The Art of Nursing

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CONDITIONS OF WORK AND WELFARE
FACILITIES BRANCH

Working paper
CONDI/T/WP.4/1996

Work-related stress in nursing:
Controlling the risk to health

Professor Tom Cox and Dr. Amanda Griffiths
Center for Organizational Health and Development
University of Nottingham
with
Professor Sue Cox
Center for Hazard and Risk Management
Loughborough University of Technology

International Labour Office Geneva

Work-related stress in nursing:
Controlling the risk to health

Professor Tom Cox and Dr. Amanda Griffiths
Center for Organizational Health and Development
University of Nottingham
with
Professor Sue Cox
Center for Hazard and Risk Management
Loughborough University of Technology

Note: Working Papers are preliminary documents circulated
in a limited number of copies solely to stimulate discussion and critical comment.

International Labour Office Geneva

Prelim page ii
Copyright page

ISBN 92-2-............

iii

Table of contents

Table of contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Part 1. Stress in nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.1.

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.2.
Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1.3.
Work hazards, stress and health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 1.4.
Psycho-social hazards and stress in nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 1.5.
Generality of findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 1.6.
Health effects of stress in nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 1.7.
Stress management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 1.8.
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Part 2. How to tackle stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1.

The control cycle: A practical approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Case study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2.

Risk assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Step 1. Problem recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Step 2. Analysing work-related stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Step 3. Estimating and evaluating the risk . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3.

Design of stress management strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Level of control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Target . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Implementation agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Agency-target pairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....
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