The Relationship of Work Stress and Self-Control with Nurses' Performance in Providing Services At UOBF Nguling Health Center

Introduction: Nurses are the most dominant health workers who provide 24-hour services, so they are vulnerable to work stress and require good self-control. This study aims to analyze the relationship between work stress and self-control with the performance of nurses in providing services at the UOBF Nguling Health Center. Method: The research study was a correlational analytical approach cross-sectional. The research sample was all nurses at the UOBF Nguling Health Center, with 31 nurses using the Total Sampling technique. The instruments used were work stress questionnaires and self-control with nurse performance. The research data were analyzed using the Spearman Rank Test. Results: The results of the research show that the p-value = 0.000 with a significance level of α = 0.05 (p <α = 0.05), so it can be concluded that there is a relationship between self-control with the performance of nurses in providing services at the UOBF Health Nguling Community Health Center. Work stress causes a decrease in performance or workability and poor work results or a decrease in nurse productivity. Conclusion: Self self-control in nurses, they can develop good behavior, be more responsible, be useful for themselves, patients, and others, and establish good relationships with patients and other people. Nurses must be able to improve their self-control abilities through modifying the environment to be responsive to support the provision of good nursing care.


INTRODUCTION
Nurses are the most dominant health workers providing services 24 hours continuously.Nursing services have a big role in improving and determining the success of health services (Budiyantoet al.,2019).Nurses are expected to have supporting factors within themselves to minimize the occurrence of work stress, one of which is having a mechanism that can help regulate and direct their behavior, namely self-control (Ardilasari, 2019).World Health Organization (WHO) stated that the prevalence of nurses throughout the world in 2020 was among the top 40 causes of stress among workers (Putri, 2021).In 2019, the Indonesian National Nurses Association (PPNI) stated that 50.9% of Indonesian nurses experienced a lot of work stress, often felt dizzy, were less friendly to patients, tired, and lacked rest due to high workloads and low income.Based on a preliminary study conducted at the UOBF Nguling Health Center using interview and observation methods with 10 nurses, 4 nurses had self-control high, while 3 Nurses had control moderate and experienced self-control low as 3 Nurses.
Nurses say that sometimes they cannot control themselves well when they are angry, they become irritable and irritable towards colleagues, doctors, and even patients' families because work demands are too heavy and excessive, and they complain about the low income and incentives given, which triggers work stress.Nurses are one of the parties in health services who have the most direct interaction with patients.Nurse performance is an important part of the health service system and is one of the determining factors for the quality of health services (Ameliaet al, 2019).Nurse performance is the productivity of nurses in providing nursing care according to their authority and responsibility which can be measured in terms of quality and quantity (Pusung,et al.,2021).The work carried out by a nurse is quite heavy.Nurses must carry out work that involves the survival of the patients being treated.Another condition states that mental and physical aspects must be taken care of.Circumstances and problems experienced by nurses.
In carrying out their duties as a nurse, things slowly change, creating pressures that will trigger stress in the workplace (Budiyantoet al.,2019).Work stress is a tension that leads to physical and psychological instability, disturbing the feelings, thoughts, and conditions of employees.If nurse work stress is not handled immediately and continues for a long time, it will cause depression in nurses and will have an impact on the performance of nurses.When working, nurses will face many possibilities when making decisions (Elizar, et al., 2020).Each individual has mechanisms that can help regulate and direct his behavior, namely self-control.This research aims to find out the relationship between work stress and self-control with the performance of nurses in providing services at the UOBF Nguling Health Center.

METHOD
The research study was a correlational analytical approach cross-sectional.The research sample was all nurses at the UOBF Nguling Health Center, with 31 nurses using the Total Sampling technique.The instruments used were work stress questionnaires and selfcontrol with nurse performance.The research data were analyzed using the Spearman Rank Test.Based on Table 1 above, the results obtained were that most genders were female with 16 respondents (53.3%), the highest age was 37-42 years as many respondents (61.3%), the highest number of years of work was 6-10 years with 18 respondents (60%), the highest level of education was as a nurse with 16 respondents (53.3%), and the highest level of employee status was as a civil servant with 16 respondents (53.3%).Based on Table 2 above, the results obtained were the characteristics of respondents based on work stress, the most moderate work stress, namely 15 respondents (50%), the characteristics of respondents based on control the most self-control moderate as many as 16 respondents (53.3%), and the characteristics of respondents based on nurse performance were mostly moderate nurse performance as many as 13 respondents (43.3%).Based on Table 3 above, the work stress most experienced by nurses was in the low category with good performance by as many as 9 respondents (81.8%).The P value obtained was 0.000 so that p < α, so there was a relationship between work stress and the performance of nurses in providing services at the UOBF Nguling Health Center.The most self-control was in the high category with good performance as many as 9 respondents (81.8%).The P value obtained is 0.000 so that p < α, so there is a relationship between selfcontrol with the performance of nurses in providing services at the UOBF Nguling Health Center.

DISCUSSION
The research results show that work stress has a relationship with nurse performance.This is in line with research conducted by Musu (2021), which states that stress arises from work demands that exceed the ability to cope so it can cause various kinds of reactions, in the form of physiological, psychological, and behavioral.Research conducted by Massie (2020) states that when work stress increases, employee performance will decrease and vice versa.High work stress can have a negative and significant effect on employee performance.The higher the work stress, the lower the employee's performance.Employee performance is the main element that helps the company achieve company goals.High job demands mean that employees, one of whom is a nurse, must be able to provide optimal service, which can lead to stressful conditions at work.Work stress on nurses can make nurses suffer from fatigue, rudeness, anxiety, increased blood pressure, job dissatisfaction, and decreased work productivity.Nurses who experience stress have irritable, moody, restless behavior and low work morale.This is also what was explained by April, et al., (2020), who stated that stress causes a decrease in performance or workability and poor work results or a decrease in productivity.If a nurse experiences work stress and does not receive treatment, it will hurt her mental condition.Therefore, to prevent psychological and physiological disorders, stress management must be carried out immediately, including taking positive and constructive actions to overcome the source of stress, which can be in the form of relaxation techniques, including listening to music, walking, and praying.Nurses can also use their free time or holidays for activities that focus on themselves and/or their families.
The research results also show that self-control has a relationship with nurse performance.This is in line with research by Puspitasari and Handayani (2019), which states that self-control in nurses is a nurse's belief in providing good nursing services to patients even though the patient is not motivated to recover.Nurses with high levels of self-control those who are high feel confident that they can produce good changes and can influence the patient's psychological condition.Self-control is one's potential to direct behavior and the ability to suppress bad behavior which makes a person able to make decisions and take effective steps to get desired results and avoid undesirable results (Maharani, 2019).There is self-control in a nurse, making nurses able to develop good behavior, be more responsible, be useful for themselves, patients, and other people, and establish good relationships with patients and other people.

CONCLUSION
Job stress has a relationship with nurse performance.Work stress can have a positive and significant effect on nurse performance.The lower the work stress, the nurse's performance will increase.Self-control has a relationship with nurse performance.Nurses must be able to improve their self-control abilities through modifying the environment to be responsive to support the provision of good nursing care.The quality of nursing care provided to patients can describe the performance of a nurse.