Relationship between Workload and Non-physical Work
Environment with Nurse Job Stress in Inpatient Room of
Menteng Mitra Afia Hospital in 2019
Friskania Devi Rosanti
1
and Mayumi Nitami
2
1
Health Policy Administration, Faculty of Public Health and Sciences, Universitas Esa Unggul, Indonesia
2
Enviromental Health, Faculty of Public Health and Sciences, Universitas Indonesia,
Jl. Arjuna Utara No.9, Blk.1 No.2, Duri Kepa. Kebon Jeruk 11510, Indonesia
Keywords: Job Stress, Workload, Nurse, Esa Unggul, October.
Abstract: Based on Riskesdas (2018) shows the prevalence of severe mental disorders in Indonesia of 7 per mile
population and mental emotional disorders 9.8% of the population. While the DKI Jakarta Province Data
shows the prevalence of mental emotional disorders is 9.7%. The purpose of this study was to determine the
relationship between workload and non-physical work environment with nurses' work stress in the inpatient
room of Menteng Mitra Afia Hospital in 2019. This study used a cross-sectional study design with 30
respondents. The sampling technique uses a total sampling method. Data obtained through a questionnaire
with the variable workload, non-physical work environment, and work stress. Data analysis using the
Chi-Square test. The results showed that there was a significant relationship between workload (p = 0.003,
PR = 0.264 or 3.78) and non-physical work environment (p = 0.026, PR = 2.222) with nurses work stress.
The researcher suggests that providing health services especially in the field of counseling and counseling as
well as routine sports activities, rotating workers and increasing the number of human resources in the
inpatient room, providing support to workers to develop careers, give appreciation and pay more attention to
the physical work environment in the inpatient room.
1 INTRODUCTION
In America, work stress is a common problem and
is detrimental to workers. Job stress can cause
health problems such as fatigue/tiredness,
dizziness, and indigestion (Munandar, 2006) The
EU-OSHA report (2013) explains that 51% of
workers report work- related stress is
commonplace for work and 4 out of 10 workers
stated that the problem of work stress was not
well managed in their organizational environment.
The high rate of work stress in Europe has caused
European member governments to take part in
solving problems that occur (The OSHA, 2013).
Work stress is an important concern for one of
them in the health service sector workers, all
professionals in the hospital have a risk of stress,
but nurses have a higher stress level (ILO, 2016).
The results of the study (Health and Safety
Executive, 2014) showed that health
professionals, teachers, and nurses had the highest
stress levels with a prevalence rate of 2500,
2190 and 3000 cases per 100,000 workers in the
period 2011/12, 2013/14 and 2014/15.
Based on data from the World Health
Organization (WHO, 2018), around 300 million
people in the world experience stress. Based on
Basic Health Research (2018), the prevalence of
severe mental disorders in Indonesia is 7 per mile
population and mental emotional disorders 9.8%
of the population. While DKI Jakarta Province
Data shows the emotional mental disorder
prevalence is 9.7%, the data shows Jakarta is
wrong one city has 9.7% mental-emotional
management challenges (Balitbangkes, 2018).
Based on data (American Nurses Association,
2017) stress data on nurses obtained as much as
82% of workers in hospitals in America. Nurses
and nursing students face unique dangers in the
workplace, the results of the HRA show there
must be a way to cope with stress levels in nurses,
especially with physical activity, nutrition, rest,
safety, and quality of life. Nurses need to get
310
Rosanti, F. and Nitami, M.
Relationship between Workload and Non-physical Work Environment with Nurse Job Stress in Inpatient Room of Menteng Mitra Afia Hospital in 2019.
DOI: 10.5220/0009594803100316
In Proceedings of the 1st International Conference on Health (ICOH 2019), pages 310-316
ISBN: 978-989-758-454-1
Copyright
c
 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

stress management programs so nurses are more
comfortable working and better able to serve
patients, as data shows that 68% of nurses report
they tend to prioritize patient safety and health
more than themselves, this causes stress levels in
nurses are quite tall.
The results of a survey conducted by PPNI
(Indonesian National Nurses Association) about
50.9% of nurses working in four provinces in
Indonesia experience work stress that is often
dizzy, tired, unable to rest due to high workload
and time- consuming (Bakri, 2014). The research
results of the Ministry of Health and the University
of Indonesia show that 78.8% of nurses carry out
cleaning duties, 63.3% perform administrative
tasks and more than 90% perform non-nursing
tasks and only 50% perform nursing care actions
according to their functions (Bakri, 2014).
A cross-sectional study conducted at 3
hospitals in the Yangon region, Myanmar, showed
that 50.2% were nurses have a high level of work
stress (Lwin, 2015).
Menteng Mitra Afia Hospital is a private
hospital located in Central Jakarta located at Jalan
Kali Pasir No. 9 Cikini, Jakarta Pusat. At its
inception in 1997, Menteng Mitra Afia Hospital
was known as a specialized Neurology and
Psychiatric Hospital. And as for the duties of
nurses in Menteng Mitra Afia Hospital is data
analysis to formulate a nursing diagnosis, plan
and carry out a simple nursing evaluation on
individuals, carry out documentation of nursing
care.
Maintain nursing and medical equipment so
that it is always in a state ready for use, handover
patients during service changes, follow periodic
meetings held by the head of the room, bring
patients for surgery, radiological examinations.
The burden of nurses' physical workers includes
lifting patients, bathing patients, helping patients
to the bathroom, pushing health equipment,
making the patient's bed, pushing the patient's
bench. While the mental workload experienced by
nurses including, working shifts or taking turns,
preparing the mentality of the patient and the
patient's family, especially for those who will
carry out surgery or in critical condition. Profile
of Menteng Mitra Afia Hospital in 2019 explained
that the capacity of beds in the inpatient room was
75 beds, the number of nurses 30 people from that
number the ratio between the number of nurses
and the number of beds was (1:1) where should
the type C hospital is one nurse caring for one
patient or one nurse with one patient's bed. This
figure indicates an increase in bed occupancy
rates or increases patient visits per day. Increased
patient visits can be an encouragement for the
hospital to realize the vision of becoming a
hospital that provides quality, trusted services and
prioritizes satisfaction and is affordable to the
community.
The increase in the number of hospitalized
patients at Menteng Mitra Afia Hospital in the
past year has continued to increase from 50
patients per day in the past few months to nearly
85 patients every day but the increase has not
been offset by an increase in the number of
nursing staff. According to Permenkes Number 56
of 2014, the number of nursing staff needs is the
same as the number of beds in an inpatient
installation (ratio 1: 1).
Based on interviews conducted using the DASS
42 questionnaire on 13 inpatient nurses found 5
people experienced moderate stress (38.5%) then
6 people experienced high stress (46%) and 2
people experienced low stress (15%). Based on
the symptoms arising from the three stresses, it
can affect a number of illnesses that are allegedly
due to the person experiencing stress that is
quite high and prolonged, including work
dissatisfaction, fatigue, moodiness and lack of
enthusiasm at work, rising work accident rates
due to lack of focus at work, wrong in making
decisions, high absenteeism and high emotional
level at work.
Based on the above background, researchers
are interested in conducting further research on
"The Relationship between Workload and the
Non- Physical Work Environment of Nurses and
Work Stress in the Inpatient Room of Menteng
Mitra Afia Hospital in 2019.
2 RESEARCH RESULT
2.1 Univariate Analysis
Table 1: Frequency Distribution of Work Stress Nurse
inpatient rooms in Menteng Mitra Afia Hospital in 2019.
Category Frequency Percentage
Stress 16 53.3
No Stress 14 46,7
Total 30 100
Based on the results of the study above shows that
the highest proportion of respondents in work
stress was 16 people (53.3%).
Relationship between Workload and Non-physical Work Environment with Nurse Job Stress in Inpatient Room of Menteng Mitra Afia
Hospital in 2019
311

Table 2: Frequency Distribution of Workload Frequency
in Inpatient Nurse at Menteng Mitra Afia Hospital.
Category Frequency Percentage
Hard 14 46,7
Light 16 43,3
Total 30 100
Based on the results of the study above shows
that the highest number of proportions were
respondents with light workloads of 16 people
(53.3%).
Table 3: Frequency Distribution of Non- Physical Work
Environment Nurse inpatient room at Menteng Mitra Afia
Hospital.
Category Frequency Percentage
Not good 11 36,7
Good 19 63,3
Total 30 100
Based on the results of the study above shows
that the highest proportion of respondents is a
good work environment with 19 people (63.3%),
and the lowest proportion is respondents with a
bad work environment of 11 people (36.7%).
Table 4: The Relationship between Workload and Nurse
Stress in the Inpatient Room at Menteng Mitra Afia
Hospital in 2019.
Workload
Work Stress
Total
Stress No Stress
N % N %
Hard 3 21,4 11 78,6 100
Light 13 81,2 3 18,8 100
Based on the results of the study in table 4.4
shows that in light workloads, the highest
proportion of people experiencing work stress
were 13 people (81.2%) while the heavy workload
had the highest proportion is those who did not
experience work stress as many as 11 people
(78.6% ). In this study using the chi-square test
using the Fisher's Exact Test value because the
results of the 2x2 table found the expected value
of less than 5 (E <5), the statistical test results
showed that there was a relationship between
workload and work stress obtained p-value =
0.003 (≤ 0.05). From the value of the Prevalence
Ratio (PR) workload with nurse work stress of
0.264 (PR <1) or 3.78 with 95% CI (0.094 -
0.739) which means that respondents who
experienced light workloads were 3.78 times
protected or prevented/minimized the occurrence
of
work stress compared to nurses who experience
heavy workloads.
Table 5: Work Environment relations Non-Physical with
the Work Stress of Nurses in the Inpatient Room Menteng
Mitra Afia Hospital in 2019.
Work
Environment
Non-
Physical
Work Stress
Total
Stress No Stress
N % N %
Not Good 9 81,8 2 18,2 100
Good 7 36,8 12 63,2 100
Based on table 4.5 shows that in a bad work
environment, the highest proportion is 9 people
who experience heavy work stress (81.8%) while
the good work environment has the highest
proportion of 12 people who experience mild
work stress (63.2%).
3 DISCUSSION
3.1 Relationship between Workload
and Nurse Stress
The results of the study of the relationship of
workload with nurses' work stress in the inpatient
room of Menteng Mitra Afia Hospital in 2019
were
obtained from 30 respondents, with light
workload,
the highest proportion was 13 people
(81.2%) while
work stress while heavy workload
had the highest
proportion of 11 people (78.6%)
who did not
experience work stress. Statistical test
results show
there is a relationship between
workload with nurses
work stress obtained by the
value of Prevalence
Ratio (PR) of 0.264 (PR <1)
or 3.78 with 95% CI
(0.094 - 0.739), which means
that respondents who
experience heavy workloads
3, 78 times are
protective or prevent the
occurrence of work stress
compared to nurses who
experience light workloads.
This study is in line
with Graduates, et. al
(2015) states that there is a
very significant
relationship between workload
and work stress of implementing nurses.
In this study using the chi square test using the
Fisher's Exact Test value because the results of
the 2x2 table there is no expected value of less
than 5 (E <5), the statistical test results indicate
there is a relationship between non-physical
work environment with work stress obtained
p-value = 0.026 (≤0.05). From the Prevalence
ICOH 2019 - 1st International Conference on Health
312

Ratio (PR) value of non-physical work
environment with nurses work stress of 2,221 with
95% CI (1,158 - 4,260), which means that
respondents who experience a non- physical work
environment are not at 2.222 times at risk for
experiencing work stress compared to nurses who
experience nonphysical work environment is good.
According to Manuaba (2000), due to
workload that is too heavy can result in a worker
suffering from work disorders or diseases.
Excessive workload will cause physical or mental
fatigue and emotional reactions such as
headaches, indigestion, and irritability. While the
workload is too little where the work that occurs
due to repetition of motion will cause boredom, a
sense of monotony. Boredom in routine daily
work due to too little work or work results in a
lack of attention to work that can potentially
endanger workers. Excessive or low workloads
can cause work stress. In general, work stress is
influenced by many factors besides workload, as
mentioned in Restiaty, et. Al. (2006) research
about workload and feeling of exhaustion the
relationship of the workload at work with work
fatigue is a physical symptom of work stress,
meaning that the heavier the workload at work,
the higher the level of work stress. This is in line
with the theory of Gibson's (1997) excess
workload and too little workload is a stress
generator. The workload can be further divided
into excessive / too little quantitative workload,
which arises as a result of tasks that are too much
/ too little given to the workforce to be completed
within a certain time. Munandar (2008) states that
physical and mental overload work is doing too
many activities both physically and mentally, and
this can be a source of job stress. This excessive
workload is very influential on the productivity of
nurses. Nurses feel that the number of nurses is
not appropriate or proportional to the amount of
work to be done. Such conditions will certainly
trigger the emergence of work stress. The
workload is the amount of energy expended from
a working system carried out by humans in a
particular work. The workload can vary according
to the number and combination of tasks
performed, the level of difficulty of the task, the
characteristics of the work and others.
The cause of the relationship of workload and
work stress of nurses in the inpatient room at
Menteng Mitra Afia Hospital because where there
is a lot of repetition of motion will arise boredom
but a monotonous position such as when
completing a report with the attitude of sitting too
long also causes stiff muscles (stiff neck ) and
tired, the workload of nurses at Menteng Mitra
Afia Hospital is to provide direct care services
based on the treatment process, carry out
treatment actions and evaluate according to the
patient's problem, accompany the doctor visit and
record programs to be carried out, make daily
reports, make handover responsibility verbally
and in writing and it is done repeatedly, in
addition to a large number of patient waiters can
also trigger stress many demands by patients and
patients' families to nurses and nurses are not
proportional to a large number of patients who
come because the nurse's movements are not so
free facing a patient's family that has a lot of
complaints. And the stress of nurses who appear is
the decrease in performance or productivity of
nurses and the number of turnover of workers in
Menteng Mitra Afia Hospital, often the number of
nurses with high absenteeism and aggression in
the workplace and irritability. Efforts that have
been made by the hospital are in the delegation of
authority to use workload calculations based on
daily reports and also the hospital has tried to do
family gatherings every once a year.
Suggestions from researchers for the hospital
is in the rotation every 6 months so that workers
do not feel bored with monotonous work,
crackdown firmly on the number of patients'
families who want to accompany patients unless
the patient's family is very necessary to assist.
This is so the inpatient room is not full and
inhibits the space for nurses in handling patients.
The way is that every person who enters must
carry a patient waiting card where each patient is
only entitled to 2 families who accompany or by
way of security control after each visiting hour
and at night and evaluate HR by increasing the
number of patients who come with existing nurses
remembering Turnover of workers is still high.
3.2 Relationship of Non-physical Work
Environment with Nurse Stress
The results of the study of the relationship of non-
physical work environment with nurses work
stress in the inpatient rooms of Menteng Mitra
Afia Hospital in 2019 were obtained from 30
respondents, the working environment was not
good, the highest proportion was 9 people who
experienced severe work stress (81.8%) while
good work environment has the highest
proportion of those who experience mild work
stress as many as 12 people (63.2%). Statistical
Relationship between Workload and Non-physical Work Environment with Nurse Job Stress in Inpatient Room of Menteng Mitra Afia
Hospital in 2019
313

test results show there is a relationship between
non-physical work environment with nurses work
stress obtained by the value of Prevalence Ratio
(PR) of 2,221 with 95% CI (1,158 - 4,260) which
means that respondents who experience non-
physical work environment are not at risk 2.222
times to experience heavy work stress compared
to nurses who experience a good non-physical
work environment.
The condition of the work environment
provides an important role in the good and bad
performance produced. If the work environment is
quite comfortable and the communication inside
runs smoothly, the resulting performance is also
maximal (Sedarmayanti, 2009). One of the
requirements to support the implementation of
professional nursing practice is to pay attention to
the nurse's work environment (Brook &
Anderson, 2004). So that a positive work
environment supports the practice of nursing and
nurse patients (Cherry & Jacob,2005).
According to Sedarmayanti (2011) states that
the non-physical work environment is all the
circumstances that occur related to relations
between colleagues, or relations with subordinates.
This is in line with the theory of Nitisemito (2001)
the positive influence on individual performance
(nurses) is demonstrated through the work environ-
ment. The work environment is anything that is
around the employees/workers that can affect
themselves in carrying out the tasks assigned.
The cause of non-physical work environment
relationship with nurses work stress is not only on
the relationship of nurses with nurses or nurses
with superiors but there are other factors that
include non- physical work environment which
includes temporal work environment such as the
standard number of hours at least 35 hours a week
and rest time working hours need to be given to
employees so that they can recover their fatigue
and the environment psychological work that is a
sense of insecurity because most nurses are still
contracted workers who at any time can break
contract, there is no opportunity to develop a
career in accordance with the ability of nurses and
several factors of the physical work environment
that is more to the work center, chairs, desks the
condition is not good, the size of the room is quite
narrow and set the workspace to be comfortable
for nurses. The hospital's effort is to begin
renovation and procurement of inventory items
such as shelves and will be done in stages.
Suggestions from researchers for the hospital
are to include nurses in training or seminar
workshops to add/upgrade existing knowledge
such as nursing training, emergency or managerial
so that each nurse is ready with managerial
knowledge, prioritizing workers with good
performance to be appointed to be permanent
employees and besides having to pay attention to
the non- physical work environment, the physical
work environment must also be given more
attention such as a room that is not cramped,
adequate lighting, a place to rest for nurses must
also be comfortable, the desk chair must also be in
good condition and not lacking because when the
work environment being physically unwell can
also trigger stress.
4 CONCLUSIONS AND
SUGGESTIONS
4.1 Conclusions
1. The description of the proportion of workload
in the inpatient room at Menteng Mitra Afia
Hospital shows that the highest proportion is
nurses experiencing light workloads of 16
people (53.3%).
2. The description of the proportion of nurses'
non-physical work environment in the
inpatient room of Menteng Mitra Afia
Hospital shows that the highest proportion is
nurses experiencing good work environment,
as many as 19 people (63.3%).
3. The description of the proportion of nurses
who experience severe work stress in the
inpatient room of Menteng Mitra Afia
Hospital shows that the highest proportion is
nurses experiencing severe work stress that is
as many as 16 people (53.3%).
4. There is a significant relationship between
workload with nurses works stress in the
inpatient room at Menteng Mitra Afia
Hospital with respondents who experience
light workloads at 3,792 times the risk of
experiencing heavy work stress compared to
nurses who experience heavy workloads.
5. There is a significant relationship between
non-physical work environment with nurses
work stress in the inpatient room of Menteng
Mitra Afia Hospital with respondents who
experience non-physical work environment is
not at risk 2.221 times to experience severe
work stress compared to nurses who experien-
ce non-physical work environment both.
ICOH 2019 - 1st International Conference on Health
314

4.2 Suggestion
Based on the results of the study and the
limitations of the research held in this study it can
be recommended as follows:
1.
The hospital must provide health services
especially in the field of counseling and
counseling or stress assessment for each
employee so that they can be evaluated and
carry out routine sports activities.
2.
Menteng Mitra Afia Hospital rotates
workers and increases the number of human
resources in the inpatient room.
3.
Provide support to workers to develop
careers, give appreciation and pay more
attention to the physical work environment
in the inpatient room.
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