Investigating work-related stress among health professionals at different hierarchical levels: A cross-sectional study

Nurs Open. 2020 Mar 14;7(4):969-979. doi: 10.1002/nop2.469. eCollection 2020 Jul.


Aim: To determine the extent of stress at work among health professionals working in upper-, middle- and lower-management positions and those not working in management positions.

Design: Cross-sectional design and randomly selected hospitals, nursing homes and home care organizations.

Methods: The study sample included nursing staff and midwives, physicians, medical-technical and medical-therapeutic professionals at all hierarchical levels (N = 8,112). Data were collected using self-report questionnaires and analysed using multiple regression models.

Results: Health professionals in upper- and middle-management positions reported higher quantitative demands, severe work-private life conflicts (p < .05) as well as less role clarity in middle-management positions (B = -1.58, p < .05). In lower-management positions, health professionals reported higher physical (B = 3.80, p < .001) and emotional demands (B = 1.79, p < .01), stress symptoms (B = 1.81, p < .05) and job dissatisfaction (B = -1.17, p < .05). Health professionals without management responsibilities reported the poorest working conditions in relation to various stressors, job satisfaction (B = -5.20, p < .001) and health-related outcomes (e.g. burnout symptoms: B = 1.89, p < .01).

Keywords: nurses; nursing; stress; work; workforce.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Burnout, Professional* / epidemiology
  • Cross-Sectional Studies
  • Health Personnel
  • Humans
  • Job Satisfaction
  • Occupational Stress* / epidemiology