Evaluation of the Relationship between Occupational Stress, Job Satisfaction and Spiritual Well-being in Nurses Working in Razi Hospital in Saravan at 2017 View PDF

Recently researches have paid more attention to occupational stress due since it affects efficacy and work morale [1]. Occupational stress is a process in which job related factors lead to a change in spiritual and physiologic conditions and arises disorder in the individual natural performance [2]. Stress is not always harmful; at low levels, it is an important and vital motivational factor to perform the job. But frequent increased stress level may cause physical and mental diseases [3]. Stress is considered the main factor in up to 80% of all occupational-related injuries and is associated with 40% of changing job.

Nursing is among the jobs that experience a high stress level. A nurse experiences high stress level when demands are more the abilities [3]. Occupational stress not only affects nurse health but also the quality of their services [4]. Recent studies suggest that the major source of nurses’ stress includes inappropriate relationship between nurses and physicians and other health care providers, emergent situations, high workload, lack of personnel and support or positive feedback of nursing manager and their conflicts [3]. If occupational stress is not well managed it will affect quality of patient care, increase job absence and financial burden and lower job satisfaction [4]. Lower job satisfaction results in negative attitude towards their jobs and co-workers [1]. Job satisfaction is the level of personal satisfaction or dissatisfaction of his or her job [5]. A person is considered to have job satisfaction when not only the physiologic needs are fulfilled but also emotional security and individual values [6]. Occupational satisfaction is an important aspect of nurse lives who can affect security, efficacy, performance, and quality of provided care, organizational and occupational affiliation [5,6]. Spiritual well-being affects occupational stress. If spiritual well-being is increased, occupational stress decreases and subsequently job satisfaction improves [5]. Spiritual well-being includes understanding perceptions and it is a combination of personality factors and basic beliefs about existence and having a meaningful life which is related to social, physical, and psychological aspects of life [7]. Those who are spiritually healthy can help others by providing spiritual supports to other people. Since nurses belong to the biggest group in health care providing system they need to fulfill spiritual well-being of the patients which is an important aspect in care providing for the patient. Moreover, spiritual well-being affects occupational affiliation and nurses performance [8,9].

Spiritual well-being is individual’s flexibility in facing problems such as nursing complexity which can improve their spiritual health and quality of life since they experience stressful and critical job environment [9]. Nursing job is stressful leading to lower job stability and job satisfaction. Spiritual health is considered a defense mechanism against stressful condition having a significant role in the performance of the personnel and subsequent improvement in job satisfaction and job stability. This study is conducted to evaluate the relationship between occupational stress, job satisfaction and spiritual well-being in nurses working in Razi Hospital in Saravan at 2017.

Current study is a descriptive analytic study to determine the relationship between occupational stress, job satisfaction and spiritual well-being in nurses working in Razi Hospital in Saravan. Sample included 80 nurses working in Razi Hospital, Saravan which were selected using convenient sampling method. Study inclusion criteria consisted of: a minimum of 6 months of job experience in a therapeutic ward and desire entering the study. Study exclusion criteria included lack of desire to enter the study or incomplete feeling of the questionnaire. Data collection included demographic information questionnaire, as well as, Nurse Stress Scale (NSS), Job Satisfaction Survey (JSS), and Paloutzian and Ellison spiritual wellbeing questionnaires.

Nurse stress scale:  Nursing Stress Scale is proposed by Gray-Toft and is the first tool for measuring occupational stress instead of the general occupational stress questionnaires. This questionnaire includes statements in 7 subjects: patient’s suffering and death (7 questions), conflict with physicians (5 questions), lack of appropriate preparation (3 questions), conflict with other nurses (5 questions), lack of supporting sources (3 questions), work pressure (6 questions), and lack of belief in the treatment (5 questions). Answers ranged from never stressful (score 1) to always stressful (score 4) of Likert scale. Total Score in this questionnaire ranged from 34 to 136. Score equal or below 68, score 69-103, and score equal or more than 104 show low stress, average stress, and high stress respectively [10]. Questionnaire reliability was evaluated again in (r=0.74) Rezai et al. [11].

Job satisfaction survey (JSS): Spector Job Satisfaction Survey consists of 36 questions used to evaluate employees’ satisfaction to their jobs. Answers were based on Likert scale ranging from completely agrees to completely disagree in 6 items. Some questions had positive score and some other questions had negative scores. Coincidence coefficient of this questionnaire was 0.91 using Cronbach alfa and 0.71 in recovery method with 18 items. Reliability of this questionnaire was reported to be 0.86 according to Cronbach alfa [12].

Paloutzian and ellison spiritual well-being questionnaire: Spiritual well-being questionnaire consists of 20 questions. Total score ranged from 20 to 120. Cronbach alfa of this questionnaire was reported to be 0.87 in Abbasi et al. [13].

The researcher explained the study objectives and questionnaires to the participants; thereafter participants filled out the forms. Data was analyzed b SPSS23 software using descriptive and analytic statistical tests.

Age of participants ranged from 25 to 54 (mean ± SD= 35.06 ± 8.85). 55.4% of participants were women and 44.6% of them were men. 38.5% of them were single and 61.5% of them were married. 15.4% of participants had associate degree and the other 84.6% had bachelor degree. Participants had a mean work experience of 7.27 ± 6.25 years. 21.5% of participants were duty employee, 10.8% contractual employee, 6.2% corporate employee, 26.2% contract employee, 33.8% were officially employed.

Overall spiritual well-being of nurses in this study was 71.43 ± 15.36 (95.4% medium and 4.6% high spiritual well-being). Mean and standard deviation of score in different areas of spiritual well-being are presented in Table 1. Mean overall occupational stress score 95.10 ± 12.70 was . Data analysis suggested that 76.5% of the participants experienced medium stress, and 21.5% of the participants experienced severe stress while 1.5% did not feel any stress. Other subscales of occupational stress are shown in Table 2. Mean job satisfaction of nurses was 89.87 ± 14.76 and data analysis showed that 12.3% had

Table 1: Spiritual well-being and subscales.

Table 2: Occupational stress and subscales.

Table 3: Relationship between occupational stress with job satisfaction and spiritual well-being.

medium job satisfaction while a majority of 87.7% did not have job satisfaction.

Results of this study indicated that there is a significant statistical relationship between occupational stress, job satisfaction and spiritual well-being in the evaluated nurses. Pearson correlation test showed that there is a correlation between occupational stress and spiritual well-being (P=0.000, r=-0.58) and between occupational stress and job satisfaction (p=0.004, r=-0.34); an increase in occupational stress, will reduce spiritual well-being and job satisfaction (Table 3).

Data analysis showed that most nurses experience medium stress level. Moreover, the highest stress level of nurses belonged to patient’s death and suffering followed by work load. Results of this study is consistent with Hosseini et al. [14], Rezaei et al. [13] and Shahraki Vahed et al. who reported nurse stress levels of 57.4, 59, and 47.6 percent respectively [14-16]. On the contrary, Haghani et al. [17] showed that 90 percent of working nurses do not experience occupational stress [17]. This inconsistency can be attributed to the difference in measuring tools which was nurse Stress Scale (NSS) in this study. Moreover, geographical factors and level of hospital admission should be considered. In this case, Saravan Hospital is the only hospital in the region with high admission and referrals lacking enough equipment which may increase occupational stress in nurses. Highest stress level of nurses belonged to Patient’s death and suffering and work load which strengthen this explanation. This study is consistent with Moallemi et al. [18] and Fathi et al. [19] in which highest stress level of nurses belonged to death and sufferings of the patients [17,18].

High occupational stress decreases job satisfaction of the nurses which can lead to leaving the job. Data analysis showed a negative relationship between occupational stress and job satisfaction. Results of this study are consistent with Lavasani et al. [20] and Khamisa et al. [21] regarding the effect of occupational stress on job satisfaction [4,20,21]. Nursing occupational stress is related to the nature of the jobs including nurse role in workplace, the relationships between personnel, occupational advancement and so on. Thus, the nurses who experience more tensions have a lower job satisfaction [20,21]. Spiritual well-being is an effective factor in preventing from occupational stress [22]. Nurse care giving will not be complete without spirituality and nurses who lack spiritual well-being will not be able to take care of patients. Lack of enough time and lack of paying attention to the importance of spiritual care are among factors decreasing nurse health [22,23]. Results of this study showed that spiritual health of most of the participants were at medium level and had a significant negative relationship with occupational stress. Results of this study are consistent with Masomi et al. [22] on evaluation of occupational stress on spiritual well-being of nurses [22]. Consequently, paying attention to spiritual health should be considered as a factor to reduce occupational stress and improve job satisfaction. Lac of attention of occupational stress will not only does harm to the health of nursing society but also affect quality of patient care.

Emotional responses of the participant nurses and low sample size were limitations the current study. Further studies with higher sample size are suggested.

Conflict of Interest

Authors announce no conflict of interest.

Contributing Authors

Study design, data collection, data analysis, edition of the final version of the paper: Jasem allahyari

Study deigns, data collection, data analysis: Mohammad Sadegh Sargolzaei.

Data collection and writing the initial version of the paper: Naser Shirani and Ahamadreza Siyasari.

Data collection: Mahmood Anbari and Javad Jafari.

Authors announce their special thanks to all who cooperated in this study. In case of lack of their cooperation, conducting this study was not possible.

1. Mathew MNA (2013) Effect of Stress on job satisfaction among nurses in central Kerala. J Bus Manag 7: 47-51.
2. Sarafis P, Rousaki E, Tsounis A, Malliarou M, Lahana L, et al. (2016) The impact of occupational stress on nurses’ caring behaviors and their health related quality of life. BMC nursing 15: 56.
3. Gulavani A, Shinde M (2014) Occupational stress and job satisfaction among nurses. International IJSR 3: 733-740.
4. Sharma P, Davey A, Davey S, Shukla A, Shrivastava K, et al. (2014) Occupational stress among staff nurses: Controlling the risk to health. IJOEM 18: 52-56.
5. Castaneda GA, Scanlan JM (2014) Job satisfaction in nursing: A concept analysis. Nursing forum 49: 130-138.
6. Olatunde EB, Odusanya O (2015) Job satisfaction and psychological well-being among mental health nurses. Int J Transla-tion Community Dis 3: 64-70.
7. Didarloo A, Rahmatnezhad L, Sheikhi S, Khodai F (2017) Relationship of Spiritual Health and Perceived Stress with Breastfeeding Self-efficacy: A Survey on Mothers with Hospitalized Neonates. Int J Pediatr 5: 6179-6188.
8. Chiang YC, Lee HC, Chu TL, Han CY, Hsiao YC (2016) The impact of nurses’ spiritual health on their attitudes toward spiritual care, professional commitment, and caring. Nurs Outlook 64: 215-224.
9. Atashzadeh-Shoorideh F, Abdoljabbar M, Karamkhani M, Khubestani MS, Pishgooie SA (2017) The relationship between Nurses’ spiritual health and their caring behaviors. J Res Religion Health 3: 5-17.
10. Pak PF, Mansur L, Sadeghi M, Purebraham T (2012) The Relationship of Job Stress with Marital Satisfactionand Mental Health in Nurses of Tehran Hospitals. JCOC 4: 27- 54.
11. Sadeghi R, Jafari S (2013) Occupational Stress and its Determinants among Nurs ing Staff of Hospitals Affiliated to Zanjan University of Medica l Sciences in 2011. J Health Develop 2: 74-82.
12. Karami J, Moradi A, Hatamian P (2017) The Effect of Resilience, Self-Efficacy, and Social Support on Job Satisfaction Among the Employed, Middle-Aged and Elderly. J Ageing 12: 300-11.
13. YarMohammadi S, Makarem A, Rezaei M, Bakhshi E, Bakhtyari V (2016) The relationship between spiritual health, happiness and job satisfaction among elderly caregivers at nursing homes of Tehran. Ir J Geriat Nurs 2: 9-24.
14. Hosseini Z, Hazavehei M, Imanzad M, Ghanbarnezhad A, Gharlipour Z (2014) Occupational stress and mental health relationship in nurses. Adv Nurs Midwifery 23: 55-62.
15. Rezaee N, Behbahany N, Yarandy A, Hosseine F (2006) Correlation between occupational stress and social support among nurses. Iran J Nurs 19: 71-78.
16. Vahed SA, Hamuleh MM (2010) Assessment of the relationship between mental health and job stress among nurses. J Jahrom Univ Med Sci 8: 34-40.
17. Khaghanizadeh M, Ebadi A, Siratynayer M, Rahmani M (2008) Relation between job stress and quality of work life among nurses in arm force hospitals. Iran J Milit Med 10: 175-184.
18. Moallemi S, Adroom M (2016) Comparison of job stress and job satisfaction amongst nurses of different units. Milit Caring Sci 3: 165-173.
19. Fathi M (2004) Assessing of Stress amongntensive care unit nurses. SJKUMS 7: 53-62.
20. Lavasani M, Keyvanzade M, Arjmand N (2008) Spirituality, job stress, organizational commitment, and job satisfaction among nurses in Tehran. J Contemporary Psychology 3: 61-73.
21. Khamisa N, Oldenburg B, Peltzer K, Ilic D (2015) Work related stress, burnout, job satisfaction and general health of nurses. Int J Environ Res Public Health 12: 652-666.
22. Masoumi M, Tahmasebi R, Jalali M, Jafari F (2016) The Study of the relationship between Job stress andspiritual health of nurses working in Intensive care ward at Bushehr Hospitals. J Nurs Adm 3: 37-47.
23. Baldacchino DR (2008) Teaching on the spiritual dimension in care to undergraduate nursing students: The content and teaching methods. Nurse Educ Today 28: 550-562.