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  1. Seago, Jean Ann PhD, RN
  2. Faucett, Julia PhD, RN


Objective: The authors describe factors associated with job strain for various job titles in the acute care hospital using the Karasek Job Strain Model, discuss the reliability and validity of the Job Content Questionnaire, and discuss use of the model to enhance the work environment.


Background: The Karasek Job Strain Model has been used to describe many occupations in the United States and other countries. Some research indicates that occupations that arouse stress hormones are those in which employees have little job control or must complete psychologically demanding tasks, such as those under time pressure, and these positions can be described as high-strain jobs.


Method: This descriptive correlation study was conducted at five tertiary care hospitals on the West Coast. A purposive volunteer sample of staff members working at least 20 hours per week in the adult medical-surgical and specialty nursing units was recruited.


Results: Mean scores for each of the nursing units and the overall mean scores for the staff in the initial analysis fell into the Active Work quadrant of the Karasek Job Strain Model. When nursing job titles were analyzed, registered nurses had significantly higher Decision Latitude scores than did nurse assistants (P < 0.001) and clerical staff (P < 0.001), but there were no significant differences for Psychological Demands.


Conclusions: Working with nurse assistants to appropriately increase decision latitude related to their work has the potential to enhance the work environment by reducing job strain and improving staff health and morale.