Journal of Education and Practice www.iiste.

org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&&
Exploring the Work Related Stress Sources and Its Effect among
the Palestinian Nurses at the Governmental Hospitals

()*ad (+ed
,
% -aeda E.tait% I*ad -as)afs)e)% /a0ra* 1as)eer% /orad (.el% 2o3aa Nassar% /a+se* #*ar+
Nursing 2epart*ent% (ra4 (*erican 5ni6ersit+% Palestine
,E- *ail of t)e correspondence aut)or7 8eina)*ad29+a)oo.co*

Astract
!ackground" Nursing is a )ig)l+ stressful occupation. Nurses are particularl+ at ris0 fro* stress-related
pro4le*s% wit) )ig) rates of turno6er% a4senteeis*% and 4urnout. (t t)e sa*e ti*e% it s)ould 4e noted t)at stress
is una6oida4le and *a+ e6en 4e desira4le to a certain degree. (t *oderate le6els% stress is a *oti6ator and
i*pro6es a wor0er3s participation in )is or )er :o4. ;owe6er% w)en stress 4eco*es e<cessi6e% it *a+ 4eco*e
distracting% de-*oti6ating% and e6en )a8ardous. Aim of the Stud#7 =)e stud+ ai*ed to e<plore t)e wor0 related
stress sources and its effects on t)e p)+sical and *ental )ealt) a*ong Palestinian nurses wor0ing at intensi6e
care units and neonatal units at *inistr+ of )ealt) )ospitals >afedia% =)a4et =)a4et% and ?)alil Solai*an
)ospitals at Nort) @est 1an0 Aities. $esign" 2escripti6e% cross sectional design utili8ed in t)e current stud+.
Sample" !2 Palestinian nurses were included and wor0ing in t)e 3 )ospitals affiliated to *inistr+ of )ealt).
Procedure" 2ata collected t)roug) nursesB socio-de*ograp)ic c)aracteristic% wor0 related stress% p)+sical and
*ental )ealt) pro4le*s Scale w)ic) is de6eloped 4+ t)e researc)ers. $alidit+ and pilot stud+ were e<a*ined .
Results7 Stud+ results )a6e s)own t)at t)e *ost co**on t+pe of wor0-related stress for Palestinian nurses was
due to dealing wit) deat) and d+ing followed 4+ wor0load. Nearl+ )alf of nurses were suffering fro* p)+sical
and *ental illnesses. #ur stud+ pro6ed a )ig)l+ statisticall+ significant relation 4etween *ental pro4le*s and
wor0ing stress and statisticall+ significant relation 4etween wor0ing stress% p)+sical pro4le*s. %onclusion and
recommendation7 @or0 related stress affect p)+sical and *ental )ealt) of Palestinian nurses% so t)e+ need to
pro6ide continued ad*inistrati6e support% appropriate training progra*s to deal wit) potentiall+ stressful
conditions in t)e )ealt) facilit+.
&e#'ords" wor0 related stress% intensi6e care unit% neonatal unit

() Introduction
(ccording to t)e 5.S. National Institute of #ccupational Safet+ and ;ealt)% :o4 stress is a )ar*ful response
p)+sicall+ and e*otionall+ w)en t)e e*plo+ee3s s0ills% resources% and needs could not fulfill t)e re.uire*ent of
t)e :o4 *@el0er -;ood% 2&&C.
Di6en t)e widespread i*pact of wor0place stressors on wor0ing peopleBs )ealt)% su4stantial )ealt) and econo*ic
costs% 4ot) related to a4senteeis* and decreased producti6it+% s)ould not 4e surprising (Sc)nall% 2o4son% and
>oss0a*% 2&&E. Stress is also a significant contri4uting factor to organi8ational inefficienc+% )ig) staff turno6er%
a4senteeis* 4ecause of occupational stress% increased costs of )ealt) care% and decreased :o4 satisfaction ((4u
(l>u4% 2&&'.
Nursing is a )ig)l+ stressful occupation (?awano% 2&&!. Nurses are particularl+ at ris0 fro* stress-related
pro4le*s% wit) )ig) rates of turno6er% a4senteeis*% and 4urnout ((ntigoni% Pediadita0i% and 2i*itrios% 2&11F
/ar0 and S*it)% 2&11. (t t)e sa*e ti*e% it s)ould 4e noted t)at stress is una6oida4le and *a+ e6en 4e
desira4le to a certain degree ((l6es% 2&&5. (t *oderate le6els% stress is a *oti6ator and i*pro6es a wor0er3s
participation in )is or )er :o4. ;owe6er% w)en stress 4eco*es e<cessi6e% it *a+ 4eco*e distracting% de-
*oti6ating% and e6en )a8ardous. In 2&&'% t)e Aanadian -ederation of Nurses 5nion reported t)at !CG of nurses
e<perienced t)eir wor0places as stressfulF !CG reported t)eir wor0place as understaffedF !!G said t)e+ were
under-resourced at wor0F and E1G reported )ea6+ wor0loads (Dreenslade and Paddoc0% 2&&7.
Nu*erous studies )a6e focused on wor0 stress in nurses 4ecause t)e+ wor0 in )ig)-stress en6iron*ent% w)ic)
)as detri*ental effects 4ot) on t)eir *ental and p)+sical )ealt)% producti6it+ and efficac+ at wor0% a4senteeis*%
as well as on patientsB outco*es suc) as increased *ortalit+ and patient dissatisfaction ($a)e+% (i0en% Sloane%
Soc)als0i% 1usse% H Alar0e, 2&&'. Stress-related )ealt) pro4le*s and issues can include7 gastrointestinal
pro4le*s% sleep distur4ances% *ood fluctuations% )eadac)es% as well as acri*onious relations)ips wit) fa*il+
and friends (Edwards% 2&&3F ;urrel and (risteguieta% 2&&5. ( growing 4od+ of e6idence supports t)e assertion
t)at wor0place stress pla+s an i*portant role in se6eral t+pes of c)ronic )ealt) pro4le*s% in particular%
cardio6ascular disease% dia4etes (?roen0e% 2&&7% and c)ronic low 4ac0 pain (/itc)ell% 2&&E.
( large nu*4er of studies on stress in nurses )a6e 4een conducted in @estern clinical settings. =)e co**on
sources of stress at wor0 identified include s)ift wor0% long wor0ing )ours% lac0 of control and conflicting
de*ands% 4ad relations wit) colleagues% low pa+% and poor wor0ing en6iron*ents (Edwards% 1urnard% ;annigan%
Aooper% (da*s% Juggessur% H Ao+le% 2&&CF ?awano% 2&&!F =o)% (ng H 2e6i% 2&12. Aonsidering t)at cultural
factors can pla+ an i*portant role in stress% it is i*portant to 4e cautious w)en appl+ing results o4tained in
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&1
@estern societies to different cultures (Iau% "iao% Jee% =sang H@ong% 2&12. In addition to cultural differences%
t)ere are also local effects on @>S. -or e<a*ple% e6en nurses wor0ing in different )ospital units are e<posed to
different t+pes of @>S (?awano% 2&&!.
( Norwegian stud+ 4+ 1egat% Ellefsen% H Se6erinsson (2&&5 sur6e+ed 71 nurses on )ow t)e stress le6els t)e+
e<perienced at wor0 correlated wit) :o4 satisfaction and perception of ps+c)osocial wor0 en6iron*ent. =)e
stud+ found t)at t)ere were si< factors t)at )ad a )ig) correlation to :o4 stress and an<iet+. -actor 1 *easured
:o4 stressKan<iet+ w)ic) accounted for (15.&5G and factor one attri4uted increased stress to nurses feeling t)e+
)ad too *uc) to do and 4eing stressed out on t)e :o4. -actor 2 e<plored relations)ips wit) colleagues w)ic)
accounted for (13.CCG. In -actor 3% colla4orationKco**unication was responsi4le for (11.2G. -actor ' (1&.7G
s)owed nurse felt *ore :o4 *oti6ation w)en t)e+ were engaged at wor0 and found t)e wor0 interesting and
sti*ulating. -actor 5 loo0ed at wor0 de*ands (7.!G% specificall+ planning% and noted a correlation 4etween
stress and no :o4 description and lac0 of planning or routines. Jastl+% -actor C found a positi6e correlation wit)
professional de6elop*ent (5.EG and nurses 4eing encouraged to de6elop new s0ills. #6erall% t)ese C factors
e<plained C'.3G of t)e principal co*ponents of nurses perceptions of t)eir ps+c)osocial wor0 en6iron*ent .
A)ang% 2al+% ;ancoc0% 1idewell% Jo)nson% and Ja*4ert (2&&C in a cross sectional sur6e+ e<a*ined t)e
en6iron*ental occupational stressors of (ustralian )ospital nurses in S+dne+ w)ere participants co*pleted four
.uestionnaires t)at e<a*ined stress and .ualit+ of wor0 life. @or0load was identified as t)e c)ief stressor for
(ustralian nurses wor0ing in pu4lic acute care )ospitals. Statisticall+ significant correlations 4etween stressors
(e.g.% wor0place supports% t)e nu*4er of +ears wor0ed in t)e unit% and wor0load and p)+sical and *ental )ealt)
were o4ser6ed. Stepwise *ultiple regressions re6ealed age to 4e t)e onl+ significant factor of p)+sical )ealt).
In a stud+ soug)t to deter*ine t)e *ost co**on wor0place stressors a*ong A)inese )ospital nurses s)owed
t)at wor0place stressors *ost fre.uentl+ identified were wor0load and dealing wit) deat) and d+ing. =)e 4est
predictors of p)+sical )ealt) were ps+c)ological )ardiness% conflict wit) ot)er nurses% uncertaint+ a4out patient
treat*ent% see0ing social support and confronti6e coping. =)e 4est predictors of *ental )ealt) were
ps+c)ological )ardiness% conflict wit) ot)er nurses% wor0load% see0ing social support% and age (Ja*4ert%
Ja*4ert% Petrini% L)ang, 2&&7
( stud+ in6estigated t)e effects of :o4 stress on t)e p)+sical )ealt)% *ental )ealt) personal and wor0 4e)a6iors
of nurses in pu4lic )ospitals in I4adan /etropolis% Nigeria. =)e stud+ was carried out a*ong 153 nurses wor0ing
in two pu4lic )ospitals in I4adan /etropolis% Nigeria. ( single .uestionnaire tagged MStress (ssess*ent
Nuestionnaire for ;ospital Nurses (S(N-;N was de6eloped and used for t)e stud+. It contains 72 ite*s%
*easuring de*ograp)ic 6aria4les% :o4 stress% p)+sical and *ental s+*pto*s% personal and wor0 4e)a6ior.
-indings fro* t)e stud+ re6ealed t)at t)e )ig)l+ stressed nurses (!5 or 55.5G e<)i4ited personal and wor0
4e)a6ioral pro4le*s li0e 4ull+ing% a4senteeis*% resignation or turno6er. 2ue to 4eing stressed or frustrated%
so*e of t)e nurses engage in aggressi6e )ostile or 6indicti6e 4e)a6ior on t)eir wards .=)e stud+ esta4lis)ed t)at
:o4 stress )as significant effect on p)+sical and *ental )ealt) of t)e nurses (/o:o+inola% 2&&!
( .uantitati6e stud+ conducted 4+ Preto and PedrOo (2&&E to c)aracteri8e nurses wor0ing at IA5 and 6erif+ t)e
presence of stress a*ong t)e*. ( total of 21 IA5 nurses fro* fi6e )ospitals located in t)e state of SOo Paulo
answered a series of .uestions a4out t)e IA5 and co*pleted t)e Nurse Stress In6entor+. >esults s)owed t)at t)e
nurses wit) no post-graduation education s)owed a )ig)er le6el of stress t)an nurses wit) at least one
speciali8ation% E&G of 1&& nurses *entioned t)at wor0ing in IA5s is stressful% wear+ing% and tiring.
Dolu4ic% /ilose6ic% ?ne8e6ic% H /usta:4ego6ic (2&&E cited si< *a:or groups of occupational stressors in a
stud+ of Aroatian nurses. ( cross-sectional stud+ of 1&!C nurses identified organi8ation of wor0 and financial
issues% pu4lic criticis*% )a8ards in t)e wor0 place% interpersonal conflict% s)ift wor0 and professional and
intellectual de*ands as contri4utors to increased wor0 stress. Specificall+% organi8ation of wor0 and financial
issues t)at were significant was7 insufficient nu*4er of co-wor0ers% une<pected situations% and paperwor0.
Pu4lic criticis* s)owed significance in conflicts wit) patients% patientsB inade.uate e<pectations % and
professional and pri6ate life stress . In t)e areas of )a8ard in t)e wor0place and s)ift wor0% all 6aria4les s)owed
statistical significance. =)e researc)er concluded t)at in Aroatian nurses wit) )ig)er education t)ere were
su4stantiall+ decreased le6els of low wor0a4ilit+% 37G in t)ose wit) secondar+ education 6ersus 3&G wit)
)ig)er education% indicating a need to furt)er in6estigate t)e role )ig)er education pla+s in decreasing factors
causing wor0-related stress.
( clinical stud+ conducted 4+ /et8ent)in% ;elfric)t% Joer4ro0s% =erris% ;aug% Su4ra*anian% H -isc)er (2&&E
*easured sali6ar+ cortisol le6els in con:unction wit) a su4:ecti6e stress tool in !2 pediatric and critical care
nurses in Swit8erland. =)e researc) re6ealed a statisticall+ significant increase in cortisol le6els w)en co*pared
to su4:ecti6e reported stress (pP&.&'. (dditionall+% o4:ecti6e stress *easured t)roug) a standardi8ed )ospital
*anage*ent tool did not s)ow a statistical relations)ip to cortisol le6els (pP.5C.
( s+ste*atic re6iew was e<a*ined of t)e sources and conse.uences of occupational stress on nursesB ade.uac+%
producti6it+% efficienc+. ( s+ste*atic re6iew was *ade in MEuropean (genc+ for Safet+ and ;ealt) at @or0Q%
MNational Institute for #ccupational Safet+ and ;ealt) (NI#S;Q% MJo4 Stress Networ0 M we4 sites for 6arious
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&2
pu4lications and a4stracts around t)e e<act t)e*e and t)e M#ccupational and En6iron*ental /edicine JournalQ
using as 0e+ words Rstress% occupational stress% and NursingR. >esults s)owed t)at a nu*4er of aspects of
wor0ing life )a6e 4een lin0ed to stress. (spects of t)e wor0 itself can 4e stressful% na*el+ wor0 o6erload and
role-4ased factors suc) as lac0 of power% role a*4iguit+% and role conSict. =)reats to career de6elop*ent and
ac)ie6e*ent% including t)reat of redundanc+% 4eing under6alued and unclear pro*otion prospects are stressful.
Stress is associated wit) reduced efficienc+% decreased capacit+ to perfor*% a lac0 of concern for t)e
organi8ation and colleagues ( /ousta0a and Aonstantinidis% 2&1&
In a stud+ ai*ed at finding out t)e distri4ution of depression% an<iet+ and stress a*ong nurses at Pantang
)ospital wit) regards to de*ograp)ic c)aracteristics suc) as age% gender% ran0% duration and )ospital unit wor0ed.
( sa*ple of 57 Nurses of Pantang ;ospital was rando*l+ selected for t)e stud+. =)e results indicated t)at t)e
)ig)er t)e age of t)e Nurse t)e *ore )e or s)e is e<posed to t)ese e*otional ((tindan4ila% (4asi*i% and (ni*%
2&12
( cross sectional stud+ conducted 4+ /osadeg)ard (2&13 to e<plore t)e status of occupational stress a*ong
)ospital nurses in Isfa)an% Iran. ( 6alidated .uestionnaire was used to collect data fro* 2EC nurses. >espondents
were as0ed to rate t)e intensit+ of 3& co**on occupational stressors using a fi6e-point scale. =)e results
re6ealed t)at t)ird of )ospital nurses rated t)eir occupational stress )ig). =)e *a:or sources of stress were
inade.uate pa+% ine.ualit+ at wor0% too *uc) wor0% staff s)ortage% lac0 of pro*otion% :o4 insecurit+ and lac0 of
*anage*ent support. /ore t)an 35G of nurses stated t)at t)e+ are considering lea6ing t)e )ospital% if t)e+ could
find anot)er :o4 opportunit+.
In a recent a cross-sectional stud+ ai*ed to assess t)e le6el of and t)e relations)ip 4etween :o4 satisfaction% :o4
stress% and 4urnout s+*pto*s. =)e stud+ perfor*ed at IA5s at #slo 5ni6ersit+ ;ospital on 1'5 of 1EC (7'G
staff *e*4ers (1C p)+sicians and 12E nurses. >esults s)owed t)at t)e fe*ales scored )ig)er t)an *ales on
6ulnera4ilit+% 3.3 (2.ET3.7 6ersus 2.& (1.1T2.E (P U &.&5% and e<perienced staff were less 6ulnera4le% 2.7 (2.2T
3.2% t)an ine<perienced staff% 3.C (3.&T'.2 (P U &.&5 (/+)ren% E0e4erg H Sto0land% 2&13.
(not)er stud+ conducted 4+ ;asan8ade) and (tas)puor (2&1& occupational Stress and /ental ;ealt) of
E*plo+ees of a Petroc)e*ical Ao*pan+ 4efore and after Pri6ati8ation to deter*ine t)e le6el of occupational
stress and *ental )ealt) of e*plo+ees of a petroc)e*ical co*pan+ in Isfa)an% Aentral Iran% 4efore and 3 *ont)s
after pri6ati8ation. #ut of t)e 7&& e*plo+ees of t)e studied co*pan+% using a stratified rando* sa*pling
tec)ni.ue% 1'& persons were selected. >esults s)owed t)at t)ere was a significant (pU&.&&1 positi6e correlation
4etween t)e *ental )ealt) status score and :o4 score (r P &.'7C.
( recent 2escripti6e e<plorati6e stud+ conducted 4+ (l ;osis% /ersal H ?es)0 (2&13% a purposi6e sa*ple )as
4een used% 152 Saudi nurses were included and wor0ing in t)e ' )ospitals affiliated to *inistr+ of )ealt) in
Nassi* region. 2ata collected t)roug)F nursesB socio-de*ograp)ic c)aracteristic% wor0 c)aracteristics%
occupational stress scale and wor0 Stress S+*pto* Scale Effects of Jo4 Stress on ;ealt) of Saudi Nurses
@or0ing in /inistr+ of ;ealt) ;ospitals in Nassi* >egion in ?S(. >esults7 Stud+ results )a6e s)own t)at t)e
*ost co**on t+pe of wor0-related stress for Saudi nurses was due to :o4 pressure followed 4+ poor rapport wit)
*anagers. Nearl+ )alf of nurses were suffering fro* p)+sical and *ental illnesses. =)e stud+ pro6ed a )ig)l+
statisticall+ significant relation 4etween *ental pro4le*s and wor0ing stress and statisticall+ significant relation
4etween wor0ing stress% p)+sical pro4le*s and *arital status.

+) Su,ects and -ethod
+)( Aim of the stud#
=)e stud+ ai*ed to e<plore t)e wor0 related stress sources and its effects of on t)e p)+sical and *ental )ealt)
a*ong Palestinian nurses wor0ing at intensi6e care units and neonatal units at *inistr+ of )ealt) )ospitals
>afedia% =)a4et =)a4et% and ?)alil Solai*an )ospitals at Nort) @est 1an0 Aities
+)+ .,ectives of the stud#
1 - (ssess of stress le6el of nurses wor0ing in IA5 and Neonatal units.
2 - E<plore t)e effect of stress on p)+sical and *ental )ealt) of Palestinian nurses in IA5 and Neonatal units.
+)/ Research 0uestions
1. (re nurses wor0ing in IA5 and Neonatal units suffering fro* wor0 related stressV
2. Is t)ere a relation a*ong sources of wor0 related stress and gender% past nursing e<perience% and le6el of
educationV
3. Is t)ere a relation a*ong sources of wor0 related stress on p)+sical and *ental )ealt) of nursesV
+)1 Research H#potheses
1. =)ere will 4e wor0 related stress a*ong nurses in t)e selected )ospitals.
2. =)ere will 4e a significant difference 4etween wor0 related sources of stress and gender% past nursing
e<perience% and le6el of education.
3. =)ere will 4e a significant difference 4etween sources of wor0 related stress and p)+sical )ealt) pro4le*s
a*ong t)e nurses in t)e selected )ospitals.
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&3
'. =)ere will 4e a significant difference 4etween sources of wor0 related stress and *ental )ealt) pro4le*s
a*ong t)e nurses in t)e selected )ospitals.
+)2 Stud# design" 2escripti6e cross sectional e<plorati6e stud+ was used for conducting t)e stud+.
+)3 Stud# Setting" =)e data )as 4een collected fro* intensi6e care units and neonatal units at t)ree )ospitals
affiliated to *inistr+ of )ealt) in Nort) @est 1an0 region% firstF >afedia ;ospital in Na4lus cit+% SecondF =)a4et
=)a4et ;ospital in =ul0are* cit+% and t)irdF ?)alil Sulai*an ;ospital in Jenin.
+)4 Stud# Sample" ( purposi6e sa*ple consisted of E3 nurses% w)o wor0 in t)e pre6iousl+ *entioned settings
in6ited to participate in t)e stud+. -i6e nurses refused to participate and C wit)draw wit)out un0nown cause
fro* t)e stud+. So% t)e final participants were !2 nurses.
+)5 6he inclusion criteria" =)e inclusion criteria set for sa*ple selection were as follows7 Palestinian nurses
and wor0ing in t)e intensi6e care units or neonatal units at >afedia% =)a4et =)a4et% and ?)alil Solai*an
)ospitals wit) full ti*e e*plo+*ent.
+)7 A tool of data collection" -or data collection a self-ad*inistrati6e .uestionnaire was de6eloped 4+
researc)ers and used to assess 7
a NursesB socio-de*ograp)ic c)aracteristic as regards t)eir age% gender% educational le6el% *arital status% :o4
position% total e<perience +ears and current e<perience in t)e selected units.
4 Sources of wor0 stress as regards dealing wit) 2eat) and d+ing% Aonflict wit) p)+sicians% Inade.uate
preparation% Jac0 of support% Aonflict wit) ot)er nurses% @or0 load% and 5ncertaint+ concerning treat*ent. =)e
.uestions used t)e 3-point Ji0ert scale fro* 6er+ low stress to )ig) le6el stress. =)e score were calculated for as
follows7 scores 1 P low le6el of stress% scores 2 P *oderate le6el of stress and scores 3 P )ig) le6el of stress.
c P)+sical ;ealt) as regard S0in allerg+% Pneu*onia% $aricose 6ein% -atigue% ;eadac)e% -ainting% Ara*ps%
Sto*ac)ac)e% (cidit+% 2ecrease in )earing ade.uac+% and 1ac0 pain. =)e .uestions used t)e 2-point
dic)oto*ous scale +es or no. =)e score were gi6en 2 to +es answer and 1 score to no answer.
d /ental )ealt) as regard E<)austion% 2ifficulties to concentrate% Inso*nia% and Ner6ousness. =)e .uestions
used t)e 3-point Ji0ert scale fro* 6er+ low stress to )ig) le6el stress. =)e score were calculated for as follows7
scores 1 P low le6el of stress% scores 2 P *oderate le6el of stress and scores 3 P )ig) le6el of stress.

/) 8alidit# and reliailit# of the stud#
=)e .uestionnaire was re6ised and 6alidated 4+ panel of 5 e<perts in acade*ic and ps+c)ological fieldF t)e+
agreed and no co**ents. Internal consistenc+ esti*ate was using Aron4ac)3s alp)a. =)e initial findings wit)
a6erage &.E2 w)ic) is strongl+ relia4le.

1) Pilot stud#
( pilot stud+ was used to test t)e instru*ent. ( pilot stud+ was conducted wit) ten nurses in t)e intensi6e care
unit fro* (l- @atani )ospital w)ic) is go6ern*ental )ospital and li0e t)e )ospitals included in t)e stud+ to
deter*ine t)e clarit+ of .uestions% effecti6eness of instructions% co*pleteness of response sets% ti*e re.uired to
co*plete t)e .uestionnaire and success of data collection tec)ni.ue. Pilot su4:ects were as0ed to co**ent on t)e
applica4ilit+ and appropriateness (6alidit+ of t)e .uestionnaire. (ll .uestions were answered no clarit+ of
.uestions was re.uired. =)e researc)ers deter*ined t)at it would ta0e twent+ (2& *inutes to co*plete t)e
.uestionnaire.

2) $ata anal#sis
=)e .uantitati6e data were entered and anal+8ed using t)e SPSS (Statistical Pac0age for Social Sciences 6ersion
2&.&% and t)e le6el of significance (W was set at &.&5. 2e*ograp)ic and 4aseline 6aria4les were anal+8ed using
fre.uenc+% percentage% and 4ar c)art. ;+pot)esis were tested and anal+8ed 4+ using t. test and (no6a one wa+
test.

3) Ethical considerations
=)is stud+ was appro6ed 4+ t)e nursing depart*ent% (ra4 (*erican 5ni6ersit+. =)is e*p)asi8ed 4+ /#;
agree*ent wit) t)eir per*ission for t)e in6estigator to utili8e t)e targeted )ospitals. (ppro6al fro* nurses were
o4tained. Se6eral strategies were utili8ed to protect t)e nurse3s rig)ts w)o agreed to participate in t)is stud+. -irst%
oral 6er4al consent of t)e nurses was o4tained prior to t)e ad*inistration of t)e .uestionnaire. =)e nurses were
infor*ed of t)e purpose of t)e stud+% and t)at t)e+ )ad t)e rig)t to refuse to participate. (lso t)e 6oluntar+
nature of participation was stressed as well as confidentialit+. -urt)er*ore% t)e nurses were told t)at t)e+ can
refrain fro* answering an+ .uestions and t)e+ can ter*inate at an+ ti*e. (non+*it+ of t)e nurses was
*aintained at all ti*es.

4) Results
=)e *ain findings of t)e stud+ using descripti6e and inferential anal+sis. =)e stud+ targeted nurses wor0ing in
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&'
IA5 and neonate unitsF !2 nurses participate in t)e stud+.
$escription of the sample
=a4le 1. (ssess*ent t)e 4ase line c)aracteristics of t)e studied sa*ple
Para*eters No. G
(ge Jess t)an 25 +ears 37 '5.1
2C-3& +ears 2E 35.'
/ore t)an 3& +ears 1C 1E.5
;ospital =)a4et =)a4et 1' 17.1
>afedia '1 5&.&
?)alil Solai*an 27 32.E
Dender /ale 31 37.!
-e*ale 51 C2.2
Educational le6el 2iplo*a or less 1! 22.&
1ac)elor 5' C5.E
/aster 1& 12.2
Jo4 position Practical nurse 32 3E.&
Staff nurse '5 5'.E
;ead nurse 5 C.1
/arital status Single '1 5&.&
/arried '1 5&.&
Past E<perience Jess t)an 5 +ears 3C '3.E
5-1& +ears 31 37.!
/ore t)an 1& +ears 15 1!.3
Aurrent :o4 e<perience Jess t)an 5 +ears '3 52.'
5 +ears and *ore 3E '7.C
=a4le 1 s)owed t)at t)e large group age of t)e studied sa*ple ('5.1G was less t)an 25 +ears% )alf of t)e
studied sa*ple (5&G were single% (round two t)irds (C2G of nurses were fe*ales% and in relation to t)e
educational le6el% it was found t)at t)e *a:orit+ (C5.EG of t)e* )ad nursing 4ac)elor. Jess t)an )alf ('3.EG
of t)e nurses )ad an e<perience less t)an 5 +ears. =)is ta4le illustrated t)at in relation to current :o4 e<perience
*ore t)an )alf (52.' G of nurses )ad less t)an 5 +ears e<perience% nearl+ )alf (5&G wor0ing in >afedia
)ospital.

-igure 1. 2istri4ution of nurses gender in t)e stud+ sa*ple.

-igure 1 s)owed t)at t)ere was 51 fe*ale nurses and 32 *ale nurses a*ong nurses in t)e stud+.
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&5

-igure 2. 2istri4ution of nurses total e<perience in t)e stud+ sa*ple
-igure 2 s)owed t)at t)ere was 3C )ad e<perience less t)an 5 +ears% 31 nurses 4etween 5-1& +ears % and 15
nurses a4o6e 1& +ears



-igure 3. 2istri4ution of nurses education le6el in t)e stud+ sa*ple
-igure 3 s)owed t)at t)ere was 1! nurses )ad diplo*a or less% 5' nurses )ad 4ac)elor% and 1& nurses )ad *aster
degree.
=a4le 2. Nu*4er and percent distri4ution of nurses according to t)eir e<posure to wor0 stressors
=a4le 2 illustrated t)at (1E.5G and 53.7G of nurses were suffering fro* se6ere stress and *oderate stress
respecti6el+ regarding dealing wit)deat) and d+ing% and (E.!G and 53.7G of nurses were suffering fro* se6ere

No.

Sources of wor0 stress


S
e
6
e
r
e

s
t
r
e
s
s

/
o
d
e
r
a
t
e


s
t
r
e
s
s

J
o
w


s
t
r
e
s
s

No. G No. G No. G
1 2ealing wit) 2eat) and d+ing 1C 1E.5 '' 53.7 22 2C.!
2 Aonflict wit) p)+sicians ! E.! '' 53.7 3& 3C.C
3 Inade.uate preparation E 11.& 'C 5C.1 27 32.E
' Jac0 of support 5 C.1 '5 '5.E 32 3E.&
5 Aonflict wit) ot)er nurses ' '.E 37 '5.1 '1 5&.&
C @or0 load 1' 17.1 '! 5!.5 2& 2'.'
7 5ncertaint+ concerning treat*ent ' '.E 51 C2.2 27 32.E
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&C
stress and *oderate stress respecti6el+ regarding conflict wit) p)+sician. >egarding inade.uate preparation% it
was found t)at (11.&G and 5C.1G of nurses were suffering fro* se6ere stress and *oderate stress respecti6el+
and it was found t)at (C.1G and '5.EG of nurses were suffering fro* se6ere stress and *oderate stress
respecti6el+ regarding lac0 of support. -or conflict wit) nurses% it was found t)at ('.EG and '5.1G of nurses
were suffering fro* se6ere stress and *oderate stress respecti6el+ and it was found t)at ( 17.1G and 5!.5G of
nurses were suffering fro* se6ere stress and *oderate stress respecti6el+. >egarding 5ncertaint+ concerning
treat*ent% it was found t)at ('.EG and C2.2G of nurses were suffering fro* se6ere stress and *oderate stress
respecti6el+
=a4le 3. Nu*4er H percent distri4ution of nurses3 p)+sical )ealt) pro4le* (during wor0 e<perience

=a4le 3 ela4orated t)at *ore )alf (C!.3 G% 7E.3G % C'.CG% C'.CG% C'.CG % C2.2G% C!.3and 25.CG of nurses
were suffering fro* s0in allerg+% pneu*onia% 6aricose 6eins% fainting% cra*ps% sto*ac)ac)e acidit+% and decrease
in )earing ade.uac+ respecti6el+ and nearl+ one t)ird (35.' G and 2E.3G of nurses were suffering fro*
)eadac)e and fatigue respecti6el+. (lso it was found t)at one .uarter (25.C G of nurses were suffering fro*
4ac0 pain.
=a4le '. Nu*4er and percent distri4ution of nurses according to t)eir *ental illness to stressors

=a4le ' s)owed t)at around one .uarter (23.2 G of nurses were suffering fro* se6ere e<)austion and one fift)
(2&.7G of nurses were suffering fro* se6ere difficulties to concentrate. #ne .uarter of nurses suffering fro*
se6ere inso*nia. >egarding ner6ousness% it was found t)at around one t)ird (3'.1G of nurses were suffering
fro* se6ere ner6ousness.


No. P)+sical )ealt) Ies No
Ies G No. G
1 S0in allerg+ 5C C!.3 2C 31.7
2 Pneu*onia C5 7E.3 17 2&.7
3 $aricose 6ein 53 C'.C 2E 35.'
' -atigue 2' 2E.3 5! 7&.7
5 ;eadac)e 2E 35.' 53 C'.C
C -ainting 53 C'.C 2E 35.'
7 Ara*ps 53 C'.C 2E 35.'
! Sto*ac)ac)e 51 C2.2 31 37.!
E (cidit+ 5C C!.3 2C 31.7
1& 2ecrease in )earing ade.uac+ 55 C7.1 27 32.E
11 1ac0 pain 21 25.C C1 7'.'


No.


Para*eters
S
e
6
e
r
e

/
o
d
e
r
a
t
e

J
o
w

No. G No. G No. G
1 E<)austion 1E 23.2 52 C3.' 11 13.'
2 2ifficulties to concentrate 17 2&.7 '7 57.3 1! 22.&
3 Inso*nia 21 25.C '' 53.7 17 2&.7
' Ner6ousness 2! 3'.1 3E '7.C 15 1!.3
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&7
=a4le 5. >elations)ip 4etween *ean of total sources of wor0 related stress and% gender% *arital status% :o4
position% total e<perience% past e<perience% )ospital% and educational degree
Ite*s /ean of stress N Std. 2e6iation - Sig
Dender
-e*ale 2.C'5E 51 &.5&3&7
&.&11

&.E1! /ale 2.C33! 31 &.5'&!3
/arital status
/arried 2.C!!7 '1 .51'2&
&.CE2

.'&! Single 2.5E'& '1 .51C52
Jo4 position
Practical nurse 2.C'71 32 .'E'&!
&.!51

.'31 Staff nurse 2.CCE3 '5 .533!2
;ead nurse 2.352E 5 .'C73C
Past Experience
Jess t)an 5 +ears 2.55!! 3C .'!C55 &.!5E &.'2!
5-1& +ears 2.72&1 31 .5C7&C
a4o6e 1& +ears 2.C7C5 15 .'CC2'
Aurrent :o4 e<perience
Jess t)an 5 +ears 2.C5CC '3 .'E751 &.&7E &.77E
5 +ears and *ore 2.C2'' 3E .53!3E
;ospital
=)a4et =)a4et 2.7773 1' .5217! '.5!7 .&13
>afedia 2.'77& '1 .'E3!E
?)alil Solai*an 2.!2&3 27 .'7C5!
Educational le6el
2iplo*a 2.51'7 1! .'3!37 2.C5! &.&7C
1ac)elor 2.C23C 5' .5277C
/aster 2.EC'7 1& .'77''
=a4le 5 re6ealed t)at a )ig)l+ statisticall+ significant relation 4etween )ospitals and total *ean of sources of
stress (pX&.&13. (lso it was re6ealed t)at no statistical significant relation a*ong total *ean of sources of
stress and +ears of past e<perience% current :o4 e<perience% gender and educational le6el.

=a4le C. =)e relations)ip 4etween t)e sources of :o4 stress and p)+sical )ealt) pro4le* and *ental )ealt)
pro4le*s
Ite*s /ean of stress N Std. 2e6iation t. test Sig

Sources of :o4 stress 2.C'13 !2 &.51'3! 22.7C! &.&&1
P)+sical )ealt) pro4le*s 1.'27E !2 &.2'&E'

Sources of :o4 stress 2.C'13 !2 &.51'3! 1&.132 &.&&&
/ental )ealt) pro4le*s 2.&732 !2 &. 5&!'&
=a4le C re6ealed t)at a )ig)l+ statisticall+ significant relation 4etween p)+sical )ealt) pro4le*s and total *ean
of sources of nursing :o4 stress (pX&.&&1. (lso it was re6ealed statistical significant relation a*ong total *ean
of sources of nursing :o4 stress and *ental )ealt) pro4le*s (pX&.&&& .

5) $iscussion
=)is stud+ was a cross section design. =)e sa*ple of !2 nurses *et t)e criteria for participation. Participants
were wor0ing on selected units.
Eig)t+ two participants (NP!2 co*pleted de*ograp)ic data for*s as well as t)e sources of :o4 stress scale%
p)+sical )ealt) pro4le*s scale% and *ental )ealt) pro4le*s scale.
(ccording to t)e first )+pot)esis t)e stud+ results )a6e s)own t)at t)e *ost co**on t+pe of wor0-related stress
for Palestinian nurses was due to deat) and d+ing followed 4+ wor0load. =)ese results were in accordance wit)
A)ang et al. (2&&C% Ja*4ert et al. (2&&7% /ousta0a and Aonstantinidis (2&1&% and /osadeg)rad (2&13.
A)ang et al. (2&&C added t)at statisticall+ significant correlations 4etween stressors and wor0load. Ja*4ert et al.
(2&&7 reported t)at a )ig) le6el of wor0place stressors is related to wor0load and dealing wit) deat) and d+ing.
/ousta0a and Aonstantinidis (2&1& s)owed reported t)at aspects of t)e wor0 itself can 4e stressful as wor0
o6erload. /osadeg)rad (2&13 concluded t)at t)e *a:or sources of stress was too *uc) wor0.
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&!
-or t)e second )+pot)esis% t)e stud+ re6ealed t)at t)ere wasnBt difference 4etween *ale and fe*ale nurses
according to :o4 stress and t)is is inconsistent wit) (/+)ren% E0e4erg H Sto0land% 2&13. /+)ren% E0e4erg H
Sto0land ( 2&13 s)owed t)at t)e fe*ales scored )ig)er t)an *ales on 6ulnera4ilit+ to :o4 stress. =)is *a+ due
t)at )alf of t)e nurses is single and *ales ta0e nig)t s)ift instead of fe*ale nurses as t)e *ale nurses *a+ wor0
anot)er wor0 in *orning s)ifts. (lso% t)e stud+ re6ealed t)at t)ere wasnBt difference 4etween past e<perience
le6els of nurses and :o4 stress and t)is is inconsistent wit) (/+)ren% E0e4erg H Sto0land% 2&13. /+)ren%
E0e4erg H Sto0land (2&13 s)owed t)at t)e e<perienced staff were less 6ulnera4le t)an ine<perienced staff to
:o4 stress. =)is *a+ due to despite of e<perience t)ere wasnBt training progra*s focuses on su4:ects related to
critical issues in IA5 and neonate. (t t)e sa*e ti*e% t)e stud+ re6ealed t)at t)ere wasnBt difference 4etween
educational le6el of nurses and :o4 stress and t)is is inconsistent wit) Preto and PedrOo (2&&E. Preto and PedrOo
(2&&E s)owed t)at t)e nurses wit) no post-graduation education s)owed a )ig)er le6el of stress t)an nurses wit)
at least one speciali8ation. =)is *a+ due to no presence of specific :o4 description for nurses.
(ccording to t)e t)ird )+pot)esis% t)e stud+ re6ealed t)at t)ere are relations)ip 4etween sources of nursing :o4
stress and p)+sical )ealt) pro4le*. =)is is consistent wit) pre6ious studies (A)ang et al.% 2&&CF /o:o+inola 2&&!F
/ousta0a and Aonstantinidis% 2&1&F (l ;osis% /ersal and ?es)0% 2&13.
(lso% for t)e fourt) )+pot)esis t)e stud+ re6ealed t)at t)ere are relations)ip 4etween sources of nursing :o4
stress and *ental )ealt) pro4le*. =)is is consistent wit) pre6ious studies (2&&C% /o:o+inola (2&&!%
;asan8ade) and (tas)puor (2&1&% (l ;osis% /ersal and ?es)0 (2&13.

7) %onclusion
Stud+ results )a6e s)own t)at t)e *ost co**on t+pe of wor0-related stress for Palestinian nurses was due to
dealing wit) deat) and d+ing followed 4+ wor0load. /ost of nurses were suffering fro* p)+sical and *ental
illnesses. #ur stud+ pro6ed a )ig)l+ statisticall+ significant relation 4etween *ental pro4le*s and wor0ing stress
and statisticall+ significant relation 4etween wor0ing stress% p)+sical pro4le*s

(9) Recommendation
() Recommendations related to research
Potential areas for future stud+ include replicating t)is stud+ using a larger sa*ple. Nualitati6e researc) could 4e
used to e<plore and descri4e t)e e<periences of nurses in t)e wor0 en6iron*ent and future researc) on t)e
effects of stress *anage*ent.
+) Recommendations related to nursing practice
=)e findings of t)e stud+ would appear t)at organi8ational inter6entions at reducing t)e i*pact of stressors suc)
as wor0load (t)at is% pro6iding *ore staff to ade.uatel+ co6er unit *ig)t 4e *ore appropriate and *a+ 4enefit
so*e staff *ore t)an stress *anage*ent. E*plo+ing *ore nurses is an o46ious potential re*ed+ for reducing
wor0load% increasing clerical staff to reduce non-nursing tas0s.
/) Recommendations for health polic# makers
1- Pro*oting pro*pt% constructi6e resolution of conflicts.
2- Ps+c)ological counseling and t)erap+ s)ould 4e easil+ accessi4le and a6aila4le for trou4led staff *e*4ers.
3- Policies t)at reduce stress fro* s)ift wor0 s)ould 4e de6eloped. =)ese could include reducing t)e nu*4er of
)ours of t)e nig)t s)ift% increasing t)e rest ti*e 4etween s)ifts% pro6iding ade.uate *eal ti*es% and pro6iding a
fair distri4ution of wee0end and )olida+ wor0.
'- Support group for nursing personnel is reco**ended
(() Ackno'ledgement"
=)e researc)ers are grateful to t)e nurses in t)e t)ree go6ern*ental )ospitals for t)e participation in t)is stud+% to
t)e /inistr+ of )ealt) ad*inistration of Palestine% and to t)e (ra4 (*erican 5ni6ersit+ for )elp and support.
References
(4u (l->u4% >.-.% Jo4 stress% :o4 perfor*ance% and social support a*ong )ospital nurses. Journal of Nursing
Sc)olars)ip% 2&&'. 3C(17 p. 73-7!.
(l ;osis ?).% /ersal -. and ?es)0 J. (2&13% Effects of Jo4 Stress on ;ealt) of Saudi Nurses @or0ing in
/inistr+ of ;ealt) ;ospitals in Nassi* >egion in ?S(. Jife Science Journal 2&13F1&(17 1&3C-1&''
(l6es S.(2&&5. ( stud+ of occupational stress% scope of practice% and colla4oration in nurse anest)etists
practicing in anest)esia care tea* settings. ((N( Journal. $ol. 73(C7 p. ''3-'52.
(ntigoni -.% Pediadita0i #.% and 2i*itrios =. (2&117 Nursing staff under )ea6+ stress7 focus on Dreece ( critical
re6iew% International Journal of Aaring Sciences% $ol. ' (17 11-12
(tindan4ila S.% (4asi*i E.% and (ni* /.% (2&12. ( Stud+ of @or0 >elated 2epression% (n<iet+ and Stress of
Nurses at Pantang ;ospital in D)ana. >esearc) on ;u*anities and Social Sciences%2%(E71-!
1egat I.% Ellefsen 1.% H Se6erinsson E. (2&&5. Nurses3 satisfaction wit) t)eir wor0 en6iron*ent and t)e
outco*es of clinical nursing super6ision on nurses3 e<periences of well-4eing -- a Norwegian stud+. Journal of
Nursing /anage*ent% 13(3% 221-23&.
Journal of Education and Practice www.iiste.org
ISSN 2222-1735 (Paper ISSN 2222-2!!" (#nline
$ol.5% No.21% 2&1'

1&E
A)ang E% 2al+ J% ;ancoc0 ?% 1idewell J% Jo)nson (% Ja*4ert $ and Ja*4ert A (2&&C. =)e relations)ips
a*ong wor0place stressors% coping *et)ods% de*ograp)ic c)aracteristics and )ealt) in (ustralian nurses% J Prof
NursF 22 (17 3&-!.
Edwards 2. (2&&3. ( s+ste*atic re6iew of stress and stress *anage*ent inter6entions for *ental )ealt) nurses.
Journal of (d6anced Nursing. $ol. '2(27 p. 2&&.
Edwards 2.% 1urnard P.% ;annigan 1.% Aooper J.% (da*s J.% Juggessur=.% Ao+le 2. (2&&C. Alinical super6ision
and 4urnout7 =)e influence of clinical super6ision for co**unit+ *ental )ealt) nurses. Journal of Alinical
Nursing% 15%1&&7T1&15.
Dolu4ic >.% /ilose6ic /.% ?ne8e6ic 1.% H /usta:4ego6ic J. (2&&E. @or0-related stress% education and wor0
a4ilit+ a*ong )ospital nurses. Journal of (d6anced Nursing% C5(1&% 2&5C-2&CC.
Dreenslade /. and Paddoc0 ?.% @or0ing conditions of nurses7 ( cause for concern.% 2&&7% ;ealt) Aanada7
#ttawa% #N% Aanada.
;asan8ade)(. and (tas)puor(. (2&1&#ccupational Stress and /ental ;ealt) of E*plo+ees of a Petroc)e*ical
Ao*pan+ 4efore and after Pri6ati8ation. International Journal of #ccupational and En6iron*ental /edicine.$ol
1 Nu*4er 27 75-7E
;urrel% J. and A. (risteguieta% #ccupational Stress% in #ccupational and en6iron*ental )ealt) 7 recogni8ing and
pre6enting disease and in:ur+% 1. Je6+% et al.% Editors. 2&&5% #<ford 5ni6ersit+ Press7 New Ior0% NI. p. 3!2-
3EC
?awano I. (2&&!. (ssociation of :o4-related stress factors wit) ps+c)ological and so*atic s+*pto*s a*ong
Japanese )ospital nurses7 Effect of depart*ental en6iron*ent in acute care )ospitals. Journal of #ccupational
;ealt)% 5&% 7ET!5.
?roen0e% A.;. (2&&7. @or0 c)aracteristics and incidence of t+pe 2 dia4etes in wo*en. (*erican :ournal of
epide*iolog+ 1C5 (27 p. 175-175.
Ja*4ert $.% Ja*4ert /.% Petrini% "/Ji I. L)ang (2&&77 @or0place and personal factors associated wit)
p)+sical and *ental )ealt) in )ospital nurses in A)ina. Nursing H ;ealt) Sciences E(2% 12&-12C.
/ar0 D. and S*it) (. P. (2&117 #ccupational stress% :o4 c)aracteristics% coping% and t)e *ental )ealt) of nurses%
1ritis) Journal of ;ealt) Ps+c)olog+% 2#I71&.1111K:.2&''- !2!7.2&11.&2&51.<%1717.
/et8ent)in P.% ;elfric)t S.% Joer4ro0s (.% =erris 2.% ;aug ;.% Su4ra*anian S.% H -isc)er J. (2&&E. ( one-ite*
su4:ecti6e wor0 stress assess*ent tool is associated wit) cortisol secretion le6els in critical care nurses.
Pre6enti6e /edicine% '!(5% 'C2-'CC.
/itc)ell =.% et al.% 1iops+c)osocial factors are associated wit) low 4ac0 pain in fe*ale nursing students7 a cross-
sectional stud+. International :ournal of nursing studies% 2&&E. 'C(57 p. C7!- C!!.
/o:o+inola J. (2&&!7 Effects of Jo4 Stress on ;ealt)% Personal and @or0 1e)a6iour of Nurses in Pu4lic
;ospitals in I4adan /etropolis% Nigeria% Et)no-/ed.% 2(27 1'3-1'!
/ousta0a and Aonstantinidis (2&1&. Sources and effects of @or0-related stress in nursing. ;ealt) Science
Journal. $ol. ' ('7 21& T 21C
/osadeg)rad (. (2&13 occupational stress and turno6er intention7 i*plications for nursing *anage*ent. Int J
;ealt) Polic+ /anag. 1(27 1CET17C
/+)ren ;.% E0e4erg #.%H Sto0land #. (2&13. Jo4 Satisfaction and 1urnout a*ong Intensi6e Aare 5nit Nurses
and P)+sicians. Aritical Aare >esearc) and Practice. $ol.2&13% P1-C
Preto1 $. and PedrOo J.(2&&E Stress a*ong nurses w)o wor0 at t)e intensi6e care unit. >e6 Esc Enfer* 5SP
2&&EF '3('7!3!-'5
Sc)nall% P.% 2o4son /.% and >oss0a* E. (2&&E. @or0% Ps+c)osocial Stressors% and t)e 1otto* Jine% in
5n)ealt) @or07 Aauses% Aonse.uences% Aures% P. Sc)nall% /. 2o4son% and E. >oss0a*% Editors. 1a+wood
Pu4lis)ing Ao*pan+% Inc.7 (*it+6ille% NI. p. !7.
=o)% S.% (ng E.%H 2e6i% /. (2&12. S+ste*atic re6iew on t)e relations)ip 4etween t)e nursing s)ortage and :o4
satisfaction% stress and 4urnout le6els a*ong nurses in oncolog+K )ae*atolog+ settings. International Journal of
E6idence-1ased ;ealt)care% 1&% 12CT1'1.
$a)e+ 2.% (i0en J.% Sloane 2.% Soc)als0i J.% 1usse >.% Alar0e ;. (2&&'FNurse 4urnout and patient satisfaction.
/ed Aare. '2 Suppl7 II-57-CC. /edline71'73'E'3
@el0er-;ood% ?. (2&&C7 2oes wor0place stress lead to accident or errorV7 /an+ nurses feel t)e pressure.
(*erican Journal of Nursing 1&C(E% 1&'.
Iau S.% "iao ".% Jee J.% =sang (.% @ong S.% H@ong ?. (2&12. Jo4 stress a*ong nurses in A)ina. (pplied
Nursing >esearc)% 25% C&TC'. doi71&.1&1CK:.apnr.2&11.&7.&&1


The IISTE is a pioneer in the Open-Access hosting service and academic event
management. The aim of the firm is Accelerating Global Knowledge Sharing.

More information about the firm can be found on the homepage:
http://www.iiste.org

CALL FOR JOURNAL PAPERS
There are more than 30 peer-reviewed academic journals hosted under the hosting
platform.
Prospective authors of journals can find the submission instruction on the
following page: http://www.iiste.org/journals/ All the journals articles are available
online to the readers all over the world without financial, legal, or technical barriers
other than those inseparable from gaining access to the internet itself. Paper version
of the journals is also available upon request of readers and authors.

MORE RESOURCES
Book publication information: http://www.iiste.org/book/

IISTE Knowledge Sharing Partners
EBSCO, Index Copernicus, Ulrich's Periodicals Directory, JournalTOCS, PKP Open
Archives Harvester, Bielefeld Academic Search Engine, Elektronische
Zeitschriftenbibliothek EZB, Open J-Gate, OCLC WorldCat, Universe Digtial
Library , NewJour, Google Scholar