Work-related stress and stress management practice among Chinese hospital staff working night shifts: A mixed-methods study.

Abstract

Health care workers (HCWs) are susceptible to cumulative stressors and their detrimental effects. Hence, it is important to identify the factors in HCWs’ stress management behaviors to help them better cope with daily stress. Inspired by the health belief model (HBM), we decided to focus on examining the psychosocial pathway between stressors and stress outcomes among HCWs. A sequential explanatory mixed-methods study was conducted in two general hospitals in Wuhan, China. A constructive questionnaire was applied to assess the psychological measures of stress, and the Holter devices were used to evaluate the physical effects of stress. Subsequently, a multiple case study was conducted to better understand factors related to stress management attitudes and behaviors among HCWs. A total of 292 HCWs were included in this study. The results showed that 67.1% of participants were overstressed, with 57.5%, 69.2%, and 78.4% of participants suffering from depression, anxiety, and stress symptoms, respectively. Only half of the participants adopted stress management behaviors, and stress management attitudes and behaviors played a mediating role between stressors and stress outcomes for both physical indicators (β = 0.014, p = .006) and psychological measures (β = −.001, p = .052). Analyses of the results of this qualitative study consistently found that knowledge, skills, and positive feedback were critical elements for stress management behaviors. Promoting positive health beliefs around stress management, and emphasizing, in particular, the positive role of stress management in HCWs’ personal lives, was critical to help HCWs build stress management behaviors.

The Effects of a Complex Interactive Multimodal Intervention on Personalized Stress Management Among Health Care Workers in China: Nonrandomized Controlled Study

“…Building new stress management habits, however, may be difficult for HCWs, especially those with distress symptoms. Based on the findings of a recent mixed-methods study, while the majority of HCWs were aware of some of the stress effects and stress management methods, almost half of them fail to adopt stress management behaviors [18]. Individuals suffering from distress symptoms such as anxiety and depression may experience loneliness, isolation, and stigma, which can lead to stress coping failure and increased stress responses [19].…”

Complex interactive multimodal intervention to improve personalized stress management among healthcare workers in China: A knowledge translation protocol

“…According to a recent mixed-methods study, even though being fully aware of the presence and potential detrimental effects of work stress, approximately half of HCWs failed to implement stress management behaviors because multiple stressors, such as overwhelming workload and emotional burdens, made it difficult for the HCWs to change their current status on their own. 12 Previous research has also discovered that long-term stress symptoms may undermine a person's sense of self-efficacy and social support, deterring them from benefiting from stress management. 13 , 14 There appears to be a vicious circle of “stress-distress” preventing HCWs from implementing stress management strategies derived from scientific research.…”