A Study Of Healthcare Employees' Opinions About …gcbe.us/2009_OBEC/data/Belal Barhem, Hassan...

2009 Oxford Business & Economics Conference Program ISBN : 978-0-9742114-1-1

A Study of HealthCare Employees’ Opinions aboutStress Patterns in the UAE

Belal BarhemAbu Dhabi University, College of Business Administration

Hassan Younies*

UAE University, College of Business and Economics

This study aims to investigate workplace stress and its related patterns (sources, patient’s

interaction, and coping strategies) among health care employees in the UAE. A sample of

175 respondents from different health organizations in the public and private sectors of

health care in the UAE participated in the study. The results show significant

relationships between role ambiguity and age and between role conflict and age and

marital status. The patients as a source of workplace stress constitute the only factor

related to the nature of the job and to income. The correlation and regression analysis for

coping strategies revealed that self-knowledge as a coping strategy related significantly to

the nature of the job and the years of experience. Wide interests were affected

significantly by age, marital status and the nature of the job; and flexibility and being

active and productive similarly related significantly to the type of organization.

KEY WORDS: UAE, work stress, health care

* Corresponding Author, [email protected]

June 24-26, 2009St. Hugh’s College, Oxford University, Oxford, UK

1

mailto:[email protected]


Introduction

Workplace stress is a continual problem facing managers at all levels in all types of

organization. It generates increasing public and media concern and its cost at work is

significantly increasing. Although stress is inherent in life (Modern Business Report,

1975) and human behavior (Auerbach and Gramling, 1998), workplace stress is not

confined to the workplace, but it is frequently brought home as well (Doby and Caplan,

1995).

Increasingly, employers, trade unions, and health and safety representatives at work are

finding guidance on the nature and causes of the problem and on the organizational

requirements relating to its prevention and control. A number of factors have to be

considered in the study of stress, for example, the multidimensionality of the nature of

workplace stress, the definition of stress, the direct relationship between stress and

behavior, coping with stress and the increasing negative effects of stress on work. The

multidimensionality of stress, according to Hogan and Joyce (1982), is evidenced by the

fact that it takes different forms and is the concern of different fields, for example,

Clinical and Applied Psychology, Anthropology, Sociology, Psychosomatic Medicine,

Industrial Relations and Epidemiology.

It is useful to clarify that stressors can derive from any component of the quality of life,

whether economic, physical, emotional, social, intellectual or spiritual, as discussed by

Girdano et al (1993). Stress can influence individual behavior either negatively or

positively. Many researchers, such as Spielberger (1979), believe that workplace stress is

one of the most important factors affecting productivity because of the direct relationship

between individual behavior and the stress experienced.


2


Referring to the literature on workplace stress, some researchers have understood stress

as person-environment fit (Bhagat et al, 1995; Mass, 1981; ILO, 1984). The study by

Bhagat et al, (1995) defined stress as “a problematic level of environmental demand that

interacts with the individual to change his/her psychological or physiological condition

such that the person (mind or/and body) is forced to deviate from normal functioning”.

Arroba and James (1987), however, define stress as a result of pressure. It is first

necessary to understand the person and environmental circumstances before the cause of

stress is understood (Lazarus, 1995). Spielberger and Sarason (1986) find that the

environment must be dealt with first, which means that multiple variables have first to be

tackled.

Another dimension in defining, according to Matteson and Ivancivich (1987), is “an

adaptive response, moderated by individual differences, that is a consequence of any

action, situation, or event that places special demands upon a person.” Similarly, Barhem

et al (2004) define stress as an extraordinary state affecting individual human functions as

an outcome of internal and external factors which differ qualitatively (having different

types of stressors) and quantitatively (having different numbers of stressors) from

individual performance, due to individual differences. Alternatively, Hendrix et al (1995)

define stress as “an uncomfortable cognitive state resulting from exposure to a stressor

that can result in psychological and physiological strain.” Fontana (1989), for his part,

defines stress in relation to personal capabilities ‘a demand made on the adaptive

capacities of the mind and body’.

The factors related to job stress and work conditions need to be defined accurately.

Among physicians, various stressors have been found in connection with job stress (Lee,


3


1986; Scheiber, 1987; Butterfield1988; Richardsen and Burke, 1991). Among the factors

causing them job stress are work demands, excessive work load, long duty hours,

financial problems, conflict between professional and personal life, problems with

patients and those related to the occurrence of death (Mawardi, 1979, Charles et al, 1987;

Richardsen and Burke, 1991). A significant relationship has also been found between

interactions with colleagues, inadequacy of perceived professional knowledge, diagnosis

and treatment process, stress in dialogues with patients and the degree of psychological

morbidity (Tattersall et al, 1999) and responsibility, (Heim, 1992). Boredom with

providing the same services over time may also help to explain workplace stress (Locke

1976) and consistent exposure to chronic and difficult clients could be another cause.

A further important aspect of workplace stress is its relationship to individual differences

(gender, age, educational level, cultural differences such as religion, experience, etc.).

Individual staff members bring their own personal characteristics to the job, which may

contribute to factors leading to work dissatisfaction and burnout (Rockwell et al, 1995).

Vedat et al (2004) listed other factors causing stress in health care professionals, such as

marital status, age, professional career, unfairness in promotion opportunities, imbalance

between jobs and responsibilities, conflict with colleagues, responsibilities of role, long

and tiring work hours, problems experienced with patients and their relatives, and

problems of communication with team members. Other studies reported other sources of

stress, such as work conditions, low salaries and inadequate social facilities, lack of in-

service training, the status of just starting work, the end of career, lack of opportunities

for promotion, and decline in the appreciation of patients and superiors (Beemsterboer

and Baum, 1984; Bram and Katz, 1989; Whippen and Canellos, 1991; Hershbach, 1992;


4


Ramirez et al, 1995; Wilkinson, 1995; Isikhan et al, 1998; Fielden and Peckar, 1999;

Tattersall et al, 1999).

There are many dimensions to understanding and dealing with workplace stress. Kahn

and Cooper (1993) state that the word “stress”, as generally used, means essentially four

fundamentally different things: an environmental condition, an appraisal of an

environment situation, the response to that condition, and some form of relationship

between one’s environmental demands and the ability to meet them.

The workplace stress problem seems to do more damage in uniform jobs, due to the high

degree of responsibility for others’ lives. Health care is one of the main areas in which

workers’ main duty is to save the lives of others. Distress among healthcare professionals

can have negative effects on the well-being of these professionals and also on the quality

of care they provide to patients. The importance of keeping such workers energized,

motivated and satisfied is obvious. Stress, burnout, depression and anxiety have been

described in up to 25 per cent of practicing physicians (Agius et al, 1996). Examples of

writers on workplace stress in the health sector are: Chan and Chan (2004), Maslach and

Jackson (1982), Mowardi (1983), Arnetz (1991), Dallender et al (1999), Mechteld et al

(2003), Ramirez et al (1996), and Cronin-Stubbs and Rooks (1985).

The impact of these adverse outcomes can be considerable: worsening of doctor-patient

communication, diminished productivity, lower quality of care and turnover in physician

practices. Predictors of stress have been posited and assessed in other countries than the

UAE but research has rarely addressed the predictors of stress in UAE health care

employees.


5


Rapid changes in the UAE health care system may be a good starting-place for

considering the stress on health care employees. The health care services in the UAE in

all health tasks are mostly provided by expatriates, from every country. Working overseas

may lead to additional sources of workplace stress and exhibit the multifarious nature of

coping strategies. A model with ‘therapeutic implications’ for preventing stress would be

beneficial.

The literature on coping is itself wide. Coping with workplace stress is defined as ‘the

cognitive and behavioural efforts a person makes to manage demands that tax or exceed

his/her personal resources’ (Lazarus, 1995; Lazarus and Lunier, 1987). It is also a range

of behaviours by which individuals can prevent, alleviate or respond to stressful

circumstances (Pearlin and Scholer, 1978). To cope with stress efficiently, it has to be

remembered that stress can vary within a person and from time to time (Crandall and

Perrewé, 1995). Stark (1999) believes that it is helpful to establish realistic deadlines.

Another way to minimize stress at work is to ensure that the employees clearly

understand their duties. Vagueness about their responsibilities portends big problems.

Coping strategies are the ways used by an individual, group or organization to minimize

the effects of stress. To help us cope, we must first recognize that stress is variable for

individuals and over time, as a natural part of life. As such, it cannot be avoided, but

only minimized for a better response.

It is not sufficient to detect the sources and levels of workplace stress; it is even more

important to devise coping strategies to deal with it. According to Krohe (1999), coping

with stress is the effective reduction of its negative effects. He states that senior

managers often think it necessary to create a stressful work environment to induce the


6


best performance from their staff. However, stress is rather an obstacle to good

performance, innovation and creativity.

A person’s reaction to stress very much depends on his/her attitude; therefore, the stress

felt will differ between people according to their circumstances (Mclean, 1979).

Similarly, the ILO (1984) found that the effectiveness of coping techniques very much

depends on the individual. Potential predictors include gender, age, case mix, time

pressure in patient visits, workload, practice type, specialty, work control, isolation and

support in balancing work and home.

Empirical studies suggest that: nurses who report high levels of workload use more

problem-solving strategies; nurses who are subjected to stress due to patient demands and

home/work conflicts use social support strategies; and avoidance is the most reliable

symptom of stress and job dissatisfaction (Tyler and Cushway, 1992; Tyson and

Pongruengphant, (1996.

The sources of workplace stress differ in nature; they can be psychological, workplace-

related, social, economic and personal. Workplace-related sources include role

ambiguity (Mclean, 1979). Caplan and Jones (1975) report that role ambiguity results in

anxiety and depression. According to Froiland (1993), role conflict occurs when an

individual in a particular job is torn by conflicting job demands or doing things which

he/she does not think are part of the job see also Sutherland and Cooper (1990).

Additional sources are career development (Mclean, 1979); role overload – quantitative,

(Marglies et al, 1974); role overload-qualitative (Kahn and Cooper, 1993; Schermerhorn

et al, 2000); and responsibility for other people (McLean, 1980). Wardwell et al (1964)


7


report that responsibility for people is significantly more likely to lead to coronary heart

disease (CHD) than responsibility for things.

The level of workplace stress may be determined by other moderator variables, such as:

country (Peterson et al, 1995; Brown and Cooper, 1996); gender, since men and women

differ naturally in many ways, and therefore differences in their response to stressors are

not unexpected (Russo, 1985; Stoney et al, 1985; Kerrler et al, 1985; Jick and Mitz,

1985). As stress affects age, so too does age affect stress (Matteson and Ivancivich, 1987;

Leighton, 1963; Comslock and Helsing, 1976; Kaufman, 1982; Kahn and Cooper, 1993).

In terms of experience, Auerbach and Gramling (1998) find that coping ability is very

much a function of past experience, Kahn and Cooper (1993); regarding educational

level, Syme (1975) finds that stress illness rates increased as individuals climbed above

the social level commensurate with their educational level. The better educated and

endowed a person is, the less stress he feels (Sutherland and Cooper, 1990). Marital

status also affects stress levels, among the possibilities of single, married, divorced or

widowed status. Being married is less stressful and more satisfying for men than for

women (Jenkins, 1991; Crosby, 1984; Valdez and Gutek, 1987).

Model of the Study

The coping strategies proposed by many workers will be evaluated in this study. They

are: i) flexibility (Pun, 1997; Schönpflug, 1983); ii) acceptance of others’ values; iii)

self-knowledge (Pun, 1997; Powell and Enright, 1990); iv), wide interests; and v) activity

and productiveness (Mclean, 1980). All these strategies were described in detail in the


8

Demographic variablesGender, Age, Years of Experience (YEX), Educational Level (EDU), Marital Status (MIS),

Ethnicity, Income, Type of Organization, Size, Set-up, and Nature of Work

Sources of workplace stress -Role Ambiguity (RAB)-Role Conflict (RC)-Career Development (CRD)-Role Overload, Quantitative (ROQN)-Role Overload, Qualitative (ROQL)-Responsibility for Other People (RES)- Patients

Coping strategies-Flexibility (FLX)-Acceptance of Others’ Values (ACCV)-Self-Knowledge (SKW)-Wide Interests (WIT)-Activity and Productiveness (ACPD)


third part of the questionnaire. Diagram 1 represents the model of the study and clarifies

which relationships between different aspects of workplace stress were investigated.

Diagram (1): The model of the study

Hypothesis

The study examined the following hypotheses:

H1: there is a significant relationship between Sources of workplace stress and

Demographic variables

H2: there is a significant relationship between Coping strategies and Demographic

variables

Tool of the study

The tool of the study is a four-part questionnaire in which we examined 3 areas

considered important in relation to job stress; sources of workplace stress, coping


9


strategies, patients’ response, and certain demographic variables. The measurement for

sources of workplace stress was adopted from Ivancivich and Michael (1980). It is

composed of 30 items aimed to evaluate the influence of sources of workplace stress.

The level of stress was measured by the respondents on a five-point scale (1 = strongly

disagree, to 5 = strongly agree). Questions on the following different sources of stress

were posed: role ambiguity, role conflict, role overload – quantitative, role overload –

qualitative, career development and responsibility for others

The measurement used for coping strategies is adopted from Mclean (1980) and includes

20 questions to evaluate the effects of personal traits on the ability to cope with stress.

The participants are asked to use a five-point scale (Statements 1-9: 1= Very true to 5=

Not at all true; Statements 10-18: 5= Very true, to 1=Not at all true). The personal traits

(Coping Strategies) considered were: Self-Knowledge, Wide Interests, Flexibility,

Acceptance of others’ values, and Activity and Productiveness.

The reliability test for the different parts of the questionnaire is represented in Table (1).

It reveals a Cronbach's Alpha level from 0.67 to 0.9 which is considered acceptable

according to the research criteria.

Table (1): Reliability Statistics

Cronbach's Alpha N of Items0.912 300.674 200.754 5

A sample of 175 respondents from different organizations in the public and private health

care sectors in the UAE participated in the study.

The respondents’ profile is presented in Table (2); most of them worked in the public

sector, which explains the majority of Arabs (52%) among the sample members. Even


10


though 60% of the sample members were more than 30 years old, the category of 26-30

years is the largest single category, and we can understand why 52% of the sample had

less than 4 years’ experience. The majority had a university degree as a result of the new

standards in hiring health staff in the UAE.

Married workers constituted 75% of the sample and more than 52% of the respondents

were working in organizations where more than 300 were employed. Physicians and

nurses were the largest groups, 37% and 31% respectively. People with an income below

10,000 Dh accounted for more than 54% of the whole sample.


11


Table (2): Respondents profile (n 175)Profile Category Frequency Percentage

TypePublic 88 50.3Private 80 45.7Semipublic 7 4.0

Age

< 20 years 1 .621-25 6 3.426-30 years 43 24.631-35 years 33 18.936-40 years 40 22.941-50 27 15.4> 50 years 25 14.3

Education

Certificate/diploma 28 16.0Professional 46 26.3Bachelor’s 54 30.9Master’s 30 17.1PhD 17 9.7

Experience

<4 years 91 52.04-8 years 54 30.98-12 years 12 6.9>12 years 18 10.3

Marital status

Single 37 21.1Married 130 74.3Divorced 5 2.9Separated 3 1.7

Gender Male 90 51.4Female 85 48.6

Ethnicity

Arab 95 54.3Chinese 1 .6Indians 39 22.3Others 40 22.9

Set-up

LESS THAN 5 69 39.45-10 24 13.710-20 24 13.7More than 20 58 33.1

Size

< 100 39 22.3100-200 31 17.7200-300 14 8.0More than 300 91 52.0

Task

administrative 11 6.3physician 65 37.1nurse 55 31.4technician 17 9.7laboratory 4 2.3other 23 13.1

Income

less than 5,000 47 26.95,000-10,000 48 27.410,000-15,000 31 17.7More than 15,000 49 28.0


12


Analysis

The analysis relies on means, standard deviation, correlation and regression. The main

source of workplace stress for health care employees in the UAE, as reported in Table

(3), is role ambiguity. Similarly, Vedat et al (2004) and Heim (1992) report that

imbalance between jobs and responsibilities, conflict with colleagues and responsibilities

of role are the main sources of workplace stress. The medical services are usually

provided by teams and it is very important to know one’s exact role among the team

members, with clear and specific responsibilities, otherwise lack of clarity about

assignments and duties may lead to fatal errors. It is thought that stress in oncology

clinics emanates from the imbalance between the coping ability of the individual and the

demands of the work place, with the demands outweighing their ability to cope (Ullrich

and Fitzgerald, 1990). Moreover, Fagin et al (1996) attribute burnout among psychiatric

nurses to staff shortages, health service changes, poor morale and not being notified of

changes before they occurred.

Role overload – qualitative ranked as the second source, due to the high professional

skills required to perform the medical tasks. This is close to the results of the study by

Guppy and Gutteridge (1991) that 85% of stress in nurses was due to heavy workload.

Although support and good relations with colleagues are important, responsibility for

others ranked in sixth place, contradicting the study by Chan and Chan (2004). Both

doctors and nurses highlighted that attending on the badly injured or those who have been

killed is the most distressing experience for them. This is a not unexpected result of the

nature of their work. Patients, however, were the lowest causes of stress; some


13


researchers did not even consider them among the major causes (Ullrich and Fitzgerald,

1990; Vedat et al, 2004; Heim, 1992).

Table (3): Sources of workplace stress for health care employees in the UAE

RAB ROQL RC ROQN CR RES PatMean 3.5646 3.3703 3.2926 3.0377 2.96 2.7794 2.1014Std. Deviation

0.819 0.7487 0.7565 0.8217 0.8582 0.6553 0.6206

- Role Ambiguity (RAB) - Career Development (CRD)- Role Overload Quantitative (ROQN) - Role Conflict (RC)- Role Overload Qualitative (ROQL) - Responsibility for Other People (RES) - Pat (Patients)

In terms of coping strategies, as revealed in Table 4, the main coping strategy for of

workplace stress by health care employees in the UAE is to be active and productive.

When dealing with people’s lives, it is very important to be careful, but at the same time

the patients need to be served as much as possible. To keep a balance, employees must be

flexible and socially intelligent; acceptance of others’ values ranked third in the list of

important qualities and this helps to minimize the level of workplace stress.

Table (4): Coping strategies for workplace stress by health care employees

ACT FLEX ACV WIT SKWMean 2.8829 2.6529 2.6129 2.5714 2.38Std. Deviation

0.6122 0.6716 0.5398 0.6064 0.4602

- Flexibility (FLX) - Self-Knowledge (SKW) - Wide Interests (WIT)- Activity and Productiveness (ACPD) - Acceptance of Others’ Values (ACCV)

Table (5) shows significant relationships between role ambiguity and age, while role

conflict related significantly to age and marital status. Role overload – quantitative, Role

overload – qualitative and career development all related significantly with age.

Responsibility for others is the only source of stress which is related to years of

experience. The study by A.R. and Gh.R. (2006) stated that significant positive

correlation was noted between age and years of experience for the psychiatric nurses. The

patients as source of workplace stress is the only factor related to number of children,


14


nature of the job (according to C Renzi, et al, 2005, burnout was similar for

dermatologists and other specialists), and income.

The independent variable nature of the job related significantly with the patients, this

result complies with some previous studies such as the studies by Cronin-Stubbs and

Rooks (1985) and Yousefy and Ghassemi (2006). The latter study states that psychiatric

nurses experienced a greater degree of emotional exhaustion than do medical nurses.

Table (5): Correlation table for demographic variables and source of workplace stress (n 175)

RAB RC ROQN ROQL CR RES Pat

Sig. .002 .005 .047 .005 .001 .899

Gender P. Corr -.039 -.022 -.017 -.065 -.120 .017 -.085

Sig. .608 .770 .825 .389 .113 .827 .261

Ethnicity P. Corr .069 -.018 .064 .032 -.071 .041 .077

Sig. .366 .816 .397 .678 .353 .587 .308

Age P. Corr .198(**) .209(**) .205(**) .239(**) .301(**) .052 -.165(*)

Sig. .009 .006 .007 .001 .000 .495 .030

EDU P. Corr .113 .063 .085 .064 .107 .066 -.141

Sig. .136 .406 .266 .404 .158 .383 .063

MIS P. Corr .033 .178(*) .143 .128 .136 .150(*) .007

Sig. .663 .018 .058 .091 .072 .048 .928

Type P. Corr .085 .073 .052 .107 .125 .173(*) -.041

Sig. .266 .339 .496 .160 .098 .022 .592

Job P. Corr -.080 .060 -.027 -.094 -.130 -.056 .259(**)

Sig. .292 .431 .723 .214 .086 .461 .001

YEX P. Corr -.023 -.008 -.050 -.057 -.030 -.228(**) .030

Sig. .767 .917 .509 .450 .696 .002 .697

Income P. Corr -.061 -.106 -.044 -.064 .067 -.079 -.289(**)

Sig. .423 .164 .565 .397 .377 .297 .000

EDU: Educational level MIS: Marital status Type: Type of organizationJob: Nature of the job YEX: Years of experience Pear. Corr: Pearson correlation

Table (6) reveals several significant similar (to correlation) relationships for the sources

of workplace stress. For example, all the sources except responsibility for others, related


15


significantly to the age variable. According to Schaufeli et al (1998), burnout seems to be

less prevalent among older people and among married people, and it is the same for years

of experience and for the responsibility for others. Characteristics which individual staff

members reported as related to burnout include length of time at their current job and in

their career (Maslach and Florian 1988). According to Gerits L et al (2005), female

nurses were characterized by fewer symptoms of burnout, relatively high emotional

intelligence profiles and lower social skills than male nurses.

Table (6): Regression analysis for demographic variables and source

Pat RAM ROQL RC ROQN CR RESPear. Corr

Sig. Pear. Corr

Sig. Pear. Corr

Sig. Pear. Corr

Sig. Pear. Corr

Sig. Pear. Corr

Sig. Pear. Corr

Sig.

)Constant( 8.059 .000 6.165 .000 5.461 .000 4.438 .000 6.542 .000 4.262 .000 6.183 .000

Gender -2.91 0.004 .034 .973 .277 .782 .525 .600 -.156 .876 -.337 .736 .797 .426

Ethnicity 0.076 0.94 .527 .599 -.958 .340 .510 .611 -.268 .789 -1.29 .198 -.564 .573

Age -1.28 0.202 2.397 .018 2.643 .009 2.429 .016 2.881 .004 3.267 .001 .815 .416

EDU -0.37 0.71 1.132 .259 .598 .551 .788 .432 .110 .913 -.126 .900 .691 .491

MIS 1.3 0.196 -.689 .492 1.356 .177 .987 .325 .450 .653 .123 .902 1.960 .052

Type -1.46 0.147 .293 .770 .231 .817 -.381 .704 .443 .658 1.581 .116 .630 .530

Job 1.445 0.15 -.793 .429 1.165 .246 .196 .845 -.779 .437 -.497 .620 -.365 .715

YEX 0.613 0.541 -.403 .688 -1.17 .244 -1.39 .166 -1.23 .222 -.796 .427 -2.98 .003

Income -3.18 0.002 -1.60 .112 -1.81 .072 -1.10 .274 -1.80 .074 -.352 .725 -1.28 .201

R Square 0.178 .100 0.075 0.097 .125 0.111

Table (7) represents the correlation among the coping strategies and demographic

variables. Self-knowledge related significantly to the nature of the job and years of

experience. Wide interests was affected significantly by age, marital status and the nature

of the job. Flexibility, and active and productive similarly related significantly to the type

of organization but differed in relating significantly to ethnicity and the nature of the job.


16


Table (7): Correlation table for demographic variables and the coping strategies for workplace stress (n 175)

SKW WIT FLEX ACV ACT

P. Corr -.051 -.105 -.107 -.087 -.071

Gender Sig. .502 .165 .160 .253 .350

P. Corr .033 -.042 .007 .007 .020

Ethnicity Sig. .668 .582 .925 .932 .789

P. Corr .060 .281(**) .109 .136 .175(*)

Age Sig. .434 .000 .151 .073 .021

P. Corr .080 .139 .108 -.024 -.017

EDU Sig. .290 .067 .155 .751 .820

P. Corr -.105 .191(*) .006 .164(*) -.017

MIS Sig. .167 .011 .935 .030 .822

P. Corr -.070 .067 .069 .044 -.106

Type Sig. .358 .382 .365 .561 .163

P. Corr -.173(*) -.320(**) -.194(*) -.070 -.240(**)

Job Sig. .022 .000 .010 .358 .001

P. Corr -.163(*) -.055 -.237(**) -.043 -.111

YEX Sig. .032 .467 .002 .575 .142

P. Corr .108 .085 .112 .021 .116

Income Sig. .154 .265 .140 .787 .127

Regression analysis in Table (8) supported the correlation results to some extent. It

revealed significant relationships among the different dependent and independent

variables. Self-knowledge correlated with years of experience; wide interests with age,

the nature of the job and income; flexibility with years of experience; activity and

productiveness with the type of the organization, nature of the job and years of

experience. Based on the theory of professionalization of Forsyth and Danisiewicz

(1985), it might be expected that staff who are more active in their profession would

perceive themselves to be more autonomous from their organization but not from their

clients. Moreover, stronger attachments to clients who are at times very difficult may


17


contribute to burnout. Additionally, there is considerable evidence that younger

employees experience higher levels of burnout (Cordes and Dougherty 1993), possibly

because they become disillusioned by the “real world” after having held an idealistic

view which influenced their career choice and reinforced in their training programs.

Vedat et al (2004, 1) reveals that the level of stress indicates signs of both physical and

psychological stress. They also claim that health care professionals use similar strategies

in order to cope with stress. The most common strategy used by physicians and nurses

was a self-confident approach, while the strategy least used was a submissive approach.

Results, Recommendations and Managerial Implications

The main source of workplace stress among health care employees in the UAE, as shown

in Table (3) is role ambiguity, while the main coping strategy is to be active and

productive. The correlation and regression analysis shows significant relationships

between role ambiguity and age and between role conflict and age and marital status.

Role overload – quantitative, role overload – qualitative and career development related

significantly to age. Responsibility for others is the only source of stress that is related to

years of experience. The patients as a source of workplace stress constitute the only

factor related to the nature of the job and to income. The correlation and regression

analysis for coping strategies revealed that self-knowledge related significantly with the

nature of the job and years of experience. Wide interests was affected significantly by

age, marital status, and the nature of the job, while flexibility and being active and

productive similarly related significantly to the type of organization but differed between

in relating significantly to ethnicity and to the nature of the job. The cross tabulation


18


analysis showed other significant results between the sources of workplace stress and

ethnicity and gender.

The health care managers in the UAE health organizations can minimize costs by taking

into consideration the negative effects of workplace stress level in the workplace, such as

turnover, which is costly in the UAE, absenteeism and dissatisfaction. Most of the public

hospitals in the UAE are managed now by international outsourcing, for example, the

JOHNS HOPKINS foundation, which calls for additional concern for employee

satisfaction if high quality services are to be provided. Diversity in the nationalities or

races employed may require role problems to be minimizing and increasing importance

being given to creativity.

References

Agius, R.M., Blerkin, H., Deary, I.J., Zealley, H.E. and Wood, R.A. (1996), Survey of Perceived Stress and Work Demands of Consultant, Physicians, Occup Environ Med; 53: 217–224.

Arnetz, B. (1991), White Collar Stress: What Studies of Physicians can Teach us, Psychother Psychosom; 55:2–4.

Auerbach, Stephen M. and Gramling, Sandra (1998), Stress Management: Psychological Foundations, Prentice Hall, New Jersey.

Barhem, Belal, Samsinar, Md. Sidin., Abdullah, Iskandar and Alsagoff , Syed Kadir (2004), New Model for Workplace Stress Patterns, Asian Academy of Management Journal, Vol. 9, no.1, pp 53-77.

Beemsterboer, J. and Baum, H.B. (1984), Burnout Definition and Health Care Management, Social Work in Health Care 10, 97–107..

Bhagat, Rabi S, Allie, Stephen M, Jr. and Ford, David L, (1995), Coping with Stressful Life Events: An Empirical Analysis, In Rick Crandall and Pamela L. Perrewé (Eds.) Occupational Stress, Taylor and Francis, pp: 93-112


19


Bram, P.J. and Katz, L.F. (1989), A Study of Burnout in Nurses Working in Hospice and Hospital Oncology Settings. Oncology Nursing Forum 16 (4), 555–560.

Brown, Jennifer and Campbell, Elizabeth (1994), Stress and Policing: Sources and Strategies, John Wiley, p. 25.

Butterfield, P.S. (1988), The Stress of Residency: A Review of Literature, Archives of Internal Medicine, 148, 1428–1433.

Caplan, R. D. and Jones K. W. (1975), Effects of Work Load, Role Ambiguity, and Type A Personality on, Anxiety, Depression, and Heart Rate, Journal of Applied Psychology, 60, pp: 713-719.

Chan, Angelina O. M. and Chan, Yiong Huak (2004), Influence of Work Environment on Emotional Health in A Health Care Setting, Occupational Medicine; 54:207–212 DOI: 10.1093/occmed/kqh062Charles, S.C., Warnecke, R.B., Wilbert, J.R., et al (1987), Sued and Non-Sued Physicians: Satisfaction, Dissatisfaction, and Sources of Stress, Psychosomatics, 28, 462–468.

Cooper, Cary L. and Payne, Roye (1988), Causes, Coping and Consequences of Stress at Work, John Wiley and Sons, New York, pp: 234-240.

Cordes, Cynthia L. and Dougherty, Thomas W. (1993), “A Review and an Integration of Research on Job Burnout.” Academy of Management Review 18:621-56.

Crandall, Rick, and Perrewé, Pamela L. (Eds.) (1995), Occupational Stress, Taylor and Francis, p. 45.

Cronin-Stubbs, D. and Rooks, C.A. (1985), The Stress, Social Support, and Burnout of Critical Care Nurses, Heart & lung, 14(1): 31–9.

Dallender, J., Nolan P., Soares, J., Thomsen, S. and Arnetz, B. (1999), A Comparative Study of the Perceptions of British Mental Health Nurses and Psychiatrists of their Work Environment, Journal of Advanced Nursing, 29 (1), 36-43.

Doby, Victoria J. and Caplan, Robert D. (1995), Organisational Stress as Threat to Reputation: Effects on Anxiety at Work and at Home, Academy of Management Journal, 38 (4), pp: 1105-1123.

Fagin, L. et al (1996), Stress, Coping and Burnout in Mental Health Nurses: Findings From Three Research Studies, International journal of social psychiatry, 42(2):102–10.

Fielden, S.L. and, Peckar, J. (1999), Workplace Stress and Hospital Doctors: A Comparative Study, Stress Medicine 15, 137–141.


20


Fontana, David (1989), Managing Stress, The British Psychological Society and Routledge Ltd, Guilford, p. 2.

Forsyth, Patrick B. and Danisiewicz, Thomas J. (1985), Toward a Theory of Professionalization, Work and Occupations 159-76.Froiland, Paul (1993), What Cures Job Stress, Training, DEC, p. 34.

Gerits, L. et al (2005), Emotional intelligence profiles of nurses caring for people with severe behaviour problems, Personality and individual differences, 38(1):33–43.

Girdano, Daniel. A., Everly, George S., Everly, Dorothy E. and Dusek, E. (1993), Controlling Stress and Tension: A holistic Approach, Prentice Hall, New Jersey.

Guppy A. and Gutteridge, T. (1991), Job satisfaction and occupational stress in UK general hospitals nursing staff, Workplace stress; 5:315–323.Heim, E. (1992), Stressors in health occupations: do females have a greater health risk, Zeitschrift fur Psychosomatische Medizin und Psychoanalyse, 38 (3), 207–226.

Hendrix, William H, Summers, Timothy P., Leap, Terry L. and Steel, Robert P. (1995), Antecedents and Organizational Effectiveness: Outcomes of Employee Stress and Health, in, Organization. In, K. Rowland and G. Ferris (Eds.), Personal Management (pp 390-419), Boston: Allyn and Bacon, p. 75.

Hershbach, P. (1992), Work-related stress specific to physicians and nurses working with cancer patients, Journal of Psychosocial Oncology 10 (2), 79–99.

Hogan, Robert and Hogan, Joyce C. (1982), Subjective Correlates of Stress and Human Performance. In, Earl A. Alluisi and Edwin A. Fleishman (Eds.), Human Performance and Productivity, Lawrence Erlbaum Associates, Vol. 3, New Jersey, p. 141.

ILO (International Labor Office) (1984): Automation, Work Organization and Occupational Stress, International Labor Office, Geneva, p. 171.

Isikhan, V., et al (1998), Kanser hastalar”yyla -cal”y-san sa&gl”yk personelinin t .ukenmi-slik durumlar”y (Burnout states of health personnel working with cancer patients, Turkish Journal of Hemotology-Oncology), Turk. Hematoloji-Onkoloji Dergisi 8 (3), 146–152.

Ivancivich, JM and Matteson, MT (1980), Stress and Work: A Managerial Perspective, Scot Foresman and Company, pp: 118-120.

Jick, T. D, and Mitz, L. F. (1985), Sex Differences in Workplace stress, Academy of Management Review, 10, pp: 408-420.

Kahn, Haward, and Cooper, Cary L. (1993), Stress in the Dealing Room, Routledge, London, p. 33.


21


Kahn, R. L. (1978), Job Burnout: Prevention and Remedies, Public Welfare, 16, pp: 61-63.

Kahn, R. L., Quinn, D.M., Snock, R.P. and Rosenthal, R.N (1964), Organisational Stress: Studies in Role Conflict and Ambiguity. New York, Wiley.

Kaufman, H. G. (1982), Professionals in Search of Work: Coping With the Stress of Job Loss and Underemployment, John Wiley and Sons, New York, p. 62.

Kivisto, J. and Couture, R.T. (1997), Stress management for nurses: controlling the whirlwind. Nursing Forum 32 (1), 25–33.

Krohe, James Jr., (1999), Workplace Stress, Across the Board, 36 (2), p. 36.Lee, C. (1986), Professionals in medical settings: the research evidence in the 1980s. Journal of Organizational Behavior, Management 8, 195–213.

Locke, Edwin A. (1976), “The Nature and Causes of Job Satisfaction.” The Handbook of Industrial and Organizational Psychology, edited by M.D. Dunnette. Chicago, IL: Rand McNally College Publishing Company, London, p. 4, pp. 1297-1347.

Maslach, Christina and Florian, Victor (1988), Burnout, Job Setting, and Self-Evaluation Among Rehabilitation Counselors, Rehabilitation Psychology 33:85-93.

Mawardi, B.H. (1979), Satisfactions, dissatisfactions, and causes of stress in medical practice, Journal of the American Medical Association, 241, 1483–1486.

Mclean, Albert (1980), Workplace Stress, Reading Mass: Addison-Wesley, pp: 126-127.

Mclean, Alan A. (1979), Workplace Stress, Addison-Wesley, Philippines, p. 34.

Mechteld, R.M., Visser, Ellen M.A., Smets, Frans J., Oort, Hanneke and de Haes, C.J.M. (2003), Stress, satisfaction and burnout among Dutch medical specialists, Canadian Medical Association or its licensors, CMAJ, FEB. 4, 2003; 168 (3)

Modern Business Reports (1975), Health in Business: How it Affects Executives, Their Employees and their Productivity, Hamilton, Alexander, English Edition, No E-020, p. 12.

Mowardi, B.H. (1983), Aspects of the impaired physician. In: B. Farber (EB, ed. ) Stress and Burnout in the Human Service Professions. New York: Pergamon Press.

Pearlin L. , Scholer C. (1978). The Stress Process. Journal of Health and Social Behavior, 22, 337-356.


22


Peterson, M.F., Smith, P.B., Akande, A., Ayestaran, S., Bochner, S., Callan, V., Cho,N., Iscte, J., D'amorim, M., Francois, P., Hofmann, K., Leung, K., Lim, T., Mortazavi, S.,Munene, J., Radford, M., Ropo, A., Savage, G., Setiadi, B., Sinha, T., Sorenson, R., &

Viedge, C.(1995), Role Conflict, Ambiguity, and Overload: A 21 Nations Study, Academy of Management Journal, 38 (2), pp: 429-452.

Ramirez, A.J., Graham, J., Richards, M.A., Cull, A. and Gregory, W.M. (1996), Mental Health of Hospital Consultants: The Effects of Stress and Satisfaction at Work, Lancet; 347:724-8

Ramirez, A.J., Graham, J., Richards, M.A., et al (1995), Burnout and Psychiatric Disorder among Cancer Clinicians, British Journal Cancer 71, 1263–1269.Renzi, C., Tabolli, S., Ianni, A., di Pietro, C. and Pudd, P. (2005), Burnout and Job Satisfaction Comparing Healthcare Staff of a Dermatological Hospital and a General Hospital, JEADV, 19, 153–157

Richardsen, M.A. and Burke, J.R. (1991), Occupational Stress and Job Satisfaction among Canadian Physicians, Work and Stress 5 (4), 301–313.

Rockwell, Schulz, Greenley, James R. and Brown, Roger (1995), Organization Management, and Client Effects on Staff Burnout, Journal of Health and Social Behavior, Vol. 36 (December): 333-345

Schaufeli, W.B. and Enzmann, D. (1998), The burnout companion to study & practice; a critical analysis. London: Taylor and Francis, p. 77-8.

Scheiber, S.C. (1987), Stress in physicians. In: R. Payne and J.R. Firth-Cozen (Eds.), Stress in the Health Professions. Wiley, New York, pp. 23–44.

Schermerhorn, Hunt J., Jr, and Osborn, R. (2003), Organizational Behavior, John Whiley, New York.

Spielberger, Charles (1979), Understanding Stress and Anxiety, Harper and Row Publishers,

Stark, Nancy (1999), How Do You Reduce Stress in The Workplace? Baltimore Business Journal, 16 (42), p. 19.

Syme, S. L. (1975), Social and Psychological Risk Factors in Coronary Heart Disease, Journal of American Heart Association, 44, pp: 17-21.


23


Tattersall, J.A., Paul, B. and Stirling, P. (1999), Stress and coping in hospital doctors, Stress Medicine, 15, 109–113.

Tyler, P. and Cushway, D. (1992), Stress, coping and mental wellbeing in hospital nurses, Stress Medicine, 8, 91–98.

Tyson, P.D. and Pongruengphant, R., (1996), Avoidance as a coping strategy for nurses in Thailand, Psychological Reports, 79, 592–594.

Ullrich, A. and, Fitzgerald, P. (1990), Stress experienced by physicians and nurses in the cancer ward, Social Science & Medicine, 31 (9), 1013–1022.

Vedat, Isikhana, Turhan, Comezb, Zafer, M. and Danis, M. (2004), Job stress and coping strategies in health care professionals working with cancer patients, European Oncology Nursing Society, 234–244

Wardwell, W. I, Hayman, M.M. and Bahnson, C.B. (1964), Stress and Coronary Disease in Three Field Studies, Journal of Chronic Disease, New York, 17, pp: 73-84.

Whippen, D.A. and Canellos, G.P. (1991), Burnout syndrome in the practice of oncology: results of a random survey of 1,000 oncologists, Journal of Clinical Oncology, 9 (10), 1916–1920.

Wilkinson, S.M. (1995), The Changing Pressures for Cancer Nurses. European Journal of Cancer Care 4, 69–74.

Williams, Eric S. and Konrad, Thomas R. Physician stress: results from the physician work life study, Stress and Health, 18: 37–42, 38-42

Yousefy, A.R. and Ghassemi, G.R. (2006), Job Burnout in Psychiatric and Medical Nurses in Isfahan, Islamic Republic of Iran, La Revue de Santé de la Méditerranée orientale, Vol. 12, No 5, 2006, 662- 669


24

A Study Of Healthcare Employees' Opinions About …gcbe.us/2009_OBEC/data/Belal Barhem, Hassan...

Documents

Transcript of A Study Of Healthcare Employees' Opinions About …gcbe.us/2009_OBEC/data/Belal Barhem, Hassan...