Factors Related to Occupational Stress Among Nurses in the Inpatient Unit of Madani Mamboro Regional General Hospital.
Palu City Sadli Syam*1.
Muhammad Sabri Syahrir2.
Adhe Sofyan Anas3.
Muhammad Akbar Durya4 1Department Health Promotion and Behavioral Science.
Public Health Faculty.
Tadulako University 2,4Department Occupational Health and Safety.
Public Health Faculty.
Tadulako University 3Department Environmental Health.
Public Health Faculty.
Tadulako University Author's Email Correspondence ( * ): sadlisyam.
pk@gmail.
( 62-813-5558-9.
ABSTRACT
Work stress is a common issue faced by healthcare workers, particularly nurses.
It arises when there is an imbalance between an individualAos capabilities and the demands of the work environment.
the greater this mismatch, the higher the level of stress experienced.
Various factors have been identified as contributors to work stress, including workload, work shifts, lighting conditions, and age.
This study aimed to examine the relationship between workload, work shifts, lighting intensity, and age with work stress among psychiatric nurses at RSUD Madani in Central Sulawesi Province.
A quantitative analytic method with a cross-sectional design was employed.
The study involved total sampling, with 54 nurses participating as respondents.
Data were collected using structured questionnaires based on Likert and Guttman scales.
The results indicated significant associations between workload .
= 0.
and work shifts .
= 0.
with work stress.
However, no significant relationships were found between lighting intensity .
= 0.
or age .
= 0.
and work stress.
These findings suggest that workload and shift schedules are key factors influencing work stress among nurses in inpatient units.
Therefore, it is recommended that RSUD MadaniAos management adjust nursesAo workloads and improve shift scheduling in order to reduce work stress Keywords: Workload.
Lighting Intensity.
Work Shift.
Work Stress.
Age.
Published by:
Tadulako University Address:
Jl.
Soekarno Hatta KM 9.
Kota Palu.
Sulawesi Tengah.
Indonesia.
Phone: 6282290859075 Email: preventifjournal.
fkm@gmail.
Article history :
Received : 13 07 2025 Received in revised form : 08 08 2025 Accepted : 28 08 2025 Available online : 31 08 2025 licensed by Creative Commons Attribution-ShareAlike 4.
0 International License.
PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2
INTRODUCTION
According to the World Health Organization (WHO, 2.
, occupational health and safety aim to protect workers from injuries and illnesses caused by working conditions, while also creating a work environment that supports mental well-being, which contributes to work related stress.
Several factors are suspected to contribute to job stress among nurses, especially those working in high demand environments such as general hospitals and psychiatric hospitals.
A lack of attention to occupational health and safety (OHS) aspects can significantly trigger work related stress, including factors such as workload, work shifts, and lighting intensity.
A heavy workload, such as the number of patients to be cared for and the complexity of nursing tasks, can lead to physical and mental fatigue.
Work shifts especially rotating schedules that disrupt nurses sleep and rest patterns can also increase stress levels.
In addition, lighting intensity in psychiatric hospital environments can affect both work comfort and the psychological well being of nurses, whether the lighting is excessively bright or too dim.
These conditions add to the complexity of their Moreover, irregular work shifts and inadequate environmental conditions, such as poor lighting intensity, may further exacerbate nurses stress levels.
The World Health Organization (WHO) reports that around 450 million people globally suffer from work related stress.
This condition arises from a range of internal or external pressures that negatively affect an individualAos health, potentially leading to illness.
Stress is triggered by exposure to stressors and is reflected through emotional and physiological responses in the body.
In an effort to understand the factors that influence work stress in nurses, the Job Demands-Resources (JD-R) model offers a comprehensive conceptual framework.
This model suggests that stress arises due to an imbalance between job demands .
ob demand.
and personal resources or work .
obs/personal resource.
the context of nurses in inpatient units, job demands such as high workload, shift work systems, and lighting intensity in the work environment can contribute to increased psychological pressure.
On the other hand, personal resources such as age, work experience, and capability of individual coping play an important role in reducing the level PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2 of stress by increasing resistance to work pressure.
When these demands exceed the available resource capacity, the risk of work stress will increase significantly.
Work related stress is one of the major challenges faced by healthcare workers, particularly nurses working in inpatient units of psychiatric hospitals.
High job demands, complex work environments, and intensive interactions with patients experiencing mental disorders can significantly increase the risk of stress.
When not properly managed, this stress can negatively impact nurses physical and mental health, reduce their performance, and ultimately affect the quality of care provided to patients.
Nurses workloads are heavily influenced by the adequacy of staffing levels or the nurse-to-patient ratio.
Research shows that when a small number of nurses are responsible for a large volume of tasks, it leads to a high workload and increased workrelated stress.
Many nurses report experiencing excessive workloads, particularly during periods of high inpatient or outpatient volumes.
In hospital settings, approximately 3% of nurses experience moderate to heavy workloads, and 82% perceive their workload as heavy.
Shift work refers to the division of working hours into several parts, typically categorized as morning, evening, and night shifts.
Many employees struggle to adapt to shift work systems, as it requires significant adjustments to daily routines, including sleep schedules, meal times, and time spent with family.
In the context of nurses in inpatient units, job demands such as high workload, shift work systems, and lighting intensity in the work environment can contribute to increased psychological pressure.
On the other hand, personal resources such as age, work experience, and capability of individual coping play an important role in reducing the level of stress by increasing resistance to work pressure.
When these demands exceed the available resource capacity, the risk of work stress will increase significantly.
According to Hidayat et al.
, light is one of the key factors regulating the human biological rhythm.
Improper lighting can lead to sleep disturbances and chronic fatigue, ultimately triggering stress.
Therefore, proper lighting management in psychiatric PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2 hospitals is crucial to support the well-being of both nurses and patients.
Good lighting can enhance mood, boost productivity, and improve psychological well being.
On the other hand, poor lighting can contribute to stress, fatigue, and physical issues such as headaches or eye strain.
Light intensity measured in lux .
refers to the amount of light entering a Adequate lighting is essential for the comfort and health of nurses.
In an effort to understand the factors that influence work stress in nurses, the Job Demands-Resources (JD-R) model offers a comprehensive conceptual framework.
This model suggests that stress arises due to an imbalance between job demands .
ob demand.
and personal resources or work .
obs/personal resource.
In the context of nurses in inpatient units, job demands such as high workload, shift work systems, and lighting intensity in the work environment can contribute to increased psychological pressure.
the other hand, personal resources such as age, work experience, and capability of individual coping play an important role in reducing the level of stress by increasing resistance to work pressure.
When these demands exceed the available resource capacity, the risk of work stress will increase significantly METHODS Validity & reliability of the questionnaire Before use, the questionnaire has gone through the validity test and reliability test.
The validity test was carried out using the pearson correlation with the results showing that all items have a value table .
<0.
, which shows that the items are valid and are able to measure the construct in question.
Furthermore, the reliability test was carried out using CronbachAos Alpha, and the Ou 0.
70 value was obtained for all subscales, which indicates that the instrument has a good internal consistency.
Operational definition of Auheavy/lightAy workload & lux standard (Ou 300 l.
The research instrument used in this study was in the form of a structured questionnaire compiled based on indicators that were relevant to national regulations.
The work stress variable and lighting intensity are formulated based on the Regulation of the PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2 Minister of Manpower of the Republic of Indonesia Number 5 of 2018 concerning Safety and Health of the Work Environment, which contains provisions on psychological risk factors in the workplace and decent lighting threshold.
The workload variable and work shift refer to the provisions in Law Number 13 of 2003 concerning Employment and Implementation Regulations, which regulate the work time and distribution of employee Statistical tests .
hi-square only? Consider logistic regressio.
In this study the Chi-Square test was used as a statistical analysis method to determine the relationship between independent variables .
uch as workload, shift work system, lighting intensit.
with the dependent variable, namely the level of work stress.
The selection of the Chi-Square test is based on the characteristics of category-scale data .
ominal or ordina.
, both in the independent and bound variables.
This test is suitable to be used to analyze the relationship between two categorical variables in an independent population, the use of this test is also supported by the assumption that the sample used is random, the category of data exclusive, and expectations count in each contingency cell is sufficient (> .
Thus, the Chi-Square test provides an appropriate analytical basis for testing the research hypothesis regarding the relationship between work characteristics and work stress among the nurses of inpatient units of Madani Mamboro Hospital.
Ethical approval & permit no.
This study is an observational study that uses a survey method with an anonymous questionnaire and does not involve intervention or treatment of the subject.
Therefore, research does not require formal ethical permission or special ethical approval number.
Nevertheless, researchers continue to comply with the principles of research ethics by maintaining the confidentiality of respondents' data, obtaining the approval of participants voluntarily through informed consent, and ensuring that participation does not pose a risk or negative impact for the participants.
PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2
RESULTS
Univariat Analysis Table 1 Distribution of Respondents by Age Group at Madani Regional General Hospital.
Central Sulawesi Province Age Group Frequency .
Percentage (%) 22,2 % 11,1 % 27,9 % 22,2 % 3,7 % 3,7 % 9,2 % Total Source: Primary data, 2025 Based on Table 5.
1, the highest distribution of respondents by age group was in the 35Ae39 age group, with 15 respondents .
9%).
The lowest distributions were found in the 45Ae49 and 50Ae54 age groups, each with 2 respondents .
7%).
Table 2 Distribution of Respondents by Gender Group at Madani Regional General Hospital.
Central Sulawesi Province Age Frequency .
Percentage (%) Male
53,7%
Female 46,3% Total Source: Primary data, 2025 Based on Table 5.
2, the highest distribution of respondents by gender was male, with 29 respondents .
7%), while the lowest was female, with 25 respondents .
3%).
PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2
Table 3 Distribution of Respondents by Last Education Level at Madani Regional General Hospital.
Central Sulawesi Province Education Level Frequency .
Percentage (%) 22,2 % D-IV
1,85 %
D-i 61,1 % Ners 14,8 % Total Source: Primary data, 2025 Based on Table 5.
3, out of 54 respondents analyzed, the highest proportion was in the D-i category with 33 respondents .
1%), while the lowest was in the D-IV category with only 1 respondent .
85%).
Table 4 Distribution of Respondents by Length of Service at Madani Regional General Hospital.
Central Sulawesi Province Length of Service Frequency .
Percentage (%) 1 Ae 9 Years 10 Ae 18 Years 19 Ae 27 Years 28 Ae 36 Years Total Source: Primary data, 2025 Based on Table 5.
4, out of 54 respondents analyzed, the highest proportion was in the 1Ae9 years category with 26 respondents .
1%), while the lowest was in the 19Ae27 years category with 5 respondents .
3%).
Table 5 Distribution of Respondents by Marital Status at Madani Regional General Hospital.
Central Sulawesi Province Married Category Frequency .
Percentage (%) Married Unmarried 12,9 % Total Source: Primary data, 2025 Based on Table 5.
5, out of 54 respondents analyzed, 47 respondents .
%) were in the married category, while the remaining 7 respondents .
9%) were categorized as PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2 unmarried.
Table 6 Distribution of Respondents by Workload at Madani Regional General Hospital.
Central Sulawesi Province Workload Frequency .
Percentage (%) Heavy 85,1% Light
14,8 %
Total Source: Primary Data, 2025 Based on Table 5.
6, the highest distribution was among respondents experiencing a heavy workload, with 46 respondents .
1%), while the lowest was among those with a light workload, totaling 8 respondents .
8%).
Table 7 Distribution of Respondents by Work Shift at Madani Regional General Hospital.
Central Sulawesi Province Work Shift Frequency .
Percentage (%) Confroming 66,6% Non Conforming 14,8 % Total Source: Primary Data, 2025 Based on Table 5.
7, the highest distribution of respondents was in the AuconformingAy work shift category, with 36 respondents .
6%), while the lowest was in the AunonconformingAy work shift category, with 18 respondents .
3%).
Table 8 Distribution of Respondents by Lighting Intensity at Madani Regional General Hospital.
Central Sulawesi Province Lighting Intensity Frequency .
Percentage (%) Meets the standard Does not meet the Total Source: Primary Data, 2025 Based on Table 5.
8, the highest distribution of respondents by lighting intensity was in the Aumeets the standardAy category, with 44 respondents .
5%), while the lowest was in the Audoes not meet the standardAy category, with 10 respondents .
5%).
PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2
Table 9 Distribution of Respondents by Work Stress at Madani Regional General Hospital.
Central Sulawesi Province Work Stress Frequency .
Percentage (%) Experiencing 70,3 % Not experiencing 29,6 % Total Source: Primary Data, 2025 Based on Table 5.
9, the highest distribution of respondents was among those experiencing work stress, with 38 respondents .
3%), while the lowest was among those not experiencing stress, with 16 respondents .
6%).
Bivariate Analysis Table 10 The Relationship Between Workload and Work Stres
Work Stres
Total
Workload
p-value Stres
Not Stres
Heavy N % Light
Total
Source: Primary Data, 2025
0,001
The table above shows that among respondents with a heavy workload, 26 respondents .
7%) experienced stress, while 3 respondents .
3%) did not.
Meanwhile, among those with a light workload, 11 respondents .
%) experienced stress and 14 respondents .
%) did not.
PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2
Table 11 The Relationship Between Work Shifts and Work Stress
Work Stres
Total
Work Shifts Stres
Stres
p-value Non
Conforming Conforming Total
0,019
Source: Primary Data, 2025 The table above shows that among respondents with non-conforming work shifts, 10 respondents .
6%) experienced stress, while 11 respondents .
4%) did not.
contrast, among those with conforming work shifts, 27 respondents .
8%) experienced stress, and 6 respondents .
2%) did not.
Table 12 The Relationship Between Lighting Intensity and Work Stress
Work Stress
Total
Lighting Stres
Not Stres
p-value Intensity N % Adequate Inadequate Total
0,791
Source: Primary Data, 2025 The table above shows that among respondents with adequate lighting intensity, 31 respondents .
5%) experienced stress, while 13 respondents .
5%) did not.
Meanwhile, among those with inadequate lighting intensity, 6 respondents .
%) experienced stress and 4 respondents .
%) did not.
PREVENTIF: JURNAL KESEHATAN MASYARAKAT VOLUME XVI NOMOR 2
Table 13 The Relationship Between Age and Work Stress
Work Stress
Total
Age
Stres
Not Stres
p-value Young < 40
Tahun Old > 40
Tahun Total
0,181
Source: Primary Data, 2025 The table above shows that among younger respondents under 40 years old, 26 respondents .
5%) experienced stress, while 8 respondents .
5%) did not.
Meanwhile, among older respondents aged 40 years and above, 11 respondents .
%) experienced stress, and 9 respondents .
%) did not.
DISCUSSION