Stress Management Proposal (Mimie)

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Effectiveness of stress management intervention techniques used by organizations a case study of

Zvishavane District hospital.

Introduction
Stress if not handled well becomes a great hindrance to optimal performance at the work place. This
could be looked at from various perspectives more so on innovativeness and the quality of work.

For developed countries for example where the economy is driven by service based industries the
impact is high. Stress has no gender or post and it affects everyone which makes it important to put
measures to manage it.

Abstract
Stress, that had an effect on care workers, has been receiving greater attention than before as the health care labour
force is one of the major work groups in all over the world. According to Nolan & Smojkis (2003) nursing is
considered as a profession which is based on both skills and values providing care and service. This is a profession
based on highest technical skills with scientific knowledge and experience. However, despite the qualities and values
possessed by nurses and nursing environment, there are major conflicts related to their work and may lead to serious
health conditions which can threaten on their mental and physical well-being. These conflicts are criticized to result in
stress and hypertension among nurses. Such factors are common among all healthcare professionals, but are found
to be higher among nurses. Critical care units are much prone to such issues.

Introduction

In modern life work can give a sense of intelligence. Work may be stressful by means of its

nature. Successful stress management could lead to development. Where stress management
failed, there might be the distress experience and negative stress. Long-term exposure
towards the work stress may produce lower well being. Stress can be a risk factor in the
mental and physical well being of the workers and the service quality within the
organizations (Klein, 2011). Stress, that had an effect on care workers, has been receiving greater
attention than before as
the health care labour force is one of the major work groups in all over the world. According to
Nolan & Smojkis (2003) nursing is considered as a profession which is based on both skills and
values providing care and service. This is a profession based on highest technical skills with
scientific knowledge and experience. However, despite the qualities and values possessed by
nurses and nursing environment, there are major conflicts related to their work and may lead to
serious health conditions which can threaten on their mental and physical well-being. These
conflicts are criticized to result in stress and hypertension among nurses. Such factors are
common among all healthcare professionals, but are found to be higher among nurses. Critical
care units are much prone to such issues. Many of the nurses who operate in ICUs are exposed
to death, acute pain, dying babies, and emotionally draining scenes. The mortality rate among the
ICU patients is much higher than any other areas in the hospital (Yu & Chan, 2009). According
to Jennings (2008, p 225), it is widely accepted that the street among nurses are higher than any
other institution and industries. The studies in this area, especially those made by Rout &
Rout (1998) within the NHS context in the UK shed light on the impact, reasons,
prevalence of stress in healthcare institutions. Other studies such as the relation between
stress and psychosomatic illness among nurses (Kane, 2009), occupational burnout and coping
strategies, sources and effects of stress in nursing (Moustaka & Constantinidis, 2010) provide
more authentic and detailed examples and information to the problems and its prevalence in the
nursing domain. It is very
difficult to trace the root of such issues, and many of them argue that the only possible way to
overcome stress related issues among nurses are to increase the staff intake in such settings.
However, as the recruitment and retention crisis is becoming more intense, the availability of
staff is less in the hospitals. Due to this issue, many institutions run their departments
understaffed (Nolan & Smojkis, 2003).
Studies related to occupational stress has been well documented by many researchers (Landa
& Lopez-Zafra, 2010; Jennings, 2008) but the consequences of stress among nurses often
leaves as under documented, and only coping strategies and burnout has been mentioned as
the major issues in the literatures. Among most the studies, Jennings‟s (2008) findings pay
much attention to the factors that contribute to stress among nurses. According to him, the
factors that lead to stress cannot be generalised, as they are too personal. He argues that an
individual‟s personal setting, the perception about events, and emotional level/ intelligence
determine the nature of events as positive or negative. Therefore, the generalization is
possible in very few factors only. Jennings (2008) had identified four types of factors that
lead to stress among nurses, they are changing, responsibility, patient care, and decision
making. As nurses are more human and social oriented, the work they perform is also
associated with socializing, engaging, caring, with interpersonal activities which involve
extra working hours, night shifts, physical labor, human suffering, interpersonal conflicts.
These activities are the core of a nurse‟s job.

The demand for much attention and care raised by modern patient orientated management
models. Many of the nursing staffs have found that it is very hard to fit in new techniques and
required skills (Jennings, 2008). Other factors which contribute to work stress are the family
and social issues. They are facing more issues due to their long working hours, night shifts,
and inability to handle multiple roles. Those issues found more among women rather than
men, as the family responsibilities and caring roles of them in a family setting is more
challenging, which increases when they enter parenthood (Jennings, 2008).

Landa& Lopez-Zafra (2010) has found that the role of emotions in determining the level of
stress a nurse is envisaged to meet. The research conducted by Korompeli et al. (2009)
reported that the impact of job rotation and night shifts among nurses and the hormone
imbalance due to the shift patterns on work stress. Such hormone imbalances are found to be
causes of stress and lower quality of life in many ways. These balances may lead to physical
and mental disruption among the nurses, and later turn into frustration and distress.

The issue that the health care industry is facing has been studied by Yongqing (2001),
reported that the staff turnover as the major consequence of stress. According to him, higher
staff turnover is the outcome of less performance of the organization, higher pressure to the
nurses, especially those who work in ICUs, and higher administration costs. The high demand
to perform the task may result the feeling of tension, fatigue and physical strain. Such issues
may lead to unwanted outcomes such as depersonalization, frustration and finally stress and
burnout. As those conditions prevail in the organization for a long time, existing staff may
seek permanent solutions such as leaving the job. He also indicated that higher turnover
among staff results high stress level among the rest of the workforce. Therefore, it is also
considered as the leading cause of occupational stress need to be studied. He also identified
that such issues related to stress also leads to reduced performance by employees and the
organization as a whole followed by reducing levels of employee loyalty and commitment
towards work. ICU nurses when exposed to such issues along with the exhausting
environment in critical care units may find difficult to cope up with the demand and seek
permanent solutions.
The importance of eradicating stress related issues among the nursing

Background

These intervention are designed to improve personal well-being and general wellness at the
workplace over important aspects of the work environment

in order to reduce physical or mental strain due to work related stressors. The interest in stress
management has grown massively .In Malaysia, Alphonso (2017) investigated the effects of
stress management treatments on organizational organisms in the manufacturing industry. The
goal of the study was to look into the effectiveness of stress management interventions used by
businesses in order to reduce stress-related problems in the workplace. A number of issues, such
as significant labor turnover, absenteeism, and a high rate of occurrence at work, prompted the
investigation. This research adopted quantitative approach to gather data and from a sample of
100 participants, 67% of the respondents were of the view that such problems were caused by
poor stress management interventions at the workplace.

und out that the above mentioned stress related problems were caused by several factors that
existed in the organization. Stress causing factors articulated by the researcher included poor
working conditions, role conflict and poor organizational policies that govern employees conduct
at work. These stress causing factors accelerated due to the less effectiveness of stress
management interventions exercised by firm. The researcher reported that the stress management
interventions were less effective because the stress management interventions were taken for
granted, meaning there were exercised with less caution and commitment, lack of standard
funding and that management did not include employees in decision making as far as choosing
the best intervention strategy to undertake in order to alleviate a particular stress related
problems. Therefore, basing on the above findings the researcher recommended that
organizations should frequently exercise sound stress management interventions that are fully
funded, well planned and being the intervention of choice to the employees in context.

Moreover, Ajayi (2005) conducted an investigation in Nigeria named the efficiency of stress
management techniques in the Nigerian Banking Industry. The purpose of this particular
investigation was to identify sources of occupational stress and examine the usefulness of SMI
that were being undertaking by the Nigerian Banking Industry in order to minimize the impact of
occupational stress. This research was conducted due to high labour turnovers, high rate of
absenteeism and low organisational performances that existed in the Nigerian Baking Industry.

Further, Makoni and Mutanana (2016) also did research in a Harare manufacturing firm titled
"Effective management of occupational stress as perceived by workers at a manufacturing
company in Zimbabwe." The goal of this study was to look into the organization's management
techniques for reducing occupational stress. Employee absenteeism, poor service delivery,
frequent labor turnovers, poor financial situation, dissatisfaction, and disregard of duty prompted
this study. The study used both qualitative and quantitative research methods as the two are
known for complementing each other. A sample of 35 participants was identified using the
convenience sampling technique. The researchers used two research instruments; a questionnaire
and an interview guide. The response rate was 73%. Findings revealed that workers were
stressed due to poor working conditions and unsatisfactory remunerations. The organization
brought in some stress management interventions such as cushioning allowances to cater for
unsatisfactory remunerations. These SMI were effective at that particular time. To this end, the
study recommends employers to ensure continuous exercise of stress management interventions
that are effective in order to reduce the impacts of stressors.

Furthermore, Destiny of Africa Network Harare is not exempt from stress management
interventions, as evidenced by the Human Resource annual report of January 2021, which
revealed issues such as bad financial condition, absenteeism and dissatisfaction, disregard of
duty and poor performance, as well as workplace accidents. Furthermore, according to the
Human Resource Journal, they organize quarterly campaigns with the topic "Zero Tolerance for
Workplace Injuries," wellness programs, and career development trainings as stress management
intervention programs. As a result, it was against this

Statement of the problem


The paper will look at various stress management intervention techniques used by companies and how
effective they are in helping their employees. According to Tetrick and Winslow 2015, stress
problems account for most of the common psycho-emotional disorders causing job absences and
inability to work This paper will work on bring out question and answers to do with stress
management and its impact on job performance and how to deal with the vice in organizations .

Women constitute a greater number of employees in environment where there are female stereotypes.
They occupy positions such as the administrative and clerical among others. Pregnant women and
those who are at the stage of giving birth are prohibited from getting jobs because of the conclusion
that they prioritize their family. Women are also affected in their performance by their monthly cycle
and countries like Canada are proposing that women should get sick leaves when they are having
periods. Stress can emanate in the work places due to the use of parameters such as awarding of
salaries and giving of job benefits by favoring a particular gender.This has an effect of exposing
women in big offices which have huge salary, increased chances of moving up in the company. The
paper also looks at possible way of dealing with stress at the workplace by having to deal with such
cases of gender discrimination.

RESEARCH OBJECTIVES

The objectives of the study are as follows;


Main objective

To examine the interplay of stress management intervention techniques and the performance of

works at Zvishavane district hospital.

Sub-objectives

 To access the effectiveness of comprehensive workplace stress management

 To access the consistency of participatory action oriented training and individual

management

 To analyse the effects of stress management intervention on performance in the

workplace

 To make recommendations based on the research

RESEARCH QUESTIONS

 To what extent does the stress management intervention techniques have an impact on
performance at the hospital ?

 Does the educational level of the employee have an impact on how they deal with stress?

 What is the barriers to effective stress management intervention programs at the


organization ?

 What are the recommendations based on research findings?

 What are the possible solutions to better stress management interventions?

RESEARCH HYPOTHESIS
The study will test the following research hypothesis.

H 1: There is a relationship between the stress management intervention techniques and

performance at the district hospital.

H 2: There is a relationship between the educational level of employees the board members and

the framework of enhancing transparency and accountability among rural local authorities in

Zimbabwe.

SCOPE OF THE STUDY

This study will look at the performance of workers at the district hospital due to the aspects

stress .The research will be compiled between 2018 and 2021 when there was a change of

government in the country and a time when most hospital were facing challenges of service

delivery and performance.

SIGNIFICANCE OF THE STUDY

 The study will mainly help Zimbabwean district hospitals since they will be able to see

other local hospitals case study, so that they will be able to correct as well as avoiding the

same mistakes . The central government in Zimbabwe will also benefit from the study as

well as the regulators of the district hospitals.

 The researcher wants to cover the gap of identifying the aspects of stress management

that influence the performance of district hospital in Zimbabwe.

 The findings will help the government and regulators to find the proxy or measures of

stress management . The public sector members in Zimbabwe may be able to interpret

assess and manage the activities used for expected performance.


 The finding will also be useful as reference material for the university library as well as

other researches that may be related to the same subject.

ASSUMPTIONS OF THE STUDY

The study will be done under the guideline of the stated assumptions

 The data on selected Zimbabwean district hospitals is free from window dressing.

 This study will be objective in data analysis and presentation.

 Sample drawn was a true representative of the total population of the study.

Literature review

Selye’s General Adaptation Syndrome of Stress is a model that analyses an individual’s


response to long term stress which is broken down into three main stages, the initial
alarm stage, the interim resistance stage and finally the exhaustion stage (Nicky Hayes,
1994). If the stressor persists the individual will progress through each of the stages, and
in some cases disease and even death can result.

During the alarm stage the body reacts to the stressor with a ‘fight or flight’ response in
which the parasympathetic nervous system is activated and hormones (e.g. adrenalin
and noradrenaline) are released from the adrenal medulla (Richard Gross, 2010). If the
stressor remains, the body then goes into the resistance stage during which it may
outwardly appear to be functioning normally, however levels of blood glucose, cortisol
(stimulated by adrenocorticotrophic hormones known as ACTH) and adrenaline remain
higher than normal and the individual’s heart rate, blood pressure and breathing will be
higher than normal. The individual may appear calm but they are physically and
mentally at ‘action stations’ (currentnursing.com, 2014). During the final, exhaustion
stage the further release of ACTH is inhibited by the hormones it has already stimulated
and the levels of ACTH itself circulating in the blood. At this point the body begins to
use up its energy reserves or resources and the body cannot function adequately. Blood
sugar levels drop and the individual becomes vulnerable to disease and death. As Nicky
Hayes (1994, p450) states ‘This [final stage] produces an immediate and strong –
sometimes excessive – reaction to even mild sources of additional stress’.

As a model of stress, the General Adaption Syndrome (GAS) is focused primarily on the
bodies’ physiological response to stress. It does not take into account other factors
influencing an individual’s response to stress such as their thoughts, perceptions or
feelings and how these cognitive and psychological factors impact upon their
experience of stress itself (garysturt, 2004). Nonetheless the GAS was a hugely influential
model which generated a lot of further study (currentnursing.com, 2014).

2. Folkman & Lazarus’ (1984) Cognitive Appraisal Theory of stress

Unlike the GAS model of stress, the Cognitive Appraisal Theory of stress focuses on an
individual’s cognition of a stressor which informs their emotional response. It is ‘a theory
of emotion which implicates peoples personal interpretation of an event in determining
their emotional reaction’ (psychcentral, 2014). The way in which an individual interprets
the stressor is significant and according to Folkman and Lazarus we respond to a
stressful event or situation by making a primary appraisal, during which we assess
whether the event is harmful to us either physically or in terms of our esteem, core
beliefs and our values or goals (Folkman, 1986). During the secondary appraisal (which
can take place before, at the same time or after primary appraisal) we consider whether
we have the resources to manage the stressor; the outcome of which affects our coping
strategy.

Coping strategies can be understood as either: problem based; where the stressor is
perceived as a challenge and we generate strategies to manage it or solutions to
remove it, or emotional based; where the problem is considered to be a threat that
cannot be resolved and various coping strategies such as avoidance, distancing and
acceptance are employed (blackswanstress, 2014).
According to the Cognitive Appraisal of Stress model then, in response to a stressor we
establish if there is a threat, employ coping strategies and then reassesses the threat
which results in identification of emotional responses (Nicky Hayes, 1994). Stress is
viewed in a more transactional sense, as a two way process in which individuals respond
dynamically to their environment. Unlike the GAS model then, cognitive approaches are
of paramount importance and it is a more fluid and responsive model, recognising the
importance of the individual in each and every stress response.

With reference to the case study, examine the evidence that there is a link
between personality and stress.

There is little dispute that life events can have a dramatic effect on an individual’s
mental health, and even their physical health. However an individual’s reaction to a
stressor is subjective and influenced by their cognitive and psychological makeup. An
individual’s experience of stress will depend upon their personality. Kobasa (1979)
proposed that this response to stressful events will be determined in part by an
individual’s hardiness, with those low on hardiness more likely to experience
psychological and physiological illness in response to stressful life events, whilst those
high on hardiness are buffered to a certain extent from the effects of stress, using
research amongst executives to back up this hypothesis. Hardiness is to be understood
as having a sense of commitment (both individual and work related), as having an
internal locus of control and, as a positive response to change viewing it more as a
challenge and less as a threat (psych.uft.ed, 2014).

Other studies of personality support the work done by Kobasa, for example Ironson
(2010) completed a study on disease progression in HIV in which she found that ‘Those
low on optimism (25th percentile) lost CD4 cells at a rate 1.55 times faster than those
high on optimism (75th percentile) … reap[ing] health benefits partly through
behavioural (proactive behaviour), cognitive (avoidant coping), and affective
(depression) pathways’. Although some studies such as Funk & Houston 1987, and
Schmid & Lawler 1986, have not supported or replicated Kobasa’s findings it is believed
that at least in terms of cognitive processes, personality and an individual’s subjective
response to life situations (stressful or not) directly impact their experience of stress, and
the degree to which they experience stress (fatih.edu.tr, 2014).

With reference to the case study, Nick could be described as having low levels of
hardiness. Although his commitment to his work seems high it is at the expense of his
sense of commitment to himself (evidenced by his persistent failure to take a lunch
break). In addition his feeling out of control may indicate that he has an external locus
of control and finally his rigid attitude towards his work life may suggest that he might
struggle with change, viewing it more as a threat and less as an opportunity. According
to Kobasa et al, this could explain why he suddenly experienced chest pains (which
could be either a panic attack or symptoms of a heart condition)

This section concentrates on reviewing related literature to the problem under investigation.
Researcher will draw themes and subthemes from research objectives. The literature review will
focus on various stress management intervention techniques used by district hospital in
Zimbabwe. The conceptual framework and theoretical framework will also be incorporated.

The prevalence of stress the work environment is generally reported to be very high in the US,
the percentage is nearly 65% (http.//www.apa.org/helpcenter/work-stress.aspx). While in the UK
is about 40%

Stress refers to the psychological and physiological arousal that follows when a person identifies
a menace to something of value to him or her and that menace consumes the resources he or she
has available to cope with it (Lippine and Jackson 2004).
Discussions
The world today experiences great challenges concerning management and delegation of duties in the
work places especially in Africa . This has brought in the issue of gender equality which the corporate
world is striving to achieve. Gender discrimination has led to various negative impacts in job
performance.

Most of the victims of discrimination based on gender have their morale brought down especially in
the political circles . The low morale of a worker will definitely lead to poor results. It is a fact that
most of the action taken by employees has a drive factor. If the working conditions aren’t conducive
enough to discriminate on a worker, definitely the quality of work will go down (Cleveland, Stockdale
& Murphy, 2000).

Creation of bottlenecks to getting to a job position by using the gender factor is a common form of
gender discrimination. Such action goes in great way in propagating negative gender based
stereotypes. This sometimes happens when managers have the fear of humiliation from performances
brought up by their staff which could outshine them and hence bring down the confidence there
followers have in them.

Gender discrimination can lead to negative effects to organizations such as reduced innovations and
improvements. Innovations can only be possible if everyone in the work situation is comfortable with
their working conditions. People tend to work well when their brains are well settled.

A gender discriminated employee is likely to take more time thinking of their negative predicaments
hence may not be able to think connotatively and come up with an innovation. This would lead to the
victim being unable to unleash their potential fully.

The image of institutions can be watered down when gender discrimination thrive. If word goes round
on what is happening with a certain conglomerate concerning gender discrimination, this would lead
to negative publicity that could hurt the company’s wellbeing. The sexual abuses towards women
today has the potential of watering down the credibility of the managers and hence the institution as a
whole.

There has been reduced diversity of employee search for jobs. Haven’t you heard of someone saying
that they cannot go or even apply for an interview because of a simple reason-they are likely not to be
considered for the job? This brings in two aspects.

The first is that the person could be bearing negative self image based on their gender. The second is
that its true there will be discrimination. This will automatically reduce the number of applications and
hence the diversity of skills goes down. The employer will end up loosing the great expertise that is
not in the market for selection.

One should determine if the workplace behavior of others sums up to discrimination based on gender.
Discrimination may be looked at from various perspectives.

For example there can be gender based discrimination when contra positive action is taken by boss in
repeatedly assigning you duties that were meant to be shared by your male counterparts of the
opposite sex. If it has happened only once then this might not sum up to gender discrimination.

Another way of dealing with workplace gender discrimination is through engaging the people who
heightens gender discrimination at the places of work. Such a step should be handled with a lot of
caution as if not well handled could lead to massive damages to and among the workers.

This can happen since humans are prone to lack of identification of their discriminatory actions.
Talking to the person involved in a proper way can lead to total change of the person not only to the
victim but to others who would witness the change.

In dealing with gender discrimination in the workplace once one is sure of being discriminated
against, they can contact the workplace human resources to seek solution to the problem. This is a key
step to dealing with the problem once and for all. One should always do this in a manner that they will
be able to protect their anonymity.
Other than having the problem sorted out internally, one can call for the support workers’ union or
local government agency that handles workplace gender discrimination. Counseling can also be
appropriate as it can help one deal with any gender stereotypes they could have acquired during or
after being discriminated against (Stein, 2010).

Conclusion
Gender discrimination in the workplace has negatively impacted on the performance of the companies
and institutions both directly and indirectly in Zimbabwe . This vice is also against the human rights as
human conscience is applied more at work and not just the instinct.

While addressing this gender discrimination one should have in mind that there is no better sex hence
the psychological view is dealt with since the inside leads to the outward which are the actions that
either promotes or reduce gender discrimination at the work place. Companies and other institutions
should work towards eliminating the vice since it largely works negatively to the institutional
wellbeing hence reducing their profit margin.
References

Lippine and Jackson 2004

Tetrick and Winslow 2015,

Cleveland, J., Stockdale, M.S. & Murphy, K.R. (2000). Women and men in organizations: sex and
gender issues at work. New York: Routledge

Dipboye, R. L. & Colella, A. (2005). Discrimination at work: the psychological and organizational


bases. New York: Routledge

Gregory, R. F. (2003). Women and workplace discrimination: overcoming barriers to gender


equality. New Jersey: Rutgers University Press
Stein, S. J. (2010). Make Your Workplace Great: The 7 Keys to an Emotionally Intelligent
Organization. New Jersey: John Wiley and Sons

StudyCorgi. (2020, March 4). Gender Discrimination and Performance in the Workplace. Retrieved


from https://studycorgi.com/gender-discrimination-and-performance-in-the-workplace/

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