Dr. Dalia Abdallah El-ShafeiLecturer, Community medicine department, Zagazig University

WORK STRESS

A Brief History of Job Stress

Occupational stress is a relatively new research domain that crystallized in the early 1970s.

Hans Selye

“The father of the stress field“(January 26, 1907 — October 16, 1982)

Canadian endocrinologist

Walter Cannon

1871 -1945 AD.American Psychologist.

“Fight-or-Flight" response Cannon advanced the concept ofphysiologic homeostasis &developed an engineeringconcept of stress and strain.

Richard S. Lazarus

American Professor of Psychology.1922 – 2002

Stress, Appraisal, and Coping

Cognitive appraisal: Intrapsychic process that translates

objective events into stressful experiences.

Subjective factors play larger role in stress experience than

objective events.

Any objective event can at once be perceived positively by one

person & negatively by another "One person's meat is

another person's poison".

Arthur Kornhauser

American Industrial psychologist

1896-1990

Presidents of the Industrial and Business Section of the American Association for Applied Psychology (AAAP)

{1941-1943}

“Psychological tests in business” (1924)

“When Labor Votes: a Study of Auto Workers" (1956)

"Mental Health of the Industrial Worker" (1965).

occupational stress

NIOSH (1996) identified the "organization of work"

which includes work-related psychosocial stressors,

as one of 21 national OSH research priorities.

Top 10 Most Stressful Jobs for 2013:

1) Enlisted military personnel

2) Police Officer

3) Miner

4) Taxi Driver

5) Firefighter

6) Commercial Pilot

7) Newspaper Reporter

8) Photojournalist

9) Loss prevention officer

10) Mental Health Case Manager

11) Medical professional

20) Teacher

The 10 Least Stressful Jobs for 2013:

1. University professors

2. Tailors

3. Medical Records Technician

4. Jeweler

5. Medical lab technician

6. Audiologist

7. Dietitian

8. Hairstylist

9. Librarian

10. Drill Press Operator

Model of Job Stress and Health

Over the past 25 years a paradigm of stress was developedby researchers at NIOSH to guide efforts at examining therelationship between working conditions and healthconsequences.

The ‘bucket’ model

• Workload(Qualitative or Ouantitative). - Work pace.

• Degree of decision latitude. - Shift work.

Job

or

task

d

eman

ds

• Role stressors: role ambiguity & role conflict

• Management styles: lack of participation in decision making & effective consultation & excessive restrictions

• Career development: over or under promotion, lack of job security & fear of task redundancy, job obsolescence, & early retirement.

• Poor relationships: aggression, violence (U.S. workers; 6% physical violence, 41% nonphysical aggression).

Org

an

izati

on

al

fact

ors

• Excessive noise. - Heat or cold.

• Poor ventilation. outbreaks of MSI

• Inadequate lighting. - Ergonomic design deficiencies.Ph

ysi

cal

con

dit

ion

sJob Stressors & Their Consequences

Karasek job-strain model

Moderating Factors

A number of personal & situational characteristics can Alter or Modify the way individual workers exposed to a work

environment Perceive or React to it.

• Type A behavior pattern (TABP): intense striving for achievement,competitiveness, time urgency, excessive drive, & over commitment tovocation or profession.

• Hardy personality: optimistic appraisals of events

• Internal locus of control: a general belief that events in life are controlledby their actions.

• Stage of career development: work experience (job tenure)Ind

ivid

ua

l F

act

ors

•Interpersonal, marital, financial, & child-rearing stressors.

Workers clearly do not leave their family & personal problems behind

when they go to work, nor do they forget job problems on returning

home.

No

nw

ork

or

Ex

tra

O

ccu

pa

tio

na

l F

act

ors

• Social Support: work & nonwork sources

• Coping (educational level & income): Maladaptive coping (such asworking harder, but making more mistakes). But resistance of maybe due to the impersonal nature of work & lack of worker controlover this class of stressors (Personality Hardiness).

• Lifestyle Factors: physical fitness & exercise, smoking cessation,sound nutrition habits, and stress management (Health promotion).B

uff

er

Fa

cto

rs(↓

or

elim

inat

e th

e ef

fect

s o

f jo

b s

tres

sors

)

Hardiness

(3Cs)

Commitment

(Sense of inner purpose)

Challenge

(Viewing stressful situations as opportunities for growth & development of individual abilities)

Internal locus of Control

(Having power over owns life & attitude)

Focus of coping

Problem-focused

Emotion-focused

method of coping

Behavioral methods

Control Escape Social Solitary

Cognitive methods

Control the stressor

Escape from the stressor

A prolonged response to chronic emotional & interpersonal stressors on the job.

Human service industry.

Emotional exhaustion

Lack of personal

accomplishment

Depersonalization

“Feelings of cynicism & detachment from the job &

sense of ineffectiveness”

3 key dimensions of Multidimensional model of burnout phenomenon.

Stress BurnoutOver-engagement Dis-engagement

Emotions are overreactive Emotions are blunted

Produces urgency & hyperactivity

Produces helplessness & hopelessness

Loss of energy Loss of motivation, ideals & hope

Leads to anxiety disorders Leads to depression“mood disorders”

Primary damage is physical

Primary damage is emotional

May kill you prematurely May make life seem not worth living

Prevention & Intervention

Tertiary

heal traumatized

Secondary(stress management)

alter the ways to perceive or respond to job stressors

Primary↓ or eliminate risk

factors or job stressors

• Medical Care

• Psychological Counseling & Therapy

• Individual-oriented strategies.

• Organizationally oriented strategies.

• Psychosocial interventions

• Socio-technical interventions

Focus primarily on human processes & psychosocial aspectsof the work setting.

Aim: ↓ stress by changing employees' perceptions of workenvironment (modifications of objective working conditions).

Psychosocial Interventions

Participatory Action Research (PAR)

Employees are involved, jointly with outside experts, in anempowering process of defining problems (identifyingstressors), developing intervention strategies,introducing changes that benefit employees, andmeasuring outcomes.

Methodology in which researchers & workers collaboratein a process of data-guided problem solving for the dualpurposes of improving the organization's ability toprovide workers with desired outcomes & contributingto the general operational knowledge.

Socio-technical Interventions

Focus primarily on changes to objective working

conditions & are considered to have implications for work-

related stress.

Aimed at eliminating job stressors by making change to

objective working conditions or environment.

Involved the modification of workload, work schedules,

& work processes.

Help workers to modify their appraisals of stressfulsituations or to deal with the symptoms of stress orboth.

Typically, Prescriptive & person-oriented

Relaxation-based techniques:

1. Biofeedback,

2. Progressive muscle relaxation,

3. Meditation,

4. Self-hypnosis

5. Cognitive-behavioral skills training.

لعالجية األستراتيجيات الوق ائية واللضغط النفسي

غط النفسياألستراتيجيات الوق ائية والعالجية للضليومية ، للتخفيف من آثار الضغوط التي يواجهها الفرد في حياته ا

أي مساعدته على السيطرة عليها أو الحد منها أو إدارتها أو

.تحملها والتكيف معها

:يالنشاط البدن-1

مجهدالالفكريالعملمنساعةنصفكلبعدقصيرةوقفةمجردأن

نفسيةتبحركاتقيامهمعالحجرةفيويسيرالفردفيهاينهض،

الظهرعلىاإلنحناءمعالكرسيعلىجسمهشدأوعميقة،

يالفكرالعملإمكاناتفيزيادةذلكيضمنبعمق،والتنفس

.ملموسبشكلوإنتاجيته

: اإلسترخاء-2

.كاملةراحةإلىيؤديالنومأثناءتامإسترخاءتحقيق-

.النبضوالتنفستنظموالعصبيالجهازتهدئ-

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:اليوغا-3

،رخاءباإلستوراعشمحدثة،التنفسوحركةالقلبنبضاتتهدئ

.النومأوالنعاسحدليبلغ

ماءالصالغددخاصة،المختلفةاألعضاءعمقإلىتصلفتمارينها

لفرداوبإمكانالفقري،للعمودالسليمالشكلوالدمويةوالدورة

منعضلةألياإلراديالتحكمإلىيصلأنلهاالممارس

.جسمهعضالت

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.ردالفعلىوالمخاوفالضغطووالقلقالمشاغلتأثيرات

: ةالعالجات الفيزيائي-5

ر وفي العالج بالماء أو بالتدليك، استخدام الماء بجميع الصو

ارخالبحمام درجات حرارة مختلفة كدوش الماء ، أو

(الساونا)

الوضوء يطفيء نار الغضب

:السلوكيالعالج المعرفي-6

تجابةاسبذلكفتتغيرمجهدا،يعتبرالذيالموقفإدراكتغيير

.إجهاديحدثوالواالنفعاليةالفسيولوجيةالعضو

.هي كيفية تقييمنا للحدث وليس في الحدث نفسفالمشكلة

لوى لرسول صلى هللا عليه وسلم أعرابيا مريضا يتاعندما عاد

بل هي :فقال األعرابي "طهور":من شدة الحمى، فواسا قائال

ول حمى تفور، على شيخ كبير ، لتورده القبور، فقال الرس

."فهي إذن ":صلى هللا عليه وسلم

الغذاء الصحي-7

األسماك وزيت بذرة الكتان وزيت السمسم:3–أوميجا.

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والدجاج البيض، والسمك، والجزر، والسبانخ،: ومن مصادره الغذائية. بالسعادة في المخ". اللب السوري" والخميرة، وبذور دوار الشمس

كفيلة أن تعمل على تحسين ( غرام85)أن قطعة صغيرة من الشوكوالتة :الشوكوالتة

دة المزاج ورفع الروح المعنوية بدرجة كبيرة وذلك إلحتواء مسحوق الكاكاو على ما.المنشطة للحالة المزاجية والنفسية Tryptophanالتربيتوفان

ن والمانجو هناك أنواع من الفاكهة تمتاز بإرتفاع نسبة سكر الغلوكوز فيها كالتي:الفاكهة

لى والعنب والبطيخ والشمام األمر الذي يمد الجسم بما يحتاجه من الطاقة ويحافظ عالحالة المزاجية له

كما جسمفي ال" اإلندروفين"أن تناول الفلفل الحار يحفز على زيادة هرمون :الفلفل الحار

لحالة الذي يساعد على تهدئة المخ وصفاء ا" الماغنسيوم"على نسبة جيدة من يحتوي

يرات السلبية ومن جهة أخرى تفيد األبحاث أن الوجبات الغنية بالشّطة تقاوم التأث. الذهنية.الناتجة عن التوتر أو الضغوط النفسية

World pillow fight day

“ابريل6”اليوم العاملي لضرب املخدات صينيين تطايرت في الهواء وسائد تحمل أسماء رؤساء العمل ومدرسين بعد ان احتشد مئات ال

ام للعام واجتذب الحدث الذي يق. في مدينة شنغهاي لضرب الوسائد للتنفيس عن الضغوط

رضون الخامس على التوالي أعدادا متزايدة من المرؤوسين والتالميذ المحبطين الذين يتع

ميالد كما للضغوط مما اضطر المنظمين الى تخصيص ليلتين لمعارك الوسائد قبل عيد ال

. ديسمبر الحالي30يعتزمون اقامة مناسبة اخرى يوم

على كل شخص ان يكتب على الوسادة اسماء رؤسائه في العمل او مدرسية او مواد

غوط بوسعنا بعد التنفيس عن الض». االمتحانات ويستمتع وينفس عن نفسه الى اقصى درجة

طلق في وعند الدخول توزع الوسائد على المشاركين وتن. «ان نواجه الحياة من جديد بفرحة

.االجواء نغمات موسيقى الروك كعامل للتحفيز ثم تبدأ معركة الوسائد

Individual-oriented strategies:

Often easier to implement,

Can be evaluated in the short term

Not require disruptions in production schedules ororganizational structure,

Fit nicely with the frequently held management view thatstress is an individual rather than an organizationalproblem

Compatible with the expanding interest of employers inhealth promotion & disease prevention programs that focusexclusively on individual lifestyle & behavior changes toimprove health.

Organizational-oriented strategies:

Require an assessment of the work conditions that generate stress & knowledge of the dynamics of change processes in organizations.

These change strategies can be expensive & disruptive and may make them less appealing to management.

Cognitive-behavioral skills training: effective in ↓

psychological symptoms of stress

Muscle relaxation training: main effects on physiologicindicators such as muscle activity.

Combinations of techniques, especially musclerelaxation plus cognitive-behavioral skills training, are themost common type of stress management intervention.

These interventions focused on changing the individualworker, not the job-related sources of stress. None of themeffective in producing effects on job/organization-relevantoutcomes, as productivity, absenteeism, or job satisfaction.

Therapeutic treatment of physical, psychological or behavioral consequences of exposures to job stressors.

Medical Care

Psychological Counseling & Therapy

Treat work-related mental health problems.

Behavior & cognitive therapy; Supportivecounseling, and Insight-oriented psychotherapy.

Employee Assistance Programs (EAPs): provide avariety of mental health-related services. Employeescan refer themselves to the EAP or be referred bymanagement.

The goals of an EAP are to restore employeesto full productivity

Identifying employees with drug abuse, emotional, orbehavioral problems resulting in deviant workperformance;

Motivating such individuals to seek help

Supplying short-term professional counselingassistance.

Referral & Directing employees toward best availableassistance

Providing continuing support & guidance throughoutproblem-solving period.

Cost-effectiveness of EAP programs:

Reduced health claims, financial savings, lowerabsenteeism rates & overall return on investment.

Confidentiality, may limit the use of onsite mental health resources.