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Home / Issues / № 1, 2013

Medical sciences

The Factors of Professional Stress in the Work of the Nurses of Psycho-neurological Clinic
Bykov S.V.

The analysis of scientific research devoted to exploration of stress in human professional activity shows that in recent years the indicated problem is considered as the most urgent in the world psychological science and practice. Nowdays, on the one hand, there exist a lot of research works on various types of stress such as life stress, posttraumatic stress, professional stress etc., on the other hand, most authors point out complexity and contradiction of the developments and in addition to it, this psychological phenomenon is not enough worked out methodologically and conceptually [7, 42]. Applied research works and different anti stress program developments are connected with its negative influence on the efficiency of human activities and human mental health [1, 108]. First of all, this is the growth of the number of illnesses of stressful etiology and as a consequence, a violation of the incapacity of the active part of the population, difficulties of adaptation to new types and forms of work, the development of conditions of reduced working capacity, the development of different forms of personal trouble (the phenomenon of alienation of labour, de socialization,, personal and professional deformation). Therefore, most of the stress research has the applied character and is focused on studying the phenomenology of the clinical symptoms of stress in the professional activity. The attention to the development of the psychological problems of stress can be explained by its direct connection with the vital demands of modern life. Difficulties in adaptation, inability to tolerate higher professional load, the various forms of personal disadvantage - here is a list of problems, which today is fairly perceived by the public as a direct threat to quality of life and mental health of the person. Professional stress is a diverse phenomenon, resulting in mental and physical reactions to tense situation in the labour activity of a human [4, 25]. Research of the state of stress in the professional activity indicate that phenomenologically and in terms of the peculiarities of mechanisms of regulation of work-related stress , this is a specific type of stress, which reflects the physiological and psychological peculiarities of its development. There distinguish a sufficiently large number of types of professional stress, which may be caused by various factors, related to labour activity, to the role of the employee in the organization, with relations at work, the career, with the organizational structure and psychological climate, non organizational factors. Despite the increasing number of researches, directed on the study of the various aspects of professional stress, today, unfortunately, there exist few papers devoted to a comparative analysis of the different concepts of professional stress. In studies made by Vodopyanova N.E. and Starchenkova E.S., among the representatives of various communication professions a link between indicators of «burnout» and indicators of quality of life (organizational stress, frustration, satisfaction with health, personal success, working atmosphere and interpersonal relations in situations of professional and family communication, mood, etc.) found [3, 168]. The obtained data allowed to make a conclusion that the «burn-out» cannot be considered only as a consequence of occupational stress. An existential stress plays a significant role in the dynamics of «burnout». The origin of the «burnout» is the result of a complex interaction of personality characteristics of a person, a situation of his interpersonal relationships in a professional environment and family life, as well as the personal experiences of self-efficiency. The balance of satisfaction in self-realization in professional and personal life is of particular importance against the «burnout». The recognition of the existential aspect of the professional «burnout» requires a revision of the common approaches to the provision of help to persons who may be survivors of the «burning», that is to say, it requires to move the focus of attention from communicative behavioural aspect to the existential-humanistic one. To reduce the destructive influence of professional stress, the training of social (communication) skills, self-control and self-management skills, development of constructive models of coping with obstacles behavior is recommended. For «burnout» persons the restoration of psycho-energetic potential, actualization of personality (deep) resources, gaining of the lost sense of personal and professional activity, strengthening of belief in their own forces, the expansion of the «I concept» is vitally important . «Burnout» is the result of cumulative impacts of multiple external (professional) and internal (existential) stress factors and can be seen in terms of the quality of life as an indicator of the self-realization satisfaction [7, 169]. Bodrov V.A., through the analysis of various theories and concepts of psychological and professional stress, shows that they reflect the two angle of main characteristics of stress: on the one hand, procedural and regulatory, on the other hand - the subject and correlative ones[6, 635]. Leonova A. B. in hier works has identified and analysed the three main approaches to the study of professional stress: the ecological, transact, regulatory [6, 627]. At the same time, the researchers noted that many experts, working in the same environment, secure good health and stable emotional state and continue to grow professionally [7, 174]. Also effects of stress depend on individual peculiarities of the person. Some people can resist the destructive effects of stress much better than the others. There are several factors that mitigate the impact of stress on our mental and physical health: social support, persistence, optimism, commitment to the sharp feelings and reactivity of the vegetative nervous system. The attention of researchers of professional stress is more and more displaced from individual, biological characteristics to the personal, psychological ones. More often among them the most complex, motivation and personality traits of the human take the first place. The specificity of motivation and personality characteristics of an adult person is largely determined by the nature of its leading activities in the framework of which he is putting out his strength and realizes his potential. Therefore, a deeper study of professional stress is possible in the first place in the study of values and motivational aims, self-assessment of an individual, connected with the context of a particular work. Work mainly influences positively on the individual and his personal peculiarities. However, the professional development can be of a downward character, with the partial or complete influence on the personality. In the case of partial reversal of the professional development one of its elements is affected in the progressive development of the system in general and its efficient functioning. The complete regress means that the negative processes have affected the separate structures of psychological system activity leading to their destruction that may reduce the effectiveness of the activities. The appearance of various professional deformations is the symptom of the negative impact of the occupation on the personality. The experience of professional deformation is accompanied by psychic tension , psychological discomfort and in some cases, by conflicts and crisis. The successful overcoming of professional difficulties leads to further improvement of the activities and professional development of the individual. The problem of the research is the professional activity of medical workers of psycho-neurological clinic, which is closely connected with numerous stressful situations, the specifics of which is determined by:

1. the performance of their professional duties in conditions, which may be related to emotional and psychological overloads;

2. the special regulations of working time (for example, night duty in the hospital and the ambulance);

3. the involvement in the various management systems: «human - human», «human - machine» (medical hardware diagnostics);

4. the high dynamics of social mobility.

The employee of the psycho-neurological clinic should be prepared for these situations. To confront successfully against stress factors he must have a certain level of nervous and mental stability. For the employee of psycho-neurological clinic it is important to realize that not comfortable conditions of work may cause negative impact of the occupation on the personality, when professional development begins to have the downward character. The symptom of this phenomenon is the appearance of various professional deformations, such as the syndrome of emotional burnout, which has a negative impact on all aspects of the personality and its behavior, reducing ultimately the effectiveness of professional activity and satisfaction with it.

Despite the demand for the research works of various aspects of emotional burnout, there are not enough psychological studies of professional deformations among doctors and there are few researches, where aspects of professional stress among line - level and middle-level medical staff are considered. The need to preserve and improve the psychological health of workers of the psycho-neurological clinic, prevention of professional deformation is urgent, as well as the addition of new developments of the recommendations of the psychological help system, taking into account the peculiarities of professional activity of employees of the psycho neurologic dispensary. The practical significance of the research lies in the fact that the results make it possible to identify a number of important factors influencing the development of syndrome of emotional burnout of workers of psycho neurologic dispensary. The aim of our research was the identification of the relationship of employment stress and emotional burnout with the development of professional deformation of workers of psycho neurologic dispensary, as well as determination of the main directions of psycho prophylactic work. The object of the research is a professional stress, and the subject of it - is the interrelation between the professional stress and the emotional burnout of the workers of the psycho-neurological clinic. On the basis of the goals, we put forward the following hypothesis: the level of neuro psychic sustainability of the employees of the psycho-neurological clinic and personal qualities are interrelated with the development of professional stress in the process of labour activity. Methodology of research the study was conducted on the basis of the State Institution of Health of the Samara region in Togliatti Psycho neurological dispensary (department № 2). 50 female employees of psycho-neurological clinic were involved in the study. Their experience of work in the health care system is from 5 to 14 years. For the diagnostics of individual-psychological characteristics of the person, the method of R. Cattell 16 PF multi factorial study of the personality was used. This method is designed to measure the sixteen personality factors and gives complex information about the individual-psychological characteristics of the subjects, which are called the constitutional factors. The technique allows you to explore the personality in detail on a number of interconnected characteristics: the emotional-volitional characteristics, communication skills and peculiarities of interpersonal relations, intellectual peculiarities of the personality. The Methodology of R. Cattell has a statistically-oriented value in the knowledge of the person and in the typology of its properties. To determine the nervous and mental stability of the subjects and the risk of exclusion in a state of stress, we used the method of the «Forecast». The scores received by the methodology are correlated with a notional 10-point scale NPU: the more the point value of the scale, the more nervous and mental stability of the subject. The methodology of V.V. Boyko was used for the diagnostics of the level of emotional burnout syndrome. The method gives a detailed picture of syndrome of emotional burnout, split in three phases, each of which includes four symptoms. The statistical test of the received data was carried out with the help of the Pearson correlation coefficient to determine the relationship between two parameters. The results of the study as a result of the analysis of the recieved data there were identified the following indicators. There were identified high rates of factors C, G, Q3 in combination with low values of the factors I, O among 36 subjects (72 %). Among 14 subjects (28 %) highest values were observed on the factor L in combination with low values of factor F, M. High assessment marks to the factor B (intellect) were identified among all the tested people. They are also characterised by low values of factors F and M. They are characterized by prudence, reasonable caution, taciturnity. In addition to it they are characterized by the tendency to make everything more complicated, some concern, pessimism in perception of the reality. Others may seem them boring, dull and too stiff (low value of the F - an average of 2 Stan) . At the same time they are practical and conscientious, they are oriented to the external reality and follow the generally accepted norms. They can be characterized with some limitations and excessive attention to detail (low values of M - an average of 2 Stan). All subjects have higher scores on a scale of nervous and mental stability. Comparative analysis of the methods of Cattell and «Forecast» has shown that the subjects scored high values on a scale NPU (8 - 10 points), who are characterized by high values of factors C, G, Q3 and low values of the factors I, O. Subjects with the average values of the aforementioned factors scored values on the scale of NPU above the average (6 - 7 points). To test the statistical significance of the result, we used the Pearson correlation coefficient. We established the correlation between the degree of nervous and mental stability and performance factors of the person according to the Cattell. Thus, as a result of the research we have identified directly proportional relationship (positive value of correlation coefficient) between the factors C, G, Q3, M and the level of nervous and mental stability. The higher the score on these factors (i.e. the higher the emotional stability, responsibility, self-control and practicality of our subjects), the higher their nervous and mental stability. Back-proportional relationship (negative value of a correlation coefficient) is found between the level of nervous and mental stability and factors I, O, L. The higher the score on these factors, the lower the level of nervous and mental stability. The results of our research confirms the findings of other authors about the fact that the combination of high values of factors C, G, Q3 in combination with low values of the factors I, O, testify high nervous and mental stability of the individual [8, 114]. This type of responsible, diligent and disciplined workers of socionomical professions exposed to occupational stress and burnout to the greatest extent [2, 160].

The results of the research:

Thus, the higher emotional stability, patterns, responsibility, practicality, self-control, the more syndrome of emotional burnout and a big predisposition to the labour stress is formed. On the basis of the theoretical analysis of the socio-psychological literature on the problems of professional deformation and the results of our empirical study we have developed the basic directions of psycho prophylactic work with the employees of the psycho-neurological clinic for the prevention of syndrome of emotional burnout.

The concept of coherence can serve as the theoretical basis of prevention of emotional burnout according to which the determinants of mental health in a professional environment are the following: a sense of agreement between their capabilities and requirements of the environment; adequate assessment of their possibility; the experience of the situation as important and having a personal meaning and value; the feeling of self-importance and the effectiveness of the actions [6, 90].

The combination of these factors creates preconditions for personal and professional development of a person. Perception of the environment as a significant and positive, as well as the expectation of positive results of activities, extends the competence of the individual, reduces the probability of developing symptoms of burnout.



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Bibliographic reference

Bykov S.V. The Factors of Professional Stress in the Work of the Nurses of Psycho-neurological Clinic. International Journal Of Applied And Fundamental Research. – 2013. – № 1 –
URL: www.science-sd.com/452-24055 (25.08.2019).