title: Recurrent changes in the work environment, job resources and distress among nurses: a comparative cross-sectional survey.
abstract: OBJECTIVE
  Occupational stress in nursing has frequently been considered in nursing literature. The operationalization of job demands in different work settings and its relation to distress have been discussed to identify significant interactions with job resources. In this study, job demands were defined as recurrent changes in the work environment of nurses (i.e. changing colleagues, supervisors, workplaces, working hours and tasks). In particular, we focused on the 'negative appraisal' (i.e. 'threat') of these changes. The interaction between 'threat' and job resources (i.e. timing control, method control and supervisor support) and its relation to distress among Registered Nurses was examined.
  
  
  METHODS
  The study was part of a larger cross-sectional survey among 7863 (response rate 51%) employees belonging to 10 general hospitals in Belgium. The results are based on self-administered questionnaires of 1094 Registered Nurses employed in intensive care units (ICU) (n = 416) and surgery/medical wards (non-ICU) (n = 678). General Linear Modelling was used to test the moderating effects.
  
  
  RESULTS
  In both study samples, 'threat' was positively associated with distress (P < 0.001). However, in contrast with non-ICU nurses, ICU nurses only considered 'supervisor support' as a significant moderator in the positive relationship between 'threat' and distress (P = 0.023). 'Timing and method control', instead of supervisor support, moderated this relation among non-ICU nurses (P = < 0.001 and 0.018, respectively).
  
  
  CONCLUSIONS
  These findings provide additional evidence to consider negative appraisal of recurrent changes as occupational specific stressor in nursing. Moreover, the buffering effects which were found between 'threat' and the measured job resources in relation to distress, and the difference of these interactions in ICU and non-ICU health care settings, confirmed the suggestion to consider particular job characteristics in job stress research. Finally, the findings of our study may be of importance for nursing administrators who are dealing with distress among nurses.
authors.affiliation: Department of Management Information, Operations Management and Technology Policy, Faculty of Economics and Business Administration, Ghent University, Belgium. rik.verhaeghe@ugent.be
authors.forename: Rik
authors.initials: R
authors.lastname: Verhaeghe
authors.forename: Peter
authors.initials: P
authors.lastname: Vlerick
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.forename: Georges
authors.initials: G
authors.lastname: Van Maele
authors.forename: Paul
authors.initials: P
authors.lastname: Gemmel
mesh_terms: D001530:Belgium; D003430:Cross-Sectional Studies; D003625:Data Collection; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D007389:Internal-External Control; D016014:Linear Models; D009741:Nursing Staff, Hospital / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D010557:Personnel Administration, Hospital; D010561:Personnel Staffing and Scheduling; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D017132:Workplace