Abstract
Workplace stress and resilience in the Australian nursing workforce were the focus of this integrative review. According to the synthesis results, nurses are under a moderate to a high level of stress at any given time. Individual and organizational resources are used by nurses to cope with workplace difficulties. Job-life balance and arranging one’s work as a mindful technique, as well as self-reliance, passion, interest, positive thinking, and emotional intelligence as self-efficacy mechanisms, are included in the individual traits. Support services leadership and role modeling are two organizational tools that are utilized to foster resilience.
Only a small number of studies on resilience focus on workplace interventions, whereas the majority of studies focus on human traits and organizational resources for building resilience. This evaluation suggests that educational treatments be given more research focus in order to improve the mental health and well-being of nurses over the long term.
Introduction
A wide range of scientific and conceptual approaches have been used to define and quantify resilience. Adversity can be overcome within the constraints of an individual’s developmental and transformative continuum, which means that resilience is a dynamic and adaptive term. Stress in the workplace is becoming increasingly well-documented among nurses in Australia (Badu et al., 2020). Several causes, including organizational and individual ones, may be to blame for the stress. Consequently, it appears that nurses’ capacity for resilience is critical, given the high levels of psychological stress they face in their work environment.
Many empirical studies on workplace stress management have been prompted by this problem. The notion has been studied extensively, but only a few studies have managed to compile all of the available information into one cohesive whole (Badu et al., 2020). As part of this integrative review, the study conducted a preliminary search and found two studies that attempted to synthesis research on Australian workplace nurses’ stress and coping strategies and models of resilience. For this reason, this study aims at providing an integrative analysis of Australian nurses’ stress levels and resilience in order to alleviate workplace adversity.
Methods
Methodology
This integrative review followed Whittemore and Knafl’s methodology (2005). When doing an integrative review, researchers can incorporate both experimental and non-experimental methods and viewpoints to better understand the issue at hand. A holistic understanding of resilience in nursing is the goal of the integrative review approaches (Badu et al., 2020). An evidence-based practice for nursing can considerably benefit from this review technique. The process consists of five stages: problem identification, literature search, data evaluation, data analysis, and presentation of the results.
Information Sources
This integrative review used qualitative, quantitative, or a combination of methodologies. The researchers focused on studies that used quantitative randomized controlled trials, non-randomized designs (analytic cross-sectional) and quantitative descriptive research (Badu et al., 2020). The qualitative articles largely used phenomenology, grounded theory, narrative, ethnography and participatory methodologies.
There were studies in the integrative review that looked at all aspects of nursing staff resilience, including papers that looked at workplace stress and papers that looked at the role of resilience in alleviating workplace difficulties. It was decided to include only articles geared specifically toward Australian nurses (Badu et al., 2020). There were no publications included in the evaluation that didn’t address resilience in the nursing field; that focused on organizations outside the nursing environment; or that focused on new graduates and nursing managers. Nurses in these settings were not included since their stress and resilience may be different from those of their counterparts in the hospital.
Search Strategy
All peer-reviewed published studies on resilience and the coping methods used by Australian workplace nurses were included in the integrative review. EMBASE, CINAHL (EBSCO), Web of Science, Scopus, PsycINFO, and MEDLINE were used to search for published publications (Badu et al., 2020). The Joanna Briggs Institute (JBI) recommended protocols for conducting systematic reviews were followed when searching for published literature.
To find information, a three-step search approach was implemented. MEDLINE and EMBASE were searched in a limited manner, followed by an examination of the article’s title and abstract, as well as the keywords used to characterize it. The remaining five databases were then searched using the same set of keywords and index phrases (Badu et al., 2020). This was followed by a search of the citations in the reference lists of all the papers identified. Only studies written in English were included in the review. This review included studies published between January 2008 and December 2018.
Selection Process
Several phases were utilized to select articles for inclusion in the review. The titles of papers were evaluated by two authors, and those that matched the selection criteria were approved by both. The abstracts were evaluated by all authors, and they decided on which ones needed to be screened in full (Badu et al., 2020). All full-text papers were also checked by the authors to make sure they satisfied the inclusion criteria. Authors all used the PRISMA flowchart for systematic reviews to depict the selection processes.
Data Management and Collection
The data extraction was handled independently by two reviewers. Software such as Endnote X8 was used to manage the search results; screening; review of articles; and the removal of duplicate references. To deal with all aspects of data extraction, the authors created a data extraction form (Badu et al., 2020). In addition to consulting with methodologists and subject matter experts, the data extraction form was constructed in accordance with the Cochrane and JBI guides for systematic reviews. Data from the studies cited in this review was converted into numerical, tabular, and textual formats by the authors (Badu et al., 2020). The study details (citation, year of publication, author, contact details of lead author, and funder/sponsoring organization), methodological characteristics, study population, subject area existing interventions and outcomes, and additional information were extracted from the literature.
Data Synthesis
A mixed-methods synthesis was used to analyze the retrieved data. Quantitative and qualitative data were coded together by the authors Data display matrices were created to document all of the coded thoughts that were taken from the analyzed data. Each of the coded thoughts was assigned an alphabet and a color (Badu et al., 2020). Descriptive themes were derived from the codes derived from the quantitative and qualitative data. Individual (personal qualities), organizational (workplace or environmental), and external factors all play an important role in the development of workplace resilience. STATA version 15 was used to analyze the background information of the included publications and emerging codes.
Results
There were 406 papers retrieved from all databases searched, and 83 of them were deemed to be duplicates. Among the non-duplicate records, 323 papers were reviewed for eligibility, following which 266 were deemed ineligible. Data extraction and quality assessment of 57 full-text articles resulted in the identification of one paper and the exclusion of 17 others. The final synthesis comprised papers from a total of 41 sources (Badu et al., 2020). One study was found to be of medium quality out of the 41 papers that were evaluated for methodological quality.
It has been shown in a number of studies that the majority of Australian nurses are under moderate to high levels of stress while on the job. Workload, administrative and budgetary concerns, and dealing with the media are just a few examples of workplace stressors that researchers have identified in their research (Badu et al., 2020). Other studies have shown influences from the surrounding environment, such as job conflict or position ambiguity. It has been documented in three articles that nurses have been bullied at work. Poor therapeutic connections between nurses and patients and between nurses have been linked to workplace bullying in several studies.
A total of ten of the papers featured in this collection addressed the issue of burnout in the Australian nursing community. Several studies have found that nurses had moderate to high degrees of personal and work-related burnout. Additionally, psychiatric distress among Australian nurses was documented in ten articles (Badu et al., 2020). Several formal systemic support systems have the potential to improve the well-being of workplace nurses, according to four of the papers featured in this theme. Health promotion, healthy eating, nutrition, and smoking cessation therapies, as well as organizational commitment and interdisciplinary team collaboration, have been shown in several studies to help nurses’ well-being.
Discussion
Australian nurses’ stress levels and their ability to cope with adversity were examined in this comprehensive review. Stress levels are to be measured and evidence gathered on human qualities and organizational resources utilized to foster resilience are to be synthesized in this study. Many studies have found that Australian nurses are frequently subjected to workplace harassment and intimidation, which can cause them moderate to high levels of stress (Badu et al., 2020).
An increase in the amount of stress, anxiety, and depression among nurses has resulted in higher degrees of burnout, emotional detachment, and psychological detachment. There is also a considerable impact on burnout, anxiety and depression among nurses at work due to rising psychological distress (Badu et al., 2020). In most cases, nurses feel burnout, anxiety, and depression based on their own personal characteristics. Individual nurses, human resources management for nurses, and health care delivery are all affected by the increasing negative emotional condition of nursing workforce.
According to a recent research, nurses employ a variety of mindful tactics to encourage and learn about resilience in the workplace, as well. Indeed, mindfulness is a crucial concept that can help nurses create and maintain resilience in the workplace (Badu et al., 2020). Nurses use organizational or environmental elements to alleviate the consequences of occupational hardship, according to the synthesised evidence. Leadership, role modeling or mentorship, and support services are some of the organizational traits that can be employed to manage workplace difficulties.
Limitations
This integrative review has various flaws that must be addressed. The integrative review’s limitations relate to the search terms, language, geographical breadth, and publication era of the included studies. The review focused on workplace resilience among nurses in Australia. The papers included had to be published in English between January 2008 and December 2018. The search phrases for resilience and stress may have missed some relevant articles (Badu et al., 2020). A focus on publications published between 2008 and 2018 may have missed pertinent non-English-language articles published previous to 2008. As well as a critical appraisal tool used to measure the methodological quality helped overcome these issues.
Conclusion
Conclusions from this study show moderate to high stress amongst Australian nurses due primarily to workplace bullying. Aside from the significant levels of melancholy and anxiety that these nurses endure, they are also extremely burned out. Several personal characteristics and organizational resources have been identified in this study as resilient mechanisms for dealing with workplace stress. It is important for nurses to be self-reliant, have a good outlook, be emotionally intelligent, like their work, and be capable of juggling both their professional and personal lives well. Support services, leadership, and role modeling are some of the organizational resources employed to improve resilience. An further finding of the review is evidence of recent Australian trials aimed at improving healthcare institutions’ resilience.
Funding
The authors stated that they have received no outside funding for their work (Badu et al., 2020).
References
Badu, E., O’Brien, A. P., Mitchell, R., Rubin, M., James, C., McNeil, K.,… & Giles, M. (2020). Workplace stress and resilience in the Australian nursing workforce: A comprehensive integrative review. International journal of mental health nursing, 29(1), 5-34. Web.