Rehabilitation staff stress as it relates to patient acuity and diagnosis

Significant concern exists regarding occupational stress among nurses; the present study explored the ways in which nurses' clinical symptoms and coping styles may relate to their working on a brain injury unit or a general rehabilitation unit within an acute physical rehabilitation hospital. A comparison of rehabilitation nurses' responses with those of physical therapists within the same setting was also completed. Staff members completed questionnaires related to job stress and satisfaction, coping (Ways of Coping Checklist) and adjustment (Symptom Checklist-90). Staff groups differed with regard to symptomatology. Brain injury nurses reported higher psychological distress than physical therapists on subscales including depression, interpersonal sensitivity and the global severity index. While brain injury nurses' distress in several areas was higher than other staff groups and than a normal non-patient sample, it did not approach the levels reported by a psychiatric outpatient normative group. Although the three staff groups did not differ notably with regard to most styles of coping, data suggest that work with brain injury patients may foster use of a problem-solving style. Lower physical and cognitive functioning of brain patients as compared with general rehabilitation patients may influence the greater psychological distress reported by brain injury nurses. Job stress appears to relate specifically to the perceived stressfulness of cognitive behavioural aspects of care for all staff groups. Implications of these findings, particularly with regard to support interventions, are discussed.