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Medical Factors
Preventing occupational stress

At a glance:
Occupational stress can cause:

Physical illness
Decreased quality of life
Poorer performance at work
Increased work absence and turnover
Increased costs for the employer and society
Organisational interventions
 aim to reduce workplace stressors, while individual interventions aim to change the way people respond to stressful situations. There is evidence that both these strategies can reduce occupational stress, which in turn would improve physical and mental health
mental health
 and reduce costs.

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

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

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

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

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

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

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

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

3. Provide clear and meaningful job descriptions

4. Be interested and supportive toward workers

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

6. Provide constructive feedback to staff

7. Provide appropriate physical work conditions

8. Increase worker control and autonomy where possible

9. Provide adequate training
Individual and organisational interventions are effective ways of managing occupational stress. Individual approaches found to be effective include cognitive behavioural therapy
Cognitive Behavioural Therapy
a therapy used to modify behaviour by changing a person's assumptions, beliefs and approach to a problem
 and relaxation training. Treating practitioners
treating practitioner
  can assist patients experiencing work stress through sensible strategies:

1. Help the patient identify the sources of their stress

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

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

4. Help the patient develop positive coping strategies
- Decreasing work hours

- Controlling stress

- Reducing self inflicted pressures, both at home and at work

- Increasing time for self

- Assertiveness – working out how to communicate issues in a clear and constructive way in the workplace

- General stress management approaches

- Yoga

- Assertiveness training

- Exercise

- Diet and sleep habits
 behavioural therapy and relaxation training. Encourage employers to address occupational stress and regard reducing stress in the workplace as an investment. Reducing stress increases workers health and reduces sick leave.

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

Preventing occupational stress in healthcare workers. Cochrane Database
Store of information (e.g. published research articles). Information can be retrieved by searching (e.g. for key words, authors, or titles).
 of Systematic Reviews (4): CD002892.
Background, Study Objectives, How It Was Done:
Occupational stress can lead to burnout or physical illness, distress, decreased quality of life and poorer performance at work. Increased work absence and turnover from occupational stress is costly for employers and for society. This review investigated interventions aimed at reducing stress in healthcare workers.

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

This review evaluates prevention strategies for occupational stress. 19 studies from Europe, North America and Asia were considered to be of high enough quality to be included in the review.
Study Findings:
In all 19 studies, individual or organisational interventions successfully reduced workplace stress.

Individual interventions were:

Cognitive behavioural therapy

Relaxation training

Therapeutic massage

Multicomponent interventions, such as combining communication skill training, stress management training, and practical skills in problem solving

Music making

Individual interventions resulted in:

Significantly reduced stress levels

Significantly reduced symptoms of burnout (emotional exhaustion and lack of accomplishment)

Significantly reduced state anxiety (acute anxiety)

Significantly reduced trait anxiety (general anxiety)

Improvement in general health for at least 1 month after cognitive behavioural therapy
Most improvements were maintained for the short and medium term. Long-term outcomes were not often recorded. In one study, however, a refresher course of cognitive behavioural therapy after 5, 11 and 17 months improved burnout in the long term.

Organisational interventions were:

Changes to work organisation, skills training and supervisor support

Psychological training to improve attitudes and communication skills

A training program to improve support between colleagues, problem solving and decision making
Organisational interventions resulted in:

Reduced stress

Reduced symptoms of burnout

Improvements to general health

Anxiety was not investigated in any of the studies
Organisational interventions aim to reduce workplace stressors, while individual interventions aim to change the way people respond to stressful situations. Both have the potential to reduce occupational stress, which in turn would improve the physical and mental health of workers and reduce costs.

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