EFFECTS OF WORK-RELATED STRESS ON ALCOHOLISM AMONG
STUDENT NURSES IN SAGANA SUB COUNTY HOSPITAL
Background of the Study
Work related stress is a frequent problem across occupations and it affects job
performance. Mahiri and Orwa (2016) argue that work performance in any health
organization is composed of such components as job design, scheduling, interpersonal
relationships, career concerns, management style and organizational characteristics.
Carrigan (2013), in his study on Occupational stress among Canadian
Academic staff posits higher performance from all over the world have been
confronted with a series of complex changes challenging their mandate, traditional
practices, authority and organizational structures resulting into work related stress.
Recent surveys in the United Kingdom (UK) and Australia have reported a serious
and growing problem of work related stress in health institution with several
deleterious consequences including decreased job satisfaction, reduced morale and ill
staff. Findings of the studies also show that health staff especially the nurses
experience high workload demands and long hours of working. Further there has been
increased pressure among employees where public funding of hospital has been
reduced (Boals & Banks, 2012).
Work related stress has been a major source of concern in last decades.
Globally, 320 000 young people aged 18-25 years die annually, from alcohol and
work related stress related causes, resulting in 9% of all deaths in that age group
(Wakim, 2014). A survey conducted by health and safety executive showed that in
2005, 50000 people in UK experienced work related stress at a high level and 245000
people experience work-related stress, anxiety and depression in previous 12 months.
Another survey by a life insurance company in United States showed that, around
46% of the employees thought that their job contained a lot of stress. The amount of
work related stress related disabilities also increased from 6% in 1982 to 13% in 1991.
In addition, one out of every three Americans has left his/her job because of work
related stress (Craft& Gordon, 2015).
Work related stress life events and chronic stressors have been correlated with
alcoholism, heavy drinking and alcohol dependence (Allan &Cooke, 2012). It is
evident that about 2 billion people globally take alcohol and 76.3 million are
diagnosed with alcohol related disorders (World Health Organization (WHO), 2014).
This is profoundly rooted in many cultures worldwide (WHO, 2013). Currently,
changes are noticeable in the drinking patterns worldwide. This includes rates of
alcohol abuse and work stress with substantial sporadic alcohol abuse and work
related stress among students nurses (WHO, 2014). This particularly affects between
18-25 years of age (Moreira, Smith, Foxcroft, & Moreira, 2013).
South African nursing program is reported to have deteriorated, substandard,
unpleasant and even life-threatening causing nurses to engage in alcoholism (Akers &
Cochran, 2012). Healthcare professionals, and in particular nurses in public-sector
hospitals, are reported to work in intolerable and harsh conditions and in
environments that are unquestionably not conducive to good professional practice and
patient care. In South Africa, alcohol consumption has been part of the human
societies throughout history (Masomboka, 2014). However, for the past decades, it
has increased in prevalence particularly among young adult (Dung & Wang, 2013). It
has been identified that many stressors have a significant relationship between alcohol
use and work related stress among the student’s nurses in training (Seay & Beck,
2013). In Uganda, levels of occupational work related stress affected job satisfaction
and job performance among hospital nurses in Kampala, Uganda (Abirye, Brown, and
Pryor & Maples, 2015).
The family plays an important and powerful role in work related stress and
alcohol use in the socialization of the young adults and so in workplace (Geraghty &
Oliver, 2015). It is also a fact that almost all cultures contain some use of alcohol in
different situations among them rituals that bear social and religious significance.
Alcohol use has been associated with certain age –linked rites, celebrations and
ceremonies (Schluter, Turner & Benefer, 2012). Work related stress occurs due to
ever changing environment affecting physical and emotions of staff and create
positive and negative influence at place of work (Singh & Kohli, 2015). Work related
stress is the body’s reaction to changes that requires physical, mental, or physiological
adjustment, (Bachman, 2014).
Work related stress is part of everyday life situation in health sector
(Segerstrom & O'Connor, 2012). Vulnerability in the work related stress and use of
alcohol has increased in the risk factors dominating in student nurses in health
institutions. The most affected group in health sector are the students nurses for they
are often no longer under directed parental supervision and are faced with new social
and economic peer pressures and work related pressure (Seay & Beck, 2013). Most
tend to seek measures to cope with stressful situation turning to alcoholism and abuse
of alcohol (Schluter, Turner & Benefer, 2012)
Work related stress inadvertent consequences lower individual and
organizational performance. Work related stress is considered rising and has become
a challenge for the employees in the workplace because high level work related stress
is resulting to low productivity. Intoxicant is a worldwide social and medical problem
(Segerstrom & O'Connor, 2012). Over the past four decades alcohol consumption has
increased in quantity and frequency among the young people due to peer pressure.
According to Shivaprasad (2013), the working youth often indulge in alcohol
consumption either on peer pressure or for enjoyment. Alcohol use during late
childhood and adolescence can lead to poor performance in the work place, as well as
in the social and emotional disturbances that often leads to high risk behavior and
impairment in psychosocial development (Bachman, Staff’Malley & Freedman-Doan,
2013).
In Kenya, there is an increasing trend of youth taking alcohol. According to
Mwenesi (2014), there is an increasing trend of alcohol misuse in Kenya majority of
the young people in Kenya have resulted into alcoholism due to unemployment,
family problems and peer pressure (Hagembe & Simiyu, 2014). Alcohol is used as a
socializing agent after work.
The increase in alcoholism among students in high school and higher learning
institutions has been increasing at an alarming rate (NACADA, 2016). Empirical
studies indicate alcoholism among nurse students practicing in public health
institutions in Kenya. According to Onyango (2013) there are rampant cases of
alcoholism among nurses and drug abuse, depression, frequent hospitalizations due to
psychiatric related issues, suicide attempt cases among nurses and practicing nurses at
KNH. Further survey by KNH (2012) indicated that nurse staff has resigned citing
work related stress as one of the causes due to heavy workload in the medical and
surgical wards. Agumba (2011) indicated that employees were depressed and suffer
psychological stress due to poor working conditions, very demanding and inadequate
support from the management leading to alcoholism in Mombasa County. These
studies however focus on urban setting and a study is required to determine the effect
of work related stress on alcoholism among student’s nurses in rural areas in Sub
county hospitals in Kenya. The studies points out that alcohol and drug abuse problem
is permeated in all levels of society within student’s nurses being the most affected
group in the society (Shivaprasad, 2013). Student’s nurses are engaging in alcoholism
in Kirinyaga County. This study sought to assess the effect of work related stress on
alcoholism among student’s nurses in Sagana Sub County Hospital in Kirinyaga
County, Kenya.
Statement of the Problem
Over the past few decades work related stress is emerging as an increasing
problem among the youth in Kenya. Work related stress exists in every organization
either big or small as the work places and organizations have become so much
complex and demanding from its employees. Students’ nurses from rural and urban
settings have been found at risk of psychological stress, mental disorders, and
decreased life satisfaction. Occupational stress, job descriptions and stressful working
conditions have been linked to low productivity, absenteeism and increased rates of
accidents on and off the workplace among the students’ nurses in developing
countries such as Uganda and Kenya. Numerous other recent studies such as Onyango
(2013) and Hagembe & Simiyu (2014) have explored work related stress among
health care personnel in Kenya. However, the studies failed to clearly demonstrate
what factors causes work related stress among students’ nurses in medical institutions
in rural areas in Kenya.
Students’ nurses’ exposure to work related stress often is psychologically
distressing. The effect of stress on alcohol use and the risk of alcohol use disorders
(AUDs) depend on the type, timing during the life course, duration, and severity of
the work related stress experienced. According to NACADA (2013), students
especially in medical field are engaging in alcoholism with high cases being reported
in Kirinyaga County. Student’s nurses in their internship at Sagana Sub County
hospital have engaged in alcoholism and fail to attend to responsibilities assigned
(GOK, 2017). This motivated this study to determine the effect of work related stress
on alcoholism among student’s nurses in Sagana Sub County Hospital in Kirinyaga
County.
REFERENCES
Allan, A., & Cooke, E. (2012). A review of the literature regarding stress among
nursing students during their clinical education. International Nursing Review,
61(3).
Arslan, S., Özlü, Z. K., Özer, N., Nazik, E., Gümüs, K., & Özlü, I. (2015).
Investigating the Stress Level of Nurses Working at Emergency Care
Services: A Pilot Study. International Journal of Caring Sciences, 8(2), 420.
Austin, T. (2011). Relationship between nurse leader emotional intelligence and
registered nurse job satisfaction. (Dissertation/Thesis), ProQuest Dissertations
Publishing. Australian Institute of Health, 113
Bachman, J.G, Staff, J, O’Malley, P.M., & Freedman-Doan, P. (2013): Adolescent
work i.ntensity, school performance, and substance use: Journal Development
Psychology, 49 (11): 2125-2128.
Bae, S.-H., & Fabry, D. (2014). Assessing the relationships between nurse work
hours/overtime and nurse and patient outcomes: Systematic literature review.
Nursing Outlook, 62(2), 138-156.
Basińska, M. A., Andruszkiewicz, A., & Grabowska, M. (2011). Nurses’ sense of
coherence and their work related patterns of behaviour. International Journal
of Occupational Medicine and Environmental Health, 24(3), 256-266.
Beanland, C. (2013). Tackling the workforce shortage. Australian Nursing Journal,
20(11), 47-48.
Bennett, E., & Alliex, S. (2014). A workforce development strategy for nursing in
early parenting services in Australia: Solutions for the 'baby boomer' exit from
the nursing workforce. Australian Journal of Child and Family Health
Nursing, 11(1), 10-16.
Blomberg, K., Isaksson, A. K., Allvin, R., Bisholt, B., Ewertsson, M., Kullén
Engström, A. & Högskolan, I, S. (2016). Work related stress among newly
graduated nurses in relation to workplace and clinical group supervision.
Journal of Nursing Management, 24(1), 80-87.
Boals, A., & Banks, J. B. (2012). Effects of Traumatic Stress and Perceived Stress on
Everyday Cognitive Functioning. Cognition & Emotion, 26(7), 1335-1343.
Boer, J., van Rikxoort, S., Bakker, A. B., & Smit, B. J. (2014). Critical incidents
among intensive care unit nurses and their need for support: explorative
interviews. Nursing in critical care, 19(4), 166-174.
Bogaert, P., Clarke, S., Willems, R., & Mondelaers, M. (2013). Nurse practice
environment, workload, burnout, job outcomes, and quality of care in
73
psychiatric hospitals: a structural equation model approach. Journal of
Advanced Nursing, 69(7), 1515-1524.
Cairney, J., Kwan, M. Y., Veldhuizen, S., & Faulkner, G. E. J. (2014). Who uses
exercise as a coping strategy for stress? Results from a national survey of
canadians. Journal of physical activity & health, 11(5), 908-916
Carrigan, C. (2013). Safe staffing: Critical to care. Australian Nursing Journal: ANJ,
The, 20(10), 26-29.
Castner, J., Ceravolo, D. J., Foltz-Ramos, K., & Yow-Wu Bill, W. (2013). Nursing
Control Over Practice and Teamwork. Journal of Issues in Nursing, 18(2), 1-1.
Clark, A., Moule, P., Topping, A., & Serpell, M. (2015). Rescheduling nursing shifts:
scoping the challenge and examining the potential of mathematical model
based tools. Journal of Nursing Management, 23(4), 411-420.
Cooper, D.R & Schindler, P.S (2013). Business Research Methods. New York: Mc
Cope, V., Jones, B., & Hendricks, J. (2016). Why nurses chose to remain in the
workforce: Portraits of resilience. Collegian (Royal College of Nursing,
Australia), 23(1), 87-95.
Craft, J. A., & Gordon, C. J. (2015) Understanding Pathophysiology. Sydney.
Elsevier.
Cricco-Lizza, R. (2014). The Need to Nurse the Nurse: Emotional Labor in Neonatal
Intensive Care. Qualitative Health Research, 24(5), 615-628.
Currie, E. J., & Carr‐Hill, R. A. (2013). What is a nurse? Is there an international consensus? International Nursing Review, 60(1), 67-74.
Davis, J. M. (2014). Hair Cortisol as a Biomarker of Stress in Mindfulness Training
for Smokers. Journal of Alternative & Complementary Medicine, 20(8), 630-
634.
Dawson, A. J., Stasa, H., Roche, M. A., Homer, C. S. E., & Duffield, C. (2014).
Nursing churn and turnover in Australian hospitals: Nurses perceptions and
suggestions for supportive Strategies. BMC nursing, 13(1), 11-11.
De Almeida, V., A., Shadvar, S., Lepage, S., & Rennick, J. E. (2016). Experienced
pediatric nurses’ perceptions of work-related stressors on general medical and
surgical units: A qualitative study. International journal of nursing studies, 60,
216-224.
Donnelly, T. (2014). Stress among nurses working in an acute hospital in Ireland.
British Journal of Nursing, 23(13), 746-750.
74
Donovan, R. O., Doody, O., & Lyons, R. (2013). The effect of stress on health and its
implications for nursing. British journal of nursing 22(16), 969-973.
Doran, D., Jeffs, L., Rizk, P., Laporte, D. R., Chilcote, A. M., & Bai, Y. Q. (2015). Evaluating the late career nurse initiative: a cross ‐
sectional survey of senior nurses in Ontario. Journal of Nursing Management, 23(7), 859-867.
Dung, J.S., & Wang, M.S. (2013). The case for alcohol research as a focus of study by
nurse researchers. South AfricaNursing Journal.4.1.89-90
Drury, V., Craigie, M., Francis, K., Aoun, S., & Hegney, D. G. (2014). Compassion
satisfaction, compassion fatigue, anxiety, depression and stress in registered
nurses in Australia: Phase 2 results. Journal of Nursing Management, 22(4), 519-
531.
Edward, K.-l., Ousey, K., Warelow, P., & Lui, S. (2014). Nursing and aggression in the
workplace: a systematic review. British Journal of Nursing, 23(12), 653-659.
Etwel, F., Russell, E., Rieder, M. J., Van Uum, S. H., & Koren, G. (2014). Hair cortisol
as a biomarker of stress in the 2011 libyan war. Clinical & Investigative
Medicine, 37(6), E403-408. 119
Faresjö, Å., Jullander, M., Göttmalm, S., & Theodorsson, E. (2014). Higher perceived
stress and poorer health reflected in elevated cortisol concentrations measured in
extracts of hair from middle-aged healthy women. BMC Psychology, 2, 30-39.
Farrelly, R. (2014). What's right with nursing? British Journal of Nursing, 23(14), 823-
823.
Field, A. P. (2013). Discovering statistics using IBM SPSS Statistics. 4. London:
SAGE.
Galbraith, N. D., Brown, K. E., & Clifton, E. (2014). A Survey of Student Nurses'
Attitudes Toward Help Seeking for Stress. Nursing Forum, 49(3), 171-181
Geraghty, S., & Oliver, K. (2015). Is work-related stress affecting nurses and midwives?
Australian Nursing and Midwifery Journal, 23(3), 32.
Giga, J. & Hoel, A (2003). Theoretical and methodological problems within
occupational stress and burnout research’, Human Relations, 41:351–369.
Goodnite, P. M. (2014). Stress: A Concept Analysis. Nursing Forum, 49(1), 71-74.
Hallman, I. S., O'Connor, N., Hasenau, S., & Brady, S. (2014). Improving the Culture of
Safety on a High-Acuity Inpatient Child/Adolescent Psychiatric Unit by
Mindfulness-Based Stress Reduction Training of Staff. Journal of Child &
Adolescent Psychiatric Nursing, 27(4), 183-189.
