WAYS OF COPING: UNDERSTANDING WORKPLACE STRESS …

WAYS OF COPING: UNDERSTANDING WORKPLACE STRESS AND COPING MECHANISMS FOR HOSPICE NURSES

by LaToya JM Harris BA, Vanderbilt University, 2002 MPH, Mercer School of Medicine, 2004

Submitted to the Graduate Faculty of Graduate School of Public Health in partial fulfillment

of the requirements for the degree of Doctor of Public Health

University of Pittsburgh 2012

UNIVERSITY OF PITTSBURGH Graduate School of Public Health

This dissertation was presented by

LaToya JM Harris

It was defended on November 8, 2012 and approved by

Mark S. Friedman, PhD, MSW Assistant Professor

Department of Behavioral and Community Health Sciences Graduate School of Public Health, University of Pittsburgh

Mary Beth Happ, PhD, RN Adjunct Professor

Department of Acute and Tertiary Care School of Nursing, University of Pittsburgh

Martha Ann Terry, PhD, MA Assistant Professor

Department of Behavioral and Community Health Sciences Graduate School of Public Health, University of Pittsburgh

Dissertation Advisor: Steven M. Albert, PhD, MSPH Professor and Chair

Department of Behavioral and Community Health Sciences Graduate School of Public Health, University of Pittsburgh

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Copyright ? by LaToya JM Harris 2012

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Steven Albert, PhD WAYS OF COPING: UNDERSTANDING WORKPLACE STRESS AND

COPING MECHANISMS FOR HOSPICE NURSES LaToya JM, Harris, DrPH

University of Pittsburgh, 2012

OBJECTIVE: Hospice programs consider nursing their primary source of professional services. Recruitment and retainment of hospice nurses has been a challenge in the last decade due in part to workplace stress. This research seeks to expand the current body of knowledge surrounding the coping process for this group. Additionally, this research explores the availability and adequacy of workplace resources in order to recommend how organizations can assist in the coping process. METHODS: This study included registered and licensed practical nurses. Eligible subjects were invited to participate in focus group sessions. Participants also completed a survey that collected demographic information and assessed coping strategies through the use of the Ways of Coping Questionnaire. Interviews were audio-recorded and transcribed. Content analysis was performed on interview data. Descriptive statistics and bivariate correlations were performed on the quantitative data.

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RESULTS: Hospice nurses reported that social support, humor and prayer/meditation were the most effective coping mechanisms. The majority of the participants shared that their hospice agencies offered no formal resources to assist them in times of stress. Informal resources emphasized individual efforts at ameliorating stress that offer little to no long-term therapeutic value. Quantitative results supported focus group feedback in regards to most frequently used strategies. Moderate associations were found between hospice nurse experience and planful problem solving and seeking social support. CONCLUSION: Traditional approaches to combat workplace stress have focused solely on individual efforts. Organizations have an opportunity to develop quality workplace resources that consider the person-environment relationship and build upon coping strategies that nurses find most effective. This information challenges organizations to explore and make available beneficial coping resources with their staff. PUBLIC HEALTH SIGNIFICANCE: Hospice nurses have been identified as a high-risk group for burnout and fatigue as a consequence of workplace stress. The results of this study indicate that there are disparate programs across hospice settings to assist nurses in coping with job stress. Further, hospice nurses consider these efforts to be primarily inadequate and ineffective. Future research should focus on identifying standard policies and practices that best protect this group from injury and illness and ensures the longevity of hospice care.

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