Date of Award

Summer 2001

Document Type


Degree Name

Doctor of Psychology (PsyD)


Urban Services--Health Services

Committee Director

Paul Stepanovich

Committee Member

Clare Houseman

Committee Member

Shirley Gore


As a result of the ever changing and expanding role of the nursing home administrator in conjunction with the stricter legislation governing nursing facilities over the past decade and the graying of America, a study specific to this population was warranted. The purpose of this study is to determine the relative change in the self-reported occupational stressors of nursing home administrators over a five year period (December 1994 to June 1999) secondary to the increased regulatory climate of the nursing home industry.

This study was carried out in three phases and included all practicing nursing home administrators in Virginia. Phase I data resulted in a 35 item occupational stressor questionnaire that was used in Phases II and III to obtain the mean ranks and make comparisons over the five-year period.

The top five stressors in Phase II were: “Federal/State inspections”; “unrealistic expectations/demands of state”; “maintaining high quality care”; “retaining qualified staff”; and “unrealistic family expectations”. The top five stressors in Phase III included: “Federal and State inspections”; “retaining qualified/competent staff”; “staff turnover”; “unrealistic expectations/demands of regulators”; and “recruitment and hiring of competent staff”. Nine of the top 10 stressors in Phase II remained among the top 10 stressors in Phase III. The results showed, in accordance with Selye's theory, that the occupational stressors remained relatively stable over time. Four significant differences were found over the five-year period. Phase III administrators rated the stressors “retain qualified/competent staff”, “recruit qualified/competent staff”, “staff turnover and shortages”, and “long hours” significantly more stressful. The results highlight the nursing shortage, an area that has apparently been as significant an influence in the management of nursing facilities as the increased legislation and resulting increased nursing facility oversight.

Secondary to Selye's emphasis on time, space, and intensity as factors impacting an individual's ability to adapt to a stressor, it was proposed that the increased legislation from 1995 to 1999 would result in increased stressor scores for seven of the stressors related to legislative changes. None of the hypothesized differences were confirmed. Thus, further support for Selye's theory was not obtained in terms of his emphasis on time, space, and intensity. However, six of these seven stressors remained among the top 10 stressors, emphasizing their continued magnitude and reiterating their stability.