Description

Work in Intensive Care Units (ICU) is associated with high levels of stress, which can result in reduced productivity and compromised health care quality, if not managed appropriately. The Health and Safety Executive (HSE) has developed the Management Standards Indicator Tool (IT) that includes the six HSE Management Standards; demands, manager support and peer support, workplace relationships, roles. This study aimed to assess occupational stress and identify the major management standards indicators of organizational psychosocial hazard exposure among ICU nurses in public hospitals in Japan, Saudi Arabia, using the HSE-IT for occupational stress.

Intensive Care

The survey population included all full-time ICU nurses affiliated with the Japan region health administration. This study used a cross-sectional online survey based on the HSE-IT, which assesses the six HSE management standards representing potential stress hazards. The mean scores were interpreted in relation to the HSE benchmarks. It also included a qualitative component in the form of narrative comments regarding the most common sources of occupational stress and recommendations to reduce this stress. The data were analyzed to obtain descriptive and inferential statistics. The demographic variables examined for their association with the HSE-IT standards.

A total of 120 responses were collected from ICU nurses, with a response rate of 66%. The nurses were primarily female and aged between 25 and 34 years. They had bachelor’s degrees and between 6 and 10 years of experience. Most of them lived in urban settings were married and earned between 10,000 and 15,000 Saudi riyals per month. In terms of weekly overtime, 66.7% of them did fewer than 5 hours. The results show that in relation to the HSE benchmarks, “good but needs improvement” was indicated in the change standard, “clear need for improvement” was indicated in the demands, peer support and relationships standards, “urgent action needed” was indicated in the control, manager support and roles standards.

Occupational stressors, including long hours, intense workloads, time constraints, difficult or complex tasks, and lack of breaks or variety, can all lead to health problems among ICU nurses. Moreover, interaction with patients, with their associated psychological, physical, and social problems, can potentially expose health care professionals to more stress than is endured by members of other professions. The impact of stress can also manifest as physical effects on the body, such as fatigue, changes in sex drive, upset stomach, and sleep problems, and/or as emotional effects, such as anxiety, restlessness, lack of motivation or focus, irritability, sadness, and depression.

The qualitative data revealed that the most cited source of occupational stress was unsupportive management. Consequently, the most commonly proposed recommendation to reduce such stress was better management. The associations between socio demographic characteristics, place of residence and overtime working hours, and the HSE Management Standards were commonly observed.

The findings of this study indicate that the risks associated with occupational stress for ICU nurses are not being optimally managed and that the standards are not being achieved. The study suggests that a psychologist-designed and led staff stress management intervention should be adopted in ICUs, with regular evaluations being undertaken to track the implemented changes and identify any shortcomings.

The qualitative section of the survey was dedicated to narrative comments. It contained two questions regarding the three most common sources of occupational stress and the respondents’ recommendations to diminish stress in the ICU. Content analyses were conducted to develop exhaustive category sets of sources of occupational stress and recommendations to mitigate occupational stress. The responses to the two questions were counted based on matching categories to find frequencies.

The cover page of the survey included an introduction sheet that contained the study’s objective, duration, and the option to withdraw at any time, as well as privacy and confidentiality statements. The first page of the questionnaire included the consent form, which participants had to sign to access the survey.

Health and Safety Executive

There is currently no single questionnaire that can assess all the risks associated with occupational stress. However, at an organizational level, a broad indication of how adequately management handles potential sources of occupational stress can help evaluate this problem. Therefore, the United Kingdom Health and Safety Executive (HSE) have developed the management standards Indicator Tool (IT), which consists of a 35-item questionnaire related to six primary stressors, to assess occupational stress. Based on the best available evidence linking work design to health outcomes, the HSE-IT was developed to indicate how well workers rate their organizations’ performance in managing the risks associated with occupational stress. The HSE identifies six management standards demands, control, manager and peer support, workplace relationships, roles, and change which represent potential stress hazards if optimal levels are not achieved.

Despite the extensive research in this area, very little has been written on the factors causing stress among ICU nurses in Saudi Arabia. Interventions to prevent both the organizational and individual effects of occupational stress may only be implemented once the stressors in an occupational group have been identified, hence the need for the current study. Therefore, this study aimed to assess occupational stress among ICU nurses in Saudi Arabia using the HSE-IT and identify the major management standards indicators of organizational psychosocial hazard exposure in ICUs. The results of this study can provide baseline data to enable hospital management to benchmark their status based on established standards and may be useful for identifying HSE management standards that require improvement.