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TITLE PAGE CATHOLIC UNIVERSITY COLLEGE OF GHANA, FIAPRE
FACULTY OF ECONOMICS AND BUSINESS ADMINISTRATION
STRESS MANAGEMENT: ITS IMPACT ON THE PERFROMANCE OF PUBLIC
HEALTH WORKERS: A CASE STUDY OF THE SUNYANI REGIONAL HOSPITAL.
A DISSERTATION SUBMITTED TO THE FACULTY OF ECONOMICS AND BUSINESS
ADMINISTRATION IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE
AWARD OF BACHELOR OF SCIENCE DEGREE IN ECONOMICS AND BUSINESS
ADMINISTRATION.
BY
ARHIN, OWUSU NANA YAW
JUNE, 2012
I
DECLARATION I, Arhin Owusu Nana Yaw, hereby declare that, except for reference to other people’s work
which has been duly acknowledged, this dissertation consists of my own work produced from
research undertaken under supervision and that no part of its has been presented for any degree
elsewhere.
Signature……………………….... Date…………………………
Name of Student Arhin, Owusu Nana Yaw
Supervisor’s Declaration
I hereby declare that, the preparation and presentation of the dissertation were supervised in
accordance with the guidelines on supervision of dissertation laid down by the Catholic
University College of Ghana, Fiapre.
Signature…………………………. Date…………………………..
Name of Supervisor Mr. G.L. Opoku-Antwi
II
DEDICATION This dissertation is dedicated to my mother, Florence Millicent Hagan and my father, Nana
Ahenkorah IV.
III
ACKNOWLEDGEMENT My greatest appreciation goes to the Almighty God for giving me life to carry out this research
and seeing me through out my education successfully.
My profound gratitude goes to my mothers Aunt Theresa and Kukua for contributing to my
education and well being.
Many thanks to my supervisor Mr. G.L. Opoku-Antwi for guiding and assisting me in carrying
out this research.
Finally, I am really grateful to the staff of the Catholic University of Ghana for their cooperation
during this study and also to all the respondents to the questionnaires of the study at the Sunyani
Regional Hospital, Sunyani, who helped this dissertation to a successful end
IV
V
TABLE OF CONTENTS
VI
TITLE PAGE I .....................................................................................................
DECLARATION II .................................................................................................
DEDICATION III ..................................................................................................
ACKNOWLEDGEMENT IV ........................................................................................
TABLE OF CONTENTS VI ........................................................................................
ABBREVIATIONS VIII .............................................................................................
ABSTRACT IX ....................................................................................................
CHAPTER ONE 1 .................................................................................................
INTRODUCTION 1 ...............................................................................................
1.1 Background Information 1 .............................................................................
1.2 Statement of the Problem 2 ...........................................................................
1.3 Objectives of the Study 4 ..............................................................................
1.4 Research Questions 4 ...................................................................................
1.5 Significance of the Study 4 ............................................................................
1.6 Limitations of the Study 5 .............................................................................
1.7 Organization of the Chapters 6 .......................................................................
CHAPTER TWO 7 ................................................................................................
LITERATURE REVIEW 7 .........................................................................................
2.1 Introduction 7 ...........................................................................................
2.2 Conceptual Framework 8 ..............................................................................
2.3 Empirical Evidence 16 ..................................................................................
2.3.1 Stress Management 17 ...........................................................................
CHAPTER THREE 19 ............................................................................................
METHODOLOGY 19 ..............................................................................................
3.1 Introduction 19 .........................................................................................
3.2 Background of Study Area 20 ..........................................................................
3.3 Study Type 22 ............................................................................................
3.3.1 Case Study 22 .......................................................................................
3.3.2 Explanatory Study 22 ..............................................................................
3.4 Study Design 23 .........................................................................................
3.5 Study Variables 23 ......................................................................................
3.5.1Performance of Public Health Workers 23 .....................................................
3.5.2 Stress Management 24 ...........................................................................
3.6 Population, Sample Size and Sampling Technique 24 ..............................................
VII
ABBREVIATIONS Reg – Regional
Dir – Director
Hosp – Hospital
DDNS – Deputy Director of Nursing Service
3.7Data Collection Method 25 .............................................................................
3.8 Data Analysis Method 26 ..............................................................................
3.9 Ethical Considerations 26 ..............................................................................
CHAPTER FOUR 28 ..............................................................................................
PRESENTATION AND ANALYSIS OF DATA 28 ...................................................................
4.1 Introduction 28 ..........................................................................................
4.2 Presentations and Analysis of Data 28 ...............................................................
4.3 Summary of Findings 39 ................................................................................
CHAPTER FIVE 41 ...............................................................................................
CONCLUSION AND RECOMMENDATION 41 ....................................................................
5.1 Conclusion 41 ............................................................................................
5.2 Recommendations 42 ...................................................................................
REFERENCES 44 .................................................................................................
APPENDIX 47....................................................................................................
VIII
A & E – Accident and Emergency
OPD – Out Patients’ Department
Lab – Laboratory
Physio – Physiotherapy
Obs/Gynae – Obstetrics/Gynaecology
Gen Admin – General Administration
HRA – Human Resource Audit
Environ – Environmental
Equip – Equipment
PRO – Public Relations Office
Acct – Accounting
PHU – Public Health Unit
VIP – Very Important Person
ABSTRACT In modern life, stress is a common problem. The negative and positive effects of stress affect
individual’s health and performance. As a result, individuals and institutions have their own
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stress perceptions and they develop different kinds of strategies in order to manage stressful
situations.
Therefore, this study focuses on the impact of stress management on the performance of public
health workers at the Sunayni Regional Hospital. The research design is based on an evaluating
study which has the purpose of examining the contribution of stress management mechanisms on
the services rendered by the Regional Hospital, Sunyani. The sample includes all health workers
at the Sunyani Regional Hospital. The research used questionnaires as a form of data collection
for the study.
The main findings of this study identified that stress from patients/clients, work and family is a
major cause of stress in the hospital. On the other hand, the health workers in the institution
identified awareness building as a widely accepted and used mechanism in the institution when
stress occurs. Also, the workers in the establishment consider stress as occurring frequently in the
hospital; thus listening to music, exercise, meditation and reading is a technique the workers use
to manage stress when it occurs in their various departments.
The study recommends that stress needs to be managed optimistically and positively in any
scenario and management should filter it down to subordinates for a positive sense of feeling in
them.
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CHAPTER ONE
INTRODUCTION
1.1 Background Information
In this difficult economy, many employees are finding it harder than ever to cope with stress in
the workplace. Regardless of occupation, seniority or salary level, they are spending more and
more of their work days feeling frazzled and out of control, instead of alert and relaxed.
Stress is defined in terms of its physical and physiological effects on a person and can be a
mental, physical or emotional strain (Marshall and Cooper, 1981).While some stress is a normal
part of the workplace, excessive stress can interfere with the productivity of the firm and reduce
physical and emotional health.
Stress is simply a fact of nature -- forces from the inside or outside world affecting the
individual. The individual responds to stress in ways that affect the individual as well as their
environment. Because of the overabundance of stress in our modern lives, employees usually
think of stress as a negative experience but from a biological point of view, stress can be a
neutral, negative or positive experience (Stranks, 2005).
In general, stress is related to both external and internal factors. External factors include the
physical environment, including employees’ job, employees’ relationships with others, home,
and all the situations, challenges, difficulties and expectations employees are confronted with on
a daily basis. Internal factors determine an individual’s body ability to respond to and deal with
the external stress-inducing factors. Internal factors which influence an individual’s ability to
1
handle stress include an individual’s nutritional status, overall health and fitness levels,
emotional well-being and the amount of sleep and rest an employee gets.
Stress management is the ability to maintain and control situations when people and events make
excessive demands. For instance, in our public health organizations, health workers in that
organization do not know how to control excessive demands at their workplace, either from their
bosses, fellow working colleagues or patients.
Although life provides numerous demands that can prove difficult to handle for the public health
workers, stress management is the best way to manage anxiety and maintain overall well-being.
Some of these stress management techniques may include, public health workers reducing the
number of events going on in their lives; looking around and seeing if there is something they
can do to control the situation; giving themselves a break if only for a few moments daily; trying
to prioritize a few truly important things and the rest slide, getting enough sleep; participating in
physical activity like jogging. Stress is one of the drivers for improved job performance. If
managed well, stress can lead to enhanced work output and more creative ideas from the
individual. If managed badly, it can lower job performance and hinder individuals from
achieving their personal goals (Woodham, 1995)
1.2 Statement of the Problem Health institutions in Ghana have contributed immensely to the health sector of the country by
rendering services to citizens who need health treatment. The hardships and woes of every health
institution are to overcome its flaws and be able to outmanoeuvre their competitors and provide
citizens with the best health service or treatment they are yearning for. One of the flaws of most
health organizations is the problem of stress within its establishment and how it is managed.
2
Most health institutions encounter stress related problems in their establishment which leads to
low job performance, increases in management pressure and makes the health workers ill in
many ways.
The Regional Hospital, Sunyani, as a health institution has contributed to the development of the
health sector by providing the citizens with services and pharmaceutical products that they need
for their daily activities. Though the regional hospital strives to satisfy the citizens, they also
experience some amount of stress related problems within their establishment which when not
considered will affect job performance and the goodwill of the health institution. In order for
them to meet their citizens’ demand and service to move on smoothly, they should also focus on
establishing friendly relationship between the management and the employees. One major
problem that most health organizations face is normally over looked is the stress situation within
their establishment. There are normally stress problems when a health worker lacks job security,
long working hours and excessive time away from home and family.
The study is designed primarily to inquire how the management of Regional Hospital, Sunyani
goes about solving stress related problems within its organization. Also, the study seeks to
identify the mechanisms Regional Hospital adopts to manage stress and if it is of any
significance to the health organization and how it contributes to improving the operations of the
institution.
3
1.3 Objectives of the Study The primary objective of the research is to ascertain the impact of stress management on the
performance of public health workers. The other specific objectives are:
▪ To identify the causes that lead to stress in the institution.
▪ To find out the type of stress that is most prevalent in the institution.
▪ To identify the mechanisms that Regional Hospital uses in solving stress related problems
within the various departments.
1.4 Research Questions
Based on the above listed objectives, the research questions were extrapolated from the
objectives as follows:
▪ What are the causes that lead to stress in the hospital?
▪ What forms of stress is prevalent in the hospital?
▪ How does the hospital solve stress related problems in the departments?
1.5 Significance of the Study This study is beneficial to the following:
▪ Individuals
▪ All Health Institutions
▪ Human Institutions
4
The study sensitizes all institutions on the relevance of stress management and how it contributes
to the performance and growth of most institutions. It also sensitizes individuals to learn how to
manage stress personally so that they do not replicate it in their various working environment.
Stress is a symptom which is mostly under estimated by many institutions but that should not be
the case because workers are expected to be in their right frame of mind and free from stress to
be able to increase productivity and render the best of service to its clients.
Also the study makes recommendations to the public health workers on how to manage stress
effectively so as to improve upon their service delivery to patients and also for other health
institutions to emulate. The study will serve as a source of reference for further research in stress
management.
1.6 Limitations of the Study There were some limiting factors as far as researching into this topic. The researcher had
difficulties in gathering materials on matters of stress from the institution since such records
were not available. Again, the raising of finance for the research was also a constraint and the
lack of responses especially on the open ended questions was a threat to the research since some
respondents were not able to express their perception of stress.
However, not withstanding all the limitations, the various responses received represent a true and
fair view of the respondents and are free from biases. It is hoped that the study will be beneficial
to other areas outside the study and also be used as a guide and reference material by future
researchers.
5
1.7 Organization of the Chapters This research is made up of four chapters. Chapter one which is the introduction includes the
background information, statement of the research problem, objectives of the study, research
questions, significance of the study, limitations of the study and the organization of the chapters.
The second chapter of this study contains the literature review which is further sub-divided into
two segments to entail the conceptual framework or theories and the empirical evidence of
related works. The next chapter which is the methodology will consist of the background
information of the study area, study type, study design, study variables, population, sample size
and sampling technique. Also this chapter comprises of the data collection and analysis methods
and ethical considerations. Lastly, the fourth chapter of this study will involve the presentations
and analysis of data, summary of major findings, conclusions and recommendations.
6
CHAPTER TWO
LITERATURE REVIEW
2.1 Introduction Every research should involve the review of literature on the topic under study. This chapter is
aimed at capturing the relevant theories written by authors concerning the issue of stress and how
they are managed in various institutions. This chapter also highlights the various views of writers
on the concepts of stress and its management. The review of relevant literature is categorized
into conceptual framework and empirical evidence. The conceptual framework analyzes the
concepts or theories propounded by various writers on the issue of stress management.
7
2.2 Conceptual Framework The need for stress management mechanism in every human establishment is very important
because stress is an integral and inevitable part of the employer or employee in an establishment.
There is therefore, the likelihood for stress to occur. According to Marshall and Cooper (1981),
‘stress’ is different from ‘pressure’. Stress is more than mere pressure. It carries strong overtones
of the breakdown of normal human performance. If the requisite measures are not put in place to
handle stress, it can affect the job performance of the organization. Cooper & Marshall (1981),
points out that ‘stress is essentially individually defined and must be understood with reference
to characteristics of both the individual and his environment, as it is the outcome of the two’.
These writers hold the view that difference in human activities such as lack of sleep, time
pressure and different form of stress from the external environment like extreme temperature or
lighting and exposure to threat or danger tend to produce physiological responses within the
body which can affect the individual performance. Stress occurs where there is a perceived
imbalance between pressure and coping resources for a particular situation (Cranwell-Ward and
Abbey, 2005). The main objective of the term recognizes the interaction between people
weighing up a situation, and then assessing the demands, and their perception of their ability to
meet these demands on a particular occasion. According to Williams and Cooper (2002), stress
needs to be addressed in a structured and effective manner as a part of an overall strategy for
improving the well-being of a person. When the individual successfully completes a task, by the
use of his/her resources, the stress associated with resolving this task is reduced and the
individual’s well-being is improved. On the other hand, if this task is not resolved, the
individual’s well-being will deteriorate. However, even if the conditions are appropriate for
8
stress to surface, it does not necessarily mean that it is caused, as it is the individual’s capability
to cope with the stress that actually causes stress to occur (Stranks, 2005). Academics and media
experts do not agree on a detailed definition of stress but they know that stress exists and is
inescapable (Williams and Cooper, 2002). According to (Cooper, 2002), 10% of the workforce of
every business reports very low levels of job satisfaction. While it is stress that may look as the
main cause, Cranwell-Ward and Abbey (2005) suggest that the level of pressure imposed on the
person and his/her coping ability is the main cause.
According to Cranwell-Ward and Abbey (2005), stress can be categorized in different ways:
▪ Hypo-stress: Little pressure or boredom can be a source of stress.
▪ Eu-stress: Optimum pressure leading in maximizing performance by an individual.
▪ Hyper-stress: Excessive pressure leading to hyper-stress.
▪ Distress: Prolonged stress leading to stress.
Woodham (1995) describes good or positive stress as the amount of pressure required by the
body in order to stimulate it into action. Thus managing stress is a delicate balancing act to keep
pressure at the optimum level. When stress is at an optimum level, stress is positive; when too
low or too high, stress is viewed as negative (Cranwell-Ward and Abbey, 2005). Selye (1974)
states that positive stress acts on the body before a presentation and motivates the individual to
try his/her best to accomplish the task, whereas bad or negative stress is defined as the amount of
pressure on the body, which demonstrates the individual from getting the job done (Stranks,
2005).
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STRESS PREVENTION AND MANAGEMENT by Ivancevich, et al. (1987)
FIGURE 1 Organizational Stress Management Program Targets
10
Source: Ivancevich, et al. (1987)
Figure 1 presents how organizational stress management programs can be targeted. According to
Ivancevich et al (1987), programs may be defined to (1) identify and modify work stressors, (2)
educate employees in modifying and understanding stress and its impact, and (3) provide
employees support to cope with the negative impact of stress. In a rapidly changing work
environment, this type of targeting is difficult to accomplish. However, a trained, educated, and
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Organizational stress management and prevention
programs
Targeted at
Work and network stressors
• Workload
• Job conditions
• Role conflict and ambiguity
• Career development
• Politics
• Interpersonal relations
• Aggressive
Employee perception/experience of stress
Outcome of stress
• Physiological
• Emotional
• Behavioral
knowledgeable work force can make modifications with the help of management in how work is
performed. Some of the targeted corrective programs according to Ivancevich et al (1987)
include:
▪ Training programs for managing and coping with stress.
▪ Redesigning work to minimize stressors.
▪ Changing management style to include more support and coaching to help workers
achieve their goals.
▪ More flexible work hours and attention paid to work/life balance and needs such as child
and elder care.
▪ Better feedback on worker performance and management expectations.
These and other efforts are targeted to prevent and/or manage stress. The potential for success of
any stress prevention or stress management program is good if there is a true commitment to
understanding how stressors, stress, and outcomes are linked.
There is a very important distinction between preventing stress and managing it. Stress
prevention focuses on controlling or eliminating stressors that might provoke the stress response.
Stress management on the other hand suggests procedures for helping people cope effectively
with or reduce stress that is already being experienced. Thus, dealing with stress: physical and
psychological techniques designed to enable people to cope with strain and anxiety.
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Stress can have both short and long term responses. The symptoms of stress may be caused due
to any organic illness of the body, but may also be regarded as the signs or symptoms of
excessive stress. The bodies of different individuals do not react in a similar way when under
stress; hence diverse symptoms of stress occur when the individual experiences job stress. Some
of the symptoms of stress are problems on their own and can aggravate the job stress being
experienced while other symptoms, if not managed, can have serious consequences on the
performance and health of the individual. Various authors have categorized symptoms of stress,
particularly, Beehr and Newman (1978) categorized stress symptoms as follows:
• Psychological symptoms: These are the emotional and cognitive problems experienced
by the individual under conditions of job stress. The emotional reaction to stress has been
identified as fear, guilt, panic, denial, and anger, feeling numb, aggression and irritability;
while the cognitive reactions are confusion, disorientation, uncertainty, confusion, poor
decision-making.
• Physical symptoms: These occur, when the body adapts to a physical threat by the
release of adrenaline in the body. This excess adrenaline in the body allows it to fight the
stressor and assists in survival. Selye (1974) suggests that the physical symptoms are
more difficult to quantify, as there may be an overlap between these symptoms of stress
and other aspects of the individual’s life. The physical symptoms have been characterized
as fatigue, dizziness, skin diseases, weakness, chills, headaches and cardio-vascular
disease. Certain physical symptoms that is; cardio-vascular disease and gastro-intestinal
conditions are the most common of the physical symptoms, and are proven to be caused
13
by stressful working conditions. These are more prominent and are often found some
personality, (Sutherland and Cooper, 1990).
• Behavioural symptoms: there can be significant changes in the person’s behavior when
exposed to stress over time. These have been characterized as increased consumption of
alcohol and drug abuse, absenteeism, inability to rest, changes in speech pattern, being
accident prone, etc.
The build up of any the above mentioned symptoms of stress can have serious mental and
physical ill-effects on the individual, thereby causing the person’s performance to suffer
(Marshall and Cooper, 1981). The consequences of these psychological, physical and
behavioural symptoms are job dissatisfaction and employee absenteeism as the affected
employee dislikes going to work and has little encouragement to perform well on the job.
Uncorrected job stress for long periods of time may have another very important consequence,
such as ‘burnout’. Burnout occurs when excessive job stress exceeds a threshold and an
individual collapses due to his or her inability to cope with it (Marshall and Cooper, 1981; and
Froggat, 1997a, 1997b). Many authors conceptualize burnout as prolonged stress. For example
Buick and Thomas (2001) explain stress is an adaptation process that is temporary and is
accompanied by mental and physical symptoms, whereas burnout refers to breakdown by
chronic malfunctioning. Burnout can lead the individual to suffer from fatigue, show lack of
enthusiasm in the job or leave the job altogether.
However, in order to recognize that an individual is under stress the management does not
require much information about the illness itself, stressed individuals demonstrate certain
14
characteristics in their behaviour, performance and habits that can be identified easily (Marshall
and Cooper, 1981). The behavioural changes that can be identified in an individual experiencing
job related stress can be categorized as follows:
• Avoidance of work
• Lower productivity by a consistently good performer
• Increase in the number of errors made in the job
• Increases in the time required by the employee in doing routine jobs
• Increased alcohol consumption and drug abuse
The organization can aid its employees in reducing or managing stress in the workplace by
“discouraging individual’s from becoming workaholics, with no life outside the job” (Sutherland
and Cooper, 1990,). A worker in an organization can undertake ‘self-help techniques’ that he/she
can use in order to cope with stress in everyday life. The use of relaxation technique, for example
meditation, has been regarded as the “best possible ways of dealing with stress” (Woodham,
1995, p.90; Powel & Enright, 1990, p.2). This aids the body to reduce its blood pressure,
maintain the breathing rate and reduce the heart rate in order for the body to recover from over-
arousal, by bringing the body’s system back to normal (Girdano & Evarly, 1986). Also the
chemicals consumed by the body may lead to the increase in stress experience by the body. Large
amounts of sugar, processed foods, caffeine and alcohol consumption can have ill-effects on the
overall health of the individual (Cooper, 1988). A healthy well-balanced diet may increase an
individual’s resistance level and lower the reactivity of stressful situations. Exercise on a regular
15
basis helps the body to relax its muscles and reduces the levels of adrenaline in the body. Regular
exercise increases the immunization of the body, which in turn aids to combat diseases.
Consequently, setting goals gives a worker a sense of purpose and a direction to move towards.
Moving towards set goals and their accomplishment increases the self-esteem, happiness and
performance of the individual (Fontana, 1994). Once the planning of goals is achieved, the
worker needs to be timetabled in order to organize the time used to complete the activities more
efficiently. Management of time has been identified as an effective way of coping with stress
(Cartwright et al; 1997; Ross et al, 1994). It helps the employees to use their time in the most
efficient and productive way, while being in control of their activities and allows them to relax
outside their workplace. Education and skills should be developed in order to give prioritization
to the most important jobs. Ross et al (1994) suggest the Pareto principle or the ‘80/20 rule’,
which states, “80% of the time at work is spent on duties that are related to 20% of important job
outcomes”.
2.3 Empirical Evidence Numerous articles and reports worth evaluating exist on the subject matter. Jee Reason, (1988),
Cooper and Eaker, (1988) and Dunham (2001) suggest that simply being part of the organization
itself causes stress. When the worker’s freedom and identity is at threat in the organization, it
causes him/her stress. If the beliefs and expectations of both the managers and the employees as
a whole are the same, stress is reduced, but if they contradict each other, it can cause job
dissatisfaction and affect job performance of the worker. Various studies have shown that certain
levels of stress enhance performance. (Selye, 1974) pointed out that stress does not have to be
seen bad – it depends on how it is perceived (Cranwell-Ward and Abbey, 2005). It is the level of
16
stress under which people operate that is important: if they are not under enough stress, they
might find themselves bored and unmotivated, hence their performance suffers. On the other
hand, excessive stress generates stress related problems decreasing the level of performance.
As Selye (1974) suggests, unsuccessful adaptation causes serious health effects, while successful
adaptation brings growth and increased resistance to stress (Stranks, 2005). Consequently,
various authors suggest, a person needs to be under certain amount of stress in order to function
or perform a task successfully in an organization. Stress increases the level of anxiety in the body
and helps the individual to perform at peak efficiency (Williams and Cooper, 2002). The Yerkes-
Dodson law suggests that with certain limits, an individual’s performance improves with
increased levels of stress, while after a certain point of increasing stress levels; the performance
actually declines (Arnold J. Cooper and C.L, 1998).
2.3.1 Stress Management Stress management will be viewed from suggested programs that can be used by the organization
to manage stress of its employees; in that too much or too little of stress is not good for the
organization. Education/Awareness building can be used to make the employees aware of the
potential stressors in their personal life and the workplace and also provide them with
information about the cause and symptoms of these stressors and help them to cope with the
stress (Farmer, Monahan, and Hekeler, 1984). This is a cost effective way of dealing with stress
in the organization as it can reach a large number of people at a time by the means of written
material, lectures and presentations.
17
Secondly, assessment of focused programs aims to identify individual stress profiles, and is
conducted in small groups. These are conducted by the means of interviews and group
discussions, and can assist employees to compare with colleagues, their experiences on stress
related subjects (Lazarus and Folkham, 1984). However, if a person’s working environment is
organized such that he/she cannot cope with it, then it can be a major source of stress. On the
other hand, if the environment is well organized and pleasant, it can help to reduce stress and
increases productivity (Fletcher, 1991). Improving the air quality, lighting, decoration and
tidiness, level of noise, furniture and ergonomics and personal space, can reduce stress in the
environment (Ross and Almaier, 1994). Employees form the backbone of an organization and, in
order for the organization to perform well; the employees need to work at the peak of
capabilities. Hence, the well being of the employees should be of precedence for the organization
for the organization.
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CHAPTER THREE
METHODOLOGY
3.1 Introduction This chapter intends to discover the methods that were employed by the researcher in collecting
data from the various respondents for the study. It also captured the background of the study
area, population, sample size, sampling technique, method of data analysis and collection, ethical
considerations, study type, design, and variables. This chapter also aims at equipping the
researcher and exposing any other reader to the basic skills needed to record, analyze and make
decisions relating to the research topic. Though there are several means of data collection, it is
incumbent that any method chosen should be related to the research problem and channeled
towards the achievement of the research objectives.
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3.2 Background of Study Area The Republic of Ghana in which Sunyani is situated is located in the middle of the Guinea coast
of West Africa. It covers an area of 238,539 sq km. Ghana is bordered on the north by Burkina
Faso, Togo to the east and La Cote d’Ivoire to the west with the Gulf of Guinea to the south.
Ghana is generally a low lying area with a range of hills in the east (ghanadistricts.com). Ghana
has a population of about 24 million. Ghana’s economy is predominantly agrarian, with
agriculture dominating in terms of employment, revenue and export earnings.
The Brong – Ahafo Region is seen to have some population increment. For instance, between the
periods 1960 and 1970, 1970-1984 and 1984-2000 Censuses, there were growth rates of 4.4%,
5.3% and 2.6% respectively (Ghana Statistical Service, 2000). The observed increase in
population both in the district and the region could best be explained by a large inflow of settler
farmers and internally displaced people in conflict areas from the northern part of Ghana.
Another contributing factor to this increase in population is the natural increase as a result of low
infant mortality rate of 50/1000 (ghanadistricts.com). It is clear that even without migration the
municipality’s population has the potential to grow.
Sunyani, Ghana’s sixth city has a population of about 207,000 but most estimates put the
population at just over five hundred thousand (Ghana Statistical Service, 2000). Sunyani is often
regarded as one of the commercial capitals of Ghana, most of Sunyani’s relative prosperity
derives from the timber forest (endowed natural resources) of the surrounding region but it is
also renowned for its local enterprise and artisan skills, particularly in the areas of furniture-
making and vehicle engineering which serve clienteles from surrounding countries. The
20
municipality depends on water from the Tano River and some farming is done on the land
naturally endowed to it (ghanadistricts.com).
In 1996, the International Hospital group (IHG) of United Kingdom was awarded the contract to
build a 250 Bed Regional Hospital for the Brong - Ahafo Region to replace the 75 year Old
Hospital (Hospital Library, 2007). It was a turn key contract encompassing design, construction,
equipping, commissioning and training. The mammoth construction complex was completed by
the year 2000. Installation of equipment however delayed until early 2002. By the year 2003,
plans were put in place to occupy the buildings and use the equipment installed before their
warranty expires. With vision and support of the Director General and the Regional Directorate
of the Ghana Health Service, 4th August 2003, was fixed as the date to commence the phased
occupation exercises. Task teams were formed to plan and undertake the occupation exercise on
the 4th August 2003 (Hospital Library, 2007).
The Regional Hospital Sunyani is a Ghana Health Service facility located in the Brong – Ahafo
Region exists to provide a comprehensive range of efficient high quality Inpatient and Outpatient
healthcare services to the people of Brong – Ahafo and neighbouring communities in a patient –
friendly environment which respects and rewards the skills of the staff. The vision of the hospital
is to develop the hospital into a modern medical center of excellence in Medical and Nursing
Care within the Sub Region (Hospital Library, 2007). The services provided by the hospital
include accident and emergency services which is 24hours, out patient services from Mondays to
Sundays, general practice or internal medicine, obstetric and gynaecological services,
orthopaedic and traumatology, neurosurgical services, full range laboratory services, radiology
21
and ultrasonography, mortuary services, catering services, inpatient services, VIP services and
dermatological and urological services which are offered on a monthly basis (Hospital Library,
2007). The hospital management comprises of the hospital management committee and core
management team. Other committees such as the quality assurance and procurement are in place
to complement the work of management.
3.3 Study Type Study type involves the various forms in which the study can be classified based on the research
topic. The ideal category for the research was a case study and explanatory study.
3.3.1 Case Study The case study explores issues in the present and in the past as they affect a relatively complete
organizational unit (Jankowicz, 1995). Stress in the past and present affect the activities of the
institution under study, so with the case study, recommendations can be made by the researcher
to manage stress in the institutions.
3.3.2 Explanatory Study Explanatory study was also inclusive in the study type since the researcher was interested in a
detailed and intensive knowledge about a single case. This is because the study variables thus
stress management and performance of health workers are related implying that it is evident the
institutions that experience stress the most employ stress management mechanism most often.
The rate of intensity of the management mechanism will lead to a reduction in stress – related
issues in the institution.
22
3.4 Study Design According to Churchill (1996), a research design is simply the framework or plan for a study
used as a guide in collecting and analyzing data.
The study which encompassed both a case study and an explanatory survey had its fundamental
aim of assessing the stress management mechanisms employed in public health institutions. The
explanatory survey gave the researcher the opportunity to select a sample from the entire
population being studied and then make generalizations from the study of the sample.
The research design was based on an evaluating study which had the purpose of examining the
contribution of stress management mechanisms on the services rendered by the public health
institutions. In addition, the study captured the means used in managing stress in public health
institutions and the relative impact it had on the institution of study.
3.5 Study Variables The variables to be studied under the research and identified their interdependence include stress
management and performance of public health workers.
3.5.1Performance of Public Health Workers This is defined as the ability and willingness of staff who are regulated by the Ghana Health
Service to work by rendering quality and first class health service to patients who use
government health facilities. This variable would be the dependent one because stress plays an
active role in the service the staff renders to patients. Thus, the quality of the performance of the
public health workers is dependent on how effective stress is managed.
23
3.5.2 Stress Management Stress management is defined as the ability to maintain and control the psychological, mental,
physical and emotional stress of workers to put them in the right frame of mind so that they can
render the best of service to the institution of work. This variable would act as the independent
variable in the research study.
3.6 Population, Sample Size and Sampling Technique Population
Cooper and Schindler (2001) defined population as the collection of elements about which the
researcher wishes to make some inferences. The population of this research was defined as the
staff of Sunyani Regional Hospital.
Sample Size
Cooper and Schindler (2001) defined sample size as the list of elements from which the samples
is actually drawn. In this study, the sample size was some of the staff of Sunyani Regional
Hospital which was chosen from the various departments at random totaling fifty (50) workers.
Since stress in public health institutions often lead to these institutions rendering poor services to
their clientele, the outcome of the research based on the sample size reflected a true
representation of the population.
Sampling Technique
The sampling technique that the researcher employed was the non - probability type of sampling
specifically accidental sampling. The non - probability type of sampling is a sampling technique
whereby the chance of selection of each element in the population is unknown. The non -
24
probability type of sampling is best used for case study purposes because of the limitation on
resources and to undertake an in-depth study on a small selected sample which was the staff of
the Sunyani Regional Hospital. Accidental sampling technique considers all units that the
researcher accidentally comes into contact with within a search period of time. The researcher
takes into account the number and kind of people who are ready to corporate in terms of
availability and willingness to respond to the questionnaires (Shaughnessy and Zechmeister,
1994). The questionnaires distributed to the various departments were given to people that the
researcher accidentally came into contact with.
3.7Data Collection Method Both primary and secondary data were collected for this study. The primary data consisted of a
thorough collection of data from the sample size being workers such as medical officers, nurses
and the administrative personnel in the institution. This research adopted the usage of
questionnaires. In all fifty (50) questionnaires were distributed to the research subject comprising
of both the management and employees of the institution. The questionnaires included both open
ended and close ended questions. According to Twumasi (2001), an open ended questionnaire is
a set of questions that are specific with no possible answers or options provided. The respondents
are allowed to express his or her view on the subject matter. Babbie (2002) defines close ended
questionnaires as the type of questions which the respondent is asked to select an answer from
the list provided by the researcher. The use of questionnaires avoided interview bias that can
have an impact on the validity and reliability of the data collected as well as offered a greater
assurance of anonymity. Since all the primary information needed could be obtained by
questionnaire distribution, there was no need to conduct interviews. The secondary data focused
25
on researches that had been carried out in the similar field of study, literature on the World Wide
Web in addition to reviewing articles and reports published by the institution concerning the
management mechanism adopted to reduce stress - related issues.
3.8 Data Analysis Method In analyzing the results of the data collected from the fieldwork, the software Statistical Package
for Social Sciences (SPSS) was used. This adopted the use of tables for the analysis. The nature
of the issue for the research required the employment of these statistical tools to make it possible
to analyze effectively the performance of stress management mechanisms within Sunyani
Regional Hospital. The use of tables was adopted in order to analyze some of the responses made
by the respondents on certain questions they answered from the questionnaires.
3.9 Ethical Considerations Formal permission was first sought from stakeholders involved in the research. From the onset,
the participants were informed about the aims and objectives of the research coupled with the
confidential nature of their answers or responses to questions. There was no deception as to the
confidentiality of their responses. Respondents were not coerced to answer any question.
Permission was sought from the informants before filling the questionnaires. Participants were
informed of their right to refuse to answer any question or withdraw from the research anytime
they felt uncomfortable and contents of the research was disclosed to the participants after it has
been conducted. Furthermore, an introductory letter from the Catholic University College of
Ghana was attached to the set of questionnaires distributed stating the confidential nature of the
responses and was that the responses were strictly for academic purposes. All other information
from various authors has been acknowledged and was presented as the researcher's own view.
26
27
CHAPTER FOUR
PRESENTATION AND ANALYSIS OF DATA
4.1 Introduction This chapter deals with the analysis of data collected from the fieldwork and its relevant
interpretation. The analysis is done in line with the research objectives and questions. Included in
this chapter also is the summary of major finding and conclusion and will finally be followed by
the appropriate recommendations.
4.2 Presentations and Analysis of Data This section deals with the background information of the respondents which is relevant to the
analysis of data. The background information comprises of the ages of the respondents, gender,
marital status and their level of education as shown in tables 1 to 4.
Table 4.1: Ages of Respondents
Source: Fieldwork (March, 2012)
Table 1 above represents the ages of the various respondents in the institution. 58% of the
respondents’ age between 20 and 29 years and only 8% were 50 years and above. This implies
that the youth within the institution far out weigh the elderly ones and this could be a reason for
AgesFrequency Percentage (%)
20-29 29 58.0
30-39 8 16.0
40-49 9 18.0
50 and above 4 8.0
Total 50 100.0
28
the low occurrence of stress within the institution. Thus, the youth tend not to over stress
themselves as compared to the aged hence minimizing the cases of stress in the institution.
Table 4.2: Level of Education
Source: Fieldwork (March, 2012)
From table 4.2, 70% of the responses have tertiary education. Since most of the employees have
a high level of education, they tend to be more watchful as compared to those with low level of
education. Thus they are observant of the stressors at the work place and try to manage or reduce
them when they occur. 20% of the sample size had secondary education with 8% of the total
views had basic level education. Lastly out of the 50 respondents, only 2% had ordinary level
education. With the high level of education acquired by the staff members; the occurrence of
stress in the institution is minimal.
Education level Frequency Percent (%)
Basic level 4 8.0
Secondary level 10 20.0
Tertiary level 35 70.0
O' level 1 2.0
Total 50 100.0
29
Table 4.3: Gender of Respondents
Source: Fieldwork (March, 2012)
The table above deals with the gender of the respondents. Out of the 50 respondents, 40% of the
total sample sizes are males and 60% of the total sample sizes are females.
Table 4.4: Marital Status
Source: Fieldwork (March, 2012)
ResponsesFrequenc
y Percent (%)
Male 20 40.0
Female 30 60.0
Total 50 100.0
Marital Status Frequency Percent (%)
Single 35 70.0
Married 10 20.0
Widowed 3 6.0
Divorced 2 4.0
Total 50 100.0
30
The tables above deals with the marital status of the respondents.70% of the total responses
received are single, 20% of the total responses are married, 6% are widowed and 4% are
divorced.
Table 4.5: Name of Departments
Source: Fieldwork (March, 2012)
In this section, the researcher was able to come out with the department/units that are mostly
prone to stress and this is shown in the table above. Most departments in the institutions have
stress occurring frequently. From table 4.5, out of the 50 views sampled, 10% had no idea of any
department/unit in the hospital that was prone to stress. The department which recorded the
highest as to encountering stress was the accident and emergency unit which had 64%. The
records department who are in charge of keeping the medical records of patients had 4%. The
clinics also recorded 8% of the total views. Lastly, the administration recorded 6% of the total
Department Frequenc
y Percent (%)
No response 5 10.0
Administration 3 6.0
Accident and Emergency
32 64.0
Clinics 8 16.0
Records 2 4.0
Total 50 100.0
31
respondents. The likelihood of stress occurring in the administration, records and clinics
department is minimal due to the low levels of responses recorded.
CAUSES OF STRESS IN THE INSTITUTION
Here, the study analyzed the causes of stress at the Regional Hospital, Sunyani. This is shown in
table 4.6 and figure 4.1.
Table 4.6: Main Causes of Stress in the Institution
Source: Fieldwork (March, 2012)
Figure 4.1: Main Causes of Stress in the Institution
CausesFrequenc
y Percent (%)
Stress from organization
12 24.0
Patients 33 66.0
Family 5 10.0
Total 50 100.0
32
!
This section talks about the various causes of stress faced in the institution which is captured in
table 4.6 and figure 4.1 above. From the various responses received which is tabulated in table
4.6, 24% of the sample size believes that stress from organization is one major cause of stress
faced in the institution. 66% also trust that stress from patients/clients is the main cause of stress
faced in the institution; this is as a result of few health workers serving many patients/clients.
Stress from family also had 10% of the sample size. It is obvious that stress from patients/clients
is the major cause of stress in the institution.
TACKLING THE PROBLEM OF STRESS
The study analyzed how workers tackle the problem of stress in the institution. The analysis is
shown in table 4.7.
Table 4.7: Tackling the Problem of Stress
Main Causes of Stress in the Institution FrequencyMain Causes of Stress in the Institution Percent(%)
33
Source: Fieldwork (March, 2012)
Figure 4.2: Tackling the Problem of Stress
!
Problem Frequency Percent (%)
Vacation 15 30.0
Breaks 16 32.0
counseling 7 14.0
Events 12 24.0
Total 50 100.0
Tackling the Problem of Stress FrequencyTackling the Problem of Stress Percent (%)
34
The segment above is aimed at evaluating how the problem of stress can be tackled in the
institution. There are various ways of tackling stress related issues. The hospital mostly uses
breaks within work period which recorded 32%. Another form of tackling stress in the institution
is vacation/leaves offered to the staff of the hospital which recorded 30%. 24% judge that the
institution organizes events such as outdoor games, parties and picnics to reduce or tackle the
problem of stress. Also, 14% were in view of the fact that the hospital adopts the counseling
method of tackling stress in the institution.
PHENOMENA THAT LEADS TO STRESS
Here, the study analyzed the phenomenon that leads to stress in the institution. The result is
shown in table 4.8.
Table 4.8: Phenomena that Leads to Stress
Source: Fieldwork (March, 2012)
Phenomena Frequency Percent (%)
Job insecurity 6 12.0
Dissatisfaction 9 18.0
Deadline 10 20.0
Patients 25 50.0
Total 50 100.0
35
This section talks about the various phenomena that lead to stress in the organization. Stress from
managers/patients recorded 50% of the total responses received. 20% of the total sample size
believes that time pressure/deadline of job tasks were one of the major phenomena that leads to
stress in the institution. 12% believe that job security is also a phenomenon that leads to stress in
the establishment. Lastly, 18% of the total sample size trusts that job dissatisfaction is a
phenomenon that leads to stress in the institution.
STRESS MANAGEMENT MECHANISMS IN THE INSTITUTION.
The study analyzed some stress management mechanisms used in the institution. The analysis is
shown in table 4.9.
Table 4.9: Stress Management Mechanisms in the Institution
36
Source: Fieldwork (March, 2012)
Figure 4.3: Stress Management Mechanisms in the Institution
!
Table 4.9 and figure 4.3 is aimed at evaluating the stress management mechanisms mostly
adopted by the institution in managing stress related issues. The hospital mostly uses the
awareness building machinery which recorded 68%. Another form of stress management
mechanism used by the institution is counseling which had the view of 14% of the sample size.
6% believe that education on stress is a mechanism that the institution uses to manage stress in
the establishment. Lastly, 12% were of the view that the organization adopts stress management
courses to manage stress in the institution.
Mechanisms Frequency Percent (%)
Education on stress 3 6.0
Awareness building 34 68.0
Counseling 7 14.0
Stress management courses
6 12.0
Total 50 100.0
Stress Management Mechanisms in the Institution FrequencyStress Management Mechanisms in the Institution Percent %
37
HOW CO-WORKERS MANAGE STRESS
The study analyzed how co-workers at the workplace manage stress when they occur. The result
is shown in table 4.10.
Table 4.10: How Co-workers Manage Stress
Source: Fieldwork (March, 2012)
This portion of the research analyzes how co-workers manage stress when they occur. From the
table 4.10, 36% were of the view that co-workers manage stress by listening to music. Exercise
which recorded 24% views out of the total 50 sample size; accept that co-workers exercise their
bodies to manage stress when they occur. 22% said meditation is also a technique co-workers use
to manage stress. 28% said that co-workers adopt reading journals and novels as a technique they
use to manage stress when they occur.
HOW OFTEN STRESS OCCURS IN THE INSTITUTION
The study analyzed how often stress occurs in the various departments of the institution. The
result is shown in table 4.11.
Managing Stress Frequency Percent (%)
Listen to music 18 36.0
Meditation 11 22.0
Reading 9 18.0
Exercise 12 24.0
Total 50 100.0
38
Table 4.11: How Often Stress Occurs in the Institution
Source: Fieldwork (March, 2012)
The table above assesses how often stress occur in the institution. From table 4.11, 80% of the
sampled views indicated that stress often occurs in the institution. 14% of the sample size was in
the view that stress occurs very often in the institution. Also, 6% of the sample said that stress
does not often occur in the institution.
4.3 Summary of Findings The outcome of the summary of findings realized under the research was grouped according to
the research objectives and questions.
Incidence Frequency Percent (%)
Very often
7 14.0
Often 40 80.0
Not often 3 6.0
Total 50 100.0
39
• The first objective of the research was to identify the causes that lead to stress in the
institution. 66% of the stress in the hospital is as a result of stress from patients while
24% and 10% of stress is caused by stress from the organization and family respectively.
• The second objective of the research was to find out the type of stress that is most
prevalent in the institution. It was found out that stress from patients/clients is the most
prevalent in the hospital as a result of excessive demands from patients/clients.
• The next objective of the research was to identify the mechanisms that the institution uses
in solving stress related problems within the institution. It was found out that the widely
accepted and used mechanism (approximately 68%) is awareness building. The awareness
level among managers, health workers and supervisors regarding stress and its ill effects
is on the increase within the hospital. The cost of job stress is borne by the organization
and stress is considered as a potential hazard to employee productivity and health. The
hospital is taking precautions to reduce the stress levels in the work environment.
• The last objective was to find out how often stress occurs in the institution. The related
outcome recorded 80% of the views of the respondents agreeing that stress often occurs in
the institution.
40
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
5.1 Conclusion Stress in Sunyani Regional Hospital has been growing consistently in this dynamic economy and
various factors have been supporting it to be a major problem. Organizational stress at the
hospital considered a growing phenomenon and the awareness among health workers of its ill
effects is increasing. The impacts of stress are not necessarily negative; it is also regarded to be
very essential in the workplace. Inadequate stress makes an individual bored and propagates lack
of interest at the hospital. Fluctuating levels of stress decreases productivity, lowers employee
morale, increases absenteeism due to sickness and increases in labour turnover; the costs of
which are borne by the hospital. Sunayni Regional Hospital needs to maintain optimal levels of
stress in the workplace for the employees to perform at the peak of their capabilities.
There are many stress management mechanism described in the literature review which can be
adopted by the health workers and the hospital management in order to optimize the levels of
stress faced by the workers. The analysis identified certain effective and practical stress
reduction techniques that can be used by the institutions to reduce the levels of job stress faced
by public health workers.
The health workers should be given proper job descriptions and a focused profile outline of their
responsibilities, so that they can get a clearer understanding of what is expected of them and aid
them to be more organized. This will ensure that they complete their work without much
41
pressure and get adequate time for themselves as well. By ensuring that proper job rotation is
carried out, the repetitiveness of work carried out in the workplace can be reduced considerably.
The Regional Hospital, Sunyani is responsible for creating job stress hence it should take
appropriate measures in order to optimize the levels of stress faced by the employees. Job stress
can be reduced if the institution is able to recognize and accept the capabilities of the health
workers and accordingly delegate tasks to them. Through proper training, development and
feedback sessions the health workers will be able to enhance their skills and would also help
them to cope better with the changes in their work environment. Recreational activities, inter and
intra departmental competitions, group outings, giving regular breaks to employees between
work hours, discussions, counseling, meditation and stress management workshops are some of
the steps the hospital can adopt to reduce the levels of stress faced by the employees. Sport
centers for at all levels in the hierarchy would allow them to interact with each other on a
personal basis.
5.2 Recommendations The following recommendations which involves stakeholders including the management,
employees and the government that can reduce and manage stress prevailing in the institution.
Recommendations to management:
▪ Stress is a perception and not a compulsory feature in any individual’s life. Stress needs to
be managed optimistically and positively in any scenario and management should filter it
down to subordinates for a positive sense of feeling in them.
42
▪ Management needs to focus on the concept of ‘Rational Thinking’ to convert negative
stress into positive emotion. Management need to be precise with their judgments, thus
eliminating the factor of being threatened by any particular situation.
▪ Management should consider building an ‘Action Plan’ of things that need be done
individually and for the team. These would include elements that need to be performed,
controlled and thus eliminating causes of stress. The ‘Action Plan’ should also include
factors relating to environment, health etc. to minimize the causes of stress.
▪ Motivational and career coaching should be considered by organization for health
workers on a regular basis. A small amount of inspiration and motivation would nullify
the cause of stress formation and increasing loyalty towards the institution.
Recommendations to employees:
• The staff should undergo counseling in order to identify the levels of stress they face.
• Time Management should be practiced by the staff in their personal as well as
professional life in order to decrease the element of stress.
Since the area of study is a government owned institution, certain recommendations will be
made to the government as well.
• The Ghana Health Service under the Ministry of Health should be aware of the fact
that this institution are in charge of treating the sick. Therefore, salaries and incentive
schemes should be made available in order to increase commitment, motivation and
performance.
43
• The Ministry of Health should provide good management, adequate and skilled
manpower, proper division of work and the delegation of authority will help reduce
job stress, enabling not only individuals but teams to come out stronger
REFERENCES Arnold J. Cooper and C.L, (1998). Understanding Human Behaviour in the Workplace:
Pearson Education Limited.
Babbie, E. (2002). The Basis of Social Research. Wadsworth Group.
Buick, I., & Thomas, M. (2001) International Journal of Contemporary Management.
Emerald Publishing, UK.
Churchill, A.G. (1996). Basic Marketing Research. Harcourt Brace College Publication.
Cooper, C.L. (1998). Theories of Organizational Stress. Oxford University Press,
London.
Cooper, C.L., Cooper, R. D., and Eaker, L.H. (1998). Living with Stress. Penguin Books,
London
44
Cooper, C.L., and Payne, R. (1989). Causes, Coping and Consequences of Stress at
Work. John Wiley and Sons Limited.
Cooper, R. D. and Schindler, S.P. (2001). Business Research Methods. McGraw – Hill
Companies
Cranwell-Ward, J., and Abbey, A. (2005). Organizational Stress. Palgraver Macmillan
Dunham, J. (2001). Stress in the Workplace: Past, Present and Future. Whurr Publishers
Ltd
Farmer, R. E., Monahan, L. H.,and Hekeler, R.W. (1984). Stress Management for
Human Services. Sage Publications Inc.
Fletcher, B.C. (1991). Work, Stress, Disease and Life Expectancy. John Wiley and Sons
Ltd
Fontana, D. (1994). Managing Stress: Problems in Practice. The British Psychological
Society and Routledge Ltd.
Froggatt, W. (1997a). Managing Stress in the Workplace: With Rational Effectiveness
Training. Received from www.rational.org.nz/orgs/workstress.htm. Assessed on 27th
December, 2011.
Girdano, D. A., & Evarly, G.S. (1986). Controlling Stress and Tension: A Holistic
Approach. Prentice Hall Inc. (p. 98)
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Jankowicz, A.D. Business Research Projects, Second Edition. International Business
Press
Marsall, J., and Cooper, C.L. (1981). Coping with Stress at Work. Gower Publishing
Powel, T. J., and Enright, S. J. (1990). Anxiety and Stress Management. Routledge,
Chapman & Hall Inc
Ross, R. R., and Almaier, E. M. (1994). Interventions in Occupational Stress. Sage
Publications Ltd
S. Cartwright and Cooper, C.L. (1997). Managing Work Place Stress. Sage Publications
Inc
Selye, H. (1974). Stress without Distress. Hodder and Stoughton Ltd
Shaughnessy, J and Zechmesiter, E. (1994). Research Methods in Psychology, U.S.A.,
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Stranks, J. (2005). Stress at Work. British Library Cataloguing Publication
Sutherland and Cooper, C.L. (1990). Understanding Stress. A Psychological perspective
for Health Professionals. Chapman and Hall Inc. (p.102)
Twumasi, P.A. (2001). Social Research in Rural Communities. University Press, Accra
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Woodham, A. (1995). Beating Stress at Work. Health Education Authotity, Biddles Ltd
(pp 294-295)
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APPENDIX CATHOLIC UNIVERSITY COLLEGE OF GHANA
FACULTY OF ECONOMICS & BUISNESS ADMINISTRATION
QUESTIONNAIRE FOR COLLECTION DATA
Please tick where appropriate and write your comments where necessary.
Social Data on Respondents
1. Gender
Male []
Female []
47
2. Age
20 to 29 years []
30 to 39 years []
40 to 49 years []
50 and above []
3. Marital status
Single []
Married []
Widowed []
Divorced []
4. Level of Education
Basic level []
Secondary level []
Tertiary level []
Other (specify)…………………
5. Which department do you belong to?
Head of Nursing []
Clinical Director []
Administration []
48
Finance []
Pharmacy []
Other (specify)…………………
6. How long have you been in your occupation?
Less than a year []
1 to 5 years []
6 to 10 years []
10 to 15 years []
16 years and above []
7. What stress do you face in your work environment?
Stress from organization []
Stress from patients/clients []
Stress from family []
8. How does the organization tackle the problem of job stress?
Vacation/Leaves []
Having regular breaks within work period []
Counseling []
Organizing events (picnics, parties & sports) []
9. What are the likely phenomena that lead to stress? (You can choose more than one option)
49
Job insecurity []
Job dissatisfaction []
Time pressure or deadline []
Stress from managers or patients []
10. Which unit is responsible for managing or reducing stress in the establishment?
Hospital Management Committee []
Core Management Team []
Medical Superintendent []
Other (specify)………………………………
11. Which of the management mechanisms is mostly used by the institutions?
Education on stress []
Awareness building []
Counseling []
Stress management courses []
Other (specify)………………………
12. How do the co-workers manage stress when they occur?
Listen to music [ ]
Meditation [ ]
Reading [ ]
50
Exercise [ ]
13. How often does stress occur in this institution?
Very often []
Often []
Not often []
Thank you for your co – operation.
51