title: A longitudinal study of job stress in the nursing profession: causes and consequences.
abstract: OBJECTIVE
  This study examines the influence of changes in work conditions on stress outcomes as well as influence of changes in stress outcomes on work conditions. As such, it answers questions still open in the literature regarding causality of work environmental characteristics and the health of nurses.
  
  
  METHODS
  A complete, two wave panel design was used with a time interval of 3 years. The sample consisted of 381 hospital nurses in different functions, working in different wards.
  
  
  RESULTS
  Changes in work conditions are predictive of the outcomes, especially of job satisfaction and emotional exhaustion. The strongest predictors of job satisfaction were social support from supervisor, reward and control over work. The strongest predictors of emotional exhaustion were work and time pressure and physical demands. Reversed relationships were also found for these outcomes.
  
  
  CONCLUSIONS
  The results of this study are consistent with transactional models of stress that indicate that stressors and stress outcomes mutually influence each other. To prevent nurses from a negative spiral, it seems of importance to intervene early in the process.
authors.affiliation: Department of Psychology, Leiden University, the Netherlands. gelsema@fsw.leidenuniv.nl
authors.forename: Tanya I
authors.initials: TI
authors.lastname: Gelsema
authors.forename: Margot
authors.initials: M
authors.lastname: van der Doef
authors.forename: Stan
authors.initials: S
authors.lastname: Maes
authors.forename: Marloes
authors.initials: M
authors.lastname: Janssen
authors.forename: Simone
authors.initials: S
authors.lastname: Akerboom
authors.forename: Chris
authors.initials: C
authors.lastname: Verhoeven
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D015984:Causality; D005260:Female; D006272:Health Facility Environment / Q000458:organization & administration; D006785:Hospitals, University; D006801:Humans; D007389:Internal-External Control; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D009936:Organizational Innovation; D017009:Professional Autonomy; D012044:Regression Analysis; D012201:Reward; D012944:Social Support; D011795:Surveys and Questionnaires; D016526:Workload; D017132:Workplace / Q000458:organization & administration / Q000523:psychology*