Prevalence of stress and associated factors among nurses working in intensive care unit at Muhimbili National Hospital Dar es salaam, Tanzania.

Abstract

Background Stress is a physical or psychological response towards unbalanced demands and resources. It is becoming increasingly recognized as one of the most serious occupational hazards for nurses who work in critical care units. Poor stress management in Intensive Care Unit (ICU) among nurses has serious impact to the patients care and outcome; and the result is increasing cost to the organization and the nation as a whole. The aim of this study was to identify prevalence of stress and associated factors among ICU nurses working at Muhimbili National Hospital (MNH). Materials and methods A descriptive cross sectional study design was conducted to assess prevalence of stress symptoms and associated factors. A total of 80 nurses working in ICUs such as Main ICU, Cardiac ICU, Acute Pediatric Care Unit (APCU), Emergency Medicine Department and Highly Dependent Unit at MNH were recruited. A questionnaire with 31 items was used. Data was coded and entered into SPSS version 16.0 (Statistical Package for Social Sciences) for descriptive analysis and inferential statistics. Results Out of 80 participants 69 (87%) were female nurses; 62 (78%) were nurse officers with diploma or degree while 18 (23%) were nurses with certificates. Significant stress symptoms were physical stress symptoms which include (back pain, headache, chest pain, stomach upset and sudden weight gain/loss); forty eight (60%) of the participants had physical stress symptoms and mean score was = 2.23 and (SD = 1.49) (moderate), thirty (38%) had psychological stress symptoms and mean score was = 1.23 (SD = 1.21) (mild), and twenty (25%) of the participants had behavioral change and mean score for behavioral changes was = 0.85 (SD= 0.92) (mild). Therefore significant stress symptom was physical stress symptoms since 60% of the participants had physical stress symptoms. By multivariate analysis three factors were associated with significant stress symptoms: 1. Personal characteristics with p-value = 0.07 for physical stress and 0.04 for psychological stress 2. Interpersonal relationship with p- value 0.05 for physical stress and 0.04 for psychological stress 3. Management issues with p- value= 0.01 for physical stress. Conclusion Majority of ICU nurses at MNH suffer moderate physical stress which was associated with poor interpersonal relationship, personal characteristics and management issues. Therefore, these factors need further investigation and additional methodological approaches to deal with issues such as recall bias, selection bias and information bias. Recommendations ICU nurses need to learn effective stress coping mechanisms like how to position themselves while turning or lifting patients. The organization has to look for possibilities to get enough and durable efficient adjustable beds to lessen nurses’ muscle straining, and efforts to raise staffing requirements since physical stress symptoms are the ones found to be significant. Also the hospital management should encourage good communication skills and interpersonal interaction that are potent for team work building. The researcher recommends qualitative approach in future to study coping mechanisms which the nurses use in managing the physical stress.