Perceived job stress among community nurses: A multi‐center cross‐sectional study.

Aim: China is reforming its health care system, which aimed to strengthen primary health care through building community health centers (stations) and assigning a "gate‐keeper" role to primary care providers. Community nurses play a key role in the reform. Little is known about the level of job stress among community nurses. Thus, this study aims to explore the level of perceived job stress and its influencing factors among community nurses. Method: A cross‐sectional design was used to conduct a survey with 1015 nurses from 56 community health centers in Sichuan province. Job stress was measured by the Community Nurses Stress Scale. Data were collected between March and November 2015. Results: Community health nurses in China perceived high levels of job stress. The job stress was related to nurses' individual characteristics and work environments. Permanently employed nurses, shift workers, and those older than 45 years age and with less training related to community nursing and involvement in childcare were more likely to experience high levels of stress. Conclusion: Reform is required of the community nursing personnel system, and development of continuing education programs and stress‐alleviating measures to reduce community nurses' job stress. The results of this study favour future advanced practice community health nursing practice and education. SUMMARY STATEMENT: What is already known about this topic? Nursing is a highly stressful occupation and job stress among clinical nurses is well‐recognized.Nurses in different workplaces may perceive different job‐related stresses.There is limited evidence regarding community health nurses' job stress, especially from different geographical areas. What this paper adds? Community health nurses perceived high levels of job stress.The nursing profession and working duties were the major job stress of community health nurses.Type of employment, shift work, age, training related to community nursing, and involvement in childcare predicted community health nurses' job stress. Contrary to existing literature, type of employment was the strongest factor related to community health nurses' job stress. The implications of this paper: Occupational health education and training programmes may be necessary to improve the knowledge and ability of nurses to cope with work demands, and reduce job stress.Findings could inform policy and practice through the development of interventions aimed at creating better work environments and reforming the community health nursing personnel system, whereby nurses can successfully perform their jobs.Further research is needed to generate interventions for the management of occupational stress. [ABSTRACT FROM AUTHOR]