The Effect of Work-Related Stress and Burnout on Nursing
Performance: a Study of Government Hospitals in Misamis
Oriental
Determinants of Burnout Among Nurses in
Selected Hospitals Misamis Oriental
Maslach Burnout Inventory™ (MBI)
Burnout and Conservation
ABSTRACT
Background:
Stress in nursing in hospitals is an important issue. Work-related stress in nursing occurs due to different
work factors that place job demands on nurses. Stress experience has significant negative effect on
nurses’ well-being, service delivery, and the organization as a whole. Stress is seen as negative factor
affecting individual’s physical and mental health. However, stress is a normal part of every individual’s
life and stress in optimal level is considered necessary to increase individual’s performance level.
Whereas stress over a prolonged period requires sustained physical and mental effort to meet job
demands. Nurses’ inability to handle job demands can lead to health problems in nurses and decreases
their productivity. The aim of this thesis is to study the sources of stress among nurses, study the
adverse effects of stress on nurses’ performance, and study the stress coping strategies in dealing with
stressful situations. This thesis is based on a literature review of 30 articles. The content analysis of this
study is based on inductive qualitative content analysis. The Job Demands-Resources (JD-R) model is
used as a theoretical framework for this study. The findings from this study indicate that occupational,
organizational, socio-demographic, and psychological factors are related to work stress in nursing. Work
overload, role ambiguity, staff shortage, job insecurity, inadequate pay, inequality at work, exposure to
death and disease, and lack of management support are associated with major sources of work stress in
nursing. Prolonged work stress experience among nurses is linked to reduced job commitment, reduced
productivity, poor patient outcomes, burnout, illness, absenteeism, and increase in negative personal
behaviors such as aggression, anxiety, apathy, etc. It is important to identify job demands that are likely
to cause stress among nurses and address those demands with relevant resources to support nurses’
work environment. This could be achieved with job redesign, trainings, proper rewards, recognition, and
organizational changes. Actions to reduce work stress are necessary to promote physical and mental
well-being of nurses
TABLE OF CONTENTS
INTRODUCTION
Stress affects all age groups, races, and occupations and is a common occurrence that can occur in
people's everyday lives, and in some cases, it is difficult to escape stress. Stress can also be the reason to
cause the physical and mental imbalance in an individual’s day to day life (Jarinto, 2011). As stress can
occur in any profession, nursing profession does not stand alone being not affected by it. Stress in
nursing has been a chronic issue which may result in many health problems among nurses and can
reduce their quality of performance (A, Osamudiamen & A, 2013). The nursing profession is a highly
demanding and responsible profession that any kind of compromises in care may lead to serious and
hazardous effects on the individual seeking for care. Work-related stress in nursing is the stress
experienced by the nurses inside their working environment which is the result of lack of support from
their colleagues and supervisors, and when their abilities and knowledges does not match the working
expectations (Gelsema et al., 2006). According to Gelsema et al. (2006), high job demands, work
overload and lack of control over work also leads to work-related stress which has been further
discussed in detail in findings and discussion chapter. Furthermore, to support this theory, this paper has
used the Job Demands-Resources (JD-R) model which has been presented in the theoretical framework
chapter. The methodology chapter includes methodology where the different methods used in the study
has been discussed and described. The findings chapter consists of detailed outcomes gathered after
collecting data from the literature review and then analyzing the collected data thoroughly. The findings
chapter also consists of the most important findings the authors have found while reviewing the
literature and have been jotted down as a Summary of Findings. The discussion and conclusion chapter
consist of detailed review of the nursing literature on work-related stress along with answering study’s
research questions. The main aim of this study is to examine the leading and primary sources of
workrelated stress among nurses in hospital setting along with its possible effects on nurses’ 6
performance. This paper also seeks to examine the stress coping strategies frequently used in nursing
profession to cope up and manage the stress. Moreover, the reason behind being inspired and selecting
this topic for further study came from the author(s) own personal experiences. Work stress among
nurses in nursing profession are felt and experienced by almost everyone. However, the level of stress
varies from person to person. The same level of stress experienced by an individual might not affect the
other. Hence, the authors felt the need of further detailed study in this topic and rule out more possible
and underlying stressors and their consequences in nursing performance along with the coping
strategies.
CONTENTS
1 Introduction..........................................................................................................5
2 Background..........................................................................................................7
2.1 Definition of Stress and Work-Related Stress............................................................... 7
2.2 Stress and Nursing........................................................................................................ 9
3 Theoretical Framework...................................................................................... 11
3.1 Job Demands-Resources (JD-R) Model ..................................................................... 11
The term burnout was introduced by Freudenberger in 1974 when he observed
a loss of motivation and reduced commitment among volunteers at a mental
health clinic [5]. It was Maslach who developed a scale, the Maslach Burnout
Inventory (MBI), which internationally is the most widely used instrument to
measure burnout [6]. According to Maslach’s conceptualisation, burnout is a
response to excessive stress at work, which is characterised by feelings of
being emotionally drained and lacking emotional resources—Emotional
Exhaustion; by a negative and detached response to other people and loss of
idealism—Depersonalisation; and by a decline in feelings of competence and
performance at work—reduced Personal Accomplishment [7].
