PERCEIVED MANAGEMENT OF OCCUPATIONAL STRESS AMONG HEALTH CARE WORKERS IN SELECTED HEALTH CARE CENTRES IN OSUN STATE.

INTRODUCTION
Stress has been defined in different ways over the years. Originally, it was conceived of as pressure from the environment, then as strain within the person. (Michie, 2002). According to Mojoyinola (2008), Stress is derived from the word “stringi”, which means “to be drawn tight”.

Stress can be defined as a physical or psychological stimulus that can produce mental tension or physiological reactions that may lead to illness. According to Sauter (1999), Occupational stress is defined as the harmful physical and emotional responses that occur when the requirement of the job do not match the capabilities, resources or need of the worker. Thus, stress is more likely in some situations than others and in some individuals than others. Stress can undermine the achievement of goals, both for individuals and for organizations. (Michie, 2002).

In Canada, 30.8% of employees confirm that most of their working days are considerably or extremely stressful (Biron, Cooper, & Bond, 2008). More than 10% of total claims for occupational diseases are attributed to stress at work (Williamson, 1994). There are a variety of stress factors in the workplace of healthcare workers that have been shown to increase the risk of distress and burnout such as increasing workload, emotional response to contact with suffering and dying patients, and organizational problems and conflicts (McNeely, 2005). In addition, many studies have shown that levels of dissatisfaction, distress and burnout at work are quite high in healthcare workers (Raiger 2005; Deckard 1994; Ramirez 1996).

Stress in the workplace is associated with a number of health problems in employees (Vézina, Bourbonnais, Brisson & Trudel, 2004). It is also linked to low job satisfaction, reduced
productivity (Cotton & Hart, 2003) and an increase in occupational accidents (Clarke & Cooper, 2004). These negative consequences for employees affect the success of organisations and their competitive edge in the marketplace. Even if the employer cannot protect employees from the sources of stress arising in their private lives and personal problems, he can protect them from sources of stress emerging in the workplace (Leka, Griffiths & Cox, 2003).

Most interventions to reduce the risk to health associated with stress in the workplace involve both individual and organizational approaches. Individual approaches include training and one-to-one psychology services—clinical, occupational, health or counseling. Organizational interventions can be of many types, ranging from structural (for example, staffing levels, work schedules, physical environment) to psychological (for example, social support, control over work, participation). (Michie, 2002). Organizational strategies to prevent occupational stress are quite simple; they involve the creation of a suitable working environment in terms of employment characteristics, labor relations, organizational structure and achievement of a healthy organizational culture. (Stoica, 2010)

Stress is acknowledged to be one of the main causes of absence from work (Mead, 2000). In Australia, most states report an increasing number of annual workers’ compensation claims resulting from workplace stress (Caulfield, Chang, Dollard, & Elshaug, 2004).

With regards to occupational stress management, the findings revealed that majority of the nurses in Central Hospital, Benin City sometimes went on break, carryout exercises, and relaxes in order to manage stress.

Stress and stressors are inevitable in the work place, especially in the hospital setting. Therefore, effective occupational stress management among health care workers is geared towards reducing and controlling health care workers’ occupational stress and improving coping skills at
work. It is towards this that this study focuses on finding out how health worker manage occupational related stress.

LITERATURE REVIEW
World Health Organization has viewed stress as a worldwide epidemic because stress has recently been observed to be associated with 90% of visits to physicians (Akinboye, Adeyemon&Akinboye2002). Occupational stress has been a long-standing concern of the health care industry. Studies indicate that health care workers have higher rates of substance abuse and suicide than other professions and elevated rates of depression and anxiety linked to job stress (NIOSH, 2008). Studies have revealed also that stress is the most common health problem attributed to long work hours and the incidence of stress due to overwork is on the increase(Lehmkuhl, 1999; Dehaas, 1998). The United Nations realized the magnitude of this problem as it has labeled job related stress as 20th century disease (Krohe, 1999).

Situations that are likely to cause stress are those that are unpredictable or uncontrollable, uncertain, ambiguous or unfamiliar, or involving conflict, loss or performance expectations. Stress may be caused by time limited events, such as the pressures of examinations or work deadlines, or by ongoing situations, such as family demands, job insecurity, or long commuting journeys. (Michie & Williams, 2001).

The signs and symptoms of stress can range from a major physical crisis like a heart attack, to more minor symptoms like tiredness and disrupted sleep patterns. The more serious stress-related problems usually emerge in the context of prolonged periods of exposure to intense stress. It is important therefore to be able to recognize and manage the early signs and symptoms of stress, in order to avoid the more serious effects of stress on your health and well-being. (Brunero, 2006). 

Depression, irritability, fatigue), behaviour (for example, being withdrawn, aggressive, tearful, unmotivated),thinking (for example, difficulties of concentration and problem solving) or physical symptoms (for example, palpitations, nausea, headaches). Anxiety, frustration, anger and feelings of inadequacy, helplessness or powerlessness are emotions often associated with stress (Smeltzer, 2008). If these are exhibited by a health care worker, then the customary activities of daily living will be distorted. A health care worker who is angry will find it difficult to give wholistic care to patients, this makes her negligent in her duties. Occupational stress in health care workers affects their health and increases absenteeism, attrition rate, injury claims, infection rates and errors in treating patient (Shirey, 2006).

If stress persists, there are changes in neuroendocrine, cardiovascular, autonomic and immunological functioning, leading to mental and physical ill health (for example anxiety, depression, heart disease). (Michie, 2002)

In the United States, work place stress has doubled since 1985. Approximately one third of all Americans considered job related stress as their greatest source of stress. According to a worldwide poll 82percent of respondents reported that work related pressure cause them to feel stress on a regular basis and almost one third of respondents experience stress everyday (Krohe, 1999). Lee & Graham (2001) stated that poor management is the major cause of stress.