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Oncology nursing is often a source of substantial stress for nurses. Many nurses, particularly novice nurses, have inadequate preparation to care for patients at the end of life and their families. Unless nurses prevent or manage work-related stress by using effective coping strategies, oncology nursing staff will continue to suffer from compassion fatigue (Ozden et al., 2013).
This study was aimed to assess stress and satisfaction of nurses caring of pediatric oncology patients through:-
1. Assessment of stress among pediatric oncology nurses.
2. Assessment of satisfaction of pediatric oncology nurses.
1. What are types of stress and satisfaction affecting nurses caring of pediatric oncology patients?
2. What are the levels of nurses’ stress and satisfaction toward nursing care provided for their children?
The subject and methods of the current study will discuss under the following four (4) designs:
I. Technical Design
II. Operational Design
III. Administrative Design
IV. Statistical Design
I. Technical Design
A descriptive design was used to conduct this study.
This study was conducted at Pediatric Oncology Department in Children’s Hospital affiliated to Ain Shams University Hospitals, in Cairo and National Oncology Institute in Tanta.
A purposive sample composed of 100 oncology nurses working with oncology children in the previously mentioned setting with the following inclusion criteria:
3. Provide care to oncology children.
4. Had at least one year of experience in dealing with oncology children.
Tools of data collection
Data were collected through use of the following tools:
Tool 1: Interview questionnaire form. This tool was designed by the researcher and written in a simple Arabic language based on scientific literature review it included three parts to assess data about the following:
It was used to assess demographic characteristics of the studied nurses such as: Age, gender, and level of education, income and years of experience.
Tool 2: Expanded Nursing Stress Scale: It was adopted from French et al. (2000) to asses nurses stress developed by Gray-Toft & Anderson (1981). The Expanded Nursing Stress Scale contained 63 items in nine subscales: (a) Death and Dying (8 items), (b) Conflict with physicians (5 items), (c) Inadequate emotional preparation (3 items), (d) Problems relating to supervisors (8 items), (e) Problems relating to peers (8 items), (f) Work load (15 items), (g) Uncertainty concerning treatment (6 items), (h) Patients and their families (7 items), and (i) Discrimination (3 items).
The Expanded Nursing Stress Scale (ENSS) has subscales were scored 1, 2, 3, 4, and 5 as follows: never stressful, occasionally stressed, frequently stressed, extremely stressed, always occur stressed responses, respectively.
For each stage, the scores of the items of subscales were summed-up and the total divided by the number of the items, giving a mean score for the part. These scores were converted into a percent score. The subject was considered stressful if the percent score was 60% and more and no stressful if less than 60%.
Tool 3: Job Satisfaction Scale. It was adopted from Afify et al. (2009), to asses nurses’ job satisfaction. It was constructed to obtain information about the staff nurses’ needs and the extent to which these needs are satisfied in the workplace. It was developed based on pertinent literature. The questionnaire to asses needs of nurses including: (a) Physiological needs (10 items), (b) Safety and security need (20 items), (c) Love and belonging (10 items), (d) Self–esteem (14 items), and (e) Self–actualization needs (8 items).
The response to the satisfaction scale items were on 5 point Likert-scale (0= extremely dissatisfied, 1= dissatisfied, 2= not determined, 3= satisfied and 4=very satisfied).
For each unit, the scores of the items were summed-up and the total divided by the number of the items, giving a mean score for the part. These scores were converted into a percent score. The subject was considered satisfied if the percent score was 60% and more, and dissatisfied if less than 60%.
II. Operation design
The operational design for this study consisted of three phases, namely preparatory phase, pilot study, and fieldwork.
This phase included reviewing of literature related to stressor for nurses working with pediatric oncology patients and job satisfaction by using books, articles, journals, and internet. This developed to serve the study tools for data collection. During this phase, the researcher also visited the selected places to get acquainted with the personnel and the study settings. Development of the tools was under supervisors’ guidance and experts’ opinions were considered.
Pilot study was carried out on 10% (10 nurses) of oncology nurses working with pediatric oncology patients in the previous mentioned settings to test the applicability of the constructed tools and the clarity of the included questions related to stressor and job satisfaction. The pilot has also served to estimate the time needed for each subject to fill in the questionnaire. The pilot participants were not included in the main study sample.
The actual field work of this study was carried out over 6 months period started from the beginning of June 2018 till the end of November 2018, The researcher was visited the study settings 2 days / weekly (Sundays and Thursdays) by rotation from 9 a.m. to 2 p.m over a 6 months period using the previously mentioned study tools and the researcher first met with the nurses and explained the aim of the study after introducing himself in order to obtain their permission, then individual interviewing was done after obtaining nurses consent to participate. The questionnaire filled in by the nurses taken 30-45 minutes.
Content and Face Validity and Reliability:
Content validity was ascertained by a group of three experts in field of Pediatric Nursing to test its content validity and applicability. Testing the reliability through Cronbach’s Alpha reliability analysis
Table (I): Cronbach’s Alpha reliability analysis.
Tools Number of items Reliability Internal consistency
Reliability Coefficient Cronbach’s Alpha
I. Expanded Nursing Stress Scale 63 0.820 0.870 Good
II. Job Satisfaction Scale 62 0.816 0.857 Good
The above table shows Alpha Cronbach’s test which used to measure the internal consistency (Reliability of the used tool or instrument) the reliability score of tool as above is (0.870 and 0.857) for expanded nursing stress scale and job satisfaction respectively.
III. Administration design
Approval obtained through on issued letter from the Dean of Faculty of Nursing, Ain Shams University to directors of the previously mentioned settings. The researcher then met the hospital director and explained the purpose and the methods of the data collection.
The research approval obtained from the faculty ethical committee before starting the study. Verbal approval obtained from the nurses before conduction of the study; a clear and simple explanation given according to their level of understanding, physical and mental readiness. They secured that all the gathered data was confidential and used for research purpose only. The nurses informed that they are allowed to choose to participate or not in the study and they have the right to withdraw from the study at any time