Emotional demands as a risk factor for mental distress among nurses.

BACKGROUND: Although it is widely acknowledged that in certain occupations emotional demands may be a critical phenomenon for workers' health, this has been traditionally taken for granted and their role in the stress process has not often been directly assessed.

OBJECTIVES: To examine the relationship between emotional demands and mental distress, adjusting for the potential effect of common psychosocial factors (workload, job control, social support, role stressors, and poor relationships) and personal psychological factors (i.e. having been diagnosed with anxiety or depressive disorder).

METHODS: A cross-sectional study on a sample of nurses of the National Healthcare Service was carried out (N = 256, 81.3% women). The psychosocial factors considered were assessed by means of widely known and validated scales. The examined health outcome (i.e. mental distress) was operationalized by means of the General Health Questionnaire (12-item version). Covariates: gender, age, tenure and shiftwork.

ANALYSES: a series of logistic regressions.

RESULTS: Exposure to emotional demands was a risk factor for mental distress. The resulting risk was not altered when adjusting for other psychosocial and personal factors. In the final model emotional demands, workload and role stressors, in addition to having been diagnosed with anxiety or depressive disorder, were significant risk factors for nurses' mental distress.

CONCLUSIONS: Emotional demands may substantially impact on nurses mental distress. These results give rise to concern in relation to work-stress prevention in certain professions, given that emotional demands are not included in the most common psychosocial risk assessment tools currently available, which may then miss identifying an important precondition of work stress.