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      Factors and symptoms associated with work stress and health-promoting lifestyles among hospital staff: a pilot study in Taiwan

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          Abstract

          Background

          Healthcare workers including physicians, nurses, medical technicians and administrative staff experience high levels of occupational stress as a result of heavy workloads, extended working hours and time-related pressure. The aims of this study were to investigate factors associated with work stress among hospital staff members and to evaluate their health-promoting lifestyle behaviors.

          Methods

          We conducted a cross-sectional study from May 1, 2010 to July 30, 2010 and recruited 775 professional staff from two regional hospitals in Taiwan using purposive sampling. Demographic data and self-reported symptoms related to work-related stress were collected. Each subject completed the Chinese versions of the Job Content Questionnaire (C-JCQ) and The Health-Promoting Lifestyle Profile (HPLSP). Linear and binary regression analyses were applied to identify associations between these two measurements and subjects’ characteristics, and associations between the two measurements and stress symptoms.

          Results

          Self-reported symptoms of work-related stress included 64.4% of subjects reporting nervousness, 33.7% nightmares, 44.1% irritability, 40.8% headaches, 35.0% insomnia, and 41.4% gastrointestinal upset. C-JCQ scores for psychological demands of the job and discretion to utilize skills had a positive correlation with stress-related symptoms; however, the C-JCQ scores for decision-making authority and social support correlated negatively with stress-related symptoms except for nightmares and irritability. All items on the HPLSP correlated negatively with stress-related symptoms except for irritability, indicating an association between subjects’ symptoms and a poor quality of health-promoting lifestyle behaviors.

          Conclusions

          We found that high demands, little decision-making authority, and low levels of social support were associated with the development of stress-related symptoms. The results also suggested that better performance on or a higher frequency of health-promoting life-style behaviors might reduce the chances of hospital staff developing stress-related symptoms. Our report may contribute to the development of educational programs designed to encourage members of high stress groups among the hospital staff to increase their health-promoting behaviors.

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          Most cited references16

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          Depression among female psychiatric nurses in southern Taiwan: main and moderating effects of job stress, coping behaviour and social support.

          In this study, we tested the following hypotheses among psychiatric nurses: (1) job stress would be positively correlated with depression; (2) coping behaviour would be significantly correlated with depression and moderate the relationship between job stress and depression; (3) social support would be significantly negatively correlated with depression and was a significant moderator on the relationship between job stress and depression. Most studies in Taiwan related to depression have focused on the general public rather than nurses. The main effect of job stress (coping behaviour, social support) on level of depression has been documented in some population, but the moderating effects of coping behaviours and social support on the relationship between job stress and depression have not been well studied among nurses, especially among psychiatric nurses. A cross-sectional research design was employed. A self-report questionnaire was adopted to measure personal characteristics, depression (Beck Depression Inventory), job stress (Taiwanese Nurse Stress Checklist), coping behaviour (Jalowiec Coping Scale) and social support (short form, Interpersonal Support Evaluation List). Eligible subjects were female, non-supervisory, inpatient ward nurses in a psychiatric hospital in southern Taiwan. One hundred and fifty-four questionnaires were distributed, and the response rate was 91.6%. After adjusting for covariates, we found that: (1) Job stress and affective-oriented coping were significantly positively correlated with BDI-II scores. (2) Coping behaviour was not a significant moderator on the relationship between job stress and depression scores among psychiatric nurses, but social support was. Depression scores were correlated with job stress and affective-oriented coping, but social support could work to reduce the effect of stress on depression among psychiatric nurses. Nursing managers should explore both ways of reducing job stress and techniques for building social support networks in the institution to protect their members against stress and depression.
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            Total workload, work stress and perceived symptoms in Swedish male and female white-collar employees.

            The aim of this study was to analyse how paid work, unpaid household tasks, child care, work-child care interactions and perceived work stress are associated with reported symptoms in male and female white-collar employees. A questionnaire was mailed to 1300 men and 1300 women belonging to the white-collar sector, with at least 35 hours of regular employment a week and a participant age of between 32 and 58 years. It contained items relating to total workload (hours spent on paid work, unpaid household tasks and childcare), subjective indices for work stress and symptoms. The response rate was 65% (743 women; 595 men). Gender difference in symptom prevalence was tested by analyses of variance. Odds ratios were used to estimate the bivariate associations between work-related variables and symptom prevalence. A multivariate analysis estimated the effect of paid and unpaid work interaction, work-childcare interplay and possible synergy. The frequency and severity of symptoms was higher in women than in men (P 50 h/week (OR 1.61; 1.02-2.54). However, childcare (<21 h/week) appeared to have a buffer effect on the risk of a high level of symptoms in men working long hours. Working life and private circumstances and the interplay between them need to be taken into account to curb stress-related ill health in both men and women.
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              Work-related stress and psychosomatic medicine

              This article introduces key concepts of work-related stress relevant to the clinical and research fields of psychosomatic medicine. Stress is a term used to describe the body's physiological and/or psychological reaction to circumstances that require behavioral adjustment. According to the Japanese National Survey of Health, the most frequent stressors are work-related problems, followed by health-related and then financial problems. Conceptually, work-related stress includes a variety of conditions, such as overwork, unemployment or job insecurity, and lack of work-family balance. Job stress has been linked to a range of adverse physical and mental health outcomes, such as cardiovascular disease, insomnia, depression, and anxiety. Stressful working conditions can also impact employee well-being indirectly by directly contributing to negative health behaviors or by limiting an individual's ability to make positive changes to lifestyle behaviors, such as smoking and sedentary behavior. Over the past two decades, two major job stress models have dominated the occupational health literature: the job demand-control-support model and the effort-reward imbalance model. In both models, standardized questionnaires have been developed and frequently used to assess job stress. Unemployment has also been reported to be associated with increased mortality and morbidity, such as by cardiovascular disease, stroke, and suicide. During the past two decades, a trend toward more flexible labor markets has emerged in the private and public sectors of developed countries, and temporary employment arrangements have increased. Temporary workers often complain that they are more productive but receive less compensation than permanent workers. A significant body of research reveals that temporary workers have reported chronic work-related stress for years. The Japanese government has urged all employers to implement four approaches to comprehensive mind/body health care for stress management in the workplace: focusing on individuals, utilizing supervisory lines, enlisting company health care staff, and referring to medical resources outside the company. Good communications between occupational health practitioners and physicians in charge in hospitals/clinics help employees with psychosomatic distress to return to work, and it is critical for psychosomatic practitioners and researchers to understand the basic ideas of work-related stress from the viewpoint of occupational health.
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                Author and article information

                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central
                1472-6963
                2012
                16 July 2012
                : 12
                : 199
                Affiliations
                [1 ]Department of Family Medicine, Mackay Memorial Hospital, Taipei City, Taiwan, 10449, Republic of China
                [2 ]Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, Ho-Ping E. Road, Sec 1, Taipei, Taiwan, 106, Republic of China
                Article
                1472-6963-12-199
                10.1186/1472-6963-12-199
                3511165
                22799278
                032e9538-1445-4a2b-8b54-9f5c579bb168
                Copyright ©2012 Tsai and Liu; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 July 2011
                : 16 July 2012
                Categories
                Research Article

                Health & Social care
                healthcare workers,job content questionnaire (jcq),health-promoting lifestyle profile (hplsp),occupational stress

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