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Distress, psychosomatic and self-restraint among staff nurses in Kerala.

Health care workers have often to face suffering and death. Although nurses have been taught to prevent, care for and relieve pain, they are not always capable of tackling death and pain as components of life (Field 1984, GarcoAa Aguilar et al. 1995).Stress in nurses is an endemic problem. It contributes to health problems in nurses and decreases their efficiency. Nurses who work in hospitals face heavy workloads, occupational stress, ethical dilemmas, and conflicting demands as part of their everyday life. Those may result in psychological stress, psychiatric morbidity. This study aimed to explore the distress, psychosomatic and self-restraint condition among staff nurses in four district of Kerala. A cross-sectional design with randomized sampling was used: 450 staff nurses were recruited from several government hospitals in Kerala. Data were collected using the questionnaires. The result revealed that there was no correlation between distress and self-restraint among staff nurses, there was positive correlation between distress and psychosomatic among staff nurses, there was negative correlation between self-restraint and psychosomatic among staff nurses, there was no significant difference between single staff nurses and married staff nurses on distress variable, there was no significant difference between single staff nurses and married staff nurses on psychosomatic variable and there was no significant difference between single staff nurses and married staff nurses on self-restraint variable. Recommendations: suitable strategy in health care organization to investigate stress and the psychological disease like distress, psychosomatic, depression and the other symptoms in health care settings is recommended.

Key Word: Staff Nurses, distress, psychosomatic, self-restraint.

INTRODUCTION

Nurses often provide care for patients and families who are suffering and were emotions are heightened. Compassion is an essential component of the care that nurses provide. Emotions play an important role in the relationship and communication between nurses. Emotionally intelligent persons perceive themselves as confident, better able to understand, control and manage their emotions. According to Folkman et al. (1986) the use of self-restraint in the work place may facilitate problem solving by allowing employees to concentrate on the task. The task of providing information to relatives of seriously ill patients is hard for nurses they need self-restraint and communication skills, skills as behaviours that in a given situation optimism positive results in the short and long term. Most definitions characterize distress as an aversive, negative state in which coping and adaptation processes fail to return an organism to physiological and psychological homeostasis ( Carstens and Morberg, 2000). Distress can follow both acute and chronic stress, provided that the body's biological functions are sufficiently altered and its coping mechanisms overwhelmed. The transition of stress to distress depends on several factors, of importance are stressors duration and intensity, either of which is likely to produce behavioral or physical signs of distress. For example, short-term restraint does not cause marked problems in adaptation, whereas prolonged restraint can result in behavioral or physiological distress sometimes expressed by vocalization or gastric ulcers. Distress may not always manifest itself with recognizable maladaptive behaviors, such as abnormal feeding or aggression, but instead with subclinical pathological changes, such as hypertension and immune suppression, which are not behavioral identifiable, (Carstens & Morberg 2000). Prior research has suggested that nurses, regardless of workplace or culture, are confronted with a variety of stressors. As the worldwide nursing shortage increases, the aged population becomes larger, there is an increase in the incidence of chronic illnesses and technology continues to advance, nurses continually will be faced with numerous workplace stressors.

People often experience bodily complaints when they undergo stress. The influence of mind on body is complex, mysterious and not yet fully understood. Particularly is the conversion of unpleasant and unacceptable thoughts and feelings into somatic symptoms. Nevertheless to some extent, it is possible to understand the influence of mind on body by tracing the psychopathology of somatization. Usually, every person experiences some form of somatic symptoms like mind aches and pains in their life. But all these limited symptoms are not diagnosed as somatoform disorders. Self-restraint has important role among the profession in health care institute especially in nurses, self- restraint is the ability to control the feelings and stop from doing things that are not right or sensible.

Objectives :

1- To calculate the correlation among the variables, distress, psychosomatic and self-restraint conditions among staff nurses who are working in hospitals.

2- To study whether there will be any difference among staff nurses categorized on the basis of marital status for the variables under study.

METHOD

Sample: The study sample includes 450 of staff nurses who are working in government hospitals, in (kollam, Thiruvananthapuram, Ernakulam and Malappuram) of Kerala state in India.

Materials: The different variables selected for present investigation are distress, psychosomatic and self-restraint that measure by following tools.

1. Somatization of Emotional Conflict Scale. (SECS).

2. Weinberger Adjustment Inventory- long form, (WAI), it has three sub scales include: distress self-restraint and defensiveness.

3. Personal data sheet.

RESULT AND DISCUSSION

The details of the Pearson correlation used among staff Nurses on

distress, psychosomatic and self-restraint variables are given in table.1

The correlation analysis of the variables Distress and psychosomatic on the sample (N= 450), was found r = .257 (**), P < 0.01, which was statistically significant. The result showed that there was statistically positive correlation between Distress and psychosomatic variables among staff nurses.

The correlation analysis of the Distress and Self-restraint variables on the sample (N = 450), was found r = -.073, P > 0.05, which was not statistically significant correlation. The result show that there was no statistically significant correlation between Distress and Self-restraint variables among staff Nurses.

The correlation analysis of the Self-restraint and Psychosomatic variables on the sample (N = 450), was found r = -.097 (*), which was statistically significant correlation at 0.05 level. This mean that self-restraint increase in value the psychosomatic decrease in value, thus, there was statistically negative correlation between self-restraint and Psychosomatic variables among staff Nurses.

Comparison of staff Nurses categorized on the basis of marital status for the Distress variable:

Table 2 revealed that the mean values obtained for the Distress variable by single (N= 105) and married (N= 345) were, 81.06 and 82.08 and the corresponding standard deviation were 10.60 and 8.960. The t value obtained was .980 which was not statistically significant. The result indicated that there was no statistically significant difference between single staff Nurses and married staff Nurses on Distress variable. From the mean values, according to 95% confidence interval of the difference, it was clear that the single staff Nurses were similar level of Distress compared to married staff Nurses. In this study marital status has no effective role on the staff nurses about distress.

Comparison of staff Nurses categorized on the basis of marital status for the psychosomatic variable:

Table 3 revealed that the mean values obtained for the Somatization Emotional conflict variable by unmarried (N= 105) and married (N= 345) were, 36.90 and 36.07 and the corresponding standard deviation were 15.87 and 16.85. The t value obtained was .447 which was not statistically significant. The result indicated that there was no statistically significant difference between unmarried staff Nurses and married staff Nurses on Somatization Emotional conflict variable. From the mean values, it is clear that the unmarried staff Nurses were similar level of Somatization Emotional conflict compared to married staff Nurses.

Comparison of staff Nurses categorized on the basis of marital status for the Self-restraint variable:

Table 4 revealed that the mean values obtained for the Self-Restraint variable by single (N= 105) and married (N= 345) were, 107.41 and 109.11 and the corresponding standard deviation were, 7.968 and 7.937. The t value obtained was 1.916 which was not statistically significant.

The result indicated that there was no statistically significant difference between single staff Nurses and married staff Nurses on Self-Restraint variable. From the mean values, it is clear that the single staff Nurses were similar level of Self-Restraint compared to married staff Nurses. In this study marital status has no effective role on the staff nurses about self-restraint variable.

Conclusion : Staff nurses face a range of problems at work and society. The problems vary according to the task being undertaken at work and these factors ultimately produce them stress, Distress, psychosomatic and self-restraint and the other psychological problems. Stress, distress and psychosomatic are many studied in populations of nurses for several reasons. These reasons include the fact the nursing is large health care professional body, it has been linked to a high incidence of burnout, the very nature of nursing is based on empathy, compassion and humanization of medicine and nurses as professionals are involved with people on an extremely personal level in an environment that is not always conductive to positive consequences. The findings of this study will be helpful to better comprehend the nurses situation to find the suitable strategies for decrease their stress, distress, psychosomatic conditions. Suitable strategy in health care organization to investigate stress and the psychological disease like distress, psychosomatic, depression and the other symptoms in health care settings is recommended.

Reference

Carstens E, & Moberg GP (2000). Recognizing pain and distress in laboratory animals. ILAR J 41:62-71.

Field D.(1984), 'we didn't want him to die on his own'- nurses account of nursing dying patients. Journal of advanced nursing, 9, 59-70

Folkman, S. & Lazarus R.S.(1988a). Coping as a mediator of emotion. Journal of Personality and Social Psychology 54.

Garcia Aguilar J.F., Camara Hurtado F. & Aparicio Ezcurra A. (1995). Comunicacion einformacion a los familiars en las unidades de cuidados intensivos. Enfermeria clinica 5, 99-104

Kohler, J.M & Grawitch, M. J (2006).Test of dynamic stress model for organization change: do males and females require different models?. An international review. 55 (2), 168-191.

Pryimachuk, S & Richards, DA (2007). Predicting stress in pre-registration nursing students. British journal of health psychology. 12, 125-144.

Snyder, C.R & Herbert, M (2001). Coping with stress. New York: Oxford University. PP. 68-88.

Trevisani & Daniele (2009). Potenziale umano. Metodi e tecniche di coaching training pre sviluppo delle performance. Milan: Franco angeli.pp, 73-74.

Received: August 18,2016

Revised: October 30,2016

Accepted : December 10, 2016

Masoomeh Kohan Sahlabadi (*) and A Basheer Kutty (**)

(*) Research scholar in psychology, Kerala University., (**) Associate Professor in Clinical Psychology, Department of Psychiatry, Medical College. Thiruvananthapuram, India
Table 1: Correlation between Distress, Psychosomatic and Self-restraint
among Staff Nurses

S.NO.  Variable            1    3

1      Distress            ( )   .073
2      Somatization of     ..
       Emotional Conflict       -.097 (*)
3      Self-restraint      ..   ( )

(*) Significant at the 0.05 level (**) Significant at the 0.01 level

Table 2: Data and result of staff nurses categorized on the basis of
Marital Status (single and married) for Distress variable

Variable  Marital  N    M      SD      t
          Status

Distress  single   105  81.06  10.60   .980
          married  345  82.08   8.960

Table 3: Data and result of staff nurses categorized on the basis of
Marital Status (single and married) for Psychosomatic variable

Variable            Marital  N    M      SD      t
                    Status

Somatization of     single   105  36.90  15.87  .447
emotional conflict  married  345  36.07  16.85

Table 4: Data and result of staff nurses categorized on the basis of
Marital Status (single and married) for Self-Restraint variable

Variable        Marital  N    M       SD     t
                Status

                single   105  107.41  7.968
Self-Restraint  married  345  109.11  7.937  1.916
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Article Details
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Title Annotation:Kerala, India
Author:Sahlabadi, Masoomeh Kohan; Kutty, A. Basheer
Publication:Indian Journal of Community Psychology
Article Type:Report
Date:Mar 1, 2017
Words:1880
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