Occupational Stress: Factors That Contribute to Its Occurrence and Effective Management
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A Report to the WORKERS’ COMPENSATION AND REHABILITATION COMMISSION Western Australia Occupational Stress: Factors that Contribute to its Occurrence and Effective Management Centre for Human Services GRIFFITH UNIVERSITY Elizabeth Kendall, Ph.D. Patricia Murphy Veronica O’Neill Samantha Bursnall August, 2000 Funded by Workers’ Compensation and Rehabilitation Commission 2000 by WorkCover Western Australia This work is copyright. Extracts from the report may be reproduced without permission, provided that the source is acknowledged. Published August 2000 ISBN 0 7307 2693 2 Publications are available from the WorkCover Internet site: http://www.workcover.wa.gov.au WorkCover Western Australia 2 Bedbrook Place Shenton Park WA 6008 Telephone: (08) 9388 5555 Acknowledgements The authors of this report would like to acknowledge the support and assistance of many people in the preparation and editing of the manuscript. In particular, thanks are due to Nicholas Buys, Ph.D., Jayne Clapton, Ph.D., Jennifer Hall, Jane Fowler, Vicky MacDonald, Greg McQueen, Ronita Neal, Tina Sandell, and John Wright. The resources, consultation and encouragement provided by Diane Munrowd, Donna Haney and Jemma Owen at WorkCover Western Australia are also gratefully acknowledged. Finally, the financial support of the Western Australian Workers Compensation and Rehabilitation Commission must be recognised as well as the opportunity they have provided to allow an investigation of work stress to be undertaken in their jurisdiction. ______________________________________________________________________________________ Occupational Stress: Causes and Management Models i Centre for Human Services, Griffith University July, 2000 Table of Contents Project Overview _______________________________________________________ 1 1. Stress in the Workplace ________________________________________________ 3 1.1 The Value of Work ________________________________________________ 4 1.2 Definitions of Work Stress __________________________________________ 5 Acute Stress ___________________________________________________________________7 Post Traumatic Stress ____________________________________________________________7 Chronic Stress__________________________________________________________________8 1.3 The Impact of Work Stress _________________________________________ 9 2. The Work Stress Process ______________________________________________ 14 3. Causative and Exacerbatory Factors ____________________________________ 21 3.1 Personal Vulnerability to Stress _____________________________________ 21 Personality Factors _____________________________________________________________22 Negative Affectivity ____________________________________________________________22 Cognitive Distortions and Negative Thinking Patterns ___________________________________24 Psychological Hardiness _________________________________________________________25 Coping Style __________________________________________________________________26 Inadequate Personal or Environmental Resources ______________________________________27 Family-Work Conflict ___________________________________________________________30 3.2 Job Demands ___________________________________________________ 30 Workload ____________________________________________________________________31 Time Pressure _________________________________________________________________32 Performance Pressure ___________________________________________________________33 Unclear Work Roles ____________________________________________________________35 Conflict at Work _______________________________________________________________36 The Emotional Demands of Work __________________________________________________38 3.3 Organisational Climate ___________________________________________ 39 Globalisation of the Economy _____________________________________________________39 The Impact of Technology________________________________________________________41 3.4 The Interaction Between Worker and Job _____________________________ 41 3.5 Organisational Culture and Socialisation______________________________ 46 3.6 The Role of Perceptions and Appraisal________________________________ 51 3.7 Human Resource Management Practices ______________________________ 55 Devolution of Responsibility in Human Resource Management ____________________________57 Lack of Job Redesign Skills _______________________________________________________60 Inadequate Performance Appraisal and Counselling Procedures____________________________61 The Demise of Unionism and Employee Participation in Decision-Making ___________________63 Failure to Adhere to Occupational Health and Safety Legislation ___________________________65 ______________________________________________________________________________________ Occupational Stress: Causes and Management Models ii Centre for Human Services, Griffith University July, 2000 3.8 The Medicalisation and Legalisation of Stress __________________________ 66 The Dominant Role of the Medical Practitioner ________________________________________67 Imperfect Diagnostic Tools _______________________________________________________68 Diagnosing Work-Relatedness_____________________________________________________74 The Statutory and Legislative Environment ___________________________________________77 3.9 Injury Management and Return to the Workplace ______________________ 80 Systemic Factors _______________________________________________________________81 Key Stakeholders_______________________________________________________________82 Delays to Return to Work ________________________________________________________83 Financial Benefits ______________________________________________________________84 Stigma of Returning to the Same Workplace __________________________________________84 Demographic Factors____________________________________________________________86 4. Management Strategies _______________________________________________ 88 4.1 Primary Prevention and Management ________________________________ 88 The Healthy Organisation ________________________________________________________90 Legislative Base for the Healthy Organisation _________________________________________93 4.2 Secondary Management Strategies___________________________________ 95 Medical Management ___________________________________________________________96 Employee Assistance Programmes__________________________________________________99 4.3 Tertiary Management Strategies ____________________________________103 Case Management _____________________________________________________________104 Injury Management ____________________________________________________________108 Disability Management _________________________________________________________110 5. Methodological Issues _______________________________________________ 111 6. Conclusions and Implications_________________________________________ 116 7. References_________________________________________________________ 120 ______________________________________________________________________________________ Occupational Stress: Causes and Management Models iii Centre for Human Services, Griffith University July, 2000 Project Overview The Western Australian Workers’ Compensation system, like many other jurisdictions, has recently undergone a major review designed to investigate spiraling costs associated with its administration. One area where costs have been found to be particularly high, regardless of the jurisdiction, is the area of occupational stress1. The Western Australian review indicated a need to focus on achieving the broad objectives of equity, early return to work and safe workplaces rather than focusing on the causes of increasing costs (Pearson, McCarthy & Guthrie, 1999). However, of all the injury types dealt with through the compensation system, work-related psychological injury (i.e., occupational or work stress) presents the greatest barrier to the achievement of these objectives because the area is plagued by conceptual confusion, practical barriers and delays. The phenomenon of increasing occupational stress was formally identified in 1989, when the Commonwealth Commission for the Safety, Rehabilitation and Compensation of Commonwealth Employees (Comcare) initiated several research projects. During the subsequent decade, prolific writings have emerged about occupational stress. An abundance of precipitating or exacerbating factors have been identified and a multitude of management programmes have been initiated. During the same period, the percentage increase in claims for work-related psychological injury has been greater than any other injury (Pearson et al., 1999). Although this increase may reflect factors such as changing legislation or increased reporting, the juxtaposition of increasing claims against the increasing level of knowledge is both alarming and counter-intuitive. Despite the volume of literature that is available about work stress, few definite conclusions can be drawn because of: (1) the elusive nature of 'work stress' as a concept; (2) methodological issues in the identification of contributing factors; (3) inadequate evaluation of management strategies; and (4) failure to consider the continuum from ______________________________________________________________________________________ Occupational Stress: Causes and Management Models 1 Centre for Human Services, Griffith University July, 2000 prevention to return to work as a coherent, single entity rather than dealing