Background. Type 2 diabetes presents a serious public health problem in the United States and world. Although stress is not recognized as a risk factor for type 2 diabetes, its effect on glucose and insulin action supports the idea of an association with the risk of type 2 diabetes. Considerable research shows that nursing is a stressful profession, and that workload, nursing unit type, shiftwork, patient acuity, ethical conflicts, dealing with death and acute illness, and role ambiguity are associated with nurses' stress and burnout.
Purpose. The aim of this study was to investigate whether there are associations among nursing stress, overall perceived stress, coping processes, and the risk of type 2 diabetes in nurses.
Method. This cross-sectional study included a random sample of 200 nurses who attended a National Critical Care Nursing exposition. The participants answered four self-administered a questionnaire assessing the key study variables of nursing stress, overall stress, emotion- and problem-focused coping processes, and risk of type 2 diabetes, and demographic items. Stress was measured with the Nursing Stress Scale by Gray-Toft and Anderson (1981) and by Cohen, Kamarck, and Mermelstein (1983). Coping processes were assessed with the Ways of Coping by Lazarus and Folkman (1984). The risk of type 2 diabetes was determined by the Diabetes Risk Questionnaire from Harvard School of Public Health (2004). Because of the low number of male respondents (n = 12), they were excluded from analyses, resulting in a sample size of 188 female subjects.
Analyses. Mean Perceived Stress Scale (PSS) scores were positively associated with mean Nursing Stress Scale (NSS) scores (r = .270, p = .0002) and, after controlling for age, with diabetes risk scores (r = .215, p = .006). PSS scores were positively associated with the coping process of Escape-Avoidance (r = .417, p ≤ .001) and Accepting Responsibility (r = .208, p ≤ .01), and negatively associated with Planful Problem Solving (r = -.310, p ≤ .001) and Seeking Social Support (r = -.212, p ≤ .01). Controlling for age and demographic variables, the interactions between mean PSS scores and each of the eight coping processes explained 27.1% of variance in nurses' diabetes risk score, R2 = .271, alpha < .003.
Implications for preventive care. This research focused on the health-risk appraisal aspect of preventive care in a group of nurses attending a national conference. As there is a shortage of nurses, promoting nurses' health and preventing chronic disease by early recognition of risk factors among nurses is an important public health agenda. In addition, the results of this study could help to further the understanding of the relationship between stress levels and the risk of type 2 diabetes among nurses, and serve as a starting point for further replication of the study in a larger nursing sample. Finally, the results of this study support the need for future lifestyle intervention programs targeting stress reduction and type 2 diabetes prevention in the nursing population.