Associations between stressful working conditions and psychosomatic symptoms among Palestinian nurses: a cross-sectional survey.

Abstract Background Stressful working conditions among nurses have adverse effects on their physical and mental health. We investigated associations between self-reported stressful working conditions and psychosomatic symptoms among nurses in the Hebron district, occupied Palestinian Territory, and whether there are differences the sexes in the perceptions of working conditions and psychosomatic symptoms. Methods We did a cross-sectional survey between Oct 7 and Dec 10, 2012, among registered nurses in all health sectors in Hebron district. A nine-point ordinal scale of working conditions was used to categorise perception of stress as low, medium, or high, and seven psychosomatic symptoms were recorded on a checklist coded as never (0), seldom (1), occasionally (2), or often (3), allowing for a total score between 0 and 21. All analyses were done with STATA (version 10). P values of less than 0·05 were significant. Participation in the study was voluntary, and written informed consent was obtained from each participant. The study was approved by the Regional Committee for Medical and Health Research Ethics, Norway. Permission to do the study was obtained from the Palestinian Ministry of Health. Findings Among 372 eligible nurses, ten were on extended leave from work, 16 declined to participate, and four had incomplete data, giving a final sample of 342 nurses (92% response rate). 212 (62%) were women and 130 (38%) were men. Low levels of stress were reported by 42 (12%) nurses, medium levels by 206 (60%), and high levels by 94 (28%). The mean score of psychosomatic symptoms for the group was 10·4 (SD 4·02, range 0–21). Scores did not differ significantly between men and women. Mean symptom scores differed between nurses with self-reported highly stressful working conditions and those with low levels of stress (12.6 vs 8.4, difference 4·1, 95% CI 2·7–5·5; p Interpretation We found that psychosomatic symptoms increased as self-reported perception of stressful working conditions increased, irrespective of sex. The study had a cross-sectional design and both exposure and outcomes were measured using self-report and, therefore, interpretation of the results should be made with caution. Longitudinal epidemiological studies are recommended. Future studies should investigate whether stressful working conditions affect the quality of patients’ care in health services. Funding Norwegian Programme for Development, Research and Education.