IMPACT OF STRESS ON QUALITY OF CARE: THE MODERATING ROLE OF WORKPLACE SPIRITUALITY

Abstract

There is nothing more important for any country than the health and well-being of citizens for which committed health services of public healthcare institutions are necessary. Nursing staff is a vital channel whose assistance is needed for fulfiling the dream of universal healthcare in India. The increase in attrition rate, aggression, conflicts, anxiety, and medical errors of nursing staff has put a serious question mark on their working environment. This study has find out the significant causes of decreasing quality of care in light of the above said issues of nursing staff working in public healthcare institutions. This century is marked by significant changes in the social and demographic structure of the country like increased number of female professionals, working couples, increased divorce rates, maternal employment and single parents. These changes have altered the family structure due to which the quality of life is eloping. Also, the disparity of demands and scarcity of time has increased the conflict between family and career life. Furthermore, death and dying, chronic diseases, scarcity of material and human resources, emotionally and physically taxing situations, and aggressive patients are integral to the nursing profession. In order to work in such a demanding profession, nurses need family and colleagues support to provide effective and efficient services. Nursing care requires the coordination and cooperation of each and every member because teamwork is emphasized and valued; so that nurses can better meet the requirements of the patients and can achieve the common goal, that is, health and well-being of patients. However, the ground reality seems to be different for nurses providing bed side care to patients. Multiple tasks along with the shortage of manpower have clustered the major burden of patient care on nursing staff, and lack of interpersonal relations at workplace has worsened the situation further. Moreover, long hierarchical structure restrains the open communication; hampers the team works and psychosomatic situations create aggression among team members. Nursing staff acts as a mediator between patients, doctors and healthcare institutes, and they face the aggressive behavior of patients and all other stakeholders of healthcare services. All these causes create strain among nursing staff and affect their quality of care services. Stress is the disparity of demand and resources at workplace even job itself can become the sources of transcendence and joy when nurses feel sense of community with ii organizational goals. This study considers workplace spirituality as a coping mechanism for stress and also as a buffering variable in between stress and quality of care. Descriptive research was used as a precursor of quantitative research design and survey method was adopted for the purpose of data collection. Nursing staff working in public healthcare institutions of Uttarakhand region were selected as the samples of the study. Convenience sampling technique was adopted for selection of sample, and accordingly, questionnaires were distributed to the selected sample. Finally, 872 questionnaires were used for analysis. Data analysis techniques like confirmatory factor analysis (CFA) and regression analysis using Hayes SPSS macro named ‘PROCESS’ were used to test the hypotheses. The results indicated that significant and positive relationship exists between independent variables and stress, and there is negative relationship between stress and quality of care. The results of the study supported the mediating role of stress between independent and dependent variables. Further, the results confirmed the buffering influence of workplace spirituality on relationship between stress and quality of care. The results showed high mean value of work-family conflict, bullying, patient incivility and stress and low mean value of workplace spirituality and quality of care. The mean values indicate high conflict and aggression at workplace which results in exhaustion of psychological and emotional resources. Transformational resource like workplace spirituality can play a vital role in expanding the conscious periphery of nurses. This study provides recommendations that will help the management and nursing leaders to better understand the ground causes of stress among nursing staff and to make better decisions about policies and procedures for better job outcomes. The limitations of this study have opened new avenues for future research in the nursing profession.