Stress Exhaustion and Work Performance of Married Call Center Agents

A Study Presented to the Faculty Of the College of Nursing of Cebu Sacred Heart College

In Partial Fulfilment of the Requirement for the Subject Nursing Research for the Degree Bachelor of Science in Nursing

Adobas, Loraine A. Sabanal, Andr Gil I.

March 2013

ACKNOWLEDGEMENT Sincerest thanks to the following people who in one way or another became part of our endeavor: To the call center agents, who employed their time out of stress from work and for religious response to queries on the research tool provided. To our research adviser, Ms. Rizzelle C. Olila, for guiding us through in completing this research and for filling us with knowledge and support. To our families, who helped suffice the needs in light of this research and the unwavering support on all our undertakings. To the librarian, Ms. Riza C. Olila, for aiding us in collecting information to support this research. To the researchers, for the help each other has extended and for the fun while learning throughout the fulfillment of this research as part of our endeavor of becoming nurses. And above all, to our Almighty Father, for being our guiding light who invicibly leads us to ways in attaining our goals and aspirations. This, we dedicate for your glory!

THE RESEARCHERS

THEORETICAL BACKGROUND This study will be anchored on the theory of Hans Selye (1956, 1974), a Hungarian endocrinologist, who identified physiologic aspects of stress, which he labeled the general adaptation syndrome with. He used laboratory animals to assess biologic system changes, the stages of body's physical response to pain, heat, toxins, and restraint, and later the mind's emotional response to real or perceived stressors. He determined three stages of reaction of stress (Shiela L. Videbeck 2001). This study also uses Selyes Optimal levels of stress model as basis. Stress theories provide nurses with a framework for understanding how stress affects individuals and their responses. The ability to adopt to stress leads to conflict resolution, whereas the inability to adapt effectively may result in physiological or mental disorders, or even death (Keltner, Schwecke, Bostrom 2002). Selye defined stress as wear and tear of the body. He developed a framework, the stress-adaptation theory, to explain the physiological response to stress (Selye, 1956). Selye viewed stressors as positive or negative occurrence, or any emotion requiring a response. Interaction with the environment and others inevitably produces stress. The type of response elicited depends on individual perception of the stressor. However, Selye discovered that by objectively measuring structural and chemical changes in the body, many individuals demonstrate the same symptoms regardless of the stressor. These changes became known as the general adaptation syndrome (GAS) and occur in three stages: alarm, resistance, and exhaustion.

The impingement of any kind of stressor on individual activates the preparation got "fight or flight". Individuals experience increase in alertness in order to focus on immediate task or threat, and to mobilized resources and defenses to concentrate on particular stressor. The levels on anxiety experienced are mild (1+) to moderate (2+). Learning and problem solving can occur. Thus, this is called the alarm reaction stage. If the stressor continues, or is not adaptively or effectively resolved, individuals experience the next stage. In this stage of resistance, individuals strive to adapt to stress. For adaptation to occur, the use of coping and defense mechanisms is increased. Problem solving and learning are difficult but can be accomplished with assistance. Psychosomatic symptoms begin to develop. The levels of anxiety experienced are moderate (2+) to severe (3+). If individuals are overwhelmed by stressor, they experience next stage. Stage of exhaustion results from stress that lasts too long or is overwhelming, or may result from individual's inability to cope. Anxiety is experienced at the severe (3+) to panic (4+) levels. Defenses are exaggerated disorganized, and dysfunctional, illogical, and and the personality becomes thinking decision making ineffective.

Delusions and hallucinations can occur with sensory misperception and greatly reduced orientation to reality. Individuals may become violent, suicidal, or may be completely immobilized. In case of immobilization, a severe level of anxiety may occur though individuals may not appear to be visibly anxious. Death may occur if exhaustion continues without intervention ( Barbara Schoen Johnson, 3rd edition) Based on Selyes Optimal levels of stress responses risky are one of our body's best defense systems against outer and inner dangers. In a situation (in case of accidents or a sudden attack on life), body

releases stress hormones that instantly make us more alert and our senses become more focused. The body is also prepared to act with increased strength and speed in a pressure situation. It is supposed to keep us sharp and ready for action. Research suggests that stress can actually increase our performance. Instead of wilting under stress, one can use it as an impetus to achieve success. Stress can stimulate one's faculties to delve deep into and discover one's true potential. Under stress the brain is emotionally and biochemically stimulated to sharpen its performance (Shiela L. Videbeck, 2010). The approach to optimizing stress depends on the sort of stress being experienced. Strategies to deal with short term stresses focus on managing adrenaline to maximize performance. Short-term stresses may be difficult meetings, sporting or other performances, or confrontational situations. With long term stress, fatigue and high adrenaline levels over a long period can seriously reduce your performance. Optimising long term stress concentrates on management of fatigue, health, energy and morale. Naturally there is some element of overlap between these (www.ayubmed.edu.pk).

CONCEPTUAL FRAMEWORK General Adaptation Syndrome (GAS)

The graph shows stages that you may go through in response to sustained levels of excessive stress. At first, will face challenges with plenty of energy. Your response will probably be positive and effective. After a period of time, one may begin to feel seriously tired. You may start to feel anxious, frustrated and upset. The quality of your work may begin to suffer. As high stress continues you may begin to feel a sense of failure and may be ill more frequently. You may also begin to feel exploited by your organization. At this stage you may start to distance yourself from your employer, perhaps starting to look for a new job. If high levels of stress continue without relief you may ultimately experience depression, burnout, nervous breakdown, or some other

form of serious stress related illness. Different people may move between these stages with different speeds under different stress conditions.

Short term stress The graph below shows the relationship between stress and the quality of performance when you are in situations that impose short-term stress: Where stress is low, you may find that your performance is low because you become bored, lack concentration and motivation. Where stress is too high, your performance can suffer from all the symptoms of excessive short-term stress. In the middle, at a moderate level of stress, there is a zone of best performance. If you can keep yourself within this zone, then you will be sufficiently aroused to perform well while not being over-stressed and unhappy. This graph, and this zone of optimum performance, are different shapes for different people. Some people may operate most effectively at a level of stress that would leave other people either bored or in pieces. It is possible that someone who functions superbly at a low level might experience difficulties at a high level. Alternatively someone who performs only moderately at low level might perform exceptionally under extreme pressure.

www.ayubmed.edu.pk

Long term stress

The problems of long term, sustained stress are more associated with fatigue, morale and health than with short-term adrenaline management. The graph as shown in Fig: 2 show the way in which performance can suffer when you are under excessive longterm stress

www.ayubmed.edu.pk

Sustained Stress

--------------- Intended Performance __________ Actual Performance

Review of Related Literature There was a A who researched to determine the quality of married relationships of wives who work in call centers, particularly in the area of their happiness and disagreements at home. The

researcher assumed that there was no relationship between working shifts and relationships of married couples. The study tried to find out the effects of work schedule on the quality of relationship among couples working in a 24-hour environment. Through a sampling approach, the researcher gave out questionnaires to 47 wives working on shifts in call centers. The wives have been married for at least five years and have no less than one child in preschool. It was gathered that 66 percent of the entire population of respondents from this group had at least one child. Fifty one percent of them were assigned on a graveyard shift and 49 percent received a monthly income of P20,00030,000. Another 15 wives were selected for the snowball approach, 53 percent of whom had one preschool child and all married for an average of seven years. The wives in this group worked on different shifts: five on the morning shift, another five in the afternoon, and the last five on graveyard shift. Forty-seven percent of the wives from this group had a monthly salary of P20,000-30,000. These are the results of the said study. On finances, majority of the couples agree on the way their finances are handled. Significantly, 31 percent of the respondents who work at night say they have disagreements with their husbands in terms of handling the finances. However, 60 percent still view their working shift positively when it comes to finances. About time, interestingly, 50 percent of the afternoon shifters, 43 percent of the graveyard shifters, and 60 percent of the flexi shifters share that they have a hard time finding reasons to be with their husbands. Since the work hours entail coming home late, it brings about disagreements on how the married couples should spend their leisure times together, as expressed by 46.80 percent of the respondents. In fact, 48.93 percent of the respondents find themselves unable to have any mutually satisfying interest to

share with their husbands.

The wives in the study rely on house

helpers and relatives to handle more of the challenges at home. On sexual relationships, fifty-three percent from the afternoon and graveyard shifts confess having sexual disagreements with their spouses. Due to stress, the wives experience fatigue, leading them to push their partners aside. On faithfulness, eighty-five percent (85.11%) of the respondents believe that having flings is taboo but some of the respondents (10 percent) say that it is acceptable, whether with the opposite or same sex. Since the evident lack of connection leads to loneliness, 48.93 percent of the respondents sometimes consider having a better option for a partner and indicate that they are open to choosing somebody other than their husbands, should they have a second chance at marriage. Almost half of the respondents (48. 94 percent) contemplate ending their marriage. On household chores, almost 96 percent of the respondents recognize the importance of household chores and do not think its degrading. All of the respondents see child-rearing as a joint responsibility. In conclusion, the wives in the study considered

themselves to have attained marital happiness only in the aspect of sharing household chores. Because of erratic schedules, the areas of finance, time, sexual relationships and faithfulness were negatively affected. More than half of the respondents argued about money, which was sad for the wives who entered the call center occupation mainly for monetary reasons. Heightened disagreements were also shared as having caused harm or violence among couples.

The following were identified as the negative effects of a call center job that requires a 24/7 schedule: limited time spent with family and friends, low satisfaction level in terms of sexual relationships of spouses, existence of flings, difficulty in managing errands and household chores, poor communication and interaction with the spouse, and poor health (The Philippine Star, Sept 9,2008 issue). The revenues that call centers are giving to a certain Local Government Unit is so promising that local leaders are encouraging investors to put up their call centers in their particular places. However, call center job is not a promise land for workers. With the kind of work they have especially the scheduling of the shifts, married couple face a great task of balancing their work and family life. "In this industry, there is no tomorrow because Philippine Call Centers are already operating 24/7 and serving different time zones."( Philippine Daily Star, July 28,2008) With a graveyard shift that starts 9 p.m, just about the time other establishments are closing and some households are preparing a night rest, a call center agent is about to start his regular working hours until 6 am just about the time a normal working man or woman would wake up and start their regular working day. The graveyard shifts, the unlikely behavior of the callers, relationship with co-workers and company pressures such as sales quota makes up the many job pressures a call center agent has. There are also problems of being hooked into smoking to battle stress and caffeine dependent to battle sleepiness. There are also issues of morality at stake especially issues of infidelities of married call center workers.

Nevertheless, "The industry is also striving to provide an even better working environment for agents in as much as call center employees work on graveyard shift and ungodly hours." With the demands of changing times, married individuals working as call center agents need help not only in coping up with the demands of work and marriage but also a reorientation towards the proper understanding of their vocation as married man or woman. The demand of such work and its effect to marriage is so great that cannot just be taken haphazardly. Call centers and their contemporary successors, contact centers, have become a preferred and prevalent means for companies to communicate with their customers. Most organizations with customer contact- private companies, as well as government and emergency services - have reengineered their infrastructure to include from one to many call centers, either internally managed or outsourced. Call centers and their contemporary successors, contact centers, have become a preferred and prevalent means for companies to communicate with their customers. Most organizations with customer contact private companies, as well as government and emergency services have reengineered their infrastructure to include from one to many call centers, either internally managed or outsourced. For many companies, such as airlines, hotels, retail banks, and credit card companies, call centers provide a primary link between customer and service provider. The call center industry is thus vast and rapidly expanding, in terms of both workforce and economic

scope. A recent analysts report estimates the number of agents working in U.S. call centers to have been 1.55 million in 1999 - more than 1.4% of private-sector employment and to be growing at a rate of more that 8% per year 43, 140.00. In 1998, AT&T reported that on an average business day about 40% of the more than 260 million calls on its network were toll-free (www.columbia.edu). No doubt Call Center is a growing business today and a source of employment for many Filipinos. This simply shows how many laborers they catered; a lot of family whose breadwinner is a call center agent relies on call centers for their daily sustenance. But more than economic gain there are hidden struggles and problems that call center agents face especially with marital and family issues. Call centers has a mechanistic organizational make-up. The agents are expected to do their job with mechanical precision. In this kind of organizational set up organizational life is often routinized with precision demanded on clockwork. People are frequently expected to arrive at work at a given time, performed a predetermined set of activities, rest at appointed hours, and then resume their tasks until work is over. In call center upon making or receiving a call agents have a pre-determined spiel, presentation or selling skills, rebuttal or closing skills and sales verification. An agent must memorize all these and diligently follow such process for the whole 8 hours of work, thus, making it a repetitious act. This type of organizational make up is often prone to boredom and stressors. This mechanistic approach to organization is confronted with severe limitation (a) it can create organizational forms that have great difficulty in adapting to changing circumstances, (b) can result to mindless bureaucracy, (c) can have unanticipated and undesirable consequences as the interest of design

to achieve, (d) can have a dehumanizing effects upon employees, especially those at the lower levels of the organizational hierarchy. "The daily experience of repetitive, intensive and stressful work, frequently results in employee "burnout". In other words, exhaustion. The work was characterized as "repetitive brain strain". These descriptions are hardly surprising, in a way, given that call centers are established by organizations to "create an environment in which work can be standardized to create relatively uniform and repetitious activities so as to achieve economies of scale and consistent quality of customer service". This means, in other words, that workplaces are organized in ways that weaken employees autonomy and enhance the potential for management control, and "a loss of control is generally understood to be an important indicator of work-related stress" (www.bpoindia.org). The primary source of stress reported is inherent to the nature of the job: spending all day on the phone dealing with people one after another, day after day, is difficult. Doing it under constant pressure to keep call volumes up, with no time between calls to "recover from an awkward call or from 'customer rejection'" is even more difficult. And doing it with "very little authority or autonomy to rectify problems" that arise is perhaps the most difficult of all. Second, organizational rhetoric in inbound call centers is concerned with 'customer care', or 'keeping customers happy' (providing quality service), yet these goals are juxtaposed with an ongoing pressure to keep call times down and call volumes up. Third, stressor is the performance target. There are various types of targets, which may vary between inbound and

outbound centers. Inbound centers typically have targets for call duration, 'wrap time', and daily call volume. Outbound centers often also have sales or 'completion' targets, which are closely monitored and upon which pay may be partially based. In addition, in some sectors, inbound call centers are attempting to introduce the practice of cross selling, where agents attempt to sell additional products to the customers who call in for another purpose. In these centers, sales targets similar to those in outbound centers are often in place. "The question of how call center employees deal with stress is an important one, particularly in view of evidence that a build-up of stress leads to illness, absenteeism and turnover," writes Houlihan (www.bpoindia.org). Other than the stressors mentioned there are other health issues that came along with the job in call centers. This includes; (a) sleeping disorders, obviously this affects first timers more severely, as they take time to adjust their biological clocks, but even experienced people or managers are not able to completely escape from it. Some call centers are looking at devising innovative mechanisms like flexible shifts with sleeping arrangements in the office premises as possible solutions, (b) Digestive system sleeping disorder, working long and odd hours without any sleep, and eating food supplied by external caterers everyday, has led to 41.9% of the respondents suffering from digestive problems, (c) depression, (d) severe stomach problem, (e) eyesight problems due to long exposure to computers, (f) ear problems this is due to prolong use of earphones. Other human related issues at call center includes (a) personal habits, specifically smoking, alcoholism and caffeine dependency, (b) discipline and behavior, (d) cases of immorality and infidelity especially to those who are married (http://gilyann-urstoff.blogspot.com).

Statement of the Problem

The main purpose of this study is to study the quality of relationship between stress exhaustion and work performance of married call center agents in IT Park, Lahug, Cebu City based on the following aspects ; economic, social, emotional, physical, sexual and spiritual. Specifically, the research study aimed to answer the following questions : 1. What is the profile of call center agents as to : a) age b) sex c) length of marriage d) number of children e) age of children f) work of the spouse g) educational attainment 2. What are the extent of stress exhaustion of call center agents on marriage in the following aspects as: a) Economic needs b) Social needs c) Emotional needs

d) Physical needs e) Spiritual needs

3. How does the job of a call center agent affect the ff : a) Work Performance b) Marriage ( relationship with spouse )

4. What are the perceived ways by call center agents to reduce stress caused by call center job in order to maintain/ improve healthy marriage ?

Statement of Null Hypothesis

The following hypotheses were formulated: 1. There is no significant difference on the extent of stress exhaustion of call center job on marriage of call center agents based on the (a) economic, (b) social, (c) emotional, (d) physical, (e) sexual and (f) spiritual needs of the respondents. 2. There is no significant difference on call center agents

understanding on how her work as a call center agent affects her performance and marriage.

SIGNIFICANCE OF THE STUDY

STUDENT RESEARCHERS: This study will allow us to know how the work of a call center agent affects their marital and family life and how they look at it as though a threat or beneficial to social, emotional, physical and spiritual aspects. This will give us the knowledge on relevant things a person should know about call center job.

STUDENT NURSES: This studies disseminates a guide in relevance to the trend of modern technology with the rise of call center industry in our country. As advocates of health, it is their concern to be mindful of health and social issues and threats. This study will aid them to keep themselves reminded with the importance of health and that information they may get from this material will be useful not just form them but to people surrounding them as well. FUTURE RESEARCHERS: To serve as basis on their future studies and to provide vital ideas with the topic discussed herewith. This brings them ideas on the flow of doing a research and it opens a gateway for them to dig into further ideas with the help of research materials and media nowadays. Also, to make themselves useful in promulgating ways to eradicate or alleviate the downside effects of stress exhaustion which is prominently experienced by call center agents. CALL CENTER COMPANIES : To be reminded that aside from customers, their employees give light to their business and that it is vital to be mindful of the possible stress that the agents may experience related to work. This study can help them find new ways or continue the beneficial ways of not just maintaining the number of the employees but also maintaining their optimal state of health to maintain or improve performance.

CALL CENTER AGENTS : To be aware of any possible means of having stress related to work and to establish ways of coping them especially for the married call center agents who are considered having two main priorities, home and work. This may allow them to provide doable ways to manage stress related to work performance.

RESEARCH METHODOLOGY

RESEARCH DESIGN Questionnaires and checklists were used as main source of data in the survey. It was to find out what the facts were with respect to condition. It analyzed, participated and reported the present status of a particular group. The assessment showed current conditions of call center agents with regards to work and marriage.

RESEARCH ENVIRONMENT This study will be conducted at IT Park, Lahug, Cebu City which is the business ground for call centers in the Province of Cebu.

RESEARCH RESPONDENTS The subjects of the study were call center agents who work in different call centers particularly from Convergys Inc., Qualfon Inc., Stream Global Services Inc. and Xlibris Publishing, Inc. The

respondents were given questionnaires to be answered. They were instructed on how to answer questions correctly. The researchers assured that the confidentiality of the details was well- established.

RESEARCH INSTRUMENT

Questionnaires formed by the researchers will be used in data gathering which contains the profile of the respondents such as age, gender, civil status. Some parts of the questionnaire asks them to supply answers on how they are affected by stress at work as married call center agents. RESEARCH PROCEDURE Data Gathering : A letter of transmittal was presented to the Dean of the College of Nursing of Cebu Sacred Heart College, Talisay City, Cebu asking permission to conduct this research. As the letter was approved, the survey was conducted. Respondents were given ample instructions and time in answering the tool. Responses on each situation were tabulated and results were calculated. Treatment of Data : The statistical tool and technique used to ensure a valid and systematic percentage. presentation. Analysis and interpretation of data is

The percentage will be computed using the formula:

P = F x 100 N

Where : P= Percentage F= Frequency N= No. of Respondents 100= Constant Value to be multiplied

Definition of Terms

impingement is the interruption or striking of something just like an impingement of privacy fight or flight it is also called as hyperarousal wherein animals react to threats with a general discharge of the sympathetic nervous system, priming the animal or fighting or fleeing psychosomatic symptoms- theseare symptoms which have psychological roots rather than physical causes and people having this may experience changes in eating habits, such as overeating or loss of appetite, difficulty concentrating or remembering things, fatigue or lack of energy, feelings of hopelessness, guilt or worthlessness nervous breakdown are signs that you have reached your limit, not that youre going mad but you are at breaking point or completely stressed out child-rearing- is the nurturing with care, love and guidance given by a parent ungodly hours- is a term used for excessive or exaggerated time for work especially to call center agents who work at night and have overtime sometimes toll free- means that the charge of the call is free for the calling party, and instead the telephone carrier charges the called party for the cost of the call. Routinized- means to develop into a regular procedure Rhetoric- is the skill in the effective use of speech Juxtaposed- is to place side by side or make a contrast on something Biological clocks is a mechanism in organisms that controls the periodicity of various functions or activities or activities, such as metabolic changes, sleep cycles