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hospice nurse stress, stress and perceived self-efficacy, occupational stress



  1. Martens, Mary Lynn PhD, RN, CHPN


Generally considered a philosophy of care rather than a place, hospice is a unique blend of services that addresses the needs of dying persons and those close to them. Frontline workers are critical to the success of hospice, so it follows that the level of stress and general well-being felt by these workers is centrally important. An overly stressed, demoralized, or alienated direct service staff is unlikely to personify hospice caring or deliver high-quality, compassionate care for the terminally ill and their families, which epitomizes the hospice caliber philosophy of care. The purpose of this study was to determine the perceived stress factors of inpatient and home hospice nurses and their correlation to perceived self-efficacy. The top stressors perceived by participating hospice nurses were "making a mistake when treating a patient," "insufficient personnel to handle workload," "fellow workers not doing their job," "inadequate support from supervisor/manager," "disagreement with a medical professional concerning treatment of patient," and "personal insult from patients or families." Statistically significant relationships exist between some of the stressors surveyed in different areas and the stressors' total and general perceived self-efficacy score. In the statistically significant relationships with perceived self-efficacy, the direction is negative, indicating a high ranking of the stressor or the total correlates to a lower score on perceived self-efficacy. Analysis was also done on the relationship of stress to age, education level, and years of experience in healthcare. This study used the research approach of a quantitative cross-sectional descriptive study using the method of survey research. Nurses working in 14 hospice organizations in Midwest United States were surveyed to learn about perceived sources of stress and perceived self-efficacy. The importance of this study is the identification of perceived occupational stressors among hospice nurses, combined with an understanding of the relationship to perceived self-efficacy. This identification of perceived stress factors in hospice nurses can lead to a better understanding of the needs of hospice nurses as it relates to hiring, education, in-services, and retention of personnel in this unique area of healthcare.