Factors Associated with Job Stress among Ambulance Nurses in Bangkok

Main Article Content

Jutamanee Sakkomonsri, RN
Plernpit Suwan-Ampai, PhD
Orawan Kaewboonchoo, PhD


OBJECTIVE: to explore the factors associated with job stress among the ambulancenurses in nine zones of Bangkok Emergency Medical Service (EMS).
MATERIALS AND METHODS: Multistage random sampling was conductedbetween December 2015 and February 2016. Two hundred and forty-five ambulancenurses of network hospitals in nine zones of Bangkok EMS who had at least 40hours EMS training and at least six months work experiences on ambulance wereselected as study samples. A self-administered questionnaire with specific questionsto explore variables such as socio-demographics, work characteristics, generalwell-being, employee engagement, role and social support was used. Job stress wasevaluated using the Karasek’s Job Demand-Control model (JCQ). The predictivefactors influencing job stress were analyzed by using Chi-square and multiplelogistic regressions.
RESULTS: A total of 245 ambulance nurses were enrolled in the study. One third(33.5%) of ambulance nurses developed high work stress. A statistically significantassociation was observed between job stress and older age (OR = 0.94, 95% CI:0.89 - 0.99), higher incomes (OR = 0.26, 95% CI: 0.09 - 0.69), higher educationlevel (OR = 4.17, 95% CI: 1.13 - 15.47), more work experience (OR = 0.32, 95%CI: 0.12 - 0.88), perception of urgent task (OR = 8.00, 95% CI: 1.44 - 44.73), poorgeneral well-being (OR = 2.36, 95% CI : 1.00 - 5.55), low superior support (OR =12.50, 95% CI: 4.62 - 33.78), low peer support (OR = 3.27, 95% CI: 1.30 - 8.21),role ambiguity (OR = 12.45, 95% CI: 4.77 - 32.51), and role conflict (OR = 14.48,95% CI: 5.14 - 40.82).
CONCLUSION: The executive and nursing administrators should be aware of jobstrain among ambulance nurses particularly in the younger age group with less than5 years of working experience. Specific training programs with supervision and peersupport should be provided. Stress management should be commenced in nursingeducation. The clarity of role and duty together with appropriate work schedule shouldbe considered to avoid the stressful situation which in turn will reduce job stress. Thisstudy is the first investigation that quantifies the strength of association between jobstress and the various factors among ambulance nurses, thereby enabling themanagement to implement logical and preventive strategies regarding work-relatedstress and improve the quality of care in the future.


Download data is not yet available.

Article Details

How to Cite
Sakkomonsri J, Suwan-Ampai P, Kaewboonchoo O. Factors Associated with Job Stress among Ambulance Nurses in Bangkok. BKK Med J [Internet]. 2016Sep.20 [cited 2020Jul.15];12(1):33. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/221555
Original Article


1. Keeratisatean O. Factor which involved with stress- in single woman. Master’s Thesis (Developmental Psychology). Srinakharinwirot University, Prasarnmitr Campus:1991;2:80-94
2. Chareonyuttong C. Study of Nursing Shortage and Brain Drain Problems in Thailand. J Nurs Sci 1995; 44:22-30.
3. Sawangdee K. Supply of Registered Nurses in Thailand, 2008. (Accessed January 10, 2015, at http:// ihppthaigov. net./publication/ attachreseach/145/ chepter.pdf.)
4. Hunpongkittikul S. Sources of Stress in Nurses of Maharaj Hospital, Chiang Mai. Master of Nursing Science (Nursing Administration), Chiang Mai University, Graduate School, 1999:40-5.
5. Emergency Medical Institute of Thailand (NIEM). (Draft) Standard Guidlines and Procedures for Emergency Nursing between Medical Center, 2014 (Accessed December 2, 2015 at http://www.niems.go.th/th/Upload/ File/255701070918519974_gkuFwicfOQkjpHyYpdf.)
6. Emergency Medical Institute of Thailand. Annual Report 2013. Emergency Medical Institute of Thailand. 2013; 2:5-40.
7. Daniel WW. Biostatistics: A Foundation for Analy sis in the Health Science (8th Ed.). USA: John Wiley & Sons, Inc:2005;22-38.
8. Karasek R, Theorell T. Healthy Work: Stress, Produc- tivity, and the Reconstruction of working life. New York: Basic Books, 1990:1-398.
9. Phakthongsuk P. Construct validity of the Thai version of the job content questionnaire in a large population of heterogeneou occupations. J Med Assoc Thai 2009;92: 564-72.
10. Sirisawasd P, Chaiear N, Pratheepawanit N, et al. Vali- dation of the Thai Version of a Work-related Quality of Life Scale in the Nursing Profession. Safety Health Work 2014;5: 80-5.
11. Rizzo JR, House RJ, Lirtzman SI. Role conflict and ambiguity in complex organizations. Administrative Science Quarterly 1970;15:150-63.
12. Glissmeyer M. Role conflict, Role Ambiguity, and Intention to quit the organization: The case of low enforcement officers. Thesis Master of Management, College of Business. New Mexico State University 2007:50-55.
13. Thangthum W. Factors Predicting Job Strain Among Male Nurses In Thailand. Thesis, Master of Science Program (Public Health), Major in Public Health Nurs ing, Mahidol University. 2014:76-85.cheap-oil-means-fewer- nose-jobs.).
14. Trousselard M, Naughton G, Cosserant S, et al. Stress among nurses working in emergency, anesthesiology and intensive care units depends on qualification: a Job Demand-Control survey. Int Arch Occup Environ Health 2016:89:221-9.
15. Lealeng V. Factors that influence the performance of the role of nurses operating room hospital. Northeast. Dissertation Master of Nursing , Faculty of Nursing , Khon Kaen University.2012
16. Amonthivanukul S. Stress factors affecting the op- eration of terrestrial reception, Thai Airways Interna- tional Public Company Limited routine at Suvarnab humi Airport. JITE 2011;10:94-109.
17. Jareansri A. Studied the external environment. And values the work that affects the quality of life of employees at the Aeronautical Radio of Thailand Ltd MBA thesis. College. Bangkok University.2014:156-8.
18. Lichrit O. Factors associated with the well-being of the family health nurse. Health Department Bangkok Journal of Public Health 2010:24;1-20.
19. Saipret T. Stress from work and health of nurses under the Ministry. Ministry of Public Health Nakhon Nayok Thailand. Master of Science Thesis (Public Health) Public Health Nursing Doctoral Programs. College Degree Mahidol University.2009:143-150