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Shift Work Impacts On Employee Health Social Work Essay

Why and how might shift work impact on the health of employees? What could be done to minimise the health risks of such work? In today’s fast developing era everything has been subjected to a change. Incorporation of change in the workplace has now taken a rapid turn. The working time patterns has been subject to change because the driving forces from part of organisations to suit their business needs in a better manner and the other from part of individuals to get a good balance between their work and home life. The Government has also been committed to enable flexible working hours for all workers especially for those with young children. According to ILO (1990) shift work is “ a method of organization of working time in which workers succeed one another at work place so that the establishment can operate longer than the hours of work of individual workers” at different daily and night hours. There is a broad categorisation of shift work from which workers can choose between a fixed shift system and a rotating one. Under fixed shift work time is organised between two or three shifts the early, late and/or night shifts. Under rotating shifts work shifts vary regularly over time. On the bright side these arrangement in the working patterns has been introduced in order to benefit the organisations, employees and the individuals. More importantly these flexible patterns of work time have enabled individuals to attain a better work and home life balance. However there is a negative turn of coin in this change of working patterns. There has been statistics revealing the fact that almost 20% of the employees are engaged in shift work and this require the individual to drastically change their sleeping habits weekly or sometimes even daily. It has been estimated that approximately 20% of shift workers report increase in the risk of accident in industries and decrease in productivity rate because the workers fall asleep during shifts thus gradually diminishing the economic gain it is designed to create (Stanley, 2000). The impact of shift system can have adverse effects on health and well being (physical, psychological, social etc).

Human beings are designed in a manner as to be more active during the day and not during the night. The direct disruption if the body clock (circadian clock) and the physiological process and can lead to chronic sleep disorders in all shift workers. It has been found through research that rotational shift workers showed higher rates of fatigue, nervousness and inadequate sleep. Research by Oswald (1980) states that the night shift workers trying to sleep during the day produces high amounts of corticosteroids and adrenaline and reduces the restorative value of sleep. Another study concluded that shift work conditions can increase sleep disorders and favour sleep related accidents (Garbarino et al, 2002). It has been found that the risk of myocardial infarction is relatively high in shift workers upto 11-15yrs of shift work and as the body adapts after this by 20yrs of experience this risk drops ( Knuttson et al, 1986). A study by Alfredsson et al 1989 found that the serum cholesterol levels are high in shift workers.

The shift patterns can also lead to destruction of physical health and psychological well being. There is likely to be disturbance in eating patterns and poor diet. Study shows that in all tested models shift work is associated with metabolic syndrome even after taking into account potential covariates such as job strain, physical activity, quantitative dietary parameters and meal distribution. It has also been suggested in the study that a follow up for shift workers should be recommended to occupational physicians (Esquirol et al, 2009). Another study conducted on offshore oil rig workers working seven nights and then seven days had high risk of heart disease than those who worked on days or nights (BBC news, 20 April 2005).Mood swings and depression are likely to happen. Coffey et al, 1988 in his research highlight that workers on permanent night shift and more preferably men are likely to face high levels of neurotic disorders and depression. Working in shifts can lead to disruption in social and family life. Divorce rates have been found to be high in this type of working population. Johnson, 1999 found that workers on rotating shift pattern experience high work-family conflict than day workers. These all in turn can result in anger frustrations and irritability (Health and safety guidelines, September 2000). It has been concluded from research that abolition of night work enables substantial improvement in mental, physical and social well being (Akerstedt et al, 1978).There is likely to be a decrease in performance rates which may result in increased rate of accidents. It is found from research that the activity count was better during the morning shifts than the evening shifts and also that the sleep time was lower for the morning shift when compared to evening shift. (Kawada et al, 2008)

Research has revealed that shift work lead to poor health habits and makes an individual prone to illnesses. It was found that shift workers were found to smoke and to be overweight than day workers which in turn makes way to health problems including coronary heart disease. (Kivimaki et al, 2001).

In order to reduce the impact of risks on the health and social life of the shift workers the following could be taken into consideration as recommended by the PHC occupational health. First of all it is necessary to work alongside the body clock and this can be attained by following the forward rotating shift pattern i.e. Mornings, Late and then Nights. The workers should try to make adjustments to accommodate night shifts and sleep/ wake patterns. Make adjustments to lifestyle and maintain some quality time with family and friends and make them aware of the job demands. Eating habits need to be put to priority. Avoid meals high in protein and fat within several hours of bedtime. Regular aerobic exercises will help increase energy levels and stamina and also improve alertness. As per the Health and Safety guidelines, September 2000 the following are to be taken into account. Periodic health assessments should be taken at the employer’s expense. It is recommended that maximum working hours in a day or a week should not exceed the permitted limit unless in case of an emergency. It should be seen that split or broken shifts are avoided so that risk of work overload can be reduced and also sufficient participation in family and social life is possible. As per OHS requirements adequate breaks should be adapted during the shift as well as between the shifts.

REFERENCES:

Akerstedt, Torbjörn, Torsvall, Lars (1978) Experimental changes in shift schedules: Their effects on well-being. Ergonomics, Vol 21(10), pp. 849-856. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Barnes-Farrell, Janet L. et al (2008) What aspects of shiftwork influence off-shift well-being of healthcare workers. Applied Ergonomics, Vol 39(5), Special issue: Contemporary research findings in shiftwork. pp. 589-596. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Esquirol, Yolande et al (2009) Shift work and metabolic syndrome: Respective impacts of job strain, physical activity, and dietary rhythms. Chronobiology International, Vol 26(3), pp. 544-559. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Fenwick, Rudy, Tausig, Mark, (2004) The Health and Family-Social Consequences of Shift Work and Schedule Control: 1977 and 1997. Fighting for time: Shifting boundaries of HYPERLINK "javascript:__doLinkPostBack('','ss~~AN "2004-21019-000"||sl~~rl','');"workHYPERLINK "javascript:__doLinkPostBack('','ss~~AN "2004-21019-000"||sl~~rl','');" and social life. ; pp. 77-110. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Garbarino, Sergio, De Carli, Fabrizio et al (2002). Sleepiness and sleep disorders in shift workers: A study on a group of Italian police officers. Sleep: Journal of Sleep and Sleep Disorders Research, Vol 25(6). pp. 642-647. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Kawada, Tomoyuki et al (2008) Activity and sleeping time monitored by an accelerometer in rotating shift workers.Work: Journal of Prevention, Assessment HYPERLINK "javascript:__doLinkPostBack('','ss~~JN "Work: Journal of Prevention, Assessment & Rehabilitation"||sl~~rl','');"&HYPERLINK "javascript:__doLinkPostBack('','ss~~JN "Work: Journal of Prevention, Assessment & Rehabilitation"||sl~~rl','');" Rehabilitation, Vol 30(2), pp. 157-160. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Kivimäki, Mika, U Helsinki, Kuisma, Päivi, Virtanen, Marianna, Elovainio, Marko (2001). Work HYPERLINK "javascript:__doLinkPostBack('','ss~~JN "Work & Stress"||sl~~rl','');"&HYPERLINK "javascript:__doLinkPostBack('','ss~~JN "Work & Stress"||sl~~rl','');" Stress, Vol 15(1), Jan, 2001. pp. 3-13. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Shen, Jianhua,Botly, Leigh C. P.,Chung, Sharon A.,Gibbs, Alison L.,Sabanadzovic, Skender,Shapiro, Colin M. (2006) Fatigue and shift work .Journal of Sleep Research.. . http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Critically review the evidence that work-life conflict leads to negative health outcomes.

Work life conflict is a state that becomes of when an individual finds it difficult to manage all the roles he is engaged in and is unable to meet the demands in his responsibility at work place and home simultaneously. This can directly or indirectly lead to less productivity at workplace, decreased commitment which gradually may lead to reduced job satisfaction, increase in rate of absenteeism and can further lead to expulsion/ termination from the designated post in the organisation. Individuals suffering from this type of conflict are likely to have problems in their personal life too, which can lead to low psychological well being and reduced physical health. There has been a number of research stating the advantages and disadvantages of work and family roles on health.

Individuals who have difficulty in maintaining a proper work life balance are more likely to be at risk of getting strain and reduced psychological well being ( Cipriano et al, 2008). Research showed that reduced conflict enhanced psychological well being and diminished physical symptoms (Pisarski et al, 2008). Studies reveal that there is a marked difference between casual and full time workers on working hours, work life conflict and health. Long working hours often resulted in disruption of family and social lives and poor work life balance. As a result of this health related problems arise including disturbance in sleep , fatigue, disrupted exercise and dietary regimes. It was also concluded that casual employees with unpredictable working hours and control are found to have more work life conflict and health problems than permanent workers (Philip et al, date unknown). Work to family and family to work conflicts can arise when it is difficult to manage multiple roles efficiently and can thus result in stress and ill-health. Research reveals that this kind of conflict has its effect on the mental health of men and women in three different countries (Chandola et al, 2004). It has been found from research that work to personal life conflict is related to depression and anxiety and personal to work life conflict was related to health concerns (Elisa et al, 2001). It has been found that irrespective of gender both men and women work life conflict results in many physical and mental health problems. Workers with increased rate of work life conflict experience a significantly high risk of self reported reduced health, anxiety and depression, lack of energy and optimism, severe backaches, headaches, sleep disorders and fatigue. It is also highlighted in the study that prevalence rates of work life conflict though high in men the health outcomes are found to have a stronger impact on women than in men ( Hamig et al, 2009). Research by Fuss et al (2008) investigated the impact of work interfering with family conflict within the psychosocial environments or work organisations of hospital physicians and also examined the individual physician’s mental and physical health. The study found that high levels of conflict were drastically correlated to increased rates of personal burnout, behavioural and cognitive stress symptoms and high intentions to leave the job. When compared with the general population, physicians were found to show increased levels of individual stress and quality of life as well as lower levels for well being. Adam et al (2009) found in their study that the work family conflict turns out to act as a stressor to the male and female physicians which can lead to job dissatisfaction and hence impact their well being and thus affect the quality of patient care. The identity theory put forward by Burke, 1991; Schlenker, 1987 states that work family conflict may be a potent stressor because it represents a threat or impediment to self-identification.

A Hierarchical logistic regression analyses reveals that both work family and family work conflict resulted in mood disorders, anxiety, and substance dependence disorder. Workers with work family conflict were 1.99–29.66 times more likely to face clinically significant mental health problem when compared to employees with no significant conflicts irrespective of gender (Frone et al 2000). Work life conflict variables including job and family dissatisfaction and psychological distress resulted in making way for unhealthy behaviors which can in turn lead to other health problems. It was found in a study by Frone et al (1994) that work family conflict was related to high rate of cigarette use and heavy drinking among working mothers of adolescents. Work life conflict has its adverse negative effect on the outcomes it has on women. It leads to increased psychological distress ( Bromet et al, 1990; Frone et al, 1991, 1992; Ilgen et al, 1992), reduced life satisfaction ( Aryee, 1992; Bedeian et al, 1988; Rice et al, 1992), and increase in physical symptomatology ( Frone et al., 1991; Guelzow et al, 199 l). Greenhaus et al (2006) in their study points out that the psychological processes involved in work family conflicts lead to negative emotions, life dissatisfaction, health related behaviours and also has a negative impact on the physical health. psychological process by which work-family conflict affects negative emotions, dissatisfaction with life and its component roles, health-related behavior, and physical health. Matheison et al (2003) in their study reveals that work life conflict tends to increase psychological distress and decreases the mental and emotional well being. It was also found in this study that social support in these conflicts worsened the situation than reduce the conflict.

REFERENCES:

Adám S, Gyorffy Z, László K (2009).High prevalence of job dissatisfaction among female physicians: work-family conflict as a potential stressor. http://www.ncbi.nlm.nih.gov/pubmed

Cipriano, Traci A (2008) Relationships among work-family interference, conflict, and health risk outcomes in attorneys: Moderation by dispositional optimism and perfectionism, Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 68(8-B), pp. 5562. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Chandola T, Martikainen P, Bartley M, Lahelma E, Marmot M, Michikazu S, Nasermoaddeli A, Kagamimori S  (2004) ; 33(4):884-93. Does conflict between home and work explain the effect of multiple roles on mental health? A comparative study of Finland, Japan, and the UK. http://www.ncbi.nlm.nih.gov/pubmed

Cullen, Jennifer Colleen, (2005) The effects of work-family conflict and the psychosocial work environment on employee safety performance. Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 66(3-B), pp. 1769. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Frone, Michael R., Barnes, Grace M. Farrell, Michael P. (1994). Relationship of work–family conflict to substance use among employed mothers: The role of negative affect. Journal of Marriage HYPERLINK "javascript:__doLinkPostBack('','ss~~JN "Journal of Marriage & the Family"||sl~~rl','');"&HYPERLINK "javascript:__doLinkPostBack('','ss~~JN "Journal of Marriage & the Family"||sl~~rl','');" the Family, Vol 56(4), pp. 1019-1030. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Frone, Michael R., (2000) Work–family conflict and employee psychiatric disorders: The national comorbidity survey.Journal of Applied Psychology, Vol 85(6), pp. 888-895. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Fuss I, Nübling M, Hasselhorn HM, Schwappach D, Rieger MA BMC Public Health. (2008). Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences. http://www.ncbi.nlm.nih.gov/pubmed

Grant-Vallone, Elisa J, Ensher, Ellen A. (2001). An examination of work and personal life conflict, organizational support and employee health among international expatriates. International Journal of Intercultural Relations, Vol 25(3), pp. 261-278. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Greenhaus, Jeffrey H.,Allen, Tammy D.,Spector, Paul E (2006). Health consequences of work-family conflict: The dark side of the work-family interface.Employee health, coping and methodologies. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Greenhaus, Jeffrey H.,Allen, Tammy D.,Spector, Paul E. (2006) Health consequences of work-family conflict: The dark side of the work-family interface. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Hämmig O, Gutzwiller F, Bauer G (2009) Work-life conflict and associations with work- and nonwork-related factors and with physical and mental health outcomes: a nationally representative cross-sectional study in Switzerland. http://www.ncbi.nlm.nih.gov/pubmed

Mathieson, Kathleen Marie ( 2003) Work-to-family conflict, social support, and psychological well-being. Dissertation Abstracts International Section A: Humanities and Social Sciences, Vol 63(12-A), pp. 4490. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Philip Bohle; Michael Quinlan; David Kennedy ; Ann Williamson (no date)Working hours, work-life conflict and health in precarious and "permanent" employment

Pisarski, Anne,Lawrence, Sandra A.,Bohle, Philip,Brook, Christine (2008), Organizational influences on the work life conflict and health of shiftworkers. Applied Ergonomics. http://0-ejournals.ebsco.com.brum.beds.ac.uk.

Discuss and critically evaluate research that has examined the impact of bullying at work

Bullying at work can be in different forms such as humiliating an individual in public, spreading false rumors, avoiding someone, giving difficult and meaningless tasks, and degrading an individual’s performance at work (CIPD report).According to Einarsen et al (2003) the definition of bullying is as follows“Bullying at work means harassing, offending, socially excluding someone or negatively affecting someone’s work tasks. In order for the label bullying (or mobbing) to be applied to a particular activity, interaction or process, it has to occur repeatedly and regularly (e.g., weekly) and over a period of time (e.g. about six months). Bullying is an escalating process in the course of which the person confronted ends up in an inferior position and becomes the target of systematic negative social acts. A conflict cannot be called bullying if the incident is an isolated event or if two parties of approximately equal ‘strength’ are in conflict” Work place bullying is known with different terminologies such as ‘emotional abuse at work’ (Keasly, 1998), ‘harassment at work’ (Brodsky, 1976; Einarsen & Raknes, 1997), ‘bullying at work’ (Vartia, 1996), ‘mistreatment’ (Spratlen, 1995),‘mobbing’ (Leymann, 1996; Zapf et al ., 1996), ‘workplace aggression’ (Baron &

Neuman, 1996) or as ‘workplace incivility’ (Andersson & Pearson, 1999). The act of bullying often takes different forms such as open verbal attacks or even physical attacks; it can also be done in a discreet manner as excluding an individual from their peer groups (Einarsen et al., 1994; Leymann, 1996; Zapf, Knorz et al, 1996). Bullying has had many adverse negative effects on the health and dignity of an individual. Research has shown that bullying at work has resulted in severe symptoms of psychological stress and mental fatigue on the victims. It results in significant consequences resulting in stress and poor mental health in the individual.

Hauge etal, (2007) in their research found that stressful situations at work place adjoined with increased levels of interpersonal friction and destructive leadership styles is responsible for the existence of the act of bullying. In their study they also highlighted that bullying was found to be more prevelant in situations where the immediate supervisor fails to intervene and manage the stressfull situations.The work environment is a place where people become vulnerable when confronting situations such as abuse, aggression or harassment (Einarsen & Raknes, 1997). According to Brodsky, 1976 work place bullying is targeted so as to tease, insult and create negative feelings of helplessness in individual who do have the courage to stand up against any offensive behaviors. Verbal abuse is often considered as a type of racial harassment; however ethnic minority group employees suffer from this harassment as a part of workplace bullying (Jones, 2002). The HSE Research report 2005, No.308) indicated that racial discrimination specifically in combination with gender and ethnicity had a strong impact on work stress. Lewis (2004) and Einarson et al (2003) in their report states that bullying at work place results in inequalities of treatment and create feelings of abandonment and isolation. As per the report given in Violence and Victims (December 2007) states that victims of work place bullying showed decreased self esteem and reduced social competency and also revealed elevated levels of role stress around work tasks and daily work.An exposure to bullying in the workplace can lead to a feeling of insecurity, threat, danger and self questioning which can definitely have a long term effect in the individual’s life ( Janoff 1992). This can in turn lead to psychosomatic, pervasive emotional and psychiatric problems (Leymann, 1990). Study by Leymann, (1990) reports that the clinical observations of victims of work place harassment showed adverse signs of social isolation, social maladjustment, psychosomatic illnesses, depressions, helplessness, anger, anxiety,and despair. Research conducted on Norwegian nurses reveals a close relationship between work place harassment and high levels of burn out and job dissatisfaction as well as reduced psychological well being (Einarsen et al, 1998). It is supported from research that bullying at work leads to post traumatic stress disorder (Heinz, 1992). Hansen etal (2006) in their study reports that victims of bullying at the work place received less support from their supervisors and co workers and also respondents state symptoms of somatisation, depression, anxiety, and negative affectivity (NA) at increased rates than the nonbullied persons. It was also found that concentration of cortisol in saliva were lower in the bullied individual which matched the concentration levels of cortisol for people with posttraumatic stress disorder (PTSD) and chronic fatigue. According to the report published in the British Journal of Guidance and counseling (2004) the impact of feelings of shame is found to last longer in University and college lecturers even long after the episodes of bullying has ended.

As per the HSE management standards launched on 3rd November 2004 it was decided between HSE and the stake holders that zero tolerance approach will be taken to bullying at work. Employees have been protected from harassment as per the UK discrimination law introduced on October 2006 onwards. It covers all grounds where discrimination is likely to occur e.g. age, gender, disability, color, and nationality, race etc. There are also many legal protection laws and Acts available to protect an individual against bullying even if it is not for discrimination reasons. The Employment Rights Act 1996, Health and safety at work etc Act 1974, Human Rights Act 1998 etc work for the protection of employees against bullying.

REFERENCES:

Agervold, Mogens; Mikkelsen, Eva Gemzøe ( 2004) Relationships between bullying, psychosocial work environment and individual stress reactions. Work & Stress, October 2004, Vol. 18 Issue: Number 4 p336-351, 16p; . http://0-ejournals.ebsco.com.brum.beds.ac.uk

Einarsen, Hoel, Zapf & Cooper (2003) Bullying and Emotional Abuse in the

Workplace: International perspectives in research and practice. Taylor and

Francis. . http://0-ejournals.ebsco.com.brum.beds.ac.uk

Hauge, Lars Johan; Skogstad, Anders; Einarsen, Ståle (2007) Relationships between stressful work environments and bullying: Results of a large representative study. Work & Stress, July 2007, Vol. 21 Issue: Number 3 p220-242, 23p; . http://0-ejournals.ebsco.com.brum.beds.ac.uk

Hansen, Åse Marie; Hogh, Annie; Persson, Roger; Karlson, Björn; Garde, Anne Helene; Ørbæk, Palle (2004) Bullying at work, health outcomes, and physiological stress response. Journal of Psychosomatic Research, Vol. 60 Issue: Number 1 p63-72, 10p; . http://0-ejournals.ebsco.com.brum.beds.ac.uk

LEWIS, DUNCAN; GUNN (2007)WORKPLACE BULLYING IN THE PUBLIC SECTOR: UNDERSTANDING THE RACIAL DIMENSION. Public Administration, Vol. 85 Issue: Number 3 p641-665, 25p; . http://0-ejournals.ebsco.com.brum.beds.ac.uk

Lutgen-Sandvik, Pamela (2008) Intensive Remedial Identity Work: Responses to Workplace Bullying Trauma and Stigmatization.Organization; Vol. 15 Issue: Number 1 p97-119, 23p; . http://0-ejournals.ebsco.com.brum.beds.ac.uk

Bullying at work: the impact of shame among university and college lecturers. British Journal of Guidance and Counselling, August 2004, Vol. 32 Issue: Number 3 p281-299, 19p; . http://0-ejournals.ebsco.com.brum.beds.ac.uk

Perpetrators and Targets of Bullying at Work: Role Stress and Individual Differences Violence and Victims, December 2007, Vol. 22 Issue: Number 6 p735-753, 19p; . http://0-ejournals.ebsco.com.brum.beds.ac.uk

J Beswick HSL/2006/30 - Bullying at HYPERLINK "http://www.hse.gov.uk/research/hsl_pdf/2006/hsl0630.pdf"workHYPERLINK "http://www.hse.gov.uk/research/hsl_pdf/2006/hsl0630.pdf": a review of the literature

www.hse.gov.uk/research/hsl_pdf/2006/hsl0630.pdf

BullyingHYPERLINK "http://www.hse.gov.uk/STRESS/furtheradvice/informationonbullying.htm"and harassment - Advice for managers

www.hse.gov.uk/STRESS/furtheradvice/informationonbullying.htm

Compare and contrast the effectiveness of primary and secondary/tertiary stress management strategies in improving employee wellbeing.

Stress in the workplace can ruin the effective functioning and standards of an organisation. Numerous researches are being carried out so as to identify the causes and the ways in which stress in the workplace can be reduced in the workplace. According to Cooper et al (2001) though there are many stress management strategies available there is lack in the understanding of the main sources of strain and the effective strategy to deal with those stressors. It has been highlighted that if the stress in the workplace is being researched from the stand of the individual facing the stress a better step towards reducing stress can be achieved. Research clearly states that unless and until the focus of stress management programmes are directed to routing out or reducing the environmental stressors inorder to face demanding situations and develop coping skills, the stress management programmes will fail to maintain employee health and well being (Cooper and Cartwright, 1997; Van der Klink et al, 2001). The deficiency of strategic level intervention studies has become a hindrance in developing knowledge of work related stress. Investigation of stress from the organisations perspective is now taking an effective turn so that it can be dealt with at the environmental level (James, 1999; Kompier et al., 2000). Strategies put forward by Organisations up to date have been to provide specific services by the employers so as to assist the employees at times of stress. The services include counselling, health checks and stress management strategies as discussed above.

Stress management Interventions consist of three major strategies i.e. primary, secondary and tertiary (Murphy, 1988) and these Intervention strategies are defined by Ivancevich et al (1990) as “any activity, program, or opportunity initiated by an organisation, which focuses on reducing the presence of work related stressors or on assisting individuals to minimise the negative outcomes of exposure to these stressors”. Stress management strategies at the primary intervention level aims at eliminating the sources responsible for stress by focussing mainly on changing the physical or socio-political environment to match the need of individuals and giving them more control to handle their work situation (Cooper et al., 2001). At the primary level intervention the following methods are implemented such as improving communication processes, redesigning jobs or involving employees in the decision-making process. Basically the aim is achieved by making changes to the group or organisation as a whole. The stress management programmes at the Organisation levels include Selection and placement, training and education programmes, physical and environmental characteristics, Communication, job redesign and other organisational level interventions. At the secondary level of intervention stress is managed by helping the individuals without eliminating or modifying the workplace stressors. The programmes used in this kind of intervention aims at making the individual identify the stress symptoms in them and try to acquire or improve their coping skills. Individual Level Programmes focus more on Relaxation, Meditation, Biofeedback, Cognitive-behavioural therapy, Exercise, Time management, Employee assistance programmes, other individual level intervention. Combination of both Individual / Organisational Level Programmes include Co-worker support groups, Person environment fit, Role issues, Participation and autonomy, Other individual / organisational level intervention. The tertiary prevention strategies guide the individuals facing on-going problems at work enabling them to adapt individual behaviour and lifestyle without changing the organisational practices.

Kompier and Cooper (1999) states that stress intervention programmes are focussing more on the secondary and tertiary prevention strategies than at the primary prevention i.e. focussing mainly on reducing the stress effects on the individuals rather than trying to reduce the source of actual stressors from the work place. The reasons for this kind of individual focused approach is because the senior management blames the employee personality and lifestyle to be the reason for stress rather than the employment factors, psychologists are paying more attention to subjective and individual differences. The organisational settings are ever changing because of which systematic intervention and evaluation will be difficult and also considering the cost involved in stress interventions it is considered better to focus on the individual approach. Management of stress from the workplace benefits both the employees and the organisation, and likewise mismanagement of the same results in loses to both of them (Quick et al., 1997). It is important to note that tertiary interventions such as providing assistance to employees are considered good practice but it may not be enforceable. These kinds of programmes are best recommended to be enforced along with either primary or secondary interventions rather than in isolation. Recently the Management Standards are concerned more with implantation of the primary prevention in terms of identifying the stressors and modifying the work place environment, skill enhancement etc. An organisation that makes and maintains a healthy environment so that employee’s physical, mental and social well being is assured will always be sensitive and focuses on health and safety issues (Cooper and Cartwright, 1997). Stress prevention and management in the workplace which comes under primary intervention programmes will depend on the commitment of managers in implementing the appropriate programmes in each of the organisational members. The length of most programmes becomes an issue as it varies from few hours to ten years with varying attitudes while dealing with work related stress. The advantage of this kind of a programme is that the root cause of stress can be identified and stressful situations can either be reduced or completely abolished. This strategy is effective though the major drawbacks lie in the fact that organisations are fast developing and the effectiveness in implementation of a programme that lasts almost ten years is doubtful as the causes of stress and coping strategies are likely to change as time rolls by. Interventions at individual levels are being studied and have demonstrated positive effect on the stress management intervention programmes. However in this case the drawback lies in the fact that since the programmes are short-term the effectiveness in the long run is unknown, so it is not possible to draw a conclusion on the effectiveness of the secondary management (Bellarosa and Chen, 1997). Furthermore the strategies at individual level aim at managing the stressful situation rather than reducing or preventing the situation (Elo et al., 1998).

As per the HSE guidance it has been brought to view that implementation of a particular intervention strategy needs to be carried out based on the context and the needs of the group in that particular situation. HSE has also published many studies that concerns with with different interventions in organisations (Cox et al, 2000; Jordan et al, 2003;

Parker et al, 1998) and has also provided some case studies to assist organisations in implementing the control measures (HSE, 2003).

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