Background of the Study
Stress is one of the most fundamental problems spanning through human endeavor. Nweze (2005) stated that for two and half decades, stress phenomenon has become a topical issue in management development, seminars and workshops in Nigeria. He further stated that the popularity of stress stems from a number of obvious reasons. First, nobody is immune to stress. We can be caught up in a situation that causes or induces stress in the individual. Thus, as a part of human living the young, old, rich, poor, professionals and lay men alike are potential victims of stress.
Second, because stress is viewed as the disease of growth and development, there is the search for the stress virtue in modern life. Nweze (2005) further stated that our traditional mechanisms of handling the stresses and strains of living are fast breaking down. This is being precipitated by the factor of rapid urban development, increasing corporate regimentation of work life, breakdown of social supports, increasing personal and group conflicts, including security threats to life and property. Stress has become part and parcel of life in human societies. The frustrations, disappointments and pressures of daily life constitute the genesis of stress. Stress has been conceptualized in many ways.
Oboegbulem (1995) defined stress as a feeling which occurs when an individual’s working or living conditions or circumstances make demands beyond his capacity to handle such a situation physically or emotionally. When a person is faced with disturbing situations, a change in his normal behavior is usually noticeable. Such an individual may be faced with emotional, cognitive and physiological disruption or malfunctioning which can disorganize and adversely affect his powers of reasoning.
Sisk (1977) defined stress as a state of strain, tension or pressure and it is a normal reaction resulting from interaction between the individual and the environment. Strain means to make great demand on something; tension is a mental or emotional strain that makes natural relaxed behavior impossible; and pressure is a powerful demand on somebody’s time, attention or energy.
Beehr & Newman (1978) perceived stress in an occupational setting to mean a condition wherein job- related factors interact with workers, to change their psychological and physiological conditions such that the person’s mind and body are forced to deviate from normal functioning. The similarity in the foregoing definitions reveals that there must be an interaction between the environment and the individual before stress can occur. The interaction arises when man is trying to deal with the problems that his environment produced. It could be in his place of work or marriage which makes it impossible for man to relax his nervous system.
Halgin &Whitbourne (2003) conceptualized stress as an unpleasant emotional reaction a person has when he or she perceives an event to be threatening. They stated that this emotional reaction may include heightened physiological arousal due to increased reactivity of the sympathetic nervous system. The stressor is the event itself, which is also called a stressful life event. In the context of this work stress refers to a condition or situation in the body that makes people prone to anxiety, depression, anger, hostility, inadequacy and low frustration tolerance Wai (2003).
Hornby (2004) described anxiety as a state of feeling nervous or worried; depression as a state of feeling very sad and without hope; anger as a strong feeling you have when something has happened that you think is bad and unfair; hostility is an unfriendly or aggressive feeling or behavior; inadequacy as a state of not being able to deal with a situation; and frustration as arising when something is preventing somebody from succeeding. Every health problem that does not have a permanent cure can be managed like stress.
Management has been defined in various ways. In the view of Esiekpe (2003) management simply implies the skill in dealing with something or to be in perfect control of a situation. Stress management as defined by Cohen & Lazarus (1979) is problem-solving effort made by an individual faced with demands that are highly relevant to his welfare but taxing his adaptive resources. Adaptive resources involve coping methods that people exhibit in order to be habituated with stress.
Okafor (1998) stated that stress management entails setting up roadblocks so that the progression to the illness or disease level does not occur. They concluded that if we could eliminate or block all potentially distressing life situations, the journey towards illness or disease levels would never begin. However, Greenberg & Dintiman (1992) opined that eliminating or blocking all potentially distressing life situations is not only impossible, but also undesirable, because life would be extremely dull if we did not have changes which require adaptation or adjustment.
For Cooper (1986), stress management strategies comprise measures taken to cope with trying periods, so that a state of psychological and physiological equilibrium is re-established and subsequently maintained. The truth of the matter is that in stress management, no one technique or strategy would be deemed to be successful for all individuals in all situations. Stress management is conceptualized in this work as the process of managing demands that are appraised as tasking or exceeding the resource of the person Lazarus & Folkman (1984).
Plotnik & Mollenauer (1986) stated that stress management strategies are referred to as the methods we employ to deal with stressful or disturbing situations. They categorized these methods into effective and ineffective strategies. Such ineffective strategies are overeating, drug abuse, aggression which may make us feel better shortly, while effective strategies are thought substitution and relaxation. (Akubue, 2000) identified other management strategies like exercise, discussion, relaxation, meditation and holiday. Also in stress management, individuals use coping strategies and resources that help them to adapt to environmental demands. These strategies play a key role in determining the nature and extent of the stress impact.
In problem-focused coping, the individual reduces stress by acting to change whatever makes the situation stressful. Coping is defined as the process of managing demands (external or internal) that are appraised as taxing or exceeding the resources of the person Folkman (1984). There are two types of strategies that have been assessed by almost all coping measures developed in the past few decades Parker & Endler (1996).
The person might make alternative plans or find a new and better way to correct the situation. By contrast, in emotion-focused coping, a person does not change anything about the situation. Thinking positively is one emotionfocused coping method people use to make themselves feel better under stressful conditions. Avoidance is another emotion-focused strategy which Halgin & Whitbourne, (2003) stated that this method is similar to the defence mechanism of denial, in which the individual refuses to acknowledge that a problem or difficulty exists. In the context of this study, the terms “coping’’ and “stress management strategies’’ are used as synonymous. Stress management strategies in this work is conceptualized as all the methods we employ to deal with stressful or disturbing situations. Some past researchers have established that stress management strategies can be influenced by some variables. Some factors that may influence stress management strategies are age and gender.
These are transactional and health realization/ innate health models. Lazarus &Folkman (1984) interpretation of stress focuses on the transaction between people and their external environment (known as transactional model). The model conceptualizes stress as a result of how a stressor is appraised and how a person appraises his or her resources to cope with the stressor. Stressors are the environmental events or forces that cause stress response. These could be economic instability, unfurnished offices, campus militancy and so on. Health realization/innate health model of stress management is founded on the idea that stress does not necessarily follow the presence of a potential stressor. Instead of focusing on the individual appraisal of so-called stressors in relation to his or her own coping skills (as the transactional model does), the health realization model focuses on the nature of thought, stating that it is ultimately a person’s thought process that determine the response to potentially stressful external circumstance.
World Health organization (WHO) has observed that stress is a worldwide epidemic because stress has recently been noted to be associated with 90% of visits to physicians.
The nursing and Doctors profession is known to be stressful throughout the world and has detrimental effects on the physical and psychological well-being of an individual’s health. Nurse plays a pivotal role in and encompass the largest workforce in any health care institution; they act as direct caregivers who serve a hospital twenty-four hours a day, seven days a week. This gives nurse a unique perspective on both patient care and hospital operations. Nursing and Doctors by virtue of its nature is a profession subjected to a high degree of stress. Occupational stress exists in all professions, but the nursing professions appears to experience more stressful (O.G.Okoye et al)
Doctors and nurses working in hospitals experience stressful and challenging situations that generate un pleasantries. Emergency situations has already made the work stressful and make it even more difficult. In addition, hospital staff most especially medical doctors and nurses must recognize demanding patients, especially those suffering from chronic debilitating illnesses as well as those suffering from acute or severe pain.
Stress is totally a normal place for neurological hassle and is strongly related to confusion, dwindled wondering ability, improved degrees of anxiety, and improved intellectual pressure. Stress can be attributed to being a form of psychological, behavioral, emotional, and cognitive response to actual or imaginary stimuli and is perceived as the overthrow of conditions that endanger or threaten a target. Some level of stress can motivate, empower, and encourage employees, thereby enhancing the nursing process. Situations that cause stress encompass rather worrying paintings with terrible support. Healthcare specialists are vulnerable to stress and burnout due to the fact they're liable for human existence and its conduct, or can nevertheless cause a lack of human existence. Because stress is a common phenomenon, we are unsure approximately the cause of stress and are in no way definitive. Regardless of that, it's far from a place of work-associated intellectual infection, which could adversely have an effect on fitness care providers. Occupational nature, place of work anxiety, interaction, and shortage of support. Some of the studies have proven that undiagnosed stress can increase the hazard of cardiovascular disease, breathing disease, disorders, reduced organ function, and loss of life. In order to see great success in terms of fitness care provision, the problem of stress amongst healthcare workers needs to be addressed. This study consequently seeks to assess the outcomes of occupational stress amongst healthcare people closer to powerful healthcare shipping in General Hospital Asokoro.
1.2 Statement of the Problem
Some scientist believes that working as medical doctors or nurses is very stressful, as a result of the excess work load, congested schedule,lack of funding, outdated and ineffective medical facilities, unqualified staffs, and inadequate tools. Stress phenomenon has become an important area of research in medicine and psychology, and in management, development, seminars and workshops in Nigeria and elsewhere. It has become a trendy topic for headlines cover stories. Internationally, United Kingdom, stress is believed to trigger 70% of visits to doctors and 85% of serious illnesses. Bussinesballs (2022). Stress and stress management. http: //www. businessballs.com/stressmanagement.htm. If there has been an appreciable level of stress that exists among high technologically developed west, one would imagine what would be the case for this country (Nigeria) where everything we embark on is a stressor.
Studies in Nigeria, Ofoegbu & Nwadiani (2006) recorded the prevalence of stressful working conditions in tertiary institutions. According to them those things are life threatening, harmful and challenging situations which are stressful to people’s existence and well-being All of these factors are related to stress faced by doctors and nurses in Nigerian hospital in General hospital Asokoro Abuja as case study. The majority of healthcare workers work in extremely harsh and unfavorable environments, resulting in inadequate service at Asokoro General Hospital due to almost all causes of stress, such as chronic and under-detection. A significant number of patients have died. Due to these factors, this study is conducted to investigate the impact of occupational stress on healthcare workers on the effective delivery of health care at Asokoro General Hospital. The limited number of departments assigned to hospitals makes it more difficult and stressful for hospitals to function.
1.3 Objective of the Study
The main objectives of this work are:
1.4 Research Questions
The following research questions are used for the study:
1.5 Research Hypotheses
There are three hypotheses to be tested in this study. They are:
1.6 Scope of the Study
This subject is delimited to only one hospital in FCT Abuja namely, general hospital Asokoro Abuja. Therefore, for the sake of this study, the research will cover events and activities relating to stress and with particular reference to medical Doctors and Nurses in the stated hospital
1.7 Significance of Study
The result of this study will aid the effective implementation of the Nigeria medical personnel’s because it points out some of the factors that are responsible for the poor performances of medical Doctors and Nurses in Nigeria hospitals. The relationship between stress and the work behavior among medical doctors and nurses will be examined. From the research questions stated above we will try and test to see whether or not they are factors in the stress among doctors and nurses.
This study also examines the ways of reducing work stress among medical doctors and nurses in hospital. If these measures are implemented, it will have impact on improving the safety of patients visiting the hospital.
The information will be useful to the Ministries of health who may use the information to address the areas where stress emanates as this will help improve medical doctors and Nurses productivity. Cascio (1989) stated that in any organization aimed at production of goods and services, an effective management of people becomes pertinent to circumvent some costly lapses that are bound to accrue to the institution sequel to stress.
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