Zabin Loai M, Qaddumi Jamal, Ghawadra Sajed Faisal
College of Nursing, Arab American University, Jenin, Palestine.
College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
BMC Nurs. 2025 Apr 1;24(1):355. doi: 10.1186/s12912-025-03009-9.
Patient safety is a global concern, with high rates of medical errors reported annually. Understanding the relationship between nurses' job stress and patient safety culture (PSC) is crucial. Despite their pivotal role in healthcare, nurses face stress due to demanding job roles and the challenging healthcare system in Palestine. This study aims to explore the relationship between nurses' job stress and PSC in Palestinian hospitals, identifying predictors that impact PSC to enhance healthcare outcomes and support healthcare professionals.
This study employed a quantitative cross-sectional approach. Data collection took place from June to September 2023. The study utilized self-report surveys, including the Hospital Survey of Patient Safety Culture (HSOPSC) and the Nursing Stress Scale (NSS), administered to 355 nurses working in 16 North West Bank hospitals in Palestine. The data collected were analyzed via descriptive and inferential analysis.
Overall, 47% of the nurses reported having positive PSC. The areas with the most positive perception were "teamwork" and "organizational learning-continuous improvement", with mean percentages of positive responses of 63.1% and 55.8%, respectively. Conversely, the composites with the lowest positive response scores included "Response to Error" and "Staffing and Work Pace", with mean percentages of positive responses of 30.9% and 34.8%, respectively. Furthermore, the most common sources of job stress perceived by nurses were "workload" and "death and dying", with mean scores of 1.42 and 1.20, respectively. However, the lowest-scoring sources of stress were in the subscales "Uncertainty concerning treatment" and "Inadequate preparation", with mean scores of 1.02 and 1.06, respectively. Statistical tests revealed that six factors were significantly associated with the perception of PSC. Among these factors, income, hospital type, activities to improve PSC, patient safety ratings of work areas, and weekly night shifts emerged as predictors of PSC. Additional tests revealed nine factors significantly associated with job stress. Among these factors, gender, educational level, engagement in stress relief activities, participation in PSC improvement activities, and patient safety ratings emerged as predictors of job stress. Moreover, the study revealed negative correlations between job stress and PSC.
This study identified the need for tailored policies and interventions that address nurses' specific stressors to enhance PSC within hospital settings. Moreover, the study shed light on the unique challenges faced by nurses in Palestine, such as limited resources, unemployment concerns, staffing, and transportation issues, which further exacerbated job stress levels and potentially compromised patient safety. Understanding these contextual factors is crucial for developing targeted interventions and support systems that prioritize the holistic well-being of nurses and the quality of patient care delivery.
患者安全是一个全球关注的问题，每年报告的医疗差错率很高。了解护士的工作压力与患者安全文化（PSC）之间的关系至关重要。尽管护士在医疗保健中发挥着关键作用，但由于工作要求高以及巴勒斯坦具有挑战性的医疗系统，他们面临着压力。本研究旨在探讨巴勒斯坦医院护士的工作压力与PSC之间的关系，确定影响PSC的预测因素，以改善医疗保健结果并支持医疗保健专业人员。
本研究采用定量横断面研究方法。数据收集于20020年6月至9月进行。该研究使用了自我报告调查，包括《患者安全文化医院调查》（HSOPSC）和《护理压力量表》（NSS），对在巴勒斯坦约旦河西岸16家医院工作的355名护士进行了调查。收集到的数据通过描述性和推断性分析进行分析。
总体而言，47%的护士报告称具有积极的PSC。认知最积极的领域是“团队合作 ”和“组织学习 - 持续改进”，积极回应的平均百分比分别为63.1%和55.8%。相反，积极回应得分最低的综合指标包括“对差错的应对”和“人员配备与工作节奏”，积极回应的平均百分比分别为30.9%和34.8%。此外，护士认为最常见的工作压力来源是“工作量”和“死亡与临终”，平均得分分别为1.42和1.20。然而，压力得分最低的来源在“治疗的不确定性”和“准备不足”子量表中，平均得分分别为1.02和1.06。统计检验表明，六个因素与PSC认知显著相关。在这些因素中，收入、医院类型、改善PSC的活动、工作区域的患者安全评级和每周夜班次数成为PSC的预测因素。进一步的检验表明，九个因素与工作压力显著相关。在这些因素中，性别、教育水平、参与减压活动、参与PSC改善活动和患者安全评级成为工作压力的预测因素。此外，该研究揭示了工作压力与PSC之间的负相关关系。
本研究确定需要制定针对性的政策和干预措施，以解决护士的特定压力源，从而在医院环境中增强PSC。此外，该研究揭示了巴勒斯坦护士面临的独特挑战，如资源有限、失业担忧、人员配备和交通问题，这些进一步加剧了工作压力水平，并可能危及患者安全。了解这些背景因素对于制定有针对性的干预措施和支持系统至关重要，这些措施和系统应优先考虑护士的整体福祉和患者护理服务质量。
