]

FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR
No: Date:

RESEARCH PROPOSAL TEMPLATE

Title (not to exceed 50 words):

Identifying the Causes of Stress among Nurses Working in the Intensive Care Unit in tertiary care
hospitals of Peshawar

Name of Candidates: Sultana bibi, Zainab bibi, Ziauddin, M Naeem, Negat seema, Noureen begum, Naila, Benazir,
Momin nisa, Ruksana

Name of Supervisor: Faisal Rehman

Co-Supervisors:

1.

2.

3.

Duration of Project: 6 months

Institute
Farkhanda Institute of Nursing & Public Health Gandhara Univeristy Peshawar

Budget Required: 60 thousand

Name & Signature of Student/Scholar:

Name & Signature of the Supervisor:

Name & Signature of Head of Institute:

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FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR
1. TITLE (not to exceed 50 words): Should reflect objective of the study.

Identifying the Causes of Stress among Nurses Working in the Intensive Care Unit in tertiary care hospitals
of Peshawar

2. INTRODUCTION: (must include problem statement, background information and rationale 250-300 words)

The nursing profession is widely acknowledged as one of the most demanding and stressful occupations
within the healthcare sector. Nurses working in the Intensive Care Unit (ICU) face particularly high
levels of stress due to the critical nature of their work, the challenging patient conditions they encounter,
and the complex decision-making involved in their daily responsibilities. Stress among ICU nurses not
only affects their well-being but also has implications for patient care and outcomes.
Several studies have highlighted the prevalence and impact of stress among ICU nurses. For example, a
study by Adriaenssens et al. (2015) found that approximately 40% of ICU nurses experienced high levels
of burnout, which is closely associated with occupational stress. Additionally, a survey conducted by
Embriaco et al. (2007) revealed that ICU nurses reported high levels of emotional exhaustion,
depersonalization, and reduced personal accomplishment, all indicative of burnout syndrome.
The causes of stress among ICU nurses are multifactorial and can be categorized into various domains.
Work-related factors such as high patient acuity, rapid patient turnover, long working hours, staffing
shortages, and limited resources contribute significantly to stress levels (Pisanti et al., 2016).
Additionally, the emotional demands associated with providing care for critically ill patients, witnessing
suffering and death, and engaging in end-of-life discussions can also be overwhelming for ICU nurses
(Mealer et al., 2017). Furthermore, organizational factors like lack of support from supervisors,
inadequate communication, and conflicts within the healthcare team can exacerbate stress levels among
ICU nurses (Laschinger et al., 2016).
Understanding the specific causes of stress among ICU nurses is crucial for developing targeted
interventions and support systems to alleviate their stress and enhance their well-being. By identifying
these stressors, healthcare organizations can implement evidence-based strategies to mitigate their impact
and foster a healthier work environment for ICU nurses. Furthermore, addressing stress among ICU
nurses can have positive implications for job satisfaction, retention rates, and overall patient care.
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FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR
3. OBJECTIVE(S):

 To identify
4. OPERATIONAL the major sources of stress experienced by nurses working in the ICU.
DEFINITIONS:
 To explore the demographic and professional factors that contribute to stress among ICU nurses.
5. HYPOTHESIS
Stress: Stress (If required):
refers to the physiological and psychological response to external pressures, demands, and challenges
 To examine the relationship between stress and job satisfaction among ICU nurses.
experienced by ICU nurses in their work environment. we have 18 Linkert scale question foe finding the cause of stress
onICUTo propose
nurses evidence-based interventions and support mechanisms to reduce stress among
Nurse:ICU nurses.
Nurse is a person who is trained and educated to look after sick and ill patients’ hospital. Some are trained
in special units like cardiac care units, intensive care units and operation theaters.
ICU: These are units for very sick and serious patients are being kept for close monitoring, and observation. In these units
patients are put on artificial ventilator and pacemaker according to patient’s condition.
6. MATERIALS AND METHODS:

6a. Study Design: This study will employ a cross-sectional quantitative research design.

6b. Study Settings: Tertiary care hospitals of Peshawar

6c. Study Duration: 6 months

6d. Sample Size: Sample size will be calculated according to slovin’s formula.
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FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR

6e. Sampling Technique: A convenience sampling technique will be utilized to recruit participants.
7. SAMPLE SELECTION:

8. 7a.
DATAInclusion Criteria:
COLLECTION PROCEDURE:
 All staff
A structured nurses who
questionnaire arebeworking
will in intensive
developed based oncare units. instruments to collect data from the participants. Th
validated
Consent Form: in this section the participant will give their consent either to participate in the study or not.
Demographic and Professional Characteristics: This section will collect information on participants' age, gender,
Stress Assessment: This section will include scales or items that assess the perceived stress levels of ICU nurses.
7b. Exclusion Criteria:

 Trainee and student nurses are not involved.

 Nurses who refused to give consent for the research study.
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FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR
9. DATA ANALYSIS PROCEDURE:

TheBIBLIOGRAPHY:
10. collected data will be analyzed using appropriate statistical techniques. Descriptive statistics will
be calculated to summarize demographic characteristics, and causes of stress. Inferential statistics,
 Adriaenssens, J., De Gucht, V., & Maes, S. (2015). Causes and consequences of occupational stress
such as correlation analysis and regression analysis, will be conducted to examine the relationships
in emergency nurses, a longitudinal study. Journal of Nursing Management, 23(3), 346-358.
between variables of interest, including the relationship between stress and demographic variables.
 Embriaco, N., Azoulay, E., Barrau, K., Kentish, N., Pochard, F., Loundou, A., ... & Aboab, J. (2007).

High level of burnout in intensivists: prevalence and associated factors. American Journal of
Respiratory and Critical Care Medicine, 175(7), 686-692.
 Laschinger, H. K. S., Purdy, N., Cho, J., & Almost, J. (2016). The impact of leader–member
exchange quality, empowerment, and core self-evaluation on nurse manager’s job satisfaction.
Journal of Nursing Administration, 46(5), 252-257.
 Mealer, M., Jones, J., & Moss, M. (2017). A qualitative study of resilience and posttraumatic stress
disorder in United States ICU nurses. Intensive Care Medicine, 43(2), 218-219.
 Pisanti, R., Lombardo, C., Lucidi, F., Violani, C., Lazzari, D., Fattirolli, F., ... & Manzoni, G. M.
(2016). Occupational stress and job satisfaction of healthcare staff in rehabilitation units. La
Medicina del Lavoro, 107(6), 435-449.
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FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR

ANNEXE:
Annexure I: Data Collection Instrument

VOLUNTARY PARTICIPATION
Your participation in this study is voluntary. It is up to you to decide whether or not to take part in this
study. If you decide to take part in this study, you will be asked to sign a consent form. After you sign the
consent form, you are still free to withdraw at any time and without giving a reason. Withdrawing from this
study will not affect the relationship you have, if any, with the researcher. If you withdraw from the study
before data collection is completed, your data will be returned to you or destroyed.

CONSENT

I have read and I understand the provided information and have had the opportunity to ask questions. I
understand that my participation is voluntary and that I am free to withdraw at any time, without giving a
reason and without cost. I understand that I will be given a copy of this consent form. I voluntarily agree to
take part in this study.

Participant's signature Date

Investigator's signature Date

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FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR

Name:

Gender:

Organization:

Age:

Qualification:

Marital Status:

Job Experience:
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FARKHANDA INSTITUTE OF NURSING & PUBLIC HEALTH

GANDHARA UNIVERISTY PESHAWAR
S.NO Question Strongly agree satisfied disagree Strongly
agree disagree
1. Lack of knowledge about operating special
equipment can (ventilators, etc.) cause stress.
2. Lack of practice and inadequate skills in performing
any procedure can cause stress. (ABGS sampling,
etc.)
3. Excess work load is a reason of stress

4. Shortage of staff is a source of stress. 5

5. Prolong shifts or extra duties (night duty and

overtime) are source of stress
6. Prolong standing and no time for break is a reason of
stress
7. Lack of support from supervisor/manager is a source
of stress
8. Lack of motivation and recognition for ones’ effort is
a reason of stress
9. Conflict with doctors during duty hours can cause
stress.
10. Lack of cooperation among nurses is a cause of
stress.
11. Lack of resources and availability of equipment can
(ventilators, etc) cause stress
12. Unexpected death of patient is a cause of stress

13. Problematic or bad-mannered behaviour of patients

are the reason of stress.
14. Aggressive and demanding family members are
source of stress.
15. Patient is undergoing through painful procedure
(CVP line, CPR, etc) is a reason stress.
16. Possibility or fear of getting cross infection from
patients can (tuberculosis, hepatitis B, C) cause
stress.
17. Improper work environment (noisy surroundings etc)
is an origin of stress.
18. Inappropriate communication between nurses and
doctors can cause stress.