Influence Of Stress Predictors on Mental Wellness of Nurses in Embu and Tharaka Nithi Counties, Kenya

Abstract

Mental health needs of nurses have become a major public concern that has challenged healthcare providers` ability to offer prudent and standard health to the members of the public. The purpose of this study was to investigate the influences of stress predictors on mental wellness among nurses in Embu Level 5 and Chuka County Referral Hospitals in Kenya. Five objectives guided this study and two theories; the Therapeutic Engagement Stress Theory (TEST) and the Person-Environment (PE) Fit Theory also guided the study. The population of the study comprised of 380 nurses and 50 doctors. The Yamane formula was applied to calculate a sample size of nurses and convenient sampling was used to sample doctors. A sample size comprising of 253 nurses was derived from the Yamane formula and 10 doctors were sampled using convenient sampling. Data was collected using online questionnaires for nurses and structured face-to-face interviews for doctors. Questionnaires were designed using the PTSD Checklist 5 (PCL-5), the Positive Mental Health Scale (PMH-Scale), the NIOSH Worker Well-Being Questionnaire (WellBQ), Depression Anxiety Stress Scale-21 (DASS-21), and the General Self-Efficacy Scale (GSE). The reliability of instruments was tested using piloting of research instruments targeting 37 nurses from Kitui County Referral Hospital selected through random sampling method. The research instruments were tested for reliability and validity. An average Cronbach reliability coefficient of 0.736 from all five constructs was recorded, which were above 0.7, an indication the instruments were reliable. In addition, the instruments’ validity was tested using content validity through conceptualization of instruments, identification of domains, and developing instruments to determine their effectiveness in collecting the study data. Descriptive statistics were used to analyze the questionnaires, with the help of SPSS version 27.0, to get frequencies, means, standard deviations, and percentages. The analyzed data was presented using tables. The simple regression analysis was used to analyze the statistical significance of variables and hence, test the null hypothesis. Diagnostic tests of normality, linearity, autocorrelation, heteroscedasticity and multicollinearity were used to check whether data adhered to assumptions of the regression analysis. Also, normality of errors was tested using Histograms and Normal P-P plot. Correlation analysis was used to determine the relationship between independent and dependent variables. The deductive data method was used to analyze qualitative data where themes were identified to find the influence between predictors of stress and mental wellness of nurses. Qualitative data was presented thematically to come up with patterns and codes that were used to generate themes. Findings from regression analysis of variables rejected all null hypotheses. Therefore, the study established that stress predictors namely: physical work environment, organizational factors, nurse-colleague relationship, care recipients` attitudes towards nurses, and self-efficacy as a moderating variable on the stress predictors influenced mental wellness of nurses. The outcome of the research was significant in establishing an evidence-based practical knowledge on the influence of predictors of stress on mental wellness. The study concluded that addressing the stress predictors is critical in enhancing the mental wellness of nurses, thereby potentially improving healthcare service delivery in Kenyan referral hospitals. The study recommended future research focuses on unit- specific stress factors and interventions to tailor support mechanisms for nurses working in different healthcare settings.