Perceived Pressure, Job Stress, and Self-Efficacy Among ‎Full-Time Hospital Caregivers in Shandong, China: A ‎Cross-Sectional Study with Qualitative Triangulation

  • Authors

    • Xuemei Li Graduate School, University of St. La Salle, Bacolod City, Philippines and Binzhou Medical University Hospital, Binzhou City, Shandong, China https://orcid.org/0000-0002-9361-1753
    • Jocelyn May Flor Cadena Level I Chair, College of Nursing, University of St. La Salle Graduate School, Bacolod City, ‎Philippines and Faculty, BSN, MN, MAN, and PhD in Nursing, University of St. La Salle, Bacolod City, ‎Philippines https://orcid.org/0009-0008-4468-7576
    • Sheilla M. Trajera Faculty, BSN, MN, MAN, and PhD in Nursing, University of St. La Salle, Bacolod City, ‎Philippines and Chair, Nursing and Education Programs, University of St. La Salle, Bacolod City, ‎Philippines https://orcid.org/0000-0003-1834-7275
    • Gregory S. Ching Professor, Graduate Institute of Educational Administration and Policy, National Chengchi ‎University, Taipei City, Taiwan https://orcid.org/0000-0001-9148-0019
    https://doi.org/10.14419/fhvg4c74

    Received date: October 22, 2025

    Accepted date: November 8, 2025

    Published date: November 14, 2025

  • Perceived Pressure; Job Stress; Self-Efficacy; Full-Time Hospital Caregivers; Mixed-Methods Triangulation; China; ‎Stress-Management

  • Abstract

    This study examined perceived pressure, job stress, and self-efficacy among full-time hospital caregivers in a Class III ‎Grade A tertiary hospital in Shandong Province, China. Using a cross-sectional descriptive design with qualitative ‎triangulation, 130 caregivers (family and employed) completed validated measures of perceived pressure, job stress, and ‎general self-efficacy; an eight-member focus group of supervising nurses provided contextual insights. Overall, caregivers ‎reported average perceived pressure and job stress, but low self-efficacy. Correlational analyses indicated that higher ‎perceived pressure and job stress were strongly associated with lower self-efficacy. One-way MANOVAs showed no ‎significant differences in perceived pressure, job stress, or self-efficacy by age, gender, education level, or ‎caregiver-patient relationship, suggesting broadly shared stress experiences across subgroups. Qualitative findings echoed ‎these patterns, highlighting system-level pressures, such as unrealistic family expectations, limited training access, and ‎suboptimal shift policies, as primary stressors, with supervising nurses noting that confidence improves when structured ‎training is available. Grounded in Roy’s Adaptation Model and Bandura’s Self-Efficacy Theory, the results underscore ‎self-efficacy as a modifiable buffer and point to the need for institutional interventions: competency-based skills training, ‎Cognitive Behavior Therapy-informed stress-management supports, and scheduling reforms (e.g., limits on consecutive ‎night shifts). The study contributes evidence to guide hospital administrators in designing targeted, scalable programs that ‎strengthen caregiver well-being and, in turn, patient care quality; future research should expand sampling and assess ‎longitudinal impacts of these interventions‎.

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    Li, X., Cadena, . J. M. F., Trajera, S. M., & Ching, G. S. (2025). Perceived Pressure, Job Stress, and Self-Efficacy Among ‎Full-Time Hospital Caregivers in Shandong, China: A ‎Cross-Sectional Study with Qualitative Triangulation. International Journal of Basic and Applied Sciences, 14(7), 337-347. https://doi.org/10.14419/fhvg4c74