IMPACT OF JOB STRESS IN THE QUALITY OF NURSES' WORK LIFE WITH

SPECIAL REFERENCE TO CHENNAI CITY

Prithivi S and A Thilagaraj

Department Of Commerce, Faculty Of Science and Humanities, SRM Institute of Science and
Technology, Kattankulathur, Tamil Nadu, India.
ABSTRACT:
Background: The concept of quality of work life refers to the extent to which individuals can use
their skills and abilities and confront and navigate circumstances that need autonomous decision-
making and self-guidance. Moreover, the persons engaged in this activity perceive it to be of value.
The objective of this research is to evaluate the quality of working life and job stress among nurses
in the private hospitals in Chennai city, as well as to establish any potential correlation between
the two variables.
Research Design: The research used a descriptive correlational methodology, with a purposive
sample of 112 nurses. The study included individuals of both genders working in the nursing
profession. The study was conducted at privately owned hospitals situated in the city of Chennai.
The data was gathered by the use of a standardised questionnaire comprising two distinct sections.
In the first section, the inclusion of personal information, work-related details, and an evaluation
of the working conditions experienced by nurses was observed. Section II of the study was
dedicated to the assessment of occupational stress by the use of a standardised scale.
Results: The study's results indicated that a significant majority of staff nurses working in private
hospitals expressed a considerable degree of satisfaction with their work environment.
Furthermore, a significant proportion of these nurses, namely 40%, reported a strong sense of
contentment with the equilibrium between their professional and personal lives. In contrast, a
minority of the participants, specifically fewer than one-quarter, indicated happiness with their
work environment, while just a small number expressed contentment with the calibre of their job
and the design of their tasks. Regarding the elements that contribute to job-related stress among
staff nurses employed in private sector hospitals, a substantial majority of respondents, nearly
75%, indicated their agreement with the proposition that their working hours are not aligned with
their personal life. Furthermore, a majority of the participants (more than 50%) identified frequent
fluctuations in work schedules, insufficient remuneration relative to the demands of their
responsibilities, and restricted opportunities for career advancement and personal development
within their particular healthcare establishments.
Conclusion: A significant inverse association was observed between nurses' sense of quality of
work life and their experience of workplace stress. Additionally, it was observed that there was a
rise in the average scores of job stress when there was a low level of work design, work life, work
context, work environment, and overall work quality of work life.
Keywords: Job stress, Quality of Work Life, and Quality of Nurses’ work life.

INTRODUCTION

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Nurses constitute a substantial and heterogeneous workforce within the healthcare system. The
term "nurse" has its etymological roots in the Latin word "Nutricius," which conveys the concept
of someone who provides nourishment, stimulates growth, and offers protection. The function of
nurses within the healthcare system is undergoing a process of expansion and transformation.
The scope of their responsibilities extends beyond institutional care to include the provision of
services across several tiers of the healthcare system. Nurses play a vital role in the healthcare
delivery system by offering individuals secure, cost-effective, and high-quality services. Nurses
have a crucial role in achieving favourable health outcomes such as a decrease in mortality,
morbidity, and disability, as well as the promotion of health via the adoption of healthy lifestyles
(Suresh, 2013).
The concept of Quality of Work Life (QWL) refers to the level of satisfaction experienced by
employees concerning their personal and professional demands, as well as their engagement in the
workplace and the attainment of organisational objectives (Swamy, Nanjundeswaraswamy &
Rashmi, 2015). The analysis of work-life quality is conducted to enhance work circumstances,
while considering the many aspects of a person's well-being, including physical, mental,
psychological, and social demands (Sirin & Sokmen, 2015).
A good quality of work life (QWL) is important to effectively recruit new workers and maintain a
stable staff. As a result, organisations are actively exploring strategies to effectively tackle
challenges related to the recruitment and retention of employees, intending to attain a high Quality
of Work Life (QWL). Prioritising the enhancement of Quality of Work Life (QWL) has the
potential to augment the overall well-being and contentment of workers, hence yielding several
benefits for the individual worker, the organisation, and the customers. Conversely, the inability
to effectively address and control these elements may result in significant consequences for
employee behavioural outcomes, including as organisational identity, work satisfaction, turnover
intention, and organisational commitment (Gayathiri & Ramakrishnan, 2013; Jebel, 2013).
Nursing is characterised by demanding labour, and occupational stress is widespread among
nurses, thereby impacting their quality of work life (QWL).
Occupational stress is a significant health concern for both nurses and the organisations they work
for. The influence of elements in the nursing work environment and work organisation on nurses'
quality of work life (QWL) is generally acknowledged. Hence, occupational stress is a
progressively acknowledged health concern that impacts the quality of work life (QWL) for nurses.
According to Behdin (2013), enhancing the work environment by detecting stresses may lead to
improvements in both the work life of nurses and the overall quality of health care.
The presence of job-related stress poses a significant threat to the quality of work-life (QWL)
experienced by nurses. Nurses are often exposed to the challenges of severe disease and mortality,
a distinct stressor that sets their job apart from others. This exposure has a significant influence on
their quality of work life (QWL) (Wilson et al., 2009). Cross-sectional research was conducted on
Croatian nurses (n=1,392) employed at four university hospitals. The study aimed to identify and
analyse the influence of eight primary categories of occupational stressors on the quality of work
life (QWL) of these nurses. The primary objective of this research was to contribute to the current

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body of literature in the field of occupational health by conducting a comprehensive analysis of

the correlation between occupational stress and quality of work life (QWL) (Wu, Chi, Chen,
Wang, & Jin, 2010).
STATEMENT OF THE PROBLEM
The nursing profession is impacted by a challenging and rigorous work environment. Nurses
frequently face a variety of stressors within their professional setting, typically characterised by
prevalent instances of physical and mental exhaustion, dissatisfaction with job demands,
compromised emotional health, persistent fatigue despite work obligations, and the occurrence of
burnout. The advent of the pandemic resulted in heightened levels of stress within the workplace,
particularly among primary healthcare workers employed in the healthcare sector. The nursing
profession has a significant influence on several aspects of an individual's personal life.
Various workplace aspects have a significant impact on individuals' impression of their
performance, level of satisfaction with their work-life balance, and overall happiness in their
nursing jobs. The primary focus of the nursing workforce is centred on job satisfaction. According
to a survey, job dissatisfaction is mostly attributed to factors such as low pay and unfavourable
working circumstances, which include deficiencies in the office environment, such as inadequate
equipment. In situations when enterprises are unable to provide employees with necessary
resources as a result of uncontrollable factors, it may impede the ability of workers to fulfil their
responsibilities which is an additional stress to the nurses.
SIGNIFICANCE OF THE STUDY
Stress has been seen to be correlated with a perceived deficiency in achieving a harmonious
equilibrium between work and personal life. The concept of work-life balance is often understood
as the state in which individuals can effectively manage their responsibilities and obligations both
in the workplace and in their personal lives while minimising any conflicts that may arise between
these two domains (Sturges & Guest, 2004).
The preservation of highly skilled nurses is crucial for the sustainability of healthcare institutions.
One potentially effective approach for examining nurse retention is to evaluate the quality of work
life (QWL) and its associated factors. This assessment can enhance healthcare organisations'
comprehension of the influence of the work environment and other related factors on nurses'
professional and personal lives, as well as on organisational productivity (Brook & Anderson,
2005; Brooks et al., 2007).
In this particular context, the investigator noted that a significant number of nurses express
dissatisfaction with many aspects of their work environment. These include working conditions,
possibilities for professional advancement, involvement in decision-making processes, workplace
safety, organisational and interpersonal relationships, as well as working hours. This research has
the potential to provide vital insights into the elements related to quality of work life that have a
substantial impact on job stress among critical care nurses. Therefore, this allows hospital
management to implement more effective policies and processes to foster and cultivate a culture
of professionalism inside the hospitals, thereby enhancing the current level of dedication towards
the institutions.

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REVIEW OF LITERATURE
According to the study conducted by Brooks and Anderson (2005), The complexity and
possibilities inherent in this conceptual framework of the Quantum Neural Network Language
(QNWL) are readily apparent. The concept of Quality of Nursing Work Life (QNWL) is supported
by robust theoretical underpinnings and has strong institutional validity. The field of organisational
literature has garnered significant interest as a consequence. The complexity mostly arises from
the presence of overlapping, poorly defined, and improperly measured empirical referents. The
concept of job satisfaction does not bear resemblance to the Quality of Nursing Work Life and
instead hinders comprehension.
Neha Gupta's 2021 study titled "Occupational Stress, Work-Life Balance, and Turnover
Intentions among Nursing Staff" examines many factors contributing to the occurrence of
occupational stress among nursing staff. Employees often experience heightened levels of
occupational stress as a result of many factors and problems related to their job duties,
organisational dynamics, relationships with supervisors and colleagues, and prevalent working
conditions, among other relevant features. Research has shown that work-related stress has
negative impacts on several dimensions of employees' lives, including job performance, job
satisfaction, physical health, mental well-being, emotional state, commitment to the company,
social interactions, personal life, and connections within the organisation. The correlation between
employee stress and increased occurrence of health problems and decreased work productivity has
been observed, leading to lower levels of job satisfaction and negative repercussions for the
company as a whole. The primary aim of this study is the examination of the stress experienced
by nurses.
Nursing professionals constitute about 33% of the healthcare workforce. The nursing profession
is distinguished by a considerable degree of stress. Although stress is a fundamental component of
all occupations and professions, some work roles are characterised by a greater level of stress in
comparison to others. Occupations or careers that need continuous interaction with others,
including diverse aspects of psychological, cognitive, or emotional connection, often demonstrate
heightened levels of demand and stress in comparison to alternative employment opportunities.
This presents a significant issue in the administration of professions such as healthcare, education,
and other closely associated fields.
Singh (2022) did research entitled "Job Stress and Quality of Work Life in Hospitals," in which
the author focused on the viewpoints of healthcare professionals, particularly nurses employed in
both government and commercial healthcare facilities. The findings of the research indicate that
nurses working in private hospitals regard their workload as a prominent determinant impacting
their quality of work life, relative to their colleagues at government hospitals. When doing a
comparative analysis of absenteeism rates among healthcare professionals, namely doctors hired
by government hospitals and nurses and other medical workers, it becomes apparent that the latter
group exhibits a greater prevalence of absenteeism. The aforementioned phenomenon might be
ascribed to the arduous working conditions encountered by individuals in their respective

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positions. The impact of stress on the quality of life experienced by nurses in private hospitals is
mostly adverse.
The publication is authored by Yustina P. M. Paschalia and was published in the year 2022.
Healthcare professionals are actively involved in a range of healthcare duties during the COVID-
19 epidemic. If the epidemic persists for a prolonged period, it will give rise to a significant degree
of uncertainty and danger. The conditions listed above possess the capacity to worsen people'
adverse self-perception, heighten stress associated to work, and reduce the general quality of life
for healthcare workers. The researcher observed a statistically significant link (p < 0.001) between
professional stress and the general well-being of healthcare workers during the COVID-19
pandemic.
The research done by Babapour et al. (2022) The nursing profession poses considerable obstacles,
and the professional stress experienced by nurses may potentially have detrimental impacts on
their general well-being and quality of life. The primary aim of this study was to investigate the
potential relationship between the quality of life perceived by nurses and their caregiving practises,
alongside the degree of work stress they confront. The study was concluded by delivering the
subsequent findings. The impact of occupational stress on the holistic well-being of nurses, with a
specific focus on their physical and mental health, is mostly detrimental. Moreover, it is important
to acknowledge that this phenomenon can impede the delivery of nursing care
OBJECTIVES OF THE STUDY
The primary objective of the present research is to evaluate the quality of working life and job
stress experienced by nurses working in the private hospitals of Chennai City.
Additionally, the study aims to establish the link between the quality of work life and job stress
among these nurses.
RESEARCH METHODOLOGY
The study used a quantitative descriptive research approach. The research was carried out among
the workforce employed in the metropolitan area of Chennai. The calculation of the sample size
was performed via the Rao sample size calculator. The survey includes a sample of 112 nurses
who are currently employed in private hospitals in Chennai. Data was collected from the nurses
via the use of the convenience sampling approach.
DATA ANALYSIS
The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS
20.0). Quality control measures were included throughout both the coding and data input stages.
The data were subjected to analysis using descriptive statistics, which included the calculation of
frequencies and percentages for qualitative variables, as well as the determination of the mean and
standard deviation (SD) for quantitative variables.
The correlation coefficient test was used by the researchers to analyse the association between
empowerment and job satisfaction. The statistical significance was established using a significance
threshold of p < 0.05.

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Table:1
DEMOGRAPHIC PROFILE AND JOB PROFILE OF THE SELECTED NURSES

DEMOGRAPHIC
PARTICULARS FREQUENCY PERCENT
VARIABLES
Male 36 32
Female 76 68
GENDER Total 112 100.0
GNM (Diploma) 15 13.4
B.Sc. Nursing 61 54.5
M.Sc. Nursing 20 17.9
EDUCATIONAL Other Courses 16 14.3
STATUS Total 112 100.0
Permanent 45 40.2
Temporary 42 37.5
Contract 25 22.3
EMPLOYMENT STATUS
Total 112 100.0
0 to 6 years 43 38.4
7 to 10 years 33 29.5
PERIOD OF More than 10
36 32.1
TENURE years
Total 112 100.0
Up to 10000 18 16.1
10001 to 20000 34 30.4
20001 to 30000 46 41.1

MONTHLY 30001 to 40000 10 8.9

INCOME More than 40000 4 3.6
Total 112 100.0
0 to 3 56 50.0
TOTAL
3 to 6 44 39.3
NUMBER OF
More than 6 12 10.7
FAMILY
Total 112 100.0
MEMBERS

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JOB PROFILE
PARTICULARS FREQUENCY PERCENTAGE
VARIABLES
Registered 34 30.4
REGISTRATION Not Registered 78 69.6
STATUS Total 112 100.0
Morning Shift 46 41.1
Evening Shift 24 21.4
Night Shift 12 10.7
SHIFT AND Rotational Shifts 30 26.8
DURATION
Total 112 100.0
Mostly Female 86 76.8
Mostly Male 7 6.3
GENDER Equal Proportion 19 17.0
RATIO
Total 112 100.0
Equal 82 73.2
Unequal 30 26.8
SALARY
DISCRIMINATION Total 112 100.0

Critical Care 23 20.5

General wards 37 33.0

UNIT
Others 52 46.4
Total 112 100.0
0 to 4 23 20.5
4 to 8 39 34.8
8 to 12 28 25.0
NO OF PATIENTS More than 12 22 19.6
Total 112 100.0
NIL 21 18.8
1-2 89 79.5

DAY OFF 3-5 2 1.8

Total 112 100.0

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Nil 62 55.4

5-30 Minutes 31 27.7

1 Hour 8 7.1
BREAKS Depends Patients Count 11 9.8
Total 112 100.0
Morning shift 68 60.7
Evening shift 33 29.5
SHIFT Night shift 11 9.8
PREFERABLE 112 100.0
Total
Less than 36 12 10.7
36-48 23 20.5
48-54 17 15.2
54-60 32 28.6

WORKING 60-70 9 8.0

HOURS 70-80 6 5.4
PER WEEK Above 90 hours 11 9.8
Total 112 100.0

Interpretation: According to the data shown in the table above, it can be seen that a significant
proportion of the participants are of the female gender, accounting for 68% of the total respondents.
Furthermore, the majority of the respondents, namely 54.5%, possess an associate bachelor's
degree in the field of nursing. The majority of nurses working in private hospitals earn a salary
within the range of 20,000 to 30,000, while their tenure typically spans fewer than 10 years. A
mere 30% of the nursing staff employed in private hospitals have completed the registration
process. According to the findings, a significant majority of nurses, namely 78%, said that the
predominant gender within their profession is female. The majority of nurses employed in private
hospitals are assigned a patient load ranging from 8 to 12 individuals. More than half of the samples
said that they do not get scheduled breaks throughout their shifts. According to a survey conducted
at private hospitals in Chennai, a majority of 61% of respondents expressed a preference for the
morning shift.

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TABLE 3: MEAN JOB STRESS SCORE

DIMENSIONS NO. OF MIN- MAX MEAN±SD
ITEMS
Origins of Stress at Work 12 35 - 67 50.5 ± 6.4
Workplace Stress Level 12 27- 53 41.1 ± 5.6
Effects of Stress at Work 6 10- 24 16.4 ± 3.1
Complete Stress at Work 30 74 - 134 108.0 ± 12.5
Interpretation: Table 3 presents the mean overall work stress ratings, which were found to be
108.0 ± 12.5. The minimum and maximum values varied from 74 to 134.
FIGURE 1: FREQUENCY DISTRIBUTION

Interpretation: The findings of the study indicate that a significant proportion of the sampled
population, specifically 88%, perceived the work design to be of average quality. This was
followed by 79% of the participants who perceived the total quality of work-life scores to be
average. Additionally, 74% of the respondents perceived the work world to be of average quality,
while 52% perceived the work life to be average. Lastly, 30% of the participants perceived the
work context to be of average quality.

FINDINGS AND DISCUSSION

According to Bragard et al. (2012), improving their organisational efficiency requires a QWL.
For them to be able to provide their patients the best care possible, nurses especially those who
work in critical care units—should have a fulfilling work life. As a result, consideration for nurses'
working lives is necessary. Because they are more focused on their personal lives than their jobs,
over half of nurse’s report being unsatisfied with their work life, which might have a negative
impact on the quality of their work.
In order to guarantee worker wellbeing, Ojekou et al. (2015) advocated in their research that
hospital administration create a conducive work atmosphere by allocating sufficient resources and
scheduling sufficient breaks. Also, most staff nurses in critical care units were unable to manage
work and family obligations, according to Abdelhakam et al. (2015), who evaluated the quality
of work as seen by staff nurses and its connection to their turnover intention.
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Thus, it can be inferred from both past and current research that administrators of health care
facilities create effective strategies to raise employee satisfaction. This aids in enhancing the work
and home settings to raise nurses' dedication and performance.
Job stress was examined in another part of this research. This section's research findings spoke to
the nurse's opinions on the origins, severity, and effects of work-related stress. When it came to
the many causes of workplace stress, such as work hours that interfere with personal life, the
majority of respondents agreed. The hospital offers limited professional growth and development
opportunities, with work shifts that change frequently. Additionally, the salary is not
commensurate with the tasks required, and there are no financial incentives. Employees also face
instability at home, lack of respect, and difficulty keeping up with the rapid advancements in
technology. In addition to the stresses already described, it seemed possible that nurses working
in various work contexts would feel varying amounts of stress.
CONCLUSION
The present study's results suggest the presence of a noteworthy inverse relationship between the
degree of job-related stress encountered by staff nurses and their evaluations of their work life's
quality. Additionally, it was noted that there existed a favourable association between average job
stress scores and diminished levels of work life, work design, work context, work environment,
and overall work quality of work life.
The presence of Quality of Work Life (QWL) has been shown to positively impact several aspects
of the work. Therefore, healthcare administrators can enhance their efforts in advancing the quality
of work life for nurses in private hospitals. The study aims to establish that by improving the
environment provided by the organization, nurses would be better equipped to balance their home
and professional lives.
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