Synopsis

Occupational Stress and its effect on Job-Performance

INTRODUCTION
Stress has become a major element at the work place. Stress not only affects the
capabilities of an individual but eventually it affects the organizational productivity on the
whole (Murphy 1996). Stress occurs when circumstances and characteristics of the job
environment are perceived as a threat to the individual. It usually evolves when demands are
made on an individual beyond that which the employee feels capable of meeting.

The word 'stress' is defined by the Oxford Dictionary as "a state of affair involving demand
on physical or mental energy". The generally accepted definition today is one of interaction
between the situation and the individual. “It is the psychological and physical state that
results when the resources of the individual are not sufficient to cope with the demands and
pressures of the situation (Michie 2002).

The increase demands of health care facilities and the sensitivity of the work at hospitals
Has increased job-stress on the individuals working in it. Especially, the amount of pressure
on the doctors has increased enormously (Polanyi et al. 2000). The delivery of high-quality
medical care contributes to improved health outcomes. Doctor’s job satisfaction affects
quality of medical cares that he/she provides patient’s satisfaction with the doctor, patient’s
adherence to treatment and decreases doctor’s turnover. (Ali et al. 2003).

The health status of Pakistan is characterised by a high rate of population growth and poor
health indicators. The provision of health services is highly inequitable; although rural
dwellers comprise almost two thirds of the population, the majority of health services and
doctors are located in the urban areas. This causes work overload on the heath sector
individuals working in the rural or sub-urban areas. The rural population of Abbottabad is
about 82%, which causes a lot of pressure on the working staff and doctors. Most of the
health facilities are located in the city. This causes a high level of patient-doctor ratio. This
eventually causes high workload resulting to stress.

The prevention and management of workplace stress requires organizational level

interventions, because it is the organization that creates the stress. Eliminating all stress
from one’s life is neither possible nor desirable. It is impossible because stress comes from
threats and challenges in our environment that are often outside our control. It is not
desirable because some stress is necessary to keep us motivated and interested. However,
the appropriate level of stress differs from one person to another (Wilkinson et al. 2003).

This study is undertaken to determine the impact the occupational stress on the performance
on an individual at the work place. Though a certain amount of stress is needed but lack of
stress and hyper-stress causes the job performance to go down. This study will try to find out
the effect of occupational stress on job performance.

LITERATURE REVIEW
Job stress intervention activity has grown rapidly over the last two decades, paralleling the
growth in recognition and acceptance of the far-reaching impacts of job stress on individual
and organizational health (Lamontagne, et al. 2002). The problem of retaining qualified and
experienced staff has highlighted the need to look at various aspects of work and the work
environment, which affect the level of job satisfaction and in turn influences quality of service
(Seecombe and Ball 1992). Occupational stress inadvertently consequences low
organizational performance (Elovainio et al. 2002).
“Job stress although has belittling impact on any organization and individual’s performance
but can shape dire consequences when related to health care.” (Mimura and Griffiths 2003;
Winefield 2003) In health care the lives of the patients are at direct risk. Poor psychological
health and sickness absence are likely to lead to problems for patients in that both the
quantity and quality of patient care may be diminished. Because staff working in teams
provides most health care, ill health and sickness absence in any one individual is likely to
cause increased work and stress for other staff. (Michie and Williams 2003)

Current evidence suggests that health care professionals in the UK have higher absence
and sickness rates than staff in other sectors (Nuffield Trust 1998). Wall et al. (1997) found
that 27% of health care staff suffered serious psychological disturbances, compared with
18% of the general working population. It has been suggested that stress may be a reason
for individuals leaving their jobs (Seecombe and Ball 1992).

Similar factors are associated with psychological ill health in health care workers in the rest
of the Europe, the USA, and Australia. The one study of doctors found an association
between work control and social support and psychological distress. “…lack of co-worker
support, job influence, and organizational climate and role ambiguity were associated with
psychological distress. [Also] …work overload and pressure, role ambiguity, lack of control
over work, and lack of participation in decision making were all found to be associated with
distress.” (Michie and Williams, 2003)

A survey conducted by the Department of Community Health Sciences, The Aga Khan
University, concluded that Majority (68%) of the doctors were not satisfied with their jobs,
females more than males (males 65% and females 72%). A vast majority of female doctors
who participated in this survey perceived that their Physical health was good but level of
stress was “high” or “moderate”. Stress in female physicians led to more time-off work and
they started taking antidepressants while some also started smoking. These doctors who are
working under stress are less likely to enjoy their practice. Characteristics, which lead to
dissatisfaction, were pay and benefits, safety and security, workload, adequate resources
and physical working conditions.

A comparison across UK hospitals in the public sector found that rates of psychological ill
health varied from 17% to 33%, with lower rates in hospitals characterized by smaller size,
greater cooperation, better communication, more performance monitoring, a stronger
emphasis on training, and allowing staff more control and flexibility in their work. (Michie,
Williams, 2003)

Although it is difficult to define accurately, stress appears to be an unavoidable and common

aspect of a doctor’s work. It may have positive aspects in that some individuals may feel
challenged and may be able to raise productivity to meet increasing demands; however, in
junior doctors, work related stress and anxiety have been shown to lead to low morale and
poorer work performance and to adversely affect the quality of care provided (Wilkinson et
al. 2003). A number of studies have shown that stress experienced by junior doctors led to
reduced job satisfaction, depression and anxiety, sickness absence, and intention to leave.
However, the problem has been difficult to study because individual responses to stressful
situations vary and certain people are more likely than others to perceive high levels of
stress in their jobs. (Michie and Williams 2003)

Stress, therefore, is also relative to a personality of an individual. Different people find quite
different situations to be stressful. Circumstances which one person experiences as
stimulating or positively challenging will cause acute distress in another person. According to
a survey, stress, anxiety, job satisfaction and the influence of personality factors on a group
of house officers in the north east of England, showed that 37.5% of women and 24% of men
house officers suffered from possible psychological stress though they experienced the
same job conditions (Birch and Kamali 2000).

Personality factors have shown inclination towards stress, anxiety, and other occupational
health outcomes in different areas of medicine, and these factors may contribute to feelings
of job dissatisfaction and stress (Michie and Williams 2003). While many studies have
addressed these issues in many different groups of healthcare workers including those at
junior, middle grade, and senior staff levels but much work is still impending. (Stebbing et al.
2000)

The research has shown that needed freedom and proper support at the workplace has
helped in greatly reducing the stress. “Organizational factors may contribute to the level of
psychological ill health experienced by staff. Long hours were found to be associated with
depression in women, but not in men. Successful interventions that improve psychological
health and levels of sickness absence use training and organizational approaches to
increase participation in decision-making and problem solving, increase support and
feedback, and improve communication (Yang et al. 2002).

OBJECTIVES OF RESEARCH
Following are the research objectives:
ƒ To investigate the affect of job related stress on job performance
ƒ To investigate the effect of stress regards personality type (Type A, Type B)
ƒ To identify the factors which have relatively high tendency towards bringing
occupational stress
ƒ To analyze job stress in different departments
ƒ To identify the gender specific job stress factors

RESEARCH DESIGN
Data collection
Primary data will be gathered through a two-part questionnaire. Part one shall address
Personality type and Part two shall gather information about job stress and performance.
Individual semi-structured interviews and observations will also be used to collect
information about of the job routine, in order to find out how the work patterns have been
influenced by environmental factors.

Analysis of Data
Hypothesis testing will be performed using One-way analysis of variance (ANOVA) to
determine the variances within variables of stress and performance and correlation analysis
to determine relationship and directionality between performance and stress.

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