Work Stressors in Nursing in the Course of Redesign: Implications for Burnout and Interactional Stress

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Abstract
The process of redesign and organizational development from a functional to a holistic nursing system is evaluated with respect to its influence on work stressors and the implications for burnout and interactional stress. The investigation is based on a longitudinal comparative study between one "model hospital" and two "control hospitals". Two groups of data were analysed: a bundle of quantitative indicators of different forms of work stressors, which proved to be reliable predictors of burnout, and qualitative data stemming from group discussions with the nursing staff to detail and to illustrate the quantitative results. Multivariate analysis of variance was applied to inspect main, simple main, and interaction effects of the factors time and hospital. The quantitative results show that work stressors were substantially reduced in the model hospital in the course of redesign, while emotional exhaustion and depersonalization increased. According to the qualitative results this effect can be interpreted in terms of an intensification of interactional stress and emotional work within the holistic nursing system. The results are discussed against the background of a modernization of work systems in people-oriented human services.