ABSTRACT
The purpose of the study was to investigate the sources of stress and stress management practices among healthcare professionals at National Orthopaedic Hospital, Enugu. Nine research questions were posited and six hypotheses were formulated to guide the study. The descriptive survey research design was used for the study. The simple random sampling technique was used to draw a sample of 221 out of 437 Healthcare professionals (HCPs). The instrument for data collection was a researcher’s designed questionnaire. The instrument was subjected to reliability test using the split half method. The data collected were analyzed using mean and percentages for research questions (1 – 9) while the null hypotheses were tested using Chi – square (χ2) statistics. The result revealed five sources of stress to healthcare professionals which are role conflict (overall x = 2.58), role ambiguity (overall x = 2.84),workload (overall x = 2.64), performance pressure (overall x = 2.55) and Home work interface (overall x = 2.41). HCPs adopted stress management practices which include relaxation (81.4%), application of humor in relationship (81.4%), sleeping (79.5%) and listening to music or watching movies (73.5%), ecclesiastical therapy (59.3%), physical exercises (55.2%) and drinking water (52.5%). and job related stress management practices such as taking a break at work (87.8%), setting achievable goals (80.5%), engagement in positive and realistic self-talk (76.9%), planning of work (76.0%), defining duty clearly (73.3%) and delegation of duties (65.2%) were adopted by healthcare professionals. The independent variables of gender, job type and age considered had significant difference at .05 level of significant on the stress management practices among HCPs (Doctors, Nurses, Pharmacist, Medical Laboratory Scientist (MLS) and Allied Healthcare professionals (AHP), at National Orthopaedic Hospital, Enugu. Based on the findings and conclusions, the researcher recommended among other things that the workload of the healthcare professionals can be reduced by employing more professionals hereby reducing stress. Also, efforts should be made by the federal government to equip the wards, theatres, medical laboratories and other necessary department with sophisticated equipment that will speed up work and reduce stress.
TABLE OF CONTENTS
Title Page
Table of contents
List of Tables
List of acronyms
Abstracts
CHAPTER ONE: Introduction
Background to the Study
Statement of the Problem
Purpose of the Study
Research Questions
Hypotheses
Significant of the Study
Scope the Study
CHAPTER TWO: Review of Related Literature
Conceptual Framework
Stress and stressors
Stress management practices
Healthcare and healthcare professionals
Socio-demographic factors influencing stress management practices among HCPs
Theoretical Framework
Response based theory (RBT)
Social cognitive theory (SCT)
Self-efficacy theory (SET)
Empirical Studies on Stress Management Practices
Summary of Literature Review
CHAPTER THREE: Methods
Research Design
Area of the Study
Population for the Study
Sample and Sampling Techniques
Instrument for Data Collection
Validity of the instrument
Reliability of the instrument
Method of Data Collection
Method of the Data Analysis
CHAPTER FOUR: Results and Discussion
Results
Summary of Major Findings
Discussion of Findings
Sources of stress
Personal stress management practices
Job related stress management practices
Differences of stress management practices of HCPs according gender, job type and age
Implication of the Study for Health Education
CHAPTER FIVE: Summary, Conclusions and Recommendations
Summary
Conclusions
Recommendations
Limitation of the study
Suggestions for Further Studies
References
Appendices
CHAPTER ONE
Introduction
Background to the Study
Stress is one of the serious emotional and mental health problems spanning through the globe today because every human being has needs and wants and there is a deep hunger and enthusiasm in people to satisfy these demands. However, as effort is being made to satisfy these numerous needs one finds himself in a stressful situation. Stress is interwoven with life. The United Nation Organization -UNO (1992) reported stress to be the 20th century epidemic. World Health Organization –WHO (1996) pointed out stress as a “World Wide Epidemic”. The American Institute of Stress (2005) also opined that the biggest threat to health today is stress. Hence, stress was rated as American number one health problem. United Kingdom Health and Safety Executives –HSE (2005) estimated that over 13 million working days are lost every year because of stress as it is believed to trigger 70 per cent of visits to doctors, and 85 per cent of serious illnesses occurring in the United Kingdom. The cost of stress in terms of human suffering, social and occupational impairment and illness are enormous. In fact, there is nothing amazing about the statement that people today are being assaulted by stress.
Nigeria is not left out in the struggle against stress. Studies have shown that oil spills and accidents can be major sources of stress (Ogundele; Ogunsola & Ogundele 2001). Nweze (2005) submitted that for two and half decades, stress has become a topical issue in management development, seminars and workshops in Nigeria. He further stated that the popularity of stress stems from a number of obvious reasons. Firstly, stress is inextricably interwoven with life and ceases only when the individual stops breathing. More so, nobody is immune to stress, the young, old, rich, poor, professionals, and lay men alike are potential victims of stress. Secondly, he further stated that our traditional mechanisms of handling the stresses and strains of living such as age grade activities, moonlight tales, watching and organizing cultural dances, swimming in village rivers are fast diminishing. This is being precipitated by the factor of rapid urban development, increasing corporate regimentation of work to life, breakdown of social supports, increasing personal and group conflicts, including security threats to life and property. The frustrations, disappointments and pressures of daily life constitute the genesis of stress. Stress has been conceptualized in many ways.
According to Sisk (1977) stress as a state of strain, tension, or pressure and it is a normal reaction resulting from interaction between the individual and the environment. Strain
Beehr and Newman (1978) perceived stress in an occupational setting to mean a condition wherein job-related factors interact with workers, to change their psychological and physiological conditions such that the person’s mind and body are forced to deviate from normal functioning. Beehr (1995) further conceptualize job stress as a situation in which some characteristics in the work situation are thought to cause poor psychological or physical health, or to cause risk factors making poor health more likely. He further stated that these characteristics in the work situation liable to cause poor psychological and physical health are labeled stressors. However, stress in this study, will be refer to as a condition or situation where individual and job related stressors force the body and mind of the healthcare professional to deviate from normal functioning. Ezeilo (1995) asserted that these stressors are demanding life situation found in our homes, places of work, communities and in our interactions with people in the environment. These stressors found in the home and communities and our interactions with people in the environment will be considered personal stressors while those found in the place of work will be considered job stress in this study. More so, the healthcare professionals may be prone to stress via various sources due to the nature of their job which requires a high level of skill, team working in a variety of situations, provision of twenty four hour delivery of care, and input of what is often referred to as emotional labor (Coon, 1994).The stresses in the workplace are many.
Ahsan, Abdullah, Fie and Alam (2009) identified six workplace stressors that may impact on healthcare professionals and they include: workload pressure, relationship with others, role conflict, home-work interface, role ambiguity and performance pressure. Workload pressure is a situation where the amount of work assigned to a person places a high demand on ones time, attention or energy; relationship with others is the behavior or feeling toward somebody else; role conflict is the disagreement or clash between ideas or principles in practice among different health professionals; home-work interface is the overlap between work and home; role ambiguity is the lack of clear information about the requirements of the health professional role; and performance pressure is the accomplishment of multiple task to keep abreast of changing technology (Ahsan, Abdullah, Fie & Alam, 2009).
In the view of Aniza, Malini, and Khalib (2010), organizational factors that can expose the healthcare professional to stress include, job condition, interpersonal factors, career development. The authors further explained job condition as the workers ability or inability to cope with working condition such as work overload, shift work, technological problems, physical danger and decision making; interpersonal factors as a worker experiencing a situation such as poor work and social support, political rivalry, jealousy and anger between colleagues; career development as a situation where a worker experiences under or over promotion, job insecurity and frustrated ambition. Basically, this study will view sources of stress among the health care professionals to include the following; role conflict, role ambiguity, workload, performance pressure and home–work interface. Effects of stress are enormous.
Stress has effect both on the organization and individual by causing ill health on the individual and on the organization, causing economic loss via high absenteeism among staff, low productivity and a decrease in decision making ability (Aniza, Malini, & Khalib, 2010). Job condition, interpersonal relationship, career development, role in the organization, and home-work interface are known stressor for the HCPs, these listed stressors are demanding situation while the way each individual professional views the outcome becomes the perception. Brunero, Cowan, Grochulski and Garvey (2006) stated that the difference between the demanding situation and the HCPs perception of the situation is what determines the degree of the stress effect.
The effect of stress at work is undesirable, both on the health and safety of workers and on the health and effectiveness of their organization (International Labour Office-ILO, 1986). Brunero, Cowan, Grochulski and Garvey (2006) posited that the effect of stress ranges from minor symptoms like tiredness and disrupted sleep patterns to major crisis like hypertension and eventual heart attack, which emerges in the context of prolonged periods of exposure to intense stress. It is important, therefore, to be able to recognize and manage the early effects of stress, in order to avoid the more serious effects of stress on the health and wellbeing of the HCPs. However, every health problem like stress that does not have a permanent cure can be managed.....
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