Date of Award


Degree Type


Degree Name

Doctor of Philosophy


School of Medical and Health Sciences

Field of Research Code



The aim of this study was to assess how years of experience and practice area influence work related stress amongst 1,200 nurses employed in a metropolitan hospital environment in Western Australia. A combination of self-administered questionnaires and hair cortisol, an objective stress biomarker, was utilised to measure stress levels and to relate these to practice area, age and experience. Questionnaire results indicated that there was a higher level of perceived stress for 40% of this cohort of nurses; the study methodology was able to unearth noteworthy factors within a local WA nursing population that impacted on their perceived stress. These being; inexperienced nurses suffer more work-related stress than the more experienced nurse. Leadership demands are a source of stress for nurse managers; and age and generational differences’ were also noted. Contrary to hypothesis two, this study could not determine a statistically significant effect relating to the practice area in which the nurses’ worked. Despite a weak correlation found between the hair cortisol level and results of the written questionnaires it is considered when used in conjunction with a stress questionnaire, that hair cortisol testing provides an effective diagnostic tool with adequate sensitivity to detect stress. The ‘curvilinear effect’ as reported by Wells’ (2014) postulated to be due to the physiology of the individuals coping mechanisms was replicated in this study, and therefore determined to be real. It is therefore considered that hair cortisol is a valid screening tool for stress in the occupational environment


Paper Location