Factors and Coping Strategy of Stress Among Emergency Room Nurses in Saudi Arabia

Running head: DISSERTATION
FACTORS AND COPING STRATEGY OF STRESS AMONG THE EMERGENCY
ROOM NURSES IN SAUDI ARABIA
Name of the Student:
Name of the University:
Author Note:

1DISSERTATION
Declaration:
I the undersigned solemnly declare that the project report is based on my own work carried
out during the course of our study under the supervision of ................ I assert the
statements made and conclusions drawn are an outcome of my research work. I further certify
that:
I. The work contained in the report is original and has been done by me under the
general supervision of my supervisor.
II. The work has not been submitted to any other Institution for any other
degree/diploma/certificate in this university or any other University of abroad.
III. We have followed the guidelines provided by the university in writing the report.
IV. Whenever we have used materials (data, theoretical analysis, and text) from other
sources, we have given due credit to them in the text of the report and giving their
details in the references.
Name:
Enrolment No.:

2DISSERTATION
Acknowledgement:
Thank you to all of those who have helped listened and encouraged me throughout this study.
I am indebted to my supervisor ......................... whose guidance, advice and patience have
been immeasurable. My sincere thanks to all members of the............... [Mention your
university/college name], both staff and students, whose continuous support have made this
thesis possible.
I would like to thank all of the participants in the study: students, teachers and Local
Education Authorities, for the time and help given throughout. Without their participation,
this research would not have been possible. In this context, I am also thankful to them, whose
research work helped me to execute this paper well.
Finally, I thank my family, without whom this thesis would not have been started or
completed! Your encouragement and support have never faltered; thank you.

3DISSERTATION
Abstract:
Introduction: Stress generates a cumulative physical, mental as well as emotional response
on an individual which limits the ability to participate in an activity with enthusiasm. Stress
normally emerges from a level of dissatisfaction that arises due to poor interaction level or
unfavourable and non-cooperative environment setting. Stress could be a result of multiple
factors, some of which include, inability to cope with an academic environment, inability to
achieve personal goals and stress generated on account of the nature of a profession.
Background: Research studies have suggested that the nursing professionals majorly
experience the burnout and fresh graduate nurses upon placement within the Emergency unit
plan to quit the profession. Therefore on the basis of the background information as well as
the problem statement, the research objectives of the study intends to evaluate the key
sources of stress within the emergency wards of the hospitals in Saudi Arabia, to determine
the impact of stress on the working conditions of the nursing professionals and to evaluate the
available strategies in order to help professionals cope with the stress.
Methodology: In order to evaluate the factors that lead to stress among nursing professionals
working within the emergency unit of a healthcare setting, a questionnaire was distributed to
the nursing professionals working within the emergency unit of reputed hospitals in Saudi
Arabia. The questionnaires were distributed to 50 native nurses and 50 foreign nurses
working within Saudi Arabia. The questionnaire responses acquired were then evaluated by
using the SPSS software and ANOVA test.
Findings: The findings revealed that nurses working within the ED experienced higher level
of stress and the level of stress did not depend on gender but dependent on the basis of
experience level and job role.

4DISSERTATION
Conclusion: Higher stress led to problems such as agitation, increased stress levels,
depression as well as mental exhaustion. Therefore, over all it was found that the level of
stress and associated poor outcome was the highest among the nursing professionals who
worked at the emergency ward.
Recommendation: Hence, there is an increased need to include programs which could help
in promoting mental wellness among the nurses so as to improve their level of job
satisfaction and at the same time improve the rates of attrition.

5DISSERTATION
Table of Contents
Chapter 1:...................................................................................................................................4
Introduction................................................................................................................................4
1.1 Background:.....................................................................................................................4
1.2 Problem Statement:..........................................................................................................5
1.3 Research Objectives:........................................................................................................5
1.4 Research Question:...........................................................................................................5
1.5: Significance of the study:................................................................................................6
1.6: Limitations of the study:.................................................................................................6
1.7: Operational Definitions...................................................................................................7
CHAPTER 2:.............................................................................................................................9
Literature Review.......................................................................................................................9
2.1: Introduction:....................................................................................................................9
2.2: Search Strategy:..............................................................................................................9
Exclusion Criteria:.................................................................................................................9
Inclusion Criteria:.................................................................................................................10
Key Words:..........................................................................................................................10
Boolean Operator aided search:...........................................................................................11
2.3: Overview on stress and related outcome on nursing professionals working within the
ED........................................................................................................................................11
Definition and nature of stress.............................................................................................11
Symptoms of stress..............................................................................................................12
Sources of stress...................................................................................................................12
Outcome of work-stress.......................................................................................................14
Socio-demographic variables and work-stress.....................................................................14
Summary:.............................................................................................................................15
Literature Gap:.....................................................................................................................16
CHAPTER 3:...........................................................................................................................17
Methodology............................................................................................................................17
3.1: Introduction:..................................................................................................................17
3.2: Research Design:...........................................................................................................17
3.3: Research Setting:...........................................................................................................17
3.4: Population:....................................................................................................................18
3.5: Sampling Criteria:.........................................................................................................18
3.6: Sample Size:..................................................................................................................18

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3.7: Variables:......................................................................................................................19
Independent Variables:.........................................................................................................19
Dependent Variables:...........................................................................................................19
3.8: Instrument:....................................................................................................................20
3.9: Validity and Reliability:................................................................................................20
3.10: Pilot Study:..................................................................................................................21
3.11: Data Collection Procedure:.........................................................................................22
3.12: Data Analysis:.............................................................................................................22
3.13: Ethical Consideration:.................................................................................................22
Chapter 4:.................................................................................................................................24
Data Analysis and Discussion:.................................................................................................24
Variable declaration and measures:.....................................................................................24
Cronbatch’s alpha reliability test:........................................................................................25
T-test to examine whether people in emergency word have higher stress...........................26
Correlation between the estimated results of the work life stress among nurses.................31
References:...............................................................................................................................36
Appendix 1:..............................................................................................................................41
Gantt Chart:..........................................................................................................................41
Appendix 2:..............................................................................................................................42
Questionnaire:......................................................................................................................42

7DISSERTATION
Chapter 1:
Introduction
1.1 Background:
According to Abu Ruz (2014), care professionals are often stressed and emotionally
exhausted on account of the nature of their profession. As suggested by Al Hosis et al. (2013)
stress generates a cumulative physical, mental as well as emotional response on an individual
which limits the ability to participate in an activity with enthusiasm. In the words of Al Sareai
et al. (2013), stress normally emerges from a level of dissatisfaction that arises due to poor
interaction level or unfavourable and non-cooperative environment setting. Stress could be a
result of multiple factors, some of which include, inability to cope with an academic
environment, inability to achieve personal goals and stress generated on account of the nature
of a profession. A number of research studies have reported a high number of turnover in the
nursing profession pertaining to burnout and stress related to the nature of the profession.
Research studies in this context, critically suggest that nursing professionals working within
an emergency environment experience stress and emotional breakdown on account of closely
witnessing deaths and grief (Alsaqri 2014). In addition to this, working in the emergency
department is often accompanied with experiences such as life threats and harassment from
family members of dying patient who are unable to accept the unprecedented or
circumstantial death of the patients. Further, the profession includes job roles such as caring
for dying patients and managing conflicts between multidisciplinary health care
professionals.