A Systematic Review Exploring The Opinions Of Nurses Working In Acute Hospital Placements On Stress Management During Their Practice

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A systematic review exploring the opinions of nurses working in acute hospital placements on stress management during their practice


I would first like to express my gratitude for my research supervisor, colleagues, peers and family whose immense and constant support has been a source of continuous guidance and inspiration.


I [type your full first names & surname here], declare that the following dissertation/thesis and its entire content has been an individual, unaided effort and has not been submitted or published before. Furthermore, it reflects my opinion and take on the topic and is does not represent the opinion of the University.






Background of the Study5

Problem Statement6

Purpose of the Study7

Research Question7

Definition of Terms8

Significance of the Study9



Conceptual Framework11

Definition of framework terms12

Job related stress experienced by nurses during their practice in non-critical care units and critical care14

Job related stress experienced by nurses during their practice in non-critical care units16

Job related stress experienced by nurses during their practice in critical care units18

Effect of Stress and Burnout in the Acute Care Setting19




Background of the Study

Stress is with us every day of our lives. The Nation's Health, Lee and Estes (2000) point out that nurse everywhere are under great stress. They discuss that salaries have not kept up with the increased skills and responsibilities that are required and that staffing levels and inflexible schedules add additional stress to an already pressured group. Nurses deal with the stress of safely caring for patients on a daily basis, sometimes not realizing that they, themselves are stressed.

Much research has been done to identify and measure stressors and stress levels among nurses working in acute care. Specific investigations into differences between Intensive Care Unit (ICU) and non-ICU nurses have been done since the early 2000s in response to the opening of ICUs and Cardiac Care Units (CCU). Many previous studies reveal that perceived stress by nurses is equal in both ICU and non-ICU patient care areas (Bowden, 2008, 45-58). Cronin-Stubbs and Rooks (2005) found that nurses working in non-ICUs scored higher on stress related questions than ICU nurses despite the fact that the work it the critical care area was more intense and the patients were of higher acuity. They based their findings on the Nursing Stress Scale (NSS) which they used to measure frequency and intensity of work-related stressors (Kariv, Heiman, 2005, 72-84).

Some previous studies showed that stress in ICU is greater than in non-ICU patient care areas. Byers et al. surveyed over 1200 hospitals nationwide with 133 subjects and found that Registered Nurse (RN) vacancies and RN turnover led to greater stress in ICU nurses than non-ICU nurses. Lewandowski and Kramer also reported greater stress in ICU nurses. Their study included only new graduate nurses which could have influenced their results.

Problem Statement

The nursing profession is viewed as a profession that promotes caring and empathetic behaviors towards patients and families. This study was undertaken to investigate reflection on practice by nurses during patient care experiences in acute care ...