This study describes nurses' experiences of stress in primary healthcare settings, and examines correlations between stress and personal factors. There were 187 nurses from 18 public primary care centers participating, drawn from one county of Lithuania. The Expanded Nursing Stress Scale was used to evaluate the study data. The study indicates that in primary healthcare centers, nurses working with adult patients experienced less stress than those working with younger patients. The most frequently reported stressors were those related to death and dying, and conflicts with physicians and patients and their families. In particular, older nurses more frequently experienced stress related to death and dying. The intensity of nurses' stress in conflict situations with physicians was related to age, however, the depth of work experience in the healthcare setting was more influential. Findings indicate that more detailed research is needed regarding stress experiences in primary health care, and especially the related impact of the social contexts involved in the setting.
Health-care organizations differ from other institutions due to their unique structure and management. Organizational culture and climate are the key constructs that compose the organizational social context, and might have an impact on employees, such as nurse managers, and the organization itself. The aim of this study was to analyze the connections between organizational culture and climate and work-related empowerment, and also to present culture and climate profiles at team and organization levels. The research was carried out in Lithuania among 193 nurse managers in seven hospitals using a questionnaire that measured organizational culture and climate (Organizational Social Context instrument), and work-related empowerment (Conditions for Work Effectiveness Questionnaire-II and Work Empowerment Questionnaire). The findings showed that nurse managers were both structurally and psychologically empowered when the organizational culture was proficient and resistant, and the climate was engaged and functional. These results suggest that nurse managers are more likely to be empowered when there is an appropriate organizational culture and climate in the workplace. Creating an empowering work environment might have a positive impact on individual and organizational outcomes.
Aim: The aim of the present study was to describe the association between primary healthcare (PHC) nurses' perceived stress and organizational culture and climate in a team context. Design: A descriptive, cross-sectional correlation study. Methods: 29 teams in 18 PHC centers situated in one Lithuanian county participated in the study. A total of 187 nurses completed the Expanded Nursing Stress Scale, while 344 healthcare professionals (including nurses) responded to the Organizational Social Context questionnaire. Results: Absolute values of Spearman's rho correlation coefficients between 0.19-0.24 (p < 0.01) were found when examining the association of nurses' stress with organizational culture and climate across PHC teams. Whether the culture was resistant or proficient seemed to have associations with some of the stress factors experienced by nurses. Additionally, how the whole team reported stress or functionality in their organizational climate seemed to be associated with perceived stress of nurses. Conclusion: Investigating the organizational culture and climate experienced by PHC teams may help identify manageable problems and decrease stress experienced by nurses. The study also allows the possibility of nursing scholars using the study's designs and instruments for further investigation of teams.
This research looks to describe experienced stress in nursing teams working in primary health care. Recent changes and increased demands in primary health care may result in highly stressed teams, which have a subsequent impact on nursing care. Nurses' experienced stress has previously been identified at individual, team, organizational and cultural levels. Team related factors associated with stress have been identified as team climate, supportive colleagues and work environment. A descriptive study was conducted among nurses from 29 teams in 18 different primary health care centres, located in one Lithuanian county. The Expanded Nursing Stress Scale (ENSS) was used. A total of 187 nurses completed the questionnaire. The stress experienced by nurses depends on the team. The study results reveal both individual and team level stress. The effect of the team size is moderate, but the background factors of the teams had little association with the sub-categories of stress. Workload tended to cause more stress in larger teams. At the nurses' team level, a strong positive correlation was found between all of the stress subcategory areas investigated, except for that of "discrimination". Different teams followed different stress profiles, but based on their common features, various clusters were identified which should be noticed by management.
The recognition and assessment of organizational social context (culture, climate and morale) is particularly valuable in primary health care. Both culture and climate have been shown to be associated with work morale and to predict job satisfaction, organizational commitment and voluntary turnover of employees in nursing. This study aims to describe the social contexts of primary health care centers from the viewpoint of health care professionals. A descriptive study using an organizational social context instrument for data collection was undertaken. From 29 teams in 18 public primary care centers of one Lithuanian county, 344 health care professionals participated. The results of the study show that different organizational cultures, climates and levels of morale existed in primary health care centers, at both team and organizational levels. The differences between teams were significant in terms of culture rigidity and resistance. Climate differences were found at both team and organization levels in regard to stress and functionality. A variance of about 7% in work morale was seen in teams and organizations. Managers should recognize the different kinds of social contexts in which teams work, in order to enable them to co-work efficiently in evidence-based primary care settings.
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