Psychosocial Resources in Health Care Systems

Towards Strategic Stress Management in the Workplace: Stress in Medical Doctors’ Professions ( P. 97)

Anna B. Leonova

The increasing complexity of modern working life requires that there is a corresponding change in psychological practices in the health promotion area. Besides the post hoc treatment of job related disorders, there has recently been an intense effort to develop preventative strategies and paradigms (Karasek &, Theorell, 1990, Leonova et al., 2001, Quick et al., 1998). Helping a worker to be more resistant to work demands, improving the personal resources available to cope with difficulties and reducing potential risk factors in the work environment are the main features of this development.

The dominant question within this productive approach to the problem of stress management is "How can we support workers’ long-term health and efficiency?" The first practical step in the realization of this approach is the development of stress management tools, which can be practically implemented in the workplace. The second step is to diagnose the individual manifestations of stress in order to develop preventive/corrective solutions.

This paper describes a new tool developed in the Laboratory of Work Psychology at Moscow State University. The theoretical basis of the instrument, data from two validation studies (with a German and a Russian samples) and an example of one of the first investigations conducted with two groups of medical doctors, working in different organizational structures, are presented.

A conceptual framework for integrative stress management research

To a large extent, the construction of diagnostic and preventive measures for stress management programs depend on the conceptual viewpoint of the authors, what the nature of the stress phenomena is, and how these phenomena can be operationally defined. In contemporary theories, one finds wide variation in the definition of stress and in the approach to its evaluation.

Besides the classical dilemma, which consists of defining stress as either (1) a set of extraordinary factors that lead to difficulty in executing behavioural tasks or (2) the individuals’ state evoked by a difficult situation (Cox &, Mackey, 1981, Hockey, 2003), several new positions have been proposed during the two last decades.

These developments in the approach to stress mainly concern the analysis of the intermediate factors, which contribute to the development of stress reactions and their consequences for workers’ well-being and mental health (e.g., Karasek &, Theorell, 1990, Parkes, 1994, Siegrist &, Peter, 1994, Warr, 1994). As a result, at least 10 substantiated theories are currently in use in the field of occupational and organizational stress research (for a review, see Cooper, 2000).

At first sight, the diversity of definitions and paradigms seems to infer ambiguity and vagueness in the basic concept of stress. From this point of view, "stress" is merely a common label for a heterogeneous mosaic of empirical problems and facts. However, a closer inspection reveals that the various models of stress seem to be relatively well integrated.

There is a consistent logic among the models, although they often concentrate on different domains or use different levels of analysis of stress-related events: risky environments or stress agents, modes of coping with stress, short- and long-term patterns of stress responses, accumulation of negative stress outcomes, etc. (Cooper, 2000, Warr, 1994).