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Article

Factors Associated with Job Stress among Hospital Nurses: A Meta-Correlation Analysis

by
Ji-Young Lim
1,
Geun-Myun Kim
2,* and
Eun-Joo Kim
2
1
Department of Nursing, Inha University, 100 Inha-ro, Michuhol-gu, Incheon 22212, Korea
2
Department of Nursing, Gangneung-Wonju National University, 150 Namwonro Heungup-Myun, Wonju 26403, Korea
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2022, 19(10), 5792; https://doi.org/10.3390/ijerph19105792
Submission received: 1 April 2022 / Revised: 5 May 2022 / Accepted: 6 May 2022 / Published: 10 May 2022
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Abstract

:
This study aims to investigate research trends concerning job stress among hospital nurses. Articles about job stress among hospital nurses published in English from 2008 to 2018 were searched. In the first search, 2673 articles were extracted from the MEDLINE, EMBASE, KoreaMed, KERIS, KISS, KISTI, and KMbase databases. Altogether, 154 articles were used in the systematic review and meta-analysis. Thirty-nine variables were explored regarding job stress. Among the major variables, insufficient job control, personal conflict, and burnout had a positive correlation. In contrast, intention to stay, job satisfaction, and personal accomplishment had a negative correlation. In the meta-analysis conducted in relation to a specific conceptual framework, the negative-outcome factors showed significant positive correlations with job stress, whereas the positive-outcome factors showed significant negative correlations with job stress. This study identified factors associated with job stress in nurses through a meta-correlation analysis, and the overall correlation coefficient was relatively high at 0.51. Job factors and moderators had significant meta-correlation coefficients. These results can be utilized in clinical practice and research to help develop intervention programs to relieve job stress among nurses.

1. Introduction

In recent years, clinical nurses have been increasingly exposed to coronavirus disease (COVID-19). Additionally, the medical environment has evolved and become specialized owing to scientific–technological advances. Such changes have led to continuously evolving job forms and higher levels of demand among hospital nurses. Moreover, pressure to provide sensitive nursing care, such as patient-centered care and activities to promote patient satisfaction, has steadily increased. This rise in job demands is provoking various levels of stress among hospital nurses. Job stress refers to stress triggered by excessive job demands that overwhelm an individual’s resources [1], and job stress in nurses refers to a state in which these overwhelming demands engender physiological, psychological, and social impairment [2].
Today, job stress has become a common and costly problem at work [3], and nursing is a stressful job due to stressors such as high expectations, excessive responsibility, and minimal authority [4]. Nurses’ job stress is a factor that lowers work productivity and efficiency, and threatens patient safety, and when job stress increases, it affects patient care as well as the quality of care [5].
Job stress in hospital nurses is influenced by various factors at the individual and organizational levels, including professional competency [6]. Changes in shift timing have a substantial impact on what is demanded of hospital nurses, which, in turn, provokes job stress, ultimately increasing organizational costs by increasing turnover and diminishing work competence [7]. For these reasons, various research attempts have been made to identify the predictors and factors associated with job stress in hospital nurses. First, job stress is influenced by individual factors, such as age, education, and experience, as proposed in the job demands–resources (JD–R) model [6,8], as well as by organizational factors, such as role ambiguity, role overload, role conflict [9], inter-professional conflict, incommensurate compensation, and authoritarian and irrational organizational culture [10].
Further, the adverse outcomes of job stress among hospital nurses include physical and mental health problems, burnout, and increased turnover intention, which, in turn, curtail work efficiency and organizational commitment, thereby impairing productivity, decreasing patient satisfaction, and hampering the advancement of the organization [7].
Factors influencing job stress among hospital nurses can be classified as antecedent factors, outcome factors, and moderator factors. By understanding the degree of relationship of these various factors with job stress, useful information can be provided for personnel management.
Ultimately, managing the job stress of hospital nurses is an essential strategy to promote work efficiency in hospitals and advance nursing organizations. In this context, many studies have attempted to identify the factors associated with job stress in nurses. However, due to the broad spectrum of these studies, more empirical findings are needed in relation to applications in clinical practice.
Therefore, this study aims to systematically review previous studies on job stress among hospital nurses and classify associated factors based on a conceptual framework in terms of a meta-correlation analysis. These findings are intended to provide foundational data for developing strategies for hospital nurses to manage job stress.

1.1. Purpose

This study aimed to systematically review and meta-analyze existing studies on factors associated with job stress among nurses working in general hospitals and develop nursing management strategies and intervention programs to reduce stress among them. The specific objectives were as follows:
  • Systematically review studies on job stress among hospital nurses.
  • Classify factors related to job stress among hospital nurses using the conceptual framework of Kath et al. [6].
  • Examine the meta-correlation coefficients of job stress and associated factors.

1.2. Conceptual Framework

We used the model proposed by Kath et al. [6] as the theoretical framework. This theory classifies factors that affect job stress based on the JD–R model [8] and role stress theory [11].
This framework considers job stress in relation to stressors, outcomes, and moderators. Job stress was defined as a state perceived when work demands exceed one’s abilities [11]. The predictors of stress were categorized into individual factors, job-related factors, and hospital-related factors. Stressors and moderators refer to the factors that led to the outcomes. In this study, the moderators were defined as autonomy and leadership style [6]. Kath et al. [6] defined moderators as factors that influence the effects of stressors on outcomes. Several previous studies have demonstrated that emotional intelligence is a factor influencing job stress [12]. Emotional intelligence modulates the level of personal factors, such as hardness and resilience, according to organizational context [13]. Therefore, in this study, it was classified as a moderator.
The factors associated with job stress were assigned to each of the three categories in the theoretical framework: stressors, outcomes, and moderators. There were 19 variables classified as stressors. Individual factors included age, hardness, health-promoting behavior, personality, resilience, self-esteem, and self-efficacy. Job-related factors included emotional labor, insufficient job control, job insecurity, lack of rewards, inter-personal conflicts among co-workers, role conflict, role identity, violence, workload, and work experience. Hospital-related factors included recreation and the work environment. A total of 11 outcomes were identified, which were categorized into positive and negative outcomes. The positive outcomes included intention to stay, job performance, job satisfaction, organizational commitment, and personal accomplishment. The negative outcomes included burnout, depression, fatigue, health problems, trauma, and turnover intention. Finally, a total of nine moderators were identified, which included autonomy, competency, coping, emotional intelligence, empowerment, leadership, professionalism, self-leadership, and social support.

2. Materials and Methods

2.1. Study Design

This study is a literature review in the form of secondary data analysis and meta-analysis that aimed at identifying factors that significantly correlated with job stress among hospital nurses.

2.2. Data Collection

2.2.1. Inclusion and Exclusion Criteria

The literature was selected using the participant, intervention, comparisons, outcomes, time, setting, and study design (PICOTS-SD) strategies. The following studies were included: (1) studies with nurses working in a general hospital as participants (P); (2) studies with the measurement of organizational behavioral factors as the intervention (I), and (3) studies with the measurement of job stress as the outcome (O). Furthermore, the comparisons (C) were not limited because this study aimed to comprehensively explore research on measuring the variables of interest. The setting (S) was limited to the general hospital, and the study design (SD) was limited to correlation studies. Time (T) was not limited. The inclusion criteria comprised studies on hospital nurses, those that measured job stress and reported correlations between job stress and any combination of personality and job-related characteristics, and those published in Korean or English. The exclusion criteria comprised studies that did not involve healthcare staff, those that were published in other languages (excluding Korean or English), those that did not report the entire study results, and those that did not provide full manuscripts, such as conference proceedings, theses, dissertations, monographs, and books.

2.2.2. Quality Appraisal

The quality of the literature was appraised using the Quality Assessment and Validity Tool for Correlational Studies, as developed by Cummings and Estabrooks [14]. This tool consists of 13 categories related to the following: application of a theoretical framework, use of randomized sampling, employment of a prospective design, appropriate sample size, data collection from multiple centers, guarantee of anonymity, response rate exceeding 60%, usage of instruments with established reliability and validity, instruments with an internal consistency of 0.7 or higher, use of appropriate statistical analyses according to the purpose of the study, and whether statistical management of outliers was presented. Studies with a score of 8 or higher for these categories were deemed as being of good quality.

2.2.3. Literature Search and Selection

A literature search was performed on December 16, 2018. The search was conducted using the MEDLINE, EMBASE, KoreaMed, KERIS, KISS, KISTI, and KMbase databases. The search terms were “hospital,” “nurse,” and “job stress.” The search period was set to 10 years from 2008 to 2018. Consequently, 2673 studies were found.
After removing 1058 duplicate studies, 1615 studies were reviewed against the inclusion/exclusion criteria. After reviewing the abstracts, a total of 1355 studies were excluded: 271 studies that were not conducted on hospital nurses, 273 studies that included non-nursing staff, 221 studies that did not present job stress or other relevant factors, 18 studies that were either abstract presentations in conferences or those providing inadequate information about the study design and study results, 100 studies that were not published in Korean or English, 117 studies where the full text was unavailable, and 355 studies that did not perform correlational analysis.
The full texts of the remaining 260 studies were reviewed. A total of 26 studies were additionally excluded: five that were not conducted on hospital nurses, 15 that did not perform correlational analysis, and six that did not present the factors related to job stress. The quality of the remaining 234 studies was assessed, and 15 studies with a rating of 7 or below were excluded. As a result, 219 studies with a rating of 8 or higher were included in the descriptive analysis. Finally, 65 studies in which variables related to job stress were only reported in a single study were excluded, as meta-correlations require a minimum of two studies reporting the same variable to compute the pooled effect size. As a result, 154 studies were included in the meta-analysis (Figure 1, [13,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144]).
Literature extraction was performed independently by two graduate students in nursing management. Cases that met the criteria were coded as 1, and those that were unsuitable were coded as 0. In case of discrepancy among the raters, whether the study was included or not was decided after discussion with the researchers.

2.3. Data Analysis

2.3.1. General Characteristics of the Selected Studies

The following four general characteristics were examined: year of publication, country of publication, sample size, and quality rating. The results are presented in the form of frequencies and percentages.

2.3.2. Classification of Variables Related to Job Stress

Variables related to job stress were classified into five factors (i.e., personal factors, job factors, hospital factors, moderators, and outcomes) based on the conceptual framework of Kath et al. [6]. The data were summarized as frequencies and percentages.

2.3.3. Summary of Descriptive Statistics for Variables Related to Job Stress

The statistical significance of variables related to job stress was evaluated in terms of frequency, percentage, correlation coefficient (r), and p-value.

2.3.4. Effect Size Calculation for Meta-Analysis and Homogeneity Testing

The correlation coefficient effect sizes of variables related to job stress among hospital nurses were statistically pooled using meta-correlation analysis (Comprehensive Meta-Analysis 3.0 software). The standardized Zr was analyzed using the standardized Fisher’s Z equation, with 95% confidence intervals. A fixed-effects model was used for high homogeneity, and a random-effects model was used for high heterogeneity. Effect sizes were interpreted per Cohen’s criteria [145]: r ≤ 0.1 (small effect size), 0.3 < r ≤ 0.5 (moderate effect size), and 0.5 < r (high effect size). Homogeneity was analyzed by computing the Q and I2 values following the chi-square distribution.

2.3.5. Publication Bias of the Studies Included in the Meta-Analysis

Publication bias was assessed using a funnel plot, and the impact of publication bias on the results was examined via trim and fill.

2.4. Ethical Considerations

Ethical review by the institutional review board of the relevant university was waived for this study because it included secondary data analysis of literature (GWNUIRB-R2019).

3. Results

3.1. General Characteristics of the Studies

A total of 154 studies covering a 10-year period (2008–2018) were located in Korean and foreign databases that explored job stress among hospital nurses through a systematic review. The largest number of studies was published in Asia (n = 148), which included South Korea, China, Croatia, Iran, Israel, Japan, and Taiwan. The most common sample size was 101–300 (81.82%), and the quality rating was 10 (74.31%) (Table 1).

3.2. Summary of Variables Associated with Job Stress

A total of 154 studies were included in the meta-analysis. Altogether, 39 variables were analyzed in relation to job stress among hospital nurses, with job satisfaction being the most studied variable (n = 39), followed by burnout (n = 38), professionalism (n = 29), turnover intention (n = 23), and work environment (n = 22). When classified according to the conceptual framework of Kath et al. [6], 11 of the variables associated with job stress (28.2%) fell under the outcomes category, followed by job factors (10, 25.6%) and moderators (9, 23.1%). Among the outcomes, five were positive factors (12.8%) and six were negative factors (15.4%) (Table 2).

3.3. Effect Size of the Variables and Homogeneity Testing

3.3.1. Correlational Meta-Analysis of Job Stress and Associated Variables

Figure 2 presents the results of the meta-analysis of the correlations among major variables associated with job stress among hospital nurses. The meta coefficient for the overall correlation was 0.051 (Z = 5.08, p < 0.001). Positive correlations were found among the following major variables: insufficient job control (r = 0.483, Z = 8.37, p < 0.001), personal conflict (r = 0.454, Z = 4.96, p < 0.001), and burnout (r = 0.437, Z = 9.44, p < 0.001). In contrast, negative correlations were found among the following variables: intention to stay (r = −0.367, Z = −2.55, p = 0.011), job satisfaction (r = −0.311, Z = −7.01, p < 0.001), and personal accomplishment (r = −0.285, Z = −3.13, p = 0.002). The other variables did not have statistically significant correlations. The I2 index was 0.00~0.99.84, indicating heterogeneity; therefore, a random-effects model was used (Figure 2).

3.3.2. Meta-Analysis According to the Theoretical Framework

According to the conceptual framework of Kath et al. [6], the subcategories that showed a significant positive correlation with job stress were negative outcome factors (r = 0.40, p < 0.001) and job factors (r = 0.29, p < 0.001). However, positive outcome factors (r = −0.27, p < 0.001), personal factors (r = −0.12, p = 0.024), and moderators (r = −0.11, p < 0.001) showed significantly negative correlations with job stress (Table 3).

3.4. Publication Bias in the Selected Studies

As shown in the funnel plot, no publication bias was apparent, given the symmetrical form around the integrated estimate. In trim and fill testing, there was no change before and after correction, indicating that there was no publication bias (Figure 3).

4. Discussion

Managing nurses’ job stress is crucial to the management and advancement of nursing organizations. This study aimed to help address issues that affect nursing organizations, such as high turnover, by identifying factors associated with job stress through a systematic review of existing literature pertinent to nurses’ job stress.
A total of 154 studies were found to have examined job stress as a study variable over a 10-year period (2008–2018), and these studies investigated various predictors of job stress. Among the 154 studies included in the analysis, 39 variables (factors, moderators, and outcomes) that had correlations with job stress were analyzed. The most extensively analyzed variables were burnout, professionalism, turnover intention, and work environment. We assigned the variables according to the model proposed by Kath et al. [6]. Most variables were assigned to the outcomes category (28.2%); positive outcomes included intention to stay, job performance, and job satisfaction, and negative outcomes included burnout, depression, fatigue, health problems, trauma, and turnover intention. In addition to the outcomes category, the variables were assigned to the moderators (23.1%), job factors (25.6%), personal factors (18.0%), and hospital factors (5.1%) categories.
A meta-analysis of variables associated with job stress among nurses showed that there was a significant overall meta-correlation of 0.051. The variables with significant positive correlations with job stress were insufficient job control, interpersonal conflict, and burnout, and those with significant negative correlations with job stress were intention to stay, job satisfaction, and personal accomplishment. Insufficient job control and interpersonal conflict are job-related factors. Pressure, role conflicts, and interpersonal conflicts at work may cause individuals to feel burdened at their job [146,147], and these are perceived as job demands that, in turn, elevate job stress. Intention to stay, job satisfaction, and personal accomplishment can be considered as outcomes of job stress, with excessive job stress likely to increase nurses’ turnover intention and diminish job satisfaction.
With reference to the model proposed by Kath et al. [6], personal factors, job factors, moderators, and outcomes were significantly correlated, but hospital factors were not.
The results are consistent with those of previous studies [13] that reported that nurses’ self-efficacy affects job stress and has a moderating effect between job satisfaction and turnover intention.
Personal factors accounted for a relatively low rate of 18% compared to other factors. Hardiness and self-esteem were not significant. Among the personal factors, it is necessary to study the factors that can be improved by education and intervention in the future.
Job-related factors, as opposed to hospital-related factors, have the most substantial effect on job stress. This result is also consistent with the significant correlations found in relation to insufficient job control and personal conflict with job stress.
These results support previous reports that job pressure, role conflict, role identity, and inadequate rewards lead to adverse job outcomes that ultimately lead to adverse personal outcomes, such as health problems or burnout [146,147]. The JD–R model classified these factors as job demands, and although job demands are not necessarily negative, they can provoke job stress if they require further effort from individuals [8].
Moderators were negatively correlated with job stress. In the model developed by Kath et al. [6], moderators involve personal factors, job factors, and hospital factors that have an effect on the (positive/negative) outcomes of job stress. Moderators include autonomy, competency, coping, emotional intelligence, empowerment, leadership, professionalism, self-leadership, and social support. In our meta-analysis, the meta-correlation coefficients were not significant for hospital factors, but were significant for personal factors (r = −0.12, p = 0.024), job factors (r = 0.29, p < 0.001), and moderators (r = −0.11, p < 0.001). This suggests that nurses’ job stress is more heavily influenced by factors related to the job itself and by personal factors, as opposed to the hospital work environment, and that the factors that moderate these effects play a crucial role. In particular, autonomy, competence, emotional intelligence, and emotional labor had statistically significant meta-correlation coefficients. In other words, in addition to improving job factors to reduce job stress among nurses, efforts to prevent adverse outcomes by moderating them are equally important. Emotional intelligence has been found to be an essential leadership attribute for nursing leaders in organizational structures that feature a complex hierarchy and team systems [147]. In medical settings, emotional intelligence is an important factor in promoting multidisciplinary collaboration. Developing emotional intelligence enhances organizational commitment while reducing job stress, thereby diminishing turnover intention [148]. Positive psychological capital, such as emotional intelligence, also begets positive outcomes for organizations [149]. Autonomy lowers nurses’ job stress, promotes collaboration in the nurse–physician relationship, and increases job satisfaction [150]. Such variables with moderating effects should be taken into consideration to help mitigate job stress among nurses. Additionally, in order to alleviate the job stress of hospital nurses, nursing managers need management strategies that take into consideration factors that have a moderating effect in relation to nurses’ jobs.
This study is meaningful in that it identified various variables related to the job stress of hospital nurses through meta-correlation analysis. By subdividing and presenting these variables into nurses’ personal factors, job factors, moderators, and outcome factors, it would be easy to establish a management strategy that can reduce nurses’ job stress at the individual, organizational, and managerial levels for each factor.
This study is significant as it provides a basis for evidence-based management in preparing such management strategies.

5. Conclusions

In this study, we conducted a meta-correlation analysis to identify the factors associated with nurses’ job stress, and the overall correlation coefficient was relatively high, at 0.51. The main study variables were categorized into personal factors, hospital factors, job factors, moderators, and outcomes for the meta-correlation analysis. The results confirmed that job factors and moderators have significant meta-correlation coefficients. We synthesized the results pertaining to job stress, and the findings highlight the importance of considering job factors and moderators in approaches taken to alleviate nurses’ job stress. These results are likely to be useful in clinical practice and research to help develop job stress intervention programs for nurses. Despite extensive attempts, this study has limitations as it includes only studies published in Korean and English. Therefore, it is suggested that a more robust theoretical model for the factors related to job stress in hospital nurses should be developed in the future, including studies published in various languages.

Author Contributions

Conceptualization, J.-Y.L.; Methodology, E.-J.K., J.-Y.L. and G.-M.K.; Software, E.-J.K.; Validation, E.-J.K. and J.-Y.L.; Investigation, J.-Y.L. and G.-M.K.; Resources, E.-J.K. and J.-Y.L.; Writing—Original Draft Preparation, E.-J.K., J.-Y.L. and G.-M.K. All authors have read and agreed to the published version of the manuscript.

Funding

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. NRF-2020R1A2C1003670).

Institutional Review Board Statement

Ethical review and approval were waived for this study due to the secondary data analysis of relevant literature undertaken (GWNUIRB-R2019).

Informed Consent Statement

Patient consent was waived due to the secondary data analysis undertaken.

Data Availability Statement

The research data can be requested from the first author.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Sulsky, L.; Smith, C.S. Work Stress; Wadsworth: Belmont, CA, USA, 2006; pp. 1–317. [Google Scholar]
  2. Lee, J.H.; Kim, J.H. Analysis of correlation between dental hygienist’s job stress and social psychological stress. J. Korea Contents Assoc. 2012, 12, 400–408. [Google Scholar] [CrossRef]
  3. Sveinsdottir, H.; Biering, P.; Ramel, A. Occupational stress, job satisfaction and working environment among Icelandic nurses: A cross-sectional questionnaire survey. Int. J. Nurs. Stud. 2006, 43, 875–889. [Google Scholar] [CrossRef] [Green Version]
  4. Jacobs, A.C.; Lourens, M. Emotional challenges faced by nurses when taking care of children in a private hospital in South Africa. Afr. J. Nurs. Midwifery 2016, 18, 196–210. [Google Scholar] [CrossRef]
  5. Choi, S.R.; Jung, H.S. Meta-analysis about the causal factors and the effect of job-stress of clinical nurses. Korean J. Occup. Health Nurs. 2005, 14, 71–78. [Google Scholar]
  6. Kath, L.M.; Stichler, J.F.; Ehrhart, M.G.; Schultze, T.A. Predictors and outcomes of nurse leader job stress experienced by AWHONN members. J. Obstet. Gynecol. Neonatal Nurs. 2013, 42, E12–E25. [Google Scholar] [CrossRef]
  7. Li, J.; Lambert, V.A. Job satisfaction among intensive care nurses from the People’s Republic of China. Int. Nurs. Rev. 2008, 55, 34–39. [Google Scholar] [CrossRef]
  8. Bakker, A.B.; Demerouti, E. The job demands-resources model: State of the art. J. Manag. Psychol. 2007, 22, 309–328. [Google Scholar] [CrossRef] [Green Version]
  9. Beehr, T.A.; Glazer, S. Organizational role stress. In Handbook of Work Stress; Barling, J., Kelloway, E.K., Frone, M.R., Eds.; Sage: Thousand Oaks, CA, USA, 2005; pp. 7–34. [Google Scholar]
  10. Chang, S.J.; Koh, S.B.; Kang, D.M.; Kim, S.A.; Kang, M.G.; Lee, C.G.; Chung, J.J.; Cho, J.J.; Son, M.; Chae, C.H. Developing an occupational stress scale for Korean employees. Ann. Occup. Environ. Med. 2005, 17, 297–317. [Google Scholar] [CrossRef]
  11. Moos, R.H. Stress and coping theory and evaluation research: An integrated perspective. Eval. Rev. 1992, 16, 534–553. [Google Scholar] [CrossRef]
  12. Baezzat, F.; Sharifzadeh, H. Relationship between spiritual intelligence and emotional intelligence with job stress in university employees. J. Career Organ. Couns. 2013, 4, 55–68. [Google Scholar]
  13. Lee, S. Emotional intelligence and job stress of clinical nurses in local public hospitals. J. Korean Acad. Nurs. Adm. 2010, 16, 466–474. [Google Scholar] [CrossRef] [Green Version]
  14. Cummings, G.; Estabrooks, C.A. The effects of hospital restructuring that included layoffs on individual nurses who remained employed: A systematic review of impact. Int. J. Sociol. Soc. Policy 2003, 23, 8–53. [Google Scholar] [CrossRef]
  15. Keykaleh, M.S.; Safarpour, H.; Yousefian, S.; Faghisolouk, F.; Mohammadi, E.; Ghomian, Z. The relationship between nurse’s job stress and patient safety. Open Access Maced. J. Med. Sci. 2018, 6, 2228–2232. [Google Scholar] [CrossRef] [Green Version]
  16. Ezenwaji, I.O.; Eseadi, C.; Okide, C.C.; Nwosu, N.C.; Ugwoke, S.C.; Ololo, K.O.; Oforka, T.O.; Oboegbulem, A.I. Work-related stress, burnout, and related sociodemographic factors among nurses: Implications for administrators, research, and policy. Medicine 2019, 98, e13889. [Google Scholar] [CrossRef]
  17. Ebstein, A.M.M.; Eller, L.S.; Tan, K.S.; Cherniss, C.; Ruggiero, J.S.; Cimiotti, J. The relationships between coping, occupational stress, and emotional intelligence in newly hired oncology nurses. Psychooncology 2019, 28, 278–283. [Google Scholar] [CrossRef]
  18. Safarpour, H.; Sabzevari, S.; Delpisheh, A. A study on the occupational stress, job satisfaction and job performance among hospital nurses in Ilam, Iran. J. Clin. Diagn. Res. 2018, 12, JC01–JC05. [Google Scholar] [CrossRef]
  19. Yim, H.Y.; Seo, H.J.; Cho, Y.; Kim, J. Mediating Role of Psychological Capital in Relationship between Occupational Stress and Turnover Intention among Nurses at Veterans Administration Hospitals in Korea. Asian Nurs. Res. 2017, 11, 6–12. [Google Scholar] [CrossRef] [Green Version]
  20. Tao, L.; Guo, H.; Liu, S.; Li, J. Work stress and job satisfaction of community health nurses in Southwest China. Biomed. Res. 2018, 29, 510–518. [Google Scholar] [CrossRef] [Green Version]
  21. Itzhaki, M.; Bluvstein, I.; Bortz, A.P.; Kostistky, H.; Noy, D.B.; Filshtinsky, V.; Theilla, M. Mental health nurse’s exposure to workplace violence leads to job stress, which leads to reduced professional quality of life. Front. Psychiatry 2018, 9, 59. [Google Scholar] [CrossRef] [Green Version]
  22. Li, L.; Ai, H.; Gao, L.; Zhou, H.; Liu, X.; Zhang, Z.; Sun, T.; Fan, L. Moderating effects of coping on work stress and job performance for nurses in tertiary hospitals: A cross-sectional survey in China. BMC Health Serv. Res. 2017, 17, 401. [Google Scholar] [CrossRef]
  23. Guo, J.; Chen, J.; Fu, J.; Ge, X.; Chen, M.; Liu, Y. Structural empowerment, job stress and burnout of nurses in China. Appl. Nurs. Res. 2016, 31, 41–45. [Google Scholar] [CrossRef]
  24. Luan, X.; Wang, P.; Hou, W.; Chen, L.; Lou, F. Job stress and burnout: A comparative study of senior and head nurses in China. Nurs. Health Sci. 2017, 19, 163–169. [Google Scholar] [CrossRef]
  25. Hong, E.; Lee, Y.S. The mediating effect of emotional intelligence between emotional labour, job stress, burnout and nurses’ turnover intention. Int. J. Nurs. Pract. 2016, 22, 625–632. [Google Scholar] [CrossRef]
  26. Oh, H.; Uhm, D.C.; Yoon, Y.J. Workplace Bullying, Job Stress, Intent to Leave, and Nurses’ Perceptions of Patient Safety in South Korean Hospitals. Nurs. Res. 2016, 65, 380–388. [Google Scholar] [CrossRef]
  27. Ravangard, R.; Yasami, S.; Shokrpour, N.; Sajjadnia, Z.; Farhadi, P. The Effects of Supervisors’ Support and Mediating Factors on the Nurses’ Job Performance Using Structural Equation Modeling: A Case Study. Health Care Manag. 2015, 34, 265–276. [Google Scholar] [CrossRef]
  28. Lee, H.; Lim, Y.; Jung, H.Y.; Shin, Y.W. Turnover intention of graduate nurses in South Korea. Jpn. J. Nurs. Sci. 2012, 9, 63–75. [Google Scholar] [CrossRef]
  29. Wu, H.; Sun, W.; Wang, L. Factors associated with occupational stress among Chinese female emergency nurses. Emerg. Med. J. 2012, 29, 554–558. [Google Scholar] [CrossRef]
  30. Jaafarpour, M.; Khani, A. Evaluation of the nurses’ job satisfaction, and its association with their moral sensitivities and well-being. J. Clin. Diagn. Res. 2012, 6, 1761–1764. [Google Scholar] [CrossRef]
  31. Laranjeira, C.A. The effects of perceived stress and ways of coping in a sample of Portuguese health workers. J. Clin. Nurs. 2012, 21, 1755–1762. [Google Scholar] [CrossRef]
  32. Purcell, S.R.; Kutash, M.; Cobb, S. The relationship between nurses’ stress and nurse staffing factors in a hospital setting. J. Nurs. Manag. 2011, 19, 714–720. [Google Scholar] [CrossRef]
  33. Hudek-Knezevic, J.; Maglica, B.K.; Krapic, N. Personality, organizational stress, and attitudes toward work as prospective predictors of professional burnout in hospital nurses. Croat. Med. J. 2011, 52, 538–549. [Google Scholar] [CrossRef] [PubMed]
  34. Kim, W.O.; Moon, S.J.; Han, S.S. Contingent nurses’ burnout and influencing factors. J. Korean Acad. Nurs. 2010, 40, 882–891. [Google Scholar] [CrossRef] [PubMed]
  35. Ida, H.; Miura, M.; Komoda, M.; Yakura, N.; Mano, T.; Hamaguchi, T.; Yamazaki, Y.; Kato, K.; Yamauchi, K. Relationship between stress and performance in a Japanese nursing organization. Int. J. Health Care Qual. Assur. 2009, 22, 642–657. [Google Scholar] [CrossRef]
  36. Lin, H.S.; Probst, J.C.; Hsu, Y.C. Depression among female psychiatric nurses in southern Taiwan: Main and moderating effects of job stress, coping behaviour and social support. J. Clin. Nurs. 2010, 19, 2342–2354. [Google Scholar] [CrossRef] [PubMed]
  37. Lautizi, M.; Laschinger, H.K.; Ravazzolo, S. Workplace empowerment, job satisfaction and job stress among Italian mental health nurses: An exploratory study. J. Nurs. Manag. 2009, 17, 446–452. [Google Scholar] [CrossRef] [PubMed]
  38. Hsu, H.Y.; Chen, S.H.; Yu, H.Y.; Lou, J.H. Job stress, achievement motivation and occupational burnout among male nurses. J. Adv. Nurs. 2010, 66, 1592–1601. [Google Scholar] [CrossRef] [PubMed]
  39. Lee, R.; Kim, M.; Choi, S.; Shin, H.Y. Factors Influencing Managerial Competence of Frontline Nurse Managers. J. Korean Acad. Nurs. Adm. 2018, 24, 435–444. [Google Scholar] [CrossRef]
  40. Ha, D.G.; Sung, M.H. Impact of Job Stress, Coping Behavior, Hardiness on Burnout in Nurses in the Emergency Department. Korean J. Occup. Health Nurs. 2018, 27, 215–223. [Google Scholar]
  41. Mun, M.Y.; Lee, S.Y.; Kim, M.Y. Influence of the Awareness of Healthcare Accreditation on Job Stress and Turnover Intention in Tertiary Hospital Nurses. Korean J. Occup. Health Nurs. 2018, 27, 180–189. [Google Scholar]
  42. Jang, Y.M.; Park, J.Y. The Effect of Job Stress on Health Promotion Behaviors of Nurses in a Regional General Hospital: The Mediating Effects of Positive Psychological Capital and Nursing Work Environment. Korean J. Occup. Health Nurs. 2018, 27, 160–170. [Google Scholar]
  43. Jang, I.S.; Park, J.Y.; Jo, E.J.; Jung, M.H. The Effects of Major Health Issues and Job Stress on Presenteeism among Clinical Nurses. Korean J. Occup. Health Nurs. 2018, 27, 121–130. [Google Scholar]
  44. Jeoung, J.Y.; Kim, C.G. Impact of Interpersonal Relationship Ability, Job Stress, and Stress Coping Type on Turnover Intention of Nurses in the Early Stage of their Careers: Focusing on Job Stress. Korean J. Occup. Health Nurs. 2018, 27, 36–47. [Google Scholar]
  45. Ji, E.A.; Kim, J.S. Factor Influencing New Graduate Nurses’ Turnover Intention according to Length of Service. J. Korean Acad. Nurs. Adm. 2018, 24, 51–60. [Google Scholar] [CrossRef]
  46. Kim, H.Y.; Nam, K.H.; Kwon, S.H. Mediating Effects of Empathy and Resilience on the Relationship between Terminal Care Stress and Performance for Nurses in a Tertiary Hospital. Korean J. Hosp. Palliat. Care 2017, 20, 253–263. [Google Scholar] [CrossRef] [Green Version]
  47. Choi, H.; Park, J.; Park, M.; Park, B.; Kim, Y. Relationship between Job Stress and Compassion Satisfaction, Compassion Fatigue, Burnout for Nurses in Children’s Hospital. Child Health Nurs. Res. 2017, 23, 459–469. [Google Scholar] [CrossRef] [Green Version]
  48. Ju, W.J.; Kim, M. Nursing Competency, Self-Esteem, and Job Stress between Floating Nurses and Clinical Nurses. J. Korean Clin. Nurs. Res. 2017, 23, 248–257. [Google Scholar]
  49. Kim, Y.O.; Yi, Y.J. Influence of Verbal Abuse on Job Stress for Special Unit Nurses and General Ward Nurses in General Hospitals. J. Korean Acad. Nurs. Adm. 2017, 23, 323–335. [Google Scholar] [CrossRef] [Green Version]
  50. Yom, Y.H.; Yang, I.S.; Han, J.H. Effects of Workplace Bullying, Job Stress, Self-esteem, and Burnout on the Intention of University Hospital Nurses to Keep Nursing Job. J. Korean Acad. Nurs. Adm. 2017, 23, 259–269. [Google Scholar] [CrossRef] [Green Version]
  51. Kim, H.J.; Kim, H.Y. Emotional Labor, Job Stress and Professional Quality of Life among Nurses in Long-term Care Hospital. Korean J. Adult. Nurs. 2017, 29, 290–301. [Google Scholar] [CrossRef]
  52. Lim, Y.S.; Kang, K.A. A Study on the Job Satisfaction of the Physician Assistant (PA) Male Nurses: A Mixed-method Design. Korean J. Occup. Health Nurs. 2017, 26, 93–104. [Google Scholar]
  53. Lim, E.J.; Lee, Y.M. Influence of the Job Stress, Resilience, and Professional Identity on Burnout in Operation Room Nurses. J. Korean Crit. Care Nurs. 2017, 10, 31–40. [Google Scholar]
  54. Jung, S.; Choi, E. The Impact of Job Stress on the Patient Safety Nursing Activity among Nurses in Small-Medium Sized General Hospitals. Korean J. Occup. Health Nurs. 2017, 26, 47–54. [Google Scholar] [CrossRef] [Green Version]
  55. Kim, S.Y.; Yoon, S.H. Effect of Incivility Experienced by Clinical Nurses on Job Stress and the Moderating Effect of Self-efficacy. J. Korean Acad. Nurs. Adm. 2017, 23, 8–17. [Google Scholar] [CrossRef]
  56. Moon, H.; Sung, M.H. Impact of Ego-resilience, Self-leadership and Stress Coping on Job Satisfaction in Emergency Department (ED) Nurses. Korean J. Occup. Health Nurs. 2016, 25, 268–276. [Google Scholar] [CrossRef] [Green Version]
  57. Bang, Y.E.; Park, B. The Effects of Nursing Work Environment and Job Stress on Health Problems of Hospital Nurses. Korean J. Occup. Health Nurs. 2016, 25, 227–237. [Google Scholar] [CrossRef] [Green Version]
  58. Jun, Y.; Song, Y. The Moderating Effect of the Leisure Satisfaction in the Job Stress on Job Satisfaction of Nurses on Shift Work. Korean J. Occup. Health Nurs. 2016, 25, 208–215. [Google Scholar] [CrossRef] [Green Version]
  59. Hwang, Y.S.; Cho, E. Factors Influencing Nurse Turnover Intention of Senior Convalescence Hospitals in the Metropolitan Area. Korean J. Occup. Health Nurs. 2016, 25, 156–167. [Google Scholar] [CrossRef] [Green Version]
  60. Oh, E.J.; Kim, Y.S. A Study on the Relationship between Upper-scale General Hospital Nurses’ Experience of Verbal Abuse and Job Stress. Korean J. Occup. Health Nurs. 2015, 24, 173–182. [Google Scholar] [CrossRef] [Green Version]
  61. Noh, J.H.; Na, Y.K. Effects of Violence Experience, Emotional Labor, and Job Stress on Clinical Nurses’ Depression. Korean J. Occup. Health Nurs. 2015, 24, 153–161. [Google Scholar] [CrossRef] [Green Version]
  62. Jang, M.J.; Lee, E.N.; Lee, Y.H. Effect of Nurses’ Job Stress on Job Satisfaction: Mediating Effect of Head Nurses’ Emotional Leadership Perceived by Nurses. J. Korean Acad. Nurs. Adm. 2015, 21, 133–141. [Google Scholar] [CrossRef] [Green Version]
  63. Ko, J.O.; Ko, E. Influence of Job Stress and Professional Self-concept on Job Satisfaction among Nurses in Rehabilitation Units. Korean J. Rehabil. Nurs. 2014, 17, 81–89. [Google Scholar] [CrossRef] [Green Version]
  64. Oh, S.J.; Shin, S.H.; Go, G.Y.; Pratibha, B. The Effect of Job Stress on Health Promoting Behaviors among Nurses: Mediating Selection, Optimization and Compensation Strategy. Korean J. Adult Nurs. 2014, 26, 149–158. [Google Scholar] [CrossRef]
  65. Yeo, A.R.; Lee, H.; Jin, H. Factors Associated with Customer Orientation and Nursing Productivity. J. Korean Acad. Nurs. Adm. 2014, 20, 167–175. [Google Scholar] [CrossRef]
  66. Lee, Y.; Lee, M.; Bernstein, K. Effect of Workplace Bullying and Job Stress on Turnover Intention in Hospital Nurses. J. Korean Acad. Psychiatr. Ment. Health Nurs. 2013, 22, 77–87. [Google Scholar] [CrossRef] [Green Version]
  67. Kim, J.H.; Lee, Y.M.; Joung, H.Y.; Choo, H.S.; Won, S.J.; Kwon, S.Y.; Bae, H.J.; Ahn, H.K.; Kim, E.M.; Jang, H.J. Effects of Emotional Labor, Emotional Intelligence and Social Support on Job Stress in Clinical Nurses. J. Korean Acad. Fundam. Nurs. 2013, 20, 157–167. [Google Scholar] [CrossRef] [Green Version]
  68. Kim, J.H.; Jo, H.S. A Comparative Study on Job Stress and Satisfaction between Ward Nurses and Outpatient Nurses. Korean J. Occup. Health Nurs. 2013, 22, 83–92. [Google Scholar] [CrossRef] [Green Version]
  69. Kwon, K.J.; Lee, S.H. Occupational Stress and Coping Styles as Factors Affecting the Burnout of Clinical Nurses. J. Korean Acad. Nurs. Adm. 2012, 18, 383–393. [Google Scholar] [CrossRef]
  70. Cho, S.Y.; Sung, M.H. Factors Influencing Turnover Intention in Emergency Department Nurses. J. Korean Acad. Fundam. Nurs. 2012, 19, 503–510. [Google Scholar] [CrossRef] [Green Version]
  71. Lee, E.S.; Kim, I.S. Factors Influencing on Fatigue in Operating Room Nurses. Korean J. Occup. Health Nurs. 2012, 21, 229–238. [Google Scholar] [CrossRef] [Green Version]
  72. Lee, E.Y.; Kim, N.H. Relationship among Nurses’ Attitude on Job Rotation, Job Stress and Organizational Commitment. Korean J. Occup. Health Nurs. 2012, 21, 154–163. [Google Scholar] [CrossRef] [Green Version]
  73. Ko, C.M. A Study on Relationship between Recovery Experience and the Burnout among Hospital Nurses. Korean J. Occup. Health Nurs. 2012, 21, 87–97. [Google Scholar] [CrossRef] [Green Version]
  74. Park, S.M.; Jang, I.S.; Choi, J.S. Affecting Factors of Nurses’ Burnout in Secondary General Hospitals. J. Korean Acad. Nurs. Adm. 2011, 17, 474–483. [Google Scholar] [CrossRef] [Green Version]
  75. Choi, J.S.; Yang, N.Y. Differences in Job Stress, and Job Satisfaction according to Teaching Style, and Personality of Preceptors. J. Korean Acad. Nurs. Adm. 2011, 17, 349–356. [Google Scholar] [CrossRef] [Green Version]
  76. Gun, M.S.; Choi, Y.H.; Park, K.H. Job Stress and Presenteeism of Clinical Nurses. Korean J. Occup. Health Nurs. 2011, 20, 163–171. [Google Scholar] [CrossRef] [Green Version]
  77. Kang, H.L. A Study of Occupational Satisfaction, Stress and Customer Orientation of Upper-scale General Hospital Nurses. Korean J. Occup. Health Nurs. 2010, 19, 268–277. [Google Scholar]
  78. Park, H.S.; Kim, K.N. Factors Affecting Burnout in ICU Nurses. J. Korean Acad. Fundam. Nurs. 2010, 17, 409–418. [Google Scholar]
  79. Nam, W.; Kim, J.W.; Kim, Y.K.; Koo, J.W.; Park, C.Y. The Reliability and Validity of the Negative Acts Questionnaire-Revised (NAQ-R) for Nurses for the Assessment of Workplace Bullying. Korean J. Occup. Environ. Med. 2010, 22, 129–139. [Google Scholar] [CrossRef]
  80. Lee, J.M. Comparative Study about the Clinical Nurses Job Stress and Turnover Intention between a Nursing Care SystemWards and a General Wards. J. Soc. Sci. 2016, 33, 1–48. [Google Scholar]
  81. Kim, S.R.; Kim, H.Y.; Kang, J.H. Effects of Type D Personality on Compassion Fatigue, Burnout, Compassion Satisfaction, and Job Stress in Clinical Nurses. J. Korean Acad. Nurs. Adm. 2014, 20, 272–280. [Google Scholar] [CrossRef]
  82. Kim, M.J.; Kang, G.Y. The Convergence Study on the Relationship between the Job Stress and Mental Health of Nurses. J. Korea Converg. Soc. 2015, 6, 39–47. [Google Scholar] [CrossRef] [Green Version]
  83. Moon, H.; Kim, J.-Y. The Influence of Clinical Nurses’ Emotional Intelligence and Job Stress on Burnout. J. Korea Entertain. Ind. Assoc. 2018, 12, 173–181. [Google Scholar] [CrossRef]
  84. Lee, Y.-H.; Park, S.-H. Nurses’ Perceived Organizational Culture, Verbal Abuse and Job Stress. J. Korea Contents Assoc. 2015, 15, 292–304. [Google Scholar] [CrossRef]
  85. Lee, A.-K.; Yeo, J.-Y.; Jung, S.; Byun, S.S. Relations on Communication Competence, Job-stress and Job-satisfaction of Clinical Nurse. J. Korea Contents Assoc. 2013, 13, 299–308. [Google Scholar] [CrossRef] [Green Version]
  86. Oh, J.W.; Han, J.S.; Moon, Y.S. Study on the Awareness, Satisfaction and Job Stress of Nurses using EMR System. J. Dingtal Converg. 2012, 10, 257–264. [Google Scholar]
  87. Sim, W.-K.; Cheon, S.-M. Development and Validation of Nurse Job-Stress Coping Scale. Locality Glob. Korean J. Soc. Sci. 2016, 40, 219–241. [Google Scholar]
  88. Noh, J.-R.; Choi, E.-A. Relationship of Job Stress and Job Satisfaction by Types of Nurses’ Leisure Activities. J. Dingtal Converg. 2018, 16, 207–215. [Google Scholar]
  89. Choi, K.L.; Heo, S.-e.; Moon, D.H. Convergence Study on the Influence of Job Stress of Shift Work Nurses on Nursing Performance. Int. Conf. Converg. Technol. 2016, 7, 107–121. [Google Scholar]
  90. Kim, Y.; Lee, Y.M. Influence of Self-Leadership on Job Stress, Job Satisfaction and Burnout among Nurses in Hospitals. J. Korean Data Anal. Soc. 2009, 11, 1939–1951. [Google Scholar]
  91. Choi, J.S.; Park, S.M. Comparison of Job Stress, Hardness, and Burnout of Nurses between Advanced general Hospitals and general Hospitals. J. Korea Contents Assoc. 2012, 12, 251–259. [Google Scholar] [CrossRef] [Green Version]
  92. Choi, I.; Hwang, H.M.; Kim, J. The Influence of Awareness of Healthcare Accreditation, Job Stress and Organizational Commitment on Turnover Intention of Small and Medium sized Hospital Nurses. J. Korea Acad. -Ind. Coop. Soc. 2017, 18, 160–168. [Google Scholar]
  93. Lim, Y.-H.; Cho, Y.-C. Effects of Job Stress, Fatigue, Burnout, and Job Satisfaction on Turnover Intention among General Hospital Nurses. J. Korea Acad.-Ind. Coop. Soc. 2018, 19, 264–274. [Google Scholar]
  94. Lee, Y.-M. The Work Stress and Coping Type of Nurses in Hospital. J. Korea Acad. -Ind. Coop. Soc. 2016, 17, 230–235. [Google Scholar]
  95. Jung, M.-R.; Jeong, E. Convergence Influence of Clinical Nurses’ Resilience to the Job Stress, Turnover intention and Vitality. J. Digit. Converg. 2017, 15, 305–314. [Google Scholar]
  96. Lee, S.-Y.; Lee, J.-S.; Kim, S.-Y.; Lee, J.-Y. The Effect of Job Stress and Job Satisfaction on Professional Self-Concept in Nurses. J. Digit. Converg. 2017, 15, 273–281. [Google Scholar]
  97. Kang, Y.-S.; Kwon, Y.-C.; Kim, Y.-a. The Effect of Communication Competency and Job Stress of Long Term Care Hospital Nurses on Turnover Intention focused on control effect of emotional intelligence. J. Digit. Converg. 2018, 16, 449–457. [Google Scholar]
  98. Jeong, H.-S. The Effect of Empathy on the Job Stress among Nurses. J. Korea Acad.-Ind. Coop. Soc. 2015, 16, 3911–3918. [Google Scholar]
  99. Han, K.; Kim, T. The Effect of Emotional Labor, Job Stress and Way of Coping on the Organizational Commitment of Nurses in a General Hospital. Korean J. Stress Res. 2015, 23, 39–48. [Google Scholar] [CrossRef] [Green Version]
  100. Oh, Y.J.; Choi, Y.H. Effects of emotional labor, job stress and burnout on somatization in nurses: In convergence era. J. Digit. Converg. 2015, 13, 415–424. [Google Scholar] [CrossRef] [Green Version]
  101. Yoo, J.-B.; Won, J.-S. Impact of Job Stress, Organizational Culture and Professional Identity on Job Satisfaction of Post-anesthesia Care Unit Nurses. J. Korean Data Anal. Soc. 2018, 20, 3211–3225. [Google Scholar] [CrossRef]
  102. Park, J.Y.; Woo, C.H. The Effect of Job Stress, Meaning of Work, and Calling on Job Embeddedness of Nurses in General Hospitals. J. Korea Converg. Soc. 2018, 9, 105–115. [Google Scholar]
  103. Yang, N.Y.; Choi, J.S. Relationships of Nurses’ Perception, Nursing performance, Job stress, and Burnout in relation to the Joint Commission International Hospital Accreditation. J. Korean Acad. Nurs. Adm. 2014, 20, 1–9. [Google Scholar] [CrossRef] [Green Version]
  104. Kim, S.-Y.; Back, S.-H. The Influence of Job Characteristics and Job Stress on Children’s Hospital Nurses’ Turnover Intention. J. Korea Contents Assoc. 2016, 16, 100–113. [Google Scholar] [CrossRef] [Green Version]
  105. Yeun, Y.-R. Job Stress, Burnout, Nursing Organizational Culture and Turnover Intention among Nurses. J. Korea Acad. -Ind. Coop. Soc. 2014, 15, 4981–4986. [Google Scholar]
  106. Yi, H.-J.; Cho, Y.-C. Relationship Between Job stress and Job Satisfaction Among Nurses in General Hospitals. J. Korea Acad.-Ind. Coop. Soc. 2015, 16, 5314–5324. [Google Scholar]
  107. Song, M.J.; Kang, I.-S.; Donghee, K.I.M. Path Analysis of the Effects of Organizational Managerial Characteristics, Job Characteristics, Job Stress, Job Involvement, and Group Coherence. J. Korean Data Anal. Soc. 2009, 11, 1953–1965. [Google Scholar]
  108. Im, A.-I.; Cho, E.-A. Relationship between Emotional Labor, Job Stress and Eating Attitudes among Clinical Nurses. J. Korea Acad. -Ind. Coop. Soc. 2014, 15, 4318–4328. [Google Scholar]
  109. Ko, Y.J. A Study of the Effect of Emotional Intelligence and Job Stress on the Job Satisfaction for Nurses. J. Korean Data Anal. Soc. 2016, 18, 2245–2256. [Google Scholar]
  110. EunJin, R.; Eun, C.S. Effects of Emotional Labor, Compassion Fatigue and Occupational Stress on the Somatization of Nurses in Hemodialysis Units. Korean J. Occup Ational Health Nurs. 2017, 26, 65–73. [Google Scholar]
  111. Hong, M.J.; Kim, Y. Effects of Job Stress and Empathy on Burnout in Nurses Who Take Care of Cancer Patients. J. Korean Data Anal. Soc. 2016, 18, 461–474. [Google Scholar]
  112. Oh, M.O.; Sung, M.H.; Kim, Y.W. Job Stress, Fatigue, Job Satisfaction and Commitment to Organization in Emergency Department Nurses. J. Korean Clin. Nurs. Res. 2011, 17, 215–227. [Google Scholar]
  113. Ko, M.S.; Choi, E.H.; Choi, K.O. A Study on the Relationship of Cultural Competence, Self Efficacy and Job Stress in Nurses Caring for Hospitalized Foreign Patients. J. Korean Clin. Nurs. Res. 2016, 22, 68–77. [Google Scholar]
  114. Hur, Y.; Lee, B. Relationship between empowerment, job stress and burnout of nurses in hemodialysis units. Keimyung J. Nurs. Sci. 2011, 15, 21–30. [Google Scholar]
  115. Kang, H.; Choi, S.K.; Kim, I.S. Factors Influencing on Patient Safety Management Activities in Operating Room Nurses. J. Korea Acad.-Ind. Coop. Soc. 2016, 17, 329–339. [Google Scholar]
  116. Jung, E.-H. Influence of the Emotional Labor on the Job Satisfaction of Geriatric Hospital Nurses—Focused on the Job Stress. J. Korea Acad.-Ind. Coop. Soc. 2018, 19, 380–388. [Google Scholar]
  117. Choi, E.J.; Park, J.W.; Cho, M.L. Factors Influencing Turnover Intention of Nurses after Evaluation for Certification at Geriatric Hospitals: Focused on Job Stress and Burnout. J. Korea Acad. -Ind. Coop. Soc. 2016, 17, 438–449. [Google Scholar]
  118. Lee, Y.-L.; Ahn, S. Impact of Job Stress on Turnover Intention among Emergency Room Nurses. J. Muscle Jt. Health 2015, 22, 30–39. [Google Scholar] [CrossRef] [Green Version]
  119. Shin, M.K.; Kang, H.L. Effects of Emotional Labor and Occupational Stress on Somatization in Nurses. J. Korean Acad. Nurs. Adm. 2011, 17, 158–167. [Google Scholar] [CrossRef]
  120. Park, H.-M.; Lee, H.-S. A Study of Communication Style, Critical Thinking Disposition, Job Satisfaction and Job Stress in Hospital Nurses. Perspect. Nurs. Sci. 2011, 8, 105–112. [Google Scholar]
  121. Park, J.O.; Lee, M.J.; Kim, K.J.; Jang, B.H.; Yoo, M.S. A Study of New Nurses’ Resilience, Job Stress and Burnout. J. Korean Acad. Home Health Care Nurs. 2013, 20, 124–132. [Google Scholar]
  122. Han, S.-S. The Influence of the Job Stress, Job Satisfaction and Social Support of Clinical Nurse’s Burnout. J. East-West Res. 2013, 19, 55–61. [Google Scholar]
  123. Lee, N.H. A Study on the Relationship among Self-Efficacy of Psychiatric Nurses, Job Stress and Burnout. Health Nurs. 2011, 23, 47–59. [Google Scholar]
  124. Bong, Y.S.; So, H.S.; You, H.S. A Study on the Relationship between Job Stress, Self-Efficacy and Job Satisfaction in Nurses. J. Korean Acad. Nurs. Adm. 2009, 15, 425–433. [Google Scholar]
  125. Lee, I.; Lee, M.; Im, J.; Bae, K. Family Support and Job Stress of Clinical Nurses. Korean Parent-Child Health J. 2016, 19, 1–8. [Google Scholar]
  126. Lee, J.M.; Yom, Y.H. Effects of Work Stress, Compassion Fatigue, and Compassion Satisfaction on Burnout in Clinical Nurses. J. Korean Acad. Nurs. Adm. 2013, 19, 689–697. [Google Scholar] [CrossRef]
  127. Son, S.S.; Yang, S.J. Job Stress and Job Satisfaction among Nurses in Gastrointestinal Endoscopy Units. J. Korean Clinial Nurs. Res. 2014, 20, 189–199. [Google Scholar]
  128. Kim, M. Effects of Job Stress, Organizational Commitment, Job Satisfaction and Leadership Style on Turnover Intention of Hospital Nurses. J. Mil. Nurs. Res. 2015, 33, 95–115. [Google Scholar]
  129. Jang, T.U.; Choi, E.J. Relationships between Occupational Stress, Burnout and Job Satisfaction of Physician Assistants. J. Korean Public Health Nurs. 2016, 30, 122–135. [Google Scholar] [CrossRef] [Green Version]
  130. Ha, H.J.; Choe, J.S.; Oh, M.S.; Jeon, J.A.; Kim, Y.J.; Chin, E.Y.; Kim, Y.H. Hospital Nurses’ Job Stress, Sleep Disturbance, and Fatigue. J. Korea Inst. Korean Med. Inform. 2016, 22, 13–25. [Google Scholar]
  131. Han, M.Y.; Sohn, S.K.; Kwon, S.H.; Choi, J.H.; Choi, K.H. The Relationships among Self-Efficacy, Spiritual Well-Being, and Job Stress in Clinical Nurses. J. East-West Res. 2014, 20, 21–28. [Google Scholar] [CrossRef] [Green Version]
  132. Lee, J.-W. Influences of Job Stress, Coping, Self-efficacy on Burnout of Clinical Nurses. J. Fish. Mar. Sci. Educ. 2014, 26, 1003–1012. [Google Scholar]
  133. Na, B.J.; Kim, E.J. A Study on the Mediating and Moderating Effect of Work-Family Conflict in the Relationship Among Emotional Labor, Occupational Stress, and Turnover Intention. J. Korean Acad. Nurs. Adm. 2016, 22, 260–269. [Google Scholar] [CrossRef]
  134. Kim, Y.I.; Geun, H.G.; Cho, H.J. The Effects of Personal Coping Resources and Perceived Organizational Supports on Job Stress among Hospital-Based Home Care Nurse Practitioners (HCNPs). J. Korean Acad. Soc. Home Health Care Nurs. 2016, 23, 195–205. [Google Scholar]
  135. Joung, S.A.; Park, K.Y. Influence of Experiencing Verbal Abuse, Job Stress and Burnout on Nurses” Turnover Intention in Hemodialysis Units. J. Korean Acad. Nurs. Adm. 2016, 22, 189–198. [Google Scholar] [CrossRef] [Green Version]
  136. Oh, E.W.; Yang, S.M.; Kim, S.H.; You, H.N.; Chin, E.Y.; Kim, Y.J.; Kim, Y.H. Compare the level of job stress, burn-out and job satisfaction between intensive care unit nurses and general unit nurses. J. Korea Inst. Korean Med. Inform. 2016, 22, 27–36. [Google Scholar]
  137. Kim, M.J.; Choi, J.S. Effects of Perception of the Healthcare Accreditation, and Job Stress on Turnover Intention in Nurses. J. Muscle Jt. Health 2015, 22, 87–95. [Google Scholar] [CrossRef] [Green Version]
  138. Kim, J.R.; Kim, K.H. A Study on Job Stress and the Turnover Intention of Long-term Care Hospital Nurses. Health Nurs. 2010, 22, 1–11. [Google Scholar]
  139. Kim, G.S.; Kim, H.Y.; Koh, H.J. The Relationship between Mentoring and Job Stress of Nurses in Small and Medium. Keimyung J. Nurs. Sci. 2011, 15, 31–40. [Google Scholar]
  140. Jung, K.; Suh, S. Relationships among Nursing Activities, the Use of Body Mechanics, and Job Stress in Nurses with Low Back Pain. J. Muscle Jt. Health 2013, 20, 141–150. [Google Scholar] [CrossRef] [Green Version]
  141. Kim, S.N.; Yoo, M.S. Relationships between Resilience, Job Stress, and Organizational Commitment in ICU Nurses. J. Korean Acad. Soc. Home Health Care Nurs. 2014, 21, 36–43. [Google Scholar]
  142. Yeom, E.Y.; Jeong, G.S.; Kim, K.A. Influencing Factors on Presenteeism of Clinical Nurses. Korean J. Occup Ational Health Nurs. 2015, 24, 302–312. [Google Scholar] [CrossRef] [Green Version]
  143. Yoo, S.J.; Choi, Y.H. Predictive Factors Influencing Turnover Intention of Nurses in Small and Medium-Sized Hospitals in Daegu City. J. Korean Acad. Nurs. Adm. 2009, 15, 16–25. [Google Scholar]
  144. Hwang, E.-H. Influence of Sleep Quality, Depression and Fatigue on Job stress of Geriatric Hospital Workers. J. Korea Acad. -Ind. Coop. Soc. 2015, 16, 5413–5421. [Google Scholar]
  145. Cohen, J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed.; Rutledge: Brooklyn, NY, USA, 1988; pp. 1–567. [Google Scholar] [CrossRef]
  146. Park, S.-A.; Ahn, S.-H. Relation of compassionate competence to burnout, job stress, turnover intention, job satisfaction and organizational commitment for oncology nurses in Korea. Asian Pac. J. Cancer Prev. 2015, 16, 5463–5469. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  147. Corning, S.P. Profiling and developing nursing leaders. J. Nurs. Adm. 2002, 32, 373–375. [Google Scholar] [CrossRef]
  148. Lindeke, L.L.; Sieckert, A.M. Nurse-physician workplace collaboration. Online J. Issues Nurs. 2005, 10, 5. [Google Scholar] [CrossRef]
  149. Kim, I.S.; Seo, R.B.; Kim, B.N.; Min, A.R. The effects of positive psychological capital, organizational commitment, customer orientation in clinical nurses. J. Korean Acad. Nurs. Adm. 2015, 21, 10–19. [Google Scholar] [CrossRef]
  150. Parizad, N.; Lopez, V.; Jasemi, M.; Gharaaghaji Asl, R.; Taylor, A.; Taghinejad, R. Job stress and its relationship with nurses’ autonomy and nurse-physician collaboration in intensive care unit. J. Nurs. Manag. 2021, 29, 2084–2091. [Google Scholar] [CrossRef]
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Figure 1. Flow diagram of study selection.
Figure 1. Flow diagram of study selection.
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Figure 2. Forest plot by related variables.
Figure 2. Forest plot by related variables.
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Figure 3. Funnel plot of the selected studies.
Figure 3. Funnel plot of the selected studies.
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Table
Table 1. General characteristics (n = 154).
Table 1. General characteristics (n = 154).
VariableCategoriesn (%)
Published year2008~201022 (14.29)
2011~201565 (42.21)
2016~201967 (43.51)
CountryAfrica1 (0.65)
Asia148 (96.10)
Europe2 (1.30)
America3 (1.95)
Number of participants≤1003 (1.95)
101~300126 (81.82)
301~50014 (9.09)
501~100010 (6.49)
1001≤1 (0.65)
Quality scoring85 (3.47)
932 (22.22)
10107 (74.31)
Table
Table 2. Classification of 39 variables based on the conceptual framework.
Table 2. Classification of 39 variables based on the conceptual framework.
Categoryn (%)Variables (Number of Studies in Which the Variable Was Used/Studied)
Personal factors7 (18.0)Age (4)
Hardness (4)
Health-promoting behavior (9)
Personality (4)
Resilience (8)
Self-esteem (2)
Self-efficacy (17)
Job factors10 (25.6)Emotional labor (17)
Insufficient job control (3)
Job insecurity (8)
Lack of reward (6)
Interpersonal conflict (10)
Role conflict (7)
Role identity (7)
Violence (12)
Workload (18)
Work experience (4)
Hospital factors2 (5.1)Recreation (2)
Work environment (22)
Moderators9 (23.1)Autonomy (6)
Competency (6)
Coping (14)
Emotional intelligence (11)
Empowerment (4)
Leadership (4)
Professionalism (29)
Self-leadership (17)
Social support (15)
Outcomes11 (28.2)
Positive5 (12.8)Intention to stay (2)
Job performance (2)
Job satisfaction (39)
Organizational commitment (14)
Personal accomplishment (3)
Negative6 (15.4)Burnout (38)
Depression (5)
Fatigue (7)
Health problem (9)
Trauma (2)
Turnover intention (23)
Total39 (100.0)
Table
Table 3. The meta-analysis of job stress according to the conceptual framework.
Table 3. The meta-analysis of job stress according to the conceptual framework.
CategoriesnrLower
Limit		Upper
Limit		ZpI2
Personal factors48−0.12−0.23−0.02−2.250.02496.50
Job factors920.290.170.394.83<0.00198.82
Hospital factors24−0.02−0.200.17−0.170.86898.10
Moderators106−0.11−0.16−0.05−3.60<0.00195.71
OutcomesNegative840.400.360.4415.98<0.00192.10
Positive60−0.27−0.33−0.21−8.67<0.00194.00
Difference by categoriesQ = 357.86p < 0.001
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Lim, J.-Y.; Kim, G.-M.; Kim, E.-J. Factors Associated with Job Stress among Hospital Nurses: A Meta-Correlation Analysis. Int. J. Environ. Res. Public Health 2022, 19, 5792. https://doi.org/10.3390/ijerph19105792

AMA Style

Lim J-Y, Kim G-M, Kim E-J. Factors Associated with Job Stress among Hospital Nurses: A Meta-Correlation Analysis. International Journal of Environmental Research and Public Health. 2022; 19(10):5792. https://doi.org/10.3390/ijerph19105792

Chicago/Turabian Style

Lim, Ji-Young, Geun-Myun Kim, and Eun-Joo Kim. 2022. "Factors Associated with Job Stress among Hospital Nurses: A Meta-Correlation Analysis" International Journal of Environmental Research and Public Health 19, no. 10: 5792. https://doi.org/10.3390/ijerph19105792

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