title: Stressors, Appraisal of Stressors, Experienced Stress and Cardiac Response: A Real-Time, Real-Life Investigation of Work Stress in Nurses.
abstract: BACKGROUND
  Stress in health care professionals may reflect both the work and appraisal of work and impacts on the individuals, their patients, colleagues and managers.
  
  
  OBJECTIVE
  The purpose of the present study is to examine physiological and psychological effects of stressors (tasks) and theory-based perceptions of work stressors within and between nurses in real time.
  
  
  METHODS
  During two work shifts, 100 nurses rated experienced stress, affect, fatigue, theory-based measures of work stress and nursing tasks on electronic diaries every 90 min, whereas heart rate and activity were measured continuously.
  
  
  RESULTS
  Heart rate was associated with both demand and effort. Experienced stress was related to demand, control, effort and reward. Effort and reward interacted as predicted (but only within people). Results were unchanged when allowance was made for work tasks.
  
  
  CONCLUSIONS
  Real-time appraisals were more important than actual tasks in predicting both psychological and physiological correlates of stress. At times when effort was high, perceived reward reduced stress.
authors.affiliation: School of Psychology, College of Life Sciences and Medicine, University of Aberdeen, Kings College, Old Aberdeen, Aberdeen, AB24 3FX, UK. d.johnston@abdn.ac.uk.
authors.forename: Derek
authors.initials: D
authors.lastname: Johnston
authors.affiliation: University of Aberdeen, Aberdeen, UK.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Bell
authors.affiliation: Dundee University, Dundee, UK.
authors.forename: Martyn
authors.initials: M
authors.lastname: Jones
authors.affiliation: Stirling University, Stirling, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Farquharson
authors.affiliation: University of Aberdeen, Aberdeen, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Allan
authors.affiliation: Greenwich University, London, UK.|Anglia Ruskin University, Chelmsford, UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Schofield
authors.affiliation: Dundee University, Dundee, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Ricketts
authors.affiliation: University of Aberdeen, Aberdeen, UK.
authors.forename: Marie
authors.initials: M
authors.lastname: Johnston
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D009729:Nursing; D016272:Occupational Health; D012201:Reward; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology*; D017132:Workplace / Q000523:psychology*
keywords: Demand-control model; Ecological momentary assessment; Effort-reward imbalance; Heart rate; Occupational stress