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Brinkman, A., & Caughley, B. (2004). Measuring on-the-job stress accurately. Kai Tiaki: Nursing New Zealand, 18(8), 12–15.
Abstract: The authors discuss the usefulness of a generic tool to measure job stress in New Zealand workplaces, and report on a study using one such generic tool. The study involved sending questionnaires to all staff (193) who had worked at a regional women's health service for a minimum of six months. The mailed package contained the Job Stress Survey (JSS), the General Health Questionnaire (GHQ-12), demographic questions (including cultural safety), shift work questions, and a blank page for “qualitative comment”. Over 12,000 pieces of data were collected from the study but this article focuses only on the results of the JSS. The JSS can be used to determine a “job stress index” and can also be used to measure “job pressure” and “lack of organisational support”. For this study, job stress index scores were calculated and organised by occupational groupings. Midwives, nurses and doctors all cited inadequate or poor quality equipment, excessive paperwork, insufficient personal time, and frequent interruptions, as their top stressors. Three of these four stressors fall within the job pressure index. The results of the survey prompted organisational changes, including: extensive discussions; equipment being updated; management being made aware of the depth of concern felt by staff; the creation of a place for staff to have personal time; and coping intervention strategies were initiated. The authors suggest that no generic measure of job stress can fully evaluate stressors unique to a particular work setting. They support additional items being constructed and administered to assess stressors that are idiosyncratic to a particular occupational group.
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Brinkman, A. (2002). Occupational stress in hospitals: A nursing perspective. Kai Tiaki: Nursing New Zealand, 8(6), 21–23.
Abstract: This article examines the environmental stressors that cause occupational stress for many nurses, particularly the health reforms and the Employment Contracts Act (ECA). The concept of stress is reviewed and theories of occupational stress are described, including the demand-control theory and the transactional model. Nurses are advised to become aware of occupational stress in their workplaces, citing a study by the author showing high levels of stress among hospital nurses.
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Hall, L. (2001). Burnout: Results of an empirical study of New Zealand nurses. Contemporary Nurse, 11(1), 71–83.
Abstract: This is the first New Zealand study to use the Maslach Burnout Inventory (MBI) and the Phase Model of Burnout to determine the extent and severity of burnout in a population of 1134 nurses. Burnout is conceptualised as a syndrome consisting of three components-emotional exhaustion, reduced personal accomplishment and depersonalisation of clients or patients that occurs in individuals who work in the human service professions, particularly nursing. It has been observed that nurses are at a high risk of burnout and burnout has been described as the 'professional cancer' of nursing. Results revealed an overall 'low to average' level of burnout, suggesting that New Zealand nurses, apart from those in the 41-45 age group, are doing better than expected insofar as they are managing to avoid or not progress to the advanced phases of burnout. Possible explanations and directions for future research are presented.
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Daniels, A. (2004). Listening to New Zealand nurses: A survey of intent to leave, job satisfaction, job stress, and burnout. Master's thesis, Auckland University of Technology, Auckland. Retrieved June 1, 2024, from http://hdl.handle.net/10292/199
Abstract: This study aims to identify work related factors contributing to New Zealand nurses' intent to leave the job. Two hundred and seventy five surveys (response rate = 68.8%) from a random sample of 400 nurses employed in one district health board were used to explore intent to leave the job. Three research questions directed the description of levels of job satisfaction, job stress, and burnout found in nurse participants, correlations between the three variables, and the identification of variables predicting intent to leave the job through regression analyses. The survey found levels of job satisfaction were high, job stress was low, and burnout was average. Specifically, lack of opportunity to participate in organisational decision making, control over work conditions, control over what goes on in the work setting (key Magnet Hospital characteristics) were not evident, and with pay rates, were the main sources of job dissatisfaction. Workload was the most frequently experienced source of stress by nurse participants. Twenty-five per cent of nurse participants reported high levels of intent to leave the job. Correlations suggested that reductions in job satisfaction influenced increases in job stress and burnout. Job stress was associated with increases in emotional exhaustion. Emotional exhaustion was influenced by eight job satisfaction, job stress, and burnout subscales. Five subscales (professional opportunities, praise and recognition, interaction opportunities, extrinsic rewards, lack of support) explained 26.2% of the variance in nurse participant's intent to leave. The author concludes that issues of power and control were associated with job dissatisfaction, job stress and burnout in nursing practice. However, predictors of intent to leave the job suggest a growing realisation by nurse participants that postgraduate education and nursing research may provide the tools to create positive change in the health care environment and make nursing visible, valued and appropriately rewarded.
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Chang, E. M., Bidewell, J. W., Huntington, A. D., Daly, J., Johnson, A., Wilson, H., et al. (2008). A survey of role stress, coping and health in Australian and New Zealand hospital nurses. Intensive & Critical Care Nursing, 44(8), 1354–1362.
Abstract: The aim of this study was to examine and compare Australian and New Zealand nurses' experience of workplace stress, coping strategies and health status. A postal survey was administered to 328 New South Wales (Australia) and 190 New Zealand volunteer acute care hospital nurses (response rate 41%) from randomly sampled nurses. The survey consisted of a demographic questionnaire, the Nursing Stress Scale, the WAYS of Coping Questionnaire and the SF-36 Health Survey Version 2. More frequent workplace stress predicted lower physical and mental health. Problem-focused coping was associated with better mental health. Emotion-focused coping was associated with reduced mental health. Coping styles did not predict physical health. New South Wales and New Zealand scored effectively the same on sources of workplace stress, stress coping methods, and physical and mental health when controlling for relevant variables. Results suggest mental health benefits for nurses who use problem-solving to cope with stress by addressing the external source of the stress, rather than emotion-focused coping in which nurses try to control or manage their internal response to stress. Cultural similarities and similar hospital environments could account for equivalent findings for New South Wales and New Zealand.
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Kell, A. - M., Gilmour, J., & Wissen, K. van. (2018). Nurses' experiences caring for patients surgically treated for oral cavity cancer. Nursing Praxis in New Zealand, 34(1). Retrieved June 1, 2024, from www.nursingpraxis.org
Abstract: Explores nurses' experiences of caring for patients who have had surgery for oral cavity cancer in one NZ hospital, involving wound care, tracheostomy management, oral care, ongoing patient education and the provision of emotional support to patients and families. Interviews three registered nurses about the challenges involved in caring for this patient group; their moral conflict over the effects of surgery on the patients; their professional uncertainty, and the emotional effort involved in nursing oral cavity cancer patients. Suggests the need for informal debriefing, grief counselling, clinical supervision, stress management training, and continuing education in this specialised role.
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Green, C. (2018). Medication simulation: enhancing nursing students' clinical environmental awareness through self-care and promotion of patient safety. Whitireia Nursing and Health Journal, (25), 37–51.
Abstract: Undertakes an evidence-based practice pilot project to examine the effectiveness of simulation-based learning in teaching nursing students to become aware of the role of stress, anxiety and distraction in medication errors. Stresses the importance of medication-error prevention at the pre-licensure level, by increasing awareness of patient safety culture. Notes the need to teach nursing students self-awareness of the distractions and stresses within the clinical environment and therefore the need for self-care to avoid medication error.
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Brown, J. (2019). Thorn in the flesh: the experience of women living with surgical mesh complications. Master's thesis, University of Otago, Dunedin. Retrieved June 1, 2024, from https://www.nzno.org.nz/resources/library/theses
Abstract: Sheds light on the experiences of seven women who have suffered pelvic surgical mesh complications as a result of surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Emphasises the existential impacts arising from disruption to the embodied self as experienced by the study participants. Discusses problems with biomedical research on pelvic surgical mesh, highlighting two key clinical studies, and a NZ study. Employs hermeneutic phenomenology and a questionnaire to survey the participants.
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Harun, I., Trimmer, W., & Thompson, S. R. (2019). Identifying and managing the pre-hospital presentation of psychogenic non-epileptic seizures: a literature review. Whitireia Journal of Nursing, Health and Social Services, (26), 73–80.
Abstract: Performs a review of the literature on the topic to assist paramedics to identify and manage patients with psychogenic, non-epileptic seizures (PNES). Explores current pre-hospital practice in NZ and makes recommendations to improve health-care and outcomes in such patients.
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Kussmaul, J. (2020). An investigation of occupational health and safety workplaces and working conditions in comparison to nursing care quality in residential aged care facilities (RACFs) in New Zealand. Doctoral thesis, University of Auckland, Auckland. Retrieved June 1, 2024, from http://hdl.handle.net/2292/50165
Abstract: Identifies critical factors related to the occupational health and safety of workplaces and working conditions in residential aged-care facilities (RACF), from the perspective of nursing staff. Correlates quality indicators for occupational health and safety for workplaces and in working conditions with nursing care quality based on the InterRAI Clinical Assessment Protocols (CAP). Uses a mixed-method approach to conduct an audit of workplace health and safety and environmental conditions in 17 RACFs. Surveys 398 registered nurses (RN), enrolled nurses (EN), and Healthcare Assistants (HCA) about the mental and physical stressors in their work.
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Tabakakis, C., McAllister, M., & Bradshaw, J. (2020). Burnout in New Zealand resgistered nurses: the role of workplace factors. Kai Tiaki Nursing Research, 11(1), 9–16.
Abstract: Investigates the impact of workplace factors on burnout in NZ RNs. Conducts a cross-sectional survey among 480 RNs in which burnout, practice environment and negative acts in the workplace were self-reported by means of the Copenhagen Burnout Inventory (CBI), the Practice Environment Scale (PES), and the Negative Acts Questionnaire (NAQ).
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Cook, C., Brunton, M., Chapman, M. K., & Roskruge, M. (2021). Frontline nurses' sensemaking during the initial phase of the COVID19 pandemic in 2020 Aotearoa New Zealand. Nursing Praxis in Aotearoa New Zealand, 37(3). Retrieved June 1, 2024, from www.nursingpraxis.org
Abstract: Identifies the impact of the pandemic on front-line nurses, based on qualitative data from a national mixed-methodology study done between October and December 2020. Conducts 29 interviews via Zoom and telephone with nurses in a range of front-line clinical roles. Highlights the place of organisational culture, communication and clinical leadership in either strengthening or weakening professional commitment.
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Jamieson, I., Andrew, C., & King, J. (2021). Keeping our borders safe: The social stigma of nursing in managed isolation and quarantine border facilities during the COVID-19 pandemic. Nursing Praxis in Aotearoa New Zealand, 37(3). Retrieved June 1, 2024, from www.nursingpraxis.org
Abstract: Reports a qualitative, single-centre descriptive study of the experiences of nurses
working in managed isolation and quarantine facilities (MIQFs)in Aotearoa New Zealand. Conducts 14 semi-structured interviews, via Zoom, with registered nurses working in MIQFs, focusing on the personal and social impacts on the nurses. Identifies four themes: protecting the community while being a risk to the community; social stigma; families and social connections; being part of, but apart from, other health professionals. Underlines the importance for employers, colleagues, and the wider community of supporting nurses during a pandemic.
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Hackney, L. H. (2021). Examining the relationship between coping strategies, burnout, bullying, and distress in Registered Nurses working in intensive care and progressive care. Master's thesis, University of Otago, Christchurch. Retrieved June 1, 2024, from http://hdl.handle.net/10523/12778
Abstract: Expands on existing research on the impact of coping constructs, derived from coping theory, on the inter-related issues of burnout, bullying, and psychological distress in RNs working in acute hospital settings, specifically Intensive Care Units (ICU) and Surgical Progressive Care Units (SPCU). Aims to demonstrate a positive relationship between burnout and bullying. Uses a quantitative cross-sectional design, collecting data via electronic questionnaire from RNs working in Christchurch Hospital's ICU and SPCU.
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Wiffin, L. (2006). Treating depression during pregnancy: Cognitive behavioural therapy as a treatment option. Available online from Eastern Institute of Technology, 14(1), 8–12.
Abstract: This article reviews the use of cognitive behavioural therapy (CBT) for pregnant women suffering from depressive symptoms. CBT provides a structured, short-term, collaborative process between clinician and client, using strategies and techniques to identify dysfunctional thinking and beliefs, challenge and change these beliefs, then implement new rational beliefs and behaviours. A process of engagement, assessment and conceptualisation is followed by treatment planning and implementation, and modification of dysfunctional thinking and behaviours. Use of CBT to treat depression in women during pregnancy is supported by the literature, especially where pharmacological intervention is declined or contraindicated. Pregnancy can bring stressors that combine with biological factors and core beliefs to contribute to depressive symptoms.
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