An Analysis of Changes in the Risk of Mortality from Chronic Obstructive Lung Disease, 1968-1977

Nonlinear hazard models are used to examine temporal trends in the age-specific mortality risks of chronic obstructive lung diseases for the U.S. population. These hazard functions are fit to age-specific mortality rates for 1968 and 1977 for four race/sex groups. Changes in the parameters of these models are used to assess two types of differences in the age pattern of the rates between 1968 and 1977. The first measure of trend in the age-specific mortality rates is the temporal change in the proportionality constant in the function used to model their age variation. By allowing only this proportionality parameter to vary between 1968 and 1977, it is possible to determine an age-constant percentage increase or decrease. The second measure reflects the absolute displacement in terms of years of life of the fitted mortality curves for the two time points. This second index can be interpreted as the acceleration or deceleration of mortality risks over the life span, i.e., the number of years that is needed for mortality rates to achieve the same level as in the comparison group. The analysis showed that the age changes in chronic obstructive lung disease mortality rates differed by race/sex group and for both measures of change over the period. Adjustment of the fitted curves for the effects of individual variability in risk was significant for three of four groups.     

Self-reported distress, job dissatisfaction and the Type A behaviour pattern in a sample of full-time employed Australians

The Type A behaviour pattern (TABP), which relates to risk of coronary heart disease (CHD), has also been shown to relate to self-reported feelings of both psychological and physical distress, at least during those times when the TABP is activated by salient environmental circumstances. The importance of the occupational setting for those with the TABP has led to the speculation that such distress may arise, in part, from job dissatisfaction which comes about when the Type A individual is unable to exert sufficient control over the environment. Associations between the TABP and measures of job dissatisfaction have not, however, been widely reported. The present study examined associations between the TABP, job (dis)satisfaction and self-reported experiences of both psychological and physical distress in a sample of employed individuals, and found tentative evidence that the relationship between the TABP and distress was mediated in a modest way by self-perceived job (dis)satisfaction. The implications of this for the areas of work stress and occupational health are discussed.     

Benchmark Duration of Work Hours for Development of Fatigue Symptoms in Japanese Workers with Adjustment for Job‐Related Stress

The objective of this study was to calculate benchmark durations and lower 95% confidence limits for benchmark durations of working hours associated with subjective fatigue symptoms by applying the benchmark dose approach while adjusting for job‐related stress using multiple logistic regression analyses. A self‐administered questionnaire was completed by 3,069 male and 412 female daytime workers (age 18–67 years) in a Japanese steel company. The eight dependent variables in the Cumulative Fatigue Symptoms Index were decreased vitality, general fatigue, physical disorders, irritability, decreased willingness to work, anxiety, depressive feelings, and chronic tiredness. Independent variables were daily working hours, four subscales (job demand, job control, interpersonal relationship, and job suitability) of the Brief Job Stress Questionnaire, and other potential covariates. Using significant parameters for working hours and those for other covariates, the benchmark durations of working hours were calculated for the corresponding Index property. Benchmark response was set at 5% or 10%. Assuming a condition of worst job stress, the benchmark duration/lower 95% confidence limit for benchmark duration of working hours per day with a benchmark response of 5% or 10% were 10.0/9.4 or 11.7/10.7 (irritability) and 9.2/8.9 or 10.4/9.8 (chronic tiredness) in men and 8.9/8.4 or 9.8/8.9 (chronic tiredness) in women. The threshold amounts of working hours for fatigue symptoms under the worst job‐related stress were very close to the standard daily working hours in Japan. The results strongly suggest that special attention should be paid to employees whose working hours exceed threshold amounts based on individual levels of job‐related stress.     

Talking about work stress: Discourse analysis and implications for stress interventions

This study used discourse analysis to explore the way in which employees understand work stress. Twenty-two female clerical workers in a Canadian city participated in focus group meetings where they talked about and made sense of their experiences of work stress. The women's accounts were analysed using discourse analysis methods (i.e. an examination of how talk is constructed). The findings revealed that talking about being stressed provides a socially acceptable way of expressing discomfort and regaining a sense of importance that is lost through feeling under-valued and under-appreciated in the organization. In contrast, admitting to being unable to cope with stress was considered to be 'abnormal'. The stress discourse fosters a sense of helplessness and ambiguity by not acknowledging external influences on clerical workers' experiences, such as their place within the power structure of the organization, and by limiting their sense of agency and control over problems experienced at work. The implications of these findings for organizational culture and interventions are discussed. For example, employers are encouraged to be conscious of the messages being sent to employees about how negative emotions or distressing experiences at work are to be addressed (i.e. how 'stress' is to be managed). Recommendations are made for future research using discourse analysis, such as the examination of alternative discourses that aim to improve conditions at work.     

Heart rate and blood pressure in male police officers and clerical workers on workdays and non-workdays

Male police officers from a city police station in Tasmania (n = 20) and a matched group of clerical workers (n = 20) monitored their heart rate, blood pressure and self-reported levels of stress and arousal over a two-week period. Measurements on workdays during which stressful events occurred were compared to non-event workdays and non-workdays. Two group differences were demonstrated, with the clerical workers reporting higher levels of stress, and the police officers reporting higher levels of arousal. Support was evident for the distinction between workdays and non-workdays, and support was demonstrated for differences between different types of workdays. Evidence suggested that restricting the time frame of such research may lead to results that are inaccurate or inconsistent because workdays differ in content.     

Nurses: Training for new job demands

This paper argues that both the present and future job demands faced by nurses are likely to exceed the resources of the training which is currently provided for them. This argument will be supported by reference to the authors' studies of stress in nursing, as well as a variety of other sources. The common themes underlying reactions to both present and future demands include first, awareness of high stress levels to be found amongst nurses, and second, an emphasis on communication as both the problem and as the proposed solution. Common responses to these two themes are outlined, including training in stress management, and communication training. Some of the problems and unexamined assumptions (for example that hospital management actually wants to lower stress levels and improve communication in nursing) are examined. Some suggestions are made for developing training in health care contexts, to deal more adequately with likely future demands.     

Mental load and work stress as two types of energy mobilization

A conceptual framework is presented in which mental load and stress are regarded as two distinct biobehavioural states in the work environment that differ in energy mobilization, mood and coping strategy. The framework combines two types of theory that are based on human performance research using laboratory tasks on the one hand and applied research in the work environment on the other. A high workload is regarded as an important but not a critical factor in the development of stress symptoms. Even under unfavourable conditions it is possible to work intensively and to be highly activated without feelings of strain or psychosomatic complaints. In contrast, working conditions that provide few possibilities for control and little social support or are associated with reduced well-being and increased health risks. The two states differ in activation, coping style and mood. A proper distinction is important not only for theory building but also for the reconstruction of the work environment. It may lead to recommendations that aim to enhance the work efficiency of employees while reducing the probability that stress responses will occur.     

Work satisfaction, health, and stress: A study of Dutch nurses

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Illegitimate tasks as a source of work stress

Illegitimate tasks represent a task-level stressor derived from role and justice theories within the framework of “Stress-as–Offense-to-Self” (SOS; Semmer, Jacobshagen, Meier, & Elfering, 2007). Tasks are illegitimate if they violate norms about what an employee can properly be expected to do, because they are perceived as unnecessary or unreasonable; they imply a threat to one's professional identity. We report three studies testing associations between illegitimate tasks and well-being/strain. In two cross-sectional studies, illegitimate tasks predicted low self-esteem, feelings of resentment towards one's organization and burnout, controlling for role conflict, distributive injustice and social stressors in Study 1, and for distributive and procedural/interactional justice in Study 2. In Study 3, illegitimate tasks predicted two strain variables (feelings of resentment towards one's organization and irritability) over a period of two months, controlling for initial values of strain. Results confirm the unique contribution of illegitimate tasks to well-being and strain, beyond the effects of other predictors. Moreover, Study 3 demonstrated that illegitimate tasks predicted strain, rather than being predicted by it. We therefore conclude that illegitimate tasks represent an aspect of job design that deserves more attention, both in research and in decisions about task assignments.     

Heart rate and blood pressure in male police officers and clerical workers on workdays and non-workdays

Abstract

Male police officers from a city police station in Tasmania (n = 20) and a matched group of clerical workers (n = 20) monitored their heart rate, blood pressure and self-reported levels of stress and arousal over a two-week period. Measurements on workdays during which stressful events occurred were compared to non-event workdays and non-workdays. Two group differences were demonstrated, with the clerical workers reporting higher levels of stress, and the police officers reporting higher levels of arousal. Support was evident for the distinction between workdays and non-workdays, and support was demonstrated for differences between different types of workdays. Evidence suggested that restricting the time frame of such research may lead to results that are inaccurate or inconsistent because workdays differ in content.     

Daily stressors and social support availability as predictors of depressed mood in male firefighters

The influence of daily stressors and social support availability on depressed mood was assessed over a 9-month period in 68 male firefighters. At 3-monthly intervals, an abbreviated Daily Stress Index (DSI) was completed for 16 days prior to administration of the Beck Depression Inventory (BDI). After negative affectivity, depressed mood and daily stress levels 3 months previously had been taken into account statistically, the DSI predicted subsequent BDI scores at the 3-, 6- and 9-month assessments. At the 3-and 6-month assessments, social support buffered the impact of DSI on depressed mood. By contrast, daily stress scores were not predicted by prior depressed mood or social support. The results are interpreted to support the causal influence of daily stressors on depressed mood, and the protective effect of social support.     

Nurses: Training for new job demands

Abstract

This paper argues that both the present and future job demands faced by nurses are likely to exceed the resources of the training which is currently provided for them. This argument will be supported by reference to the authors' studies of stress in nursing, as well as a variety of other sources. The common themes underlying reactions to both present and future demands include first, awareness of high stress levels to be found amongst nurses, and second, an emphasis on communication as both the problem and as the proposed solution. Common responses to these two themes are outlined, including training in stress management, and communication training. Some of the problems and unexamined assumptions (for example that hospital management actually wants to lower stress levels and improve communication in nursing) are examined. Some suggestions are made for developing training in health care contexts, to deal more adequately with likely future demands.     

Work satisfaction,health, and stress: A study of Dutch nurses

Abstract

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Occupational stress and cardiovascular reactivity in blue-collar workers

This study analyses the influence of chronic occupational stress on cardiovascular reactivity (heart rate [HR] and blood pressure [BP] elevation from baseline to maximal challenge) during a standard mental stress test (modified version of the STROOP colour word interference test). The test was applied to a sample of 190 healthy male blue-collar workers at the end of a regular working day. Our research hypothesis was based on the assumption that sustained autonomic activation due to chronic occupational stress may reduce cardiovascular responsiveness to challenge: workers defined by high level of chronic occupational stress exhibited lower maximal HR and BP elevations under challenge as compared to workers with low levels of stress. Three distinct indicators of occupational stress were derived from structured interviews: 'cumulative workload', 'worsening of job conditions', and 'high demand and low job security'. Statistical analysis, using ANOVA, showed that all main effects of chronic stress were in the expected direction (6 of 9 effects were statistically significant at the 0'05 level). These effects remained stable after adjusting for age, hypertensive status, physiological baseline level, cigarette smoking, test performance, and individual style of coping. In summary, cardiovascular reactivity under experimental challenge is modulated by an individual's experience of chronic occupational stress.     

The impact of negative affectivity on stressor-strain relations: A replication and extension

The present study was a replication and extension of the results of Brief et al. (1988), who found that partialling out negative affectivity reduced the magnitude of stressor-strain correlations considerably. The effect of both trait anxiety and dispositional optimism was partialled out from stressor-strain correlations. Unlike Brief et al. (1988), however, work stress was measured with specific stressor scales rather than life events. Results from two samples of university employees showed that partialling out trait anxiety, dispositional optimism, or both, reduced the magnitude of stressor-strain correlations very little. Thus, it does not appear that stressor-strain correlations can be attributed to negative affectivity. The possibility that the results of the study by Brief et al. (1988) may have been due to problems with the life events approach used to measure work stress is discussed. Future research on the impact of dispositions is suggested.     

Stress, physical activity and coronary heart disease

Recent years have witnessed an increasing popularity of corporate fitness programmes. Regular physical activity and, in particular, high aerobic fitness are associated with a lower risk of coronary heart disease. Apart from its beneficial effects on resting levels of blood pressure and cholesterol, fitness is believed to reduce the impact of psychological stress. This hypothesis has been put to the test in 33 studies examining the physiological stress response of groups selected to differ in their fitness level. Although some evidence was found for a reduced response to stress in high fit subjects, the effects were not very strong. During 54 confrontations with a stressful task, significantly lower heart rate reactions in high fit subjects were seen in only nine tasks (17%). With nine out of 36 stressors (28%), fit subjects showed a lower diastolic blood pressure response. However, in combination with a frequently found reduction in basal levels, the high fit showed a consistently favourable cardiovascular profile under stress. This adaptation may reflect the benefits of regular exercise over a more sedentary lifestyle, but a combined influence of genetic make-up on cardiovascular reactivity and fitness cannot be ruled out.     

The rise and fall? Of mental stress claims in the USA

Occupation-related mental stress has been associated with significant loss in terms of diminished productivity, higher absenteeism, and increased workers' compensation claims. The Liberty Mutual Group workers' compensation data were analysed for the years 1984-93 for mental stress-related claims. This represented over 7 million claims, over 17000 of which were identified as mental stress-related. The proportion of all stress claims was estimated for each year. The proportion by gender, age and occupation (job classification code and occupation name) was also described. Stress claims increased during the late 1980s, peaking in 1991, accounting for 0.48% of all claims and 1.69% of all claims costs, and has declined since. Even at its peak, mental stress claims were not a major portion of workers' compensation losses. However, they are expensive. The average costs of a stress claim in 1993 was about $13000. The state of California accounts for 60% of the claims reported to Liberty Mutual over this 10-year period. In 1993 women accounted for 51% of the stress claims and about 30% of all claims. The mean age of workers with stress claims was 39.3 years, with most stress claims from 30 to 34 year-olds. High-risk occupations and industries include banks, insurance companies, general labourers, management, salespersons, and drivers. The current decline in stress claims can largely be explained by a combination of changes in unemployment, increasing litigation, and changes in law in California and other states that made more stringent the requirements whereby a mental stress claim can be considered work-related. While the data presented are helpful for comparing stress claims to all claims reported to Liberty Mutual and for identifying high-risk occupations and industries, because of the uniqueness of the stress claim selection algorithm and the uncertainties with cost estimates, the cost figures are not directly comparable to other claims reporting systems.     

Beyond Negative Affectivity:

Stress researchers frequently use self-report measures to assess stress, health, psychological adjustment, and subjective dissatisfaction. We present evidence demonstrating that all of these variables are highly intercorrelated and reflect a common underlying factor of Negative Affectivity (NA). NA is a stable and pervasive personality dimension-high NA individuals report more stress, distress and physical complaints, even in the absence of any objective stressor or health problem. Thus, NA may operate as a substantial nuisance factor in many areas of research. To circumvent its influence, investigators can use non-subjective measures of stress and health. Finally, we present a two-factor model of stress and satisfaction that includes, in addition to NA, the independent factor of Positive Affectivity (PA), a trait reflecting positive feelings about oneself and one's life.     

Evaluating organizational-level work stress interventions: Beyond traditional methods

Since the early 1990s, there has been a growing literature on organizational-level interventions for work-related stress, and associated calls for such interventions to be evaluated. At the same time, doubts have been expressed about the adequacy of traditional scientific research methods in applied psychology (the natural science paradigm) in providing an effective framework for such evaluations. This paper considers some of the philosophical and methodological issues raised by evaluation research in relation to organizational-level interventions for work-related stress. Four key issues are discussed: the concept of a study being “fit for purpose” in relation to research designs and the nature of acceptable evidence; the issue of control of research conditions in real-world studies; the need to evaluate process as well as outcome, including the interrelated nature of process and outcome; and the interpretation of imperfect evidence sets. The starting point of this paper is the reality of organizational life, which is complex and continually changing. Its main objective is not to offer an alternative to a scientific approach but to argue for a more broadly conceived and eclectic framework for evaluation that acknowledges the limitations of the traditional approach. It espouses an approach that is reflective of the reality of organizational life and in which the methods used for evaluating an intervention are fit for purpose. The paper concludes by offering an outline framework for this broader approach to the evaluation of interventions.     

Health habits,type A behaviour and job burnout

Abstract

This study examined the effects of health habits and type A behaviour on psychological health outcomes in the face of daily life stress. Measures of the experience of life stress, health habits, type A behaviour, job burnout and psychological distress were collected for 146 employees at the UCLA Medical Centre. Analyses of covariance revealed that health habits contributed significant main effects to psychological distress but not job burnout. Type A behaviour, but not life stress or health habits, directly affected both job burnout and psychological distress. The implications of the research for employee health programmes are discussed.