Chronic Stress, Behavioral Tendencies, and Determinants of Health Promoting Activities in Nurses: A Mixed-Methods Approach

Abstract

Background Demographic changes and medical advances require a highly professionalized nursing sector while nurses experience high, and often chronic, levels of stress. As high-quality care can only be sustained with a healthy workforce, individualized stress-alleviating interventions for nurses are needed. This study explored barriers and resources associated with health promoting activities in nurses with different stress levels (and work-related behavioral tendencies) and identified health behavior determinants based on the Health Action Process Approach (HAPA) model. Methods Applying a cross-sectional mixed methods design, 43 nurses first filled out questionnaires assessing chronic stress (SSCS) and work-related behavior patterns (AVEM). Subsequently, interviews were conducted. With content analysis, categories of health promotion-related barriers and resources emerged. behavior determinants (self-efficacy, outcome expectancies), current health behavior, and B&Rs were quantified with magnitude and frequency coding. Finally, stress and AVEM patterns were triangulated with behavioral determinants and barriers and resources. Results Of the included nurses, 84% were chronically stressed while 49% exhibited unhealthy behavioral tendencies at the workplace. 16 personal and organizational themes (six resources, ten barriers) were identified that influence health promotion behaviors. Stress was associated with resource frequency (p = .027) and current health promotion activities (p = .07) whereas results concerning AVEM patterns were not easily interpretable. Self-efficacy significantly explained variance in health behaviors (p = .003). Implications for future health behavior change interventions in nursing populations are discussed. Conclusion Health promotion related barriers & resources affect health promotion in nurses. Practitioners need to design interventions that address population specific barriers for sustainable health promotion.

Types of behaviors and experiences at work and health condition in the group of nurses at Accident and Emergency Units

“…[4,7]. Similar results were obtained by Heuel et al (2022) in a group of German nurses [12]. Long-term occupational functioning, according to the types unfavorable to health, may cause disturbances in the physical and mental spheres.…”

“…Type S-economical characterizes people who do not expect professional success, and who see satisfaction with life in situations not related to work. This type, on the other hand, has a clear tendency to distance himself from work-related problems [4,7,11,12].…”

“…Risk type B -burn out -shows low subjective importance of work, low resistance to stress and low ability to distance oneself from problems at work. This type is characterized by a tendency to give up in di cult situations and a very low sense of inner balance [4,7,11,12].…”