Palliative care stress in a UK community hospital: evaluation of a stress-reduction programme

In this study the Nurses Stress Scale and Nurses Coping With Stress Questionnaire were used to investigate work-related stress in 18 nurses providing palliative care in a UK NHS community hospital. These instruments were administered twice before and twice after a stress-reduction programme. In depth qualitative interviews were conducted before and after the programme and a 12-item questionnaire was used to assess whether the nurses found the programme useful. The findings indicated that most nurses did not find their work particularly stressful, and most felt well equipped to cope with palliative care stress. However, the interviews identified a small group of nurses who felt ill equipped to cope and routinely found their work stressful. The principal sources of support for both groups of nurses were family and friends at home rather than colleagues at work, and most felt there was little opportunity to share experiences and feelings with their colleagues. Likewise, few (only 33%) had found an opportunity to practice the relaxation skills they had learnt during the stress-reduction programme. This might explain why there was no evidence of any general improvement in stress and coping scores following the stress-reduction programme. Although the nurses enjoyed the programme and found it helpful, such programmes need to tackle contextual barriers to coping with stress as well as improving the individual coping skills of staff.