Patient-related stressful situations and stress-related outcomes in emergency nurses: A cross-sectional study on the role of work factors and recovery during leisure time.

BACKGROUND: Emergency nurses are frequently exposed to patient-related stressful situations, making them susceptible to emotional exhaustion and symptoms of post-traumatic stress disorder. The current study aims to assess differential effects of patient-related stressful situations (emotionally demanding situations, aggression/conflict situations, and critical events) on stress-related outcomes in emergency nurses, and to identify moderating factors based on the Job Demands-Resources model and the Effort-Recovery model (job demands, job resources, and recovery experiences during leisure time). METHOD: A cross-sectional study was carried out among nurses working in the emergency departments of 19 hospitals in the Netherlands (N = 692, response rate 73%). Data were collected by means of an online survey. Multiple hierarchical regression analyses were performed, controlling for sociodemographic variables. RESULTS: The frequency of exposure to patient-related stressful situations was positively related to stress-related outcomes, with emotionally demanding situations and aggression/conflict situations mainly explaining variance in emotional exhaustion (ß = 0.16, p < .01, ∆R² = 0.08, and ß = 0.22, p < .01, ∆R² = 0.13), whereas critical events mainly explained variance in post-traumatic stress symptoms (ß = 0.29, p < .01, ∆R² = 0.11). Moderating effects were found for within worktime recovery and recovery during leisure time. Work-time demands, autonomy and social support from the supervisor were predictive of stress-related outcomes irrespectively of exposure to patient-related stressful situations. CONCLUSION: As patient-related stressful situations are difficult if not impossible to reduce in an emergency department setting, the findings suggest it would be worthwhile to stimulate within worktime recovery as well as recovery experiences during leisure time, to protect emergency nurses from emotional exhaustion and symptoms of post-traumatic stress. Furthermore, this study underscores the importance of reducing work-time demands and enhancing job resources to address stress-related outcomes in emergency nurses. Practical implications, strengths and limitations are discussed.

Goal commitment to finding a partner and satisfaction with life among female singles: the mediating role of rumination.

In this cross-sectional study among 1502 female singles between the ages of 18 and 50, commitment to the goal of finding a partner was negatively related to satisfaction with life. In line with our expectations, this relationship was fully mediated by ruminating about being and remaining single. The relationship between rumination and lower satisfaction with life was stronger in the older age groups. The findings support the notion that rumination is an important mechanism through which goal commitment may negatively influence well-being, and that reducing one's level of commitment to the pursuit of stage-specific life goals may be beneficial when reaching a new developmental stage.

Medical care-seeking and health-risk behavior in patients with head and neck cancer: the role of health value, control beliefs and psychological distress.

Health behavior plays an important role in the development, detection and course of cancer of the head and neck. Relevant health behavior includes prompt medical care seeking, and smoking and drinking cessation after diagnosis. This study examines the relationship between these health behaviors and health value and control beliefs, as well as psychological distress. Two hundred and sixty-four recently diagnosed head and neck cancer patients were interviewed about their health behavior, and they filled in a questionnaire on health beliefs and psychological distress. The results showed that one-quarter (25%) of the patients had waited more than 3 months before seeking medical care, 50% had continued to smoke and 80% had continued to drink after the diagnosis. The patients, particularly those who smoked and drank before diagnosis, reported lower levels of health value and perceived health competence than a general population sample with which they were compared. Patients who engaged in patient delay reported a lack of perceived health competence. Psychological distress and lack of perceived health competence were found to be more common among patients who continued to smoke. The implications of these findings are discussed with regard to interventions aimed at promoting these specific health behaviors.

The Revised Health Hardiness Inventory (RRHI-24): psychometric properties and relationship with self-reported health and health behavior in two Dutch samples.

Our objective was to examine the psychometric properties of a Dutch translation of the Health Hardiness Inventory (HHI), and to determine relationships between health hardiness scales and self-reported health and preventive health behavior. Data from a cross-sectional study with two samples [a general population sample (n = 205) and a student sample (n = 286)] were analyzed. The Revised Health Hardiness Inventory (RHHI-24) was found to consist of four stable and reliable scales: (1) Health Value, (2) Internal Health Locus of Control, (3) External Health Locus of Control and (4) Perceived Health Competence. Women valued their health more than men, older individuals (> 45 years) valued their health more than younger individuals (< or = 45 years) and elderly people (> 65 years) were more externally orientated with respect to health locus of control. Preventive health behavior was related to a higher value placed on health, a lower external health locus of control and a higher perceived health competence. Better self-reported health was related to a higher perceived health competence and a more internally orientated health locus of control. We conclude that the RHHI-24 is a theoretically sound instrument for the measurement of health cognitions.

Conflicting activities for exercise.

190 nonexercisers foresaw regular exercise (> or = 3 times a week) as interfering with day-to-day activities. Most frequently mentioned were various social activities, doing household chores, and watching TV. The impediment of all activities, except watching TV, was expected to be at least rather bothersome. Interventions should focus on these particular barriers to action.