ORIENTATED HEALTH PROMOTION

Orientated Health Promotion



Orientated Health Promotion

Introduction

Occupational stress is quickly becoming the single greatest cause of occupational disease (Leigh and Schnall, 2000) and can have far-reaching consequences for both the worker and the workplace. Occupational stress occurs when external demands and conditions do not match a person's needs, expectations or ideals or exceed their physical capacity, skills, or knowledge for comfortably handling a situation (French et al., 1982). For employees, chronic exposure to stressful situations such as work overload, poor supervisory support and low input into decision-making have been cross-sectionally and prospectively linked to a range of debilitating health outcomes, including depression, anxiety, emotional exhaustion, immune deficiency disorders and cardiovascular disease [e.g. (Michie and Williams, 2003; Sapolsky, 2003)]. Stressful working conditions can also have an indirect impact on employee well-being by limiting an individual's ability to make positive changes to lifestyle behaviours (e.g. smoking, sedentary behaviour) or by directly contributing to negative health behaviours (Landsbergis et al., 1998).

Chronic job stress is also considered to be a major barrier to effective organizational functioning. Occupational stress contributes to a number of outcomes that are critical to organizational success, including absenteeism, labour turnover and job performance [e.g. (Dollard et al., 2000; Michie and Williams, 2003)]. Industry overall has suffered considerable losses as a result of occupational stress and, in the UK alone, job stress has been estimated to cost employers between £353 and £381 million pounds per year (1995/1996 prices) (HSE, 1999). The estimated number of days lost due to stress has more than doubled since these calculations were undertaken (Jones et al., 2003) and, in an era of heightened downsizing, work intensification and resource rationalization, this trend appears set to continue (Sparks et al., 2001). The human and economic costs of job stress strongly suggest that it is in everybody's interests—employees, employers and the community at large—that stress prevention/reduction initiatives are high on the agenda of any workplace health promotion (WHP) programme.

Whilst there is evidence that employee stress is often the target of WHP, reviews of job stress interventions indicate that the strategies used to combat stress at work are generally limited to the individual-orientated approach (EASHW, 2002; Giga et al., 2003; Caulfield et al., 2004). This approach has been widely condemned and the first half of this paper will outline the major criticisms that have been directed at strategies that focus solely on individual employees. This section will also examine the impact of work-based sources of stress and outline the benefits of adopting a more comprehensive set of initiatives that simultaneously address the worker and the workplace. The remainder of this paper will then examine the role that WHP practitioners can play in developing comprehensive job stress prevention programmes.

INDIVIDUALLY ORIENTED STRESS MANAGEMENT PROGRAMMES

Worker-directed WHP strategies typically focus on the health-related attitudes and behaviours of individual employees and aim to provide them with information and guidance on how to adapt to, or manage, the pressures and demands faced in everyday work life. Stress management interventions that target the individual include one-to-one ...