Tuesday, October 11, 2011

Occuptional stress

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Revision Notes for Occupational Stress.

What is stress?

- Stress is a word derived from the Latin word stringere meaning to draw tight.

- Stress is any circumstance that places special physical and/or psychological demands on a person such that an unusual or out-of the ordinary responses occur.

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o The circumstance, technically termed stressor, can be, for example, a final exam, financial problems, or a difficult boss.

o The unusual or out-of-the ordinary response, more appropriately called stress response, may finish in a variety of physiological or psychological manifestations e.g. headaches, increased alcohol assumptions or depression.

- If demands and pressures (‘stresses’ and ‘stressors’) become too great, they can induce, in anyone, the harmful or potentially harmful mental and physical feelings and reactions commonly known as ‘stress’. Under demand as well as over demand can contribute to a stress situation.

- The severity of the stress will depend on the mismatch we perceive between the demands and our ability to satisfactorily respond to them and also our perception of the possible consequences of failing to do so. It may also be affected by our fitness and resilience at the time.

o by looking at stress as resulting from a misfit between an individual and his or her particular environment � can understand why one person seems to flourish in a certain setting, while others suffer.

- Long-term outcomes are often labelled strains and can be categorised as

o Behavioural (such as drug addition or performance deficit)

o Psychological (such as depression or anxiety)

o Medical (such as heart disease)

o External forces (load) are seen as exerting pressure upon individual, producing strain.

- When pressure exceeds the individual’s ability to cope, he or she enters the stress arena (Arnold, 18).

Definitions of stress

- Beehr & Franz (187)

o a force applied to an individual (stress as independent variable)

o individual responses to such forces (stress as dependent variable)

o interaction between force and response (stress results from interaction)

- Aldwin (14)

o Quality of experience, produced through a person-environment transaction, that through over or under arousal, results in psychological or physiological distress

- Hans Selye

o The non-specific result of any demand upon the body, be the effect mental or somatic

o Eustress is a positive stressful experience, a state of physical and psychological well being that is associated with increased motivation and the acceptance of a challenge.

o What is essential to well-being is a balance to produce an optimal level of arousal

o Too little stress can be as harmful as too much

o Stress can result from being over or under-stimulated

- Lazarus & Folkman (184)

o The relationship that exists between a person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his/her well-being

o This definition introduces the important notion of subjective appraisal

- Walter Canon (1) & Seyle (15)

o Introduced the concept of Fight or Flight response because when faced with a threat (stressor), the organism’s body prepares for combat or flight to safety.

o Fight and flight � through this reaction, people will choose whether to stay and fight or try to escape when confronting extreme danger.

o During the experience of stress, the fight or flight response occurs almost instantaneously.

- The Father of Stress

o Hans Selye is regarded as the “father of stress.” He is also well known for a model of stress called the General Adaptation Syndrome. It has three phases

 Alarm the individual becomes of aware of the stressor � fight or flight, body mobilizes resources to combat threat.

 e.g. experience a near-miss car accident (beating heart and heavy breathing) are the result of fight or flight response.

 Resistance the individual attempts to fight off and/or adapt to the stressor � enhanced ability to fight stressor via moderate physiological arousal, ability to withstand additional stressor (i.e. infections) is reduced.

 body begins to recovery shortly after the alarm stage.

 Exhaustion the costs of fighting and/or adaptation are so high the individual wears out- depletion of resources brings on diseases and disorders (i.e. chronically high heart rate and blood pressure increase chances of heart attack and strokes).

- Costs of stress?

o individuals health or happiness has been ravaged by the effects of stress � whether manifested as minor complaints of illness, serious heart disease or social problems such as alcoholism and drugs abuse, stress related symptoms exact a heavy payment.

- What are the effects of stress?

- On individuals

o Emotionally;

 Anxiety, anger, frustration, moodiness, irritability, loss of pleasure and interest, despair, depression and impaired sleep.

o Physically;

 Physical effects may include a weakened immune system, raised blood pressure, heart disease, tenseness, tiredness, appetite disturbance, nausea, headaches, light-headedness and the emergence or exacerbation of symptoms in any system in the body.

o Mentally;

 Impairment of perception, concentration, memory, judgement, decisiveness, accuracy, motivation and creativity.

 Increased use/dependence on caffeine, alcohol or drugs may occur. This is likely to exacerbate all of the above.

o Interpersonally;

 Relationships are likely to be more difficult, both at work and elsewhere.

o At work;

 Attendance can become either excessive or extremely poor. Regular bouts of recurring illness can occur. Timekeeping can become erratic. Performance can be impaired and the level of accidents rise.

- Stress reflected in the Workplace

o Differing stress levels in various occupations

 Certain occupations, such as mining, piloting, police, advertising and acting are believed to provide the highest stress levels.

 Stress on the job becomes an occupational hazard for certain ‘helping’ professionals, such as physicians, dentists, nurses and health technologists, who have a higher than expected rates of suicide and alcohol/drug abuse.

o Job performance

 An individual’s performance actually improves with increased levels of stress. After a point, however, stress clearly results in reduced performance.

o Absenteeism and turnover of labour force

 Absenteeism is one of the most obvious costs of stress to employers.

 Absenteeism is a widespread and accelerating problem in many occupations.

 Confederation of British Industry (CBI) reported that absenteeism has risen alarmingly I recent years in spite of improvements in social and working conditions, income levels and family health.

- Possible sources of stress in the workplace.

o The following can be sources of stress arising from work

- Work organisation and conditions

continual changes in work, organisations and structures lack of participation in decision making complexity and demands of new systems

lack of control over work inadequate staffing low pay or low status

job insecurity lack of recognition or promotion prospects lack of facilities for rest breaks

unclear reporting lines over promotion lone working

excessive working hours shift working excessive workload

- Work relationships

inconsistent management poor management communication customer/client complaints

lack of support or assistance bullying lack of appropriate training

social isolation harassment the threat of violence

inconsiderate management conflicting demands tasks inappropriate to ability

boring, repetitive work surveillance uncertainty about responsibilities

under use of skills time pressures responsibility for others

- Physical conditions

excessive noise poor ventilation exposure to fumes, chemicals, or other unpleasant substances

poor lighting poor equipment exposure to the elements

poor temperature control poor workstation

- What are the sources of stress?

o Every job has potential stress agents regardless of how one job may compare to another in terms of stress.

o Researchers have identified 5 major categories of work stress. Common to all jobs, factors vary in the degree to which they are found to be casually linked to stress in each job.

- Factors intrinsic to the job

o Working conditions

 Our physical surroundings � noise, lighting, smells, and all the stimulus which bombard our senses � can affect our moods and overall mental state, whether or not we find them consciously, objectionable.

 Kornhauser (165) stated that ‘poor mental health was directly related to unpleasant working conditions, the necessity to work fast and to expend a lot of physical effort, and to excessive and inconvenient hour’.

 Lighting for example causes eye strain especially to those individual’s who are dealing with close detail work.

 The physical design of the workplace can be another potential source of stress � poor communication networks, layout.

o Shift work

 Many workers today have jobs requiring them to work in shifts, some of which involve working staggered hours.

 Studies have found that shift work is a common occupational stress factor. It has been demonstrated that shift work affects blood temp, metabolic rate, blood sugar levels, mental efficiency and work motivation, and also sleep patterns, family and social life.

 In a study of offshore oil rig, the rd most important source of stress found was a general category labelled ‘work patterns’, such as shift work, physical conditions and travel. The longer the work shift � for example, 8 days on, 8 days off’ vs. ’14 days on, 14 days off’ � greater the stress.

 Predictor of physical ill health.

o Long hours

 The long working hours required by many jobs appear to take a toll on employee health.

o Risks and danger

 A job which involves risk or danger can result in higher stress levels.

 For example, when someone is constantly aware of potential danger, he or she is prepared to react immediately � the individual is in a constant state of arousal (fight or flight syndrome). The resulting adrenaline rush, respiration changes and muscle tension are all seen as potentially threatening to long term health.

 On the other hand, individuals who face physical danger � such as police, mine workers, fire-fighters and soldiers � often appear to have reduced stress levels, particularly those who are adequately trained and equipped to deal with emergency situations.

o New technology

 The introduction of new technology in the work environment has required workers, particularly blue collar workers, to adapt continually to new equipment, systems and ways of working.

 Mangers in ‘developing countries’ for example, felt pressure due to increasing emphasis on new technology, the need to deal wit an adequately trained workforce and the imposition of deadlines.

 New technology was a great source of pressure at work.

o Work overload

 Two types of work overload

• Quantitative overload which refers simply to having too much work to do.

o Too much work often leads to working long hours with the attendant problems.

• Qualitative overload refers to work that is too difficult for an individual.

o Too heavy a work burden has been connected with increased smoking.

o Work underload

 Job underload associated with repetitive routine, boring and under stimulating work has been associated with ill health.

 Certain workers, such as pilots, air traffic controllers and nuclear power workers, face a special aspect of work underload. They deal with long periods of time in which they have little to do, while facing the possibility that they may suddenly be required to spring into action in a crisis.

- Role in the organisation

o When a person’s role in an organisation is clearly defined and understood when expectations placed upon individual are also clear and non-conflicting, stress can be kept to a minimum � not the case n may workplaces.

o Role ambiguity

 Arises when individuals do not have a clear picture about their work objectives, their co-workers’ expectations of them, and the scope and responsibilities of their job.

 Ambiguity results because a supervisor does not lay out to the employee exactly what their role is.

 Warshaw (17) stated ‘the individual just doesn’t know how he or she fits into the organisation and is unsure of any rewards no matter how well he or she may perform’.

 Wide range of activities can create ambiguity � first job, promotion, transfer, a new boss, the first supervisor responsibility, new company, or a change in the structure of the existing organisation � all of these and others may serve to create temporary state of role ambiguity.

 Stress indicators � drepressed moods, lowered self esteem, life dissatisfaction, low motivation to work and intentions to leave job.

o Role conflict

 Exists when the individual is torn by conflicting job demands or by doing things that e or she does not really want to do, or tings which the individual does not believe are part of the job.

 Individual’s may feel torn between two groups of people who demand different types of behaviour or who believe the job entails different functions.

 Role conflict leads to reduced job satisfaction and higher anxiety level.

o Personality variables

 People with high anxiety levels suffer more from role conflicts than do people who are more flexible in their approach to life.

 Anxiety prone individuals experience role conflict more acutely and react to it with greater tension than people who are less anxiety prone; and more flexible individuals respond to high role conflict with lesser feeling of tension than their more rigid counterparts.

o Responsibility - Two types of responsibilities in organisations

o Responsibility for people

 Found to be particularly stressful and lead to heart disease.

 Requires spending more time interacting with others, attending meetings and attempting to meet deadlines.

 Ivancevich & Matteson (180) stated ‘part of the reason responsibility for people acts as a stressor undoubtedly results from specific nature of the responsibility particularly as it relates to the need to make unpleasant interpersonal decisions. Another part of the reason…is that people in responsibility positions lend themselves to overload, and perhaps role conflict and ambiguity as well’.

o Relationships at work

 Selye (174) suggested that learning to live with other people is one of the most stressful aspects of life.

 Lazarus (166) suggested that supportive social relationships with peers, supervisors and subordinates at work are less likely to create interpersonal pressures, and will directly reduce levels of perceived job stress. Poor relationships include low trust, low supportiveness, and low interest in listening and trying to deal with problems that confront the organisational members.

 Mistrust of fellow workers is connected with high role ambiguity, poor communications, and psychological strain in the form if low job satisfaction and to feelings of job related threat to ones well-being.

o Relationship with superiors

 Problems with emotional disability often result when the relationship between a subordinate and a boss is psychologically unhealthy for one reason or another.

 Buck (17) focused on the relationship of workers to an immediate boss and found that when the boss was perceived as ‘considerate’, there was ‘friendship, mutual trust, respect and certain warmth between boss and subordinate’. Workers who stated that their boss was low on ‘consideration’ reported feeling more pressured. Those under pressure reported that their bosses did not give them criticism in a helpful way, played favourites and pulled rank and took advantage of them whenever they had a chance.

o Relationship with subordinates

 Ways in which a manager supervises the work of others has always been considered a critical aspect of his or her work. For instance, the inability to delegate has been a common criticism levelled against some managers.

o Relationship with colleagues

 Stress among co workers can arise from the competition and personality conflicts usually described as ‘office politics’.

 Most people spend so much time at work, the relationships among co-workers can provide valuable support, or conversely can be a huge source of stress.

 French & Caplan (17) found that strong social support from co-workers eased job strain.

o Career development

 A host of issues can act as potential stress factors throughout ones working life.

 Lack of job security, fear of redundancy, obsolescence of retirement, and numerous performance appraisals can cause pressure and strain.

o Organisational climate and structure.

 Organisation workers sometimes complain that they don’t have a sense of belonging, lack adequate opportunities to participate, feel their behaviour is unduly restricted and are not included in office communications and consultations.

 Workers who are allowed more participation in decision-making produce more and have a higher job satisfaction.

 Non-participation at work can be a significant predictor of strain and job related stress, relating to general poor health, drinking, depression, low self-esteem, absenteeism and plans to leave work.

 Participation in decision making process on the part of the individual help increase his or her feeling of investment in the company’s success, create a sense of belonging and improve communication channels within the organisation.

Indicators that there may be stress.

- Stress can be caused by certainty or uncertainty.

All sources of stress have an effect on individuals

Raised blood pressure, High absenteeism,

Depressed mood, High labour turnover,

Excessive smoking, Poor quality control,

Coronary heart disease, Long strikes/disputes

Mental illness. Accidents & apathy.

- Cognitive - Transactional Model

o Seyles assumed that stress depended only on the intensity of the stressor.

o Lazarus proposed that a mental process determines whether stress occurs � Appraisal

- Lazarus & Folkman (184)

o Propose that the interpretation of stressful events is more important than the events themselves

o It is neither the environmental event nor the person’s response that defines stress

o It is the individual’s perception of the psychological situation that defines stress

o Stress is a function of the person’s feeling of threat, vulnerability, and ability to cope rather than a function of the stressor

o Distinguish three kinds of appraisal

- (1) Primary appraisal � is stressor negative?

o Can be negative if it involves harm or loss, threat or challenge (chance to grow).

Y No No Stress

- () Secondary Appraisal � Can I control the situation?

o Concerned with a person’s evaluation of his/her ability to cope with the situation

o If coping resources are adequate then options can be considered problem-focused or emotion-focused coping strategies.

o Reappraisal

 continuous reappraisal on the basis of new information

 identical to the initial process

 may lead to more stress

- () Coping

- Lazarus and Folkman (184)

o Constantly changing cognitive and behavioural efforts to manage specific internal and/or external demands that are appraised as taxing or exceeding the resources of the person

- Several important elements of the definition

o Coping is a process of constant evaluation of the degree of success of one’s strategies

o Coping is learned as one encounters situations

o Coping requires effort

o Coping is an effort to manage. Success is not contingent on mastery, just good enough

- Problem Focussed Coping

o a response aimed at reducing, modifying or eliminating a source of stress.

o consists of changing the situation

o defining the problem

o looking at alternative solutions

o evaluating the implications of the alternatives

o choosing the best one to act on

o Employee coping strategies

 Time Management,

 Getting Help From a Mentor,

 Role Negotiation (The process through which workers actively try to change their roles in order to reduce role conflict, role ambiguity, or overload)

o Organisational coping strategies

 Job Redesign and Rotation

 Reduction of Uncertainty

 Job Security

 Company Day Care

 Flexible Work Schedules and Job Sharing

- Emotion-focussed coping

o A response aimed at reducing the emotional impact of the stressor.

o consists of controlling and possibly changing the emotional response to an event

o cognitive responses such as avoidance or minimization

o the goal is to decrease emotional distress

o often used when the individual feels that nothing can be done about the situation

o Employee coping strategies Organisational coping strategies

 Exercise - On-Site Exercise Facilities

 Meditation - Employee Assistance Programs

 Social Support - Personal Days and Sabbaticals

 Clinical Counselling

 Non-functional Strategies

- Model of stress management intervention

o DeFrank & Cooper (187) stated that stress interventions can focus on the individual, the organisation or the individual-organisational interface.

o Murphy (188) emphasised that there are levels of intervention

 Primary, or reducing the sources of organisational stress;

 Secondary, or stress management training; and

 Tertiary, or health promotion and workplace counselling.

o Cooper & Cartwright (14) highlighted, that most workplace initiatives operate at the secondary or tertiary levels, which focus on stress management training or counselling.

o EAP � tend to be ‘employee’ rather than ‘organisation’ directed strategies whereby the focus is directed at changing the behaviours of individuals and improving their lifestyles and/or stress management skills.

- Employee Assistance Programme (EAP) and Stress management training

o EAP, usual refers to a counselling service provided for employees, most often by outside providers.

o While organisation-directed interventions are attempting to eliminate the source of job or organisational stress, the focus of most workplace stress initiatives has been directed at helping employees as individuals learn to cope with any stressors.

o This can be achieved by improving the adaptability of individuals to their environment by changing their behaviour and improving their lifestyles or stress management skills.

o There is a notion that the organisation and its working environment will not change, therefore, the individual has to learn ways of coping which helps him or her to ‘fit’ in better.

o An EAP can take various forms. Involves the provision of on-site fitness facilities, dietary control, relaxation classes or stress and health education, but most often psychological counselling.

o EAP’s have proved more popular with organisations than primary-level interventions or dealing with the sources of the job/organisational stress.

o Studies by Cooper & Sadri (11) have assessed the impact of psychological counselling and has shown that there is a significant improvement in mental health and absenteeism of counselled employees, but little change in levels of organisational commitment and job satisfaction.

o If initiatives have little impact on improving job satisfaction, then it is more likely that the individual will adopt a way of coping which may have positive individual outcomes, but possibly negative implications for the organisation.

- Changing the sources of workplace stress

o Elkin & Rosch (10) summarised a range of possible organisation-directed strategies to reduce stress

 Redesign the task and work environment

 Establish flexible work schedules

 Encourage participative management

 Include the employee in career development

 Analyse work roles and establish goals

 Provide social support and feedback

o Strategies are directed at increasing employee participation and autonomy.

o Secondary and tertiary level interventions may be useful in improving and extending an individual’s coping strategies and social support, but do not directly address the important issue of control in the workplace.

o Dale, Cooper & Wilkinson (18) found that quality circle programmes, represent the ultimate form of employee involvement, have shown to impact favourably upon productivity and employee attitudes.

o Cartwright & Cooper (14) found that a healthy work environment are those which

 Levels of stress are low;

 Organisational commitment and job satisfaction are high;

 Sickness, absenteeism and labour turnover are below the national average;

 Industrial relations are good and strikes/disputes are infrequent;

 Safety and accident records are good.

o Healthy organisation can be defined as an organisation characterised by both financial success (i.e. profitability) and a physically and psychologically healthy workforce, which is able to maintain over time a healthy and satisfying work environment and organisational culture.

o ‘Healthy’ organisation, which has been successful in creating and maintaining a healthy and relatively stress-free environment, will be an organisation in which stress management and counselling are unnecessary.

o Dealing with the job and organisational sources of stress requires job redesign, flexible working arrangements, a supportive corporated culture and better organisational communication.

- Dealing with workplace stress a problem-solving framework

o Step 1 � being aware and accepting that a problem exists

 Awareness by individual and the organisation that stress is a feature of modern working life, which at some time or other everybody is likely to experience, irrespective of their position in the organisation, and furthermore, that it is not necessarily a reflection of their incompetence.

 Important that an individual is able to ‘tune in’ to the problem and recognise his or her own stress symptoms early in the stress process, and that the organisation seeks to create a climate which is perceived to be openly supportive.

 Organisation’s can monitor the variety of behavioural indices and provide training in symptom recognition and basic counselling skills for supervisors and managers to help employees.

o Step � identifying the problem/stressor and attempting to eliminate it or change it

 Individual level � stressor identification can be achieved by the maintenance of a stress diary � using the information to reveal themes, patterns and help individual to identify specific problems or problem area.

 Can develop action plans to eliminate the source of the stress or change or modify it. For example, if boss is undermining you then you can choose to confront or avoid it or leave the job.

 By cataloguing responses and ways of coping and reviewing these with benefit of retrospection, the individual can

• Identify areas where his or her coping skills could be improved

• Develop a repertoire of successful contingency-based coping methods, which can be applied to similar situations in the future.

 Organisational level � stress audits can be used to assess and monitor employee health and well-being, and identify the sources of stress, which may be operating at an organisation-wide, departmental or work group level.

 Occupational Stress Indicator (OSI) � incorporate personality measures of Type A behaviour, locus of control, and employee coping strategies.

 Different stressor � different organisational solutions.

• E.g. eliminating or reducing stressors relating to factors intrinsic to the job may involve ergonomic solutions to the problem of poorly designed equipment, whereas if a significant source of stress among employees relate to career issues, introduction of regular appraisals, career counselling or retraining opportunities.

 Diagnostic stress audits can be advantageous in terms of directing organisations to areas when they can engage in anticipatory coping strategies and arrest the stress process before it has a negative impact on employee health manifests itself.

• For example, where stress levels among employees are high, baseline outcome measures of physical and mental health and job satisfaction are comparable with normative data.

o Step � change the problem/stressor in a way that provides a solution which is mutually beneficial

 Step and go together.

o Step 4 � if the problem/stressor cant be changed, then find ways of coping with it

 There are certain stressor which neither the individual or organisation is able to change, but which have to be coped with in the conventional sense.

 It is important to recognise that all of the stress which influences the workplace is not necessarily or exclusively caused by the work environment.

 Financial crisis, bereavement, marital difficulties and other personal life events create stress, the effects of which often spill over into the workplace.

 Tertiary level interventions such as counselling can be effective in dealing with non-work-related stress.

o Step 5 � monitor and review the outcome

 Maintaining a stress diary helps individual to review the efficiency of his or her own coping strategies.

 Stress audits can provide a baseline measure whereby the introduction of any subsequent stressor reduction technique implemented by an organisation can be evaluated.

 Stressor reduction provides the most effective means of tackling the problem of occupational stress.

 The more successful the organisation is in eliminating or modifying environmental stressors, the less demand there would be for stress management training and EAP.

- Managing stress at work requires a stage by stage approach identifying a problem, intervening to change it or find ways of coping with it, and monitoring and reviewing progress.

- Summary.

o The experience of stress is composed of environmental sources, or stressors, immediate physiological responses and short-term and long-term outcomes or strains.

o The physiological responses present a paradox because although they are adaptive in the short-term they can be very destructive as chronic responses to stress.

o The perception of stress or cognitive appraisal also occupies the central role in the stress experience.

o The organisation itself can be a source of stress, particularly lower level jobs, and jobs in service professions, such as law enforcement and medicine.

o Environmental stressors, such as noise and heat are common stressors for many blue collar workers.

o The work role based stressors, role conflict and ambiguity have all been associated with strains.

o Regardless of whether a worker experiences environmental or organisational stressors or both, all workers are subject to various sources of non-work stressors, i.e. financial problems, marital problems etc…Stressors apart from work settings are believed to influence or spill over into work and vice versa.

o Job-related stressors are considered to e associated with health problems and Type A behavioural patterns and attitudes.

o People cope with stress in a variety of ways.

o Coping strategies can be proactive and take-charge or escapist and avoidant. These strategies have often been the focus of stress management programs in industry that typically target the individual or the organisation as the focus of change.

o Individual stress managements include exercise, relaxation/meditation, EAP

o Organisational stress management include work group interventions (Team building), and structural interventions such as participative management and job or task redesign.

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