EFFECT OF A DAILY POSITIVE WORK REFLECTION JOURNAL BASED ON OREM'S SELF-CARE THEORY ON WORK-RELATED STRESS AMONG EMERGENCY DEPARTMENT NURSES
Keywords:
Daily Positive Work Reflection Journal; Emergency Department Nurses; Orem's Self-Care Theory; Work-Related Stress.Abstract
Background: Emergency Department (ED) nurses are frequently exposed to high job demands, heavy workloads, time pressure, and unpredictable clinical situations, making them particularly vulnerable to work-related stress. Reflective journaling has emerged as a promising self-care strategy to enhance emotional regulation and coping. However, evidence regarding the effectiveness of a daily positive work reflection journal based on Orem's Self-Care Theory remains limited.
Objective: To examine the effect of a Daily Positive Work Reflection Journal based on Orem's Self-Care Theory on work-related stress among Emergency Department nurses.
Methods: A pre-experimental study with a one-group pretest–posttest design was conducted among 25 Emergency Department nurses selected using total sampling. Work-related stress was measured using the Expanded Nursing Stress Scale (ENSS). Participants completed a Daily Positive Work Reflection Journal in workbook format for 14 consecutive days. Data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank Test.
Results: The mean work-related stress score decreased from 67.04 before the intervention to 52.04 after the intervention. Wilcoxon Signed-Rank Test analysis demonstrated a statistically significant reduction in work-related stress following the intervention (Z = −3.373, p = 0.001). Most participants shifted from the mild and moderate stress categories before the intervention to the no-stress and mild stress categories after the intervention.
Conclusion: A Daily Positive Work Reflection Journal based on Orem's Self-Care Theory was associated with a significant reduction in work-related stress among Emergency Department nurses. This intervention may serve as a practical self-care strategy to support nurses' psychological well-being. Nevertheless, further studies employing controlled and randomized designs are recommended to confirm its effectiveness.
