An interactional model of occupational stress in health service employees

Abstract

This large scale study (869 participants from a mental health Trust) employed a questionnaire based on an interactional model of occupational stress to investigate (i) burnout in psychiatric nurses, (ii) occupational stress in medics and the professions allied to medicine, (iii) job satisfaction in health service management and support staff, and (iv) the moderating effect of social support in health service personnel. A range of analytic procedures were used including hierarchical regression analysis. Levels of burnout in nurses were low overall, although a significant proportion reported higher levels of emotional exhaustion. Among nurses, negative affectivity and predictability acted as common factors across the three constructs of the burnout syndrome. Medics and professions allied to medicine (P.AM. 's) reported similar levels of stressors to each other. Role ambiguity, role conflict and predictability, in combination with negative affectivity, accounted for most of the reported work related stressors of medics and P.AM. 's. Levels of job satisfaction in management and support staff was on a par with their peers elsewhere. Role ambiguity, role conflict, job future ambiguity, control and non-occupational concerns had an influence on job satisfaction among management and support staff. A significant proportion of nurses, medics and P.AM.'s reported low levels of work support. Those most at risk in this regard appeared to be highly educated, community based, non-shift workers. Higher levels of support were associated with increased job satisfaction and lower levels of both emotional exhaustion and psychological distress. The model adopted in the present study, although not necessarily applicable to all occupational groups, had utility in understanding the complex relationships between variables in this population from a mental health Trust. Despite common themes emerging across occupational groups, clear differences were also apparent, reinforcing the need for tailor-made interventions in occupational stress. The results also highlighted the necessity of including individual characteristics and nonoccupational stressors in any consideration of occupational stress. Further recommendations for each occupational group and the NHS in general are discussed.