Volume 3 Issue 1 September 2015 International Journal of Informative & Futuristic Research Symptoms Of Occupational Stress Among Paper ID IJIFR/ V3/ E1/ 018 Page No. 83-89 Subject Area Commerce Key Words Physiological Symptom, Stress, Behavioural, physical manifestations, Primary Health Centre(PHC), Government Hospitals (), Hospitals(PH), Thoothukudi District A. Bharathiraja 1 Dr. G. Paulraj 2 Ph.D. Research Scholar, P.G, & Research Dept. of Commerce, V.O. Chidambaram College, Thoothukudi Associate Professor, P.G, & Research Dept. of Commerce, V.O. Chidambaram College, Thoothukudi Abstract This paper aims to bring out the prevalence of physiological, psychological and behavioural symptoms of healthcare personnel in their occupational setup and identify the phenomena which are comparable in multiple working places and with different occupational groups. The capacity of the professional s adaptability to stressful situation in the job in the form of psychological demands. The balance between effort and reward in the job that continuously provokes emotional, behavioural and physiological natures. 1. Introduction In the working atmosphere there is an occupational stress for the employees. Work stress is recognized world-wide as a major challenge to employee s health and healthiness of their organization. Stress experienced at work can have adverse outcomes for the well-being of individual employees, health of the patients and organization as whole. So it is a complex, dynamic process of interaction between a person and his life. It is the war one reacts physically, mentally and emotionally to the various conditions. In fact it can lead to mental distress and have a negative impact on their cognitive functioning and long term capabilities. Every health workers need to cope up with the family and social demands of the patients whom they encounter in their profession. Again stressed employees are more likely to be unhealthy, poorly motivated, less productive and less safe at work. Excessive stress called distress and its various physical manifestations account for more than 80% of all visits to health-care professionals. Distress also accounts for approximately 14% of all occupational disease workers compensation claims, while the benefit payments for stress-related disorders average more or less twice www.ijifr.com Published Online On: 15/09/2015 83
those of physical disorders. It is described that excessive stress as a plague to healthcare workers and to society (Everly and Lating, 1995). As far as health care providers are concerned they need to anticipate and address institutional barriers to caring for patients with a life limiting illness. These barriers often include a lack of trained medical interpreters and the predominance of the western biomedical explanatory model in the health care service delivery with its inherent individualistic values and beliefs. These encourage health care providers to openly disclose the diagnosis to the dying patient, ask an advance care plan be developed and minimize physical suffering through symptom. This in turn reduces their employees stress to some extent. The psychosocial, physiological and behavioral assessment among the health care personnel is focused more on the significant functioning in relationship to patients, others and their environment. Ideally one should identify the goals, barriers to achieving those goals and strengths available to overcome and/or adapt in the presence of constant change. They serve the purpose of understanding the illness from the perspective of patients and families as well as articulating goals of care. A comprehensive assessment helps to clarify and identify strengths, challenges, areas of support and overall functioning of the concern. 2. Methodology The study was conducted among the healthcare personnel of Primary Health Centre (PHC), Government Hospitals () and private hospitals in Thoothukudi district. By applying convenience sampling method data were collected from 431 respondents in the study area. It consists of doctors around 175 comprising of and PHC about 63 each and private doctors of 49. Among 266 nurses, 97 from, 87 from PHC and 82 from private hospitals. Statistical tools of ANOVA and t-test are used for analysis. 3. Symptoms of Stress for Doctors and Nurses Occupational stress has become a common and costly problem, leaving few workers untouched. Not all stress is bad. Learning to deal with and manage stress is critical to maximizing job performance, staying safe on the job, and maintaining physical and mental health. During stress, as a pre-programmed biological system, the brain activates hormone release, pulse, respiration, muscles etc. which is called as flight response to defend the alarming situation. Every person faces this situation separately from repetition of the same in frequent intervals is a cause of concern. Continuing the body in such constant state of activation damages the biological systems. Such recurrent misbalance causes fatigue and curtails the bodily ability to defend. In biological term, stress is the consequences of the failure of a human body to respond appropriately to emotional or physical threats to the organism, whether actual or imagined. (Selye, 1956) identifies a common stress symptoms are irritability, muscular tension, inability to concentrate and a variety of physical reactions, such as headache and accelerated heart rate. The prevalence of physiological symptom of the healthcare personnel in the occupational setting and to identify the phenomena which are comparable in multiple working places and with different occupational groups is a concern for evaluation. 4. Result & Analysis 4.1 Physiological Symptom for Doctors and Nurses: Physiological symptoms that may occur because of occupational stress include fatigue, headache, stomach problems, muscles aches, 84
chronic mild illness, sleep disturbances and eating disorders. Cannon (1932), the body possesses an internal mechanism to keep body functioning constantly (equilibrium or homeostasis). As the environment presents the individual with various challenges, the body should react to each new status by adapting various physiological systems to compensate for the resources being affected. Failure of the body to react to environmental challenges by keeping bodily homeostasis leads to damage to body organs and finally death. Table 1: Gender wise Physiological Symptoms Personnel Hospitals Gender N Mean S.D t value P value Doctors Nurses PHC PHC Male 44 3.02.976 Female 19 3.32 1.250 Male 40 2.48 1.037 Female 23 2.43 1.237 Male 22 2.73 1.518 Female 17 2.53 1.281 Male 9 1.56.726 Female 88 2.58 1.036 Male 2 1.50.707 Female 85 3.00 1.282 Male 4 4.00 1.414 Female 78 2.97 1.279 1.003 0.320 0.138 0.891 0.432 0.669 2.886 0.005 1.643 0.104 1.558 0.123 As per the analysis, the mean scores of females are high with regard to the government hospitals. But, the mean scores of males are high for primary health centre and private hospitals. The hypotheses of gender of the doctors and their physiological symptoms are accepted as their P values are more than 0.05 at 5 percent level of significance. It indicates that gender of the doctors does not have any role in their physiological symptom of stress in all three hospitals. The mean scores of female nurses are high with regard to the government hospitals and primary health centre while it is low in case of private hospitals. The hypotheses of gender with primary health centre and private hospitals are accepted as their P values are more than 0.05. In contrast to the above, the hypothesis for the government hospital is rejected as its P value is less than0.05 at 5 percent level of significance. So the gender of the nurses does not influence the physiological symptom in primary health centre and private hospitals but it influences in government hospitals. The previous study by Escot et al (2001) found that psychological distress among nurses of a cancer hospital at Montpellier, France. Thirty seven nurses agreed to participate among them 97% of them were female. 4.2 Behavioral Symptom for Doctors and Nurses The behavioral symptoms such as alcohol/drug abuse, over/under eating, conflict with co employees, loss of interest in the work and mood disorder are commonly present in the working class. Indeed, professional nursing is to recognise, analyse as well as give advice and assistance 85
with regard to actual or threatening consequences of physical and mental courses of diseases, handicaps, disorders and their treatments for the benefit of the fundamental activities of daily living of an individual. Nursing influences individuals in such a way that human potential is used for maintaining and promoting health. Table 2: Age wise Behavioral Symptom of the Doctors and Nurses Personnel Hospitals Age N Mean SD F value P value Up to 30 34 2.41 1.305 31-40 16 1.50.894 4.649.013 Above 40 13 1.62.768 Up to 30 17 1.94 1.029 Doctors PHC 31-40 21 1.86 1.153.295.746 Above 40 25 2.08.812 Up to 30 14 2.00.555 31-40 12 1.33.492 7.054.003 Above 40 13 2.77 1.481 Up to 30 19 1.68.885 31-40 51 1.47.758.384.682 Above 40 27 1.52 1.156 Up to 30 49 2.86 1.472 Nurses PHC 31-40 13 1.69.947 4.558.013 Above 40 25 2.16 1.405 Up to 30 50 2.10 1.502 31-40 16 1.31 1.014 2.654.077 Above 40 16 1.50 1.095 The mean score of doctors whose age does not exceed 30 years in is high, but in PHC and private hospitals, the mean scores are high in case of doctors whose age exceeds 40 years. On the other hand, the lowest mean scores seen in doctors who fall under 31-40 years of age group in all the cases. The age of the doctors is associated with their behavioral symptoms of stress in government and private hospitals. The behavioral symptoms of doctors stress in primary health centre do not have a significant relationship with their age as its P value is more than 0.05. Thus doctors age is significantly related to their behavioral symptom in private and government hospitals whereas it does not affect the doctors stress in the behavioural symptom in primary health centre. As far as the nurses are concerned, age is associated with their behavioral symptoms of stress in primary health centre. The behavioral symptoms of stress for government hospital and private hospitals do not have a significant relationship with the nurses age as their P values are more than 0.05. In simple, age group of the nurses does not significantly relate to the behavioral symptom of nurses in government and private hospitals but they exist in primary health centre. Table 3. Food Preference wise Behavioral Symptom of the Doctors and Nurses Preference of P Personnel Hospitals N Mean S.D t value food value Vegetarian 21 1.71 1.056 1.441.155 Doctors Non-Vegetarian 42 2.17 1.228 PHC Vegetarian 23 2.30 1.063 2.114.039 86
Non-Vegetarian 40 1.78.891 Vegetarian 17 1.82 1.380 Non-Vegetarian 22 2.23.813 1.142.269 Vegetarian 20 1.20.616 Non-Vegetarian 77 1.61.948 1.834.070 Nurses PHC Vegetarian 10 2.50 1.650 Non-Vegetarian 77 2.48 1.429.040.968 Vegetarian 14 1.64 1.336 Non-Vegetarian 68 1.87 1.392.554.581 An analysis of doctors food preference vis-a-vis occupational stress with their behavioral symptoms reveals that the mean values are greater in government and private hospitals for nonvegetarian while the value is greater for vegetarian in primary health centre. The hypothesis of food preference with primary health centre is rejected as its P value is less than 0.05. In contrast, the hypotheses for the government and private hospitals are accepted as their P values are greater than 0.05 at 5% significance level. Explicit result of food habit of the doctors does not find any association with the behavioral symptom on occupational stress in government and private hospitals but it exists in primary health centre. Nurses food habit is analysed with that of their behavioral symptom in all the hospitals. It shows that the mean values are greater in government and private hospitals for non- vegetarian while it is greater for vegetarian in primary health centre. The hypotheses of food habit of nurses and their behavioural symptoms are accepted as their P values are more than 0.05 implying that food habit of the nurses does not find any association with their behavioral symptoms. Table 4: Marital Status wise Behavioral Symptom of the Doctors and Nurses Personnel Hospitals Marital Status N Mean S.D t value P value Married 33 1.58.830 Unmarried 30 2.50 1.333 3.336.001 Doctors PHC Married 44 2.09.936 Unmarried 19 1.68 1.057 1.523.133 Married 35 2.06 1.110 Unmarried 4 2.00 1.155.097.923 Married 86 1.48.864 Unmarried 10 2.00 1.155 1.748.084 Nurses PHC Married 66 2.35 1.398 Unmarried 21 2.90 1.546 1.548.125 Married 38 1.63 1.217 Unmarried 44 2.00 1.494 1.212.229 The analysis of behavioral symptom of stress among the doctors with their marital status indicates that the mean values is higher for unmarried doctors in government hospitals while the mean values are greater for married doctors in primary health centre and private hospitals. In primary health centre and private hospitals, the doctors marital status do not have a significant relation to their behavioural symptoms as their P values are greater than 0.05. In contrast to the above, the hypothesis for the government hospitals is rejected, since its P value is less than 0.05 at 5% significance level. Indicating that the marital status of the doctors found to have no association with the behavioral symptoms in primary health centre and private hospitals however there exists a marital status of the doctors in government hospital as far as their behavioural symptoms of stress 87
are concerned. The analysis of behavioral symptom of the nurses, in relation to their marital status indicates that the mean values are higher for unmarried nurses in all hospitals. The hypotheses are accepted for all the hospitals since their P values are greater than 0.05 at 5 percent level of significance implying that the marital status of the nurses found to have no association with their behavioral symptoms of stress in all hospitals. 4.3 Psychological Symptoms for Doctors and Nurses Stress research has evolved and continues to evolve with the changing demands of work place settings. The healthcare is one among the areas that has undergone major levels of change during the last decade. Whilst stress can be a product of working and caring for people, it is still an occupational hazard that should be controlled and managed like any other stress. Through the identification of risk factors and the introduction of appropriate measures, the stress and ill health in the work place can be distinctly relieved. Especially in case of health industry where the expectations are very high from a medical professional in adverse conditions the psychological stress is becoming important part of doctors life which is affecting their physical, mental, personal and social life. Psychological distress is a group of emotional and cognitive symptoms which include depression, anxiety and anger, (Perrault, 1989). Cooper observed that that difficulty in coping with stress combined with psychological or emotional instability could lead to violence and the healthcare workers specifically nurses and clinic personnel are mostly affected by the risk of physical violence, particularly in the emergency rooms which is a source of stress. The factors related to a patient s quality of life are paramount in providing comfort care to patients and their loved ones. The provision of psychological support for patients and families confronted with a life limiting illness is one that is often overlooked and can be even more undermined when physical pain becomes the main focus of the treatment plan, J Hosp Palliat Nurs (2006). Table 5: Family Background and Existence of Psychological Stress Type of P Personnel Hospitals N Mean S.D t value family value Joint 22 2.45 1.299 1.172.246 Nuclear 41 2.83 1.160 Joint 37 2.32.852 Doctors PHC.089.929 Nuclear 26 2.35 1.093 Joint 15 2.33.816.865.392 Nuclear 24 2.67 1.341 Joint 34 2.18 1.141 2.745.007 Nuclear 62 2.79.994 Joint 38 2.53 1.059 Nurses PHC 1.969.052 Nuclear 49 3.06 1.391 Joint 22 2.64 1.399 1.053.296 Nuclear 60 3.02 1.467 Source: primary data The psychological symptom of the doctors is analyzed with their family setup. As per the analysis, the mean scores of the nuclear families are higher in all the cases. The null hypotheses are accepted for all the three hospitals- government, primary health centre and private as their P values are greater than 0.05 at 5 percent level of significance implying that there is no significant influence found in the doctors family type and their psychological symptoms. 88
An analysis of psychological symptom of the nurses with their family type reveals that the mean scores of the nuclear families are higher in all the hospitals. The hypothesis is rejected in government hospital as its P value is less than 0.05. Contrarily, the hypotheses for the primary health centre and private hospitals are accepted, since their P values are higher than 0.05 at 5% significance level. In brief, there is no considerable impact is found in the family type of the nurses with their psychological symptom in primary health centre and private hospitals but there exists an impact in government hospitals. It is noteworthy that psychological symptoms were correlated negatively with work satisfaction as found by (Arafa et al, 2003). 5. Conclusion The long-term effects of untreated stress in the workplace can be as insidious as they are harmful which affects the healthcare industry. In, doctors age and their marital status keep them in behavioural symptom, but it is not present by their food habit. Contrarily there seems a reverse impact for the doctors in PHC. As far as doctors in private hospital are concerned, age factor presents their behavioural symptom while their marital status and food habit have no impact on them. Gender of the nurses does not influence the physiological symptom in primary health centre and private hospitals but it influences in government hospitals. Again their age does not influence in the presence of psychological symptom in all three hospitals. Similarly there is no considerable impact at nurse s family type and their psychological symptom in primary health centre and private hospitals except government hospitals. in fact psychological illness in health professionals needs to be improved with balance of work and life. 6. References [1] Arafa M, Nazel M, Ibrahim N and Attia A (2003). Predictors of psychological well-being of nurses in Alexandria, Egypt, International Journal of Nursing Practice; 9 (5): 313-320. [2] Cannon, W. B. (1932). The wisdom of the body. New York, NY: Norton. [3] Cooper C.L, Cooper R.D, Eaker L.H. Living with stress. Harmonsworth: Penguin, 1988. [4] Egan K, Labyak M. Hospice (2006) palliative care: a model for quality end- of-life care. Oxford (England): Oxford University Press;. [5] Escot C, Artero S, Gandubert C, Boulenger J and Ritchie K (2001). Stress levels in nursing staff working in oncology, Stress and Health; 17 (5): 273-279. [6] Everly, Jr.,G.S. &Lating, J.T, Eds. (1995). Psycho traumatology: Key papers and core concepts in posttraumatic stress. New York: Plenum [7] Green A. A person-centered approach to palliative care nursing. J Hosp Palliat Nurs. 2006;8:294-301. [8] Perrault C (1989) Health-Quebec Survey, and Mental Health of Quebecois: Framework and method, Sante mentale au Quebec; 14 (1), 132-143. [9] Selye, H. (1956) The stress of life. New York: McGraw Hill. 89