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Occupational health: Stress at the workplace

Work-related stress is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope. Stress occurs in a wide range of work circumstances but is often made worse when employees feel they have little support from supervisors and colleagues, as well as little control over work processes. There is often confusion between pressure or challenge and stress, and sometimes this is used to excuse bad management practice.

Pressure at the workplace is unavoidable due to the demands of the contemporary work environment. Pressure perceived as acceptable by an individual may even keep workers alert, motivated, able to work and learn, depending on the available resources and personal characteristics. However, when that pressure becomes excessive or otherwise unmanageable it leads to stress. Stress can damage an employees' health and the business performance.

Work-related stress can be caused by poor work organization (the way we design jobs and work systems, and the way we manage them), by poor work design (for example, lack of control over work processes), poor management, unsatisfactory working conditions and lack of support from colleagues and supervisors.

Research findings show that the most stressful type of work is that which values excessive demands and pressures that are not matched to workers’ knowledge and abilities, where there is little opportunity to exercise any choice or control, and where there is little support from others.

Workers are less likely to experience work-related stress when demands and pressures of work are matched to their knowledge and abilities, control can be exercised over their work and the way they do it, support is received from supervisors and colleagues, and participation in decisions that concern their jobs is provided.

Stress related hazards at work can be divided into work content and work context.

Work contents includes job content (monotony, under-stimulation, meaningless of tasks, lack of variety, etc); work load and work pace (too much or too little to do, work under time pressure, etc.); working hours (strict or inflexible, long and unsocial, unpredictable, badly designed shift systems); and participation and control (lack of participation in decision-making, lack of control over work processes, pace, hours, methods, and the work environment).

Work context includes career development, status and pay (job insecurity, lack of promotion opportunities, under- or over-promotion, work of low social value, piece rate payment schemes, unclear or unfair performance evaluation systems, being over- or under-skilled for a job); the worker’s role in the organization (unclear role, conflicting roles); interpersonal relationships (inadequate, inconsiderate or unsupportive supervision, poor relationships with colleagues, bullying/harassment and violence, isolated or solitary work, etc.); organizational culture (poor communication, poor leadership, lack of behavioural rule, lack of clarity about organizational objectives, structures and strategies); and work-life balance (conflicting demands of work and home, lack of support for domestic problems at work, lack of support for work problems at home, lack of organizational rules and policies to support work-life balance).

Raising awareness of stress at work in developing countries
Work organization and stress
Psychosocial RIsk MAnagement – European Framework (PRIMA-EF)
Raising awareness of harassment at work

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Occupational Health Psychology: From Burnout to Well-being at Work

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This Research Topic focuses on Occupational Health Psychology (OHP) – the branch of psychology that emerged out of two applied disciplines within psychology: health psychology and industrial/organizational psychology. It involves the application of psychological principles and practices in promoting quality ...

Keywords : Occupational health psychology, burnout, engagement, stress, well-being, work, working conditions, changes, COVID-19, working-from-home

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Occupational Stress and Health: Psychological Burden and Burnout

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section " Occupational Safety and Health ".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 154820

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A growing body of empirical evidence shows that occupational health is now more relevant than ever due to the COVID-19 pandemic. Occupational stress in health-care workers has attracted the attention of many researchers. In addition, other professionals have also experienced major changes in the workplace (e.g., teleworking). A Special Issue on occupational health is both timely and necessary in order to acquire a greater understanding of recent developments and studies in this field, and to identify and analyze best practices. This Special Issue aims to provide a comprehensive approach to occupational health from a broad range of perspectives. For instance, leadership is a relevant variable to consider as employees’ perception about their superiors’ particular leadership style is related to their well-being at work. Other recommended topics may include (but are not limited to) the following:

Work and organizational psychology;
Occupational health (with a focus on promotion);
Psychosocial risk factors at work settings (with a focus on prevention);
Work-related stress;
Burnout and related variables (e.g., exhaustion, cynicism, detachment from the job, professional self-efficacy);
Employees wellbeing and key indicators (e.g., work engagement);
Absenteeism, presenteeism, and work addiction;
How to create and promote healthy organizations.

We welcome submissions addressing these topics, especially quantitative papers combining advanced methodology and a high academic standard together with practical implications in organizational settings.

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Characteristics of Publications on Occupational Stress: Contributions and Trends

Affiliations.

1 Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
2 Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
3 Department of Environmental Health and Occupational Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
4 Department of Occupational Hazard Assessment, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
PMID: 34211952
PMCID: PMC8239141
DOI: 10.3389/fpubh.2021.664013

This study aimed to analyze the bibliometric characteristics of the publications on occupational stress and highlight key research topics and future trends. The Web of Science Core Collection database was searched to collect publications on occupational stress, from inception to December 9, 2020. Two authors independently screened eligible literature and extracted the data. Bibliometric analyses were performed using VOSviewer 1.6.6 and R 3.6.3 software. Overall, 6,564 publications on occupational stress were included. "Stress," with a total link strength of 1,252, appeared as the most co-occurrence keyword, followed by "occupational stress," "job stress," and "job satisfaction." All studies were published between 1956 and 2020. Among them, 6,176 (94.35%) papers were written in English, and 4,706 (70.25%) were original articles. The top three Web of Science categories were "public environmental occupational health" ( n = 1,711), "psychology, applied" ( n = 846), and "psychology, multidisciplinary" ( n = 650). The 100 top-cited articles were mentioned a total of 36,145 times, with a median of 361, ranging from 174 to 5,574. The United States was the most productive country, with 1,780 publications. The main partners of the United States were England and China. Three themes of occupational stress research were identified: job satisfaction, burnout, and occupational stress-related health problems. This bibliometric analysis provides a comprehensive understanding of the trends and most influential contributions to the field of occupational stress, thus promoting ideas for future research.

Keywords: bibliometric analysis; citation; occupational stress; top-cited; work related.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Published: 24 August 2024

Sociodemographic and work-related factors associated with psychological resilience in South African healthcare workers: a cross-sectional study

Thandokazi Mcizana ORCID: orcid.org/0009-0002-4078-1991 1 ,
Shahieda Adams ORCID: orcid.org/0000-0002-3630-1855 2 ,
Saajida Khan ORCID: orcid.org/0009-0001-8454-2215 2 , 3 , 4 &
Itumeleng Ntatamala ORCID: orcid.org/0000-0001-9799-0132 2

BMC Health Services Research volume 24 , Article number: 979 ( 2024 ) Cite this article

120 Accesses

Metrics details

Psychological resilience facilitates adaptation in stressful environments and is an important personal characteristic that enables workers to navigate occupational challenges. Few studies have evaluated the factors associated with psychological resilience in healthcare workers.

To determine the prevalence and factors associated with psychological resilience in a group of South African medical doctors and ambulance personnel.

Materials and methods

This analytical cross-sectional study used secondary data obtained from two studies conducted among healthcare workers in 2019 and 2022. Self-reported factors associated with resilience, as measured by the Connor-Davidson Resilience Scale-10 (CD-RISC-10), were evaluated. R statistical software was used for analysing the data and performing statistical tests.

A total of 647 healthcare workers were included in the study, of which 259 were doctors and 388 were ambulance personnel. Resilience scores were low overall (27.6 ± 6.6) but higher for ambulance personnel (28.0 ± 6.9) than for doctors (27.1 ± 6.0) ( p = 0.006). Female gender (OR 1.94, 95%CI 1.03–3.72, p = 0.043), job category (OR 6.94 95%CI 1.22–60.50, p = 0.044) and overtime work (OR 13.88, 95%CI 1.61–368.00, p = 0.044) significantly increased the odds of low resilience for doctors. Conversely, salary (OR 0.13, 95%CI 0.02–0.64, p = 0.024) and current smoking status (OR 0.16, 95%CI 0.02–0.66, p = 0.027) significantly reduced the odds of low resilience amongst doctors. In addition, only previous alcohol use significantly reduced the odds of low resilience for ambulance personnel (OR 0.44, 95%CI 0.20–0.94, p = 0.038) and overall sample (OR 0.52, 95%CI 0.29–0.91, p = 0.024).

Conclusions

Resilience was relatively low in this group of South African healthcare workers. The strong association between low resilience and individual and workplace factors provides avenues for early intervention and building resilience among healthcare workers.

Peer Review reports

Introduction

The healthcare systems of most low- and middle-income countries (LMICs) are under severe strain due to high patient load, significant burden of communicable and noncommunicable diseases, lack of human and financial resources, the brain drain phenomenon, corruption and poor administration [ 1 , 2 , 3 , 4 ]. South Africa, an upper middle-income country, faces similar challenges, with a quadruple burden of disease including HIV/AIDS and tuberculosis, high maternal and child mortality, high levels of violence and injuries and noncommunicable diseases [ 5 ]. Poor health outcomes and a disproportionate distribution of healthcare resources in the country may be ascribed to the legacy of an undemocratic political apartheid regime (1948–1993) compounded by ongoing challenges in managing the health system in a post-apartheid South Africa [ 4 , 5 ]. In 2021, for example, South Africa had a doctor-patient ratio of 80 physician per 100,000 people in South Africa, which is lower than the average in upper middle-income countries of 210 physicians per 100,000 people [ 6 ]. South Africa’s government is currently in the process of implementing a National Health Insurance (NHI) scheme to address the tremendous challenges that plague the health system [ 2 ]. However, the country’s preparedness remains uncertain, especially given the ongoing shortage of healthcare worker posts and rising unemployment in the health sector [ 5 , 7 ]. These challenges place immense pressure on employed healthcare workers, making psychological resilience an important inherent ability that can aid in supporting and protecting healthcare workers against adverse mental health outcomes and contributing to improved service delivery.

Psychological resilience is an important personal characteristic that enables healthcare workers to navigate the challenges encountered in their occupation [ 8 ]. Herrman and colleagues explored the evolution of the term in their narrative review and concluded that fundamentally, resilience is the ‘inherent ability’ for one to adapt positively following adversity or stressful events [ 9 ]. As such, psychological resilience describes an individual’s coping mechanism, optimism, self-efficacy, high levels of hope and thriving mental health amid adversity and challenging circumstances [ 10 ]. Research on the role of psychological resilience as a protective factor in frontline healthcare workers has increased recently during the coronavirus disease (COVID-19) pandemic [ 11 ]. Much of the research in this area has been conducted in high-income countries (HICs) and China, and little is known about the factors that predict psychological resilience in workers in LMICs, including South Africa [ 11 ]. A systematic review on resilience among primary healthcare workers, found that most research on the topic primarily frames resilience as an explanatory variable in relation to burnout [ 12 ]. This study therefore aimed to determine the prevalence, and factors associated with psychological resilience of healthcare workers practising in the South African healthcare system.

Study design and setting

This is an analytical cross-sectional study using secondary data obtained from two cross-sectional studies of healthcare workers in South Africa. The first study on post-traumatic stress disorder (PTSD) included ambulance personnel employed by the Western Cape Department of Health, and data was collected between 15 November 2019 and 17 January 2020 [ 13 ]. This study included 388 responses out of approximately 2000 ambulance personnel. The second study on burnout included medical doctors employed in three public sector hospitals in the Eastern Cape province, and data was collected between 1 April and 31 May 2022 [ 14 ]. This study included 260 responses out of 430 doctors. The present study included data of all healthcare workers who had completed the Connor-Davidson Resilience Scale-10 (CD-RISC-10) questionnaire and relevant sociodemographic and occupational questions.

Measurements

This study used secondary data generated from self-administered questionnaires that consisted of sociodemographic factors, work-related factors, and the CD-RISC-10 questionnaire.

Sociodemographic and work-related factors

The data obtained from the questionnaires included self-reported information on age, gender, language, marital status, job category, professional qualifications, overtime work, salary, and length of service. In addition, data on mental health and medical history, including self-reported mental health conditions and substance use (smoking, alcohol use, illicit and prescription drugs), year of debut, and the use of substances to manage work-related stress, were obtained.

Psychological resilience (outcome variable) was measured using the 10-item CD-RISC questionnaire. The CD-RISC-10 is a self-administered 10-item questionnaire, which is a shorter version of the CD-RISC-25. Participants identified their adaptive behaviours in stressful situations and scored them on a 5-point Likert scale (0 = not at all true, 4 = true nearly all the time) [ 15 ]. The resulting scores ranged between 0 and 40. This scale has previously been reported to be a reliable and efficient measure of psychological resilience for adults [ 16 ]. In addition, it has previously been validated for use in South Africa by Pretorius and Padmanabhanunni as a measure of psychological resilience and has been used in several studies of South African healthcare workers [ 3 , 13 , 14 , 17 , 18 , 19 ]. Written permission to use the scale was previously obtained [ 13 , 14 ].

Data analysis

After ethical approval, the secondary data were received and cleaned in password-protected Microsoft Excel. R statistical software (version 4.3.1) was used for analysing the data and performing the statistical tests. Descriptive statistics for continuous variables in this study are presented as the means (standard deviations) and medians (interquartile ranges) where appropriate. In addition, descriptive statistics for categorical variables are presented as proportions.

Mann‒Whitney and Kruskal‒Wallis tests were used to determine significant differences in CD-RISC-10 scores. In addition, unadjusted logistic regression and adjusted logistic regression (adjusted for age and gender) were performed. Low resilience, as an outcome measure, was defined as a CD-RISC-10 score less than 25.5 [ 20 ]. Variables from the adjusted logistic regression analysis with a p value less than 0.250 were selected for the multivariable logistic regression model to investigate factors associated with increased resilience score. The odds ratios (OR), 95% confidence intervals (95%CI) and p values (p) were calculated for both the univariable and multivariable analyses. A p value of less than 0.050 was considered the cut-off point for statistical significance.

Missing data

Only the age factor had missing data of more than 1% of the total recorded values and thus necessitated imputation (see Supplementary Table S1 and Supplementary Fig. S1 online). Age is also important when performing this regression analysis, as age has previously been reported to be an important confounder of psychological resilience and needs to be adjusted for when performing regression analysis [ 11 , 21 , 22 , 23 ]. Multiple imputation was chosen because it results in valid statistical inferences [ 24 ]. To assess the sensitivity of the results with respect to the multiple imputation method chosen, multiple imputation using the three methods available in the Multivariate Imputation by Chained Equation (MICE) package in R were performed (see Supplementary Table S2 online). The imputed data from the Classification and regression tree (CART) method was chosen for use in the following regression analysis, given its minimal impact on the distribution of the age factor. Supplementary Fig. S2 shows the distribution of the age factor before and after CART imputation.

From the original datasets received (648 records), only one record was removed because the participant indicated that they were gender nonconforming, resulting in several skewed results. In total therefore, 647 observations were included in the present analysis, of which 259 were from doctors and 388 were from ambulance personnel.

Sociodemographic and work-related characteristics

Among the 259 doctors, the majority, 150 (57.9%) were female, while most ambulance personnel, 213 (54.9%) were male (Table 1 ). Most of the doctors, 171 (66.0%) were English speaking and 110 (42.5%) were in the 20–29 years age group, while most of the ambulance personnel, 178 (45.9%) were Afrikaans speaking and, 144 (37.1%) were in the 30–39 years age group. Doctors’ years of service in the current role were lower, with a median of 2 (IQR: 4), while ambulance personnel had a median of 7 (IQR: 9). A greater percentage of doctors, 251 (96.9%) reported working overtime than, 266 (68.6%) ambulance personnel.

Substance use, mental health, and work-related stress management

The prevalence of smoking was greater among ambulance personnel, 118 (30.4%) than among, 23 (8.9%) of doctors, while current alcohol usage was 166 (64.1%) for doctors, greater than 200 (51.5%) for ambulance personnel (Table 2 ). Only 18 (2.8%) of the overall sample reported current use of illicit substances or drugs. A quarter of the doctors, 65 (25.1%), reported having been diagnosed with a mental health condition compared to 43 (11.1%) of the ambulance personnel. In addition, 45 (17.4%) of doctors reported being on treatment for a mental health condition, compared to, 28 (7.2%) of ambulance personnel.

Regarding managing work-related stress (WRS), more than a quarter, 103 (26.5%) of the ambulance personnel self-reported the need to smoke to manage WRS, while 53 (20.5%) of the doctors reported the need to use alcohol to manage WRS. Interestingly, 29 (4.5%) of the overall sample felt the need to use illicit drugs to manage WRS, which is higher than the current prevalence of illicit drug use. Most participants supported the provision of psychological counselling, 492 (76.0%) and addressing staff shortages, 483 (74.7%) to assist with reducing WRS.

Prevalence of resilience

The overall average CD-RISC-10 score was 27.6 (± 6.6) among the 647 healthcare workers in this study (Table 2 ). The average CD-RISC-10 score for the ambulance personnel was 28.0 (± 6.9), which was significantly higher than the average score of 27.1 (± 6.0) for the doctors ( p = 0.006). The total score for the CD-RISC-10 can be classified into a 4-level variable using quantiles: lowest (0–24), low (25–28), moderate (29–32), and highest (33–40) [ 15 ]. More than half of the doctors (58.7%) were classified as having the lowest or low resilience. However, for ambulance personnel, the majority (54.2%) were classified as having moderate or high resilience.

Factors associated with resilience

Bivariable analysis was performed to examine differences in CD-RISC-10 scores across several sociodemographic and work-related variables (Table 3 ). Compared with female doctors, male doctors had significantly greater resilience scores ( p < 0.001). Those in certain job categories, such as senior doctors and ambulance personnel, had significantly greater resilience than did junior doctors ( p = 0.019). In addition, doctors who earned in the highest salary bracket demonstrated greater resilience than did those who earned less ( p = 0.020). Doctors who were current smokers had greater resilience (30.7) than those who had never smoked (27.2) or were previous smokers (26.7) ( p = 0.012). In addition, a history of alcohol use significantly increased resilience for ambulance personnel (30.5) compared to current users (27.6) and never users (27.1) ( p = 0.002). Participants who self-reported as having been diagnosed with a mental health condition had significantly lower resilience scores compared to those who have not, for doctors ( p = 0.037), ambulance personnel ( p = 0.010) and overall sample ( p < 0.001). In addition, ambulance personnel and the overall sample currently on treatment for a mental health condition had significantly lower resilience scores ( p = 0.029 and p = 0.002 respectively). Lastly, participants who felt the need to drink alcohol to manage WRS had significantly lower resilience scores amongst doctors ( p = 0.034), ambulance personnel ( p = 0.048) and overall sample ( p = 0.002).

Unadjusted (see Supplementary Table S3 online) and adjusted (Supplementary Table S4 online) logistic regression analyses were also performed. Table 4 below provides the results from the multivariable logistic regression analysis performed with selected variables with p value less than 0.25 from Supplementary Table S4 online. For doctors, female gender, job category and overtime work significantly increased the odds of low resilience (OR 1.94, 95%CI 1.03–3.72, p = 0.043; OR 6.94, 95%CI 1.22–60.50, p = 0.044 and OR 13.88, 95%CI 1.61–368.00, p = 0.044 respectively) (Table 4 ). Conversely, salary and current smoking status significantly reduced the odds of low resilience amongst doctors (OR 0.13, 95%CI 0.02–0.64, p = 0.024 and OR 0.16, 95%CI 0.02–0.66, p = 0.027 respectively). In addition, for ambulance personnel and overall sample, only previous alcohol use significantly reduced the odds of low resilience (OR 0.44, 95%CI 0.20–0.94, p = 0.038 and OR 0.52, 95%CI 0.29–0.91, p = 0.024 respectively). It should also be noted that the results from the multivariable logistic analysis reported in Table 4 are consistent with the results from the bivariable analysis in Table 3 .

This study aimed to estimate the prevalence of resilience and determinants of psychological resilience among a group of healthcare workers in South Africa comprising doctors and ambulance personnel.

The study found the prevalence of psychological resilience among healthcare workers was relatively low, at 27.6 (± 6.6). The average score of the ambulance personnel (28.0 ± 6.9) was greater than that of the doctors (27.1 ± 6.0). Kang and colleagues reported an overall average score of 29.0 (± 6.8) for a group of ambulance personnel in China, which is higher than the overall average score obtained in this study [ 25 ]. A study comparing doctors and ambulance technicians in Spain, reported an overall average score of 30.6 (± 5.0), which was higher than that obtained in the present study [ 26 ]. A longitudinal study on healthcare workers in South Africa reported average scores of 26.7 (± 8.8) and 30 (± 6.7) for the two time points considered [ 3 ]. The average resilience score for the second time point of the longitudinal study was greater than that of the present study. Furthermore, two studies on Malaysian healthcare workers reported overall average scores of 28.6 (± 6.3) and 30.0 (± 6.3), respectively, both of which were higher than those in the present study [ 22 , 27 ]. Zhou and colleagues, however, reported an overall average score of 23.2 (± 9.3) in their study of Chinese resident doctors, which is lower than that obtained in the present study [ 28 ]. This variability in the level of resilience observed may be due to differences in the study context (population sampled, time when the study was conducted), resources available in the healthcare system and differences in cultural values and norms, which may result in different coping styles among healthcare workers [ 5 ]. Overall, the results from this study were consistent with results from comparative studies on the resilience of healthcare workers when considering the standard deviations reported.

The study revealed a statistically significant association between psychological resilience and gender, with females having significantly lower resilience than males. These results are consistent with previous studies on psychological resilience showing that female gender is associated with lower resilience scores [ 12 , 22 , 29 , 30 ]. This could be attributed to females assuming multiple roles at home and in the workplace, experiencing more emotional exhaustion and being more sensitive and susceptible to stress [ 12 , 29 ]. The difference could also be due to social desirability bias, with males answering in a way that portrays an image of being able to manage pressure better [ 22 ].

We observed that doctors who were current smokers had greater average resilience scores than did those who were previous smokers and those who had never smoked before. These results contrast with the results of previous studies in which current smokers were found to have significantly lower psychological resilience [ 31 ]. It is probable that current smoking may be reflective of a coping mechanism and could mask low levels of resilience among current smokers. Substance use and medication use have been used as maladaptive coping mechanisms to address mental health issues and work-related stress [ 14 , 32 ].

Similarly, in ambulance personnel and the overall sample, a significant relationship was found between psychological resilience and alcohol history, with previous alcohol users having reduced odds of low resilience. Guidelines for rehabilitation programs (alcohol and smoking) consider improving resilience to be necessary for preventing substance use onset, abuse problems and relapse [ 31 , 33 , 34 ]. In addition, Yamashita and colleagues reported that a lower relapse risk was associated with greater resilience [ 35 ]. It is also probable that previous alcohol use may be reflective of a coping mechanism and could mask low levels of resilience among previous alcohol users.

This study found no significant associations between psychological resilience and other sociodemographic or lifestyle factors, such as age, home language and relationship status. This is consistent with the results of previous research on resilience [ 18 , 36 , 37 ].

Years in the current role and professional qualifications were not found to be significant predictors of the CD-RISC-10 score in the present study. Wang and colleagues argued that senior healthcare workers have better experience and professional skills to address complex situations that arise in the workplace [ 21 ]. Previous researchers have reported that years in practice was positively associated with psychological resilience [ 20 , 23 ]. Afshari and colleagues noted that an increase in healthcare workers’ education and work experience may be linked to the progression of skills, which results in the development of positive coping strategies, leading to greater resilience [ 38 ]. Herman and colleagues noted that these inconsistencies observed between psychological resilience and predictive factors may be due to differences in study methodologies and the definition of resilience used by the investigators [ 9 ].

Notably, the average resilience of ambulance personnel was significantly greater than that of doctors in this study, similar to the findings of Mantas-Jiménez and colleagues, who compared doctors and ambulance technicians in Spain [ 26 ]. This could be attributable to the social demographic and work-related characteristics of ambulance personnel compared to doctors in the study. Ambulance personnel were older and mostly male, had longer years of service and worked less overtime compared to the doctors. Organisational factors such as the culture within the ambulance service could be different to the medical hospital-based environment. These factors have all been reported previously as factors associated with higher resilience for healthcare workers [ 11 ].

Overtime work was found to be significant negatively associated with resilience among doctors in the present study. These results are in line with the interventions recommended by the healthcare workers in the present study to reduce WRS, with most of the participants indicating that addressing staff shortages was important for reducing WRS. A study on nurses in China, also found that working longer hours a day resulted in significantly lower psychological resilience [ 39 ]. However, Rossouw and colleagues did not find any significant relationship between resilience and overtime hours in their study of healthcare workers in South Africa [ 18 ]. High workload and occupational stressors were likely to lead to low job satisfaction, poor work performance and high job turnover for healthcare workers, resulting in a vicious cycle and ultimately leading to burnout and low resilience [ 30 ].

The present study revealed a significantly negative association between psychological resilience and self-reported mental health conditions and treatment for mental health conditions for the overall sample. Past research on resilience has found that psychological resilience has been identified to have a protective role against mental health issues [ 40 , 41 ]. A study on Indonesian medical students, reported that higher resilience was moderately correlated with lower scores for depressive and anxious symptoms [ 42 ]. In addition, Keragholi and colleagues, in their study of Iranian ambulance personnel, also reported that mental health status was negatively associated with resilience [ 40 ]. A study on South African healthcare workers reported that healthcare workers using medication or other forms of treatment for their anxiety or depression symptoms had significantly lower resilience than did those not using medication [ 18 ]. Furthermore, stigma and denial related to mental health might impact the ability of healthcare workers to seek help, which could also lead to underreporting in research studies [ 18 ].

The resilience score of participants who reported needing to use alcohol to manage WRS was significantly lower than that of participants who reported not needing to use alcohol. In addition, the preference of most participants (76.7%) was for the provision of psychological counselling as an intervention that could be provided by institutions to assist with reducing WRS. This is a positive coping strategy compared to substance use, which is recognised as a maladaptive coping mechanism used by those with mental health issues or WRS [ 32 ]. In addition, resilience interacts with stress to impact on the development of addiction and relapse [ 33 ]. Other studies have also identified the protective role of psychological resilience on WRS [ 43 ].

Strengths and limitations

The primary strength of this study was that it included a large population of healthcare workers in South Africa. In addition, both previous surveys used to collect data for this study had good response rates. The study also used a validated and standardised questionnaire to measure the outcome variable, which provides an opportunity to compare the results of this study with those of previous studies.

This study had several limitations. First, as a secondary data analysis was undertaken, the information available was limited to what had been provided and collected from the previous two studies. Second, causation cannot be inferred via a cross-sectional study design, and the risk factors identified need to be interpreted accordingly. Third, as self-reported data were used, the risk of social desirability bias was high, as respondents may have been influenced by stigma associated with substance use and mental health. In addition, recall bias may have occurred during the initial data collection phase where the participants’ memory was relied upon. Most questions used in this study, however, did not require recall over many months. Fourth, selection bias was largely unavoidable, as participation in the surveys was voluntary, and those who had been experiencing problems such as PTSD or burnout may have been more likely to complete the survey, as PTSD and burnout were the focus of the primary studies. In addition, confidentiality concerns may also affect participation and contribute to bias. The initial investigators had put in place measures to mitigate this bias, including introductory letters to explain the data handling procedure and the preservation of confidentiality. Last, the healthy worker effect may result in the overestimation of healthcare workers’ resilience status since those with low levels of resilience may have already left active work.

Conclusion and recommendations

Resilience was relatively low in this group of South African healthcare workers compared to similar studies globally, highlighting the need to build resilience among healthcare workers in South Africa. This study demonstrated that resources need to be directed towards building resilience among female healthcare workers, those working long hours and earning lower income. In addition, support such as psychological counselling should be offered to healthcare workers who have been diagnosed with mental health conditions. Further research is needed to better characterise the sociodemographic and work-related factors impacting the psychological resilience of healthcare workers in South Africa. Additional research could focus on resilience specifically, consider a larger and more representative sample and include qualitative research methods. This will assist in understanding determinants of psychological resilience and may inform intervention strategies that would build psychological resilience in the healthcare workforce in South Africa.

Data availability

The data are available upon reasonable request from the corresponding author.

Abbreviations

Classification and regression tree

Connor-Davidson Resilience Scale

Connor-Davidson Resilience Scale 10

Connor-Davidson Resilience Scale 25

95% Confidence Interval

Coronavirus disease

Emergency medical services

Healthcare Workers

High-income countries

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome

Interquartile Range

Low-and middle-income countries

Multivariate Imputation by Chained Equation

Not applicable

National Health Insurance

Probability Value

Posttraumatic stress disorder

Standard deviation

Work-Related Stress

South African Rand

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Acknowledgements

The authors would like to thank all the medical doctors and ambulance personnel who voluntarily participate in the primary data collection.

This research was partly funded by an award granted by the University of Cape Town’s Division of Actuarial Science, School of management studies and the Faculty of Health Sciences Research Committee.

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Shahieda Adams, Saajida Khan & Itumeleng Ntatamala

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T.M. conceptualised the study and was responsible for the data analysis, initial write-up and subsequent manuscript revisions. I.N. provided part of the dataset and assisted with study conceptualisation, data analysis and write-up of this study. S.A. assisted with study conceptualisation, data analysis and write-up of this study. S.K. provided part of the dataset and made editorial manuscript revisions. All authors read and approved the final manuscript.

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Mcizana, T., Adams, S., Khan, S. et al. Sociodemographic and work-related factors associated with psychological resilience in South African healthcare workers: a cross-sectional study. BMC Health Serv Res 24 , 979 (2024). https://doi.org/10.1186/s12913-024-11430-0

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The IHP Interview: Becca Willman on Occupational Therapy as a Tool for Eating Disorder Treatment

Rebecca Willman, OTD '23, published her research paper " The potential role of occupational therapy in the treatment of avoidant/restrictive food intake disorder " earlier this year. Willman’s research on how occupational therapy could help patients with avoidant/restrictive food intake disorder (ARFID) was the culmination of her yearlong independent study with Dr. Jennifer Thomas , the co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital.

A new lab instructor for the Occupational Therapy in Mental Health course, Willman recently won the OT Department's Alumni Professional Achievement Award for her work at The Home for Little Wanderers and McLean Hospital, where she has taken a role as the first dedicated occupational therapist treating patients at McLean’s Klarman Eating Disorders Center . In this month's IHP Interview, Strategic Communications Intern Sophie Hauck spoke with Willman about how occupational therapists play a unique role in eating disorder treatment, and why treating ARFID could be a gateway for OTs to work with people with eating disorders.

Why did you decide to specialize in eating disorder treatment as an occupational therapist?

I studied psychology and minored in nutrition in undergrad, and I saw this gap in how these two disciplines approach eating disorders. That's what occupational therapy is — the bridge between all the different aspects of eating disorder treatment. From then on, I became committed to research and advocacy for eating disorder treatment.

When you have an eating disorder, a lot of times, you're one circle, and the eating disorder is another, and you're overlapped. A lot of treatment is about separating yourself from the eating disorder, and then working through it with cognitive coping skills and different types of psychotherapy and psychoeducation. Occupational therapy is uniquely positioned to work through applying those skills in realistic context for patients in their daily life.

I take a lifestyle redesign approach, which is a framework that we use in occupational therapy where we go through every part of your day in a systematic way, and we determine, where are the problems? What are the challenges? What are some habits that are not aligned with what you want for recovery? Then we collaboratively problem-solve those things.

You spent a year conducting research with Dr. Jennifer Thomas at Mass General Hospital about how occupational therapy could help patients with avoidant/restrictive food intake disorder (ARFID). What is ARFID, and what were your findings?

Avoidant Restrictive Food Intake Disorder (ARFID) is a newer diagnosis in the DSM-5, characterized by a disturbance in eating or feeding that is not driven by body image concerns. There are three subtypes including a lack of interest in eating or food, avoidance based on the sensory characteristics of food, and fear of aversive consequences of eating — all of which have unique clinical presentations and functional implications.

I didn't know much about ARFID before I started my research. I've always been drawn to more well-known eating disorders, like anorexia nervosa, bulimia nervosa, or binge eating disorder. Dr. Jennifer Thomas specializes in ARFID, so she pitched the idea to me to learn more about what occupational therapy can do in ARFID treatment.

In the paper, I write about how OT has a long history of being involved in pediatric feeding disorders and feeding disorders in general. Oral motor differences often cause functional differences and physical impairments in eating and feeding. These experiences can impact someone's relationship with food psychologically or cognitively, which is where ARFID is maintained. ARFID can then persist even if those physical oral motor differences are remediated.

With OT intervention to address oral motor differences early, an individual may have less aversive experiences with food and therefore a lower risk of developing ARFID. OTs can help prevent those issues through rehab of the muscles, and we have different tools that can promote more effective use of the mouth in eating and feeding, as well as and oral sensory function.

There's also the sensory approach, where you can do whole-body sensory input to get somebody into a space where they're able to access higher levels of cognition. If their fight-or-flight response is on all the time because they have experienced trauma related to eating or feeding, and that's a perpetuator of their ARFID, then using those whole-body sensory inputs can help them regulate and come into a less distressed state, so they can try foods and have an appetite.

Then there’s the component of overall occupational balance. A lot of times, when you have ARFID, it can isolate you, or your treatment might interfere with your social participation or your leisure. You can't do the things that you want to do all the time, and OT can help reshape those routines and roles and habits to promote recovery from ARFID.

Content creators are raising ARFID awareness through social media. Have you seen public knowledge of this eating disorder increase since you began researching it?

ARFID is a newer DSM diagnosis. Once there’s a diagnosis, more people are bound to receive that diagnosis, and with more people receiving a diagnosis, more people will naturally know about ARFID.

I did a guest lecture for the Occupational Therapy in Mental Health course at the IHP in June, and when I was a student here, ARFID wasn't even mentioned. I added it into my presentation, and I asked, ‘Has anyone heard of ARFID?’ and almost everyone raised their hands. I was very shocked to see that progression because I know that none of my friends in grad school knew about it, but almost everybody knew about it in the current cohort in the OT program. That was cool.

How did your background in research shape your clinical experience at the MGH Institute, as well as the client-facing work you do now?

Throughout grad school, all my field work and clinical experiences were such foundational components because I was drawn more to analysis, research, and theory.

I still want to be doing research, so I'm actively applying to PhD programs to try to teach eventually. Clinical experience is so important to have as a researcher and as a professor because, especially with clinical research, you can understand the barriers to implementing research in clinical practice, and you can understand what clinical practice needs.

I gain a lot of perspective from working with my clients and hearing their stories, and it keeps you out of that, one-size-fits-all, monotonous, robotic approach because you have to individualize to make a difference in the daily life of a person, versus just taking a protocol and applying it to their case.

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Clinical Affiliations

Extending the minority stress model to understand mental health problems experienced by the autistic population

Autistic mental health disparities may be partially explained by the minority stress model

Suggested instructions

This research summary can be incorporated into a lecture or shared with students as a reading to demonstrate how psychological science explores the diversity of human experience. This resource can also be used to encourage students to identify the major components of a research study (i.e., the hypothesis or study question, sample, method, and findings). Students can be asked to identify potential limitations of the study and encouraged to discuss the implications for our understanding of human behavior. Keywords highlight how concepts within and across pillars are incorporated into a single research study.

Research summary

The minority stress model suggests that people from minoritized groups experience higher levels of stress, in the form of discrimination, prejudice, and stigma, and that this influences mental and physical health outcomes. Monique Botha, a self-identified autistic psychologist, along with David Frost, a social psychologist who studies minority stress, hypothesized that the minority stress model can explain the higher rates of mental and physical health problems among autistic people. Their sample of 111 autistic people completed an online survey measuring several minority stress variables and indicating whether they are autistic. Findings suggest that autistic people do indeed experience an added stress burden from minority stress. Results affirm the utility of the minority stress model for accounting for increased mental health problems among autistic populations. Stressors such as victimization, internalized stigma, and expectation of rejection predicted lower well-being outcomes. This finding suggests that some of the mental health disparities observed among autistic populations may be preventable. Implications include normalizing research that is grounded in the understanding that autism is another social identity, like sexuality or race, as opposed to a biomedical model that seeks to convert or cure individuals. Additionally, this study points to social factors as significant correlates of mental health disparities, all potential topics for future consideration.

Botha, M., & Frost, D. M. (2020). Extending the minority stress model to understand mental health problems experienced by the autistic population. Society and Mental Health, 10 (1), 20–34. https://doi.org/10.1177/2156869318804297

Social, Mental Health, Autism, Disparities, Stress, Prejudice

The development of resources to broaden diversity and representation in the teaching of high school psychology resources is an APA Committee of Teachers of Psychology in Secondary Schools initiative supported by funding from the American Psychological Foundation David and Carol Myers Fund. This resource was developed by Kara Ayers, PhD; Emily Lund, PhD; Erika Sanborne; and Allison Shaver.

Resources to Broaden Diversity and Representation in the High School Curriculum
Race and Racialized Identity: Social and Personality Pillar
Disability and Neurodiversity: Social and Personality Pillar

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How do you deal with stress? In Nigeria, swinging a sledgehammer in a 'rage room' helps

by CHINEDU ASADU and DAN IKPOYI

How do you deal with stress? In Lagos, Nigeria's largest city, people are finding their reset button in a "rage room" where they pay to smash electronics and furniture with a sledgehammer as a break from the worst cost-of-living crisis in a generation.

The Shadow Rage Room, apparently the first of its kind in Nigeria, offers "a safe space" for people to let out pent-up emotions, according to Dr. James Babajide Banjoko, the founder and a physician. The idea, he said, came during the COVID-19 pandemic in 2020 after he lost his mother and struggled with work.

For 7,500 naira ($5), customers are left alone with protective gear and a sledgehammer or bat in a room for a 30-minute session with the items that are later recycled.

Times are tough in Nigeria, a country of over 200 million people where growing frustration among youths led to recent mass protests in which several people were killed by security forces. The inflation rate has reached a 28-year-high of 33.4%, while the naira currency has fallen to record lows against the dollar.

Mental health services remain foreign or unaffordable for many in Africa's most populous country, where 40% of citizens live below $2 per day.

The West African nation has fewer than 400 registered psychologists, according to the Nigerian Association of Clinical Psychologists. That means one psychologist for about every half a million people.

Even when therapy is available, stigma remains a challenge, NACP president Gboyega Emmanuel Abikoye said in an interview.

Rage rooms aren't necessarily new in other parts of the world. There is no documented evidence of their mental health benefits beyond the momentary relief that comes with venting your feelings, Abikoye said.

Experts in Nigeria instead see a growing need for more long-term emotional support , especially among young people .

In Lagos, an overcrowded city of about 20 million people and a magnet for those seeking better opportunities , such needs are even more pronounced. Daily stressors include traffic jams notorious for trapping drivers and passengers on streets for hours in heat and smog in one of the world's most polluted cities.

Some Nigerians have turned to social media platforms like Tiktok as a way to cope with stress. Some find support in communities wherever they can, from the church or mosque to the gym.

And now there's the rage room, which opens on weekends and is usually fully booked up to two weeks ahead, according to Banjoko, the founder.

At the end of one session of smashing, Olaribigbe Akeem, a recent visitor, came out sweating but relieved and visibly happy.

"As an average Nigerian, you get to deal with a lot every day," Akeem said. "The anger has been piling up (and) instead of venting on somebody, this is the best avenue for me, and I feel a lot renewed."

Rage room visitors also include couples who want to get something off their chest.

At times, people come in for recreation but find something more.

"My favorite people are those that … just want to try it, and at the end of the day, you see them, they break down, they cry, they become very expressive," Banjoko said. He said he often refers them to therapy.

Dr. Maymunah Yusuf Kadiri, a Lagos-based psychiatrist, said any benefit from smashing things is usually short-lived and can't be a replacement for therapy.

There is also the risk of such a practice making someone less likely to use "healthy coping strategies," she said, and expressed concern that "repeated engagement … might reinforce aggressive tendencies."

At the rage room, some customers said their problems feel lighter only until they leave and re-enter daily life .

But being vulnerable with yourself while inside, sledgehammer in hand, is still worth it, said Eka Stephanie Paul, an actor and TV host.

"Problem no dey finish anyway," she said in the pidgin widely spoken across Nigeria, acknowledging that the rage room is hardly a cure. "But right now, I feel very light."

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Indian J Med Res
v.146(4); 2017 Oct

Workplace stress: A neglected aspect of mental health wellbeing

Pallab k. maulik.

Deputy Director and Head of Research, The George Institute for Global Health, New Delhi 110 025, India ni.gro.etutitsniegroeg@kiluamp

Workplace stress is defined by the World Health Organization as ‘the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope’, and elaborated that it can be caused ‘by poor work organization (the way we design jobs and work systems, and the way we manage them), by poor work design ( e.g ., lack of control over work processes), poor management, unsatisfactory working conditions and lack of support from colleagues and supervisors’ 1 . While workplace stress, stigma and attitudes towards employees suffering from stress or mental illness have been researched and interventions developed to address them better, globally 2 , 3 , it still remains an oft-neglected aspect across different industries and countries, including India, and only a few of the learnings are actually implemented.

International laws have been in force for many decades to protect human rights of employees at workplace, and the key ones being Article 23 of the Universal Declaration of Human Rights 4 , Articles 6 and 7 of the International Covenant on Economic, Social and Cultural Rights 5 and Article 27 of United Nations Convention on the Rights of Persons with Disabilities 6 . However, the execution of policies is variable and often suboptimal. Moreover, low- and middle-income countries where one has the largest population in working age groups, continue to lag behind in conducting or identifying suitable interventions, and often do not have adequate policies in place to prevent discrimination against employees with mental disorders 7 .

Workplace-related stress – a reality that needs to be addressed through evidence-based interventions

Brouwers et al 8 conducted a cross-sectional study across 35 countries including India and reported that about two-third of employees who had suffered from depression either faced discrimination at work or faced discrimination while applying for new jobs. This study also found that both anticipated and perceived discrimination was more in high-income countries compared to lower-income countries. Both perceived and anticipated discrimination are major causes for people suffering silently at the workplace and not seeking proper care. This by itself can be a major issue when seeking care for mental disorders as it adds to stigma related to help-seeking and increases treatment gap - the gap in the proportion of people who suffer from mental disorders and the proportion of them who actually receive adequate mental health care. If organizations are made aware of this, and they encourage staff to seek appropriate mental health care as per need, then it will not only lead to improved care for persons with mental disorders, but also to a situation where employees are comfortable discussing their mental health issues with appropriate staff and take actions early on, so that more severe mental disorders do not manifest.

Another risk factor is that besides depression or anxiety being an outcome of stress, physical disorders such as hypertension and diabetes can also be caused due to stress. While research has established the two-way link between stress and these physical disorders 9 , 10 , organizations need to realize this and encourage staff to maintain a good work-life balance. This by itself can be a difficult task to implement given deadlines, having a competitive edge, sustaining growth and one's personal need to earn more by doing overtime. Thus, organizations need to have guidelines about working hours based on good industrial practices and take measures to enforce these routinely.

Sexual harassment and bullying at workplace is another workplace-related stress that can happen at any organization. Both genders could be affected by these, but often women and those lower in the hierarchy are at increased risk. Organizations should be cognizant of this and take active measures to ensure that workplace is a safe and secure place for every worker. In India, there are specific legal provisions to ensure safety at workplace ( http://labour.gov.in/policies/safety-health-and-environment-work-place ), and there are specific laws to prevent sexual harassment of women ( http://indiacode.nic.in/acts-in-pdf/142013.pdf ). Strict guidelines and processes are advocated, and every organization should have identified committees to handle any such issue.

While extant research has tended to focus on alleviation of symptoms and risk factors associated with workplace-related mental disorders, less emphasis has been placed on gathering evidence on how mental disorders affect performance and absenteeism and how interventions have resulted in improvement of work performance and absenteeism 3 . Thus, more research is needed to gather evidence on the cost-effectiveness of interventions and the cost of mental disorder-related loss of productivity on the larger community. This is relevant to all countries and becomes specifically significant when each employment sector tries to become more competitive and wants to increase productivity while at the same time tries to keep their cost to a minimum. In low- and middle-income countries, there are additional needs to ( i ) conduct basic epidemiological studies to understand the prevalence of workplace-related mental disorders and specific risk factors associated with different employment sectors, ( ii ) understand what kind of systems are being put in place by different sectors to manage them, and ( iii ) to what degree are existing laws being followed and implemented, and what organizational restructuring is needed to improve the situation. Current evidence suggests that no single intervention can work in isolation and it is recommended to have a package of interventions at organization level which could be accessed by those in need 3 . Some interventions that were specifically found to be useful were enhancing employee control, promoting physical activity, cognitive behaviour therapy for stress management and problem-focused return to work programmes. On the contrary, counselling and debriefing following trauma were not effective 3 and any exposure to trauma should be followed by provision of psychological first aid and formal psychological support by trained professionals. Workplace screening for mental disorders followed by access to basic mental health services has been found to be effective, but could lead to a potential increase in anxiety levels in those who are screened as false positives, so routine screening at workplace is not recommended 3 .

Guidelines to improve workplace culture and reduce stress

The World Health Organization has outlined key factors related to stress at workplace and advocated guidelines to redeem them 11 . Some factors that cause increased stress at workplace include ‘workload (both excessive and insufficient work), lack of participation and control in the workplace, monotonous or unpleasant tasks, role ambiguity or conflict, lack of recognition at work, inequity, poor interpersonal relationships, poor working conditions, poor leadership and communication and conflicting home and work demands’ 11 . This document also outlined guidelines to improve the situation and enumerated four key steps which are not only relevant to individual organizations, but to other stakeholders also, such as trade unions, employees, government and employees 11 .

Step 1 : Analyzing the mental health issues - As a first step, it is essential to have a clear understanding of not only the prevalence/incidence and risk factors associated with workplace stress, but also a better knowledge about the cost implications to an organization in terms of lost productivity. This is an exercise that can be done at individual organizations, at specific employment sector level in specific regions or across regions. This may need gathering new data through surveys or collating data available with the human resources or anonymized health records.

Step 2 : Developing the policy - A policy can be developed once the initial knowledge gained through the first step is available. The primary objective of such a policy should be to address concerns of all stakeholders and adhere to the organizations vision and mission. This should involve multiple meetings with different stakeholders to identify key components that need to be addressed. This engagement should be a continuous process throughout the development and execution of the policy.

Step 3 : Developing strategies to implement the policy - While implementing the policies, care should be taken to identify the key strategies that need to be implemented, the processes that need to be in place to implement such strategies, targets to be achieved and timelines that need to be adhered to while implementing the strategies. Finally, any additional budgetary allocations or training required to implement the policies, need to be made available.

Step 4 : Implementing and evaluating the policy - The implementation of any strategy will need collaboration and clear buy-in from all stakeholders. For some strategies, one might need to have a small demonstration project to start off, and based on the results tweak the strategies and then scale it up to a larger forum. Before implementing a policy, information should be disseminated widely either through a formal launch meeting or individual organizations’ dissemination network. For example, major government level policies that impact large number of employees or employers could have a launch meeting, whereas policies affecting only one organization with limited staff could be disseminated through office emails. This would enable everyone to be aware of the policies. One major drawback of many policies is that they lack a formal evaluation. This should be built into the system and appropriately funded from the outset. Specific guidelines about how to monitor and evaluate the policies should be in place at the time of the launch of the policies and conducted as per agreed timelines.

Role of government

The government should play a key role in ensuring that policies are in place that address workplace stress. Not only should the government identify vulnerable populations such as women, children, persons with disability at different workplaces, but also ensure that every sector has appropriate safeguards to protect the rights of all employees including vulnerable populations. The government should also monitor how different sectors are performing with respect to workplace stress and have additional strategies in place to address issues related to sectors which have specifically higher level of physical or psychological stress such as mines, factories, health sector, among others. Legal mechanisms should be in place to enforce laws and regulate them and penalize organizations which flout existing laws. The legal system should provide avenues that can be accessed both by employers and employees alike. The aim should be that workplace is seen as a fair and non-discriminatory zone as far as stress, and mental ill-health are concerned.

Workplace stress and associated mental ill-health is a fact that every employer and employee lives with on a daily basis. However, it often is the case that neither are aware of the issues fully and nor are well informed about its ramifications. Although laws are present in most countries to ensure that the rights of persons suffering from mental disorders related to workplace stress are safeguarded, often such are not executed or regulated effectively, leading to a situation where persons with mental disorders are not able to verbalize their problems and suffer silently - a situation that ultimately leads to increasing mental health-related disability that affects productivity. In this year, when workplace stress is being identified globally as a cause for concern, all stakeholders should take additional notice of its importance and see what needs to be done to improve the situation on the ground and make workplace a safer and healthier place for all.

Acknowledgment

The author is an intermediate fellow of the Wellcome Trust/DBT India Alliance.

IMAGES

(PDF) Occupational Stress Management
Understanding and Managing Occupational Stress [Infographic]
The Occupational Stress Index: An Approach Derived from Cognitive
Occupational Stress: Breakthroughs in Research and Practice
(PDF) OCCUPATIONAL STRESS AND WORKPLACE STRESS REDUCTION METHODS
(PDF) What Qualitative Research has Taught us about Occupational Stress

VIDEO

Occupational Health
Level 6 Diploma in Occupational Health and Safety Management
Occupational Health Psychology in Action: Moving from Burnout to Proactive Job Redesign
Occupational Stress Tips
ASSESSMENT OF OCCUPATIONAL RISK RELATED STRESS AT WORK AMONG WORKERS IN OIL AND GAS INDUSTRY
Practical on Occupational stress index by Dr.Ak srivastava and Dr.Ashok singh

COMMENTS

Occupational Stress: A Comprehensive Review of the Top 50 Annual and
Moreover, the authors identified the number of articles that may have emanated from a single research project. Although numerous studies on occupational stress are framed by a theory, model, or framework, the topic of an article fell under this category only if the study directly examined a theory, model, or framework in the research question.
Occupational Stress: Preventing Suffering, Enhancing Wellbeing
Occupational stress is a known health risk for a range of psychological, behavioral, and medical disorders and diseases. Organizations and individuals can mitigate these disorders through preventive stress management and enhanced wellbeing. This article addresses, first, the known health risk evidence related to occupational stress; second, the ...
Occupational Stress: A Comprehensive Review of the Top 50 ...
This study determined the impact and influence of published articles on the field of occupational stress. A transdisciplinary approach was used to identify the 50 work-related stress articles with the most lifetime citations and the 50 work-related stress articles with the highest annual citation rates. Studies were categorized based on their ...
Occupational Stress and Employees Complete Mental Health: A Cross
Given the shortcomings of previous research on occupational stress and mental health (e.g., predominantly in Western, educated, industrialized, rich and democratic (WEIRD) societies, based on the traditional mental health model and a lack of comparative ...
Occupational Stress
Occupational stress is exceptionally high in employees of the healthcare sector. Stress in health personnel is associated with many chronic diseases, health impairing behaviors as well as staff turnover and medical errors. Physical activity is being discussed on having a stress reducing or regulating effect.
Work & Stress
Work & Stress publishes research on occupational health psychology, social relations at work, motivation and burnout, and work-life balance.
Occupational health: Stress at the workplace
Occupational health: Stress at the workplace. What is work-related stress? Work-related stress is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope. Stress occurs in a wide range of work circumstances but is often made worse ...
The nurses' occupational stress components and outcomes, findings from
Occupational stress and related factors for nurses may change over time, reflecting factors such as developments in health care and changes in consumer relations. Furthermore, the increase in nursing research in recent years with geographical and cultural reach may indicate new findings.
Frontiers
This study aimed to analyze the bibliometric characteristics of the publications on occupational stress and highlight key research topics and future trends. ...
Occupational Stress
Occupational stress is a complex condition and is described as the sum of the physical, mental, and psychological responses to work that are transformed into negative emotional reactions. Occupational stress may result in increased absences and decreases in productivity and service delivery.10,11. Occupational stress can be considered as the ...
Occupational Health Psychology: From Burnout to Well-being at Work
This Research Topic focuses on Occupational Health Psychology (OHP) - the branch of psychology that emerged out of two applied disciplines within psychology: health psychology and industrial/organizational psychology. It involves the application of psychological principles and practices in promoting quality of life at work, protecting and promoting the health and well-being of workers ...
Occupational Stress: A Comprehensive Review of the Top 50 Annual and
Although numerous studies on occupational stress are framed by a theory, model, or framework, the topic of an article fell under this category only if the study directly examined a theory, model, or framework in the research question.
Occupational Stress and Health: Psychological Burden and Burnout
International Journal of Environmental Research and Public Health, an international, peer-reviewed Open Access journal.
Characteristics of Publications on Occupational Stress ...
This study aimed to analyze the bibliometric characteristics of the publications on occupational stress and highlight key research topics and future trends. The Web of Science Core Collection database was searched to collect publications on occupational stress, from inception to December 9, 2020.
Occupational Stress and Employee Control
Occupational Stress and Employee Control Employee control over work can reduce stress and enhance motivation and growth. Several key findings have prompted employers to search for ways to give workers a greater sense of control, to improve health, productivity and morale.
Sources of Occupational Stress among Office Workers—A Focus Group Study
Workplace stress remains a major interest of occupational health research, usually based on theoretical models and quantitative large-scale studies. Office workers are especially exposed to stressors such as high workload and time pressure. The aim of ...
(PDF) Stress at the Workplace and Its Impacts on Productivity: A
PDF | In every fast-paced surrounding, stress is present in every life aspect, including at the workplace. It is a deeply person-al experience, with... | Find, read and cite all the research you ...
Workplace Stress
83% of US workers suffer from work-related stress and. 54% of workers report that work stress affects their home life 5. For every $1 spent on ordinary mental health concerns, employers see a $4 return in productivity gains. Stress can be harmful to our health and increase mental health challenges. Mental health challenges can include clinical ...
53 questions with answers in OCCUPATIONAL STRESS
Occupational Stress - Science topic Explore the latest questions and answers in Occupational Stress, and find Occupational Stress experts.
Research in Occupational Stress and Well Being
The objective of this series is to promote theory and research in the increasingly growing area of occupational stress, health and well being, and in the process, to bring together and showcase the work of the best researchers and theorists who contribute to this area. Questions of work stress span many disciplines, most of which have their own ...
Sociodemographic and work-related factors associated with psychological
Background Psychological resilience facilitates adaptation in stressful environments and is an important personal characteristic that enables workers to navigate occupational challenges. Few studies have evaluated the factors associated with psychological resilience in healthcare workers. Objectives To determine the prevalence and factors associated with psychological resilience in a group of ...
The IHP Interview: Becca Willman on Occupational Therapy as a Tool for
Rebecca Willman, OTD '23, published her research paper "The potential role of occupational therapy in the treatment of avoidant/restrictive food intake disorder" earlier this year.Willman's research on how occupational therapy could help patients with avoidant/restrictive food intake disorder (ARFID) was the culmination of her yearlong independent study with Dr. Jennifer Thomas, the co ...
Work stress, mental health, and employee performance
Although recent studies have demonstrated the relationship between work stress and employee performance, some insufficiencies persist, which must be resolved. Research on how work stress affects employee performance has remained fragmented and limited. First, the research into how work stress affects employee performance is still insufficient.
Extending the minority stress model to understand mental health
Monique Botha, a self-identified autistic psychologist, along with David Frost, a social psychologist who studies minority stress, hypothesized that the minority stress model can explain the higher rates of mental and physical health problems among autistic people.
How do you deal with stress? In Nigeria, swinging a sledgehammer in a
The Shadow Rage Room, apparently the first of its kind in Nigeria, offers "a safe space" for people to let out pent-up emotions, according to Dr. James Babajide Banjoko, the founder and a physician.
Preventing occupational stress in healthcare workers
Preventing occupational stress in healthcare workers. Background. Healthcare workers suffer from work‐related or occupational stress. Often this is because healthcare workers face high expectations and they may not have enough time, skills and social support at work. This can lead to severe distress, burnout or physical illness.
Pollution affect the growth and behavior of aquatic organisms
New research reveals that size-based selection, like in fishing, may impact the stress tolerance of fish, which in turn has a significant impact on the condition and coping of fish in changing ...
Workplace stress: A neglected aspect of mental health wellbeing
While workplace stress, stigma and attitudes towards employees suffering from stress or mental illness have been researched and interventions developed to address them better, globally 2, 3, it still remains an oft-neglected aspect across different industries and countries, including India, and only a few of the learnings are actually implemented.

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Substance use, mental health, and work-related stress management

Prevalence of resilience

Factors associated with resilience

Strengths and limitations

Conclusion and recommendations

Data availability

Abbreviations

Acknowledgements

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Contributions

Corresponding author

Ethics declarations

Consent for publication

Competing interests

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