Work Related Stress and Alcoholism Affected Performance
The fourth objective was to examine the relationship between work related
stress and alcoholism among student nurses in Sagana Sub County Hospital. The
respondents were requested to indicate on how work related stress and Alcoholism
affected their performance. From the findings, majority of the respondents indicated
that work related stress could also lead to alcohol abuse and especially alcoholism
affecting organizational commitment of employees. Low organizational
commitment could be interpreted as an escape from, compensation for, or protest
against occupational stressors, which could result in absenteeism. This implies
that work related stress and alcoholism affected performance. This is in line with
Onyango (2013) and Hagembe & Simiyu (2014) that 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 student nurses in developing countries such as Uganda and
Kenya.
Table Gender Attitude towards Salary Scale Satisfaction Crosstab
Count
Drinking of Alcohol
Below Excessive Above Average
Average Alcohol Average
drinking
Gender Male 6 15 8 4
Female 12 4 2 0
Total 18 19 10 4
The study sought the association between gender and excessive drinking
of alcohol. Respondents were asked about their views on the extent of alcohol
drinking. Male student nurses were found to be the majority 19 (38%) engaging in
excessive alcohol taking compared to women 4(8%) while majority of women
drunk alcohol to a below average. This demonstrated that work related stress
influence male student nurses in excessive alcoholism compared to women
counterpart.Correlation Analysis
The study conducted a Pearson Correlation analysis for all the study variables as
presented Table 4.21.
Table Correlation of the Study Variables
Work related stress factors in Alcoholism
Sagana Sub County Hospital
Organizational Support Pearson Correlation 0.736(*)
Sig. (2-tailed) 0.001
Life styles Pearson Correlation 0.815(*)
Sig. (2-tailed) .000
Role Clarity Pearson Correlation 0.801(**)
Sig. (2-tailed) .003
Workload in Hospital Pearson Correlation 0.691(*)
Sig. (2-tailed) .001
Hospital Environment Pearson Correlation 0.748(**)
Sig. (2-tailed) .000
* Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed).
The strength of association between organizational support and alcoholism
was strong, significant and negative having scored a correlation coefficient of 0.736
, PV=0.001<0.05. Thi simplied that low support from the top management for
students nurses of Sagana Sub County increase students nurses engagement in taking
execessive alcohol.
The study found that there existed a strong, significant and negative
correlation between life styles and alcoholism having score correlation factor r=
0.815, PV=000 and a 95% confidence level. This implied that improving life styles
of the students nurses would decrease workstress and reduce level of alcoholism
among students nurses in Sagana Sub County hospital, Kirinyaga County, Kenya.
The results
were supported by Cricco-Lizza, (2014) that pattern of consumption has significant
repercussions in working relationships, reducing productivity and compromising work
safety, besides increasing absenteeism and present’s phenomena.
The correlation results indicated that there exist a significant , strong and
negative correlation between role clarity and alcoholism among students nurses at
Sagana Sub County hospital as indicated by correlation factor , r=801,
PV=0.003<0.01. Reduction in role clarity for students nurses would lead to
workstress and increase level of frequent taking of alcohol. The study concurred with
Ross-Adjie, Leslie, and Gillman (2007) reported work related stress factors to include
excessive workloads, violence against nursing staff and poor skill mix, insufficient
time to provide quality patient care as a major demand.
From the correlation results, there also existed a strong and positive
association between work load in hospital and alcoholism as indicated by a correlation
coefficient, r= 0.691, PV=0.001 <0.05. This demostrated that increase in workload
significance increase rate of taking alcohol among the students nurses as increase in
workload increase level of stress that influence student in taking alcohol.
Furtherm correlation results indicated that there eixt a strong, significant and
negative relationship between hospital enviroment and alcoholism as indicated by
correlation factor, r= 0.748, PV=0.000<0.01. This clearly demostrated that reduction
in hospital enviroment conditions increase level of alcoholism due to increase in
workstress among the students nurses in Sagana Sub County .
The results were further supported by interview guide results. Key informants
indicated that increases in level of workstress led student nurses to indulge in alcohol
consumption. Results revealed that increase level of anxiety and anger led to poor
physical and psychological wellbeing of the nurse resulting into lower productivity
level, reduce job performance. The interviewees indicated that job stress results into
high workload which results into burnout syndrome and affect student nurses
concentration and commitment and increased errors leading to alcoholism and poor
job performance. The interviewees also indicated that increase in job stress results
into health complication due to the high workloads within their work area as a result
of an inadequate nurse patient ratio, increasing rate of absenteeism and affect students
nurses job performance. The finding were supported by Labrague (2013) who
indicated that a slightly different perspective, student nurses report negative
interactions with clinical staff due to a theory-practice gap as a major source of their
too much work related stress and that overtime worked, in addition to the nurse’s
normal weekly hours, and their continuously high workloads, which far surpass that of
nurses in other countries such as Australia or the United State of America (USA).
Mitigation for Work-Related Stress and Alcoholism on Job Performance
In the respondents’ opinion on what should be done to mitigate work-related
stress and alcoholism on job performance, the study found that, management in the
hospital could reduce workstress among the student nurses through improving
working environment, defining their responsibilities, training of the students nurses,
foster top management interrelations and support as well as improving work life
balance. This is in line with Margolis, (2012 who stated that the denial of the harm
inherent in binge drinking stems from student nurse’s anxiety to admit drinking
creates difficulties, rather than eliminates problems. The interviewees opined that
various approaches could be adopted to effectively address work related stress and
alcoholism in the workplace. Interviewees indicated that defining the responsibilities
of student nurses could be used to reduce work related stress and reduce alcoholism
among the student nurses.
The study found that effective orientation in the workplace, adequate support
from top management in the health facility and motivating student nurses through
offering financial support, offering housing and accommodation mitigate work related
stress and reduce intern alcoholism to a large extent. The interviewees indicated that
development of supportive framework for the student nurses at the point of entry into
the health facility and during stay in the facility would motivate the student nurses and
act as an instrument to mitigate occurrence of work related stress. This was supported
by Gardner, (2013) has demonstrated that stress-management support programs play a
positive role in reducing the psychological distress and alcohol of student nurses in
their internship in the hospital in order to establish a helpful stress-management
strategy to enhance and improve the student’s nurse’s well-being and academic skills.
The interviewees also indicated that support of student nurses through
provision of working tools and instruments, provision of conducive working rooms,
clean environment and having effective working schedules act as approaches that
address workplace stress and mitigate alcoholism among the student nurses at Sagana
Sub County hospital. The Key informants also indicated that the improving family
relationships and support is an approach that could reduce almost all student nurses
ultimately needs family support. The interviewees indicated that good relationship
from family act as motivators and reduce level of stress and anxiety among the
students nurses. Improving relations with other working student nurses also act as an
approach to reduce workstress and lower anxiety among student nurses. The study
was supported by Malta (2014) recognizes that stressors may induce higher level of
stress and anxiety and affect quality of health provision to patient and that
responsibility and consequently have to cope with the pressure of work expected in
the internship period, lack of leisure time and work relationship
Further interviewees indicated that job designing and redesigning would be an
approach that would reduced workstress among student nurses at Sagana Sub County
hospital as this would reduce excessive workload demands and reduce conflicting
expectations in workplace. The interviewees explained that this would provide
favourable working conditions as critical to reduction of job stress.
The interviewees also indicated that use of training approach would be
appropriate in reducing stress among the students nurses as its enable them to become
aware of the signs of stress, using this to interrupt behaviour patterns when the stress
reaction is just beginning, able to assess the situation and developing an active plan to
reduce the stressors, enhance learning skills to actively cope and relax as well as
develop a lifestyle that creates buffer against stress and engage in a more constructive
engagement rather than results into taking alcohol. Further key informants revealed
that student nurses need to be trained on stress management to foster physiological
support to enhance coping with patients and people, improve interpersonal awareness
through reductions in depression, anxiety, psychological strain, and emotional
exhaustion immediately after the programme. The result were supported by
Masomboka (2014) that provision of adequate academic and practicum training
programs were the main mitigation of work related stress among student nurses across
all five years of the curriculum in this study, followed by personal issues.
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
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.
