A process evaluation of individual and organizational occupational stress and health interventions

There is reason to believe that many health and stress interventions fail due to inattention to the effects of intervention implementation processes, but evaluations of these processes are found only rarely in the literature. The objective of the present study was to explore the issue of obstacles to implementation that may occur when stress and health interventions are introduced in work organizations. The study was conducted as a process evaluation of seven different individual and organizational interventions. Interviews were conducted in 22 post offices, 12 organizational units (such as care homes and local administrative units) of a Norwegian municipality, and in 10 shops in a shopping mall. The interviews took place before and after the interventions. The following key process factors were identified: (1) the ability to learn from failure and to motivate participants; (2) multi-level participation and negotiation, and differences in organizational perception; (3) insight into tacit and informal organizational behaviour; (4) clarification of roles and responsibilities, especially the role of middle management; and (5) competing projects and reorganization. For improved studies of interventions in the future we recommend that qualitative and quantitative methods be combined, that researchers build more on natural interventions that occur naturally within the organization, and that a pilot study be undertaken in order to investigate the cultural maturity of the organization.     

An appraisal of key factors in the implementation of occupational stress interventions

Empirical research on stress intervention in organizations, and experience from organizational change programmes in general, indicates that obtaining intended change is often more difficult than it had been conceived to be at the outset. In order to facilitate the accomplishment of stress prevention and effective organizational change, this paper examines the importance of the social and cognitive processes influencing the implementation of any intervention. It states that if change is to be managed skilfully, it is important (1) to create a social climate of learning from failure, (2) to provide opportunities for multi-level participation and negotiation in the design of interventions, (3) to be aware of tacit behaviours that possibly undermine the objectives of interventions, and (4) to define roles and responsibilities before and during the intervention period.     

Using a stress audit: The construction site manager experience in the UK

Abstract

The aim of this study was to conduct a stress audit among construction industry site managers in the UK as a precursor to a stress management intervention programme. Qualitative data were obtained from in-dept interviews with a total of 36 male middle and senior construction site managers; and aquantitative data were obtained by questionnaire. Based on the analysis of 561 postal quenstionnaires, eight stressor factors were identified, most significantly, ambiguity (i.e. role and task). Job satisfaction levels were low compared to a normative population and influenced by grade level. Measures of mental health were similar to the norm for males, but both grade of management and type of contract affected mental health. Anxiety levels were signficantly high, independent of managerial grade. The stress of work overload and role insecurity (fear of failure) were associated with reduced mental health and high anxiety, and the stress of the organizational culture and climate was the strongest predictor of job dissatisfaction. There was some cause for concern for the vulnerable high-risk groups, i.e. the extreme type A and those working overtime. Medical data from a small subset of managers (n = 78) revealed that this group evidenced a better quality of psychological health than the group in total; but a high percentage of personnel had high levels of triglycerides and cholesterol. Recommendations for action focused on the needs of specific subgroups, and guided the organization on the acceptability of possible interventions at individual, interpersonal and organizational levels.     

Developing criteria for healthy organizational change

Abstract

The objective of this study was to identify criteria for healthy change in organizations and to develop practical guidelines for intended change. We aimed to explore how change processes at the shop floor level can be better informed by consultants and labour inspectors. A total of 180 interviews were conducted with managers and employees in 90 units of public and private organizations in Norway. The interviews were analysed through four steps representing an expansion of grounded theory, and converted to qualitative analysis using QSR and N6 software. We found that organizational change processes were better managed by more attention to awareness of the local norms and diversity among employees in the perception and reactions to change efforts. An inspector or consultant should be aware of these phenomena in any change effort and tell the organization how to deal with them. The other three factors identified were early role clarification, manager availability, and using constructive conflicts to deal with change. They are all important coping mechanisms at the organizational level that will bring change processes onto a more optimal track if correctly managed. A healthy process empowers individuals instead of making them insecure and defensive in times of change. This will help them restore perceived control and promote job security, which benefits both them and the organization.     

Interventions for musculoskeletal disorders in computer-intense office work: A framework for evaluation

Workplace interventions for work-related musculoskeletal disorders (WMSDs) are usually multifaceted. These interventions tend to deal with multiple work organizational and physical risk factors and have components occurring at different organizational levels. The organizations are often changing, with shifting initiatives and priorities. Evaluation of such interventions poses challenges in documentation of implementation, reduction in exposures, and assessment of improved health outcomes. We describe a means-outcomes framework for evaluating field interventions that includes strategies, activities, objectives and metrics for outcomes using quantitative and qualitative methods. We demonstrate application of the framework to our work with a large newspaper, which builds on existing laboratory, aetiological and best practice evidence to improve musculoskeletal health. The newspaper had adopted several organizational strategies aimed at improving financial performance, including restructuring into teams, a major set of moves/renovations and introduction of new software. Concomitant WMSD-related organizational strategies include an ergonomics policy, human resources activities, promotion of team work, changes in environment and equipment specifications and development of information systems. We have found the framework useful for focusing the purpose of data collection and ensuring coverage of important components. At the same time, it provides sufficient flexibility to respond to the changing process of implementation.     

Implementing workforce development in health care: A conceptual framework to guide and evaluate health service reform

Abstract

The term ‘workforce development’ is increasingly popular in the health-care field. It appears to encompass a range of human and organizational development activity. However, there has been limited explication of the concept of workforce development in Australian health care at area health service levels. It is timely to develop a framework for workforce development and processes to guide any evaluation of the implementation of workforce development strategies. This paper presents a framework that has been developed through consultative processes in an area health service and an associated review of literature.     

Stress,social support and psychological well-being in British accountants

Abstract

This paper reports an exploratory study of stress, social support and psychological well-being in British chartered accountants, using data from 399 self-report questionnaires. The results suggest that the underlying structure of stress in British accountancy can be explained by three dimensions; quantitative overload stressors, professional/administrative interface stressors and nuisance stressors. The underlying structure of social support for the sample can be represented by three dimensions of help support, social dependability and esteem support. Intensity of quantitative overload stressors, intensity of professional/administrative interface stressors and all three dimensions of support were found to be related to psychological well-being in the sample. Differences between these variables, types of organization and organizational position were examined. The results are discussed with reference to stress management interventions for accountants. Possible generalizations to other professional groups are discussed.     

Organizational change,health, and sick leave among health care employees: A longitudinal study measuring stress markers,individual, and work site factors

Abstract

This controlled longitudinal study was conducted to investigate the effects of organizational change on employees’ self-reported health, work satisfaction, work-related exhaustion, stress, and sick leave. The population consisted of 226 employees at T1 and 198 at T2, divided into a study group affected by organizational changes, and a reference group not affected by them. Group differences for the outcome measures self-rated health (SRH), work satisfaction, work-related exhaustion, and hormones associated with stress were analysed using a two-factor ANOVA design for repeated measurements. Our findings showed no significant differences, either across time or between groups for SRH, work satisfaction, and work-related exhaustion. However, we did find significant change across time and between groups for the recovery hormone DHEA-S. Days of sick leave increased by 7% for employees in the study group and by 2% in the reference group. Serum cortisol showed significantly decreased levels across time but not between groups. The decreased recovery potential in the study group might have long-term health implications. The study points to the importance of looking at the impact of organizational change on employee well-being from a number of perspectives, such as self-reported health parameters, registered sick-leave data, and biological stress markers.     

The effectiveness and specificity of change management in a public organization: Transformational leadership and a bureaucratic organizational structure

There is an extensive private sector literature on organizational change management. However, recent studies have suggested that the specific context of public organizations may have consequences for the management organizational change. This study examines to what extent different change approaches and transformational leadership of direct supervisors contribute to the effective implementation of organizational change in public organizations, and to what extent the bureaucratic structure of public organizations makes the implementation of organizational change s3pecific. The implementation of an organizational change in a Dutch public organization is studied using quantitative methods and techniques. The results indicate that bureaucratic organizations may effectively implement organizational change with both planned and emergent change approaches. The contribution of transformational leadership depends on the type of change approach and organizational structure. Transformational leadership behavior of direct supervisors contributes little to planned processes of change, but is crucial in emergent processes of change in a non-bureaucratic context. Although the literature on change management mostly emphasizes the leadership of senior managers, the leadership role of direct supervisors should not be overlooked during organizational change in public organizations.     

Exploring team mental model dynamics during strategic change implementation in professional service organizations. A sensemaking perspective

The purpose of this paper is to provide a deeper process understanding of team mental model dynamics in a context of strategic change implementation. To do so, we adopt a change recipient sensemaking perspective with the objective to identify salient determinants of team mental model dynamics. We aim to contribute to the managerial and organizational cognition literature by identifying critical micro-foundations that shape team cognition and interpretation processes during strategic change implementation. This adds to the field’s understanding of the under-researched collective dimension of strategic processes in general and strategic change implementation more specifically. Through an explorative case study conducted at a professional service organization, we identified five determinants of team mental model dynamics: coherence between ostensive and performative aspects of organizational routines, equivocality of expectations, dominance of organizational discourse, shifts in organizational identification and cross-understanding between departmental thought worlds. Case findings reveal that implementation processes of strategic change become intricate and difficult if change recipient sensemaking is not effectively acted upon. The five determinants identified require adequate managerial attention in order to avoid slipping into organizational inertia. As a consequence, professional workers are unable to ‘drop their tools’ and fail to integrate the strategic change effort in updated team mental models.     

Employee strain and job satisfaction related to an implementation of quality in a public service organization: A longitudinal study

To date, few studies have focused on employee reactions to the quality-related aspects of the introduction of New Public Management (NPM). The aim of this study was to investigate the effects on employee strain and satisfaction of the implementation NPM in a public service organization. The study was designed as an empirical examination of the 'context-dependent approach' ( Edwards, Collinson, & Rees, 1998 ). This approach suggests that effects of an organizational change depend on the context of the implementation, i.e. organizational aspects (implementation strategies), job content and job context dimensions. They employed a single-case longitudinal design. The case was a large municipal service unit responsible for the public housing system of a city in Austria. The sample consisted of 217 employees. Measurements were taken before the organizational change, and at two different times during the change process. While the implementation of NPM can be considered to have been an organizational success (increase in customer satisfaction), it was accompanied by increases in job strain, and, at the same time, mixed results in job satisfaction. Less qualified employees mainly responsible for the customer interface experienced the organizational change most negatively. Using structural equation modelling, the context-dependent approach was empirically confirmed. Job control, role clarity and information were found to be the most important job and organizational resources.     

Editorial: Cognitive science,occupational stress and organizational health

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Evaluation of an intervention programme based on empowerment for eldercare nursing staff

Abstract

This study evaluated the impact of an intervention programme at individual, worksite, and organizational level, for eldercare nursing staff at 12 eldercare units. The project aimed at empowering auxiliary nurses and nursing assistants, thus promoting good working conditions, health and well-being of eldercare staff, and improving their evaluation of the quality of nursing care. Questionnaire responses from the nursing staff (n=200) before and after an 18-month intervention programme evaluated the effects using ANOVA, repeated measures for the statistical analyses. Although the improvements were limited, the intervention seemed to impact on work conditions and on the perceived quality of nursing rather than on the health and well-being of staff. Work at nursing homes or at home-care was shown to modify the outcome due to different needs and priorities for work unit improvements. Staff turnover and multiple reorganizations are discussed as inhibiting factors for performance as well as for the evaluation of workplace interventions. The sharing of power between occupational groups or organizational levels must be carefully considered. The study emphasizes the importance of involving the middle management in early project planning and decisions.     

Individual and organizational strategies for coping with organizational change

Abstract

During times of significant change to organizations in strategies and structures, employees can experience high levels of stress as their jobs, areas of responsibility and roles also change. Yet research is curiously silent about how people react to organizational change, especially towards promoting healthy responses to change. As a first step to outlining areas for future research this paper considers a range of individual and organizational strategies that may be effective in reducing employee stress and related problems. Prior to the implementation of these strategies, however, organizations must empower employees to adopt the role of change agent and encourage them to take action to solve the problems that stress them. At the individual level, employees can respond to the stress created by organizational change by using problem- and emotion-focused strategies. Also important in coping with change are the personal resources of employees, including a sense of hardiness, beliefs about having control over their work environment, and the availability of social supports within and outside the organization. Although few organizations fully acknowledge their role in helping employees cope with change, there are a number of initiatives that organizations can pursue. Several strategies are discussed in relation to communication, leadership, job-related tasks and stress management programmes.     

Organizational interventions: A research-based framework for the evaluation of both process and effects

Abstract

Organizational interventions are often recommended when organizations want to improve employee psychological health and well-being. Research, however, has revealed inconsistent results and reviewers have called for research on why interventions either bring about desired change or fail to do so. Answering the “how” and “why” of intervention outcomes requires a close examination of the elements that hinder or facilitate desired outcomes, thus moving beyond evaluation of only the overall effects. In this paper, we present an evaluation framework based on recent intervention research and process-oriented organization theory. The framework offers suggestions for which elements to include when evaluating organizational interventions. Within the framework, elements crucial to intervention evaluation are grouped into four overarching categories that we argue are crucial to evaluation over the five phases of an intervention programme. These categories are: the organizational “actors”; the mental models of those actors; the context of the intervention; and intervention design and process. Evaluation during the process as well as of the overall effects, as recommended by this framework, should throw light on what works for whom, why, how and under which circumstances.     

Exploring the Effects of Cultural Variables in the Implementation of Behavior-Based Safety in Two Organizations

Abstract

The present case study examines how culture can influence behavior-based safety in different organizational settings and how behavior-based safety can impact different organizational cultures. Behavior-based safety processes implemented in two culturally diverse work settings are described. Specifically, despite identical implementation plans, similarities and differences in the actual implementation of the two behavior-based safety processes are presented with an emphasis on the effects of employee-driven decisions. Data on both implementations and outcome measures are provided. The results are discussed with respect to the potential impact of specific cultural variables.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

An appraisal of key factors in the implementation of occupational stress interventions

Empirical research on stress intervention in organizations, and experience from organizational change programmes in general, indicates that obtaining intended change is often more difficult than it had been conceived to be at the outset. In order to facilitate the accomplishment of stress prevention and effective organizational change, this paper examines the importance of the social and cognitive processes influencing the implementation of any intervention. It states that if change is to be managed skilfully, it is important (1) to create a social climate of learning from failure, (2) to provide opportunities for multi-level participation and negotiation in the design of interventions, (3) to be aware of tacit behaviours that possibly undermine the objectives of interventions, and (4) to define roles and responsibilities before and during the intervention period.     

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.     

Productive organizational energy mediates the impact of organizational structure on absorptive capacity

The ability of an organization to cope with radical technological change is regarded to be heavily dependent on its ability to absorb and apply knowledge from its environment. This study investigates the role of organizational structure in driving absorptive capacity and uncovers the role of the emergent phenomenon of organizational energy as the enabler of this relationship. A field study was conducted among firms that are challenged by the disruptive nature of Cloud computing. Our results show that organizational design affects the degree of mobilization of an organization's affective, cognitive and behavioral resources, which in turn influence the effectiveness of learning processes related to the absorption and exchange of knowledge within the organization. Furthermore, they reveal the positive relationship between the enactment of absorptive capacity and the successful adoption of Cloud technology for incumbent firms. The findings contribute to our understanding of the micro-foundations of absorptive capacity and how positive organizational phenomena facilitate effective adoption and implementation of emerging technologies.