A Study of stress levels amongst health care staff working in two older persons institutions using the effort reward imbalance model.

Abstract

Research suggests that working III older people rehabilitative institutions is perceived as a stressful situation. The Effort Reward Imbalance Model (Siegrist 2004) guided the study. A cross-sectional descriptive correlation design has been adopted to investigate the frequency and intensity (incidence) of the occupational stressors experienced by employees working in two older persons institutions and their association with the Effort Reward Imbalance model theory of well being and job satisfaction. It also sought to identify significant differences between the employees' demographic variables and their perception of stress. The sample consisted of a total population of employees (n=200) working on full-time bases in these two institutions in Malta. A 71 % (n=142) response rate was obtained. Data were collected by means of a questionnaire and focus groups carried out between ten representative employees. The questionnaire was piloted and tested for its content validity. Descriptive and inferential statistics were used to analyze the quantitative data while content analysis was used to analyze the qualitative data. The findings of this study indicated that employees frequently encounter and suffer from intense stress. The most 'frequent' and 'intense' stressors reported by employees were oriented mainly towards the management, extrinsic demands, low rewards, and to intrinsic issues. In accordance with the Effort Reward Imbalance Model (Siegrist 2004), findings showed a significant association of these variables to individual well being and also significant difference in employees' perception of stress and certain demographic variables such as gender, job category, experience and working roster. These findings suggest that stress appraisal may be an individual phenomenon (Lazarus & Folkman, 1984). Well being was strongly positively related to both the 'frequency' and 'intensity' of the stressors encountered by these employees. The overall results suggested that health amongst health care workers was found high and significantly correlated with stress. The reasons given the respondents in the qualitative data referred to extrinsic and intrinsic demands, interpersonal relationships and issues with low rewards especially esteem rewards. In an attempt to reduce employee' stress in such environments the main recommendations were to have adequate staffing, policies to decrease stress from workload, a more decentralised and supportive management, creating a conducive and healthy work environment and organising educational programmes on leadership and management training.