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      Perceptions of work stress causes and effective interventions in employees working in public, private and non-governmental organisations: a qualitative study

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          Abstract

          Aims and method

          To identify causes of stress at work as well as individual, organisational and personal interventions used by employees to manage stress in public, private and non-governmental organizations (NGOs). Qualitative interviews were conducted with 51 employees from a range of organisations.

          Results

          Participants reported adverse working conditions and management practices as common causes of work stress. Stress-inducing management practices included unrealistic demands, lack of support, unfair treatment, low decision latitude, lack of appreciation, effort–reward imbalance, conflicting roles, lack of transparency and poor communication. Organisational interventions were perceived as effective if they improved management styles, and included physical exercise, taking breaks and ensuring adequate time for planning work tasks. Personal interventions used outside of work were important to prevent and remedy stress.

          Clinical implications

          Interventions should improve management practices as well as promoting personal interventions outside of the work setting.

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          Most cited references31

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          Adverse health effects of high-effort/low-reward conditions.

          J Siegrist (1996)
          In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
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            The benefits of interventions for work-related stress.

            This quantitative meta-analysis sought to determine the effectiveness of occupational stress-reducing interventions and the populations for which such interventions are most beneficial. Forty-eight experimental studies (n = 3736) were included in the analysis. Four intervention types were distinguished: cognitive-behavioral interventions, relaxation techniques, multimodal programs, and organization-focused interventions. A small but significant overall effect was found. A moderate effect was found for cognitive-behavioral interventions and multimodal interventions, and a small effect was found for relaxation techniques. The effect size for organization-focused interventions was nonsignificant. Effects were most pronounced on the following outcome categories: complaints, psychologic resources and responses, and perceived quality of work life. Stress management interventions are effective. Cognitive-behavioral interventions are more effective than the other intervention types.
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              A typology of actions to tackle social inequalities in health.

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                Author and article information

                Journal
                BJPsych Bull
                BJPsych Bull
                pbrcpsych
                BJPsych Bulletin
                Royal College of Psychiatrists
                2056-4694
                2056-4708
                December 2016
                : 40
                : 6
                : 318-325
                Affiliations
                [1 ]Barts and The London School of Medicine and Dentistry
                [2 ]BPP University, London
                Author notes
                Correspondence to Kamaldeep Bhui ( k.s.bhui@ 123456qmul.ac.uk )

                Kamaldeep Bhui is Professor of Cultural Psychiatry and Epidemiology, Barts and The London School of Medicine and Dentistry, Wolfson Institute of Preventive Medicine, Centre for Psychiatry, London. Sokratis Dinos is Programme Lead in Psychology, BPP University, School of Health, Department of Psychology, London. Magdalena Galant-Miecznikowska is a trainee CBT therapist, Bertine de Jongh is a psychologist and psychotherapist and Stephen Stansfeld is Professor of Psychiatry, all at Barts and The London School of Medicine and Dentistry, Wolfson Institute of Preventive Medicine, Centre for Psychiatry, London.

                Article
                10.1192/pb.bp.115.050823
                5353523
                28377811
                8bec5d34-2b19-4523-a230-249d6a36e36a
                © 2016 The Authors

                This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 February 2015
                : 22 February 2016
                Categories
                Original Papers

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