Effect of Emotional Labor and Stress on Premenstrual Syndrome among Hospital Nurses

Sun Hee Lee; Ji-Ah Song; Myung Haeng Hur

doi:10.4069/kjwhn.2016.22.1.61

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Lee, Song, and Hur: Effect of Emotional Labor and Stress on Premenstrual Syndrome among Hospital Nurses

Original Article

Korean Journal of Women Health Nursing 2016; 22(1): 61-70.

Published online: 26 March 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.1.61

Effect of Emotional Labor and Stress on Premenstrual Syndrome among Hospital Nurses

Sun Hee Lee¹, Ji-Ah Song², Myung Haeng Hur¹

¹Department of Nursing, Eulji University, Daejeon, Korea.

²Department of Nursing, Woosong College, Daejeon, Korea.

Corresponding author: Hur, Myung Haeng. Department of Nursing, Eulji University, 77 Gyeryong-ro, 771beon-gil, Jung-gu, Daejeon 34824 , Korea. Tel: +82-42-259-1714, Fax: +82-42-259-1709, mhhur@eulji.ac.kr

Received 2 October 2015 Revised 8 March 2016 Accepted 14 March 2016

(open-access):

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.

Abstract

Purpose

This study is an explorative survey to examine emotional labor, stress, and premenstrual syndrome among hospital nurses and to examine relationships among them.

Methods

Data were collected from 228 nurses working at hospitals using structured questionnaires from September to October, 2014. Data were analyzed using SPSS 21.0 by frequency, descriptive statistics, t-test, one-way ANOVA, and Pearson's correlation coefficient.

Results

Score of emotional labor was different by work time per week (F=4.03, p=.019), and menstrual amount (F=5.18, p=.006). Level of stress was different by marital status (t=2.29, p=.023), pattern of work (t=-3.63, p<.001), work time per week (F=3.39, p=.035), regularity of menstrual cycle (t=-4.20, p<.001), and exercise frequency (F=4.28, p=.015). Scores of premenstrual syndrome were different by regularity of menstrual cycle (t=-3.18, p=.002), and menstrual amount (F=5.88, p=.003). Emotional labor was related with perceived stress (r=.40, p<.001) and premenstrual syndrome (r=.23, p<.001). Also, perceived stress was related with premenstrual syndrome (r=.33, p<.001).

Conclusion

Nurses' emotional labor, stress, and premenstrual syndrome were higher than the average. Emotional labor was correlated with stress and premenstrual syndrome, premenstrual syndrome with stress. This study shows that it is necessary to understand these relationships and to search for nursing intervention to ease emotional labor, stress, and premenstrual syndrome.

Keywords: Emotion, Stress, Labor, Premenstrual syndrome

Figures and Tables

Table 1

General and Job-related Characteristics of Participants (N=228)

Characteristics	Categories	n (%)	M±SD
Age (year)			27.1±4.71
BMI	<18.5 (Underweight)	50 (21.9)
	<23.0 (Standard)	149 (65.4)
	<25.0 (Overweight)	19 (8.3)
	<30.0 (Obesity)	8 (3.5)
	≥30.0 (Obese)	2 (0.9)
Education level	Diploma	88 (38.6)
	Bachelor	105 (46.0)
	≥Graduate school	35 (15.4)
Marital status	Unmarried	192 (84.2)
Marital status	Married	36 (15.8)
Delivery experience	No	207 (90.8)
	1 time	11 (04.8)
	2 times	10 (04.4)
Pattern of work	Day fixed worker	33 (14.5)
Pattern of work	3 shift worker	195 (85.5)
Number of night shifts (day/month)			5.5±2.45
Work time per week (hrs)	<40 hrs	23 (10.1)
	<50 hrs	162 (71.0)
	≥50 hrs	43 (18.9)
Department career (month)			40.2±32.05
Clinical career (month)			61.1±54.33
Menarche age (year)			13.5±1.61
Regularity of menstrual cycle	Regular	147 (64.5)
Regularity of menstrual cycle	Irregular	81 (35.5)
Menstruation interval (day)			28.4±2.67
Amounts of menstruation	A little	35 (15.4)
	Moderate	173 (75.8)
	Heavy	20 (08.8)
Exercise	No	134 (58.8)
	1~2 times/week	68 (29.8)
	≥3 times/week	26 (11.4)

Table 2

Emotional Labor, Stress of Participants and Differences in Emotional Labor, Stress by General and Job-related Characteristics (N=228)

Characteristics	Categories	Emotional labor		Frequency of emotional display		Attentiveness to required display rules		Emotional dissonance		Stress
Characteristics	Categories	M±SD	t or F (p) Scheffé	M±SD	t or F (p) Scheffé	M±SD	t or F (p) Scheffé	M±SD	t or F (p) Scheffé	M±SD	t or F (p) Scheffé
Education level	Diploma	27.9±4.39	2.73 (.067)	9.9±1.64	2.99 (.052)	9.2±1.56	0.78 (.457)	8.9±2.05	2.44 (.089)	54.0±16.25	0.50 (.604)
	Bachelor	28.8±4.87		10.2±1.90		9.4±1.72		9.1±2.03		53.5±14.81
	≥Graduate	30.1±4.93		10.7±1.95		9.6±1.77		9.8±2.39		50.8±19.64
Marital status	Unmarried	28.5±4.73	-1.29 (.195)	10.1±1.81	-1.83 (.068)	9.3±1.69	-0.67 (.500)	9.0±2.11	-0.79 (.426)	54.4±16.11	2.29 (.023)
Marital status	Married	29.6±4.69	-1.29 (.195)	10.7±1.84	-1.83 (.068)	9.5±1.56	-0.67 (.500)	9.4±2.13	-0.79 (.426)	47.7±15.41	2.29 (.023)
Pattern of work	Day fixed	28.9±4.62	0.34 (.729)	10.6±1.94	1.53 (.127)	9.4±1.52	0.03 (.975)	8.9±2.21	-0.566 (.572)	44.1±14.57	-3.63 (<.001)
Pattern of work	3 shift	28.6±4.76	0.34 (.729)	10.0±1.80	1.53 (.127)	9.4±1.80	0.03 (.975)	9.2±2.09	-0.566 (.572)	54.9±15.91	-3.63 (<.001)
Work time per week (hrs)	<40^a	26.1±4.54	4.03 (.019) a<b	9.3±1.86	3.27 (.040) a<b	8.7±1.60	1.78 (.170)	8.1±1.63	3.66 (.027) a<b	49.4±15.74	3.39 (.035)
	<50^b	29.1±4.64		10.3±1.73		9.4±1.61		9.3±2.19		52.4±15.98
	≥50^c	28.4±4.84		10.1±2.05		9.4±1.86		8.9±1.85		58.7±16.11
Regularity of menstrual cycle	Regular	28.6±4.81	-0.37 (.710)	10.2±1.96	0.14 (.885)	9.3±1.63	-0.51 (.606)	9.1±2.09	-0.54 (.585)	50.1±15.55	-4.20 (<.001)
Regularity of menstrual cycle	Irregular	28.8±4.61	-0.37 (.710)	10.1±1.56	0.14 (.885)	9.4±1.73	-0.51 (.606)	9.2±2.15	-0.54 (.585)	59.2±15.66	-4.20 (<.001)
Amounts of menstruation	A little^a	27.1±5.21	5.18 (.006) a<c	9.9±1.96	2.68 (.070)	9.0±1.74	5.29 (.006) a<c, b<c	8.2±2.16	5.08 (.007) a<b, a<c	51.1±19.92	1.34 (.263)
	Moderate^b	28.7±4.55		10.1±1.74		9.3±1.58		9.2±2.04		53.2±15.30
	Heavy^c	31.3±4.49		11.0±2.10		10.5±1.88		9.8±2.14		58.4±15.82
Exercise (times/week)	No^a	28.7±4.62	0.06 (.935)	10.3±1.76	1.42 (.242)	9.3±1.60	0.14 (.868)	9.1±2.10	0.04 (.959)	55.6±15.17	4.28 (.015) a>c
	1~2^b	28.6±4.69		10.0±1.73		9.4±1.80		9.1±2.06		51.5±16.70
	≥3^c	28.3±5.55		9.7±2.31		9.4±1.72		9.2±2.34		46.4±17.59
M±SD		28.6±4.73		10.2±1.82		9.4±1.67		9.1±2.11		53.3±16.15
n (%) or M±SD		3.2±0.53		3.4±0.61		3.1±0.56		3.0±0.70		HG	5 (2.2)
										PSG	161 (70.6)
										HSG	62 (27.2)

HG=health group (≤22); PSG=potential stress group (23~62); HSG=high risk of stress group (≥63)

Table 3

Premenstrual syndrome of Participants and Differences in Premenstrual syndrome by General and Job-related Characteristics (N=228)

Characteristics	Categories	Premenstrual syndrome		Affect		Pain		Water retention
Characteristics	Categories	M±SD	t or F (p) Scheffé	M±SD	t or F (p) Scheffé	M±SD	t or F (p) Scheffé	M±SD	t or F (p) Scheffé
Education level	Diploma	28.9±9.71	0.48 (.617)	11.2±4.48	0.17 (.837)	6.8±2.68	0.04 (.960)	10.9±4.36	1.75 (.175)
	Bachelor	28.1±10.72		10.8±5.34		6.9±2.52		10.5±4.57
	≥Graduate	30.1±9.79		11.0±4.48		7.0±2.18		12.1±4.33
Marital status	Unmarried	29.1±10.39	1.36 (.173)	11.1±5.00	1.10 (.269)	7.0±2.54	2.07 (.039)	11.0±4.54	0.73 (.464)
Marital status	Married	26.6±8.80	1.36 (.173)	10.1±4.10	1.10 (.269)	6.1±2.32	2.07 (.039)	10.4±4.07	0.73 (.464)
Pattern of work	Day fixed	26.1±10.54	-1.63 (.103)	9.6±4.67	-1.73 (.083)	6.0±2.59	-2.09 (.037)	10.4±4.33	-0.64 (.518)
Pattern of work	3 shift	29.2±10.07	-1.63 (.103)	11.2±4.88	-1.73 (.083)	7.0±2.49	-2.09 (.037)	11.0±4.50	-0.64 (.518)
Work time per week (hrs)	<40^a	26.7±10.50	0.95 (.386)	10.2±4.29	1.12 (.326)	6.2±2.46	1.83 (.163)	10.3±4.79	0.21 (.804)
	<50^b	28.6±10.48		10.8±4.96		6.8±2.49		11.0±4.51
	≥50^c	30.2±8.75		11.9±4.83		7.4±2.63		11.0±4.23
Regularity of menstrual cycle	Regular	27.2±10.01	-3.18 (.002)	10.1±4.75	-3.48 (.001)	6.6±2.51	-2.37 (.018)	10.4±4.44	-2.08 (.038)
Regularity of menstrual cycle	Irregular	31.6±9.92	-3.18 (.002)	12.4±4.79	-3.48 (.001)	7.4±2.47	-2.37 (.018)	11.7±4.42	-2.08 (.038)
Amounts of menstruation	A little^a	25.4±8.82	5.88 (.003) a<c, b<c	9.6±4.59	7.16 (.001) a<c, b<c	6.3±2.71	1.60 (.202)	9.5±3.68	3.93 (.021) a<c
	Moderate^b	28.7±10.00		10.8±4.65		6.9±2.48		10.9±4.48
	Heavy^c
Exercise (times/week)	No^a	28.5±10.38	0.63 (.529)	11.0±5.07	0.19 (.821)	6.9±2.56	0.28 (.750)	10.6±4.44	1.80 (.167)
	1~2^b	28.3±10.63		10.7±4.77		6.7±2.47		10.9±4.50
	≥3^c	30.8±7.71		11.3±4.24		7.1±2.52		12.4±4.39
M±SD		28.7±10.18		11.0±4.88		6.9±2.52		10.9±4.47
Mean Rating±SD		2.9±1.02		2.8±1.22		3.5±1.26		2.7±1.12

Table 4

Relationships among General Characteristics, Emotional Labor, Stress, and Premenstrual syndrome (N=228)

Variables	Age	BMI	CC	MA	DE	EL	E1	E2	E3	Stress	PS	P1	P2	P3
Age	1
BMI	.11 (.082)	1
CC	.92 (<.001)	.09 (.173)	1
MA	-.00 (.974)	-.15 (.017)	-.03 (.555)	1
DE	.55 (<.001)	.05 (.422)	.52 (<.001)	.11 (.084)	1
EL	.14 (.024)	.23 (<.001)	.14 (.025)	-.09 (.177)	.06 (.339)	1
E1	.16 (.011)	.13 (.042)	.17 (.008)	-.06 (.306)	.12 (.053)	.84 (<.001)	1
E2	.08 (.181)	.22 (.001)	.08 (.218)	-.09 (.171)	-.04 (.539)	.84 (<.001)	.62 (<.001)	1
E3	.12 (.071)	.23 (<.001)	.11 (.082)	-.07 (.289)	.06 (.335)	.85 (<.001)	.53 (<.001)	.56 (<.001)	1
Stress	-.17 (.009)	.11 (.078)	-.16 (.011)	-.05 (.410)	-.17 (.008)	.40 (<.001)	.36 (<.001)	.37 (<.001)	.30 (<.001)	1
PS	-.07 (.241)	.09 (.141)	-.04 (.512)	.04 (.480)	-.13 (.045)	.23 (<.001)	.14 (.029)	.22 (.001)	.21 (.001)	.33 (<.001)	1
P1	.01 (.808)	.14 (.033)	.04 (.534)	.08 (.226)	-.10 (.128)	.17 (.010)	.07 (.291)	.16 (.011)	.18 (.004)	.23 (<.001)	.85 (<.001)	1
P2	-.11 (.084)	.03 (.619)	-.10 (.134)	.07 (.273)	-.19 (.003)	.20 (.002)	.16 (.015)	.16 (.012)	.19 (.003)	.27 (<.001)	.81 (<.001)	.60 (<.001)	1
P3	-.11 (.075)	.05 (.390)	-.07 (.244)	-.01 (.841)	-.08 (.199)	.22 (.001)	.15 (.019)	.23 (<.001)	.18 (.007)	.33 (<.001)	.88 (<.001)	.56 (<.001)	.62 (<.001)	1

CC=clinical career; MA=menarche age; DE=delivery experience; EL=emotional labor;E1=frequency of emotional display; E2=attentiveness to required display rules; E3=emotional dissonance, PS=premenstrual syndrome; P1=affect; P2=pain; P3=water retention.

Notes

This manuscript is based on a part of the first author's master's thesis from Eulji University.

Summary Statement

▪ What is already known about this topic?

Emotional labor has accounted for a portion of nursing and psychological causes, such as stress can affect the symptoms of premenstrual syndrome.

▪ What this paper adds?

Nurses' emotional labor, stress, and premenstrual syndrome were higher than the average. And emotional labor was related with stress and premenstrual syndrome.

▪ Implications for practice, education and/or policy

It is necessary to understand these relationships and to search for nursing intervention to ease emotional labor, stress and premenstrual syndrome.

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