Author ORCID Identifier

https://orcid.org/0000-0003-2749-2992

Year of Publication

2019

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Nursing

Department

Nursing

First Advisor

Dr. Gia Mudd-Martin

Abstract

The purpose of this dissertation was to examine depression, experiences of work-related racism, and occupational stress among black nurses. Nursing is a highly stressful and demanding profession that can negatively affect health. Underscoring this is the high rate of depression experienced by nurses. In fact, nurses experience depression at a rate twice that of individuals in other occupations. Examining depression in nurses can provide insights that can inform measures addressing the psychological health of this group. This may be particularly important in black nurses who, in addition to the already high occupational stress associated with nursing, may experience additional stress due to experiences of racism in the work environment. To better understand these factors, the specific aims of this dissertation were to: (1) evaluate the current state of the science of depression in registered nurses; (2) examine the psychometric properties of the two racism on the job subscales of the Perceived Racism Scale in black registered nurses; and (3) evaluate whether past-year or lifetime experiences of work-related racism and occupational stress predicted depressive symptoms and whether, controlling for depressive symptoms, past-year and lifetime experiences of work-related racism predicted occupational stress in a cohort of black registered nurses.

For specific aim one a systematic review of the literature on depression in nurses was conducted. This review highlighted factors that underlie the high rates of depression among nurses, and the individual as well as work-related variables that contribute to nurses’ susceptibility to depression. For specific aim two the psychometric properties of two subscales of the Perceived Racism Scale in a sample of black registered nurses were evaluated. The two subscales were past year experiences of racism on the job (ROTJ-Y) and lifetime experiences of racism on the job (ROTJ-L). Reliability for each of the subscales was assessed by examining internal consistency. Construct validity was examined using principal components analysis to evaluate the factor structure of each subscale and by testing the hypothesis that job-related racism is predictive of workplace stress. These analyses demonstrated that the ROTJ-Y and ROTJ-L are valid and reliable instruments for the measurement of yearly and lifetime experiences of racism on the job in black registered nurses. Specific aim three was addressed by examining whether past-year or lifetime experiences of racism on the job and occupational stress were predictive of depression and whether work-related racism predicted occupational stress in a sample of black nurses. Multiple linear regression analyses were conducted to examine if (1) either past-year or lifetime experiences of work-related racism, and occupational stress predicted depression and (2) either past-year or lifetime experiences of racism predicted occupational stress, with control variables depressive symptoms, years of experience as a registered nurse, primary nursing practice position, work setting, work shift, and work status. Results indicated that experiences of work-related racism and occupational stress were not significant predictors of depression but that both past-year and lifetime experiences of racism were significant predictors of occupational stress.

The results of the research conducted for this dissertation highlight the effects of depression on nurses as well as the relationship between race-based discrimination at work and occupational stress among black registered nurses. This evidence can inform the development of future strategies to improve the well-being of nurses in the workplace in general and especially of black nurses.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2019.353

Funding Information

This project has been funded by the Central Appalachian Regional Education and Research Center, Occupational/Environmental Health Nursing Core, 1 T42OH010278, Delta Psi Chapter of Sigma Theta Tau, and a travel grant from the University of Kentucky Graduate School.

Available for download on Friday, August 06, 2021

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