Life satisfaction versus stress level of psychiatric nurses

Marzena Sobczak*
Elblag University of Humanities and Economy, Nursing Department
Halina Nowakowska**
Medical University of Gdańsk, Nursing Department
Life satisfaction versus stress level
of psychiatric nurses
Abstract
Life satisfaction is experienced in an exceptional way by each man. The Polish Dictionary
provides the following definition of the term in question. “Life satisfaction is perceived as
pleasure that is felt when people achieve what they really wish”. Occasionally, the term
“life satisfaction” is interchangeably used with the term “happiness”. There are various
factors that influence life satisfaction. For some people, it is a feeling that their life is better
than others. Other people, feel life satisfaction when they compare their current experiences favourably with the past ones. Stress and failures also have an unquestionable
influence on the perception of life satisfaction.
The aim of the article was to evaluate life satisfaction and stress level of psychiatric nurses. The research was conducted among 50 psychiatric nurses in Voivodeship Hospital for
Mentally-ill and Psychiatric Patients at the turn of 2012 and 2013. In order to conduct
the research, the Polish version (by Juczyński) of the Satisfaction with Life Scale by Diener
and co-authors was used. The Stress Perception Questionnaire by Plopa and Makarowski,
and the survey prepared by the authors were also used.
The results were presented with the statistics and analytics software package Statistica
10.0 and the Microsoft Excel spreadsheet.
The following results were obtained. The level of life satisfaction of the respondents was
average. The stress level was low on the scale of emotional tension, external and internal
stress. The level on the lie scale was average but with a considerable number of high results.
Keywords: life satisfaction, stress, nurses1
*
Correspondence address: Marzena Sobczak, Elblag University of Humanities and Economy, Nursing Department, 82-300 Elbląg, ul. Lotnicza 2, tel. +48 55 239 38 11, e-mail:
[email protected];
** Halina Nowakowska, Medical University of Gdańsk, Nursing Department, Medical Pedagogy and Teaching Unit, 89-952 Gdańsk, ul. Dębinki 7, tel. +48 58 349 19 83, e-mail:
[email protected].
132 Marzena Sobczak, Halina Nowakowska
QQ
Introduction
Working as a nurse can bring a great deal of satisfaction. It can be derived
from having contact with other people, having the opportunity to help other people and from having the perception of being competent. However, as
Gugała [1] maintains, this profession is not free from sources of stress which
can be connected with:
1. Features connected with the profession itself such as: vigilance, faultlessness, concentration, multitasking, exposure to pain and death;
2. Features resulting from job organisation such as: work pace, rigid
working hours, time pressure;
3. Social features resulting from the necessity to interact with people,
competitiveness, lack of supervisors’ support;
4. Psychological features such as the perception of the profession as
having low social prestige [authors’ note], responsibility for people, low remuneration, the risk of losing one’s health, limited promotion prospects;
5. Features causing the disturbance in work-life balance such as: availability, absence at home, shift work, night duties
6. Physical features of working conditions such as noise, the lack of equipment, inadequate temperature, contact with excrement and bodily secretions.
Maslach and Jackson [2] highlighted factors such as little group cohesion,
a great deal of tasks, a great deal of duties and little influence on a decision
making process.
Given the work of psychiatric nurses, additional sources of stress can
appear. They are connected with the character of a psychiatric ward. The duties that psychiatric nurses have to fulfill are different from those of nurses
working on so called somatic wards. Apart from standard nursing activities,
psychiatric nurses have to be able to use psychotherapeutic methods that are
typical of taking care of patients with mental problems [3].
Chronic work-related stress, as Ogińska – Bulik [4] maintains, can result
in the changes in:
1. health such as various afflictions and somatic disorders;
2. emotional and cognitive spheres such as the increase in psychological
tension, anxiety and burnout;
3. behaviour patters that can be visible in lower work efficiency and life
energy, failing to achieve life aims, being prone to accidents, having an increasing tendency for aggression, nicotine or psychoactive drug dependence
or depersonalisation.
Therefore, stress can have a significant and negative influence on the perception of life satisfaction.
Life satisfaction versus stress level of psychiatric nurses
QQ
133
Aim, methods and research tools
The aim of the research was to establish the level of life satisfaction and
the stress level of psychiatric nurses.
The research was conducted with an auditory survey method and 3
questionnaires were used as research tools. In order to establish socio-demographic variables, the authors prepared their own survey. In order to establish
the level of life satisfaction of the respondents, the Polish version (by Zygfryd
Juczyński) of the Satisfaction with Life Scale by Diener and co-authors was
used. In order to examine the stress level, the Stress Perception Questionnaire
by Mieczysław Plopa and Ryszard Makarowski was used.
The Satisfaction with Life Scale consists of five statements. The respondents assess the extent to which each statement refers to their life. The outcome
of the measurement is an overall rating of life satisfaction. The respondents
indicate the extent to which they agree with each statement.
The results are totalled and the overall outcome indicates the level of life
satisfaction. The range of results should be included between 5 and 35 points.
Raw scores are converted into sten scores. The higher results respondents
achieve, the higher their level of life satisfaction is. The results of about 1–4
sten scores should be regarded as low results; 7–10 sten scores should be
regarded as high results and 5–6 sten scores should be regarded as average
ones [5].
The Stress Perception Questionnaire is used to measure the feeling
of stress. It allows calculating an overall result informing about an overall
stress level. It also allows calculating the three dimensions referring to emotional tension, external and internal stress. The questionnaire includes also
the lie scale.
The questionnaire consists of 27 statements. The respondents assess
the extent to which each statement refers to their life using a Likert-scale with
the peripheral answers being “true” and “false”. Each dimension consists of 7
statements; thus, raw scores of each dimension can be included between 7–35
points. The lie scale constitutes the exception. It consists of 6 statements;
therefore, its raw scores can be included between 6–30 points. The overall
result can be included between 21–105 points and it constitutes the sum of
the three dimensions. The results gained from the lie scale are not included in
the overall result. The raw score is converted into the sten score.
The higher the sten score, the higher the stress level of a respondent.
134 Marzena Sobczak, Halina Nowakowska
QQ
Results
QQ Characteristics of the group
Fifty nurses working on the psychiatric ward in Voivodeship Hospital
for Mentally-ill and Psychiatric Patients constituted the research material.
The average age of the respondents was 42 years. The nurses who had a secondary education constituted the most numerous group, namely 25. The least
numerous group was comprised of nurses who had a higher education with
a Master degree, namely 9 nurses.
The average seniority amounted to about 20 years and 8 months.
The majority of the respondents were married (35 nurses) and they lived
in the city. 35 of them had children and 25 of them had more than one child.
20 respondents said that they liked reading books in their leisure time;
11 respondents said that they liked watching films and the same number of
respondents said that they liked going for a walk or travelling.
Satisfaction with Life Scale
Table 1. The average results of the Satisfaction with Life Scale
average
Standard Trust Trust minideviation -95,0% +95,0% mum
item
N
points
50
20.8
4.804
19.47
22.21
12.0
sten
score
50
5.6
1.714
5.11
6.09
3.0
maximum
Q25 median Q75
33.0 17.0
10.0
4.0
20.0 24.0
5.0
7.0
The respondents as a group are people with an average level of life satisfaction. This conclusion can be drawn by taking the average points – 20.8
points and also the average sten score – 5.6.
From all the statements comprising the Satisfaction with Life Scale,
the following statements achieved the highest results: “I am completely satisfied with my life” – the average 4.82 (the rating 68.9%), and “If I could live
my life over, I would change nothing” – the average 4.28 (the rating 61.1%).
The statement “The conditions of my life are excellent” achieved the lowest
result – the average 3.72 (the rating 53.1%).
The statistically significant negative average correlation between the age
of the respondents and the overall results of the Satisfaction with Life Scale
Life satisfaction versus stress level of psychiatric nurses
135
was noted. The negative correlation at the average level was noted in the statements: “I am completely satisfied with my life” and “If I could live my life over,
I would change nothing” (>0,05).
The highest results, in all positions with the exception of the statement
“The conditions of my life are excellent”, were scored by the respondents
under 30. The highest result in the abovementioned position was scored
by the respondents at the age of 41–50. The lowest results were scored
by the respondents above 50, with the exception of the statement “In most
ways, my life is close to my ideal”. In this position, the lowest result was scored
by the respondents at the age of 31–40.
Education remained in the statistically significant positive average correlation with the overall result of life satisfaction and in the average positive
correlation with the results from the statement: “The conditions of my life are
excellent” and “I am completely satisfied with my life” (<0,05).
The respondents who had a BA degree achieved the highest results in
the overall result of life satisfaction and in all other positions with the exception of the statement “I am completely satisfied with my life”. A better result
in this statement was achieved by the respondents who had a MA degree.
The lowest results were achieved by the respondents who had a secondary
education, with the exception of the statement “So far I have gained the most
important things that I want in my life”. The lowest results in the abovementioned statement were achieved by the respondents with a MA degree.
Seniority remained in the statistically significant negative average correlation with the results achieved from the statement “I am completely satisfied
with my life” and in the negative low correlation with the results achieved from
the statement “If I could live my life over, I would change nothing” (<0,05).
The respondents who had been working for less than 15 years achieved
the highest results from both the overall life satisfaction and all the statements
with the exception of the statements “I am completely satisfied with my life”
and “So far I have gained the most important things that I want in my life”.
A better result in these statements was achieved by the respondents who had
been working for 16 till 25 years. The lowest results were achieved by the respondents who had been working for more than 25 years with the exception
of the statement “In most ways, my life is close to my ideal”. The lowest result
in the abovementioned statement was achieved by the respondents who had
been working for 16 till 25 years.
The higher results obtained from each statement referring to life satisfaction and the overall results were achieved by the respondents who lived in
the village.
136 Marzena Sobczak, Halina Nowakowska
QQ Stress Perception Questionnaire
The results achieved by the respondents on the lie scale are included between the 6th and the 7th sten score, which gives an average result. However,
29 respondents achieved a high or a very high result, which is presented in
Table 2.
Table 2. The Stress Perception Questionnaire – the results on the lie scale
Stress Perception Questionnaire Results
The lie scale
very low
low
number
%
7
14.0
4
8.0
average
10
20.0
high
14
28.0
very high
15
30.0
Total
50
100.0
In order to measure whether variables such as age, seniority, the place of
residence and education refer to the results achieved on the lie scale, the Spearman’s rank-order correlation and the Mann–Whitney U test (in the case of
the place of residence) were used. No statistically significant correlations between the abovementioned variables and the lie scale were identified.
The average number of points for emotional tension of the respondents
amounted to 20.6 points. The sten score of emotional tension of the respondents amounted to 4.9. It indicates that the respondents achieved the average
result.
Table 3. The Stress Perception Questionnaire – the average results
of emotional tension of the respondents
average
Standard trust
trust
minideviation -95,0% +95,0% mum
item
N
points
50
20.6
7.359
18.55
22.73
7.0
Sten
score
50
4.9
2.279
4.25
5.55
1.0
maximum
Q25 median Q75
33.0 14.0
9.0
3.0
19.5 27.0
4.5
7.0
No statistically significant correlations between age, seniority, education
and the place of residence of the respondents and the results of emotional
tension were identified.
137
Life satisfaction versus stress level of psychiatric nurses
The results on the external stress scale and the emotional tension scale
were at a low level. The average number of points for external stress amounted to 17.8, which constitutes 4 sten scores.
Table 4. The Stress Perception Questionnaire – the average results of external stress
item
N
average
Standard trust
trust
minideviation –95,0% +95,0% mum
points
50
17.8
6.069
16.12
19.56 7.0
sten
score
50
3.4
1.939
2.87
3.97
1.0
maximum
Q25 median Q75
29.0
14.0 18.0
7.0
2.0
22.0
5.0
3.0
No statistically significant correlations between age, seniority, education
and the place of residence of the respondents and the results of external stress
were identified.
The results on the internal stress scale amounted to 16.8 points, which
constitutes 3 sten scores. It indicates that the respondents achieved a low
result.
Table 5. The Stress Perception Questionnaire – the average results of internal stress
average
Standard Trust
trust
minideviation -95,0% +95,0% mum
item
N
points
50
16.8
6.738
14.93
18.75
7.0
sten
score
50
3.1
2.060
2.55
3.73
1.0
maximum
Q25 median Q75
33.0 11.0
8.0
16.0 22.0
1.0
3.0
5.0
The average number of points for internal stress amounted to 16.8
points. The sten score of the respondents amounted to 3.1. It indicates that
the respondents as a group achieved the low result. The minimal sten score
amounted to 1, and the maximal sten score amounted to 8.
No statistically significant correlations between age, seniority, education
and the place of residence of the respondents and the results of internal stress
were identified.
QQ Life satisfaction versus stress level of the respondents
The analyses that have been made reveal that the level of life satisfaction
of the respondents remains in a statically significant negative average correlation with the results of the stress level and its components (<0,05).
138 Marzena Sobczak, Halina Nowakowska
Table 6. The correlation between Satisfaction with Life Scale
and Stress Perception Questionnaire
item
N
R
t(N-2)
p
emotional tension
50
–0.544
–4.497
0.000
external stress
50
–0.333
–2.445
0.018
internal stress
50
–0.478
–3.767
0.000
overall stress level
50
–0.510
–4.113
0.000
QQ Overview
The results of the research show that psychiatric nurses have achieved
an average level of life satisfaction. The raw score amounted to 20.8 points.
It is a higher result than the result Juczyński received while examining adult
Polish people who achieved on average 20.37 points. The result is also higher
in comparison with female teachers at primary schools who achieved 19.34
points [5]. The American research [6] that is quoted by Juczyński [5] shows
that elderly people achieved the average result of 24.40 points. The abovementioned results indicate that the older nurses have a lower level of life
satisfaction in comparison with those who are under 30. The nurses who live
in the village and those who have a higher education derive a greater satisfaction from life.
Taking into account Polish nurses who are professionally active, the level of life satisfaction can be connected with job satisfaction which comprises
such aspects as professional autonomy, relations in interdisciplinary teams,
work organization, remuneration, and professional prestige [7].
Public Opinion Research Centre conducted the research between the 30th
of November and the 6th of December 2012. It covered 1135 Polish adult
respondents who had been randomly chosen. The research revealed that
the level of job satisfaction was comparatively high. 59% of professionally active workers and former worker declared that they were satisfied with their
professional career [8].
Given the research conducted by Grzywna and Cieślik [9], 62.9% of Polish
psychiatric nurses declared that they were satisfied with their job. An alarmingly low level of job satisfaction was revealed among district nurses.
The profession of a nurse is conducive to releasing emotions experienced
at work in the family surrounding. It seems difficult to separate the constant
care about patients’ life and health from daily life. The profession of a nurse is
regarded as a social profession, the essence of which is to help other people.
Life satisfaction versus stress level of psychiatric nurses
139
Moreover, it is characterized as involving a high degree of being subjected to
stress [10]. The research has been undertaken to assess the stress level of
the psychiatric nurses and to establish the relations between the stress level and such variables as age, education, the place of residence and seniority.
What is more, the correlation between the stress level and life satisfaction of
the respondents has been evaluated.
The Stress Perception Questionnaire by Polpa and Makarowki comprises three scales examining emotional tension, external and internal stress.
The authors claim that emotional tension is connected with anxiety and excessive irritation. People with a high level of emotional tension reveal problems
with relaxation, lack of energy to act that is combined with the tendency not
to undertake various activities. These people tend to be irritable in various
interpersonal relation and they often feel exhausted without any particular
reason [11]. External stress is connected with such aspects as being subjected to unjust judgement, helplessness, cumulative exhaustion to defend one’s
viewpoints, anxiety that is experienced when one feels that one is exploited,
frustration and being aware of the requirements that have to be met. The authors of the Stress Perception Questionnaire maintain that internal stress
is connected with such aspects as concern, distress, a lower perception of
the meaning of life that is caused by the difficulties to fulfil one’s aims or everyday challenges and being psychologically vulnerable. People who achieve high
results on the scale of internal stress feel that they have problems with their
personality, past experiences that make them feel lonely and anxious. They
feel anxiety that is connected with the loss of someone or something that was
important; they cannot accept subjectively difficult situations. They feel anxious when they think about the future. They judge themselves and the world
in a pessimistic way.
The authors of the Stress Perception Questionnaire presupposed that
some of the respondents would answer the questions tendentiously or they
would be likely to apply a self-presentation technique or they would understand the items of the questionnaires in a specific way [11]. Therefore, they
introduced an additional scale, namely the lie scale which can be used to verify the respondents at the preliminary stage. The lie scale identifies people
who present themselves in a very positive way. They ascribe socially desirable features to themselves which are rarely displayed (e.g. I have never
made any empty promises). The authors of this research tool [11] think that
the tendency to present oneself in a positive way or to conceal one’s shortcomings may result from poor criticism, poor insight into oneself or deliberate
misinformation.
140 Marzena Sobczak, Halina Nowakowska
The findings of the research undertaken with a group of psychiatric
nurses showed that the lie scale measured such a situation. Despite the fact
the average result which the respondents achieved was included in the group
of average results, the number of people who had high and very high results
allows drawing a conclusion that the low results on the remaining scales
should be cautiously treated. The result that has been achieved emphasises the necessity to deepen the research. It also stresses the need to verify
the presumptions the nurses’ answers indicate that they feel the pressure
that is connected with the social and ethical expectations which nurses have
to meet. The conviction about a predisposition to be a nurse and a particular
demeanour that has been formed in the course of education and professional career may make nurses feel being trapped in the stereotypical thinking.
The lack of ability to relieve stress or the lack of social skills that are indispensable to cope with stress may make nurses avoid and negate difficult
situations. In 2010, 783 patients staying in hospitals in Elbląg and Gdańsk and
804 healthy people were examined with the Stress Perception Questionnaire
[11]. The findings showed that ill people had a higher stress level in each dimension than healthy people who achieved the overall result of 59.59 points.
It constitutes a higher result than the one that was achieved by the psychiatric
nurses who had taken part in the research.
The findings of the research revealed that a higher level of life satisfaction
is connected with a lower stress level. No correlation between the stress level
and such variables as age, seniority, education and the place of residence has
been indicated.
The findings of the research conducted by Plopa and Makarowski with
the Stress Perception Questionnaire [11] revealed a different situation.
The overall stress level is connected with the abovementioned variables.
The authors proved that the highest stress level was experienced by women
at the age of 21–30, people with higher education, those who maintain to have
a good financial status and those who are married. The nurses who took part
in Plopa and Makarowski’s research achieved an average result on the stress
level scale, namely 65.88 points.
QQ
Conclusions
1. The respondents perceive the level of their life satisfaction as average.
2. Those respondents who are young, live in the village and have a higher
education derive greater life satisfaction.
Life satisfaction versus stress level of psychiatric nurses
141
3. The respondents feel a low stress level not only in an overall dimension, but also in emotional tension, external and internal stress.
4. A big number of respondents who have achieved high and very high
results on the lie scale indicate the need to conduct the research with a bigger
number of respondents and with additional research tools.
5. A higher level of life satisfaction is connected with a lower stress level.
QQ
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