Occupational Stress in the Service Professions

Maureen Dollard, Helen R. Winefield, Anthony H. Winefield, Maureen Dollard, Helen R. Winefield, Anthony H. Winefield

• Publisher: CRC Press
• Year: 2003
• Print ISBN: 9780415267601
• eBook ISBN: 9781134498574
• Edition: 1
• Topic: Business
• Subtopic: Human Resource Management
• Index: Business

Workers in the service industry face unique types and levels of stress, and this problem is worsening. Many workers and organizations are now recognizing work stress as a significant personal and organizational cost, and seeing the need to evaluate a range of organizational issues that present psychosocial hazards to the workers. Occupation

CHAPTER ONE
Introduction: Context, Theories and Intervention

Maureen F. Dollard

1.1 INTRODUCTION

At the turn of the century a confluence of economic, political and sociocultural forces are impacting profoundly on our contemporary work arrangements (Cooper et al., 2001). The climate in organisations has changed dramatically in the past decade with increased demands from globalisation of the economy, and the rapid development of communication technology (Cascio, 1995; Schabracq and Cooper, 2000). There is rapid industrialisation in developing economies (Cheng, 2000).

The impact of globalisation of the economy has led to a shift from manufacturing to knowledge and service based economies. Further, the exponential rate of technological change has ‘outstripped efforts to develop sociotechnical perspectives that integrate human needs and values into the management of jobs and organizations’ (Cooper et al., 2001).

Kendall et al. (2000) report that within the workplace these changes translate to overemployment for many workers: those in full-time jobs are experiencing increased pressure and faster pace (Bousfield, 1999), increased workload (Townley, 2000), longer shifts and longer hours (Heiler, 1998; Winefield et al., 2002), and demands for high organisational performance. Overemployment has been linked to cardiovascular disease for some time (Breslow and Buell, 1960). The risk of heart attack for those working long hours (e.g. 11 hours) is 2.5 times the risk of those working an 8 hour day (Sokejima and Kagamimori, 1998).

Employment has also become more precarious as workers are employed increasingly on contract (Schalk et al., 2001; Winefield et al., 2002), and the permanent job itself has become more insecure, leading to predictions that by 2020 a quarter of the workforce will be in non-traditional employment arrangements (Judy and D’Amico, 1997, see Kendall et al., 2000). Quinlan (2002) describes the results of recent reviews on the health effects of precarious (casual, short term, temporary, self-) employment in 11 countries, from 1986 to 2000 (Quinlan et al., 2001), and on the health effects of downsizing/restructuring and job insecurity published in the international literature between 1966 and 2001 (Bohle et al., 2001). Overwhelmingly the reviews found a measurable deterioration in health effects for precarious and survivor groups. The latter review found that those most affected among surviving workers were committed workers, older workers, and those subject to ongoing insecurity.

Workers are now being required to perform multiple tasks, learn new skills, and self-manage to meet competitive demands. According to Kendall et al. (2000) this has lead to jobs that are more fluid (Cooper et al., 2001), possibly exacerbating role ambiguity and role conflict, and leading in turn to work stress and illness (Dunnette, 1998). In addition, for many workers the amount and scope of work has diminished with technological advances leading to underemployment (Cooper et al., 2001), and this can also be risky. Research has found that those working less than 6 hours per day have 3 times the risk of heart attack than those working an 8 hour day (Sokejima and Kagamimori, 1998). Winefield et al. (2002) however point out that those working lower hours may have been doing so because they were already suffering from the stress of too high a workload.

Technological changes have also led to an increasing amount of poor-quality work – ‘work not fit for a machine to do’ – that is unsatisfying, offering low pay, low job security and unreliable hours, and often undertaken by women and cultural minorities (Winefield et al., 2002).

Organisations have downsized and restructured to improve flexibility and competitiveness or as a result of economic recession (Kawakami, 2000) leading to both mental and physical ill-health (Chang, 2000). Flatter organisational structures are hazardous as workers find career options limited (Kasl, 1998).

Belkic et al. (2000) argue that modern work demands are squeezing out ‘passive’ and ‘relaxed’ jobs (e.g. scientists increasingly compete for funding, general practitioners participate in settings of corporate managed care), which may lead to two classes of occupations: those with high control or those with low control, but all with high demands. Further, disparity between managerial and unskilled jobs in actual levels of control has reportedly increased over the years with a greater relative increase for managerial staff (Lunde-Jensen et al., 2000).

Reports of changes in work arrangements are widespread and many have been linked to the emergence of new costs, for the individual, the organisation and society. As noted by Levi (2002) in the Preface of this book, besides negative implications for national economies, mental health problems and stress-related disorders are the biggest overall cause of premature death in Europe according to the WHO (2001).

1.2 COST OF WORK STRESS

The cost of occupational stress is acknowledged as a problem around the world, and is a common concern in both developing and industrialised nations (Kawakami, 2000).

Some attempts have been made to quantify the impact of stress on the economy in terms of Gross Domestic Product. In Denmark work related sickness and absence is estimated to be 2.5% of GDP, in Norway 10% (Lunde-Jensen, 1994) and in the European Union, 5–10% due to work stress (Cooper et al., 1996).

The impact of sickness absence in UK economy is estimated to be 12 billion pounds, 50% of which is estimated to be stress related (Cooper, 1998). In the United States, it is estimated that 54% of sickness absence is stress related (Elkin and Rosch, 1990).

The economic costs to Australia in terms of work related stress are substantial and determinable at a state level. In Australia workers are generally entitled to workers’ compensation for stress when the claimant’s employment significantly contributed to stress, not including situations where reasonable disciplinary action or failure to obtain a promotion, transfer or other benefit in relation to employment has occurred. The ‘stress’ condition is required to be ‘outside the bounds of normal mental functioning’ (insurer for the Commonwealth Government-Comcare), or a psychiatric condition listed in the Diagnostic and Statistical Manual of Mental Disorders – 4th Edition Revised (DSM IV-R), the American Psychiatric Association (DSM IV) or the International Classification of Diseases: Classification of Mental and Behavioural Disorders – 10th Ed (ICD-10) (i.e. in South Australia and most other states).

The cost and prevalence of such claims varies from state to state. The following details are drawn from the ‘Extract from the “Comparison of Workers” Compensation Arrangements in Australian Jurisdictions” ’ 2001. In New South Wales in 1999/2000 there were 1577 new claims comprising 17% of all occupational disease claims, each at an average cost of $20, 617 per claim, and the total gross cost was $33 million. The largest proportion of claims (20%) was from Health and Education where large groups of professionals coalesce. In Victoria, 5% of claims were for stress in 1997/98 (1587 new claims). Apart from circulatory disease and back injury claims, stress claims were most costly and represented the highest average payment per claim. The Victorian WorkCover Authority declared stress as a significant cause of 86 deaths since 1985, including 15 suicides.

In South Australia there were 162 claims in 1998/99 accounting for 2% of all injuries and 3.5% of all income maintenance costs. In Western Australia 601 claims were lodged in 1997/98 for work stress, 2.2% of all claims with claim cost of $23,399 twice that of other claims (an increase of 34% from 1996/97). In Queensland an increase of 19% was found in 1999/2000 and an increase of 28% in 2000/2001. The average cost of the claim was $17,249, over twice that of the next most expensive. A striking statistic is that the average duration of time off for psychological/psychiatric claims was 96.1 days compared to 28.9 days for other claims.

It is difficult to derive a GDP figure for Australia, as data sets between state jurisdictions are incomplete. However estimates are around $49 million in 1995/96 (National Occupation Health and Safety Commission, 1998) (excluding Victoria and Australian Capital Territory data) with an additional $38 million for Commonwealth workers in 1995–96 (Australian National Audit Office, 1997).

Work stress claim costs generally measure the cost of the problem to workplace insurer, but do not reflect all stress costs. For example, stress may manifest itself in other classifiable (physical health) symptoms. In US the National Institute of Occupational Health and Safety identified psychological disorders (including neuroses, personality disorder, and alcohol and drug dependency) as one of the 10 leading occupational diseases and injuries (Sauter et al., 1990).

Also in Australia there is a lot of stigma associated with making stress claims, which may inhibit people from making them. There may also be organisational challenges to stress claims. Claim rates therefore do not reflect the stress risk of work environments.

Costs do not include the additional costs to organisations incurred through staff replacement and retraining, special supervision, work flow interference, unplanned absences and service complaints, and the cost of sick leave leading up to the compensation claim (Toohey, 1995). Further, they do not reflect the costs to the individual such as loss of self-esteem, loss of professional-esteem, new or exacerbated physical symptoms, loss of physical stamina, disruption to intimate life, lost hours of professional development, loss of professional sensitivity, or increased psychological distress. Work stress cost estimates therefore grossly underestimate the real cost of the problem.

In addition to psychological disorders, stress at work may lead to other costly behaviours such as smoking and aggression. O’L eary et al. (1996) argue that organisationally motivated aggression (revenge, retaliation), may occur when workers perceived an inequitable disbursement of rewards and other resources by the organisation. As we shall see later these conditions lead to strain according to the Effort–Reward Imbalance Model (see Section 1.4.3).

According to a report published last year in US, ‘the cost of workplace violence to employers is estimated to be between $6.4 billion and $36 billion in lost productivity, diminished image, insurance payments and increased security’ (Daw, 2001, p. 52).

Surveys confirm widespread reporting of the experience of work stress. In Europe, 28% of 15 000 workers surveyed report that stress is a work-related health problem (Paoli, 1997). In Australia, the Australia Workplace and Industrial Relations Survey (1995), report that 26% of people rate work stress as the second largest cause of work related injury and illness (behind physical strains and sprains-43%) (See Extract from the ‘Comparison of Workers’ Compensation Arrangements in Australian Jurisdictions’ July, 2000.). In Japan 63% of workers in a nation wide survey 1997 report ‘strong worry, anxiety or stress at work or in daily working life’, an increase of 12% since 1982. In Japan the emergence of ‘karoshi’ (death from overwork) is an increasing social concern (Kawakami, 2000). In US 68% of respondents to a survey reported they had to work very fast, and 60% never had enough time to finish their work (Theorell, 1999).

Finally, income disparity resulting from ‘good’ and ‘bad’ jobs is argued to have ...

Table of contents

• COVER PAGE
• TITLE PAGE
• COPYRIGHT PAGE
• FOREWORD
• ACKNOWLEDGEMENTS
• CONTRIBUTORS
• CHAPTER ONE: INTRODUCTION: CONTEXT, THEORIES AND INTERVENTION
• CHAPTER TWO: THE DISC MODEL: DEMAND-INDUCED STRAIN COMPENSATION MECHANISMS IN JOB STRESS
• CHAPTER THREE: MEASUREMENT AND METHODOLOGICAL ISSUES IN WORK STRESS RESEARCH
• CHAPTER FOUR: CONVENTIONAL WISDOM IS OFTEN MISLEADING: POLICE STRESS WITHIN AN ORGANISATIONAL HEALTH FRAMEWORK
• CHAPTER FIVE: BURNOUT AMONG ONCOLOGY CARE PROVIDERS: RADIATION ASSISTANTS, PHYSICIANS AND NURSES
• CHAPTER SIX: SENIOR NURSES: INTERVENTIONS TO REDUCE WORK STRESS
• CHAPTER SEVEN: WORK STRESS AND ITS EFFECTS IN GENERAL PRACTITIONERS
• CHAPTER EIGHT: TEACHER STRESS
• CHAPTER NINE: STRESS IN UNIVERSITY ACADEMICS
• CHAPTER TEN: PROSTITUTION: AN ILLUSTRATION OF OCCUPATIONAL STRESS IN ‘DIRTY WORK’
• CHAPTER ELEVEN: SOCIAL WORKERS AND HUMAN SERVICE PRACTITIONERS
• CHAPTER TWELVE: CLERGY IN CRISIS
• CHAPTER THIRTEEN: STRESS IN PSYCHOLOGICAL WORK
• CHAPTER FOURTEEN: VOLUNTEERING WORK STRESS AND SATISFACTION AT THE TURN OF THE 21ST CENTURY
• CHAPTER FIFTEEN: CONCLUSION