Hardiness, work support and psychological distress among nursing assistants and registered nurses in Quebec

BACKGROUND: Although nursing assistants (NAs) represent a large segment of Canadian health care providers, little is known about psychosocial factors related to their physical and psychological well-being and how these compare with their registered nurse (RN) counterparts. AIM: Guided by Maddi and Kobasa's theoretical framework of Factors Affecting Health-Illness Status, the purpose of the present study was to examine relationships among hardiness, psychological distress and work support in NAs, and to compare results with those from a sample of RNs. METHOD: A random sample of 171 NAs in Quebec completed self-report questionnaires. The study instruments included validated French-Canadian versions of Kobasa's Hardiness Scale, Ilfeld's Psychiatric Symptom Index, and Moos' Work Relationship Index. RESULTS: As theoretically predicted, statistically significant correlations were found between hardiness and psychological distress (r = -0.42; P < 0.001), hardiness and work support (r = 0.27; P < 0.001), and between work support and psychological distress (r = -0.21; P < 0.001). Using a mediational model and multiple regression analyses, hardiness among NAs was found to be a significant mediator between work support and psychological distress. Comparative analyses revealed that whereas NAs and RNs reported similar levels of psychological distress (P = 0.25) and work support (P = 0.13), NAs reported significantly less hardiness (t = -5.58; P < 0.01). In addition, NAs and RNs reported significantly more psychological distress than the general population of Quebec, Canada (t = 9.07 and 22.84, P < 0.01, respectively). CONCLUSION: Results add support to Maddi and Kobasa's theoretical propositions linking personal and contextual resources to health-related outcomes and offer insights into specific factors that may affect the health and well-being of both NAs and RNs as well as their work climate.