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AIM: This paper is a report of a study conducted to determine which occupational stressors are present in nurses' working environment; to describe and compare occupational stress between two educational groups of nurses; to estimate which stressors and to what extent predict nurses' work ability; and to determine if educational level predicts nurses' work ability. BACKGROUND: Nurses' occupational stress adversely affects their health and nursing quality. Higher educational level has been shown to have positive effects on the preservation of good work ability. METHOD: A cross-sectional study was conducted in 2006-2007. Questionnaires were distributed to a convenience sample of 1392 (59%) nurses employed at four university hospitals in Croatia (n = 2364). The response rate was 78% (n = 1086). Data were collected using the Occupational Stress Assessment Questionnaire and Work Ability Index Questionnaire. FINDINGS: We identified six major groups of occupational stressors: 'Organization of work and financial issues', 'public criticism', 'hazards at workplace', 'interpersonal conflicts at workplace', 'shift work' and 'professional and intellectual demands'. Nurses with secondary school qualifications perceived Hazards at workplace and Shift work as statistically significantly more stressful than nurses a with college degree. Predictors statistically significantly related with low work ability were: Organization of work and financial issues (odds ratio = 1.69, 95% confidence interval 122-236), lower educational level (odds ratio = 1.69, 95% confidence interval 122-236) and older age (odds ratio = 1.07, 95% confidence interval 1.05-1.09). CONCLUSION: Hospital managers should develop strategies to address and improve the quality of working conditions for nurses in Croatian hospitals. Providing educational and career prospects can contribute to decreasing nurses' occupational stress levels, thus maintaining their work ability.

Original publication




Journal article


J Adv Nurs

Publication Date





2056 - 2066


Adult, Attitude of Health Personnel, Burnout, Professional, Croatia, Cross-Sectional Studies, Data Interpretation, Statistical, Educational Status, Efficiency, Female, Humans, Job Satisfaction, Male, Middle Aged, Nursing Staff, Hospital, Surveys and Questionnaires, Workload, Workplace, Young Adult