Primary Interventions for Work-Related Stress
1) The Worksite Profile
2) The Risk Management Framework for Work-related Stress
3) Stress prevention in an airport management company (using stress working groups)
4) Open Rota System for Work Scheduling
5) Health Circles
6) SMEs Vital
7) The Prevenlab-Psicosocial Methodology
8) Healthy working for health - using the WEBA method
9) Organisational interventions in the service sector
10) Survey feedback as a method of stress management
Author(s): Inga-Lill Petterson and Lena Backman Country: Sweden
Is the intervention sector specific?
Is the intervention usable with different enterprise sizes?
Is the intervention equally applicable to both genders?
Is the intervention based on theory?
Can the intervention approach be adapted/ tailored?
Does the intervention promote CSR and how?
Yes, the intervention promotes responsible business practices. All three stages of the interventions are based on employee participation and require impetus from the management of companies to be successful.
Does the intervention promote social dialogue and how?aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
The user is encouraged to return the results of the questionnaire to all the group members and then discuss the results. The dialogue between the members enables them to find out what is most important to improve in the work environment and helps them to identify ways to achieve the goal.
Overview (including risk assessment and law – legal requirements etc.):
The Worksite Profile method is a self-instructive tool (in a CD-package) with a questionnaire and instructions to improve the work environment and health of employees in occupational settings. It facilitates Systematic Work Environment Management (SWEN), which involves:
· Making such decisions and taking such measures in the course of everyday work that employees are not injured, do not become ill and are not harmed in any other way.
· This means observing and considering both psychological and social conditions, as well as work environment issues of a “technical” nature.
· Work environment management also applies to work not done at a permanent workplace, e.g. transport work or work in other people’s homes.
According to the Swedish Work Environment Act, SWEN is the responsibility of the employer. The aim of the Worksite Profile is to get employees and managers involved to participate in the development and improvement of their own work conditions. The questionnaires have been developed based on extensive research. The intervention is easily applicable and used at a practical level. The method is prepared for self-administration. All instructions needed are included in the CD-package. The self-instructive method has been used by for example Occupational Safety and Health Services, the Swedish Church and smaller enterprises.
The intervention is carried out in three steps:
(a) Competence programme: The first activity, a competence and training programme, is directed towards a selected group of employees.
(b) Worksite competence circles: The second activity is directed to all worksite staff, the aim of the competence circles is to initiate a learning organisation, &
(c) Local worksite projects: The target of the third activity is the separate worksites and the organisation. As part of the third step, worksite improvement projects, project plans are elaborated jointly by the participating employees.
Each step is a separate activity, connected by a main thread, and implemented successively, each activity being a necessary basis for the next step. Different activities are directed towards the individual, the worksite, and the organisation. As a tool to initiate and stimulate discussions across occupational groups and to assess the stressors, each unit uses the feedback of their baseline questionnaire results, presented as local work quality profiles. The questionnaire is comprehensive, including more than 100 questions about work demands, job control, support, evaluations of quality of care, musculoskeletal, psychosomatic, and stress symptoms, well-being, and measures of personal resources, such as coping, self-esteem, and mastery. Most of the questions have been used in research and some of the scales are internationally known and well established.
Local reference groups, consisting of the unit manager, the project co-ordinator, the innovation leaders (those who undergo the competence and training programme), and representatives of employee groups, support the projects on the worksite level. A support network of all innovation leaders and unit managers is created at the organisational level. The started projects generally refer to issues such as introduction of new employees, quality development, the meaning of quality to employees, customers, routines for staff meetings and communication, and communication between personnel.
The method can be handled within an organisation. It is easily applicable and used at a practical level. The method is prepared for self-administration and all instructions needed are included in the CD-package.
The questionnaire has been designed so that it can be distributed as a web-based questionnaire if required.
Evaluation (including process issues, outcomes and sustainability):
The Worksite Profile method has been tested in different occupational sectors and at different organisational levels. The method has been evaluated regarding the validity of the questionnaires and regarding the usefulness of the method for Systematic work environment management. The questionnaires have face validity. Using the method, two key factors have been found to be important; time for discussions at the worksite and manager engagement. The method has also been found to be less useful in organisations that faced lack of time and non-engaged managers.
The intervention effects have evaluated in some studies by a comprehensive questionnaire prior to (baseline) and after (follow-up) the intervention. In some cases, research teams, not involved in the implementation, have evaluated the effects of the intervention by questionnaires before and after the programme, using a wide range of measures. The method has been found to be effective leading to sustainable outcomes.
Benefits (including cost effectiveness):
The method is flexible and can be tailored to suit the organisation. The CD-package is economical thereby making it possible for smaller workplaces to buy it.
Petterson, I.L., Donnersvärd, H.Å., Lagerström, M. And Toomingas, A. (2006). Evaluation of an intervention programme based on empowerment for eldercare nursing staff', Work & Stress, 20(4), 353- 369.
The Swedish Work Environment Authority (2003). Systematic work environment management: Guidelines. Work Environment Authority, Publication Services. ISBN 91-7464-432-7. Also available at: http://www.av.se/dokument/inenglish/books/h367eng.pdf
Time for discussion at the worksite and manager engagement are essential for the success of this intervention. Employee feedback is an essential element of the method and is required in all three stages of the intervention. The Worksite Profile method requires impetus from management of companies to be successful. The authors recommend the user to do investments in special consultations to make improvements of the work situation if needed.
Author(s): Tom Cox, Raymond Randall & Amanda Griffiths Country: United Kingdom
The risk management process is based on dialogue and collaboration of management, workers and other key stakeholders. A steering group is central in the process. The main responsibility of this group is overseeing and facilitating the process. Typically, this group is comprised of management, staff representatives (or union representatives), occupational health, health and safety and human resources specialists.
In the UK, the Management of Health and Safety at Work Regulations 1992 and its revision in 1999 require employers to undertake assessments for all risks to health. Managers were advised by the Health and Safety Executive (1995) to include work-related stress in their assessment of risks. This would fulfil both UK and European legal obligations that ask employers to assess and manage any type of risk to workers’ health, including psychosocial risks. The risk management process is driven by active participation of employees in a series of stages: familiarisation (including the formation of the steering group and workplace visits), risk assessment (using methods such as surveys, group discussions and individual interviews), audit of management systems and employee support, action innovation (defining risk reduction interventions on the basis of the risk assessment results) and evaluation). The process promotes a continuous improvement cycle. The tools and methods used to conduct an effective risk assessment are tailored to the size of the group and the nature of the work in the organisation.
At the beginning of the risk management process, a steering group should be established. The central responsibility of this group is overseeing and facilitating the risk management process. Typically, this group is comprised of management, staff representatives (in some cases union representatives), occupational health, health and safety and human resources specialists. Publicity of the risk management project is of central importance; this ensures transparency of the process and recruits the widespread involvement of the organisation. Prior to commencing risk management, considerable consultation between stakeholders and experts should be conducted; with a concentrated focus of setting appropriate expectations, schedules and identifying communication channels.
Risk Assessment: The aim of the risk assessment stage is to identify, for a defined group, significant potential sources of stress (psychosocial hazards) relating to employees’ work and working conditions; and examine their overall indices relating the health of the individual and the organisation. Subsequently, an audit of management systems and employee support is conducted which identifies and assesses current management systems in relation to the control and management of the hazards and the experience of work-related stress, and in relation to the provision of support for employees experiencing problems.
Translation / Action Innovation: The results of the risk assessment are fed back to the organisation and the steering group, which form the basis of discussion among the stakeholders. This information, and the resulting discussion, is used to develop a plan of action (i.e., a package of interventions) that are reasonable and practicable; the aim of which is to reduce likely risk factors for stress in at work. These are also discussed with workers so as they are actively involved in the design of the interventions and have ownership of the actions to be taken.
Intervention/ Risk reduction: Developing an action plan involves deciding upon what is being targeted, the methods being used, those responsible, the proposed time schedule, the resources required and how the intervention will be evaluated. The primary aim of the action plan is in reducing likely risk factors that have the potential to cause stress. The change initiatives identified through this process, can be integrated into existing management plans for change; thus, minimising the degree of disruption within the organisation.
Evaluation: The next step in the risk management process is the evaluation of the action plan.
The risk management framework has been used effectively to identify and reduce work-related stress (psychosocial hazards) in a number of organisations. It is applicable in large enterprises as well as SMEs.
The process is driven by active participation of employees through all stages, including intervention design. A number of methods are combined in the risk management process. The evaluative step in the risk management process addresses the question of whether the intervention was effective in reducing stress and it allows for the reassessment of the situation and the identification of further problems needing to be addressed. This process of reassessment feeds into a cycle of continuous improvement within the company; thereby yielding a basis for organisational learning.
The objectives of the evaluation stage are to determine: whether the intervention was implemented effectively, and whether the intervention had any impact on the problems identified during the risk assessment. This can be accomplished through several methods, which can be tailored/adapted to size of the group being assessed and the nature of work in the particular organisational context. Several evaluation tools can be utilized: interviews with key stakeholders, interviews with staff, surveys (including measures of work and well-being used in the risk assessment), group discussions and review of organisational data. The evaluation tools contain three elements, each of which yields important information, specifically, they measure: the level of awareness, participation and reaction to the intervention; the impact of the intervention of changes to working conditions; and whether the intervention has made an impact on the health and wellbeing of employees.
A number of benefits have been demonstrated of the risk management intervention in research and implementation in organisations. The majority of groups involved in the risk management process improved their working conditions, and employees’ reactions to the risk management interventions have been favourable and generally positive. There were observed positive trends towards improvement of employee wellbeing. Additional benefits were observed in regards to the risk management process. Firstly, it was seen as a useful tool for stimulating new ideas and ways of thinking about problems. Secondly, it quantified problems, which could be used to inform prioritisation of the identify issues and the required resources required. Thirdly, it focused efforts and actions to promote a coherent and targeted approach to action. Finally, it yielded a framework for evaluating progress and monitoring change – a strategy that could be used to evaluate employees’ planned and unplanned change.
Cox, T., Randall, R., & Griffiths, A. (2002) Interventions to control stress at work in hospital staff. HSE report 435 Norwich: HSE books. See www.hse.gov.uk/research/crr_pdf/2002/crr02435.pdf
Guiding principles: In planning the risk management there are several guiding principles and practical issues of importance:
· Work with defined groups: each risk assessment is carried out within a specified and defined group (a department, company or profession).
· Focus on work not the individual: The aim of risk assessment is to identify the aspects of work giving rise to stress, not the individuals experiencing stress.
· Focus on ‘big issues’: the focus is on problems that staff agree on that staff agree on, rather than individual complaints.
· Use of reliable measures: all methods of data collection are designed to be reliable and valid.
· Confidentiality of information given by employees must be guaranteed; thus, data collected must be stored securely and not disclosed.
Risk reduction as a goal: risk assessment tools are designed to provide sufficient detail and context-specific information to allow for intervention design.
Author(s): Richard Wynne & Rose Rafferty Country: Ireland
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In 1989, the Irish Safety Health and Welfare at Work Act was enacted and the Health and Safety Authority was established. Although the legalisation does not directly require employers to act upon occupational stress, its provisions concerning the work environment and working methods do, in effect, cover/ address the psychosocial working environment and, in turn, work-related stress. This legalisation requires employers to do everything reasonably practicable to ensure and protect the health and safety of their employees; this has been interpreted to cover occupational stress.
The impetus for the airport management company to address work-related stress was due to the concerns voiced by employees within the organisation to upper level management. To address this, the company established a group within the organisation known as the ‘stress working group’. The aim of this group was fourfold: firstly, to investigate the issues of stress within the organisation; secondly, to identify the origins and causes; thirdly, to formulate an action plan; and lastly, disseminate information for individuals coping with stress to promote enhanced coping and effective management. This last objective was achieved by developing a booklet, with the assistance to external help agencies, to be published and subsequently distributed to all staff members.
In order to achieve the first three objectives it was decided to undertake a survey. This survey was conducted in two phases:
(1) Piloting the survey: Developing the pilot questionnaire involved two processes. In the first process, a questionnaire was proposed that broadly examined sources of stress, coping health-related behaviours and outcomes of stress. The second phase, involved extensive discussion with the “stress working group” to tailor the questionnaire to the needs and requirements of the organisation and its specific situation. The results of the survey were analysed and the appropriate modification to survey were made.
(2) Survey: The instrument was widely distributed throughout the organisation. The survey was comprehensive and covered the following areas: personal and work-related demography, sources of stress at work, personal life events, coping styles, social support at and outside work, physical health status, psychological wellbeing status, health-related behaviours, and job satisfaction. The survey was constructed based on a series of established scientific measures; however, most of these scales were augmented with additional questions to respectively tailor the questionnaire to the organisation’s specific situation. The survey was used to identify the main psychosocial features of the work environment which were related to reduced health and well being. Additionally, the analysis concentrated on characterising the experience of stress for specific groups in the workforce (e.g., identify ‘at risk’ groups, examining gender, age, company departments, shift work, and grade levels).