.svg){kind=icon}
Abstract:
Occupational stress among remote area nurses is an emerging concept in the nursing literature. Consistent with general nursing stress research, remote area nurses (RANs) also suffer from high levels of occupational stress, exacerbated by geographical, social and professional isolation. The structure of the very remote health workforce requires RANs to be the constant frontline workers, performing frequently in the absence of medical practitioners and allied health professionals. They are consequently required to practice an extended clinical role. This thesis explores the nature of the occupational stress experience for nurses working in very remote Australia and identifies the specific stressors inherent in the remote area nursing workplace. Levels of stress in this context have been measured and comparisons drawn between nurses working remotely and nurses working in hospital-based settings. Levels of stress were also compared to that of other professional samples. Data were obtained through two waves of survey administration, completed by 349 nurses working in very remote Australia and 277 nurses working in major Australian hospitals (2008), and later, 433 nurses working in very remote Australia and 177 nurses working in a major Australian hospital (2010). Analyses examined both cross-sectional and longitudinal data. Initial findings provided support for the expectation that, relative to other professional samples, remote area nurses experience higher levels of occupational stress. Contrary to expectation, however, remote area nurses reported lower levels of occupational stress than nurses working in major Australian hospitals. Importantly, resilience was found to mediate the relationship between job demands and psychological distress for the remote area nursing sample but not the hospital-based nursing sample. In addition to these findings, a review of nursing stress measures demonstrated that no existing psychometric instrument could be suitably applied to assess occupational stress in the remote area nursing workforce. This thesis consequently describes the development and validation of the Remote Area Nursing Stress Scale (RANSS) – a new self-report instrument designed specifically to measure occupational stress in this context. Finally, an ecological, macro-level framework is presented for the occupational stress experience of remote area nurses, proposing that worker well-being is impacted by the environmental context, organisation-environment adaptation, and the influence of these factors on task-level job demands and resources.
