Psychology Research and Behavior Management (Feb 2024)
Factors Influencing Occupational Stress Perceived by Emergency Nurses During Prehospital Care: A Systematic Review
Abstract
Diego José Montero-Tejero,1 Nerea Jiménez-Picón,2 Juan Gómez-Salgado,3,4,* Elena Vidal-Tejero,5 Javier Fagundo-Rivera6,* 1Department of Emergency, Hospital Universitario Lucus Augusti, Galician Health Service, Lugo, Galicia, Spain; 2Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Andalusia, Spain; 3Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Andalusia, Spain; 4Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador; 5Department of Cardiology, Hospital Universitario Virgen Del Rocío, Andalusian Health Service, Sevilla, Andalusia, Spain; 6Centro Universitario de Enfermería Cruz Roja, University of Seville, Sevilla, Andalusia, Spain*These authors contributed equally to this workCorrespondence: Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Avda. Tres de Marzo, S/N, Huelva, 21007, Spain, Tel +34 959219700, Email [email protected] Javier Fagundo-Rivera, Centro Universitario de Enfermería Cruz Roja, Sevilla, Spain, Avda, de la Cruz Roja, 1, duplicado, Sevilla, 41009, Spain, Tel +34 954350997, Email [email protected]: To assess personal and work-related factors influencing the stress levels of nurses during prehospital care. Specifically, to identify associations between the level of perceived stress, the degree of professional experience, and the level of knowledge. Secondly, to examine the relationship between stress levels and violence in the work environment. And third, to investigate the main protective factors against work-related stress during prehospital care.Methods: Systematic review in PubMed, WOS, Enfispo, Cochrane, and LILACS databases following the PRISMA methodology (last search 08/Aug/2023). Following the PECO framework, studies on occupational stress factors in ambulance emergency nurses were investigated. Studies in English or Spanish, from 2013 to 2023, and only research articles were admitted, thus excluding reviews, dissertations, and grey literature. Possible bias and level evidence were assessed using critical appraisal tools and GRADE. This protocol was registered in PROSPERO with code CRD42023446080.Results: Fourteen articles were selected, and n=855 prehospital nurses were identified. One study was a clinical trial, and the others were observational and qualitative. The level of evidence was very low (n=7), low (n=6), and moderate (n=1); any study was excluded due to methodological bias. Five categories of stressors were extracted: the management of the health service (ie, workload organisation, and resources), patient care (mainly paediatric care), interpersonal stressors (relationship with peers), environmental factors (exposure to injuries), and personal factors (training, experience, and coping strategies). Violence at work is frequent for prehospital nurses, implying both verbal and physical aggressions. Support from peers was associated with positive results against stress.Conclusion: Managing workload and improving resources in the work environment are essential to reduce fatigue and allow emotional processes to be addressed. Providing workers with coping skills also imposes on them the responsibility to cope with stress. Collective awareness is the main element in reducing the incidence of stress.Keywords: ambulance, prehospital, emergency care, nurses, stress, occupational health, management
