Nederlandse titel proefschrift Hoofdverpleegkundigen over leven in het ziekenhuis
Engelse titel proefschrift Headnurses about life in general hospitals
Promovendus Bergh-Braam, Anneke van den
Gepromoveerde is verpleegkundige (geweest)
Universiteit Rijksuniversiteit Limburg
Datum promotie 08/06/1984
Promotores Prof. Dr. Ch.J. de Wolff; Prof. Dr. H. Philipsen
Abstract (Engels)

The survey was set up to study the problems experienced by headnurses in the execution of their function. Headnurses are considered as keyfigures on the ward. By a survey on stress of headnurses we wished to create a basis for measures to improve nursing care.
30 Hospitals participated in the survey. The sample at random was stratified on size of hospital, ward type and region. We used the so-called role-set approach. Here the headnurse is the central point. As role-senders are acting: immediate superiors, consultants, registered nurses and student-nurses.
The number of replies were 600: 120 of eacht group. The survey is based on the stressmodel adopted from Kahn (1964) and French and Caplan (1972).

Summary findings
We want to present the main findings of this survey as replies to the ten survey-questions from chapter 3. Numbers below refer to the corresponding numbers in that chapter.

Chapter 5
1. One of the most important findings of the survey is that joint task-clarity between headnurses and role-senders does not lead to experienced role-clarity of headnurses, sometimes we even observe the contrary.

Chapter 6
2. As second important point of this study we mention the deviating insights between headnurses and role-senders on their mutual understanding, tensions, expectations and work-appreciation (joint role-ambiquity).
There are significant differences between headnurses on the one side and on the other side immediate superiors, consultants and student-nurses on the question of whether headnurses are sufficiently acquainted with their work-appreciation. Immediate superiors and consultants are of the opinion that they keep the headnurses better posted than the headnurses experience themselves.

3. The third important point of this survey is found to be the relation we recorded between experienced role-ambiquity of headnurses and the behaviour of rolesenders experienced by them as less favourable. Especially the behaviours of immediate superiors should be mentioned in this respect.

Chapter 7
4. From the analysis it appears that the institutional context has no effect on the experienced role-clarity/ambiguity: neither size of hospital, type of ward nor region are connect with the experienced role-clarity/ambiguity.

5. We examined reactions shown by headnurses on experienced role-ambiguity of headnurses is greater, the experienced responsability for others proves to be more remote.

Chapter 8
6. In the second half of the study we checked the conditioning effects of some variables on the relations between experienced role-ambiguity and some other stressors and strains.
We selected rigidity for further study because connections are found in the research literature between rigidity of a functionary and the experienced role-clarity. Our analysis confirmed this: rigid headnurses experience significantly more role-clarity than flexible heads of wards.

7. Once headnurses experience role-ambiguity do we than find within the group of rigid heads of wards more or less negative reactions on it than within the group of flexible headnurses ?
Rigid heads of wards prove to react on experienced role-ambiguity more with role-conflicts than flexible headnurses do, but the last react (on experienced role-ambiguity) more with health complaints.

Chapter 9
8. In the literary study and research findings repeatedly the view comesto the fore that experienced role ambiguity is connected with less favourable interhuman relations. We therefore examined which conditioning effects interhuman relations have on the relation between experienced role-ambiguity and other stressors and strains.

9. If we look at favourable/less favourable interhuman relations from the point of view of headnurses, what do we observe?
Significant connections prove to exist between on the one side experienced role-ambiguity of headnurses and on the other side less favourable social support by immediate superiors and less favourable social support by colleagues.

10. The last point of research concerns the difference in reaction on experienced role-ambiguity between headnurses reporting favourable and those reporting less favourable interhuman relations. From this analysis it comes to the fore that with favourable/less favourable social support by immediate superiors, the reactions on experienced role-ambiguity are not significantly different.

You can find the complete thesis in the library of the Florence Nighingale Institute