INTRODUCTION:

Stress is a multi-dimensional concept and may be defined based on language and organizational perspectives. It often occurs when individuals’ physical and emotional do not match or cannot handle their job demands, constraints and/or opportunities (Leka et al., 2004; Ugoji, 2003; Ugoji and Isele, (2009). In an organizational context, occupational stress is also known as job stress and/or work stress. These terms are often used interchangeably in organizations, but its meaning refers to the same thing (AbuAlRub, 2004; Larson, 2004). It has two major dimensions: physiological stress and psychological stress. Physiological stress is often viewed as a physiological reaction of the body (headache, migraine, abdominal pain, lethargic, backache, chest pain, fatigue, heart palpitation, sleep disturbance and muscle ache, as well as changes in eating, drinking, sleeping and smoking habits) to various stressful triggers at the workplace (Antoniou et al., 1998; Beehr et al., 2001; Critchley et al., 2004; Mansor etal., 2003). Occupational stress can be defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the resources, capabilities and needs of the worker (Alves, 2005; Bianchi, 2004; Lindholm, 2006; Nakasis and Ouzouni, 2008). Stress is part of everyday life for health professionals such as nurses, physicians, and hospital administrators since their main responsibility focuses upon providing help to patients who are usually encountering life crises. Typically, nurses from both public and private hospitals report a similar pattern of stressful experiences (Dewe, 1987; Hingley and Cooper, 1986). Nurses rated high workloads and dealing with ‘death and dying’ as their major stressful events (Hipwell et al., 1989).

In addition to pressures due to insufficient time and resources to complete nursing tasks, organizational factors within the hospital appear to be major sources of stress and determining factors of job satisfaction (Humphrey, 1992). Hospitals throughout the world are currently undergoing massive changes to their organizational structure in an effort to reduce costs (Yin and Yang, 2002). In some cases, organizational change means hospital closure, job loss, reduced employee status, and higher levels of workload (Burke and Greenglass, 2000). With shrinking health care budgets, cutbacks in the workforce, and increasing demands for healthcare, nurses were hypothesized to respond by experiencing increased levels of stress and reduced job satisfaction.

The widespread nursing shortage and nurses’ high turnover has become a global issue (Kingma, 2001) which is of increasing importance to both the developed and developing countries .While numerous factors have been linked to nurses’ turnover, job satisfaction is the most frequently cited (Cavanagh and Coffin, 1992; Blegen, 1993; Irvine and Evans, 1995), and therefore merits attention. In the 1980s and 1990s, many researchers have been addressed nurse job satisfaction. The understanding of nurse job satisfaction and its contributing variables are important for any health care organization to exist and prosper. Job satisfaction is defined as the degree to which employees enjoy their jobs (McCloskey and McCain 1987). Nurse Job satisfaction is a multidimensional phenomenon that is influenced by many variables. Autonomy has been identified as the strongest predictor of nurse job satisfaction, which in turn reflects positively on nurse retention (Boyle et al.1999, Chaboyer et al. 1999, 2001, O’Rouke et al. 2000, Upenieks 2000, Finn 2001). Sengin (2003) supported Hinshaw and Atwood (1984), who are in a comprehensive literature review identified variables that influence nurse job satisfaction. These factors included: (1) demographic variables: education, experience, and position in the hierarchy; (2) job characteristics: autonomy, tasks repetitiveness, and salaries; and (3) organizational environment factors: degree of professionalization, type of unit, and nursing care delivery model. Recent research identified new variables that influence nurse job satisfaction such as environment and job settings (Shaver and Lacey 2003). Non-supportive work environments increase nurse’s stress and job dissatisfaction (Sims 2003), which negatively influence nurse retention.

Job satisfaction of nurses is an important concept as levels of job satisfaction may impact upon the global nursing workforce. Although the reported studies differed regarding levels of job satisfaction among nurses, the literature reveals that the sources of job satisfaction are relatively similar, e.g., physical working conditions, relationships with fellow workers and managers, pay, promotion, job security, responsibility, the recognition from managers and hours of work. Furthermore, it seems that nurses who had received tertiary education felt less satisfied with their jobs than those who had not received tertiary education. Most published research from various countries indicates that job satisfaction is a significant predictor of nursing absenteeism, burnout, turnover and intention to quit; however, there have been some inconsistent findings. Much research has revealed that job satisfaction of hospital nurses is closely related to job stress, role conflict and ambiguity, organizational commitment and professional commitment. This study aimed to describe the relationship of organizational stress with the job satisfaction among registered staff nurses.

OBJECTIVES:

1. To identify perceived organizational role stress among staff nurses

2. To rank the factors of organizational role stress among staff nurses

3. To find out the level of job satisfaction

4. To determine the association of demographic variables with organizational role stress and job satisfaction.

5. To find out the correlation between organizational role stress with the level of job satisfaction.

METHODS:

A descriptive survey design was adopted for the present study. A structural modified organizational stress scale which was modified form of organizational role stress scale and another job satisfaction survey scale was used to find out the correlation between organizational role stress and job satisfaction.

SETTING:

The study was conducted in selected private hospital of Bhubaneswar, Odisha.

SAMPLING

The sample size consists of 50 registered staff nurses of selected hospital and samples were selected by simple random sampling technique.

INSTRUMENTS:

Sociodemographic characteristics of the subjects were obtained by self administered questionnaire which was validated by the experts. The perceived organizational stress was identified by using modified form of organizational stress scale in which reliability was calculated by using cronbach α test in which α = 0.89 .The level of job satisfaction was identified by job satisfaction survey scale in which the α was 0.86 and both tools were found reliable and the tool were validated by different experts.

Based on all the components the overall stress scale percentage were categorized into less stress (< 50% of total score) and more stress (>50% of total score), the level of job satisfaction were categorized into not satisfied (<50% of total score) and satisfied (>50% of total score).

DATA COLLECTION:

After obtaining permission from the concerned authority the purpose of the study was explained and written consent obtained from the staff nurses of different departments. The samples were requested to fill information in the self administered questionnaire.

DATA ANALYSIS:

Data were coded and entered in the master sheet. Analysis was done using SPSS version 11.5.It consisted of both inferential and descriptive statistics.

RESULTS:

The analysis of demographic characteristics revealed that 52% of subjects were in the age group of 20-25 yrs and 84% were females. Analysis related to educational qualification revealed that 72% of the respondents were GNM qualified and 28% were having B.sc Nursing degree. As per working area 20% of respondents were in I.C.U, Medicine ward, surgical ward, O.T and from casualty respectively.

It was noted that 76% of subjects were have mild to moderate level of stress and 24% were having severe stress.

The data presented in Table-1 and fig-1 indicates that the rank order of factors of organizational role stress as % score were personal inadequacy having 1^st rank , role strength was ranked 2^nd, role isolation ranked 3^rd and role extension conflict was having 10^th rank.

Table-1

Showing percentage scores and rank order of different factors of organizational role stress.

Sl. no	Factors of organizational role stress	Percentage score	Rank
1	Inter role distance (IRD)	32%	9^th
2	Role stagnation (RS)	61%	2^nd
3	Role expectation conflict (REC)	31%	10^th
4	Role erosion (RE)	34%	8^th
5	Role overload (RO)	38%	6^th
6	Role isolation (RI)	58%	3^rd
7	Personal inadequacy (PI)	65%	1^st
8	Self role distance (SRD)	35%	7^th
9	Role ambiguity (RA)	51%	5^th
10	Resource inadequacy (RI)	56%	4^th

The study also revealed that 28% of subjects were not satisfied at all with their job and 72% were satisfied with their job.

Chi square value was computed to find out association between demographic variables with organizational stress and job satisfaction, which showed extremely statistically significant association between level of education and R.S (χ²_{=13.4, DF=1}and two tailed P value equals to 0.0003).

Level of education and R.E.C were very statistically significant where (χ²_=8.2,
DF=1and two tailed P value equals to 0.0042).

Level of education and role erosion were considered to be statistically significant as (χ²_{=5.9, DF=1}and two tailed P value equals to 0.0151).

Level of education and role overload were extremely statistically significant where (χ²_{=13.4, DF=1}and two tailed P value equals to 0.0003).

Level of education and personal inadequacy were extremely statistically significant in which (χ²_{=73.3, DF=1}and two tailed P value < 0.0001).

Level of education and role ambiguity were also extremely significant where(χ²_=31.1,
DF=1and two tailed P value < 0.0001).

Level of education and resource inadequacy were also very statistically significant where The association between level of education and job satisfaction was considered to bewere extremely statistically significant in which (χ²_{=73.3, DF=1}and two tailed P value < 0.0001).

The association between level of education and job satisfaction is considered to be extremely statistically significant where (χ²_{=88.5, DF=1}and two tailed P value < 0.0001)

The association between setting of work and role extension conflict was considered to be very statistically significant where (χ²_{=15.2, DF=4}and two tailed P value equals to 0.0043).

Setting of work and personal inadequacy were considered to be statistically significant where (χ²_{=12.1, DF=4}and two tailed P value equals to 0.0166).

Setting of work and role ambiguity were considered to be statistically significant where (χ²_{=10, DF=4}and two tailed P value equals to 0.0404).

The setting of work and job satisfaction survey were considered to be statistically significant where(χ²_{=16.9, DF=4}and two tailed P value equals to 0.0020).

The study results revealed that the correlation between organizational role stress and the level of job satisfaction was computed by Pearson correlation coefficient in which the correlation between role erosion and job satisfaction was considered to be statistically significant in which _{( r}_{= - 0.34, DF=48}and two tailed P value equals to 0.0157).The correlation between Other factors of organizational role stress were not statistically significant with job satisfaction.

DISCUSSION:

According to Alves (2005), 40% of all American workers perceive their jobs as being extremely stressful. Similar findings are noted in the United Kingdom, where occupational stress is estimated to be the largest occupational health problem (Edwards and Burnard, 2003).

Analysis of present study related to educational qualification revealed that 72% of the respondents were GNM qualified and 28% were having B.sc Nursing degree. As per working area 20% of respondents were in I.C.U, Medicine ward, surgical ward, O.T and from casualty respectively. It was noted that 76% of subjects were have mild to moderate level of stress and 24% were having severe stress. The present study revealed that the rank order of factors of organizational role stress as % score were personal inadequacy having 1^st rank , role strength was ranked 2^nd, role isolation ranked 3^rd and role extension conflict was having 10^th rank.

A study conducted in China by Hong Lu and Alison.E in (2006) entitled “ Job satisfaction survey and it’s related factors”, which revealed that more than half of nurses (53.7%) were satisfied or very satisfied with their jobs and 15% felt moderate to extreme occupational stress and reported role conflict and role ambiguity were very often. Nurses with diploma degree reported lower level of role conflict than with bachelor degree (P<0.05),but there were not significant differences in job satisfaction, occupational stress and role ambiguity by educational programme (p< 0.05) .

The investigator observed that the association between level of education and job satisfaction is considered to be extremely statistically significant where (χ²_=88.5,
DF=1and two tailed P value < 0.0001)_.The association between setting of work and role extension conflict was considered to be very statistically significant where (χ²_{=15.2, DF=4}and two tailed P value equals to 0.0043).

Similar study conducted in Taiwan by Wen-Hgien Ho et al(2009) entitled “Effects of job rotation and role stress among nurses job satisfaction which revealed that orgnisational role stress among nurses could have a negative effect on their job satisfaction. The study results revealed that the correlation between organizational role stress and the level of job satisfaction was computed by Pearson correlation coefficient in which the correlation between role erosion and job satisfaction was considered to be statistically significant in which ( r = - 0.34, DF=48 and two tailed P value equals to 0.0157).

CONCLUSION:

Due to the fact that hospitals depend on nurses' work to operate and it takes tremendous time and effort to train nurses' talent, retaining excellent nurses and stimulating them to do their best to serve hospitals and take on future challenges are crucial issues for hospitals to stay competitive in today's environment. As a practical and excellent strategy for manpower utilization, a hospital could promote the benefits of job distribution to both individuals and the hospital while implementing job distribution fairly. Medical organization should attempt to enhance nurses' commitment to the organization; the findings suggest that reduction of role stress has the best effect on enhancing nurses' organizational commitment. The ultimate goal should be to increase nurses' job satisfaction and encourage them to stay in their career. This would avoid the vicious circle of high turnover, which is wasteful of the organization's valuable human resources. Future research is needed to examine best practices for human resource managers to improve nurse motivation, job satisfaction and nurse performance in hospitals. The ultimate effort of administrator should be to increase nurses' job satisfaction and encourage them to stay at their work. This would avoid the vicious circle of high turnover which is wasteful of the organization's valuable human resources.

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Received on 22.07.2013 Modified on 12.10.2013

Asian J. Nur. Edu. & Research 4(1): Jan.-March 2014; Page 45-49