A research report submitted to the Faculty of Health Sciences of the University of the
Witwatersrand in partial fulfillment of the requirements for the degree of Master of
Medicine in the branch of Community Health (Public Health Medicine).
May 2014 / Background
Occupational stress represents a substantial public health challenge. Although there
has been an extensive focus on this form of stress within the international setting,
there appears to be a paucity of relevant evidence within South Africa. Specifically,
within the local context, there are relatively few: (1) reliability testing studies of
screening and assessment instruments, (2) prevalence analyses of occupational
stress and (3) work-related stress management intervention designs.
Methods
A cross-sectional descriptive and analytical study was undertaken in a large tertiary
hospital in Johannesburg. Primary data were collected between February 2013 and
September 2013 using the Copenhagen Psychosocial Questionnaire (COPSOQ). A
sample (n=166) of administrative staff was selected, stratified into front line staff
(n=54), back office staff (n=90) and managers (n=22).
Data analysis included reliability testing of the COPSOQ using the Cronbach‘s alpha
statistic. Prevalence measurement was also undertaken to describe the distribution
of stress and other variables across the study sample. Finally, logistic regression
was used to estimate associations between the exposure variables and the stress
outcome (at the p < 0.05 level of significance).
Results
The Cronbach‘s alpha range for the COPSOQ was 0.31 to 0.85. Two out of 24
scales of the instrument fell below the unacceptability threshold of 0.5. In terms of
prevalence, the stress mean for the study sample (on a scale from 0 to 100) was
38.8 (SD 19.8). Furthermore, 68.1% (n=113) of the study sample had a stress value
above the reference mean. There were also significant differences in the stress
values by job category, with managers having the highest mean at 51.2 (SD 24.2).
Adjusting for job category, risk factors significantly associated with occupational
stress in the main logistic model were offensive behaviour (OR 3.38, 95% CI: 1.54 –
7.43), quantitative demands (OR 2.83, 95% CI: 1.35 – 5.92) and emotional demands
(OR 2.32, 95% CI: 1.08 – 4.96), while quality of leadership (OR 0.32, 95% CI: 0.15 –
0.67) was a protective factor. Further analysis showed that the most harmful risk
factor for females was work-family conflict (OR 4.03; 95% CI: 1.45 - 11.21), and for
males was exposure to offensive behaviour (OR 4.63; 95% CI: 1.15 - 18.63). Finally,
ordinal regression found offensive behaviour (OR 3.60; 95% CI: 1.92 - 6.75) and
quantitative demands (OR: 2.38; 95% CI: 1.27 - 4.46) to be significant risks for
moving from low stress to high stress, while a commitment to workplace (OR 0.46;
95% CI: 0.24 - 0.86) could help to prevent this.
Conclusions
The level of occupational stress in the study sample was high relative to reference
values. An occupational stress intervention is recommended, which should include
primary, secondary and tertiary prevention strategies (according to identified risks).
Further development of the instrument is also recommended, so as to improve its
reliability in the local context. Finally, future research into occupational stress should
explore the impact of factors such as resource constraints and HIV/AIDS, and should
include an expansion into other settings and occupational categories.
Key words
Occupational stress, questionnaire reliability, psychosocial risks, intervention design.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17345 |
| Date | 27 March 2015 |
| Creators | Volmink, Heinrich Cyril |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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