012) and the subsequent use of the tool created by the team of teachers for students in the first, second and third-year courses of the 2013/14 academic year, covering all the internships called for in those years. Results: All nursing students enrolled in the first, second and third year of the nursing undergraduate degree program at the University of Pavia (no. 471) participated in this survey. A total of 1,758 clinical internships were carried out: 461 for the first year, 471 for the second year and 826 for the third year. Setting objectives, beginning with the educational offerings in the several clinical contexts, represents a strong point for this process. The results highlight a level of heterogeneity and complexity intrinsic to the University of Pavia educational system, characterized by clinical settings with different clinical levels (Research hospital and other traditional hospitals) that offering different levels of training. Conclusions: The use of the self-evaluation form for clinical learning made it possible to perform real-time observations of the training activities of the entire student body. An educational model structured in this way allows the student to develop their capacity for critical thinking. For educational activities, such a self-evaluation form represents an ideal instrument for identifying areas in need of improvement. This explorative study, carried out by means of a self-evaluation form, is the first-step toward the development of an educational programme that is more uniform and easily traceable within the academic system.
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Nursing students' clinical competencies: A survey on clinical education objectives
Article
Full-text available
  • Apr 2017
Background. Developing clearly defined competencies and identifying strategies for their measurement remain unfortunately a critical aspect of nursing training. In the current international context, which continues to be characterised by deep economic crisis, universities have a fundamental role to play in redefining the educational goals to respond to the expectations of certain geographical areas of interest, as underscored in the Bologna Process (Joint Declaration of the European Ministers of Education Convened in Bologna 19 June 1999). Design and Aim of the Study. The aim of this observational study was to examine the clinical learning context of nursing students using a tool developed by a team of teachers for the analysis of clinical learning. Methods. Redefinition of the clinical learning objectives with reference to the competencies set out in the questionnaire validated by Venturini et al. (2012) and the subsequent use of the tool created by the team of teachers for students in the first, second and third-year courses of the 2013/14 academic year, covering all the internships called for in those years. Results. All nursing students enrolled in the first, second and third year of the nursing undergraduate degree program at the University of Pavia (no. 471) participated in this survey. A total of 1,758 clinical internships were carried out: 461 for the first year, 471 for the second year and 826 for the third year. Setting objectives, beginning with the educational offerings in the several clinical contexts, represents a strong point for this process. The results highlight a level of heterogeneity and complexity intrinsic to the University of Pavia educational system, characterized by clinical settings with different clinical levels (Research hospital and other traditional hospitals) that offering different levels of training. Conclusions. The use of the self-evaluation form for clinical learning made it possible to perform realtime observations of the training activities of the entire student body. An educational model structured in this way allows the student to develop their capacity for critical thinking. For educational activities, such a self-evaluation form represents an ideal instrument for identifying areas in need of improvement. This explorative study, carried out by means of a self-evaluation form, is the first-step toward the development of an educational programme that is more uniform and easily traceable within the academic system.
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Gender and Racial Differences in Stress, Coping, and Health-Related Quality of Life in Chronic Kidney Disease
Article
Full-text available
  • Sep 2016
  • J PAIN SYMPTOM MANAG
Context Living with chronic kidney disease can be stressful and influence an individual's health-related quality of life. Effective coping strategies may reduce stress and improve quality of life in individuals with chronic medical conditions. Objectives Health-related quality of life (HRQOL) is an important outcome for patients living with chronic kidney disease (CKD), and it is necessary to better understand potential gender and racial differences and predictors associated with reduced HRQOL, so that effective interventions can be developed. Methods Participants included 182 patients with CKD who were administered a battery of questions that included the Medical Outcomes Study Short-Form 36, Perceived Stress Scale, and the Brief COPE. Demographic and disease-specific information was abstracted from the patients' medical record. Results No differences by race were observed with regard to stress, quality of life, or coping with the exception that minority patients reported use of religious coping more often (P = 0.001) and had higher levels of energy compared with nonminority patients with CKD (P = 0.27). Women with CKD tended to use self-distraction (P = 0.002), positive reframing (P = 0.035), venting (P = 0.024), and religious coping (P = 0 < 0.001) more often than men. No significant differences in perceived stress or domains of quality of life were observed between men and women with CKD. A link between coping strategies and HRQOL was observed in women (P = 0.001–0.02) but not men. Perceived stress was associated with poorer quality of life for men (P = 0.017 to <0.001) and women (P = 0.001 to <0.001), but more domains of men's quality of life were affected by perceived stress compared with women. Conclusions The findings of the study suggest that the wider range of coping strategies used by women may be associated with buffering the link between perceived stress and quality of life. Men with CKD may benefit from interventions that not only reduce stress but also facilitate the use of a broader range of coping strategies to reduce stress and improve quality of life.
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What is Behind Counterproductive Work Behaviors in the Nursing Profession? A Systematic Review
Article
Full-text available
  • Aug 2016
Background: Counterproductive work behaviors are considered an important issue for every workplace. This is particularly the case in the nursing setting, as such behaviors can also be detrimental for patients. However, the reasons underpinning nurses’ counterproductive behavior have been little studied, and the literature from the perspective of perpetrators’ is fragmented. Purpose: The aim of this systematic literature review was to identify and summarize studies concerning antecedents that could lead nurses to display counterproductive work behaviors. Methods: The PRISMA Statement and Flowchart were used to select the studies included in this review. The research was performed in July 2015 using the PubMed, CINAHL, PsycINFO, and Cochrane databases. Data were selected in stages based on inclusion, exclusion and quality criteria, and analyzed using Popay’s method. Results: Fourteen papers were selected. Counterproductive work behaviors in the nursing work environment were observed. The majority of studies were performed in North America (USA and Canada), using quantitative or qualitative designs. These work behaviors were studied in order to delineate predisposing factors and their relationship to Moral Disengagement. When counterproductive work behaviors are not sanctioned, and enforcement policies are not applied, they become an important problem for organizations. From the results of our systematic review, it is possible to identify two main foci: counterproductive work behaviors’ protective factors, and counterproductive work behaviors’ risk factors. Conclusion and implications for practice: This literature review identified specific antecedents that predispose nurses to engaging in counterproductive work behaviors, which negatively affect the quality of assistance and which can result in endangering the patient. This literature review helps to understanding the reasons that lead nurses to display counterproductive work behaviors, and can help prevent and restrict these phenomena.
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Che cosa ostacola l'implementazione di competenze specialistiche per l'infermiere? La prospettiva degli infermieri clinici: uno studio esplorativo e descrittivo
Article
Full-text available
  • May 2016
Introduzione: I paradigmi della personalizzazione delle cure e la crisi economica portano nuove sfide per l’infermieristica italiana, come l’implementazione di modelli di sviluppo di competenze specialistiche per l’infermiere, oggetto di un dibattito professionale e politico. Lo studio ha l’obiettivo di indagare che cosa ostacola l’implementazione di questi modelli. Materiali e metodi: E’ stato condotto uno studio in due fasi. Nella prima fase, con disegno qualitativo esplorativo, tramite un focus group è stato discusso, in un campione di 7 infermieri, che cosa ostacola l’implementazione di modelli di sviluppo di competenze specialistiche per l’infermiere. La seconda fase, con disegno quantitativo descrittivo e osservazionale trasversale (cross-sectional), ha previsto la costruzione di un questionario ad hoc, partendo dai risultati della fase precedente, che è stato poi somministrato agli infermieri di due grossi ospedali dell’area milanese. Risultati: Il focus group ha fatto emergere cinque temi principali: l’incertezza nel riconoscimento delle competenze, le criticità nella formazione, nella prassi, nel ricambio generazionale e i conflitti. Il questionario realizzato ha indagato tre domini di ostacoli: l’area della cultura, del riconoscimento e della prassi. Lo strumento ha buone caratteristiche di validità e affidabilità. I principali ostacoli emersi dall'indagine sono stati: la mancanza di incentivi economici, il sovraccarico di lavoro, il divario tra teoria e prassi e l’iter normativo. Conclusioni: I risultati mettono le basi per ulteriori approfondimenti e riflessioni che potrebbero essere utili ai colleghi coinvolti in progetti di implementazione di competenze specialistiche, poiché evidenziano quali sono gli ostacoli maggiormente percepiti.
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Towards an integrated model of nursing competence: an overview of the literature reviews and concept analysis
Article
Full-text available
  • Apr 2016
Introduction: Competence is considered a fundamental element when measuring a nurse's or student's ability to provide nursing care, but there is no consensus on what competence really is. This paper aims to review the existing meanings and models of nursing competence. Method: The overview of literature reviews and concept analysis was performed through a search on Pubmed, Cinahl and PsychINFO from January 2005 to September 2014. It included key words, such as: Competence Model; Professional Competence; Nursing Competence; Competency Model; Professional Competency; Nursing Competency. Result: A total of 14 papers were found, coming from educational or clinical nursing field. It was possible to identify some common themes: description of competence determinants; confu- sion around the competence concept; lack in competence evaluation; lack when competence have to be operationalized. Conclusion: The overview results, enriched by the literature coming out from the organiza- tional studies, build the conceptual basis of an integrated model of nursing competence. More empirical research is needed to test the theoretical assumptions.
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What do we know about emotional labour in nursing? A narrative review
Article
  • Jan 2017
Nurses have to manage their emotions and the expression of emotion to perform best care, and their behaviours pass through emotional labour (EL). However, EL seems to be an under-appreciated aspect of caring work and there is no synthetic portrait of literature about EL in the nursing profession. Hence, this review was conducted to synthesize and to critically analyse the literature in the nursing field related to EL. Twenty-seven papers were included and analysed with a narrative approach, where two main themes were found: EL strategies and EL antecedents and consequences. Hence, EL is a multidimensional, complex concept and it represents a nursing competence to perform the best caring. Moreover, nurses have a high awareness of EL as a professional competence, which is a fundamental element to balance engagement with an appropriate degree of detachment to accomplish tasks for best practice, and to provide high-quality patient care.
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Gender Differences in Job Stress and Stress Coping Strategies among Korean Nurses
Article
  • Jun 2016
Gender differences among nursing professionals were investigated in the area of job stress and stress coping strategies. Seventy six male nurses and 93 female nurses from 3 general hospitals were participated in this study. Korean job stress measurement developed by Chang (2005) and stress coping measurement modified by Yim (1994) were used. Using SPSS 22.0 program, gender differences in the level of job stress and coping strategies were compared by frequency, percentage, and independent t-test. Furthermore, the level of job stress and coping strategies according to the duration of work experience between male and female nurses were compared. The overall levels of job stress were significantly higher among male nurses than female nurses. In specific, the stress level from interpersonal conflict was higher among male nurses. According to duration of work, male nurses working more than 5 years showed higher level of job stress than female nurses in the area of autonomy, interpersonal conflict, and lack of reward. For coping strategies, more male nurses working more than 5 years used challenging, emotion focused, and avoidant coping strategies. In conclusion, male nurses have more difficulties in interpersonal conflicts than female nurses. The longer male nurses worked, the higher and broader their job stress level became. Therefore, specific continuing education program only for male nurses should be developed and implemented.
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Development and validation of the Nursing Profession Self-Efficacy Scale
Article
  • Jun 2016
Aim: This study describes the development and validation of the Nursing Profession Self-Efficacy Scale. Background: Self-efficacy can be useful in predicting performance, job satisfaction or well-being. In the nursing field, there is a shortage of studies on self-efficacy with regard to a nurses’ global confidence in coping ability across a range of everyday challenging work situations. Methods: To define the theoretical framework of nursing professional self-efficacy, two focus groups and a literature review were performed. An empirical study was then conducted to test validity and reliability. Face and content validity, construct validity, concurrent validity, internal consistency and test–retest reliability were examined. The content validity index was evaluated by 12 experts who suggested deleting 11 redundant items. The final developed tool was tested for construct analysis using a cross-validation approach, randomly splitting the overall sample of 917 nurses in two sub-groups. Findings: The construct validity indicated two dimensions. The face and content validity were adequate. Test–retest reliability displayed a good stability, and internal consistency (Cronbach’s a) was acceptable. Moreover, concurrent validity using the Generalized Self-Efficacy Scale was in line with the theoretical framework. Conclusion: The scale showed evidence of validity and reliability. The major limitation is the strong influence of the Italian context in the tool development. Implications for nursing and health policy: The Nursing Profession Self-Efficacy Scale could be a fruitful tool that facilitates the application of theories (i.e. social-cognitive theory) in the nursing field and even development of interventions. Furthermore, a measurement of self-efficacy could be used to predict nursing clinical performance.
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Stress Levels of Nurses in Oncology Outpatient Units
Article
  • Apr 2016
  • Clin J Oncol Nurs
Background: Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from burnout and compassion fatigue. Objectives: The purpose of this article is to identify stress levels and stressful factors of nurses working in oncology outpatient units and to explore coping behaviors for work-related stress of oncology staff nurses in outpatient units. Methods: A descriptive, cross-sectional design was used to identify stress levels and stressful factors for outpatient oncology nurses, investigate differences in stress levels among nurses' demographic characteristics, and explore coping behaviors of the nurses. Study participants (N = 40) included RNs and licensed practical nurses who completed the Nursing Stress Scale, three open-ended questions, and a demographic questionnaire. Findings: The highest sources of stress were workload and patient death and dying. Demographic variables of age and work experience in nursing showed a significant positive relationship to work-related stress scores. The three most frequently used coping behaviors were verbalizing, exercising or relaxing, and taking time for self. Continuing education programs on stress management are highly recommended. Outpatient oncology nurses should be nurtured and supported through tailored interventions at multiple levels to help them find effective coping strategies and develop self-care competencies. Although younger and less experienced nurses had lower mean stress scores than older and more experienced nurses, the continuing education programs and tailored interventions would be helpful for all oncology nursing staff.
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