Skip to content

Workplace Stress Research Paper

Work stress is a generic term that refers to work-related stimuli (aka job stressors) that may lead to physical, behavioral, or psychological consequences (i.e., strains) that affect both the health and well-being of the employee and the organization. Not all stressors lead to strains, but all strains are a result of stressors, actual or perceived. Common terms often used interchangeably with work stress are occupational stress, job stress, and work-related stress. Terms used interchangeably with job stressors include work stressors, and as the specificity of the type of stressor might include psychosocial stressor (referring to the psychological experience of work demands that have a social component, e.g., conflict between two people; Hauke, Flintrop, Brun, & Rugulies, 2011), hindrance stressor (i.e., a stressor that prevents goal attainment; Cavanaugh, Boswell, Roehling, & Boudreau, 2000), and challenge stressor (i.e., a stressor that is difficult, but attainable and possibly rewarding to attain; Cavanaugh et al., 2000).

Stress in the workplace continues to be a highly pervasive problem, having both direct negative effects on individuals experiencing it and companies paying for it, and indirect costs vis à vis lost productivity (Dopkeen & DuBois, 2014). For example, U.K. public civil servants’ work-related stress rose from 10.8% in 2006 to 22.4% in 2013 and about one-third of the workforce has taken more than 20 days of leave due to stress-related ill-health, while well over 50% are present at work when ill (French, 2015). These findings are consistent with a report by the International Labor Organization (ILO, 2012), whereby 50% to 60% of all workdays are lost due to absence attributed to factors associated with work stress.

The prevalence of work-related stress is not diminishing despite improvements in technology and employment rates. The sources of stress, such as workload, seem to exacerbate with improvements in technology (Coovert & Thompson, 2003). Moreover, accessibility through mobile technology and virtual computer terminals is linking people to their work more than ever before (ILO, 2012; Tarafdar, Tu, Ragu-Nathan, & Ragu-Nathan, 2007). Evidence of this kind of mobility and flexibility is further reinforced in a June 2007 survey of 4,025 email users (over 13 years of age); AOL reported that four in ten survey respondents reported planning their vacations around email accessibility and 83% checked their emails at least once a day while away (McMahon, 2007). Ironically, despite these mounting work-related stressors and clear financial and performance outcomes, some individuals are reporting they are less “stressed,” but only because “stress has become the new normal” (Jayson, 2012, para. 4).

This new normal is likely the source of psychological and physiological illness. Siegrist (2010) contends that conditions in the workplace, particularly psychosocial stressors that are perceived as unfavorable relationships with others and self, and an increasingly sedentary lifestyle (reinforced with desk jobs) are increasingly contributing to cardiovascular disease. These factors together justify a need to continue on the path of helping individuals recognize and cope with deleterious stressors in the work environment and, equally important, to find ways to help organizations prevent harmful stressors over which they have control, as well as implement policies or mechanisms to help employees deal with these stressors and subsequent strains. Along with a greater focus on mitigating environmental constraints are interventions that can be used to prevent anxiety, poor attitudes toward the workplace conditions and arrangements, and subsequent cardiovascular illness, absenteeism, and poor job performance (Siegrist, 2010).

Even the ILO has presented guidance on how the workplace can help prevent harmful job stressors (aka hindrance stressors) or at least help workers cope with them. Consistent with the view that well-being is not the absence of stressors or strains and with the view that positive psychology offers a lens for proactively preventing stressors, the ILO promotes increasing preventative risk assessments, interventions to prevent and control stressors, transparent organizational communication, worker involvement in decision-making, networks and mechanisms for workplace social support, awareness of how working and living conditions interact, safety, health, and well-being in the organization (ILO, n.d.). The field of industrial and organizational (IO) psychology supports the ILO’s recommendations.

IO psychology views work stress as the process of a person’s interaction with multiple aspects of the work environment, job design, and work conditions in the organization. Interventions to manage work stress, therefore, focus on the psychosocial factors of the person and his or her relationships with others and the socio-technical factors related to the work environment and work processes. Viewing work stress from the lens of the person and the environment stems from Kurt Lewin’s (1936) work that stipulates a person’s state of mental health and behaviors are a function of the person within a specific environment or situation. Aspects of the work environment that affect individuals’ mental states and behaviors include organizational hierarchy, organizational climate (including processes, policies, practices, and reward structures), resources to support a person’s ability to fulfill job duties, and management structure (including leadership). Job design refers to each contributor’s tasks and responsibilities for fulfilling goals associated with the work role. Finally, working conditions refers not only to the physical environment, but also the interpersonal relationships with other contributors.

Each of the conditions that are identified in the work environment may be perceived as potentially harmful or a threat to the person or as an opportunity. When a stressor is perceived as a threat to attaining desired goals or outcomes, the stressor may be labeled as a hindrance stressor (e.g., LePine, Podsakoff, & Lepine, 2005). When the stressor is perceived as an opportunity to attain a desired goal or end state, it may be labeled as a challenge stressor. According to LePine and colleagues’ (2005), both challenge (e.g., time urgency, workload) and hindrance (e.g., hassles, role ambiguity, role conflict) stressors could lead to strains (as measured by “anxiety, depersonalization, depression, emotional exhaustion, frustration, health complaints, hostility, illness, physical symptoms, and tension” [p. 767]). However, challenge stressors positively relate with motivation and performance, whereas hindrance stressors negatively relate with motivation and performance. Moreover, motivation and strains partially mediate the relationship between hindrance and challenge stressors with performance.

In order to (1) minimize any potential negative effects from stressors, (2) increase coping skills to deal with stressors, or (3) manage strains, organizational practitioners or consultants will devise organizational interventions geared toward prevention, coping, and/or stress management. Ultimately, toxic factors in the work environment can have deleterious effects on a person’s physical and psychological well-being, as well as on an organization’s total health. It behooves management to take stock of the organization’s health, which includes the health and well-being of its employees, if the organization wishes to thrive and be profitable. According to Page and Vella-Brodrick’s (2009) model of employee well-being, employee well-being results from subjective well-being (i.e., life satisfaction and general positive or negative affect), workplace well-being (composed of job satisfaction and work-specific positive or negative affect), and psychological well-being (e.g., self-acceptance, positive social relations, mastery, purpose in life). Job stressors that become unbearable are likely to negatively affect workplace well-being and thus overall employee well-being. Because work stress is a major organizational pain point and organizations often employ organizational consultants to help identify and remediate pain points, the focus here is on organizational development (OD) frameworks; several work stress frameworks are presented that together signal areas where organizations might focus efforts for change in employee behaviors, attitudes, and performance, as well as the organization’s performance and climate. Work stress, interventions, and several OD and stress frameworks are depicted in Figure 1.

The goals are: (1) to conceptually define and clarify terms associated with stress and stress management, particularly focusing on organizational factors that contribute to stress and stress management, and (2) to present research that informs current knowledge and practices on workplace stress management strategies. Stressors and strains will be defined, leading OD and work stress frameworks that are used to organize and help organizations make sense of the work environment and the organization’s responsibility in stress management will be explored, and stress management will be explained as an overarching thematic label; an area of study and practice that focuses on prevention (primary) interventions, coping (secondary) interventions, and managing strains (tertiary) interventions; as well as the label typically used to denote tertiary interventions. Suggestions for future research and implications toward becoming a healthy organization are presented.

Click to view larger

Figure 1. Organizational development frameworks to guide identification of work stress and interventions.

Defining Stressors and Strains

Work-related stressors or job stressors can lead to different kinds of strains individuals and organizations might experience. Various types of stress management interventions, guided by OD and work stress frameworks, may be employed to prevent or cope with job stressors and manage strains that develop(ed).

Stressors

A job stressor is a stimulus external to an employee and a result of an employee’s work conditions. Example job stressors include organizational constraints, workplace mistreatments (such as abusive supervision, workplace ostracism, incivility, bullying), role stressors, workload, work-family conflicts, errors or mistakes, examinations and evaluations, and lack of structure (Jex & Beehr, 1991; Liu, Spector, & Shi, 2007; Narayanan, Menon, & Spector, 1999). Although stressors may be categorized as hindrances and challenges, there is not yet sufficient information to be able to propose which stress management interventions would better serve to reduce those hindrance stressors or to reduce strain-producing challenge stressors while reinforcing engagement-producing challenge stressors.

Organizational Constraints

Organizational constraints may be hindrance stressors as they prevent employees from translating their motivation and ability into high-level job performance (Peters & O’Connor, 1980). Peters and O’Connor (1988) defined 11 categories of organizational constraints: (1) job-related information, (2) budgetary support, (3) required support, (4) materials and supplies, (5) required services and help from others, (6) task preparation, (7) time availability, (8) the work environment, (9) scheduling of activities, (10) transportation, and (11) job-relevant authority. The inhibiting effect of organizational constraints may be due to the lack of, inadequacy of, or poor quality of these categories.

Workplace Mistreatment

Workplace mistreatment presents a cluster of interpersonal variables, such as interpersonal conflict, bullying, incivility, and workplace ostracism (Hershcovis, 2011; Tepper & Henle, 2011). Typical workplace mistreatment behaviors include gossiping, rude comments, showing favoritism, yelling, lying, and ignoring other people at work (Tepper & Henle, 2011). These variables relate to employees’ psychological well-being, physical well-being, work attitudes (e.g., job satisfaction and organizational commitment), and turnover intention (e.g., Hershcovis, 2011; Spector & Jex, 1998). Some researchers differentiated the source of mistreatment, such as mistreatment from one’s supervisor versus mistreatment from one’s coworker (e.g., Bruk-Lee & Spector, 2006; Frone, 2000; Liu, Liu, Spector, & Shi, 2011).

Role Stressors

Role stressors are demands, constraints, or opportunities a person perceives to be associated, and thus expected, with his or her work role(s) across various situations. Three commonly studied role stressors are role ambiguity, role conflict, and role overload (Glazer & Beehr, 2005; Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964). Role ambiguity in the workplace occurs when an employee lacks clarity regarding what performance-related behaviors are expected of him or her. Role conflict refers to situations wherein an employee receives incompatible role requests from the same or different supervisors or the employee is asked to engage in work that impedes his or her performance in other work or nonwork roles or clashes with his or her values. Role overload refers to excessive demands and insufficient time (quantitative) or knowledge (qualitative) to complete the work. The construct is often used interchangeably with workload, though role overload focuses more on perceived expectations from others about one’s workload. These role stressors significantly relate to low job satisfaction, low organizational commitment, low job performance, high tension or anxiety, and high turnover intention (Abramis, 1994; Glazer & Beehr, 2005; Jackson & Schuler, 1985).

Workload

Excessive workload is one of the most salient stressors at work (e.g., Liu et al., 2007). There are two types of workload: quantitative and qualitative workload (LaRocco, Tetrick, & Meder, 1989; Parasuraman & Purohit, 2000). Quantitative workload refers to the excessive amount of work one has. In a summary of a Chartered Institute of Personnel & Development Report from 2006, Dewe and Kompier (2008) noted that quantitative workload was one of the top three stressors workers experienced at work. Qualitative workload refers to the difficulty of work. Workload also differs by the type of the load. There are mental workload and physical workload (Dwyer & Ganster, 1991). Excessive physical workload may result in physical discomfort or illness. Excessive mental workload will cause psychological distress such as anxiety or frustration (Bowling & Kirkendall, 2012). Another factor affecting quantitative workload is interruptions (during the workday). Lin, Kain, and Fritz (2013) found that interruptions delay completion of job tasks, thus adding to the perception of workload.

Work-Family Conflict

Work-family conflict is a form of inter-role conflict in which demands from one’s work domain and one’s family domain are incompatible to some extent (Greenhaus & Beutell, 1985). Work can interfere with family (WIF) and/or family can interfere with work (FIW) due to time-related commitments to participating in one domain or another, incompatible behavioral expectations, or when strains in one domain carry over to the other (Greenhaus & Beutell, 1985). Work-family conflict significantly relates to work-related outcomes (e.g., job satisfaction, organizational commitment, turnover intention, burnout, absenteeism, job performance, job strains, career satisfaction, and organizational citizenship behaviors), family-related outcomes (e.g., marital satisfaction, family satisfaction, family-related performance, family-related strains), and domain-unspecific outcomes (e.g., life satisfaction, psychological strain, somatic or physical symptoms, depression, substance use or abuse, and anxiety; Amstad, Meier, Fasel, Elfering, & Semmer, 2011).

Strains

Individuals and organizations can experience work-related strains. Sometimes organizations will experience strains through the employee’s negative attitudes or strains, such as that a worker’s absence might yield lower production rates, which would roll up into an organizational metric of organizational performance. In the industrial and organizational (IO) psychology literature, organizational strains are mostly observed as macro-level indicators, such as health insurance costs, accident-free days, and pervasive problems with company morale. In contrast, individual strains, usually referred to as job strains, are internal to an employee. They are responses to work conditions and relate to health and well-being of employees. In other words, “job strains are adverse reactions employees have to job stressors” (Spector, Chen, & O’Connell, 2000, p. 211). Job strains tend to fall into three categories: behavioral, physical, and psychological (Jex & Beehr, 1991).

Behavioral strains consist of actions that employees take in response to job stressors. Examples of behavioral strains include employees drinking alcohol in the workplace or intentionally calling in sick when they are not ill (Spector et al., 2000). Physical strains consist of health symptoms that are physiological in nature that employees contract in response to job stressors. Headaches and ulcers are examples of physical strains. Lastly, psychological strains are emotional reactions and attitudes that employees have in response to job stressors. Examples of psychological strains are job dissatisfaction, anxiety, and frustration (Spector et al., 2000). Interestingly, research studies that utilize self-report measures find that most job strains experienced by employees tend to be psychological strains (Spector et al., 2000).

Leading Frameworks

Organizations that are keen on identifying organizational pain points and remedying them through organizational campaigns or initiatives often discover the pain points are rooted in work-related stressors and strains and the initiatives have to focus on reducing workers’ stress and increasing a company’s profitability. Through organizational climate surveys, for example, companies discover that aspects of the organization’s environment, including its policies, practices, reward structures, procedures, and processes, as well as employees at all levels of the company, are contributing to the individual and organizational stress. Recent studies have even begun to examine team climates for eustress and distress assessed in terms of team members’ homogenous psychological experience of vigor, efficacy, dedication, and cynicism (e.g., Kożusznik, Rodriguez, & Peiro, 2015).

Each of the frameworks presented advances different aspects that need to be identified in order to understand the source and potential remedy for stressors and strains. In some models, the focus is on resources, in others on the interaction of the person and environment, and in still others on the role of the person in the workplace. Few frameworks directly examine the role of the organization, but the organization could use these frameworks to plan interventions that would minimize stressors, cope with existing stressors, and prevent and/or manage strains. One of the leading frameworks in work stress research that is used to guide organizational interventions is the person and environment (P-E) fit (French & Caplan, 1972). Its precursor is the University of Michigan Institute for Social Research’s (ISR) role stress model (Kahn, Wolfe, Quinn, Snoek, & Rosenthal, 1964) and Lewin’s Field Theory. Several other theories have since evolved from the P-E fit framework, including Karasek and Theorell’s (1990), Karasek (1979) Job Demands-Control Model (JD-C), the transactional framework (Lazarus & Folkman, 1984), Conservation of Resources (COR) theory (Hobfoll, 1989), and Siegrist’s (1996) Effort-Reward Imbalance (ERI) Model.

Field Theory

The premise of Kahn et al.’s (1964) role stress theory is Lewin’s (1997) Field Theory. Lewin purported that behavior and mental events are a dynamic function of the whole person, including a person’s beliefs, values, abilities, needs, thoughts, and feelings, within a given situation (field or environment), as well as the way a person represents his or her understanding of the field and behaves in that space. Lewin explains that work-related strains are a result of individuals’ subjective perceptions of objective factors, such as work roles, relationships with others in the workplace, as well as personality indicators, and can be used to predict people’s reactions, including illness. Thus, to make changes to an organizational system, it is necessary to understand a field and try to move that field from the current state to the desired state. Making this move necessitates identifying mechanisms influencing individuals.

Role Stress Theory

Role stress theory mostly isolates the perspective a person has about his or her work-related responsibilities and expectations to determine how those perceptions relate with a person’s work-related strains. However, those relationships have been met with somewhat varied results, which Glazer and Beehr (2005) concluded might be a function of differences in culture, an environmental factor often neglected in research. Kahn et al.’s (1964) role stress theory, coupled with Lewin’s (1936) Field Theory, serves as the foundation for the P-E fit theory. Lewin (1936) wrote, “Every psychological event depends upon the state of the person and at the same time on the environment” (p. 12). Researchers of IO psychology have narrowed the environment to the organization or work team. This narrowed view of the organizational environment is evident in French and Caplan’s (1972) P-E fit framework.

Person-Environment Fit Theory

The P-E fit framework focuses on the extent to which there is congruence between the person and a given environment, such as the organization (Caplan, 1987; Edwards, 2008). For example, does the person have the necessary skills and abilities to fulfill an organization’s demands, or does the environment support a person’s desire for autonomy (i.e., do the values align?) or fulfill a person’s needs (i.e., a person’s needs are rewarded). Theoretically and empirically, the greater the person-organization fit, the greater a person’s job satisfaction and organizational commitment, the less a person’s turnover intention and work-related stress (see meta-analyses by Assouline & Meir, 1987; Kristof-Brown, Zimmerman, & Johnson, 2005; Verquer, Beehr, & Wagner, 2003).

Job Demands-Control/Support (JD-C/S) and Job Demands-Resources (JD-R) Model

Focusing more closely on concrete aspects of work demands and the extent to which a person perceives he or she has control or decision latitude over those demands, Karasek (1979) developed the JD-C model. Karasek and Theorell (1990) posited that high job demands under conditions of little decision latitude or control yield high strains, which have varied implications on the health of an organization (e.g., in terms of high turnover, employee ill-health, poor organizational performance). This theory was modified slightly to address not only control, but also other resources that could protect a person from unruly job demands, including support (aka JD-C/S, Johnson & Hall, 1988; and JD-R, Bakker, van Veldhoven, & Xanthopoulou, 2010). Whether focusing on control or resources, both they and job demands are said to reflect workplace characteristics, while control and resources also represent coping strategies or tools (Siegrist, 2010).

Despite the glut of research testing the JD-C and JD-R, results are somewhat mixed. Testing the interaction between job demands and control, Beehr, Glaser, Canali, and Wallwey (2001) did not find empirical support for the JD-C theory. However, Dawson, O’Brien, and Beehr (2016) found that high control and high support buffered against the independent deleterious effects of interpersonal conflict, role conflict, and organizational politics (demands that were categorized as hindrance stressors) on anxiety, as well as the effects of interpersonal conflict and organizational politics on physiological symptoms, but control and support did not moderate the effects between challenge stressors and strains. Coupled with Bakker, Demerouti, and Sanz-Vergel’s (2014) note that excessive job demands are a source of strain, but increased job resources are a source of engagement, Dawson et al.’s results suggest that when an organization identifies that demands are hindrances, it can create strategies for primary (preventative) stress management interventions and attempt to remove or reduce such work demands. If the demands are challenging, though manageable, but latitude to control the challenging stressors and support are insufficient, the organization could modify practices and train employees on adopting better strategies for meeting or coping (secondary stress management intervention) with the demands. Finally, if the organization can neither afford to modify the demands or the level of control and support, it will be necessary for the organization to develop stress management (tertiary) interventions to deal with the inevitable strains.

Conservation of Resources Theory

The idea that job resources reinforce engagement in work has been propagated in Hobfoll’s (1989) Conservation of Resources (COR) theory. COR theory also draws on the foundational premise that people’s mental health is a function of the person and the environment, forwarding that how people interpret their environment (including the societal context) affects their stress levels. Hobfoll focuses on resources such as objects, personal characteristics, conditions, or energies as particularly instrumental to minimizing strains. He asserts that people do whatever they can to protect their valued resources. Thus, strains develop when resources are threatened to be taken away, actually taken away, or when additional resources are not attainable after investing in the possibility of gaining more resources (Hobfoll, 2001). By extension, organizations can invest in activities that would minimize resource loss and create opportunities for resource gains and thus have direct implications for devising primary and secondary stress management interventions.

Transactional Framework

Lazarus and Folkman (1984) developed the widely studied transactional framework of stress. This framework holds as a key component the cognitive appraisal process. When individuals perceive factors in the work environment as a threat (i.e., primary appraisal), they will scan the available resources (external or internal to himself or herself) to cope with the stressors (i.e., secondary appraisal). If the coping resources provide minimal relief, strains develop. Until recently, little attention has been given to the cognitive appraisal associated with different work stressors (Dewe & Kompier, 2008; Liu & Li, 2017). In a study of Polish and Spanish social care service providers, stressors appraised as a threat related positively to burnout and less engagement, but stressors perceived as challenges yielded greater engagement and less burnout (Kożusznik, Rodriguez, & Peiro, 2012). Similarly, Dawson et al. (2016) found that even with support and control resources, hindrance demands were more strain-producing than challenge demands, suggesting that appraisal of the stressor is important. In fact, “many people respond well to challenging work” (Beehr et al., 2001, p. 126). Kożusznik et al. (2012) recommend training employees to change the way they view work demands in order to increase engagement, considering that part of the problem may be about how the person appraises his or her environment and, thus, copes with the stressors.

Effort-Reward Imbalance

Siegrist’s (1996) Model of Effort-Reward Imbalance (ERI) focuses on the notion of social reciprocity, such that a person fulfills required work tasks in exchange for desired rewards (Siegrist, 2010). ERI sheds light on how an imbalance in a person’s expectations of an organization’s rewards (e.g., pay, bonus, sense of advancement and development, job security) in exchange for a person’s efforts, that is a break in one’s work contract, leads to negative responses, including long-term ill-health (Siegrist, 2010; Siegrist et al., 2014). In fact, prolonged perception of a work contract imbalance leads to adverse health, including immunological problems and inflammation, which contribute to cardiovascular disease (Siegrist, 2010). The model resembles the relational and interactional psychological contract theory in that it describes an employee’s perception of the terms of the relationship between the person and the workplace, including expectations of performance, job security, training and development opportunities, career progression, salary, and bonuses (Thomas, Au, & Ravlin, 2003). The psychological contract, like the ERI model, focuses on social exchange. Furthermore, the psychological contract, like stress theories, are influenced by cultural factors that shape how people interpret their environments (Glazer, 2008; Thomas et al., 2003). Violations of the psychological contract will negatively affect a person’s attitudes toward the workplace and subsequent health and well-being (Siegrist, 2010). To remediate strain, Siegrist (2010) focuses on both the person and the environment, recognizing that the organization is particularly responsible for changing unfavorable work conditions and the person is responsible for modifying his or her reactions to such conditions.

Stress Management Interventions: Primary, Secondary, and Tertiary

Remediation of work stress and organizational development interventions are about realigning the employee’s experiences in the workplace with factors in the environment, as well as closing the gap between the current environment and the desired environment. Work stress develops when an employee perceives the work demands to exceed the person’s resources to cope and thus threatens employee well-being (Dewe & Kompier, 2008). Likewise, an organization’s need to change arises when forces in the environment are creating a need to change in order to survive (see Figure 1). Lewin’s (1951) Force Field Analysis, the foundations of which are in Field Theory, is one of the first organizational development intervention tools presented in the social science literature. The concept behind Force Field Analysis is that in order to survive, organizations must adapt to environmental forces driving a need for organizational change and remove restraining forces that create obstacles to organizational change. In order to do this, management needs to delineate the current field in which the organization is functioning, understand the driving forces for change, identify and dampen or eliminate the restraining forces against change. Several models for analyses may be applied, but most approaches are variations of organizational climate surveys.

Through organizational surveys, workers provide management with a snapshot view of how they perceive aspects of their work environment. Thus, the view of the health of an organization is a function of several factors, chief among them employees’ views (i.e., the climate) about the workplace (Lewin, 1951). Indeed, French and Kahn (1962) posited that well-being depends on the extent to which properties of the person and properties of the environment align in terms of what a person requires and the resources available in a given environment. Therefore, only when properties of the person and properties of the environment are sufficiently understood can plans for change be developed and implemented targeting the environment (e.g., change reporting structures to relieve, and thus prevent future, communication stressors) and/or the person (e.g., providing more autonomy, vacation days, training on new technology). In short, climate survey findings can guide consultants about the emphasis for organizational interventions: before a problem arises aka stress prevention, e.g., carefully crafting job roles), when a problem is present, but steps are taken to mitigate their consequences (aka coping, e.g., providing social support groups), and/or once strains develop (aka. stress management, e.g., healthcare management policies).

For each of the primary (prevention), secondary (coping), and tertiary (stress management) techniques the target for intervention can be the entire workforce, a subset of the workforce, or a specific person. Interventions that target the entire workforce may be considered organizational interventions, as they have direct implications on the health of all individuals and consequently the health of the organization. Several interventions categorized as primary and secondary interventions may also be implemented after strains have developed and after it has been discerned that a person or the organization did not do enough to mitigate stressors or strains (see Figure 1). The designation of many of the interventions as belonging to one category or another may be viewed as merely a suggestion.

Primary Interventions (Preventative Stress Management)

Before individuals begin to perceive work-related stressors, organizations engage in stress prevention strategies, such as providing people with resources (e.g., computers, printers, desk space, information about the job role, organizational reporting structures) to do their jobs. However, sometimes the institutional structures and resources are insufficient or ambiguous. Scholars and practitioners have identified several preventative stress management strategies that may be implemented.

Planning and Time Management

When employees feel quantitatively overloaded, sometimes the remedy is improving the employees’ abilities to plan and manage their time (Quick, Quick, Nelson, & Hurrell, 2003). Planning is a future-oriented activity that focuses on conceptual and comprehensive work goals. Time management is a behavior that focuses on organizing, prioritizing, and scheduling work activities to achieve short-term goals. Given the purpose of time management, it is considered a primary intervention, as engaging in time management helps to prevent work tasks from mounting and becoming unmanageable, which would subsequently lead to adverse outcomes. Time management comprises three fundamental components: (1) establishing goals, (2) identifying and prioritizing tasks to fulfill the goals, and (3) scheduling and monitoring progress toward goal achievement (Peeters & Rutte, 2005). Workers who employ time management have less role ambiguity (Macan, Shahani, Dipboye, & Philips, 1990), psychological stress or strain (Adams & Jex, 1999; Jex & Elaqua, 1999; Macan et al., 1990), and greater job satisfaction (Macan, 1994). However, Macan (1994) did not find a relationship between time management and performance. Still, Claessens, van Eerde, Rutte, and Roe (2004) found that perceived control of time partially mediated the relationships between planning behavior (an indicator of time management), job autonomy, and workload on one hand, and job strains, job satisfaction, and job performance on the other hand. Moreover, Peeters and Rutte (2005) observed that teachers with high work demands and low autonomy experienced more burnout when they had poor time management skills.

Person-Organization Fit

Just as it is important for organizations to find the right person for the job and organization, so is it the responsibility of a person to choose to work at the right organization—an organization that fulfills the person’s needs and upholds the values important to the individual, as much as the person fulfills the organization’s needs and adapts to its values. When people fit their employing organizations they are setting themselves up for experiencing less strain-producing stressors (Kristof-Brown et al., 2005). In a meta-analysis of 62 person-job fit studies and 110 person-organization fit studies, Kristof-Brown et al. (2005) found that person-job fit had a negative correlation with indicators of job strain. In fact, a primary intervention of career counseling can help to reduce stress levels (Firth-Cozens, 2003).

Job Redesign

The Job Demands-Control/Support (JD-C/S), Job Demands-Resources (JD-R), and transactional models all suggest that factors in the work context require modifications in order to reduce potential ill-health and poor organizational performance. Drawing on Hackman and Oldham’s (1980) Job Characteristics Model, it is possible to assess with the Job Diagnostics Survey (JDS) the current state of work characteristics related to skill variety, task identity, task significance, autonomy, and feedback. Modifying those aspects would help create a sense of meaningfulness, sense of responsibility, and feeling of knowing how one is performing, which subsequently affects a person’s well-being as identified in assessments of motivation, satisfaction, improved performance, and reduced withdrawal intentions and behaviors. Extending this argument to the stress models, it can be deduced that reducing uncertainty or perceived unfairness that may be associated with a person’s perception of these work characteristics, as well as making changes to physical characteristics of the environment (e.g., lighting, seating, desk, air quality), nature of work (e.g., job responsibilities, roles, decision-making latitude), and organizational arrangements (e.g., reporting structure and feedback mechanisms), can help mitigate against numerous ill-health consequences and reduced organizational performance. In fact, Fried et al. (2013) showed that healthy patients of a medical clinic whose jobs were excessively low (i.e., monotonous) or excessively high (i.e., overstimulating) on job enrichment (as measured by the JDS) had greater abdominal obesity than those whose jobs were optimally enriched. By taking stock of employees’ perceptions of the current work situation, managers might think about ways to enhance employees’ coping toolkit, such as training on how to deal with difficult clients or creating stimulating opportunities when jobs have low levels of enrichment.

Participatory Action Research Interventions

Participatory action research (PAR) is an intervention wherein, through group discussions, employees help to identify and define problems in organizational structure, processes, policies, practices, and reward structures, as well as help to design, implement, and evaluate success of solutions. PAR is in itself an intervention, but its goal is to design interventions to eliminate or reduce work-related factors that are impeding performance and causing people to be unwell. An example of a successful primary intervention, utilizing principles of PAR and driven by the JD-C and JD-C/S stress frameworks is Health Circles (HCs; Aust & Ducki, 2004).

HCs, developed in Germany in the 1980s, were popular practices in industries, such as metal, steel, and chemical, and service. Similar to other problem-solving practices, such as quality circles, HCs were based on the assumptions that employees are the experts of their jobs. For this reason, to promote employee well-being, management and administrators solicited suggestions and ideas from the employees to improve occupational health, thereby increasing employees’ job control. HCs also promoted communication between managers and employees, which had a potential to increase social support. With more control and support, employees would experience less strains and better occupational well-being.

Employing the three-steps of (1) problem analysis (i.e., diagnosis or discovery through data generated from organizational records of absenteeism length, frequency, rate, and reason and employee survey), (2) HC meetings (6 to 10 meetings held over several months to brainstorm ideas to improve occupational safety and health concerns identified in the discovery phase), and (3) HC evaluation (to determine if desired changes were accomplished and if employees’ reports of stressors and strains changed after the course of 15 months), improvements were to be expected (Aust & Ducki, 2004). Aust and Ducki (2004) reviewed 11 studies presenting 81 health circles in 30 different organizations. Overall study participants had high satisfaction with the HCs practices. Most companies acted upon employees’ suggestions (e.g., improving driver’s seat and cab, reducing ticket sale during drive, team restructuring and job rotation to facilitate communication, hiring more employees during summer time, and supervisor training program to improve leadership and communication skills) to improve work conditions. Thus, HCs represent a successful theory-grounded intervention to routinely improve employees’ occupational health.

Physical Setting

The physical environment or physical workspace has an enormous impact on individuals’ well-being, attitudes, and interactions with others, as well as on the implications on innovation and well-being (Oksanen & Ståhle, 2013; Vischer, 2007). In a study of 74 new product development teams (total of 437 study respondents) in Western Europe, Chong, van Eerde, Rutte, and Chai (2012) found that when teams were faced with challenge time pressures, meaning the teams had a strong interest and desire in tackling complex, but engaging tasks, when they were working proximally close with one another, team communication improved. Chong et al. assert that their finding aligns with prior studies that have shown that physical proximity promotes increased awareness of other team members, greater tendency to initiate conversations, and greater team identification. However, they also found that when faced with hindrance time pressures, physical proximity related to low levels of team communication, but when hindrance time pressure was low, team proximity had an increasingly greater positive relationship with team communication.

In addition to considering the type of work demand teams must address, other physical workspace considerations include whether people need to work collaboratively and synchronously or independently and remotely (or a combination thereof). Consideration needs to be given to how company contributors would satisfy client needs through various modes of communication, such as email vs. telephone, and whether individuals who work by a window might need shading to block bright sunlight from glaring on their computer screens. Finally, people who have to use the telephone for extensive periods of time would benefit from earphones to prevent neck strains. Most physical stressors are rather simple to rectify. However, companies are often not aware of a problem until after a problem arises, such as when a person’s back is strained from trying to move heavy equipment. Companies then implement strategies to remediate the environmental stressor. With the help of human factors, and organizational and office design consultants, many of the physical barriers to optimal performance can be prevented (Rousseau & Aubé, 2010). In a study of 215 French-speaking Canadian healthcare employees, Rousseau and Aubé (2010) found that although supervisor instrumental support positively related with affective commitment to the organization, the relationship was even stronger for those who reported satisfaction with the ambient environment (i.e., temperature, lighting, sound, ventilation, and cleanliness).

Secondary Interventions (Coping)

Secondary interventions, also referred to as coping, focus on resources people can use to mitigate the risk of work-related illness or workplace injury. Resources may include properties related to social resources, behaviors, and cognitive structures. Each of these resource domains may be employed to cope with stressors. Monat and Lazarus (1991) summarize the definition of coping as “an individual’s efforts to master demands (or conditions of harm, threat, or challenge) that are appraised (or perceived) as exceeding or taxing his or her resources” (p. 5). To master demands requires use of the aforementioned resources. Secondary interventions help employees become aware of the psychological, physical, and behavioral responses that may occur from the stressors presented in their working environment. Secondary interventions help a person detect and attend to stressors and identify resources for and ways of mitigating job strains. Often, coping strategies are learned skills that have a cognitive foundation and serve important functions in improving people’s management of stressors (Lazarus & Folkman, 1991). Coping is effortful, but with practice it becomes easier to employ. This idea is the foundation for understanding the role of resilience in coping with stressors. However, “not all adaptive processes are coping. Coping is a subset of adaptational activities that involves effort and does not include everything that we do in relating to the environment” (Lazarus & Folkman, 1991, p. 198). Furthermore, sometimes to cope with a stressor, a person may call upon social support sources to help with tangible materials or emotional comfort. People call upon support resources because they help to restructure how a person approaches or thinks about the stressor.

Most secondary interventions are aimed at helping the individual, though companies, as a policy, might require all employees to partake in training aimed at increasing employees’ awareness of and skills aimed at handling difficult situations vis à vis company channels (e.g., reporting on sexual harassment or discrimination). Furthermore, organizations might institute mentoring programs or work groups to address various work-related matters. These programs employ awareness-raising activities, stress-education, or skills training (cf., Bhagat, Segovis, & Nelson, 2012), which include development of skills in problem-solving, understanding emotion-focused coping, identifying and using social support, and enhancing capacity for resilience. The aim of these programs, therefore, is to help employees proactively review their perceptions of psychological, physical, and behavioral job-related strains, thereby extending their resilience, enabling them to form a personal plan to control stressors and practice coping skills (Cooper, Dewe, & O’Driscoll, 2011).

Often these stress management programs are instituted after an organization has observed excessive absenteeism and work-related performance problems and, therefore, are sometimes categorized as a tertiary stress management intervention or even a primary (prevention) intervention. However, the skills developed for coping with stressors also place the programs in secondary stress management interventions. Example programs that are categorized as tertiary or primary stress management interventions may also be secondary stress management interventions (see Figure 1

Stress has been defined in different ways over the years. Originally, it was conceived of as pressure from the environment, then as strain within the person. The generally accepted definition today is one of interaction between the situation and the individual. It is the psychological and physical state that results when the resources of the individual are not sufficient to cope with the demands and pressures of the situation. Thus, stress is more likely in some situations than others and in some individuals than others. Stress can undermine the achievement of goals, both for individuals and for organisations (box 1).

Signs of stress can be seen in people's behaviour, especially in changes in behaviour.

Acute responses to stress may be in the areas of feelings (for example, anxiety, depression, irritability, fatigue), behaviour (for example, being withdrawn, aggressive, tearful, unmotivated), thinking (for example, difficulties of concentration and problem solving) or physical symptoms (for example, palpitations, nausea, headaches). If stress persists, there are changes in neuroendocrine, cardiovascular, autonomic and immunological functioning, leading to mental and physical ill health (for example anxiety, depression, heart disease) (box 2, fig 1).1

Figure 1

A model of stress at work.1

Situations that are likely to cause stress are those that are unpredictable or uncontrollable, uncertain, ambiguous or unfamiliar, or involving conflict, loss or performance expectations. Stress may be caused by time limited events, such as the pressures of examinations or work deadlines, or by ongoing situations, such as family demands, job insecurity, or long commuting journeys.

Resources that help meet the pressures and demands faced at work include personal characteristics such as coping skills (for example, problem solving, assertiveness, time management) and the work situation such as a good working environment and social support. These resources can be increased by investment in work infrastructure, training, good management and employment practices, and the way that work is organised.

Historically, the typical response from employers to stress at work has been to blame the victim of stress, rather than its cause. Increasingly, it is being recognised that employers have a duty, in many cases in law, to ensure that employees do not become ill. It is also in their long term economic interests to prevent stress, as stress is likely to lead to high staff turnover, an increase in sickness absence and early retirement, increased stress in those staff still at work, reduced work performance and increased rate of accidents, and reduced client satisfaction.

Good employment practice includes assessing the risk of stress amongst employees. This involves:

  • looking for pressures at work which could cause high and long lasting levels of stress

  • deciding who might be harmed by these

  • deciding whether you are doing enough to prevent that harm.

HOW STRESS IS CAUSED

The degree of stress experienced depends on the functioning of two protective physiological mechanisms:

  • “Alarm reaction”. When confronted with a threat to our safety, our first response is physiological arousal: our muscles tense and breathing and heart rate become more rapid. This serves us well when the threat is the proverbial bull in the field rushing towards us. We either fight or flee. Present day threats tend to be more psychological—for example, unjustified verbal attack by a superior at work. It is usually not socially acceptable to act by “fight or flight”, and an alternative means of expressing the resultant emotional and physical energy is required. This falls in the arena of assertive communication.

  • “Adaptation”. The second adaptive mechanism allows us to cease responding when we learn that stimuli in the environment are no longer a threat to our safety. For example, when we first spend time in a house near a railway line, our response to trains hurtling past is to be startled, as described above. Over time, our response dwindles. If this process did not function, we would eventually collapse from physical wear and tear, and mental exhaustion.

Stress is experienced when either of these mechanisms are not functioning properly or when we find it difficult to switch appropriately from one to another. This forms the basis of individual approaches to stress management (fig 2). Figure 2 shows that it is the perception, or appraisal, of the situation that is key to whether or not it causes stress. This is the basis of the transactional model of stress,2 whereby the ability of a person to prevent or reduce stress is determined by that person's appraisal of (a) the threat within a situation (primary appraisal), and (b) the appraisal of his/her coping skills to deal with that threat (secondary appraisal). These appraisals have been shaped by past experiences of confronting stress and, in turn, influence future behaviour and appraisals. Thus, the process of appraisal, behaviour, and stress is continuous, and managing stress can result from changing the way the situation is appraised (cognitive techniques) or responded to (behavioural or cognitive techniques).

Figure 2

A model of stress and its management.

WORKPLACE FACTORS CAUSING STRESS

The workplace is an important source of both demands and pressures causing stress, and structural and social resources to counteract stress.

The workplace factors that have been found to be associated with stress and health risks can be categorised as those to do with the content of work and those to do with the social and organisational context of work (fig 1). Those that are intrinsic to the job include long hours, work overload, time pressure, difficult or complex tasks, lack of breaks, lack of variety, and poor physical work conditions (for example, space, temperature, light).

Unclear work or conflicting roles and boundaries can cause stress, as can having responsibility for people. The possibilities for job development are important buffers against current stress, with under promotion, lack of training, and job insecurity being stressful. There are two other sources of stress, or buffers against stress: relationships at work, and the organisational culture. Managers who are critical, demanding, unsupportive or bullying create stress, whereas a positive social dimension of work and good team working reduces it.

An organisational culture of unpaid overtime or “presenteeism” causes stress. On the other hand, a culture of involving people in decisions, keeping them informed about what is happening in the organisation, and providing good amenities and recreation facilities reduce stress. Organisational change, especially when consultation has been inadequate, is a huge source of stress. Such changes include mergers, relocation, restructuring or “downsizing”, individual contracts, and redundancies within the organisation.

Empirical review

A systematic review of the evidence for work factors associated with psychological ill health and associated absenteeism3 (Michie and Williams 2001, unpublished data) found the key factors to be:

  • long hours worked, work overload and pressure

  • the effects of these on personal lives

  • lack of control over work and lack of participation in decision making

  • poor social support

  • unclear management and work role and poor management style.

Explanatory model

Three of these factors form part of the influential control-demand model of work related strain.4 According to this model, work related strain and risks to health are most likely to arise when high job demands are coupled with low decision latitude (that is, low personal control over work and limited opportunities to develop skills). On the other hand, high job demands with high decision latitude gives the possibility of motivation to learn, active learning, and a sense of accomplishment. Of the two, decision latitude has been found to be more important than demand.5 Since its introduction in 1979, the model has been extended to include social support at work as a predictor of job strain.6 Karasek's model has received sufficient empirical support for it to provide a useful framework for interventions at work.

INDIVIDUAL DIFFERENCES

As is evident from figs 1 and 2, individuals differ in their risk of experiencing stress and in their vulnerability to the adverse effects of stress. Individuals are more likely to experience stress if they lack material resources (for example, financial security) and psychological resources (for example, coping skills, self esteem), and are more likely to be harmed by this stress if they tend to react emotionally to situations and are highly competitive and pressured (type A behaviour).

The association between pressures and well being and functioning can be thought of as an inverted U, with well being and functioning being low when pressures are either high or very low (for example, in circumstances of unemployment). Different people demonstrate different shapes of this inverted U, showing their different thresholds for responses to stress. A successful strategy for preventing stress within the workplace will ensure that the job fits the person, rather than trying to make people fit jobs that they are not well suited to.

INTERACTIONS BETWEEN WORK AND HOME STRESS

Increasingly, the demands on the individual in the workplace reach out into the homes and social lives of employees. Long, uncertain or unsocial hours, working away from home, taking work home, high levels of responsibility, job insecurity, and job relocation all may adversely affect family responsibilities and leisure activities. This is likely to undermine a good and relaxing quality of life outside work, which is an important buffer against the stress caused by work. In addition, domestic pressures such as childcare responsibilities, financial worries, bereavement, and housing problems may affect a person's robustness at work. Thus, a vicious cycle is set up in which the stress caused in either area of one's life, work or home, spills over and makes coping with the other more difficult.

Women are especially likely to experience these sources of stress,7 since they still carry more of the burden of childcare and domestic responsibilities than men. In addition, women are concentrated in lower paid, lower status jobs, may often work shifts in order to accommodate domestic responsibilities, and may suffer discrimination and harassment

INDIVIDUAL STRESS MANAGEMENT

Most interventions to reduce the risk to health associated with stress in the workplace involve both individual and organisational approaches. Individual approaches include training and one-to-one psychology services—clinical, occupational, health or counselling. They should aim to change individual skills and resources and help the individual change their situation. The techniques listed in fig 3 mirror the active coping (fight/flight) and rest phases (habituation) of the stress model presented earlier.

Figure 3

Techniques for managing stress.

Training helps prevent stress through:

  • becoming aware of the signs of stress

  • using this to interrupt behaviour patterns when the stress reaction is just beginning. Stress usually builds up gradually. The more stress builds up, the more difficult it is to deal with

  • analysing the situation and developing an active plan to minimise the stressors

  • learning skills of active coping and relaxation, developing a lifestyle that creates a buffer against stress

  • practising the above in low stress situations first to maximise chances of early success and boost self confidence and motivation to continue.

A wide variety of training courses may help in developing active coping techniques—for example, assertiveness, communications skills, time management, problem solving, and effective management.

However, there are many sources of stress that the individual is likely to perceive as outside his or her power to change, such as the structure, management style or culture of the organisation. It is important to note that stress management approaches that concentrate on changing the individual without changing the sources of stress are of limited effectiveness, and may be counterproductive by masking these sources. For example, breathing deeply and thinking positively about a situation causing stress may make for a temporary feeling of well being, but will allow a damaging situation to continue, causing persistent stress and, probably, stress to others. The primary aim of the individual approach should be to develop people's skills and confidence to change their situation, not to help them adapt to and accept a stressful situation.

ORGANISATIONAL STRESS MANAGEMENT

The prevention and management of workplace stress requires organisational level interventions, because it is the organisation that creates the stress. An approach that is limited to helping those already experiencing stress is analogous to administering sticking plaster on wounds, rather than dealing with the causes of the damage. An alternative analogy is trying to run up an escalator that's going down! Organisational interventions can be of many types, ranging from structural (for example, staffing levels, work schedules, physical environment) to psychological (for example, social support, control over work, participation).

The emphasis on the organisation, rather than the individual, being the problem is well illustrated by the principles used in Scandinavia, where there is an excellent record of creating healthy and safe working environments3,8 (box 3).

Box 3 : Principles of preventing work stress in Scandinavia

  • Working conditions are adapted to people's differing physical and mental aptitudes

  • Employee is given the opportunity to participate in the design of his/her own work situation, and in the processes of change and development affecting his/her work

  • Technology, work organisation, and job content are designed so that the employee is not exposed to physical or mental strains that may lead to illness or accidents. Forms of remuneration and the distribution of working hours are taken into account

  • Closely controlled or restricted work is avoided or limited

  • Work should provide opportunities for variety, social contact, and cooperation as well as coherence between different working operations

  • Working conditions should provide opportunities for personal and vocational development, as well as for self determination and professional responsibility

Assessing the risk of stress within the workplace must take into account:

  • the likelihood and the extent of ill health which could occur as a result of exposure to a particular hazard

  • the extent to which an individual is exposed to the hazard

  • the number of employees exposed to the hazard.

The analysis of stressful hazards at work should consider all aspects of its design and management, and its social and organisational context.9 Although the priority is prevention, protective measures can be introduced to control the risk and reduce the effects of a given hazard. A detailed account of how to assess and reduce risk associated with exposure to stressful hazards is summarised in box 4.

Box 4 : A risk assessment strategy—six stages9

  • Hazard identification:

    Reliably identify the stressors which exist in relation to work and working conditions, for specified groups of employees, and make an assessment of the degree of exposure

  • Assessment of harm:

    Collect evidence that exposure to such stressors is associated with impaired health in the group being assessed or of the wider organisation. This should include a wide range of health-related outcomes, including symptoms of general malaise and specific disorders, and of organisational and health related behaviours such as smoking and drinking, and sickness absence

  • Identification of likely risk factors:

    Explore the associations between exposure to stressors and measures of harm to identify likely risk factors at the group level, and to make some estimate of their size and/or significance

  • Description of underlying mechanisms:

    Understand and describe the possible mechanisms by which exposure to the stressors is associated with damage to the health of the assessment group or to the organisation

  • Audit existing management control and employee support systems:

    Identify and assess all existing management systems both in relation to the control of stressors and the experience of work stress, and in relation to the provision of support for employees experiencing problems.

  • Recommendations on residual risk:

    Take existing management control and employee support systems into proper account, make recommendations on the residual risk associated with the likely risk factors related to work stress

Increasingly, legislation requires employers to assess and address all risks to employee health and safety, including their mental health (for example, the European Commission's framework directive on the introduction of measures to encourage improvements in the safety and health of workers at work). Creating a safe system of work requires targeting equipment, materials, the environment and people (for example, ensuring sufficient skills for the tasks). It also requires having monitoring and review systems to assess the extent to which prevention and control strategies are effective.10

Although associations between workplace factors and psychological ill health and associated sickness absence have been well documented, evidence based interventions to reduce these problems are scarce.3

Successful interventions used training and organisational approaches to increase participation in decision making and problem solving, increase support and feedback and improve communication.11–16 These studies found that:

  • those taught skills to mobilise support at work and to participate in problem solving and decision making reported more supportive feedback, feeling more able to cope, and better work team functioning and climate. Among those most at risk of leaving, those undergoing the training reported reduced depression12

  • staff facing organisational change who were taught skills of stress management, how to participate in, and control, their work showed a decrease of stress hormone levels14

  • staff taught verbal and non-verbal communication and empathy skills demonstrated reduced staff resignations and sick leave16

  • physically inactive employees undergoing stress management training improved their perceived coping ability and those undergoing aerobic exercise improved their feelings of well being and decreased their complaints of muscle pain, but also reported reduced job satisfaction11

  • employees undergoing one of seven training programmes emphasising one or more aspects of stress management—physiological processes, coping with people or interpersonal awareness processes—showed reductions in depression, anxiety, psychological strain, and emotional exhaustion immediately after the programme. There was a further reduction in psychological strain and emotional exhaustion at 9–16 months' follow up13

  • those on long term sickness absence who were referred early to the occupational health department (within two or three months absence) reduced their sickness absence from 40 to 25 weeks before resumption of work and from 72 to 53 weeks before leaving employment for medical reasons, leading to large financial savings.15

Success in managing and preventing stress will depend on the culture in the organisation. Stress should be seen as helpful information to guide action, not as weakness in individuals. A culture of openness and understanding, rather than of blame and criticism, is essential. Building this type of culture requires active leadership and role models from the top of the organisation, the development and implementation of a stress policy throughout the organisation, and systems to identify problems early and to review and improve the strategies developed to address them. The policy and its implementation should be negotiated with the relevant trade unions and health and safety committees (for a trade union example of a model agreement for preventing stress at work see the Manufacturing, Science and Finance Union guide17).

Last, but by no means least, interventions should be evaluated, so that their effectiveness can be assessed. Ideally, the method of achieving this should include a high response rate, valid and reliable measures, and a control group. Two measures that provide a comprehensive analysis of work stress and have been widely used are the Job Content Questionnaire, which includes measures of the predictors of job strain described earlier,18 and the Occupational Stress Indicator.19

QUESTIONS (SEE ANSWERS ON P 8)

  1. Stress is best seen as:

    1. pressures and demands put on an individual

    2. maladaptive responses of individuals—for example, anxiety, irritability, aches and pains

    3. an interaction between situational demands and the resources of the individual to cope with them

    4. a reaction that can be positive or negative, depending on the person and the situation

    5. a transactional process, whereby the ability of a person to prevent stress is determined by that person's appraisal of threat and his/her appraisal of his/her coping abilities

  2. The following are key dimensions of Karasek's model of job strain:

    1. job demands

    2. person–environment fit

    3. decision latitude

    4. role ambiguity

    5. social support

  3. The following are examples of active coping:

    1. problem solving

    2. distracting oneself from the problem

    3. assertive behaviour

    4. resting

    5. time management

  4. Individual approaches to stress management aim to:

    1. help the individual change their situation

    2. train skills

    3. change the sources of stress

    4. help develop people's confidence

    5. help people adapt to the stressful situation

  5. Organisational approaches to stress management:

    1. are analogous to putting a sticking plaster on a wound

    2. consider stress in terms of hazards

    3. depend on training

    4. are appropriate in a culture of blame and criticism

    5. include interventions designed to increase participation in decision making

REFERENCES

Box 1:

The problem of stress