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HARDINESS: IT'S RELATIONSHIP TO STRESS IN
GRADUATE NURSING STUDENTS

presented by

Laurie Porter

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1198 cJClRCID‘oOrnpes-nu

HARDINESS: IT'S RELATIONSHIP TO STRESS IN
GRADUATE NURSING STUDENTS

BY

Laurie L. Porter

A THESIS
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF SCIENCE IN NURSING

College of Nursing

1998

ABSTRACT

HARDINESS: IT'S RELATIONSHIP TO STRESS IN
GRADUATE NURSING STUDENTS

BY

Laurie Porter

Nurses are a vital component of the health care
delivery system. During the last decade, there has been
increasing recognition of the stress experienced by nurses.
Hardiness is viewed as a personality characteristic that
mediates the harmful effects of stress.

The purpose of this study was to explore the
relationships of both total personality hardiness and the
three subscales of hardiness, that is, commitment, control,
and challenge to stress resistance. A descriptive
correlation design was used to investigate the relationship
of hardiness to stress in a graduate nurse population.
Suzanne Kobasa's theory of hardiness provided the conceptual
framework for this study.

The findings supported a relationship between control,
commitment and challenge. These results are consistent with
the view that the personality characteristic of hardiness
may moderate the effects of stress by way of cognitive
process. Advanced Practice Nurses can use these findings to
begin an exploration of further research devoted to the

concept of hardiness.

LIST OF TABLES . . .

LIST OF FIGURES . . .

INTRODUCTION . . . .

The Foundation of th
Analysis of the Concept of Hardiness .

CONCEPTUAL FRAMEWORK

REVIEW OF THE LITERATURE
Summary of Literature Review

METHODOLOGY . . . . .
Hypothesis . . .
Research Design
Sample . . . . .
Instrumentation

Personal Views Survey (PVS)

TABLE OF CONTENTS

Nursing Stress Scale (NSS)

PROCEDURE FOR DATA COLLECTION .

STATISTICAL ANALYSIS

PROTECTION OF HUMAN SUBJECTS

RESEARCH ASSUMPTIONS

DEMOGRAPHICS . . . .

PROCEDURE FOR DATA ANALYSIS

ANALYSIS OF RESEARCH HYPOTHESIS

DISCUSSION, RECOMMENDATIONS, AND SUMMARY

Sample . . . . .
Instrumentation

Research Limitations

Hypotheses . . .
Summary . . . .

iii

Hardiness Concept

Page

. 15
. 25

. 27
. 27
. 27
. 27
. 28
. 28
. 29

. 37
. 37
. 38
. 39
. 41
. 43

TABLE or CONTENTS (cont.)

Commitment and Stress . . . . . . . . . . .
and Stress . . . . . . . . . . . . .
Challenge and Stress . . . . . . . . . . . .

Control

IMPLICATIONS FOR FURTHER RESEARCH . . . . . . . .

LIST OF REFERENCES . . . . . . . . . . . . . . .

APPENDICIES
Appendix

Appendix
Appendix

Appendix

Personal Views Survey
Nursing Stress Scale .
UCRIHS Approval . . .
Consent Letters . . . .
Permission to use Nursing Stress

Letter . . . . . . . . . . .
Permission to use Personal Views

iv

44
45
45

46
5O
56
61
64
65

67
68

LI ST OF TABLES

Page
Table 1: Demographic Data . . . . . . . . . . . . . . . . 32
Table 2: Demographic Characteristics of the Sample . . . 35
Table 3: Computed Reliability . . . . . . . . . . . . . . 36

Table 4: Correlation Coefficients . . . . . . . . . . . . 38

LIST OF FIGURES

Page

Figure 1: Relationships between hardiness, stress,
and burnout . . . . . . . . . . . . . . . . . . 14

vi

INTRODUCTION

Hardiness is viewed as a personality characteristic
that mediates the harmful effects of stress (Kobasa, 1977).
Stress is considered to be an integral facet of contemporary
life (Seyle, 1980). Stress has been shown to result in
compromised health status, to the extent of actual disease
process (Seyle, 1978; Sutterley, 1986), and has been linked
to burnout (Maslach, 1986; Topf, 1989). Human responses to
the same stressor or stressful situation vary markedly, as
do adaptation outcomes. Adaptation is a complex process
involving numerous internal and external factors that
influence response and the subsequent level of adaptation
established. The hardiness characteristic has been
identified as a motivating factor in resolving stressful
situations and in adapting to these conditions (Boyle, Grap
& Thornby, 1991).

During the last decade, there has been increasing
recognition of the stress experienced by nurses (Bates &
Moore, 1975; Beszterczey, 1977; Cassem & Hackett, 1972; Hay
& Oken, 1972; Kornfeld, 1971; Quinby & Bernstein, 1971;
Wertzel, 1977). Although some stressful situations are
specific to a particular type of nursing unit, nurses are

subject to general stress which arises from the physical,

1

2

psychological, and social aspects of the work environment
(Edelstein, 1966; Hay & Oken, 1972; Kornfeld, 1971; Malone,
1964; Menzies, 1960; Price & Bergen, 1977; Schulz &
Aderman, 1976; Vreeland & Ellis, 1969). While awareness of
nursing stress and its consequences has grown, there has
been limited research to investigate the role of hardiness
as a mediator of stress within the nursing profession. The
growth of corporate orientation for health care structures
with a focus on bottom-line management has radically altered
the role of the nurse (Snyder, 1995). With the
organization's emphasis on performance, productivity, and
outcomes, successful nurses are now integrating the
management of the delivery of nursing care with the
management of complex corporate structures and
relationships. Stress in an integral part of this process
and must be managed effectively if the nurse is to succeed.

For a considerable time, there has been growing concern
about work stress and it's impact on nurses' and other
healthcare professional's. While previous studies of
hardiness have looked at stress in the acute care nurse
setting, there has been little investigation of stress and
hardiness within the Advanced Practice Nurse (APN) role.

Advanced Practice Nurses within the primary care role
have been identified as risk-takes within the nursing
profession. Certainly, they are often in prime positions to

implement changes in health care delivery and respond

3
creatively to the rapid changes that characterize health
care today.

The very nature of the APN's role implies that the
nurses are willing to try new identities and take on new
aspects of their practice and increased accountability.
With increased accountability and change there is inherent
stress.

Fundamental to the formulation of hardiness is the
existential position that individuals can rise to the
challenges of their environment and turn stressful life
events into possibilities or opportunities for personal
growth and benefit. It is the combined effect of
commitment, control, and challenge, acting as a resistance
resource, that mitigates the detrimental effects of stress.

Human responses to the same stressor or stressful
situation vary markedly as do adaptation outcomes.
Adaptation is a complex process involving numerous internal
and external factors that influence response and the
subsequent level of adaptation established. The hardiness
characteristic has been identified as a motivating factor in
resolving stressful situations and in adapting to these
conditions (Boyle, Grap, & Thornby, 1991).

Hardiness is a personality characteristic with three
dimensions that includes a sense of commitment to one's self
and work, the perception of control over one's environment,

and the tendency to view changes as a challenge, or stimulus

4
to growth, rather than as a threat to security (Kobasa
1982b).

Increased level of hardiness has been associated with
the perception of less stress and fewer health problems
among various occupational groups. Among individuals
exposed to common stressors, some defend successfully with
minimal effort, while others must mount a more valiant
defense (Jenkins, 1979). According to Lazarus and Folkman's
transactional model of coping, differences in mastery of
stress exert their influence primarily in the person's
appraisal of the stressful encounter (Lazarus & Folkman
1984). Cognitive appraisal is an intrapsychic process
translating objective events into stressful experiences,
which may be positive for one person and negative for
another.

Lazarus and Folkman distinguish between primary and
secondary appraisal. Primary appraisal is the individual's
assessment of a situation as benign-positive, stressful or
irrelevant. Secondary appraisals include harm/loss, threat
and challenge. Secondary appraisal evaluates what might and
can be done based on one's coping resources. Factor's
affecting one's appraisal of a potentially stressful
situation may be person-related, such as hardiness and ways
of coping, or environmental such as social support.

Those individuals with less hardiness have demonstrated
increased stress and exhaustion. This is probably related

to the way the individual perceives the stressor and the

5
coping mechanism that is available to deal with that event.
In other words although the stressor may be the same upon
two individuals the perception of that stressor will vary as
will the coping mechanisms to address it. Hardiness is
expected to lead to less stress, less emotional exhaustion,
and fewer health problems via more effective coping and a
stress buffering effect.

Work related stress and emotional exhaustion is
associated with greater health problems in the form of
anxiety, depression, and somatization (Lindsey, & Hills,
1992).

Stress, sometimes referred to as distress, is usually
defined as the psychological or subjective discomfort that
occurs when stressors are perceived to be too demanding or
to exceed one's coping capacity (Lazarus, 1966; Mechanic,
1978; Selye, 1956). Most stress theories conceptualize
stressors as negative factors in the environment, chronic
strains, or life events that have the potential to cause
stress. Research has identified numerous stressors involved
in nursing including dealing with death and dying,
frustrated ideals, noise pollution, interpersonal conflicts,
lack of knowledge, and insufficient social support (Claus &
Bailey, 1980; Duxbury, Armstrong, Drew, & Henly, 1984; Gray-
Toft & Anderson, 1985; Kelly & Cross, 1985; Lewis &
Robinson, 1992; Topf & Dillon, 1988). Typically, the more
stressors' one has to deals with, the greater the likelihood

of increased stress (Lazarus, 1966; Selye, 1956).

6

Emotional exhaustion has long been accepted as the
depleted emotional state resulting from chronic exposure to
stress (Selye, 1956). More recently, work-related.emotional
exhaustion has been viewed as one of several characteristics
of burnout in health professionals (Cartwright, 1980;
Maslach & Jackson, 1981). Research has shown that greater
work-related stress is often linked with increase emotional
exhaustion in hospital nurses (Oehler, Davidson, Starr, &
Lee, 1991).

The World Health Organization defined health as “a
state of complete physical, mental, and social well-being”
(Pender 1982). Health problems, then, are physical, mental,
and social conditions that impede progress toward a goal of
perfect health. Numerous studies have provided support for
the contention that nurses exposed to various work-related
stressors will undergo stress and consequent emotional
exhaustion (Claus & Bailey, 1980; Duxbury, Armstrong, Drew,
& Hemly, 1984; Gray-Topf & Anderson, 1985; Kelly & Cross
1985; Oehler, Davidson, Starr, & Lee, 1991; Topf, 1989; Topf
& Dillon, 1988). Furthermore, work-related stress and/or
emotional exhaustion has been linked with health problems in
nutrition, such as overeating and anorexia (Lewis 5
Robinson, 1992; Topf, 1988), increased alcohol use (Haack,
1988), and psychological symptoms (Jennings, 1990).

Personality hardiness has been defined as consisting of
three beliefs. In particular, hardiness consists of 1)

commitment-the belief that persistence in one's goals will

7
result in something meaningful; 2) control-the belief that
one can influence ongoing life events; and 3) challenge-the
belief that negative life events can be turned around to
result in positive outcomes (Kobasa, 1979; Maddi & Dane,
1982). Hardiness is expected to lead to less stress, less
emotional exhaustion, and fewer health problems via more
effective coping and a stress buffering effect. That is,
individuals who are more hardy are more likely to use more
effective coping. This reduces negative health outcomes due
to a decrease in overall strain and emotional mobilization.
At the same time, hardiness insulates individuals (the
stress-buffering effect) for the overall risk of health
problems (Maddi & Kobasa, 1984; Maddi & Dane, 1982).
Research involving highway patrol officers, business
executives, lawyers, and company managers has provided mixed
support for the view that hardiness facilitates less stress
and fewer health problems (Hills & Norvell, 1991; Kobasa,
Maddi, & Corrington, 1981; Kobasa, Maddi, & Zola, 1983;
Kobasa & Puccetti, 1983; Weibe, 1991). This pattern has
also occurred in studies of nurses (McCranie, Lambert, &
Lambert, 1987; Rich & Rich, 1987; Topf, 1989).

In relation to hardiness, control is the belief one can
influence events rather than remain helpless in the face of
adversity. People with control feel both capable and
empowered to achieve desired outcomes. Those lacking this
attribute feel that others (the physician, the patient, the

managed care system) control their destiny. 0f the three

8
dimensions of hardiness, control is probably the most
difficult for nurses to attain, largely because
professionally we have been taught to rely on others for
direction and have not fostered self-confidence in our
ability to make decisions (Wolf, 1990).

Challenge involves crisis. Crisis contains both danger
and opportunity. The hardy individual tends to focus on the
opportunity as a stimulus to growth rather than on the
danger as a threat to security. The individual sees change
as positive rather than negative; the glass as half full
rather than half empty. As a result, they engage in
positive self-talk that leads too increased coping skills
and increased likelihood of success. This positive energy
and outlook are vitalizing to an organization, while the
opposite is extremely draining and potentially damaging.
This type of mind-set is not created overnight. It requires
consistent role modeling over a period of time.

Research supports the premise that hardiness as a
personality characteristic facilitates less stress and
emotional exhaustion. Graduate school is only the beginning
of a career loaded with professional stress, the potential
for emotional exhaustion, and the need for adaptation to
survive and be productive in a managed care environment. By
promoting hardiness while the nurse is at a student level,
the tool they will need to face challenges in day to day

practice is refined and developed.

9

It is possible that nurses responses to stress may vary
based personality characteristics. Retaining well-qualified
nurses may mean that they should be assessed for personality
characteristics that allow them to integrate stress into
their personal and professional lives. One personality
characteristic that has demonstrated the ability to mediate
stress is psychological hardiness.

Attitude toward a situation predicts longevity, and the
individual who believes that they make a special
contribution will continue to function in a situation
(Siegal 1986). For example, if nurses hold positive
attitudes regarding the control they have in their nursing
practices, are committed to their practices, and are
challenged by their practices, they are likely to stay in
their positions longer then if they do not have positive
attitudes toward their work. Additionally, they may
consider daily stressors in their practices as challenges.
Third, the professionals may be committed to events in their
lives in general, and to their practices in particular. In
summary, there may be a relationship between possessing
positive attitudes toward control, commitment, and
challenge, otherwise known as hardiness (Kobasa, 1979), and
being a nurse who functions well under stressful conditions.
I] E i I' E I] H i' : l

The genesis of the concept of hardiness can be traced
to Kobasa (1979), whose work is central to current hardiness

research. The proposition underlying Kobasa's report was

10
that people who experienced high stress but remained healthy
had a different personality structure than people who
experienced high levels of stress and became ill. One
explanation for the variation in response to stressful life
events is a constellation of personality characteristics
known as hardiness.

Existential psychology is also central to the
theoretical underpinnings of hardiness (Kobasa, 1979, 1982).
Two major premises of existential theory are pertinent. The
first is that personality is actively constructed through a
dynamic process, and secondly that although life is
stressful because it is always changing, people can turn
stressful life events into opportunities for growth (Kobasa,
1982). Three interrelated concepts are especially relevant
to this orientation: a) control, the belief that
individuals can influence life events; b) commitment, the
ability to sustain curiosity and feel deeply involved in
life activities; and c) challenge, a view of change as
normal and an exciting incentive for further individual
development (Kobasa, 1979; Kobasa, Maddi, & Courington,
1981).

Personality hardiness is a set of beliefs about oneself
and the world one lives in. Hardier persons take control of
their lives, believe that commitment to goals will result in
positive outcomes, and perceive daily stressors as

challenges.

11

Hardiness is a construct with widespread appeal to
nurse researchers. Because of its popularity, there is a
need to analyze hardiness carefully.
Analysis_of_the_£onssnt_of_nardiness

The concept of hardiness, as a personality
characteristic, has generated considerable interest and
research in psychology. However, it is a relatively new
perspective for nursing that is of particular interest.
Although the concept of hardiness has been discussed and
examined for over a decade it has not been clearly defined
for nursing (Kobasa, 1979, Kobasa, Maddi, & Courington,
1981; Nowack, 1989).

Life itself is portrayed as being continuously in the
process of change and therefore inherently stressful. The
healthy individual is able to see life stressors as
challenges and to utilize them for personal growth. Nursing
is an occupation loaded with stressors. If nurses had a
clearer understanding of what hardiness is, and how it
relates to the stressors of daily practice, then
interventions could be iniated and tested to ascertain
whether strategies to promote hardiness would contribute to
reduction of burnout from stressful life events.

Conceptual Framework

For some time, the focus of stress and illness research
has been on resistance resources (Antonovsky, 1979, 1987).
These resistance resources potentially prevent the

psychological tension of everyday life from becoming

12
debilitating stress. Some of these resistance resources
include one's physiological adaptability, social support,
cultural context, and personality (Antonovsky, 1979).

Following the logic of this line of research, Kobasa
(1979) developed the concept of personality hardiness.
Hardiness comprises three dimensions: Commitment, challenge,
and control. Hardy individuals have a higher sense of
commitment or purpose (that is, to work, to self, etc.) as
opposed to a sense of alienation. These individuals tend to
perceive life changes as challenges rather than threatening
to their security. Finally, hardiness involves a sense of
control over one's life, as these individuals intervene in
their own behalf when needed.

Hardiness has been theorized to affect stress and
health in two ways. Greater hardiness has been conceived of
as being associated with less psychological stress and
consequently greater health because hardy individuals alter
their perception of stress (i.e., to be a challenge).
Secondly, both hardy and non-hardy individuals may undergo
high levels of stress due to life events. However, hardy
individuals are more likely to use effective coping
strategies and social resources to reduce stress and prevent
illness. This tendency has been called the stress buffering
effect of hardiness (Kobasa, 1982; Kobasa & Puccetti, 1983).

The present contention is that burnout is a negative
health outcome of occupational stress and that hardiness

affects occupational stress and burnout much as it affects

13
life event stress and illness (i.e., Kobasa, 1979). These
relationships are depicted in Figure 1.

Most conceptualizations of stress (Lazarus, 1966;
Mechanic, 1978; Selye, 1975) imply that it is the
psychological discomfort that occurs when environmental
stressors are perceived as to demanding or as exceeding
one's coping abilities. In Figure 1, the environmental
demands stem from occupational events. Burnout has been
defined as a syndrome of emotional exhaustion,
depersonalization, and reduced personal accomplishment
resulting from stress linked with occupational events in
health careers (Cartwright, 1980; Maslach & Jackson, 1981).
It is theorized that greater demands from occupational
events are linked with greater stress and consequently
greater burnout. Studies have identified sources of
occupational stress linked with burnout in nurses. These
have included interpersonal conflicts, ethical problems,
dealing with administration, dealing with death and dying,
inadequate knowledge and skill, work load, and frustrated
ideals (Claus & Bailey, 1980; Duxbury, Armstrong, Drew, &
Henly, 1984; Gray-Toft & Anderson, 1985; Kelly & Cross,
1985; Topf & Dillion, 1988).

In Figure 1, demands of occupational events cause a
stress event which in the hardy individual leads to
effecting coping and an ability to utilize resources to

avoid burnout.

burnout.

14

Demands from
Occupational
Events
+

 

_ v +

Personality Occupational I Burnout
Hardiness I Stress
+ A

 

Use of Effective -
p Coping and
Social Resources

 

 

Eignzg_1. Relationships between hardiness, stress, and

In the occupational setting pluses and minuses

indicate positive and negative relationships between

variables.

Adapted from Kobasa (1982a)

15

Hardiness is felt to buffer against stress effects.
Less stress, in turn, results in less burnout. Burnout is a
common phenomenon in many professions. But it's most likely
to occur in highly stressful occupations-like nursing.
Burnout is defined as physical and emotional exhaustion that
involves a negative job attitude and a poor professional
self-concept.

It's characterized by apathy, alienation, job
dissatisfaction, and a depersonalization of patients
(Tarolli-Jager, 1994).

Recognizing that some individuals handle stress better
than others' researchers have begun to measure the variables
than reduce or buffer burnout. One of these buffers is
personal hardiness. It is thought that hardiness changes
the perception of stress for the individual. In general,
the higher your level of personal hardiness, the less likely
you are to experience burnout. Burnout and stress cause
some nurses to leave the profession, and plague many more
who are still in nursing. Personal hardiness is an
instrument that an individual can use to take control of
events that invoke challenge and grow from that experience.

Review of the Literature

In order to understand why some people are more
resistant to the deleterious effects of stress, Kobasa
(1979, 1982) examined extensively three personality
characteristics: commitment, control, and challenge.

Together, these comprise a personality style that resists

16
stress and is considered “hardy." The evolution of the
concept of hardiness is based on the work of personality and
social psychologists who observed that individuals differ in
their perception of environmental stressors. Specifically,
an individual's orientation toward life or characteristic
interests and motivation is considered an important factor
in determining the impact of a given stressful life event.
Hardiness has been defined as “a constellation of
personality characteristics that function as a resistance
resource in the encounter with stressful life events”
(Kobasa & Maddi, 1977).

The characteristic of commitment is the ability to
believe in the “truth,” important and value of who one is
and what one is doing, and consequently to become involved
in life (Kobasa, 1982). The individual's sense of
commitment extends past the person to a community of others
and provides a sense of purpose that acts to diminish the
perceived threat of a stressor.

Control refers to the tendency to believe and act as
though one can influence the course of events. Individuals
with control seek explanations as to why something is
happening, not simply in terms of another's action but also
in terms of one's own responsibility. This allows people to
think that stressors can be manipulated and are therefore
the direct result of their action.

Challenge is based on the belief that the environment

is ever changing and that the individual can perceive a

l7
stressor as an opportunity for personal growth, rather than
as a threat to security. According to Kobasa (1982),
individuals who welcome challenge can use resources
available to cope with stressors.

The utility of hardiness as a mediator in an
individual's response to stressful events has been supported
in several studies. In a few studies, hardiness has been
found to prevent illness in groups of employees who were
exposed to high levels of stress (Kobasa, 1979; Kobasa,
Maddi, & Courington, 1981). The early population on which
Kobasa (1979) tested her hypothetical frame work was
comprised of middle and upper-level male executives. In an
attempt to verify the components of hardiness and to
construct a valid tool to measure hardiness, she studied
three groups of executives. A total of 75 high stress/high
illness executives formed one group, 86 high stress/low
illness executives formed the second group, and 81 subjects
were used to cross validate results of the analysis of data.
The components of commitment challenge, and control were
measured using a composite of several data collection
instruments: For commitment, the alienation from self and
the alienation from work scales of the Alienation Test was
utilized (Maddi, Kobasa, & Hoover, 1979). For challenge,
the security scale of the California Life Goals Evaluation
Schedule (Hahn, 1966) and selected scales from the
Personality Research Scale was utilized (Jackson, 1974).

Finally, for control, the external locus of control (Rotter,

18
Seeman, 8 Liverant, 1962), and powerlessness scale of the
Alienation Test (Maddi et al., 1979) was utilized. The
Alienation scales were expected to identify the.presence of
commitment in selected conditions, through a reverse scoring
procedure. That is, hardy individuals were expected to
score low on scales that measured alienation's from self,
from work, from interpersonal relations, from family, and
from social contacts. The security scale and the cognitive
structure scale measured challenge by testing for
perceptions, of interesting experiences, adventurousness,
endurance, and vegetativeness. Hardy individuals were
expected to score high on interesting experiences and high
on security, but they were expected to score low on scales
that measure adventurousness and vegetativeness. Aspects of
control that were measured referred to external locus of
control, powerlessness, achievement, dominance. and
leadership.

Meaningfulness was believed to be a component of
cognitive control, which is the ability to appraise and
incorporate stress into ongoing plans (Kobasa, 1982).
Meaningfulness was measured, indirectly, by appraising the
presence of nihilism, the characteristic antithetical to
meaningfulness. Hardy individuals, according to Kobasa,
should score low on a nihilism scale indicating a high level
of meaning of the events in their lives. Additionally,
hardy individuals were expected to score low on an external

locus of control scale. Finally, Kobasa claimed that a

19
hardy individual should score low on a powerlessness scale,
high on an achievement scale, high on a dominance scale, and
high on a leadership scale.

After having established two groups who should score
differently on a hardiness test, Kobasa attempted to
establish the construct-related validity for the combined
six instruments that she used to measure hardiness. By
using discriminate function analysis, she found that 78% of
the subjects was correctly classified, indicating an
acceptable level of construct-related validity for the
instrument. In summary, high stress/low illness executives
tended to be more in control of life events, more committed
to their vocations, and more oriented to challenge than were
high stress/high illness executives.

The discriminating variable for commitment was
commitment to self versus alienation from self. For
challenge, the attitude of vigorousness versus
vegetativeness was the discriminating variable, internal
versus external locus of control discriminated attitudes
related to control. Additionally, high stress/low illness
executives reported that their lives were less stressful
than high stress/high illness executives. Kobasa concluded
that the hardy personality was less likely to become ill
following stressful life events. Following this early
investigation, Kobasa, recommended that a prospective study
determine if hardiness precedes and prevents illness that

results from stressful life events. Under comparable stress

20
(high stress/high illness) (Kobasa, 1979). Similarly, the
positive effects of hardiness were supported in a variety of
empirical studies involving lawyers and gynecological
patients (Kobasa, 1982). While the utility of hardiness as
a stress-resistance resource was tested in these studies,
both employed retrospective designs.

Further research on hardiness, using a prospective
design, however, also demonstrated a relationship between
this variable and stress-illness in a group of 259 make
executives (Kobasa et al., 1981). Personality was studied
as a conditioner of the effects of stressful life events on
illness onset. Two groups of middle and upper level
executives had comparably high degrees of stressful life
events in the previous 3 years, as measured by the Holmes
and Rahe Schedule of Recent Life Events. One group suffered
high stress without falling ill, whereas the other reported
becoming sick after their encounter with stressful life
events. Illness was measured by the Wyler, Masuda, and
Holmes Seriousness of Illness Survey. Discriminate function
analysis, on half of the subjects in each group and cross-
validated on the remaining cases, supported the prediction
that high stress/low illness executives show, by comparison
with high stress/high illness executives, more hardiness,
that is, have a stronger commitment to self, an attitude of
vigorousness toward the environment, a sense of

meaningfulness, and an internal locus of control.

21

Some studies have been used to suggest how hardiness
affects health (Funk 8 Houston, 1987; Hull et al., 1987).
Among individuals under stress, those who have a greater
sense of control over what occurs in their lives will remain
healthier than those who feel powerless in the face of
external forces. The highly stressed but healthy individual
is hypothesized to have a) decisional control, or the
capability to autonomously choose among various courses of
action to handle the stress; b) cognitive control, or the
ability to interpret, appraise, and incorporate various
sorts of stressful events into an ongoing life plans and,
thereby, deactivate their jarring effects; and c) coping
skill, or a greater repertory of suitable responses to
stress developed through a characteristic motivation to
achieve across all situations. In contrast, the highly
stressed persons who become ill are powerless, and low in
motivation for achievement. When stress occurs, they are
without recourse for its resolution, give up what little
control they do possess, and succumb to the incapacity if
illness. Among persons under stress, those who feel
committed to the various areas of their lives will remain
healthier than those who are alienated. Committed
individuals have a belief system that minimizes the
perceived threat of any given stressful life event. The
encounter with a stressful environment is mitigated by a
sense of purpose that prevents giving up on one's social

context and oneself in times of great pressure.

22

Although commitment to all areas of life-work, social
institutions, interpersonal relationships, family, and self-
should be characteristic of highly stressed persons who do
not fall ill, one area is singled out as particularly
important for health. Staying healthy under stress is
critically dependent upon a strong sense of commitment to
self. An ability to recognize one's distinctive values,
goals, and priorities and an appreciation of one's capacity
to have purpose and to make decisions support the internal
balance and structure that White and other theorists deem
essential for the accurate assessment of the threat posed by
a particular life situation and for the competent handling
of it (Hamburg 8 Adams, 1974).

While the exact mechanisms remain somewhat speculative,
it has been hypothesized that hardiness acts as a buffer of
stressful life events or has direct (or main) effects and
indirect effects on the way stressful life events are
perceived (Kobasa, 1979; Kobasa 8 Puccetti, 1983).

Specifically, it is thought that the indirect effects
of hardiness occur when there is a decrease in the use of
ineffective or regressive coping strategies. In a study of
lawyers, Kobasa (1982) noted that complaints of stress
symptomatology were mediated by the personality trait of
commitment as well as by the use of regressive coping
strategies.

Determination of how the direct or buffering effects of

hardiness work as compared to the indirect effects, has been

23
less clear. According to Kobasa (1979), hardy individuals
in highly stressful situations do not become ill. In such
instances, it is hypothesized that hardiness reduces the
impact of stressful life events by increasing the use of.
successful coping strategies (Hull, 1987). While Kobasa,
Maddi, and Corrington (1981) found a significant main effect
for hardiness, they did not find a significant hardiness-
stress interaction. In fact, a significant main interaction
between life stress and hardiness has been demonstrated in
only one study (Kobasa et al., 1981). These findings are
important when considering that a significant hardiness-
stress interaction is necessary in order for hardiness to
reduce the impact (or buffer the effects) of stressful life
events. Examples of regressive coping strategies include
avoidance of problems, absenteeism, substance abuse and the
blaming of others for difficulty at work and home.
Rhodewalt and Augustsdottir (1984) reported that hardy
individuals do not experience life events that are
qualitatively different from those experienced by non-hardy
individuals, but they are more likely to perceive the events
they do experiences as positive and under their complete
control.

In a study that examined the cognitive and
physiological responses of undergraduates, Allred and Smith
(1989) found that hardy individuals use more positive self-
statements than did other individuals. These results are

consistent with the view that the personality characteristic

24
of hardiness may moderate the effects of stress by way of
cognitive processes (Allred 8 Smith, 1989).

Several authors have studied the effect of personality
hardiness on burnout. One study examined 107 staff nurses
from a variety of intensive care and non-intensive care
areas to ascertain if personality hardiness moderated the
impact of job stressors on burnout (McCranie, 1987).
Burnout was significantly associated with higher levels of
perceived job stress and lower levels of personality
hardiness. Hierarchical multiple regression analysis
indicated that work stressors, particularly stress due to
workload, and hardiness was significant predictors of
burnout. Hardiness had beneficial main effects in reducing
burnout. Hardiness had beneficial main effects in reducing
burnout, but did not appear to prevent high levels of job
stress from leading to high levels of burnout.

Rich 8 Rich (1987) studied the effects of personality
hardiness and burnout in 100 female staff nurses from a
variety of units in an acute care hospital. Burnout and
hardiness were inversely related; 41% of the variance in
burnout scores were accounted for by the combination of low
hardiness and younger age. Two-way analysis of variance
showed that the effects of personality and age on burnout
scores were accounted for by the combination of low
hardiness and younger age. Two-way analysis of variance
showed that the effects of personality and age on burnout

were independent and additive rather than interactive.

25

The nurse's ability to function competently and adapt
to the stress of a given situation depends upon the use of
effective coping strategies. Thirty critical care nurses
from a Midwestern Veterans' Administration Medical Center
were surveyed to assess coping strategies in response to
work-related stress (Lewis 8 Robinson 1992). The strategies
used by 70% of the respondents at least some of the time
included discussing problems with co-workers, problem—
solving, watching television/reading and using caffeine.
However, the study did not examine the effect of type of
coping strategy on the development of burnout.

Ceslowitz (1989) examined the relationship between
coping and burnout using 150 randomly selected nurses from
four hospitals. Nurses who experienced decreased levels of
burnout used planned problem solving, positive reappraisal,
seeking social support and self-controlling coping
strategies. Nurses who experienced increased burnout used
escape/avoidance, self-controlling and confronting
strategies, although they used self-controlling strategies
to a lesser degree.

To deal adequately with burnout, the factors
contributing to its occurrence and intensity must be clearly
documented. Further, research-based strategies to prevent
burnout must be identified.

Summary of Literature Review
In a series of papers, Kobasa and associates presented

a model of individual vulnerability to stress. They

26
hypothesized that individuals who remain healthy after
experiencing high degrees of life stress exhibit a
constellation of attitudes, beliefs, and behavioral
tendencies that distinguish them from those who become ill.
This constellation is labeled hardiness and comprises three
dimensions: Commitment, control, and challenge (Kobasa 8
Maddi, 1977). Commitment reflects a generalized sense of
purpose and meaningfulness expressed as a tendency to become
actively involved in ongoing life events rather than
remaining passively uninvolved. Control refers to the
tendency to believe and act as if one can influence the
course of events rather than feeling helpless when
confronted with adversity. Challenge is defined as the
belief that changes rather than stability is normal life and
that change can be a stimulus to growth rather than a threat
to security. Kobasa hypothesized that these interrelated
elements of the hardy personality style mitigate the
negative impact of stressful life events by influencing both
cognitive appraisal (e.g., not interpreting events as
meaningless, overwhelming, or undesirable) and coping (e.g.,
investigating activities that lead to an effective

resolution of problems caused by the events).

27
METHODOLOGY
Hypothesis
The research hypotheses were:
1. The three dimensions of psychological Hardiness, that

is, commitment, control, and challenge, have a positive

relationship.
2. Hardiness will have an inverse relationship to stress.
3. Hardiness will be positively related to the evaluation

of personal stressor's as challenging.
Research Design

In this study, self-administered questionnaires were
completed by Michigan State University graduate nursing
students. The Personal Views Scale, the Nursing Stress
Scale, a demographic questionnaire, and consent letter were
read and completed by each voluntary participant.

A design using inferential statistics was used to
analyze for significant relationships between the
independent variable of hardiness and the dependent variable
of stress.

Sample

A convenience sample of approximately one hundred and
seventeen Michigan State University graduate nursing
students was used. Of the one hundred and seventeen
graduate nursing students approached to participate in the
study, 18 students agreed and returned research packets to
Michigan State University College of Nursing for scoring and

analysis.

28
Instrumentation

Two instruments were used to measure the variables in
thisstudy. The Personal Views Scale was used to measure
hardiness, and the Nursing Stress Scale was used to measure
stress. In addition, a demographic data form was used to
obtain descriptive data about the sample.

Personal Views Survey (PVS)

The work on Kobasa's PVS began in 1983 with the current
tool being established in 1986. A large pool of
conceptually relevant items was utilized in its
construction. Following item and factor-analysis with
multiple samples there was revision of items to produce
discriminating and reliable hardiness scores for both the
components of control, commitment, and challenge and for the
total hardiness measure.

The PVS scale consists of 50 items that share the same
format and, according to Kobasa, discriminate respondents
well. The instrument uses a four point Likert scale.
Examples of the 17 control questions are: “Planning ahead
can help avoid most future problems” and “When you marry and
have children you have lost your freedom of choice."
Commitment is assessed through 16 questions such as WI find
it difficult to imagine getting excited about working” and
“I don't like things to be uncertain or unpredictable."
Seventeen questions such as TI like a lot of variety in my
work” and “Most days, life just isn't exciting for me"

measure challenge. Appendix I includes the PVS. Ratio

29

scores are calculated for the components of control,
commitment, and challenge. The hardiness score is
determined by combining the three component scores in a
mathematical formula. Estimates of internal consistency
have been reported as Coefficient Alphas >.90 for the PVS
and equal to or >.70 for each of the subscores of control,
commitment, and challenge. Appendix F includes a copy of
the PVS.

Nursing Stress Scale(NSS)

The N88 consists of 34 items that describe situations
that have been identified as causing stress for nurses in
the performance of their duties. It provides a total stress
score as well as scores on each of seven subscales that
measure the frequency of stress experienced by nurses.
Test-retest reliability as well as four measures of internal
consistency indicated that the N88 and its seven subscales
are reliable. The test-retest coefficient for the total
scale was 0.81. Four measures of internal consistency were
obtained: A Spearman-Brown coefficient of 0.79, a Guttman
split-half'coefficient of 0.79, a coefficient alpha of 0.89,
and a standardized item alpha of 0.89. All four measures
indicated a satisfactory level of consistency among items
(Gray-Toft, 1981). Test-retest reliability coefficients for
four of the seven subscales exceeded 0.70.

The validity of the NSS was determined by empirically
investigating its relationship to other important criteria

to which stress is theoretically related, namely, trait

30
anxiety, state anxiety, job satisfaction, and turnover
(Gray-Toft 8 Anderson, 1981). Appendix G includes a copy of
the NSS.
Procedure for Data Collection

Review of this study for protection of human subjects
was conducted by the University Committee on Research.
Following approval, a research packet for each nursing
graduate student was forwarded to a participating Michigan
State University classroom instructor. Each subject
received an informational/consent letter, a demographic
form, the Personal Views Survey (PVS), the Nursing Stress
Scale (NSS), an answer sheet, and instructions to return to
their instructor within a two week time period. Total
completion time for the packet was approximately 25 minutes.
A code number for each survey packet was provided to assist
the investigator in keeping track of the data but protected
the confidentiality of the respondent. The completed packet
was then returned to the Michigan State College of Nursing
for scoring and analysis by the investigator. Results of
the survey were communicated to be available in the form of
a completed thesis, abstract, or publication. A total of
eighteen research packets were returned.

Statistical Analysis

The data were coded and entered into a computer.

Descriptive statistics were used to describe the population.

Inferential statistics were used to test the hypothesis.

31
The SPSS statistical software package was utilized for data
analysis, with level of significance established at 0.05.
Protection of Human Subjects

The study used volunteer subjects with informed
consent. No potentially dangerous or adverse effect to
students for participating was known or identified. The
study was approved by Michigan State University's University
Committee on Research Involving Human Subjects (Appendix E).
The data utilized for this study has been maintained on a
computer disk by the principal investigator. The subjects
were entered by identification numbers only and did not
contain any subject identifiers. Thus, no link could be
made with the name of any subject for this study.

Research Assumptions

It was assumed that data were collected and logged
accurately. It was assumed that all potential subjects were
given the opportunity to participate. The assumption was
also made that subjects understood the instructions provided
and were able to read the instrument, and understood the
questions asked, or were provided contact phone numbers to
seek sufficient explanations by the researcher in which to
candidly and honestly answer the questions. It was assumed
that the data were accurately entered.

Demographics

The demographic characteristics of the sample are

reported in Table 1. The majority of participants were

female, currently married, had children living with them,

32
Table_1»
Demographis_nata

 

Please provide the following information about yourself.

1. Age.
years

 

2. Gender (Please check appropriate space)
male female

 

 

3. Marital status (Please check appropriate space)
single/never married

married

divorced/separated

widowed

 

4. Children
____ number living with you
number living elsewhere

 

5. Current employment status (Please check appropriate
space)

not working

working less that 10 hours per week

working 10-19 hours per week

working 20-29 hours per week

working 30-39 hours per week

working 40 hours or more per week

 

6. If you are employed, please indicate the type of work in
the space provided.

 

7. Years of experience in Nursing (Please check appropriate
space)

0-3 years

4-7 years

8-10 years

10-13 years

14-16 years

greater than 16 years

 

8. Student Status.
____ Full Time
Part Time

Please list the degree you currently hold and in what field.

 

33
were working, and had BSN degrees. This study sample
consisted of 17 women and 1 man, mean age of 35, 13 married,
4 single and never married, and 1 divorced/separated.
Eleven had children living with them and 2 had children
living elsewhere. Two were not working currently, one was
working less than 10 hours per week, four were working 10-
19 hours per week, three were working 20-29 hours per week,
seven were working 30-39 hours per week, and one was working
40 hours per week. Four were working in staff/medical
surgical positions, two in Obstetrics, two in Surgical
Intensive Care, one in Neurological Intensive Care, one in
Psychiatric Care, one in the Emergency Department, one
Patient Educator, two in Critical Care Unit/Intensive Care,
two Enterstomal Specialist, and one in Hospice/Home Care.
Years of experience in Nursing were as follows; five 0-3
years, one 4-7 years, one 8-10 years, three 10-13 years, two
14-16 years, and six greater than 16 years. Six were full
time students and 12 were part-time students. Twelve had
BSN degree, 1 BS degree, 2 MS degree, and 3 with multiple
degrees.
Procedure for Data Analysis

Demographics' variables were used to describe the
sample. Ratio scores for the control, commitment, and
challenge components of the PVS were calculated. The total
PVS hardiness score was then calculated utilizing the three

ratio scores. As applicable, means and standard deviation,

34
or correlation's were reported. A scatter plot indicated no
significant outliners.

Frequencies on all items were completed to detect
errors and strange behaviors. Only one missing datum was
detected and no serious strangeness. Three PVS subscales
was computed. Computed reliability (Cronbach's Alpha) for
N88, PVS, and each PVS subscale were as listed in Table 2.

Analysis of Research Hypothesis

The three dimensions of psychological hardiness, that
is, commitment, control, and challenge have a positive
relationship. A Pearson's product-moment correlation
coefficient was used to address this hypothesis. A
correlation coefficient of .4947 (p=.018) was obtained
between control and commitment. These results support a
positive relationship between control and commitment that is
statistically significant.

A correlation coefficient of -.1776 (p=.240) was
obtained between control and challenge. These results
support an inverse relationship between control and
challenge which is not statistically significant.

A correlation coefficient of .0634 (p=.401) was
obtained between commitment and challenge. These results
support a positive relationship between commitment and
challenge which is not statistically significant.

Hardiness will have an inverse relationship to stress.
A pearson's product-moment correlation was used to address

this hypothesis. A correlational coefficient of .1866

35

Table 2.

. l l . l' E II S 15 [n=J§I

 

 

Variable N %
Age
24-27 5 .27
28-31 1 .05
32-35 1 .05
36-39 5 .27
40-43 4 .22
44-47 2 .11
Gender
Female 17 .94
Male 1 .05
Marital Status
single/never married 4 .22
married 13 .72
divorced/separated 1 .05
widowed 0 .00
Children
(number living with you)
1-2 9 .50
3-4 2 .05
(number living elsewhere)
1-2 2 .05
Current employment status
not working 2 .11
working less than 10 hrs/wk 1 .05
working 10-19 hrs/wk 4 .22
working 10-29 hrs/wk 3 .16
working 30-39 hrs/wk 7 .38
working 40 hrs or more/wk 1 .05
If employed, type of work
Obstetrics 1 .05
Medical Surgical 4 .22
Surgical Intensive Care 2 .11
Neurological Intensive Care 1 .05
Intensive Critical Care 2 .11
Psychiatric Unit 1 .05
Emergency Department 1 .05
Patient Educator 1 .05
Enterostomal Therapy 2 .11
Hospice and Home Care 1 .05

Table 2 (cont.)

36

 

 

Variable N %
Years Experience in Nursing

0-3 years 5 .27
4-7 years 1 .05
8-10 years 1 .05
10-13 years 3 .16
14-16 years 2 .11
greater than 16 years 6 .33
Student Status

Full time 6 .33
Part time 12 .66
Current Degree

BS 1 .05
BSN 12 .66
MS 2 .11
Multiple Degree 3 .16

 

 

Table 3.

: l i E 1' 1.1.!
N88: .9081

PVS: .6785

Control: .5038

Commitment: .7203

Challenge: .6044

All five means were intercorrelated.

 

37
(p=.229) was obtained between the PVS and N88 scores. These
results support a relationship between hardiness and stress
that is not statistically significant.

Hardiness will be positively related to the evaluation
of personal stressors's as challenging.

A pearson's product-moment correlation was used to
address this hypothesis. A correlation coefficient of .0321
(p=.450) was obtained between N88 and challenge. These
results support a positive relationship that is not
statistically significant. A list of correlation
coefficients is provided in Table 4.

Discussion, Recommendations, and Summary
annals

In this study, a total of 18 subject's responses were
analyzed on the variables of hardiness and stress. The
majority of the subjects were female (94%), greater than
thirty-six years of age (60%), married (72%), currently
working (89%), part-time graduate students (66%), had been
in nursing greater than ten years (60%), and had completed
BSN degrees (66%).

Bias which may be identified in the above sample are
gender (the sample is primarily female), marital status
(what influence does external supports hold in regards of
the perception of stress), multiple concurrent stressors
(work and graduate school). An extraneous variable that
should have been considered is socioeconomic status. This

factor may influence the heterogeneity of the population

38

Table 4.
Correlatinnmfficientunsm

 

Challenge 1.0000 .0634 -.1776 .0321 .5408
P=.401 P=.24O P=.450 P=.010

Commit .0634 1.0000 .4947 .1941 .7858
P=.401 P=.018 P=.220 P=.OOO

Control -.1776 .4947 1.0000 .1464 .6018
P=.240 P=.018 P=.281 P=.OO4

Moan_NSS .0321 .1941 .1464 1.0000 .1866
P=.450 P=.220 P=.281 P=.229
Mean_PVS .5408 .7858 .6018 .1866 1.0000

' P=.010 P=.OOO P=.OO4 P=.229

 

(Coefficient/(Cases)/1-tailed Significance)

with respect to the dependent variable. For example, in
this study of the relationship of the subscales of hardiness
and stress, a person's socioeconomic status is likely to be
an important extraneous variable because poorer individual's
may have increased stress related to financial constraints
than more affluent individual's.

Even with these identified biases it is felt that the
sample is representative of the accessible population, and
the accessible population is representative of the target
population.

Instrumentation

Computed reliability (Cronbach's Alpha) for the NSS,
PVS, and each PVS subscale fell between the normal range of
The N88 had a high degree of

values between 0.0 and +1.00.

internal consistency with a value of.9081. Indices of

39
homogeneity estimate the extent to which different subparts
of an instrument are equivalent in terms of measuring the
attribute. The PVS had a lower degree of internal
consistency with a value of .6785. This may be attributed
to a combination of a small sample and a small range of
responses by this relatively uniform sample. Small ranges
of responses implies low variability, which in turn implies
a limit to the reliability.
E l 1' 'l l'

The number of participating subjects (sample size) is a
threat to the external validity of this study, and limit's
generalization to the target population. Many published
nursing studies result in nonsignificant findings; that is,
one or more of the hypotheses are not supported. Clearly
researchers run a risk of Type II errors when they use small
samples. That is, when small samples are use, the
researcher takes a sizable risk that the test result will
result in the rejection of the research hypothesis-even when
the hypothesis is, in fact, correct. Although there are no
simple formulas that indicate how large a sample is needed
in a given study, usually the larger the sample the more
representative of the population it is likely to be. Large
samples are no assurance of accuracy, however. When
nonprobability sampling methods are used, even a large
sample can harbor extensive bias.

Because practical constraints such as time,

availability of subjects, and resources often limit the

40
number of subjects included in nursing studies, many are
based on relatively small samples. In a survey of nursing
studies published over four decades (the 1950's to the
1980's), Brown (1984) found that the average sample size was
under 100 subjects in all four decades, and similar results
were reported in a more recent analysis (Moody, Wilson,
Smith, Schwartz, Tittle, 8 Vancott, 1988). In some cases, a
small sample size may be justifiable. A convenience sample
of approximately one hundred seventeen students was used,
only 18 students participated. There may have been
unidentified factors that prevented students from wanting to
participate in the study. The study was completed at the
beginning of an educational semester. The graduate students
involved may have been under increased external stress that
could impact their decision regarding participation in a
research project. The graduate students may also have been
under the incorrect assumption that if they were not
currently employed in an acute care setting that the study
would not relate to their current status as nurses.

Power analysis builds on the concept of effect size.
Effect size is concerned with the strength of the
relationship among research variables. If the independent
and dependent variables are strongly interrelated, then a
relatively small sample is generally adequate to demonstrate
the relationship statistically. If the relationship is not
strong (perhaps, modest)then a small sample can be risky.

Because this population is believed to be relatively

41

homogeneous with respect to the variables of interest, then
the small sample was felt to be adequate, even though, it is
recognized that it is at great risk for a Type II error.
This sample is relatively homogeneous that could lead to a
lack of variability. With a homogeneous sample this lack of
variability can make it difficult to identify and/or set a
range of responses.
W

The first hypothesis stated that the three dimensions
of psychological hardiness, that is commitment, control and
challenge have a positive relationship. There existed a
strong relationship between control and commitment that is
significant, there also existed a positive relationship
between commitment and challenge that was not significant.
Commitment means that an individual knows who s/he is and
what s/he is doing throughout her life situations. An
individual possessing control believes and acts as if she or
he is able to influence life's course of events. An
individual who is committed to life events has a sense of
control over these events. When it is believed that change,
not stability, is the normative mode of life, challenge is
evident. The individual views stressful life events as
opportunities and incentives for personal growth. There
existed a negative correlation between control and challenge
that was not significant. It may be theorized that the more
control an individual has over a life situation the less

challenged he will feel toward it. The less control an

42
individual perceives over a situation the more challenged
s/he will feel.

The second hypothesis was hardiness will have an
inverse relationship to stress. There existed a positive
correlation that is not significant. The results supported
a relationship between hardiness and stress that was
positive. An inverse relationship was not supported. Hardy
individuals do not experience life events that are
qualitatively different from those experienced by non-hardy
individuals, but they are more likely to perceive the events
they do experience as positive and under their complete
control. Effect size is concerned with the strength of
relationships among research variables. While a modest
relationship may in fact exist between hardiness and stress
the small sample used may not be adequate to demonstrate the
relationship statistically.

The third hypothesis was hardiness will be positively
related to the evaluation of personal stressor's as
challenging. There is a positive correlation that is not
significant. The individual with the psychological
characteristic of hardiness does not perceive change as a
threat to security but allows the individual to be a
catalyst in his environment. They perceive increasing
stress as a challenge for personal and professional growth
rather than as a threat. Hardy individuals use more
positive self-statements than other individuals (Allred 8

Smith, 1989). These results are consistent with the view

43
that the personality characteristic of hardiness may
moderate the effects of stress by way of cognitive
processes. The lack of significance is attributed to sample
size and therefore a Type II error.
Summary

It was hypothesized that commitment, control, and
challenge comprised the personality style of stress
resistance labeled as hardiness by Kobasa (1979). Hardiness
is defined as a personality trait that serves as a buffer in
the stress reaction and thereby lessens the symptoms that
result from exposure to stress. They believe that they have
personal control and can influence events in their lives.
These persons have decisional control in that they are
capable of choosing among alternative means to handle
stress. They have cognitive control in that they can
interpret, appraise, and incorporate stressful events into
their plan of life rather than becoming very upset by such
events. Hardy individuals also have a great repertoire of
coping skills, which is characteristic of their motivation
to achieve in all situations.

Hardy individuals are able to feel deeply committed or
involved in activities of daily living. Committed persons
have an inherent ability to change their perceptions of
stressors to minimize personal threat. These persons have
the ability to recognize their goals, values, and
priorities. They have an appreciation of the capacity to

have goals and to make accurate appraisals of events. Hardy

44
persons also feel committed and involved with others, which
provides the vasis for social support. They see changes as
exciting and challenges to further development. They value
a life that is filled with change and have explored their
environment to identify resources that aid them in stressful
situation.

As a constellation of three personality characteristics
(control, commitment, and challenge), hardiness facilitates
the kind of perception, coping, and evaluation that is
necessary for the successful resolution of events created by
stressful stimuli, which thereby prevents the debilitation
that results from continuous demands for adaptation.

Further study is needed to verify that hardiness is a stress
mediator in nursing and to determine how to best promote
hardiness in nurses.

CommitmenLandmfi

Commitment means that the individual knows who s/he is
and what s/he is doing throughout life situations. S/he
experiences the belief that there is truth, importance, and
value to his or her existence. This individual involves
themselves fully in various life experiences and
relationships with comfort. Commitment serves as a buffer
to stress since it provides an overall sense of purpose that
mitigates the perceived threats of various life events. The
committed individual recognizes the value of life and
personal interactions with the environment. There is

insight into both her/his value system and her/his decision

45

making process. This self-understanding is a source of
support and revitalization. The value of the support of
others is also recognized by the committed individual.
Therefore, s/he can comfortably elicit help in stressful
situations. S/he will also make her/his coping skills
available to others experiencing stress (Kobasa, Maddi, 8
Courington, 1981).
We

An individual possessing control believes and acts as
if he or she is able to influence life's course of events.
S/he perceives stressful events as predictable consequences
of her/his own activity, thus s/he maintains the ability to
manipulate the situation. S/he acknowledges her/his own
responsibility her/his life's management rather than seeing
events as the result of the actions of others or fate.
There is a feeling of control even when there is no
discernible cause-effect relationship identified since the
individual recognizes that s/he is capable of effective
functioning regardless of the situation. Such an individual
would be defined as having an internal locus of control
(Kobasa et al., 1981).
ChallengsLanLStness

When it is believed that change, not stability, is the
normative mode of life, challenge is evident. The
individual views stressful events as opportunities and
incentives for personal growth. Since change is not a

perceived threat to security the individual can be a

46
catalyst in her/his environment. S/he possesses cognitive
flexibility and is open to others. Finally, ambiguity can
be tolerated. With challenge there is a search for new and
interesting experiences that potentially add to the
possibility of stressful life events. This individual has,
however, explored her/his surroundings and knows where
stress reduction resources can be found (Kobasa et al.,
1981).
Implications for Further Research
The majority of the research has been done on white,
male executives. The research that has been done on nurses
has focused on those nurses in the acute care setting. This
study should be replicated to include a much larger sample
to determine if the findings are similar to the small
homogeneous group. Research should be broadened to include
the advanced practice nurse, particularly because of
perceived stress levels inherent in the role, and then to
expand the study to compare the advanced practice nurse to
the graduate nurse. Another consideration could be to
research the nurse at the graduate level and then re-
investigate after entering the role of the advanced practice
nurse. One could also study a group of nurses who had
undergone education to increase their levels of hardiness
and then compare that to a control group of nurses who had
not received the hardiness training. Additional research
could include comparison of nurses with studies of

individuals in other professional roles.

47

The focus of nursing on identified practice issues and
burnout has been in the area of stress reduction. The
content and process of role implementation are important
issues for the individual practicing in an advanced nursing
role. The role of the nurse in advanced practice is not
well understood in that nurses themselves are not always
clear about their roles and are, therefore, allowing the
system to use them inappropriately at times.

Role conflicts and role negotiations are a way of life
for the APN working in primary care. We can expect to
expend considerable energy trying to get physicians, other
providers, legislators, and the public to understand who we
are and what we have to offer.’ Those who serve as role
models, as faculty and preceptors, must help prepare our
students for the problems inherent in role change. In order
to obtain and utilize power, the nurse must gain access to a
number of external and internal resources to add to his or
her own strengths. We must accept that our daily practice
will be filled with challenges that can expand our
professional growth in a positive manner. Empowerment
enables nurses to participate in actions and decision-making
within a context that supports an equitable distribution of
power. Empowerment requires a commitment to connection
between self and others enabling individuals or groups to
recognize their own strengths, resources, and abilities to
feel challenged by change and to feel control over

facilitating a response to that change.

48

Why should nurses devote research time and energy to
hardiness? Both in studies of patients and themselves,
nurses place a high premium on the presence of individuals
who do well under stress, the importance of positive and
active assumptions about personality, and the need to
recognize the environmental demands or stressors placed upon
people. For example, faced with increasing dehumanization
within the high-tech medical setting, it is critical for
nurses to ensure that the individual needs and differences
of patients are recognized. Also nurse's interest in
hardiness needs to be understood in terms of longstanding
struggles within the profession. Drawing from a paper by
Fox, Aiken, and Messikomer (1990) on the culture of nursing,
the attention given to hardiness has much to do with nurses'
attempts to distinguish their identity as health care
professionals.

Fox and her colleagues describe the nursing community
as intent on revealing and legitimizing its own principals
and practices of caring for patients. Hardiness may be a
useful tool in this endeavor. Both in its general
characterization as part of peoples' essential and strenuous
search for meaning and in its more specific description as a
composite of commitment, control, and challenge, hardiness
may be well suited to nurses' drive to distinguish their
field from the profession of medicine by which it has been
historically dominated. Consider nurses' understanding of

current professional crisis, which is characterized by

49
burnout, ethical issues regarding restructuring and managed
care, and the day to day demands of practice. The loss of
control nurses feel is particular: It is not simply a matter
of lacking power over others but rather control over their
ability to care for patients in a manner consistent with
their deeply held values. This view of control is easily
linked with the hardiness definition that makes control part
of a triad that also includes commitment and challenge

(Kobasa, 1982).

LI ST OF REFERENCES

LIST OF REFERENCES

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Psxshnlnsx-
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Bates, E. M., 8 Moore, B. N. (1975). Stress in
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50

51

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Hamburg, M., 8 Adams, T. (1974). Beyond boredom and
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Hull, J. G., Van Treuren, R. R., 8 Virnelli, S. (1987).
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Hills, H., 8 Norell, N. (1991). An examination of
hardiness and neuroticism as potential moderators and stress

outcomes. Behaxinral_nedicine_11. 31- 38.

Jackson, D. N. (1974). Personality research form
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Jenkins, C. D. (1979). Psychosocial modifiers of
re8ponse to stress. Journal_of_numan_5tress.

Jennings, B. (1990). Stress, locus of control, social
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Jones, J. (1980). The Sataff Burnout Scale: A
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52

Kelly, J., 8 Cross, D, (1985). Stress, coping
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Nursin§_8_Health1_8 321- 328-

Kelly, J., 8 Cross, D. (1985). Stress. coping in
stress resistance among lawyers. '

Social_Rs¥sholog¥_11. 1- 11.

Kobasa, S. (1979). Stressful life events, personality
health: An inquiry into hardiness.

and.$ocial_zs¥cnolog¥1_11. 1- 11.

Kobasa, S. (1982a). Commitment and coping in stress

resistance among lawyers. 1ournal_of_Eersonalit¥_8_Social
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Kobasa, S. (1982b). The hardy personality: Toward a
social psychology of stress and health. In G.S. Sanders 8

J- Suls (Eds ). Social_nsYcholog¥_nf_health_and_illness.
Hillsdale, NJ: Erlbaum.

Kobasa, s. C., 8 Maddi, S. (1977). Existential
personality theory. In R. Corsini (Ed.), Current
Personality theory. Peacock: Itasca.

Kobasa, S., Maddi, S., 8 Corrington, S. (1981).
Personality and constitution as mediators in the stress-

illness relationship Inurnal_of_Health_and_Social_Beha!ior
22, 368- -78.

Kobasa, S., Maddi, S., 8 Zola, M. (1983L Type A and
hardiness. Jnurnal_of_Behayioral_nedicine1_§. 41- 51.

Kobasa, S., 8 Puccetti, M. (1983L Personality and
social resources in stress resistance. 19nzna1_gf

Eersonalitx_and_Social_£s¥cholng11_15. 839- -50.

Kornfeld, D. S. (1971). Psychiatric problems of an
intensive care unit. Medical_Clinics_of_Nnrth_America.

Lazarus, R. (1966). Psychological stress and coping.
New York: McGraw-Hill.

Lazarus, R. S., 8 Folkman S. (1984). Stress,
Appraisal, and Coping. Springer, New York.

Lewis. D., 8 Robinson, J. (1992L ICU nurses' coping
measures: Response to work-related stress. grigigal_gazg

Nn1521_12 18 23.

53

Lindsey, E., 8 Hills, M. (1992). An Analysis of the
Concept of Hardiness. The_Qanadian_Jenrnal_ef_Nureins
Research. .

Maddi, S., 8 Dane, S. (1982). Hardiness is not merely
negative affinity. Ienrna1_ef_2ereenalitY_and_Seeial
Esxehelesx-

Maddi, S., Kobasa S., 8 Hoover, J. (1979). An

alienation test. Ieurnal_ef_Human1etie_Es¥ehelesYI_12.73-
760 ‘

Malone, M. F. (1964). The dilemma of a profession in a

bureacracy. Nursing_£gznm.

Maslach, C. (1986). Burnout. The cost of caring. New
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Maslach, C., 8 Jackson, S. (1981). Maschlack Burnout
Inventory: Research edition, manual. Palo Alto, Calif.:
Consulting Psychologist Press.

McCranie, E., Lambert, V., 8 Lambert, C. (1987). Work
stress, hardiness and burnout among hospital staff nurses.

Nurs1ng_Eeseareh1_3§. 374-78-
Mechanic, D. (1978). Mediga1_sggiglggy. New York:

Free Press.

Menzies, I. E. P. (1960). A case study in the
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Human_Re1atiens.

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Oehler, J., Davidson, M., Starr, L., 8 Lee, D. (1991).
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neonatal nurses. Heazt_8_Lnng+_zQ, 500-505.

Pender. N. (1982). Health_premetien_in_nureins
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Amer1ean_leurnal_ef_Esxeh1atr¥.

54

Rhodewalt, F., 8 Augustsdottir, S. (1984). On the
relationship of hardiness to the type A behavior pattern:
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Rich, v., 8 Rich, A. (1987). personality hardiness and
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Sehelarehini_12, 63-66.

Rotter, J., Seeman, M., 8 Liverant, S. (1962).
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Selye, H. (1978). The stress cf life (rev. ed.). New
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Seyle, H. (Ed). (1980). Selye's guide to stress
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Siegal, B.S. (1986). Love, medicine, and miracles.
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Snyder, T. (1995). Work stress, hardiness, and burnout

among hospital staff nurses. Nursing_3e§eazgh.

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Nure1ng_and_flealth.

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Lung1_11. 557-73-

Tarolli-Jager, K. (1994). Personal Hardiness: Your

Buffer Against Burnout. Amer1ean_Jeurnal_ef_Nnreing1_ZQ.
44-46.

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nurse in an intensive care unit. lgnznal_gf_3mgz;gnn
11 i. J E O I. .

55

Wertzel, H. (1977). Analysis of patient-nurse

interaction in hemodialysis units. Jon:na1_gf_2syghgsgmatig
Eeseareh.

Wolf, G. (1990). Promoting Executive Hardiness.

W. 10-11.

Appendix A

56

Personal Views Survey

Below are some items with which you may agree or disagree.
Please indicate how you feel about each one by using the
provided scoring sheets. Completely fill in a circle from 1
to 4 in the space provided. A one indicates that you feel
the item is not at all true; choosing four means that you
feel the item is completely true.

As you will see, many of the items are worded very strongly.
This is to help you decide the extent to which you agree or
disagree.

Please read all the items carefully. Be sure to answer all
on the basis of the way you feel now. Don't spend too much
time on any one item.

1 = Not at all true
2 = A little true
3 = Quite a bit true
4 = Completely true
1. I often wake up eager to take up my life
where it left off the day before . . . . . . 1 2 3 4
2. I like a lot of variety in my work . . . . . 1 2 3 4

3. Most of the time, my bosses or superiors

will listen to what I have to say . . . . . 1 2 3 4
4. Planning ahead can help avoid most future
problem . . . . . . . . . . . . . . . . . . 1 2 3 4

5. I usually feel that I can change what might
happen tomorrow, by what I do today . . . . 1 2 3 4

6. I feel uncomfortable if I have to make any
changes in my everyday schedule . . . . . . 1 2 3 4

7. No matter how hard I try, my efforts will
accomplish nothing . . . . . . . . . . . . . 1 2 3 4

8. I find it difficult to imagine getting
excited about working . . . . . . . . . . . 1 2 3 4

9. No matter what you do, the “tried and true"
ways are are always the best . . . . . . . . 1 2 3 4

10. I feel that it's almost impossible to change
my spouse's/significant other's mind about
something . . . . . . . . . . . . . . . . . 1 2 3 4

57

Most people who work for a living are just
manipulated by their bosses . . . . . . . . 1

New laws shouldn't be made if they hurt a
person's income . . . . . . . . . . . . . . 1

When you marry and have children you have
lost your freedom of choice . . . . . . . . 1

No matter how hard you work, you never really
seem to reach your goals . . . . . . . . . . 1

A person whose mind seldom changes can usually
be depended on to have reliable judgment . . 1

I believe most of what happens in life is just
meant to happen . . . . . . . . . . . . . . 1

It doesn't matter if you work hard at your
job, since only the bosses profit by it
anyway . . . . . . . . . ; . . . . . . . . . 1

I don't like conversations when others are
confused about what they mean to say . . . . 1

Most of the time it just doesn't pay to try
hard, since things never turn out right
anyway I O O O O O O O O O O I O O I O O O O 1

The most exciting thing for me is my own
fantasies . . . . . . . . . . . . . . . . . l

I won't answer a person's questions until I
am very clear as to what he is asking . . . 1

When I make plans I'm certain I can make
them work 0 o o o o o o o o o o o o o o o o 1

I really look forward to my work . . . . . . 1
It doesn't bother me to step aside for a
while from something I'm involved in, if
I'm asked to do something else . . . . . . . 1

When I am at work performing a difficult
task I know when I need to ask for help . . 1

It's exciting for me to learn something
about myself . . . . . . . . . . . . . . . . 1

I enjoy being with people who are
predictable . . . . . . . . . . . . . . . . 1

58

I find it's usually very hard to change
a friend's mind about something . . . . . .

Thinking of yourself as a free person just
makes you feel frustrated and unhappy . . .

It bothers me when something unexpected
interrupts my daily routine . . . . . . . .

When I make a mistake, there's very little
I can do to make things right again . . . .

I feel no need to try my best at work, since
it makes no difference anyway . . . . . . .

I respect rules because they guide me . . .

One of the best ways to handle most problems
is just not to think about them . . . . . .

I believe that most athletes are just born
good at sports . . . . . . . . . . . . . . .

I don't like things to be uncertain or
unpredictable O O O O O O O O O O O O O O 0

People who do their best should get full
financial support from society . . . . . . .

Most of my life gets wasted doing things
that don't mean anything . . . . . . . . . .

Lots of times I don't really know my own
mind . . . . . . . . . . . . . . . . . . . .

I have no use for theories that are not
closely tied to facts . . . . . . . . . . .

Ordinary work is just too boring to be
worth doing . . . . . . . . . . . . . . . .

When other people get angry at me, it's
usually for no good reason . . . . . . . . .

Changes in routine bother me . . . . . . . .

I find it hard to believe people who tell
me that the work they do is of value to
SOCiety O o O o O O O o e o o o O o o O o O

I feel that if someone tries to hurt me,
there's usually not much I can do to try
and stop him . . . . . . . . . . . . . .

46.

47.

48.

49.

50.

Most days, life isn't very exciting for

me O O O O O O O O O O O

I think people believe in individuality only

to impress others . . .

When I'm reprimanded at work, it usually

seems to be unjustified

I want to be sure someone will take care of

me when I get old . . .

Politicians run our lives

59

60
Scoring Instructions for Personal Views Survey

Challenge items = 2, 6, 9, 12, 15, 18, 21, 24, 27, 30,
33, 36, 37, 40, 43, 46, and 49

Commitment items = 1, 8, 11, 14, 17, 20, 23, 26, 29,
32, 38, 39, 41, 44, 47, and 50

Control items = 3, 4, 5, 7, 10, 13, 16, 19, 22, 25, 28,
31, 34, 35, 42, 45, and 48

Items to be reversed: 6-21 and 27-50

For challenge score, sum over all relevant items and
divide by 51

For commitment score, sum over all relevant items and
divide by 48

For control score, sum over all relevant items and
divide by 51

To create Hardiness composite, take three ratio scores,
add together, multiply by 100, and divide by three.

61
Nursing Stress Scale

This questionnaire contains a list of situations that
commonly occur in nursing environments. For each item
indicate by filling in the appropriate number how often in
your environment you have found the situation to be
stressful.

Note that some of the items appear to be quite similar.
However, each statement describes a different aspect of your
work that may be stressful. Please respond to each item
independently, even though some may be similar. Your
responses are strictly confidential.

1 = never

2 = occasionally

3 = frequently

4 = very frequently
1. Breakdown of the computer . . . . . . . . . 1 2 3 4
2. Criticism by a physician . . . . . . . . . . 1 2 3 4
3. Performing procedures which patients

experience as painful . . . . . . . . . . . 1 2 3 4

4. Feeling helpless in the case of a patient
who fails to improve . . . . . . . . . . . . 1 2 3 4

5. Conflict with a supervisor . . . . . . . . . 1 2 3 4

6. Listening or talking to a patient about
his/her approaching death . . . . . . . . . 1 2 3 4

7. Lack of an opportunity to talk openly with
other unit personnel about problems on the

unit 0 O O O O O O O O O O O O O O O O O O O 1 2 3 4
8. The death of a patient . . . . . . . . . . . 1 2 3 4
9. Conflict with a physician . . . . . . . . . 1 2 3 4

10. Fear of making a mistake in treating a
patient . . . . . . . . . . . . . . . . . . 1 2 3 4

11. Lack of an opportunity to share experiences
and feelings with other personnel on the
unit 0 o o o o o o o e o o o o o e o o o o o 1 2 3 4

12. The death of a patient with whom you
developed a close relationship . . . . . . . 1 2 3 4

62

Physician not being present when a patient
dies 0 o o o o o o o o o o O o o o o e O O o

Disagreement concerning the treatment of a
patient 0 o O o I o O O O o o O O O O o e 0

Feeling inadequately prepared to help with
the emotional needs of a patient's family .

Lack of an opportunity to express to other
personnel on the unit my negative feelings
towards patients . . . . . . . . . . . . . .
Inadequate information from a physician
regarding the medical condition of a

patient . . . . . . . . . . . . . . . . . .

Being asked a question by a patient for
which I do not have a satisfactory answer .

Making a decision concerning a patient when
the physician is unavailable . . . . . . . .

Floating to other units that are short
staffed O O o O O O O O O O O O I O O O O 0

Watching a patient suffer . . . . . . . . .

Difficulty working with a particular nurse
(or nurses) outside the unit . . . . . . . .

Feeling inadequately prepared to help with
the emotional needs of a patient . . . . . .

Criticism by a supervisor . . . . .,. . . .
Unpredictable staffing and scheduling . . .

A physician ordering what appears to be
inappropriate treatment for a patient . . .

Too many non-nursing tasks required, such
as clerical work . . . . . . . . . . . . . .

Not enough time to provide emotional support
to a patient 0 O O C O O O O O O O O O O O 0

Difficulty in working with a particular
nurse (or nurses) on the unit . . . . . . .

Not enough time to complete all of my
nursing tasks . . . . . . . . . . . . . . .

63

31. A physician not being present in a medical
emergency . . . . . . . . . . . . . . . .

32. Not knowing what a patient or a patient's
family ought to be told about the
patient's medical condition and its
treatment . . . . . . . . . . . . . . . .

33. Uncertainty regarding the operation and
functioning of specialized equipment . . .

34. Not enough staff to adequately cover the
unit 0 o o o o o I o e o o O o o e o o o o

Appendix B

 

         
     

”=1

e.

I

—“l

OFHCEOF
RESEARCH
AND
GRADUATE
STUDIES

UnIversity Committee on
Research Involving
HumanSuMedx
(UCRIHS)

INmeawHMMnm
246 Mninrslralion Building
fistmmmemom
«MLJMG

517/355-2150
FAX' 517/432-1171

In: MW SDI: mm
mnuhwmuwammw
(retina :0 Aaron

MSU IS an )fluf‘mlm action

64

MICHIGAN STATE

 

UNIVERSITY
June 26, 1997
To: Louise Selanders

A-230 Life Sciences Bldg.

RE IRB“ 97-408
TI HARDIENSS: ITS RELATIONSHIP TO STRESS IN NURSES
REVISION REQUESTED N/A
CATEGORY: 1-C
APPROVAL DATE: 06/25/97

The university Committee on Research Involving Human Subjects'(UCRIHSI

review of this project is complete.

I am pleased to adVise that the

rights and welfare of the human subjects appear to be adequately

rotected and methods to obtain informed consent are a

ropriate.

herefore, the UCRIHS approved this-project and any rev sions listed

above.

RENEWAL:

REVISIONS:

PROBLEMS/
CHANGES:

If we can be of any future hel
at ($171355

UCRIHS approval is valid for one calendar year, beginning with
the approval date shown above. Investigators planning to
continue a project be nd one year must use the green renewal
form (enclosed with t e original a roval letter or when a

pro ect is renewed) to seek u ate certification. There is a
max mum of four such expedite renewals pogsible. Investigators
wishin to continue a roject beyond tha ime need to submit it
again or complete rev ew.

UCRIHS must review an changes in rocedures involving human
subjects, rior to in tiation of t e change. If this is done at
the time o renewal, please use the green renewal form. To
revise an approved protocol at an 0 her time during the year
send your written request to the CRIHS Chair, requesting reVised
approval and referenCing the project's IRE 5 and title. Include
in ur request a description of the change and any revised

ins ruments, consent forms or advertisements that are applicable.

Should either of the followin arise during the course of the
work, investigators must noti y UCRIHS promptly: (1) roblems-
(unexpected side effects, comp aints, e c.) involving uman
subjects.or 2).changes in the research environment or new
information ndicating greater risk to the human sub'ects than
existed when the protocol was previously reviewed an approved.

p, please do not hesitate to contact us
-2180 or FAX (51714 2- 171.

(Sincerely,. '1 ' .
(was)

vid E. Wright, Ph.D.
UCRIHS Chair

DEH:bed

cc: Laurie Porter

65

MAY 29 199.7

Laurie Porter RN.
7663 Thorpe Rd.
Bear Lake. Michigan
49614
1-616-889-3654

Dear Michigan State Student:

As a graduate student at Michigan State University. I am completing a research study in partial
fulfillment of the requirements for the degree of Master of Science in Nursing. I am Investigating
the relationship of certain personality characteristics to stress In nurses.

I would like to invite you to participate in this research endeavor. Because stress ls known to be
prevalent among nurses. this study has the potential to contribute to the facilitation of learning
and thus to the delivery of optimal patient care. I am asidng you to participate because you are a
graduate nursing student pursuing a Master‘s degree.

Your Involvement in this project will consist of completing two questionnaires. one to measure
the frequency and identify the sources of sues for nurses. and the other to measure the degree
of hardiness in nurses. You will also complete a short list of personal data items. It will take
approidmately 25 minutes to complete the process. Specific directions precede each section.

All results will be treated with strict confidence and subjects will remain anonymous in any report
of research findings; on request and within these restrictions results may be made available to
subjects in the form or a completed thesis, abstract. or derived publication. The number code
noted on your questionnaire is a subjed code to help the researchertrack data returns. but does
not identify you. Please do not write your name on any part of the returned survey.

You indicate your voluntary agreement to participate by completing and returning the research
packet. Place the completed information in the provided stamped envelope. seal it. and return
by . Questions concerning this research project or the questionnaires may be
directed to either of the individuals indicated at the bottom of this letter.

Thank you for your contribution to this important research project.

Sincerely.

Laurie Porter

Louise Selanders. RN. EdD, Supervisor Laurie Porter. RN. Researcher

A21 70 Life Sciences 7663 Thorpe Road

15811 Upton Road Bear Lake. MI 49614

East Lansing, MI 48823 1-616-889-3654

1-616-343-9196
UCRIHS APPROVAL FOR

THIS project EXPIRES:
JUN 2 5 1998
SUBMIT RENEWAL APPLICATION
ONE MONTH PRIOR TO

ABOVE DATE TO CONTINUE

66

Laurie Porter R.N.
7663 Thorpe Rd.
Bear Lake, Michigan
49614
1-616-889-3654

Dear Michigan State Student:

As a nursing graduate student at Michigan State University,
I am completing a research study in partial fulfillment of
the requirements for the degree of Master of Nursing
Science. I am investigating the role of the personality
characteristic of hardiness and its relationship to stress
within the nursing profession.

I would like to invite you to participate in this research
endeavor. Because stress is known to be prevalent among
nurses, this study has the potential to contribute to the
facilitation of learning and to the delivery of optimal
patient care. I am asking you to participate because you
are a graduate nursing student, pursuing a Master's degree.

Your involvement in this project will consist of completing
a two part questionnaire to measure the frequency and
identify the sources of stress in nurses, and to measure the
degree of hardiness in nurses. You will also complete a
short list of personal data items. It will take
approximately 25 minutes to complete the process. Specific
directions will precede each section.

I will be happy to answer any questions that you may have or
that occur during the completion of the questionnaire. I
ask that you replace the two scoring sheets and the
demographic sheet in the smaller envelope. Please seal it
and return no later than September 11, 1997. Please do not
write your name on any portion of the scoring sheets,
demographic sheet, or smaller envelope.

Thank you for your contribution to this study. A copy of
results of this study will be available to you upon
completion, as a thesis, within the College of Nursing, at
Michigan State University.

Sincerely,

Laurie Porter

Appendix C

67

7742 Traders Cove Lane
Indianapolis, IN 46254

777M x2, x997

W (m
Please find enclosed a copy of the Nursing Stress Scale that you requested. I would
request that you give the authors the appropriate recognition, and that you would
send me a copy of the results of your study when you are finished.

A couple of points regarding scoring:

0 Scores for each subscale are calculated by summing the responses for all items
within the subscale. and then dividing by the number of items.

0 Any changes to the original instrument would necessitate a factor analysis or
an Intuitive analysis for subscale definition.

Good luck on your research.
Sincerely,

as?

Pam Toft

Appendix D

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lam granting you permission to use the instrument, Personal Views Survey, as the
measurement for the concept of hardiness in your research. Enclosed is the instrument
that we are currently using in our studies in New York and the instructions for scoring. I
have included several articles which provide a concept analysis of hardiness and a critique
of the various hardiness instruments. For additional information about the construct and
its measurement, please consult a recent chapter I contributed to L. Goldberger & S.
Brcmits (EdS-) (1993)- WWW 2nd edition.
New York: Free Press. As you will find in the chapter, I feel quite strongly that (a)
improvements are needed in the scale and (B) other types of measurement approaches to
hardiness nwd to be developed. Our group is currently working on both these tracks.

I would suggest that before selecting the Personal Views Survey that you review
the literature and evaluate the reported reliabilities of the instrument both as a total scale
score and its subscales, particularly with reference to the specific sample of your study. At
this point in time, the use of a total score for hardiness has demonstrated greater
consistency across samples. To further support your selection of this instrument, it is
further recommended that you conduct a pilot study based on your specific sample to
evaluate the reliability of the instrument. A Cronbach alpha of .70 or greater demonstrates
acceptable reliability of the instrument.

I would appreciate your help in the further development of this instrument.
Therefore, it is requested that upon completion of your pilot study or thesis that you
submit an abstract of your study including a description of the sample and sample size, and
the statistics related to the reliability of the instnrment. If you have any suggestions for
new items, item rewording or interview questions to tap hardiness, your feedback would
be appreciated. I look forward to hearing from you about your work.

 

 

 

 

 

Sincerely,
Ouellette (formerly, Kobasa), PhD.

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