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    Stress Management Initiatives at Multilink

    Introduction

    [B N Bahdur Institute of Management Science] Page

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    Significance of stress Management Initiatives

    Stress management is an essential step for you to take once you have determined

    you are facing stressful situations in your life, regardless of the cause. Although there are

    helpful types of stress that enables you to cater this added burst of energy into something

    positive and productive, it is not recommended for your body. Long term stress can

    specifically produce negative impacts on your health and is recognized to deteriorate your

    health faster than some other diseases.

    Furthermore, stress can reduce your capacity to perform and function well, either at

    school or in the workplace. Therefore, stress isnt something to be dismissed. Aside from

    the personal impacts you can e!perience from stress, it also affects how you deal with the

    environment and the people in your lives.

    ". #mproves overall health status.

    $. %ou are able to assume a more positive attitude and outlook in life.

    &. #t increases productivity since employees are able to focus clearly on tasks.

    '. (etter control over emotions .). And more importantly, reduce or eliminate stress in life.

    [B N Bahdur Institute of Management Science] Page

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    Stress Management Initiatives at MULTILINK,

    Stress is a fact of life, wherever you are and whatever you are doing. %ou cannot

    avoid stress, but you can learn to manage it so it doesnt manage you. *hanges in our lives

    such as going to college, getting married, changing +obs, or illness is freuent sources of

    stress. -eep in mind that changes that cause stress can also benefit you. oving away

    from home to attend college, for e!ample, creates personal/development opportunities new

    challenges, friends, and living arrangements. That is why its important to know you and

    carefully consider the causes of stress. Learning to do this takes time, and although you

    cannot avoid stress, the good news is that you can minimize the harmful effects of stress,

    such as depression or hypertension. The key is to develop an awareness of how you

    interpret, and react to, circumstances. This awareness will help you develop coping

    techniues for managing stress.

    Although we all talk about stress, it often isnt clear what stress is really about. any

    people consider stress to be something that happens to them, an event such as an in+ury or a

    +ob loss. 0thers think that stress is what happens to our body, mind, and behaviour in

    response to an event 12.g. heart pounding, an!iety, or nail biting3. 4hile stress does involve

    events and our response to then, these are not the most important factors. 0ur thoughts

    about the situations in which we find ourselves are the critical factor. 4hen something

    happens to us, we automatically evaluate the situation mentally. 4e decide if it is

    threatening to us, how we need to deal with the situation, and what skills we can use. #f we

    decide that the demands of the situation outweigh the skills we have, then we label the

    situation as 5stressful6 and react with the classic 5stress response.6 #f we decide that our

    coping skills outweigh the demands of the situation, then we dont see it as 5stressful.6

    Stress can come from any situation or thought that makes you feel frustrated, angry,

    or an!ious. 2veryone sees situations differently and has different coping skills. For this

    reason, no two people will respond e!actly the same way to a given situation. Additionally,

    not all situations that are labelled 5stressful6 are negative. The birth of a child, being

    promoted at work, or moving to a new home may not be perceived as threatening.

    7owever, we may feel that situations are 5stressful6 because we dont feel fully prepared to

    deal with them.

    [B N Bahdur Institute of Management Science] Page

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    Stress is a normal part of life. #n small uantities, stress is good8 it can motivate you

    and help you become more productive. 7owever, too much stress, or a strong response to

    stress can be harmful. 7ow we perceive a stress provoking event and how we react to it

    determines its impact on our health. 4e may be motivated and invigorated by the events in

    our lives, or we may see some as 5stressful6 and respond in a manner that may have a

    negative effect on our physical, mental, and social well/being. #f we always respond in a

    negative way, our health and happiness may suffer. (y understanding ourselves and our

    reaction to stress/provoking situations, we can learn to handle stress more effectively. #n

    the most accurate meaning, stress management is not about learning how to avoid or escape

    the pressures and turbulence of modern living8 it is about learning to appreciate how the

    body reacts to these pressures, and about learning how to develop skills which enhance the

    bodys ad+ustment. To learn stress management is to learn about the mind/body connection

    and to the degree to which we can control our health in a positive sense.

    Causes of Stress

    The most freuent reasons for 5stressing out6 fall into three main categories9

    ". The unsettling effects of change

    $. The feeling that an outside force is challenging or threatening you

    &. The feeling that you have lost personal control.

    Life events such as marriage, changing +obs, divorce, or the death of a

    relative or friend are the most common causes of stress. Although life/threatening

    events are less common, they can be the most physiologically and psychologically

    acute. They are usually associated with public service career fields in which people

    e!perience intense stress levels because of imminent danger and a high degree of

    uncertainty:police officer, fire and rescue worker, emergency relief worker, and

    the military.

    %ou may not plan to enter a high/stress career, but as a college student, you may

    find that the demands of college life can create stressful situations. The ;ational

    [B N Bahdur Institute of Management Science] Page

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    #nstitute of ental 7ealth 1;#73 notes some of the more common stressors for

    college students9

    < #ncreased academic demands

    < (eing on your own in a new environment

    < *hanges in family relations

    < Financial responsibilities

    < *hanges in your social life

    < 2!posure to new people, ideas, and temptations

    < Awareness of your se!ual identity and orientation

    < =reparing for life after graduation.

    Symptoms of Distress

    Symptoms of stress fall into three general, but interrelated, categories:

    physical, mental, and emotional. >eview this list carefully. #f you find yourself

    freuently e!periencing these symptoms, you are likely feeling distressed9

    < 7eadaches

    < Fatigue

    < ?astrointestinal problems

    < 7ypertension 1high blood pressure3

    < 7eart problems, such as palpitations

    < #nability to focus@lack of concentration

    < Sleep disturbances, whether its sleeping too much or an inability to sleep

    < Sweating palms@shaking hands

    < An!iety

    < Se!ual problems.

    [B N Bahdur Institute of Management Science] Page

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    ffects of stress

    2ven when you dont realize it, stress can cause or contribute to serious

    physical disorders. That can lead to increases in your heart rate, respiration, blood

    pressure, and physical demands on your internal organs. (ehavioural changes are

    also e!pressions of stress. They can include9

    < #rritability

    < isruptive eating patterns 1overeating or under eating3

    < 7arsh treatment of others

    < #ncreased smoking or alcohol consumption

    [B N Bahdur Institute of Management Science] Page

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    Significance of stress management initiatives

    Stress management is an essential step for you to take once you have determined you

    are facing stressful situations in your life, regardless of the cause. Although there are helpful

    types of stress that enables you to cater this added burst of energy into something positive and

    productive, it is not recommended for your body. Long term stress can specifically produce

    negative impacts on your health and is recognized to deteriorate your health faster than some

    other diseases. Furthermore, stress can reduce your capacity to perform and function well,

    either at school or in the workplace. Therefore, stress isnt something to be dismissed. Aside

    from the personal impacts you can e!perience from stress, it also affects how you deal with

    the environment and the people in your lives.

    4hen it comes to stress management, determining the source of stress is often not

    enough. For people who are often stressed, keeping a stress +ournal is highly recommended in

    order for you to monitor the different levels of stress you are e!periencing and what effects it

    produced. This is an effective way for you to closely study your levels of stress, its triggers,

    and for you to pinpoint e!actly what you can do to relieve yourself from it. Starting on Stress

    anagement now that you know the effects that stress can do to you, getting started on a

    stress management method is necessary. anaging your stress helps you regain control over

    your life, instead of being consumed by the amount of stress you had to deal with. 7eres

    how you can get started.

    < etermine what causes stress in your life.

    < Think of ways that you can reduce that stress. Formulate your stress management

    techniue for relieving stress.

    Steps on Stress Management

    0ne thing you need to keep in mind is that you cannot e!pect to totally get rid of

    stress. #t is a process wherein your initial goal would be to reduce the amount of stress in your

    life until you eventually get rid of it. The following ideas will help you establish a stress

    management method that could work9

    < #mprove your time management skills. ost of your stress in life is a result of your inability

    to sueeze in your plans within the time available to you. So, creating your schedule will

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    enable you to achieve more in less time. 4hen creating your schedule, put the most important

    items on top of your list.

    < Study the way you react with stress. This reuires your honesty to determine whether your

    own coping mechanisms are effective or not. #f not, then look for other means.

    < Take care of your body. This is often the most neglected aspect of stress management. ?et

    enough rest and eat well. %our health is the most vital factor in stress management.

    < *hange your mind/set. 0ftentimes, stress is produced only by your mind. So, if that is the

    case with you, then adopting a new perspective might reduce your stress levels.

    !enefits of Stress Management

    #f you cannot fully understand the importance of stress management, then try thinking

    in reverse. #magine yourself not suffering from the negative impacts of stress. 4ithout the

    negative results of stress in your life, then a person is able to en+oy a more satisfying and

    stress/free life. To sum it up, here are the benefits that can be derived with practicing an

    efficient stress management method9

    ". #t improves your overall health status.

    $. %ou are able to assume a more positive attitude and outlook in life.

    &. #t increases your productivity since you are able to focus clearly on your tasks.

    '. %ou have better control over your emotions and how you respond to it.

    ). And more importantly, you reduce or eliminate stress in your life

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    Statement of t"e pro#$em

    The study designed an effective stress management program for BLT#L#;-

    2mployees. Specifically, it answered the following problems9

    ". 4hat is the level of stress e!perienced by the

    a3 iddle anagement, and

    b3 Low Level anagementC

    $. 4hat is the correlation of +ob position and level of stressC and8

    &. 4hat is the stress management program that could be designed which suits the needs of

    BLT#L#;- employeesC

    %"at "appens &"en you are stressed'

    Stress is what you feel when you have to handle more than you are used to. 4hen you

    are stressed, your body responds as though you are in danger. #t makes hormones that speed

    up your heart, make you breathe faster, and give you a burst of energy. This is called the

    fight/or/flight stress response. Some stress is normal and even useful. Stress can help if you

    need to work hard or react uickly. For e!ample, it can help you win a race or finish an

    important +ob on time.

    (ut if stress happens too often or lasts too long, it can have bad effects. #t can be

    linked toheadaches, an upset stomach,back pain, and trouble sleeping. #t can weaken your

    immune system, making it harder to fight off disease. #f you already have a health problem,

    stress may make it worse. #t can make you moody, tense, or depressed. %our relationships

    may suffer, and you may not do well at work or school.

    [B N Bahdur Institute of Management Science] Page 9

    http://www.webmd.com/heart/picture-of-the-hearthttp://www.webmd.com/migraines-headaches/default.htmhttp://www.webmd.com/migraines-headaches/default.htmhttp://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomitinghttp://www.webmd.com/back-pain/default.htmhttp://www.webmd.com/back-pain/default.htmhttp://www.webmd.com/sleep-disorders/default.htmhttp://www.webmd.com/hw-popup/immune-system-7922http://www.webmd.com/sex-relationships/default.htmhttp://www.webmd.com/migraines-headaches/default.htmhttp://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomitinghttp://www.webmd.com/back-pain/default.htmhttp://www.webmd.com/sleep-disorders/default.htmhttp://www.webmd.com/hw-popup/immune-system-7922http://www.webmd.com/sex-relationships/default.htmhttp://www.webmd.com/heart/picture-of-the-heart
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    %"at can you do a#out stress'

    The good news is that you can learn ways to manage stress. To get stress under control9

    Find out what is causing stress in your life.

    Look for ways to reduce the amount of stress in your life.

    Learn healthy ways to relieve stress and reduce its harmful effects.

    (o& do you measure your stress $eve$'

    Sometimes it is clear where stress is coming from. %ou can count on stress during a

    ma+or life change such as the death of a loved one, getting married, or having a baby. (ut

    other times it may not be so clear why you feel stressed.

    #tDs important to figure out what causes stress for you. 2veryone feels and responds to

    stress differently. Tracking your stress may help. ?et a notebook, and write down when

    something makes you feel stressed. Then write how you reacted and what you did to deal

    with the stress. Tracking your stress can help you find out what is causing your stress and

    how much stress you feel. Then you can take steps to reduce the stress or handle it better.

    [B N Bahdur Institute of Management Science] Page 1

    http://www.webmd.com/balance/stress-management/stress-management-relieving-stresshttp://www.webmd.com/balance/stress-management/stress-management-relieving-stress
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    )#*ectives of t"e study

    The broader ob+ective of the study is to understand the uniueness of stressmanagement strategies to manage the stress effectively, to improve the productivity,

    sustainability and achieve competitive advantage. T"e specific o#*ectives are

    "3 To assess *urrent stress level of employees at BLT#L#;-.

    $3 To measure the impact of stress on work and life.

    &3 To assess the stress management initiative at BLT#L#;-.

    '3 To suggest a model to reduce stress level of employees and manage it in an efficient

    manner.

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    Scope of t"e study

    The scope of this study is e!tended only to the 2mployees working in BLT#L#;-.

    #t does not cover employees working in other branches of BLT#L#;-. To fulfil the

    ob+ectives of this research, the study will be undertaken to analyze the stress management at

    BLT#L#;-, &E, 72((AL #;BST>#AL A>2A, 72((AL ysore/)GEE"H, -arnataka,

    #ndia.

    Stress management #nitiatives involves finding ways to deal with the effects of stress,

    this can be done either psychologically or physiologically. #t refers to a range of techniues to

    help reduce our stress levels. This study concentrating on the psychological methods, which

    include stress inoculation and increasing hardiness. Stress inoculation is a form of cognitive

    restructuring. #t aims to change the way people think about their lives and themselves, in

    effect, changing their emotional responses and also their behaviour. #ncreasing hardiness is

    simply learning people to become tougher, and therefore less susceptible to stress.

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    +S+C( MT()D)L)-./

    The study of this pro+ect is based on both ualitative and uantitative approach, which

    will give the benefits of both ualitative as well as uantitative researches. The data

    collection will be done through both ualitative and uantitative sources of data. The research

    approach will be deductive to critically investigate and analyze the views of women

    employees on work/life balance. The research philosophy of positive will be most useful for

    this study because it will comprehensively described the ob+ective aspects of research.

    The steps in which the pro+ect would be carried out is by collecting both the primary

    and the secondary data. The secondary data will be collected first. This collection of data will

    be done by means of reading various materials such as books, +ournals, magazines,

    newspaper articles, etc.8 looking for similar content online 1i.e., on the #nternet3. Then a

    structured uestionnaire and survey would be used as a primary data collecting tool which

    will be filled by the employees of organizations using convenience sampling.

    Type of +esearc"

    Descriptive typeThe descriptive research attempts to describe, e!plain and interpret conditions of the

    present i.e. 5what is. The purpose of a descriptive research is to e!amine a phenomenon that

    is occurring at a specific place and time. A descriptive research is concerned with conditions,

    practices, structures, differences or relationships that e!ist, opinions held processes that are

    going on or trends that are evident.

    DT S)U+CS/

    "3 =rimary source$3 Secondary source

    (oth types of the data are will be use in the current study.

    0+IM+. DT/ The primary data will be collected from the respondents by

    administering a structured, Iuestionnaire and also through 0bservation, interview and

    discussion with the management and team.

    SC)ND+. DT/ Apart from primary data the secondary data will be collected through

    te!t books, records of the company, +ournals, from library, academic reports, and internet

    sources.SM0LIN-

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    Samp$e popu$ation/ there are 1number of employees in the company 3 employees working

    in the company.

    Samp$e si1e/out the total population, the sample will be taken amongst employees i.e., )E

    respondents.

    Samp$ing area/The research will be conducted at BLTL#;-Samp$ing met"od/The research will be made by the survey in accordance to the

    convenience of the employees.

    So the sample type is convenience sampling.

    T))LS 2)+ NL.SIS/

    =rimary data will be collected through the uestionnaire by distributing the

    uestionnaires8 uestionnaire with both close ended and open ended uestions will be

    used as sample respondents. 0n the basis of the tables, the facts are presented in the

    form of (A>, =#2 charts and tables by using programs of icrosoft office.

    0LN )2 NL.SIS/

    The data will be collected and classified in an organized and systematic manner.

    The data will be collected and classified by random sampling methods.

    The classified data will be tabulated and calculated into percentages.

    The data will be Analyzed and then interpreted for getting results reuired for

    the study.

    The tabulated data will be shown in the form of Tables, (A> and =#2 charts

    for better understanding.

    LIMITTI)N )2 T( STUD.

    The present study is limited to many aspects. =roviding information about Stress

    anagement is the outcome of various variables. #t is not possible to take into *onsideration

    each and every aspect@criteria in this study.

    The research study is limited to a small size.

    Some of the information which will be given by the respondents may not be reliable

    1bias3.

    # wont be able to collect the information from all of the employees of the

    organization because of the busy schedule of employees.

    [B N Bahdur Institute of Management Science] Page 1#

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    The study is confined only to the employees of BLT#L#;- therefore the results and

    conclusions of this study may not be applicable to other organizations.

    Some 2mployees will hesitate to answer the uestions correctly.

    The analysis will be done assuming that the respondents have given correct answers

    through uestionnaire.

    C"apter3 4

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    Literature revie&

    Literature +evie&

    Literature review is the study of e!isting researches relevant to the current research

    pro+ect. The attempts are made to show how published information relates to my research

    work. This part will give an understanding of the previous researches and can be as an

    overview to the current research work. The literature review will help readers in

    understanding and evaluating the topic in more depth while assists me in finding answers to

    some of the uestions unanswered.

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    A review on the previous studies on stress among the employees is necessary to know

    the areas already covered. This will help to find our new areas uncovered and to study them

    in depth. The earlier studies made on stress among the employees are briefly reviewed here.

    The research study of Jamal. finds that +ob stressors were significantly related to

    employees psychosomatic problems, +ob satisfaction, unproductive time at the +ob, and

    absenteeism. Type A behaviour was found to be an important moderator of the stress outcome

    relationship. (rief. A. =. and J. . Atieh argues that it is not safe to assume that +ob

    conditions that have an adverse impact on affective reactions to the +ob will also have a high

    level of e!perienced an!iety or tension. >ecent research into the interaction between the mind

    and body shows that we may place our body on stress Kalert uite unconsciously, because of

    our psychological and emotional attitudes to stress.

    Anticipatory emotions like impatience, an!iety, and anger can produce the same nerve

    impulses and chemical reactions as being faced with a concrete challenge. So when faced

    with a stressful situation, we must either use up the energy created by the body to challenge

    or learn how to 5turn off6, the response using a conscious rela!ation techniue . 7ans Seyle,

    the endocrinologist, whose negative impact on overall sub+ective wellbeing. Fienmann &M

    views stress as a psychological response state of negative effect characterized by a persistent

    and a research on ?eneral Adaptation Syndrome 1?AS3, for the first time, revealed how

    human beings adapt themselves to emotional strives and strains in their lives. According to

    him emotional stress occurs in three important stages.

    ". Alarm reaction stage

    $. >esistance stage

    &. 2!haustion stage.

    Alarm reaction is caused by physical or psychological stressors. 2!haustion follows

    when A*T7 dwindles as a result of continual stress. According to Stephen .=. >obbins,

    5stress related headaches are the leading cause of loss of work time in B. S. industry6.

    *ooper and arshallN visualize stress as characteristics of both the focal individual and his

    environment. They designate the internal and e!ternal convulsive forces as Kpressures or

    Kstressors and the resulting stalk of the organism on stress.

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    ?eeta -umari and -..=andey'M worked on Job Satisfaction in =ublic Sector and

    =rivate Sector9 A *omparison. Their main findings are given below9 =ublic Sector versus

    =rivate Sector comparisons are a debate which seems to be a never ending topic. #t is very

    difficult to take stand for either of these two forms of administration. The reason behind that

    is not unknown but obvious as both provide scopes in different ways. Job satisfaction

    describes how content an individual is with his or her +ob. The happier people are within their

    +ob, the more satisfied they are said to be. This paper surveys both the sectors in most of the

    aspects of analysis..

    As the current findings show, +obholders vary regarding the e!tent of ambivalence

    e!perienced with respect to their attitude toward their +ob. The current findings also open up

    opportunities for further research regarding the conseuences of +ob ambivalence. For

    instance, the present findings imply that +ob performance of individuals with high versus low

    +ob ambivalence may fluctuate such that +ob performance is comparatively high when

    positive beliefs and affective e!periences are salient and thus predominate at a certain point

    in time but that their performance may be comparatively low at other times when negative

    beliefs and affective e!periences are salient and predominate. #n this respect, research could,

    for instance, collect manager perceptions of performance consistency. Future research should

    aim to replicate the present findings with larger and more diverse samples as well as profit

    from the use of multiple/item scales to measure +ob performance.

    ayoAkintayo 1$E"$3 found that working environment is significantly related to

    workersK morale and also working environment is significantly correlated with perceived

    workersK productivity. r. -. *handrasekar 1$E"'3 found that environmental factors are

    conducive to work and he also found that factors that affect attitude of employees to work

    are/ interpersonal relationships control over environment, shift, emotional factors, +ob

    assignment, overtime duty, e!tended work. L.S. -ang and >.S. Sandhu 1$E"'3 in their article

    said that Stress is an individuals state of mind in an encounter of a demanding situation or

    any constraint in the organization which s@he feels harmful or threatening for her@himself.

    Stress emerges from various energy seeping conditions in the working environment.

    According to =ratibha ?arg 1$E"&3 Job or occupational stress is mismatch between the

    individual capabilities and organizational demands. 2mployees often e!perience stress

    because of work overload, an e!pected work pace, difficult work schedules, role conflict,

    uncertainty regarding +ob security, poor interpersonal relationships and unpleasant working

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    conditions. This stress manifests in conflict, depression, headaches, hypertension, alcoholism

    and other conditions. The organizations do not only lose money by paying medical bills but

    there is a loss of productivity. > ;eelamegam and S Asrafi 1$E"&3 in their article said that

    Stress is a general term applied to the pressures felt in life. Stress at work is almost

    inevitable in many +obs. #t has become a ma+or buzzword and a legitimate concern of the

    time. According to ; -athirvel 1$EE3 Stress is the reaction that people take due to e!cessive

    pressure or other types of demand placed on them. #t arises when they worry that they cannot

    cope. Stress is a demand made upon the adaptive capacities of the mind and body. -ulkarni

    1$EEH3in an article (urnout said that rapid change of the modern working life is associated

    with increasing demands of learning new skills, need to adopt to new types of work, pressure

    of higher productivity and uality of work, time pressure and hectic +obs are increasing stress

    among the workforce.

    Further he added that privatization and globalization have ignited mergers,

    acuisitions and precarious employment. Anne arie (erg et al6N in study in $EEH of

    ;orwegian police said that the prevalence of sub+ective health complaints was relatively high

    and was mainly associated to +ob pressure and lack of support. ales showed more

    depressive symptoms than females. All stress factors on freuency were positively associated

    to the burnout dimensions depersonalization and emotional e!haustion e!cept work in+uries.

    Sharma, -hera and -handekar 1$EEH3 *omputer >elated 7ealth =roblems among

    #nformation Technology =rofessionals in elhi O A publication in #ndian Journal of

    *ommunity edicine in January $EEH found more on visual stress and musculoskeletal

    symptoms, initially being mild and temporary and later with increasing years assuming more

    intense and permanent nature. #t also found that computer related morbidity had become an

    important occupational health problem and of great concern. #t suggested an immediate need

    for the concerned authorities to collaborate and enforce suitable preventive measures. (arhem

    et al 1$EE'3 define stress as an e!traordinary state affecting individual human functions as an

    outcome of internal and e!ternal factors which differ ualitatively1having different types of

    stressors3 and uantitatively1having different numbers of stressors3 from individual

    performance, due to individual differences. *obb 1"G)3has the opinion that, 5The

    responsibility load creates severe stress among workers and managers.6 #f the individual

    manager cannot cope with the increased responsibilities it may lead to several physical and

    psychological disorders among them. (rook 1"G&3reported that ualitative changes in the

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    +ob create ad+ust mental problem among employees. The interpersonal relationships within

    the department and between the departments create ualitative difficulties within the

    organisation to a great e!tent.

    A literature review conducted by ichieP 4illiams in $EE$, indicated that key work

    factors associated with psychological ill health and sickness absence in staff were long H

    hours worked, work overload and pressure, and the effects of these on personal lives 1riscoll

    et al., ")8 Frone et al., ")8 -arasek, "G8 ;iedhammer et al., "Q8 =ayne P Fletcher,

    "Q&8 >eifman et al., ""8 Stansfeld et al., ")38 conflicting demands 1Stansfeld et al.,

    ")38 lack of control over work and lack of participation in decision/making 1Frone et al.,

    ")8 -arasek, "G8 -arasek, "E8 ;iedhammer et al., "Q8 =ayne and Fletcher, "Q&8

    Sparks P *ooper, "8 Stansfeld et al., "), "Q38 poor social support at work 1riscoll et

    al., ")8 Frese, "8 Fusilier et al., "QG8 La>occo et al., "QE8 ;iedhammer et al., "Q8

    >eifman et al., ""8 Stansfeld et al., "), "Q38 unclear management and work role

    1(acharach et al., ""8 *arayon et al., ")8 Frone et al.,")8 La>occo et al., "E8

    >eifman et al., ""38 interpersonal conflict 1Sparks P *ooper, "8 >omanov et al., "H38

    and conflict between work and family demands 1Sparks P *ooper, "3.

    Several e!planations have been put forward in the literature for the high levels of ill

    health in the health care environment, including the nature of the work, organisational

    changes, and the large amounts and pressure of work 1*o! ")3. *ommonly identified

    sources of stress are workload, patient care, interpersonal relationships with colleagues,

    knowledge of nursing and nursing skills, type of nursing, and bureaucratic/political

    constraints 1(ailey, "Q)3. A comparison across B- hospitals in the public sector found that

    rates of psychological ill health varied from "GR to &&R with lower rate in hospitals

    characterised by smaller size, greater cooperation, better communication, more performance

    monitoring, a stronger emphasis on training, and allowing staff more control and fle!ibility in

    their work 14all, "G3. This supports the notion that organisational factors may contribute ot

    the level of psychological ill health e!perienced by staff.

    According to a study conducted by c?rath and colleagues 1$EE&3 amongst "G"

    nurses, on occupational stress in nursing, the most commonly cited stressor by nurses was too

    little time to perform duties to the persons satisfaction and rationing of scarce resources or

    services. ;early half of the respondents mentioned the meeting of imposed deadlines G as a

    source of stress, and over a third found counteracting, unhelpful views others held of their +ob

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    a cause of stress. A significant finding from this study was that nurses tried to alleviate stress

    in their +obs through avoidance behaviours. The study clearly suggests that nurses are

    avoiding the emotional demands of patients as evidenced by $GR who report this as a cause

    of stress. #t is suggested that a coping mechanism specific to nursing may be that nurses

    unconsciously reduce stress in their +ob by setting nursing ob+ectives as physical ob+ectives in

    their +ob.

    #n the conte!t of the transnational nature of the >0S2 pro+ect, ichieP 4illiams

    1$EE$3 review on reducing work related psychological ill health and sickness absence was

    particularly significant, as it provided an assessment of whether associations between work

    factors and psychological ill health were similar across sector and across countries. #n the B-

    factors associated with psychological distress, emotional e!haustion, an!iety and depression

    in doctors, from +unior to senior grades, were long working hours 1(aldwin et al., "G3, high

    workload and pressure at work 1Agiuset al., "H8 earyet al., "H8 Sutherland and *ooper,

    "&3, and lack of role clarity 17eyworth et al., "&3. #n a study conducted with ' dentists,

    pressure at work was found to be associated with poor mental health 1*ooper et al., "QQ3.

    #n a study carried out amongst family doctors, the issues were interruptions during

    and outside surgery hours and patients demands 1Sutherland and *ooper, "&3. Among B-

    nurses the most freuently reported source of psychological distress was workload pressures

    1Tyler and *ushway, "$3. #n a study conducted amongst "H' student nurses, low

    involvement in decision making and use of skills, and low social support at work were found

    to be associated with an!iety, depression and sickness absence 1=arkes, "Q$3. Two studies

    looked at absence from work, one study found a negative association with +ob demands

    1=arkes, "Q$3, while the other found no association with control over work 1>ees P *ooper,

    "$3. Similar factors were associated with psychological ill health in health care workers in

    the rest of 2urope, the BSA, and Australia. The one study of doctors found an association

    between work control and social support and psychological distress 1Johnson et al., ")3.

    Among nurses, lack of co/worker support 1arshall P (arnett, "$8 =isarskiet al., "Q3,

    +ob influence 1=ettersonet al., ")3, and organisation climate and role ambiguity 1>evickiP

    ay, "Q3 were associated with psychological distress. Among other hospital workers, 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 1Arsenault et al., ""8 2stryn/

    (ehar et al., "E8 artin, "Q'3. Sickness absence was associated with work pressures and

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    lack of training 1LandeweerdP(oumans, "$3, unsupportive management style 1?ray/Toft

    P Anderson, "Q)3, role ambiguity, tolerance of absenteeism and low pay 1(rooke P =rice,

    "Q3.

    The studies show that, while level of psychological ill health associations between

    work factors and psychological ill health are higher in health care than in non/health care

    workers 14all, "G3, the associations between work factors and psychological ill health are

    similar. They are also similar across continents. This review suggests that a generic approach

    to reducing work related psychological ill/health may be appropriate. The findings from this

    review are also consistent with the demand/control model of +ob strain 1-arasek, "G3. They

    highlight the H key areas of work design that commonly lead to stress 1i.e. control, demands,

    support, relationships, role and change3.

    4alter *annon 1"&)3 was the first to consider stress as an Demergency responseD. 7e

    proposed that sympathetic arousal in response to a stressor allowed the individual to fight or

    flee from danger. #n other words, he considered the response to stress as adaptive and directly

    related to survival. *annonDs 1"&)3 work led to the formulation of the ?eneral Adaptation

    Syndrome by 7ans Selye 1")H3 7e found from a series of e!periments that when crude

    ovarian e!tracts were in+ected into rats, a DtriadD of changes occurred. These included adrenal

    cortical enlargement, atrophy of the thymus and other lymphatic structures, and deep

    bleeding ulcers of the stomach and duodenal lining.

    Selye later found that e!tracts of placenta, pituitary, kidney, spleen, formalin, heat, !/

    rays, trauma, pain and many other stimuli also produced the same triad of changes. 7e stated

    DG could find no no!ious agent that did not elicit the syndrome 1ason, "G), p. H3 The

    ?eneral Adaptation Syndrome was divided into three temporal phases, which Selye 1"")H3

    called the alarm reaction, the stage of resistance, and the stage of e!haustion. Selye 1")H3believed that during the alarm reaction stage, the individual mobilises the bodyDs resources in

    order to fight or flee from danger. Arousal results from the secretion of A*T7 by the pituitary

    gland, which in turn causes the release of epinephrine, norepinephrine and cortisol into the

    bloodstream by the adrenal glands. #f a strong stressor continues, the second stage of the

    ?AS, that of resistance occurs. uring this stage, the body attempts to adapt to the situation.

    =hysiological arousal is reduced, but is still at a level higher than normal.

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    Although the individual may not actually show outward signs of stress, their ability to

    cope with new stressors will be impaired, and they will be more likely to suffer from illnesses

    related to reduced immune function. The final stage of the ?AS, that of e!haustion, occurs

    when a stressor continues over a long period of time. 2nergy reserves are depleted until the

    individual may no longer be able to resist the adverse effects of a stressor, and disease and

    death are increasingly likely to result.

    Selye 1")H3 argued that this syndrome was non/specific, in that all aversive physical

    stimuli produced the same physiological response. 7e argued that stress was the sum of all

    non/specific changes caused by function or damage 1")H, p. H)3 SelyeDs 1")H3 proposal of

    the ?eneral Adaptation Syndrome was at first widely supported. #ndeed, 2ngel reported in the

    early ")EDs that =rofessor Selye has presented a concept which is almost breathtaking in its

    scope 1ason, "G), p. Q3.

    The advent of biochemical methods with which to directly measure adrenal cortical

    hormones in plasma and urine, gave researchers the opportunity to empirically test SelyeDs

    1")H3 theory more accurately than previously, when only indirect methods such as glandular

    weight and metabolic effects of hormones were available. The studies found that the levels of

    these hormones were often elevated in response to a whole range of aversive stimuli. 1ason,

    "G"3 7owever, during the "HEs, the whole concept of non/specificity was uestioned by

    many of those working within the area of psycho endocrinology.

    ason 1"HQ3 argued that most of SelyeDs 1")H3 e!perimental situations were likely

    to involve some degree of emotional reaction. 7e carried out a study whereby the

    temperature in a chamber housing a chair/restrained monkey was rapidly increased from

    GE""Fto Q)EF within a few minutes. An elevation in the monkeyDs level of "G/

    hydro!ycorticosteroid was indeed reported. 7owever, ason 1"HQ3 argued that the rapidincrease in temperature would have evoked e!treme psychological discomfort in the monkey,

    and the e!periment was not therefore a valid reflection of the effects of an aversive physical

    stimulus on the endocrine system.

    ason 1"HQ3 carried out a follow/up study, attempting to eliminate any spurious

    psychological variables. This time, the temperature rise was gradual, at a rate of " 0F per

    hour. The results showed a suppression of the monkeyDs level of "G/07*S. Although ason

    1"G"3 recognised that these and similar results from animal studies must be regarded as

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    tentative until evaluated in terms of human sub+ects, he suggested that the primary mediator

    underlying the pituitary/adrenal cortical response to Dstress researchDmay simply be the

    psychological apparatus involved in emotional or arousal reactions to threatening or

    unpleasant factors in life situations as a whole 1p. &$3. ason 1"HQ3 further argued that

    this primary mediator may in fact be a behavioural response of emotional arousal or

    hyperalerting preparatory to flight or fight a physical stimulus.

    Therefore, if a physical stressor was perceived as very threatening, ason 1"HQ3

    proposed that psych endocrine responses may occur universally, and would be superimposed

    upon the endocrine and other bodily responses to the pure DphysicalD stimulus. >esearch has

    since focused on the relationship between and within the behavioural, physiological and

    sub+ective response areas under the general assumption that stress response is likely to be

    variable across individuals and situations.

    ayoAkintayo1$E"$3 found that working environment is significantly related to

    workersK morale and also working environment is significantly correlated with perceived

    workersK productivity. r. -. *handrasekar 1$E"'3 found that environmental factors are

    conducive to work and he also found that factors that affect attitude of employees to work

    are/ interpersonal relationships control over environment, shift, emotional factors, +ob

    assignment, overtime duty, e!tended work. L.S. -ang and >.S. Sandhu 1$E"'3 in their article

    said that Stress is an individuals state of mind in an encounter of a demanding situation or

    any constraint in the organization which s@he feels harmful or threatening for her@himself.

    Stress emerges from various energy seeping conditions in the working environment.

    According to =ratibha?arg 1$E"&3 Job or occupational stress is mismatch between the

    individual capabilities and organizational demands.

    2mployees often e!perience stress because of work overload, an e!pected work pace,difficult work schedules, role conflict, uncertainty regarding +ob security, poor interpersonal

    relationships and unpleasant working conditions. This stress manifests in conflict, depression,

    headaches, hypertension, alcoholism and other conditions. The organizations do not only lose

    money by paying medical bills but there is a loss of productivity. > ;eelamegam and S Asrafi

    1$E"&3 in their article said that Stress is a general term applied to the pressures felt in life.

    Stress at work is almost inevitable in many +obs. #t has become a ma+or buzzword and a

    legitimate concern of the time. According to ; -athirvel 1$EE3 Stress is the reaction that

    people take due to e!cessive pressure or other types of demand placed on them. #t arises

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    when they worry that they cannot cope. Stress is a demand made upon the adaptive capacities

    of the mind and body.

    -ulkarni 1$EEH3 in an article (urnout said that rapid change of the modern working

    life is associated with increasing demands of learning new skills, need to adopt to new types

    of work, pressure of higher productivity and uality of work, time pressure and hectic +obs

    are increasing stress among the workforce. Further he added that privatization and

    globalization have ignited mergers, acuisitions and precarious employment.

    Anne arie (erg et al6N in a study in $EEH of ;orwegian police said that the

    prevalence of sub+ective health complaints was relatively high and was mainly associated to

    +ob pressure and lack of support. ales showed more depressive symptoms than females. All

    stress factors on freuency were positively associated to the burnout dimensions

    depersonalization and emotional e!haustion e!cept work in+uries.

    Sharma, -hera and -handekar 1$EEH3 *omputer >elated 7ealth =roblems among

    #nformation Technology =rofessionals in elhi / A publication in #ndian Journal of

    *ommunity edicine in January $EEH found more on visual stress and musculoskeletal

    symptoms, initially being mild and temporary and later with increasing years assuming more

    intense and permanent nature. #t also found that computer related morbidity had become an

    important occupational health problem and of great concern. #t suggested an immediate need

    for the concerned authorities to collaborate and enforce suitable preventive measures. (arhem

    et al 1$EE'3 define stress as an e!traordinary state affecting individual human functions as an

    outcome of internal and e!ternal factors which differ ualitatively 1having different types of

    stressors3 and uantitatively 1having different numbers of stressors3 from individual

    performance, due to individual differences.

    *obb 1"G)3 has the opinion that, 5The responsibility load creates severe stress

    among workers and managers.6 #f the individual manager cannot cope with the increased

    responsibilities it may lead to several physical and psychological disorders among them.

    (rook 1"G&3 reported that ualitative changes in the +ob create ad+ust mental problem among

    employees. The interpersonal relationships within the department and between the

    departments create ualitative difficulties within the organisation to a great e!tent.

    Stress as a stimulus The stimulus/based model of the stress process was aptlydescribed by Sir *harles Symonds in "'G, when discussing psychological disorders in >AF

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    flying personnel. 7e stated that, it should be understood once and for all that 1flying3 stress

    is that which happens to the man, not that which happens in him8 it is a set of causes, not a set

    of symptoms 1#n *o!, "GQ, p. )$3 The model describes stress in terms of stimulus

    characteristics of the environment which are recognised as disturbing.

    *o! 1"GQ3 compared the model to 7ookeDs Law of 2lectricity, which states that if the

    strain produced by a given stress passes beyond the Delastic limitD of the material, then

    permanent damage will result. Similarly, if a person e!periences an intolerable amount of

    stress, physiological or psychological damage will occur. ason 1"G)3 reported that uite

    ironically, Selye originally perceived stress in terms of a stimulus. 7is decision to define

    stress as a bodily response is not clear, although ason 1"G)3 suggested that it might have

    been as a result of a desire to focus more on the non/specificity response triad which he had

    proposed.

    The definition of stress as a stimulus is very simplistic, and allows one to determine at

    what point damage may occur. 7owever, *o! 1"GQ3 argued that humans are not machines,

    and therefore will not react in the same way to all stimuli. #ndeed ason 1"G)3 stated that

    knowledge of stimulus conditions does not necessarily allow prediction of psychological or

    psycho physiological responses, because of pervasive individual differences with regard to

    such factors as past history, threat appraisal and coping or defensive styles 1p. $Q3. #t was

    this recognition of the role of specific environmental and individual factors in the stress

    response which led to the development of an interactive model of the stress process.

    Stress as an interaction between the person and the environmental review of the

    literature on stress revealed a growing consensus amongst those working in the field, that

    stress should be defined in terms of the interaction between the individual and their

    environment. The transactional approach considers aspects of the potentially stressfulenvironment together with the individualDs cognitive and behavioural processes.

    #t is this approach which shall be used as a definition of stress in the present research.

    Lazarus 1"HH3 was one of the first researchers to e!amine the cognitive and behavioural

    processes which are believed to occur upon the onset of a stressor. 7e outlined two processes,

    appraisal and coping, which formed the foundations of the interactions model.

    =rimary and secondary appraisal 9=rimary appraisal occurs when an individualevaluates a situation, and assesses whether or not it threatens their well/being. Lazarus and

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    Launier1"GQ3 described"$primary appraisal as consisting of three basic categories. A

    situation could be appraised by the individual as being irrelevant, benign/positive, or as

    stressful. #f an event is perceived as being stressful, it is further appraised in terms of harm/

    loss, referring to the e!tent of the damage which has already occurred, as a threat, referring to

    the e!pectation of future harm/loss, or as a challenge, in which the individual perceives an

    opportunity for growth.

    uring secondary appraisal, the individual evaluates the resources which are available

    to help them to cope with the potentially stressful situation. Sarafino 1"E3 pointed out that

    although an individual tends to evaluate the coping resources available to them1secondary

    appraisal3 after an event has been perceived as stressful 1primary appraisal3, he acknowledged

    that the two processes are highly interrelated 1p. QE3and secondary appraisal of oneDs

    limited resources can in fact lead to primary 5appraisals of threat where they would not

    otherwise occur 1*oyne and 7olroyd, "Q$,p. "E3 As e!plained by ingerhoets and

    arcelissen 1"QQ3 a state of stress will tend to occur when an individual perceives a

    discrepancy between the demands of a situation and his@her capabilities. #t is therefore not

    simply the characteristics of the situation, but also the individualDs appraisal of it, which

    determines the response, andwhether or not a state of stress will develop. ingerhoets and

    arcelissen 1"QQ3proposed that this e!plains why one manDs poison may be anotherDs food

    and drink 1=.$Q'3.

    *opingThe second of LazarusDs 1"HH3 core processes is that of coping. any

    conceptual definitions of coping have been proposed, most of which have e!plained the term

    as part of the person/environment interaction which occurs when an individual appraises an

    event as being stressful 1Latack and 7avlovic, "$3. For e!ample, a fairly global definition

    of coping was suggested by *oyne, Aldwin and Lazarus 1"Q"3 who argued that coping

    refers to efforts, both cognitive and behavioural, to manage environmental and internal

    demands and conflicts affecting an individual that ta! or e!ceed a persons resources 1p.

    ''E3.

    -ahn, 4olfe, Iuinn, Snoek and >osenthal 1"H'3 proposed a two dimension typology

    of coping, namely *lass " *oping, which included problem solving, and *lass $*oping,

    which involved dealing with emotional or an!iety reactions. ore recently the terms

    problem/focused and emotion/focused coping, which were proposed by Lazarusand Folkman

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    1"Q'3 have become widespread. =roblem focused coping is defined in terms of efforts to

    manage the stressor, such as seeking medical attention or changing +ob.

    2motion/focused coping focuses on ways of dealing with the emotions caused bythe

    stressor. This includes activities such as seeking emotional support or using alcohol to try to

    forget about the problem. There is evidence to suggest that problem/focused coping may be

    more adaptive than emotion/focused strategies. For e!ample, (illings and oos 1"Q'3 found

    thatU problem/focused coping was associated with lower levels of depression than emotion

    focused coping. 7owever, as pointed out by eichenbaurn 1"Q)3, the key to effective stress

    reduction may be in the diversity and fle!ibility of an individualDs coping repertoire.

    eichenbaum 1"Q)3 argued that different types of coping strategies maybe reuired

    in different situations. For e!ample, he stated that in uncontrollable situations, emotion/

    focused coping methods such as acceptance and denial may be most effective. This should be

    considered in terms of the techniues offered within a stress management intervention.

    =sychosocial factors which moderate an individualDs response to stress. 0ver the last

    twenty years, researchers have become interested in e!amining those psychosocial factors

    which moderate an individualDs response to a potentially stressful"'event 1*ohen and

    Lazarus, "Q&8 -obasa, "QH8 2lliot, Trief and Stein, "QH87ouston, "QH3. These factors

    include individual variables such as personal control, hardiness, self/esteem, type A@type (

    behaviour patterns and social support.

    =ersonal control >odin 1"QH3 defined personal control as the feeling that one can

    make decisions and take effective action in order to produce desirable outcomes and avoid

    undesirable ones. #ndividuals who believe that they have control over events which happen to

    them in their lives are described as having an internal locus of control. 7owever, those people

    who believe that events which they e!perience are due to luck, chance or fate have an

    e!ternal locus of control. 1>otter, "HH3.

    The research literature surrounding the mediatory role of locus of control in the

    stressor/strain relationship is somewhat contradictory. Johnson and Sarason 1"GQ3found a

    correlation between negative life stress and depression and an!iety amongst e!ternally/

    oriented individuals only. 7owever, Schill et al 1"Q$3 divided e!ternals into congruentD and

    DdefensiveD categories, whereby the former were described as internalising this cognitive styleand the latter used it as a verbal techniue. The authors found that it was the defensive

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    e!ternally/oriented individuals who were most vulnerable to stress because, they argued,

    defensive e!ternals were less likely to seek social support.

    =rospective studies on the role of locus of control on the stressor/strain relationship

    do not appear to support the view that e!ternally/oriented individuals are more vulnerable to

    stress, however. Sanderman 1"QQ3 considered the effects of locus of control on individualsD

    levels of strain, and the interaction effects with life events over the period of the study. #t was

    found that there was neither a main effect for locus of control, nor an interaction effect with

    life events. #t would therefore appear from this research that locus of control did not have a

    moderating effect on individualsD levels of strain throughout the period of the study. 0rmel

    and Sanderman 1"Q3 argued that this type of prospective design is a more rigorous test of

    the role of locus of control than retrospective or cross/sectional studies. Further prospective

    studies are therefore reuired to support the findings of previous research, and to allow a

    greater understanding of the role of locus of control on the stressor/strain relationship.

    #t would/be particularly interesting to consider the role of locus of control with other

    individual variables, in order to determine whether there may be interactive effects between

    suchvariables and individualsD levels of stress over time. 7ardiness *riticisms of the research

    showing a direct link between stress and illness led -obasa1"G3 to e!amine those factors

    which she believed e!plained why some individuals have highly stressful lives, in terms of

    the number of potential stressors they encounter, but do not become ill. -obasa 1"G3

    proposed that such people have a personality structure differentiating them from persons

    who become sick under stress 1p. &3This Dpersonality structure was defined in terms of

    hardiness, a broad concept which included the characteristics of control, commitment and

    challenge. *ontrol was defined as above, in terms of an individualDs belief that they influence

    events in their lives. *ommitment was defined as an active involvement in activities at work,

    home and at leisure. Finally, challenge was seen in terms of an individualDs perception of an

    event as an opportunity for growth and e!pansion, rather than as a threat.

    Bsing a number of standardised tests to measure the components of hardiness, stress and

    illness, -obasa 1"G3 found that amongst a group of middle and upper level e!ecutives,

    those sub+ects who reported high stress but low illness showed a greater degree of hardiness

    than those e!ecutives who reported high stress and high illness.

    The former group showed a stronger commitment to self, an attitude of vigorousness

    toward the environment, a sense of meaningfulness, and an internal locus of control1-obasa,

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    "G, p. "3.A number of studies have considered the effect of hardiness, combined with other

    factors, on individualsD health outcomes. For e!ample, -obasa,addi, =uccettiaVola 1"Q)3

    e!amined the way in which hardiness, e!ercise and social support protect individuals from

    becoming ill. >etrospective and prospective data of e!ecutive menDs scores on scales of

    hardiness, and amount of e!ercise and social support revealed protective effects against

    illness for all three factors, with hardiness showing the greatest effects. ?entry and -obasa

    1"Q'3 pointed out that although research has consistently shown the protective effects of the

    control and commitment components of hardiness, the research is much less divisive in terms

    of the challenge component.

    Furthermore Sarafino 1"E3 highlighted the fact that the research on hardiness has

    tended to be based upon white middle/class professionals. 7e argued that hardiness may not

    have the same effects on the health outcome of groups of different gender, age, ethnicity and

    socio/economic status. Further research into the moderating role of hardiness in the stressor/

    strain relationship is clearly reuired.

    Se$f3esteem

    >ector, >oger and ;ussbaum 1"&3 stated that many of the items relating to the

    commitment and challenge components of hardiness were taken from the Alienation Test

    1addi, -obasa and 7oover, "G3. They argued that e!amination of these itemssuggested

    that a more robust, higher/order factor may underlie the two dimensions1>ector, >oger and

    ;ussbaum, "&, p. &3. They believed that this higher/order factor was self/esteem.

    Self/esteem can be defined as the degree to which a person positively

    valueshim"herseff and the e!tent to which they believe they are capable and woithy 1>ector,

    >oger and ;ussbaum, "&, p. &3 Although several studies have suggested that self esteem

    mediates the stressor/strain relationship 17obfoll and Lieberman, "QG8 >ector, >oger and

    ;ussbaum, "&3, the ma+ority have used co relational analysis to determine the relationship

    between self/esteem and health outcome. 7owever, a study by >ector and >oger 1"'3

    manipulated participantsD self/esteem and then e!posed them to a stressful event. They found

    that those sub+ects in the high self/esteem group reported less stress, less negative affect and

    made fewer errors on a task than those in a neutral self/esteem group.

    7owever, in a follow/up study, >ector and >oger 1"'3 found that males in the lower

    self/esteem group appeared to actively defend their self/esteem, as demonstrated by

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    the results on the manipulation check. efending their self/esteem served to reduce the

    physiological arousal which would have otherwise occurred, but caused this group to report

    more negative affect during completion of the task. >ector and >oger 1"'3 suggested that

    those people with low self/esteem may e!perience increased responsibility to stress initially,

    followed by physiological effects associated with anger as they attempt to defend their low

    self/esteem. They stated that whilst the female neutral self/esteem group also reported

    feelings of anger, the males were more likely to defend their self/esteem. The authors

    therefore argued that different e!planations are reuired to account for the stress reactivity of

    men and women.

    Type 5Type ! #e"aviour patterns

    The type A behaviour pattern was developed by Friedman and >osen man 1"G'3 to

    describe those individuals who were very competitive, impatient and easily became angry or

    hostile. #n contrast, type ( individuals were described as more easy/going, and as less

    competitive and hostile. uch research has shown that type A individual react more strongly

    in the presence of a stressor than do type ( individuals. For e!ample, several studies have

    found that type A individuals show greater increases in blood pressure, heart rate, cortisol,

    epinephrine and nor epinephrine than type ( individuals 1anuck, *raft and ?old, "GQ8

    4illiams, Lane, -uhn, elosh, 4hite and Schanberg, "Q$3 7owever, research has also

    shown that individuals showing the type A behaviour pattern are more likely to encounter

    stressful events in their lives. For e!ample, (aker, earborn, 7astings and 7amburger 1"Q'3

    found that type individuals were more likely to work in fast/paced, competitive environments

    and have higher workloads than type ( individuals. A vicious circle therefore results whereby

    type individuals not only react more negatively in stressful situations, but also actively seek

    out environments which are potentially stressful.

    )ptimism5pessimism

    0ver the last decade, research has focused on the role of dispositional optimism as a

    moderator in the stressor/strain relationship. ispositional optimism can be defined as

    generalised e!pectancies of favourable outcomes, with pessimism clearly being defined as

    generalised e!pectancies of unfavourable outcomes. 1Scheier and *arver, "Q)3 #n a study by

    Scheier and *arver 1"Q)3, college undergraduates completed a measure of dispositional

    optimism and a checklist of physical symptoms at two different times during a stressful

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    period in their lives. An inverse relationship between optimism and symptom reporting was

    found, suggesting that optimists may respond to stress in a different way than pessimists. This

    hypothesis formed the basis of a study by Scheier, 4eintraub and *arver 1"QH3. They

    considered the way in which optimists and pessimists cope with stress. The results found

    modest positive correlations between optimism and problem/focused coping, seeking of

    support and emphasising positive aspects of stressful situations. 4hen the stressor was

    uncontrollable, optimism was also associated with acceptance@resig nation.

    =essimism, however, correlated positively with denial, distancing, focusing on

    stressful Wfeelings and disengagement from oneDs previous goal with which the stressor was

    #nterfering. The authors therefore suggested that optimists tend to partake in more adaptive

    coping behaviours than pessimists, and that this can, at least in part, e!plain the higher stress

    levels of pessimists. This clearly has implications in terms of the design of stress management

    interventions for optimists and pessimists.

    motiona$ contro$

    *ameron and eichenbaurn 1"Q$3 suggested that the habit of mentally rehearsing

    failures and concurrently engaging in self/denigrating thoughts might interfere with at least

    some dimension of the unwinding process 1p. GE$3. >oger and ;esshoever 1"QG3 argued

    that this type of behaviour is reflected by the personality variable of emotional control. They

    defined emotional control as the tendency to inhibit the e!pression of emotional responses

    1>oger and ;esshoever, "QG, p. )$G3, and developed a scale with which to measure this

    personality variable. This scale consisted of three factors, namely >ehearsal 1r3, 2motional

    #nhibition 12#3, Aggression *ontrol 1A*3 and (enign *ontrol 1(*3. Further research found

    that >ehearsal in particular provided a moderator role within the stressor/strain relationship.

    >oger 1"QQ3 found that individuals who had a tendency to continue to think about

    emotionally upsetting events in their lives showed prolonged heart rate recovery, and had

    high levels of cortical following a stressful event. >oger 1"QQ3 argued that these findings are

    Significant in the light of evidence that prolonged physiological arousal is related to

    increased susceptibility to various pathological diseases.

    Socia$ support

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    Sarafino 1"E3 defined social support as the perceived comfort, caring, esteem, or

    help a person receives from other people or groups 1p. "EG3. Sarafino1"E3 suggested that

    there were four types of support, namely emotional, esteem, tangible or instrumental and

    informational. 2motional support involves the e!pression of empathy and caring toward the

    individual, in order to comfort and reassure them.

    2steem support was defined in terms of the e!pression of encouragement and

    agreement with an individualDs ideas, and positive regard for them. Tangible or instrumental

    support involves direct help for the individual such as helping to sort out funeral

    arrangements. Finally informational support involves offering advice and suggestions. The

    sources of support can vary widely between individuals, from a spouse and family members,

    to work colleagues or self/help groups.

    >esearch by Sherman and Lieberman 1"Q", #n Lieberman, "Q$3 found that upon the

    death of a child, parents sought help from a variety of sources. 0f HH& parents considered in

    the study, all but four per cent had sought some kind of help. #n forty/two per cent of cases,

    the parents had sought help from multiple sources including both formal and informal

    sources, with only eighteen per cent seeking help solely from informal sources such as family

    and friends.

    The role of social support as a mediating factor within the stressor/strain relationship

    has received much attention within the research literature. La>occo, 7ouse and French

    1"QE, #n 7ouse, "Q'3 considered the effects of emotional and tangible or instrumental

    support on the levels of an!iety, depression and irritation of over $EEE men working in a

    variety of white/ and blue/collar environments. The results showed that the greater the social

    support available, the less psychological strain was reported by individuals.

    >educed +ob stress was found to be more strongly related with the social support

    individuals received from their supervisors and colleagues than from their family and friends.

    This clearly has implications in terms of stress management within the workplace. Two

    theories have been proposed to e!plain the moderating role of social support in the stress/

    strain relationship. 1Sarafino, "E3 The buffering hypothesis suggests that social support

    protects the individual against the adverse effects of high levels of stress. Sarafino 1"E3

    pointed out that the buffering effects of social support appear to be evident only or mainly in

    highly stressful situations.

    *ohen and 4ills 1"Q)3 proposed that the buffering effects of social support may be

    due to the fact that individuals with high levels of social support will be less likely to

    perceive a situation as stressful as those with low levels of support. They may find situations

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    less threatening because they know that someone will be there to help them. Alternatively,

    social support might suffer the effects of stress through their response to a situation after they

    have appraised it as stressful. *ohen and 4ills 1"Q)3 argued that people with high levels of

    social support might know someone who will help them, and therefore perceive themselves

    as having the resources available to cope with a stressful situation.

    The second theory proposed to e!plain the moderating effects of social support on

    individualsD response to stress, is termed the direct effects hypothesis. This theory suggests

    that social support is beneficial to individualsD health both in low and in high stress situations.

    *ohen and 4illis 1"Q)3 argued that individuals with high levels of social support might have

    high self/esteem due to a feeling of belonging. Their positive outlook on life may then make

    them less vulnerable to infection, in either low or high stress situations. Alternatively people

    with high levels of social support may try to lead a healthier lifestyle because they feel that

    others depend on them and care about them.

    Although much work has focused on the moderating role of social support, both at

    work and at home, further research is reuired. As highlighted by (urke 1"QG3, unanswered

    Iuestions still remain, for e!ample concerning definitions and measures of social support,

    and the functions of social support. Social support is a rather global concept, and the author

    would suggest that researchers should endeavour to break it down and consider its individual

    components in terms of type, source and function.

    Sources of stress and t"eir measurement

    Ma*or $ife events

    #ntegral to the interactions model of stress, is the primary environmental source of the

    stress. A plethora of research has focused on a wide number of stressful environments, both at

    home and at work, and considered what it is about these environments which cause the

    individual to feel threatened and unable to cope. Life events research has a long and varied

    background, including studies of the effects of natural and man/made disasters 1Lindemann,

    "''3 to the consideration of discrete events which reuire adaptation or change 17olmes and

    >ahe, "HG3. For e!ample, Iuadagno, i!on, enney and (uck 1"QH3 found that the time

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    following the birth of a baby can be a very stressful period.. This could be caused by a variety

    of factors including lack of sleep, a disordered lifestyle and the taking on of a new role as a

    parent. Sarafino 1"E3 also pointed out that the timing of life changes may be important,

    particularly if events do not occur as e!pected. 7e argued that this in itself may be stressful,

    since people may perceive themselves as failures if events do not occur at the e!pected times,

    or they may be denied support from friends in similar situations.

    The life events approach to stress formed the basis of the Social >ead+ustment Scale

    17olmes and >ahe, "HG3, which consists of a list of ma+or life events which were drawn up

    on the basis of cliniciansD e!periences with patients. alues were then assigned to each event,

    based on hundreds of sub+ectsD ratings of how much ad+ustment each event would reuire. An

    individualDs total stress score is then calculated as the sum of the values assigned to each of

    the events they reported as having e!perienced over a specified period of time. The Social

    >ead+ustment Scale 17olmes and >ahe, "HG3 has been criticised however for its failure to

    recognise the different meanings that an event such as the death of a spouse, assigned the

    highest value of "EE, has to the individual.

    Some may perceive this event as very stressful, particularly if the death was sudden.

    7owever, others may consider such a death as a relief if the person was ill and in pain for a

    very long period of time. #f the integrationist approach to stress is used as the model of stress,

    as in the present research, one must acknowledge an individualDs own perception of a life

    event and what it means to them. Sarason, Johnson and Siegel 1"GQ3 considered this issue in

    the construction of their life events scale, the Life 2!periences Survey. To complete this

    scale, the individual has to rate each of the fifty/seven items on a seven/point scale from

    e!tremely negative to e!tremely positive. A total change score is then calculated as the sum

    of the individual scores for each item. This method of measuring the e!tent of life events

    e!perienced by individuals therefore incorporates the individualDs appraisal of the event into

    its total score.

    Dai$y "ass$es

    Although the life events approach to stress has received a considerable amount of

    support, several researchers have argued that the minor stressors of everyday life are more

    likely to have a negative effect on an individualDs psychological health. 1Savery and 4ooden,

    "'3 -anner, *oyne, Scheafer and Lazarus 1"Q"3 have found from their research that thefreuency and intensity of such minor events or hassles have a stronger relationship with

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    individualsD psychological and somatic health than do life events. They e!plained these

    findings in terms of the cumulative effect of these hassles, whereby the individual becomes

    unable to adapt to their environment. This approach to stress led to the development of a

    measure of minor everyday events called the aily 7assles Scale 1Lazarus and Folkman,

    "Q3. The scale consists of a list of ""G items which individuals rate on a four/point scale as

    Dnone or did not occur, Dsomewhat severeD, Dmoderately severeD or Ke!tremely severeD. A

    freuency score is calculated as the number of items endorsed, with a severity score, being

    the average severity rating on the scale.

    A study by #vancevich 1"QH3 considered the relationship between daily hassles and

    life events, and the health symptoms, absenteeism rates and productivity of "Q) employees of

    an organisation. #t was found that the relationship between daily hassles scores, and

    symptoms of poor health and absenteeism, were stronger than the relationship between life

    events, and poor health and absenteeism. ore recent research by Savery and 4ooden 1"'3

    found that there was a stronger relationship between freuency of daily hassles and in+uries in

    the workplace than between life events and in+uries. The authors argued that the findings have

    implications for stress management. They proposed that interventions should aim to help

    people cope better with daily hassles, both at home and at work, in order to reduce their

    levels of stress, and stress/related outcomes. #t must be considered however that the

    researchers employed their own measures of life events and daily hassles, based upon items

    included in previous scales. alidation of these scales is therefore necessary before any firm

    conclusions can be drawn from the research.

    )ccupationa$ stress

    ;ewman and (eehr 1"G3 stated that the term Doccupational stressD first appeared as a

    key word in =sychological Abstracts in "G&. Since this time, a growing body of research has

    focused on stress at work, and e!amined the effects it has on the individualDs physical and

    psychological health.

    As with models of general stress, the approaches to occupational stress have varied

    from stress as an ob+ective physical stressor, to stress as a physiological response, to stress as

    an interaction between the individual and their working environment. 1?riffiths, *o! and

    (arlow, ")3. There is growing consensus amongst researchers around. The adeuacy of the

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    interactive model, whereby stress results from an individualDs perception of an imbalance

    between the demands of a +ob and their ability to cope with it.

    >esearch has revealed a wide variety of factors that have been found to be stressful

    within the working environment. Studies have focused on the effects of e!posure to physical

    hazards such as e!treme temperatures and noise 1Iuick and Iuick, "Q'3 and also on more

    psychosocial aspects of work, such as perceived lack of control over oneDs +ob 1*ottington

    and 7ouse, "QG3, and poor relationships with managers and colleagues 1Iuick and Iuick,

    "Q'3. #n a recent report for the B- 7ealth and Safety 2!ecutive, *o! 1"&3 divided

    psychosocial stressors into nine broad categories which have been shown to be associated

    with stress and@or ill/health. These categories include the +ob content, the workload or

    workpace, the work schedule, interpersonal relationships at work, control, the organisational

    culture and function, the role of the individual in the organisation, career development and

    the home/work interface.

    The final category in this list, the home/work interface, emphasises the need for a

    global perspective to be taken towards the stress process. >esearchers must be aware of the

    role of e!tra/organisational stressors on the individualDs response to stressors at work.

    ?reenhaus and (eutell 1"Q)3 reviewed the literature on work@family conflict and concluded

    that it e!ists when the time devoted to, the strain resulting from and the behaviour reuired by

    one role does not allow one to fulfil the reuirements of the other role. This suggests that

    researchers should envisage occupational stress as interaction between factors at work, home

    and at leisure.

    The effects of stress >esearch has considered the way in which stress effects not only

    our physiological system, but also our psychological functioning, including the way we think,

    feel and behave. There has been debate centred around the issue of whether a link e!ists

    between stress and health, with much research focusing on the role of stress in the

    development of illnesses as diverse as asthma, coronary heart disease and cancer.

    0"ysio$ogica$ effects of stress

    Asterita 1""Q)3 stated that two main physiological pathways, the neural and neurone

    doctrine systems, are activated when an individual responds to stress. essages which have

    been encoded as threatening are sent to the hypothalamus from cortical and limbic structures.

    Those signals with the encoded information which emerge from the posterior section of the

    hypothalamus then activate the sympathetic division of the autonomic nervous system.

    Similarly, the signals from the anterior section of the hypothalamus activate the para

    sympathetic division of the autonomic nervous system. Activation of the sympathetic division

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    of the autonomic nervous system causes arousal of the body as a whole. This is reflected in

    the bodyDs increased heart rate, circulation, o!ygen supply, metabolism and energy. Asterita

    1"Q)3 commented that this overall arousal of the body leads to stimulation of the organs

    needed in the Dflight or fightD response, which if prolonged can result in a stress/related

    disorder. Activation of the parasympathetic division of the autonomic nervous system results

    in effects opposite to those described above. 7eart rate is slowed down, pupils constrict and

    blood vessels dilate. #n other words, the body is gradually slowed down.

    Asterita 1"Q)3 stated that the sympathetic and parasympathetic divisions of the

    autonomic nervous system often work together as a complete unit, and that when part of a

    system is activated, all or most of that system is also activated. 7owever there are many

    occasions when the systems act independently, and where only individual endorgans, or

    multiple groups of organs are stimulated. The ne!t stage of the physiological stress process is

    what *annon 1"&)3 described as the Dflight or fightD response.

    The response begins in the consommX diala my gdalar comple!, with neural

    pathways passing to the lateral and posterior parts of the hypothalamus, down to the thoracic

    regions, and on to the adrenal medulla. The catecholamines, epinephrine and nor epinephrine

    are then released upon sympathetic stimulation of the adrenal medulla. Secretion of these

    hormones can have significant physiological effects upon various bodily systems, including

    oneDs respiratory system, cardiovascular system, gastrointestinal system, central nervous

    system, and also oneDs blood and metabolism.

    The final phase of the stress response is activation of the endocrine a!