Effects on job stress on Iranian clinical nurses


Background: Nurses constitute the largest professional group in the health-care sector, and they are subjected to high level of occupational stress. Work-related stress is likely to have a profound psychosomatic effect and led to health problem. Objective: The study investigates job stress and its side effects in clinical nurses in a hospital in Iran. Materials and Methods: This study is a cross-sectional with descriptive analytical. The participants included 350 nurses from a hospital of Iran. A job stress questionnaire was used for the purposes of the study. Accident-related documents were also used to collect accident data. The study is a cross-sectional study taking advantage of dossiers and personal memories. SPSS version 22 and Chi-square were used to analyze collected data. Results: Twenty-six percent of the participants stated a very low job satisfaction and only 6% of them were completely satisfied with their job. 71.4% of the nurses, again because of job problems and difficulties, had medium to high levels of stress. The most important stress-causing factors are work load, ambiguity of duty, responsibility, social level, level of managers, and physical environment. Conclusion: The findings of the study indicate that stress causes adverse effects in nurses. The study also shows that physical environment, workload, and ambiguity of duties are the main factors that cause medium- to high-level stress. Furthermore, findings show that stress is severe in nurses with sleep disorder and digestive problem and sued effect of stress is mental.

Keywords: Human factor, job stress, nurses

How to cite this article:
Poursadeghiyan M, Moghimian M, Amjad RN, Baneshi MM, Yari A, Noroozi M, Hami M, Khammar A, Farrokhi M. Effects on job stress on Iranian clinical nurses. Ann Trop Med Public Health 2017;10:985-8


How to cite this URL:
Poursadeghiyan M, Moghimian M, Amjad RN, Baneshi MM, Yari A, Noroozi M, Hami M, Khammar A, Farrokhi M. Effects on job stress on Iranian clinical nurses. Ann Trop Med Public Health [serial online] 2017 [cited 2020 Dec 5];10:985-8. Available from: https://www.atmph.org/text.asp?2017/10/4/985/215878



In recent years, environment and lifestyles have drastically changed worldwide. These changes have caused social and economic chaos, especially in industrialized countries.[1] Consequently, stress factors have increased in communities and people experience stress constantly.[2]

In these societies, human life, both in terms of environment and lifestyle, has experienced substantial changes in comparison with the past years.[3] Today, almost all countries of the world sources of stress are prevalent more than ever, and the story is worst in industrial countries and the societies where economic chaos has interrupted normal life,[1],[4] so that stress can be considered the black plague in our time.[5] Stress factors have experienced an increasing growth till the early 1908s, and this led to more stress in work and life in the west. This trend intensified till 1990. Observations show that the science and technology are among factors affect such changes. For instance, the advent of new technologies including airplane and the discovery of electricity in 1900, radar and television in the 1930s, nuclear energy in the 1950s, space explorations in the 1960s and 1970s, and the information technology and the internet in the 1980s and 2000s, intensified job stress, and significantly changed lifestyle.[6],[7] Today, people experience more and more stress in their daily life compare to the past. These changes become more complicated and intensified day by day. Increasing number of the studies in this field and emergence of new scientific fields such as industrial psychiatry and working medicine confirm the correctness of this announcement.[7],[8],[9]

According to Jones and Bright, although the level of welfare and health has increased in western countries, stress has increased simultaneously and this trend is already underway.[10] Certainly, to eliminate these stress factors, they should be identified first. Given that, different causes of stress make different effects, then different methods and mechanisms are needed to address them.[10],[11],[12],[13] According to Fletcher (1988), 60% of the absences from work are due to stress-related disorders, so that only in England, 100 million work-day loss due to these absences.[14] Sperry estimated that the costs of physical problems related to psychological disorders amount to 50 or even 100 million dollars a year.[11]

Different definitions, models, and theories are developed on how stress affects people in workplaces.[15],[16] After a comprehensive review, Cox defines the stress as a complex psychological condition which derives from cognitive power of the person, according to the requirements of his or her job.[17] Sharit and Salvendy categorized stress in physiological, psychological, and social kinds.[18] According to them, both the responsibilities that demand higher than the person’s ability and those that demand lower than the person’s ability can cause stress.[17],[18],[19]

According to Cooper and Marshall, managers experience different psychological symptoms of job stress. Heart coronary blood vessels, stomach and duodenal ulcers, misusage of drugs, and anxiety, among the others, are some of disorders that may result from chaos in the life circumstances of the individuals and their families.[2],[3],[12] Physical and mental effects of stress make people vulnerable and impose large costs on their employing organizations. Organizations mostly do not consider these costs although they affect the total performance of workers. From their point of view, job stress is not as important as other problems.[20] According to Fletcher (1988), 60% of wok absences are due to stress-related disorders, and only in England, these absences include 100 million work-days.[14] Sperry revealed that problems related to psychological disorders impose about 50–100 million dollars a year. He analyzed the costs in his study.[11]

Human factors account for 60%–70% of accidents.[21] Human factors include everything related to human that is involved and interacting with the system. The factors can be categorized as psychological, biological, or social, and all of them can affect worker’s behavior in a way. These effects, if negative and unfavorable, can cause accidents. The studies show an increase in job stress leads to increase in car accidents.[22] Simon and Corbett (1996) the reason behind this fact is that in stress conditions, the workers do not observe the rules and do not notice the alarming signs.[22]


The present study aims to provide a managerial solution to measure job stress and its adverse effects and consequently to reduce these problems.

Materials and Methods

The present descriptive-analytical study was performed in a cross-sectional design study. The participants include 350 nurses in a hospital in Iran. Life history and referring to the working medicine clinic were considered. Then, for depression (Beck Anxiety Inventory) and job-stress (OSIPOW), questionnaires and reply of degree of job satisfaction were used.[2],[3] Finally, the data were collected and analyzed through statistical software and the results were reported. The study is a cross-sectional one based on dossiers and personal memoirs.SPSSr version 21.0 (SPSS Inc., Chicago, IL) was used to analyze collected data.


The average age of the nurses taking part in the study was 38.4 ± 8.22, and they ranged from 25 to 60 years. The mean of their working hour was 13.62 ± 3.64 h. The nurses’ work history is presented in [Table 1].

Table 1: Distribution of the length of employment period among nurses

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As observed in the table, most of nurses have been unsatisfied with their job.

According to [Table 3], most of the nurses had medium to high degrees of stress

Table 3: Distribution of the degree of job stress among nurses

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As it can be seen from [Table 4], the main factors which cause stress in the medium to high level are as follows: physical environment, work load, social level, level of managers and colleagues, and organization.

Table 4: Distribution of the effectiveness of job stresses among nurses

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As it can be seen from [Table 2], a high percentage of the participants are not satisfied with their job. According to the table, 26% of the participants stated a very low job satisfaction and only 6% of them were completely satisfied with their job. Therefore, it can be said that this group of nurses enjoy a very low level of job satisfaction. These dissatisfactions are due to job problems. In addition, 71.4% of the nurses, again because of job problems and difficulties, had medium to high levels of stress. The most important stress causing factors [Table 4] are work load, ambiguity of duty, responsibility, social level, level of managers, and physical environment. These factors are the most important factors that cause the most job stress in the nurses. These findings are consistent with findings presented by Yao et al.[23]

Table 2: Distribution of satisfaction with job among nurses

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In this study, the relationship between cardiac diseases, digestive diseases, and sleep disorders and degree of stress were investigated [Table 6]. As it can be seen from the table, there is a direct relationship between degrees of stress and having a previous record of being afflicted with these diseases. Yao et al. investigated the effects of job stress on cardiovascular performance. They measured stress-causing factors, blood pressure, blood sugar, and blood triglycerides in 839 participants. Their study indicated that blood pressure is higher among older individuals and those who stand up for longer periods.[23] These findings are also consistent with findings by Yu et al.[24] The survey of the degrees of depression and job satisfaction was also investigated in our study based on [Table 5] in the findings of the other study show a direct relationship between depression and stress and an inverse relationship between job satisfaction and stress.[3]

Table 6: Relationship between the record of cardiac diseases, digestive diseases, and sleep disorders with the degree of stress

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Table 5: Distribution of degree of depression among nurses

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Some of the causes of stress in shift work, this problem is solved by bright light shock for adaptation to night works.[7],[25],[26]


These findings show that stress is severe in nurses with sleep disorder and digestive problem and effect on mental health. The main causes of stress among them in hospital nurses were physical environment, workload and ambiguity of duties, responsibility


We would like to thank authorities and nurses of University of Social Welfare and Rehabilitation Sciences for their valuable cooperation and unflinching support for this study.

Financial support and sponsorship

This study was supported by grant No 1549 in University of Social Welfare & Rehabilitation Sciences.

Conflicts of interest

There are no conflicts of interest.



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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ATMPH.ATMPH_306_17


[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]

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