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Combined and Selective Effects of Psychosocial Stressors in Nurses Rachel McNamara

CWERC Seminar 7 April 2008. Combined and Selective Effects of Psychosocial Stressors in Nurses Rachel McNamara. Combined & selective effects of psychosocial stressors. Objectives: Are additional psychosocial stressors associated with acute ill health in addition to NOF?

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Combined and Selective Effects of Psychosocial Stressors in Nurses Rachel McNamara

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  1. CWERC Seminar 7 April 2008 Combined and Selective Effects of Psychosocial Stressors in Nurses Rachel McNamara

  2. 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?

  3. 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)

  4. 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)

  5. Combined & selective effects of psychosocial stressors

  6. Combined & selective effects of psychosocial stressors Work stress _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

  7. Combined & selective effects of psychosocial stressors Anxiety _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Depression _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

  8. Combined & selective effects of psychosocial stressors 14-day symptoms 14-day LRTIs _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

  9. Combined & selective effects of psychosocial stressors Work stress (p<.0001) ***(p<.0001) +(p<.05) JD = job demand E = Intrinsic/extrinsic effort WH = working hrs/hazards

  10. Combined & selective effects of psychosocial stressors Anxiety (p<.0001) Depression (p<.0001) ***(p<.0001) *(p<.01)

  11. Combined & selective effects of psychosocial stressors 14-day symptoms (p<.0001) ***(p<.0001) *(p<.01) 14-day LRTIs (p<.008)

  12. 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)

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