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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

The Effect of Job Stress on Health Promoting Behaviors among Nurses: Mediating Selection, Optimization and Compensation Strategy

Seung Jin Oh1, Sun Hwa Shin1, Gee Youn Go2, Pratibha Bhandari1
Korean Journal of Adult Nursing 2014;26(2):149-158.
Published online: April 30, 2014

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Corresponding author: Shin, Sun Hwa Division of Nursing Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-10-2932-9387, Fax: +82-2-3399-1594, E-mail: ffssh@hanmail.net
• Received: August 22, 2013   • Accepted: April 4, 2014

© 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to determine whether Selection, Optimization and Compensation (SOC) Strategy mediated the relationship between job stress and health promoting behaviors among nurses.
  • Methods
    A descriptive causal relationship research design was used. 245 subjects recruited from the five general hospitals, which have over 500 beds in Seoul and Kyunggi-do, participated in the study by completing a survey which included questions about SOC strategy, job stress and health promoting behaviors. t-test, ANOVA, Pearson's correlation coefficient and multiple regression were used to analyze the data. SPSS/WIN 20.0 was used for all analysis.
  • Results
    The mean job stress score was 47.89; mean SOC strategy score was .71. ‘Spiritual development’ was the highest reported health promoting behavior with a mean of 3.57. Job stress was significantly and negatively related to health promoting behaviors. The result showed that all the mediating paths of SOC strategy were significant. The partial mediating model showed high goodness of fit demonstrating that the model was outstanding.
  • Conclusion
    SOC strategy mediated the relationship between job stress and health promoting behaviors. Applying better SOC strategies among nurses will increase flexibility in responding to job stress and will also better perform health promoting behaviors.
  • Key Words: Nurse; Psychological stress; Health promotion
Table 1.
General Characteristics of the Study Participants (N=245)
Characteristics Variables n (%) or M±SD
Age (year)   28.72±5.25
20~29 146 (59.6)
30~39 84 (34.3)
40~49 14 (5.7)
No answer 1 (0.4)
Gender Male 11 (4.5)
Female 234 (95.5)
Religion Yes 143 (58.4)
No 102 (41.6)
Education level College 113 (46.1)
University 99 (40.4)
≥Graduate school 27 (11.1)
Etc. 5 (2.0)
No answer 1 (0.4)
Marital status Unmarried 175 (71.4)
Married 70 (28.6)
Work unit General ward 102 (41.6)
Special ward† 91 (37.1)
Outpatient clinic 25 (10.2)
Etc. 27 (11.1)
Type of work shifts Full-time 69 (28.1)
2 shifts 7 (2.9)
3 shifts 169 (69.0)
Career length (year)   6.10±5.00
≤1 25 (10.2)
2~3 61 (24.5)
4~6 58 (23.7)
≥7 102 (41.6)
Position General nurse 211 (86.1)
Charge nurse 24 (9.8)
Head nurse 9 (3.7)
No answer 1 (0.4)
Income monthly (10,000 won) ＜200 26 (10.6)
≥200~＜300 150 (61.2)
≥300~＜400 60 (24.5)
≥400 7 (2.9)
No answer 2 (0.8)
Job satisfaction Satisfied 121 (49.4)
Some what satisfied 96 (39.2)
Not satisfied 25 (10.2)
No answer 3 (1.2)
Intent to continue current job Intent to stay on job as long as possible 71 (29.0)
Intent to stay only till required 116 (47.3)
Intent to quit at the earliest 17 (6.9)
Don't know 41 (16.7)

†Intensive care unit, emergency room, operation room.

Table 2.
Mean Scores for Job Stress, SOC Coping Strategy, and Health Promoting Behaviors (N=245)
Variables Categories M±SD Range
Job stress Job demand (JD) 62.28±14.46 0~100
Insufficient job control (IJC) 47.38±12.61
Interpersonal conflict (IC) 35.10±12.05
Job insecurity (JI) 44.49±21.35
Occupational system (OS) 53.06±13.98
Lack of reward (LR) 50.02±15.83
Organization climate (OC) 42.89±13.16
Total 47.89±8.51 0~100
SOC coping strategy Elective selection (ES) 0.55±0.24 0~1
Loss-based selection (LS) 0.76±0.21
Optimization (O) 0.77±0.22
Compensation (C) 0.78±0.20
Total 0.71±0.16 0~1
Health promoting behavior Health responsibility (HR) 3.00±0.49 1~5
Physical activity (PA) 2.43±0.81
Nutrition (NU) 2.65±0.59
Spiritual growth (SG) 3.54±0.46
Interpersonal relation (PR) 3.15±0.54
Stress management (SM) 2.72±0.48
Total 2.93±0.40 1~5

SOC=selection-optimization-compensation.

Table 3.
Job Stress, SOC Coping Strategy, and Health Promoting Behaviors of the Subjects according to General Characteristics (N=245)
Characteristics Categories Job stress SOC coping strategy Health promoting behavior
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
Age (year) 20~29 46.75±8.05 3.49 0.70±0.17 0.89 2.87±0.40 4.51
30~39 49.80±9.23 (.032) 0.72±0.15 (.413) 2.98±0.39 (.012)
40~49 48.07±7.23 a＜b 0.76±0.17   3.16±0.40 a＜c
Gender Male 46.57±8.25 -0.54 0.77±0.21 0.96 3.13±0.42 1.61
Female 47.95±8.53 (.599) 0.71±0.16 (.358) 2.92±0.40 (.136)
Religion Yes 47.88±9.07 -0.03 0.72±0.16 0.80 3.01±0.39 3.93
No 47.91±7.70 (.978) 0.70±0.16 (.424) 2.81±0.40 (＜.001)
Education level College 48.84±9.20 1.66 0.71±0.15 0.30 2.91±0.40 1.15
University 46.42±7.92 (.177) 0.71±0.17 (.826) 2.91±0.42 (.329)
≥Graduate school 48.87±7.89   0.72±0.19   3.06±0.35  
Etc. 49.60±3.41   0.77±0.11   3.03±0.45  
Marital status Unmarried 47.80±8.30 -0.25 0.71±0.16 -0.57 2.89±0.40 -2.03
Married 48.11±9.07 (.804) 0.72±0.17 (.568) 3.01±0.41 (.040)
Work unit General ward 46.97±7.85 1.13 0.70±0.15 1.94 2.94±0.42 0.46
Special ward† 47.99±9.00 (.337) 0.74±0.17 (.124) 2.90±0.42 (.708)
Outpatient clinic 48.90±8.88   0.66±0.19   3.00±0.29  
Etc. 50.10±8.79   0.72±0.12   2.92±0.35  
Type of work shifts Full-time 48.62±8.23 0.36 0.72±0.15 0.29 3.01±0.35 1.97
2 shifts 47.28±11.05 (.700) 0.76±0.13 (.746) 2.94±0.63 (.141)
3 shifts 47.62±8.55   0.71±0.17   2.90±0.41  
Career length (year) ≤1a 42.40±8.98 5.51 0.73±0.14 2.31 3.03±0.34 2.23
2~3b 47.58±7.14 (.001) 0.67±0.18 (.077) 2.84±0.43 (.086)
4~6c 47.30±7.65 a＜d 0.75±0.14   2.90±0.42  
≥7d 49.75±9.04   0.72±0.16   2.98±0.39  
Position General nursea 47.74±8.47 0.22 0.71±0.16 1.45 2.90±0.40 4.26
Charge nurseb 48.88±9.79 (.802) 0.70±0.21 (.236) 3.12±0.40 (.015)
Head nursec 48.59±6.86   0.80±0.10   3.09±0.33 a＜b
Income monthly (10,000 won) ＜200a 46.78±9.10 0.20 0.69±0.16 1.86 2.94±0.35 3.12
≥200~＜300b 47.88±8.40 (.898) 0.71±0.16 (.138) 2.88±0.42 (.027)
≥300~＜400c 48.01±8.57   0.75±0.15   3.06±0.33 b＜c
≥400d 49.15±9.60   0.64±0.27   2.88±0.54  
Job satisfaction Satisfieda 44.21±7.48 30.40 0.73±0.17 1.63 3.05±0.38 12.89
Some what satisfiedb 50.67±7.79 (＜.001) 0.70±0.14 (.198) 2.80±0.37 (＜.001)
Not satisfiedc 54.78±8.02 a＜b,c 0.68±0.20   2.79±0.46 b, c＜a
Intent to continue current job Intent to stay on job as long as possiblea 44.44±7.54 9.55 0.70±0.17 0.71 3.02±0.38 2.23
    (＜.001)   (.550)   (.085)
Intent to stay only till requiredb 49.53±8.65 a, d＜c 0.73±0.15   2.91±0.40  
Intent to quit at the earliestc 54.11±7.64   0.68±0.16   2.77±0.42  
Don't knowd 46.63±7.53   0.70±0.18   2.90±0.44  

†Intensive care unit, emergency room, operation room.

Table 4.
Correlations of Job Stress, SOC Coping Strategy, and Health Promoting Behaviors (N=245)
Variables JS SOC HPB
JS 1    
SOC -.14* (.030) 1  
HPB .23** (＜.001) .34** (＜.001) 1

JS=job stress; SOC=selection-optimization-compensation coping strategy; HPB=health promoting behavior.

*p＜.05,

**p＜.01.

Table 5.
Mediating Effect of SOC Coping Strategy on the Relationship between Job Stress and Health Promoting Behaviors (N=245)
Step Variable B SE β t p R2
1 JS→SOC -.09 .04 -.14 -2.18 .030 .019
2 JS→HPB -.37 .10 -.23 -3.60 ＜.001 .050
3 SOC→HPB .78 .15 .31 5.24 ＜.001 .147
  JS→HPB -.30 .10 -.19 -3.02 .003  

JS=job stress; SOC=selection-optimization-compensation coping strategy; HPB=health promoting behavior.

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    The Effect of Job Stress on Health Promoting Behaviors among Nurses: Mediating Selection, Optimization and Compensation Strategy
    Korean J Adult Nurs. 2014;26(2):149-158.   Published online April 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.2.149
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    The Effect of Job Stress on Health Promoting Behaviors among Nurses: Mediating Selection, Optimization and Compensation Strategy
    Korean J Adult Nurs. 2014;26(2):149-158.   Published online April 30, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.2.149
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    The Effect of Job Stress on Health Promoting Behaviors among Nurses: Mediating Selection, Optimization and Compensation Strategy
    The Effect of Job Stress on Health Promoting Behaviors among Nurses: Mediating Selection, Optimization and Compensation Strategy

    General Characteristics of the Study Participants (N=245)

    Characteristics Variables n (%) or M±SD
    Age (year)   28.72±5.25
    20~29 146 (59.6)
    30~39 84 (34.3)
    40~49 14 (5.7)
    No answer 1 (0.4)
    Gender Male 11 (4.5)
    Female 234 (95.5)
    Religion Yes 143 (58.4)
    No 102 (41.6)
    Education level College 113 (46.1)
    University 99 (40.4)
    ≥Graduate school 27 (11.1)
    Etc. 5 (2.0)
    No answer 1 (0.4)
    Marital status Unmarried 175 (71.4)
    Married 70 (28.6)
    Work unit General ward 102 (41.6)
    Special ward† 91 (37.1)
    Outpatient clinic 25 (10.2)
    Etc. 27 (11.1)
    Type of work shifts Full-time 69 (28.1)
    2 shifts 7 (2.9)
    3 shifts 169 (69.0)
    Career length (year)   6.10±5.00
    ≤1 25 (10.2)
    2~3 61 (24.5)
    4~6 58 (23.7)
    ≥7 102 (41.6)
    Position General nurse 211 (86.1)
    Charge nurse 24 (9.8)
    Head nurse 9 (3.7)
    No answer 1 (0.4)
    Income monthly (10,000 won) ＜200 26 (10.6)
    ≥200~＜300 150 (61.2)
    ≥300~＜400 60 (24.5)
    ≥400 7 (2.9)
    No answer 2 (0.8)
    Job satisfaction Satisfied 121 (49.4)
    Some what satisfied 96 (39.2)
    Not satisfied 25 (10.2)
    No answer 3 (1.2)
    Intent to continue current job Intent to stay on job as long as possible 71 (29.0)
    Intent to stay only till required 116 (47.3)
    Intent to quit at the earliest 17 (6.9)
    Don't know 41 (16.7)

    †Intensive care unit, emergency room, operation room.

    Mean Scores for Job Stress, SOC Coping Strategy, and Health Promoting Behaviors (N=245)

    Variables Categories M±SD Range
    Job stress Job demand (JD) 62.28±14.46 0~100
    Insufficient job control (IJC) 47.38±12.61
    Interpersonal conflict (IC) 35.10±12.05
    Job insecurity (JI) 44.49±21.35
    Occupational system (OS) 53.06±13.98
    Lack of reward (LR) 50.02±15.83
    Organization climate (OC) 42.89±13.16
    Total 47.89±8.51 0~100
    SOC coping strategy Elective selection (ES) 0.55±0.24 0~1
    Loss-based selection (LS) 0.76±0.21
    Optimization (O) 0.77±0.22
    Compensation (C) 0.78±0.20
    Total 0.71±0.16 0~1
    Health promoting behavior Health responsibility (HR) 3.00±0.49 1~5
    Physical activity (PA) 2.43±0.81
    Nutrition (NU) 2.65±0.59
    Spiritual growth (SG) 3.54±0.46
    Interpersonal relation (PR) 3.15±0.54
    Stress management (SM) 2.72±0.48
    Total 2.93±0.40 1~5

    SOC=selection-optimization-compensation.

    Job Stress, SOC Coping Strategy, and Health Promoting Behaviors of the Subjects according to General Characteristics (N=245)

    Characteristics Categories Job stress SOC coping strategy Health promoting behavior
    M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
    Age (year) 20~29 46.75±8.05 3.49 0.70±0.17 0.89 2.87±0.40 4.51
    30~39 49.80±9.23 (.032) 0.72±0.15 (.413) 2.98±0.39 (.012)
    40~49 48.07±7.23 a＜b 0.76±0.17   3.16±0.40 a＜c
    Gender Male 46.57±8.25 -0.54 0.77±0.21 0.96 3.13±0.42 1.61
    Female 47.95±8.53 (.599) 0.71±0.16 (.358) 2.92±0.40 (.136)
    Religion Yes 47.88±9.07 -0.03 0.72±0.16 0.80 3.01±0.39 3.93
    No 47.91±7.70 (.978) 0.70±0.16 (.424) 2.81±0.40 (＜.001)
    Education level College 48.84±9.20 1.66 0.71±0.15 0.30 2.91±0.40 1.15
    University 46.42±7.92 (.177) 0.71±0.17 (.826) 2.91±0.42 (.329)
    ≥Graduate school 48.87±7.89   0.72±0.19   3.06±0.35  
    Etc. 49.60±3.41   0.77±0.11   3.03±0.45  
    Marital status Unmarried 47.80±8.30 -0.25 0.71±0.16 -0.57 2.89±0.40 -2.03
    Married 48.11±9.07 (.804) 0.72±0.17 (.568) 3.01±0.41 (.040)
    Work unit General ward 46.97±7.85 1.13 0.70±0.15 1.94 2.94±0.42 0.46
    Special ward† 47.99±9.00 (.337) 0.74±0.17 (.124) 2.90±0.42 (.708)
    Outpatient clinic 48.90±8.88   0.66±0.19   3.00±0.29  
    Etc. 50.10±8.79   0.72±0.12   2.92±0.35  
    Type of work shifts Full-time 48.62±8.23 0.36 0.72±0.15 0.29 3.01±0.35 1.97
    2 shifts 47.28±11.05 (.700) 0.76±0.13 (.746) 2.94±0.63 (.141)
    3 shifts 47.62±8.55   0.71±0.17   2.90±0.41  
    Career length (year) ≤1a 42.40±8.98 5.51 0.73±0.14 2.31 3.03±0.34 2.23
    2~3b 47.58±7.14 (.001) 0.67±0.18 (.077) 2.84±0.43 (.086)
    4~6c 47.30±7.65 a＜d 0.75±0.14   2.90±0.42  
    ≥7d 49.75±9.04   0.72±0.16   2.98±0.39  
    Position General nursea 47.74±8.47 0.22 0.71±0.16 1.45 2.90±0.40 4.26
    Charge nurseb 48.88±9.79 (.802) 0.70±0.21 (.236) 3.12±0.40 (.015)
    Head nursec 48.59±6.86   0.80±0.10   3.09±0.33 a＜b
    Income monthly (10,000 won) ＜200a 46.78±9.10 0.20 0.69±0.16 1.86 2.94±0.35 3.12
    ≥200~＜300b 47.88±8.40 (.898) 0.71±0.16 (.138) 2.88±0.42 (.027)
    ≥300~＜400c 48.01±8.57   0.75±0.15   3.06±0.33 b＜c
    ≥400d 49.15±9.60   0.64±0.27   2.88±0.54  
    Job satisfaction Satisfieda 44.21±7.48 30.40 0.73±0.17 1.63 3.05±0.38 12.89
    Some what satisfiedb 50.67±7.79 (＜.001) 0.70±0.14 (.198) 2.80±0.37 (＜.001)
    Not satisfiedc 54.78±8.02 a＜b,c 0.68±0.20   2.79±0.46 b, c＜a
    Intent to continue current job Intent to stay on job as long as possiblea 44.44±7.54 9.55 0.70±0.17 0.71 3.02±0.38 2.23
        (＜.001)   (.550)   (.085)
    Intent to stay only till requiredb 49.53±8.65 a, d＜c 0.73±0.15   2.91±0.40  
    Intent to quit at the earliestc 54.11±7.64   0.68±0.16   2.77±0.42  
    Don't knowd 46.63±7.53   0.70±0.18   2.90±0.44  

    †Intensive care unit, emergency room, operation room.

    Correlations of Job Stress, SOC Coping Strategy, and Health Promoting Behaviors (N=245)

    Variables JS SOC HPB
    JS 1    
    SOC -.14* (.030) 1  
    HPB .23** (＜.001) .34** (＜.001) 1

    JS=job stress; SOC=selection-optimization-compensation coping strategy; HPB=health promoting behavior.

    *p＜.05,

    **p＜.01.

    Mediating Effect of SOC Coping Strategy on the Relationship between Job Stress and Health Promoting Behaviors (N=245)

    Step Variable B SE β t p R2
    1 JS→SOC -.09 .04 -.14 -2.18 .030 .019
    2 JS→HPB -.37 .10 -.23 -3.60 ＜.001 .050
    3 SOC→HPB .78 .15 .31 5.24 ＜.001 .147
      JS→HPB -.30 .10 -.19 -3.02 .003  

    JS=job stress; SOC=selection-optimization-compensation coping strategy; HPB=health promoting behavior.
    Table 1. General Characteristics of the Study Participants (N=245)

    Intensive care unit, emergency room, operation room.

    Table 2. Mean Scores for Job Stress, SOC Coping Strategy, and Health Promoting Behaviors (N=245)

    SOC=selection-optimization-compensation.

    Table 3. Job Stress, SOC Coping Strategy, and Health Promoting Behaviors of the Subjects according to General Characteristics (N=245)

    Intensive care unit, emergency room, operation room.

    Table 4. Correlations of Job Stress, SOC Coping Strategy, and Health Promoting Behaviors (N=245)

    JS=job stress; SOC=selection-optimization-compensation coping strategy; HPB=health promoting behavior.

    p＜.05,

    p＜.01.

    Table 5. Mediating Effect of SOC Coping Strategy on the Relationship between Job Stress and Health Promoting Behaviors (N=245)

    JS=job stress; SOC=selection-optimization-compensation coping strategy; HPB=health promoting behavior.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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