MEDICAL FACTORS

ARTICLE #8: PREVENTING OCCUPATIONAL STRESS

At a glance:
Occupational stress can cause:

Organizational interventions aim to reduce workplace stressors, while individual interventions aim to change the way people respond to stressful situations. There is evidence that both these strategies can reduce occupational stress, which in turn would improve physical and mental health and reduce costs.

PERSPECTIVES:

Employee
Stress is an individual's reaction to a stressful situation or event. This means that we can reduce stress both by reducing stressful situations and by developing new skills to cope with them. Both approaches can effectively reduce stress and its associated physical symptoms.

For some people experiencing stress at work, it might be difficult to embrace stress-management training or relaxation. These techniques might seem a bit woolly, or not really your cup of tea. You might feel that using the individual approach is letting the workplace “off the hook', or not dealing with the real cause of the problem. However the benefits of stress management programs are supported by scientific evidence. They give you skills and strategies that improve overall health and your ability to cope with difficult situations, which is worthwhile in itself.

If you feel that workplace issues are part of the problem, discussing this with your supervisor or employer could help. Are there some positive suggestions you could make? Reducing stress in the workplace is an investment for employers as it improves the overall health of their workers and reduces sick leave.

Employer
Occupational stress can lead to burnout or physical illness, distress, decreased quality of life and poorer performance at work, and increase work absence and turnover. Reducing stress is a worthwhile investment for employers.

Both individual and workplace interventions have been shown to be effective. Workplaces can reduce stress by promoting support and open communication in the workplace, by making changes to the organization of tasks, by offering stress-management programs and by providing training for supervisors (as supervisor behavior has been shown to have a strong influence on workers stress).

Coping skills also play a role in occupational stress. However, individuals might be more likely to address personal stress management if they perceive that the organization is also making an effort to reduce stress. The following are some of the strategies that can reduce workplace stress:

1. Be aware of sources of stress - are there departments at risk?

2. Engage employees in decision making as much as possible.

3. Provide clear and meaningful job descriptions

4. Be interested and supportive toward workers

5. Encourage regular breaks, during the shift and with regular use of vacation time

6. Provide constructive feedback to staff

7. Provide appropriate physical work conditions

8. Increase worker control and autonomy where possible

9. Provide adequate training

Treater
Individual and organizational interventions are effective ways of managing occupational stress. Individual approaches found to be effective include cognitive behavioral therapy and relaxation training. Treating practitioners can assist patients experiencing work stress through sensible strategies:


1. Help the patient identify the sources of their stress

2. Help the patient identify whether each source of stress that can or cannot be altered

3. Help the patient identify their own signs and symptoms that indicate a stressed state

4. Help the patient develop positive coping strategies

- Decreasing work hours
- Controlling stress
- Reducing self inflicted pressures, both at home and at work
- Increasing time for self
- Assertiveness – working out how to communicate issues in a clear and constructive way in the workplace
- General stress management approaches
- Yoga
- Assertiveness training
- Exercise
- Diet and sleep habits

Insurer
Individual and organizational interventions are effective ways of managing occupational stress. Individual approaches found to be effective include cognitive behavioral therapy and relaxation training. Encourage employers to address occupational stress and regard reducing stress in the workplace as an investment. Reducing stress increases workers health and reduces sick leave.

Original Article, Authors & Publication Details:
A. Marine, J. Ruotsalainen, C. Serra, J. Verbeek. (2006).

Preventing occupational stress in healthcare workers. Cochrane Database of Systematic Reviews (4): CD002892.

Background, Study Objectives, How It Was Done:
Occupational stress can lead to burnout or physical illness, distress, decreased quality of life and poorer performance at work. Increased work absence and turnover from occupational stress is costly for employers and for society. This review investigated interventions aimed at reducing stress in healthcare workers.

Stress may be caused by an imbalance in demands, skills and social support at work. However, the effect of these stressors depends on an individual's coping skills. Therefore, strategies for preventing stress can be either organizational (“work-directed') or individual (“person-directed'). Individual interventions include psychological treatment and stress management programs, often including cognitive behavioral therapy or relaxation techniques. Organizational interventions include improving communication, increasing the participation of workers and changing the work environment, tasks or procedures.

This review evaluates prevention strategies for occupational stress. 19 studies from Europe, North America and Asia were considered to be of high enough quality to be included in the review.

Study Findings:
In all 19 studies, individual or organizational interventions successfully reduced workplace stress.

Individual interventions were:

Most improvements were maintained for the short and medium term. Long-term outcomes were not often recorded. In one study, however, a refresher course of cognitive behavioral therapy after 5, 11 and 17 months improved burnout in the long term.

Organizational interventions were:

Organizational interventions resulted in:

Anxiety was not investigated in any of the studies

Conclusions:
Organizational interventions aim to reduce workplace stressors, while individual interventions aim to change the way people respond to stressful situations. Both have the potential to reduce occupational stress, which in turn would improve the physical and mental health of workers and reduce costs.

This is an area that requires more research. Broad organizational interventions in the workplace are generally regarded as more useful and appropriate for preventing stress. Unfortunately, there are few studies evaluating these strategies.

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