title: Stress among nurses working in emergency, anesthesiology and intensive care units depends on qualification: a Job Demand-Control survey.
abstract: BACKGROUND
  The nurse stress literature reports an overwhelming culture of acceptance and expectation of work stressors, ironically linked to the control of the workplace to effectively and proactively manage stress. The stressors involved in delivering "stress management" have been well studied in nursing-related workplaces, especially in acute care settings in accordance with the Karasek Job Demand-Control-Support (JDCS) model. However, little is known about the effects of specificity of an acute care unit and the level of qualifications on stress experienced by nurses.
  
  
  METHODS
  A survey using the JDCS model was conducted among 385 nurses working in three different acute care units (anesthesiology, emergency and intensive care unit) from a university hospital. Specific questions explored variables such as gender, acute care units, level of qualification and working experience.
  
  
  RESULTS
  Two hundred questionnaires were returned. A high level of job strain was highlighted without a gender effect and in the absence of isostrain. Nurses from acute care units were located in the high stress quadrant of the JDCS model. Conversely, other nurses were commonly located in the "active" quadrant. Independent of acute care settings, the highest level of education was associated with the highest job strain and the lowest level of control.
  
  
  CONCLUSIONS
  In an acute care setting, a high level of education was a key factor for high job stress and was associated with a perception of a low control in the workplace, both of which may be predictors of adverse mental health. In particular, the lack of control has been associated with moral distress, a frequently reported characteristic of acute care settings. To enhance the personal and professional outcomes of the advanced registered nurses, strategies for supporting nurses manage daily stressors in acute care are urgently required.
authors.affiliation: Neurophysiology of Stress, Armies' Biomedical Research Institute, Armies' Health Service, Bretigny sur Orge, France. marion.trousselard@gmail.com.
authors.forename: Marion
authors.initials: M
authors.lastname: Trousselard
authors.affiliation: Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France. frederic.dutheil@acu.edu.au.|School of Exercise Science, Faculty of Health, Australian Catholic University, Melbourne, VIC, 3065, Australia. frederic.dutheil@acu.edu.au.|Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions EA3533, Blaise Pascal University, Clermont-Ferrand, France. frederic.dutheil@acu.edu.au.|University Clermont Auvergne, 63000, Clermont-Ferrand, France. frederic.dutheil@acu.edu.au.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dutheil
authors.affiliation: School of Exercise Science, Faculty of Health, Australian Catholic University, Melbourne, VIC, 3065, Australia. geraldine.naughton@acu.edu.au.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Naughton
authors.affiliation: Anesthésie-Réanimation, Pôle BLOC-ARCHI, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France. scosserant@chu-clermontferrand.fr.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Cosserant
authors.affiliation: Anesthésie-Réanimation, Pôle BLOC-ARCHI, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France. samadon@chu-clermontferrand.fr.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Amadon
authors.affiliation: Centre de Pharmacologie Clinique, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France. cduale@chu-clermontferrand.fr.|Inserm, CIC1405, 63003, Clermont-Ferrand, France. cduale@chu-clermontferrand.fr.
authors.forename: Christian
authors.initials: C
authors.lastname: Dualé
authors.affiliation: University Clermont Auvergne, 63000, Clermont-Ferrand, France. pschoeffler@chu-clermontferrand.fr.|Anesthésie-Réanimation, Pôle BLOC-ARCHI, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France. pschoeffler@chu-clermontferrand.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Schoeffler
mesh_terms: D000776:Anesthesiology; D002983:Clinical Competence; D064648:Critical Care Nursing; D004522:Educational Status; D016529:Emergency Nursing; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000592:standards; D016272:Occupational Health; D017009:Professional Autonomy; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology
keywords: Hospital; Karasek; Occupation; Psychology; Social support; Strain; Stress