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Stress Control Strategies for Nurses


The ever-changing conditions of the modern world may lead to various psychological problems, disorders, and illnesses, including stress, frustration, nervous overstrain, depression, etc. The organization of the work of nurses that is closely associated with interpersonal communication becomes an object of increasing attention in recent years. The problem of the occupational stress or the syndrome of burnout is regarded as a multidimensional phenomenon expressed in mental and physiological responses to a wide range of situations, while the negative effects are considered in several planes: the impact on the results of labor and mental health of nurses. This paper proposes the importance of stress control strategies to reduce burnout in nurses, focusing on the emotional intelligence model, innovative mindfulness-based stress reduction program, and multi-factor coping behaviors.

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As a dependent variable, it is possible to consider the level of burnout in nurses and stress reduction models as dependant ones. The term burnout refers to a syndrome arising from the prolonged occupational stress and affecting a person and his or her interaction with others in a negative way expressed in aggression, irritation, inattention, etc. With this in mind, the hypothesis for the perspective research may be identified as follows: the implication of stress control theories is likely to reduce burnout rates in nurses.

Theoretical Framework

The psychological stress theory (PST) will be used as a theoretical framework for the proposed research due to its focus on the cognitive approach. In particular, the mentioned theory developed by Lazarus implies the study of stress as an individual reaction of a person determined by his or her subjective assessment of threats (stress factors) and resources to overcome them (Rice, 2012).

In other words, the theory by Lazarus prioritizes the vision of a person regarding his or her environment and specific reaction to the assessment of the world. Considering that every person is a unique human being, such a theory is likely to integrate several aspects, including personal and environmental, to address the challenge in terms of the individual approach. The psychological stress is defined as a certain relationship between a person and the excessive demands of the environment, which is due to the excess of resources and the creation of a threat to personal well-being (Rice, 2012). This state is viewed as a process, cognitive evaluation of which is the main regulating factor of reaction to occupational stress.

The proposed theoretical framework seems to be a rather important instrument, specifying the very approach to the study. Considering burnout reduction from the psychological view, it will be possible to understand how stress control models affect a nurse in the workplace and which of them are the most effective. More to the point, PST provides the basis for the study, viewing a nurse in terms of cognitive aspect. The concepts to be explored in the proposed study are stress, burnout, stress reduction models, and the role of cognition in stress coping.

Review of the Literature

The scholarly literature regarding the specified topic is presented by various theoretical and practical studies. Epp (2012) defines burnout as “high emotional exhaustion; depersonalization, cynicism, or detachment; and low levels of personal effectiveness or accomplishment” (p. 25). The comparison of the features of the formation and course of burnout syndrome in different professional groups shows that this phenomenon is most often encountered in representatives of the professions belonging to human systems that apply to nurses as well.

At present, more and more strategies are used with the aim of reducing and overcoming burnout rates. Some of them, such as emotional intelligence, focus on increasing awareness in nurses by continuously informing them and training on early signs of burnout and the related risk factors (Görgens‐Ekermans & Brand, 2012). The sooner nurses find out about how the syndrome arises and what the characteristic features are, the more they have the ability to avoid or reduce it.

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The transactional theories is another option that implies the special courses, lectures, and training sessions on the development of effective nurse-patient communication and skills to overcome burnout that are typically included in the curriculum. Mark and Smith (2012) state that “transactional theories of stress place emphasis not just on job characteristics, but also on subjective perceptions of stressors, and individual differences in ways of coping, viewing problems, past experience, personality-type” (p. 508).

In these models, a gradual transformation of the subjective vision and understanding of the situation is carried out, using various strategies for overcoming professional stress, including such aspects as emotional (actualization of feelings and reduction of emotional tension), cognitive (reevaluation of the situation and resources for the problem resolution), and behavioral (active and purposeful change of the situation). The most effective are group forms of training aimed at professional and personal growth and increase of the communicative competence

In their study, Bazarko, Cate, Azocar, and Kreitzer (2013) explore the impact of Mindfulness-Based Stress Reduction (MBSR) program, concluding that it contributes to the significant positive outcomes in those nurses that participate in the experiment. More to the point, the authors note that it is a feasible and cost-effective method.

In their turn, Happell et al. (2013) emphasize the importance of multi-factor coping behaviors that may involve but not limited to workload modification, changing shift hours, “forwarding suggestions for change, music, special events, organisational development, ensuring nurses get breaks, massage therapists, acknowledgement from management and leadership within wards” (p. 638). Thus, the brief literature review shows that the topic of burnout in nurses presents the relevant problem that needs to be studied in an in-depth manner to reveal the potential solutions.


The qualitative research design will be used to conduct the proposed research. In particular, a series of interviews and questionnaires will be offered to nurses of the local hospital to complete. This type of research aligns well with the purpose of the study and the selected theoretical framework, allowing focusing on qualitative data and understanding the effects of stress control measures through communication with the respondents. The randomized-controlled trial will be used as the study design to ensure reliability of the collected data by minimizing the occurrence of bias and facilitating credible results.

The sample will include 50 nurses from different departments of the hospital regardless of age, sex, and ethnicity. The inclusion criteria will be the presence of burnout and the consent to participate in the proposed study. As a sampling method, random sampling will be applied since it helps to provide the purest form of probability and equal opportunities for every participant to be involved in the study. The hospital’s guest room will be used to conduct interviews, and questionnaires may be completed online and sent via email for convenience of respondents. The face-to-face interviews and web-based questionnaires will compose data collection instruments. The process of data collection will take approximately one month.

The protection of human subjects will be ensured by the informed consent that will enumerate all the points regarding ethics of the research. All the respondents will receive this document in advance and participate voluntarily. The aim of the study as well as the procedures to be used and other related information will be provided, and confidentiality of respondents will be guaranteed.

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Data Analysis

In order to analyze the collected data and present rich description of the results, qualitative data analysis will be applied. The inductive content analysis will be used to interpret information received from participants and make the corresponding conclusions. As a method of scientific knowledge, induction is the formulation of the logical reasoning by generalizing the data of observation and experiment.

Since this method is oriented to the analysis of qualitative information, the received verbal and written information will be compressed to have it in a more compact form. In this case, encoding will act as the key compression technique. Coding will involve the selection of semantic segments of the text and the subsequent categorization and reorganization. The analyzed data will be displayed in diagrams and tables accompanied with the detailed description and discussion. Thus, coding and visual representation of information will be the main methods of qualitative analysis in the proposed study.

Applicability to Nursing

Speaking of the applicability of the selected topic to nursing, it is important to point out that burnout becomes one of the core causes of nurses’ dissatisfaction by work and ineffectiveness of retention strategies. The work of a nurse is one of the most difficult in the world, since it requires increased dedication, constant improvement of one’s personal and professional skills, maximum concentration of attention, emotional stability, and constant sense of responsibility for the life and health of their patients. In case a nurse experiences burnout symptoms, it becomes rather difficult to meet patients’ expectations and provide high quality health care services. According to the recent report provided by Centers for Disease Control and Prevention, the work of nurses is considered one of the most stressful ones in healthcare (Rice, 2012).

In the light of the mentioned statements, it becomes evident that the proposed research is rather relevant to the modern needs of nurses and will contribute to both theory and practice of healthcare. In particular, the results of the study will serve as the guide for nurses and the theoretical basis for the perspective studies. Taking into account that the proposed study will focus on various stress control strategies, it is possible to point out its comprehensive manner and the opportunity to reveal the most effective measures, so that nursing knowledge will be enriched with the new prospects regarding stress coping. Such areas of nursing as communication with patients, self-awareness, and efficient collaboration with others in terms of teamwork are likely to benefit from the perspective study. It is expected that hospice palliative care nursing, critical care nursing, and occupational health nursing will be especially interested in the study as these areas are considered to be the most prone to stress.


Bazarko, D., Cate, R. A., Azocar, F., & Kreitzer, M. J. (2013). The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. Journal of Workplace Behavioral Health, 28(2), 107-133.

Epp, K. (2012). Burnout in critical care nurses: A literature review. Dynamics, 23(4), 25-31.

Görgens‐Ekermans, G., & Brand, T. (2012). Emotional intelligence as a moderator in the stress–burnout relationship: A questionnaire study on nurses. Journal of Clinical Nursing, 21(15), 2275-2285.

Happell, B., Dwyer, T., Reid‐Searl, K., Burke, K. J., Caperchione, C. M., & Gaskin, C. J. (2013). Nurses and stress: Recognizing causes and seeking solutions. Journal of Nursing Management, 21(4), 638-647.

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Mark, G., & Smith, A. P. (2012). Occupational stress, job characteristics, coping, and the mental health of nurses. British Journal of Health Psychology, 17(3), 505-521.

Rice, V. H. (2012). Handbook of stress, coping, and health: Implications for nursing research, theory, and practice (2nd ed.). New York, NY: Sage.

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