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Article Contents

1. introduction, 2. the psychology of stress, 3. the law relating to stress, 4. broader structural questions, 5. conclusion.

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Stress at Work: Individuals or Structures?

  • Article contents
  • Figures & tables
  • Supplementary Data

A C L Davies, Stress at Work: Individuals or Structures?, Industrial Law Journal , Volume 51, Issue 2, June 2022, Pages 403–434, https://doi.org/10.1093/indlaw/dwab006

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Stress is a significant practical problem in modern workplaces. According to the Health and Safety Executive (HSE), more than half of all working days lost to ill health each year are attributed to stress, depression or anxiety. This article offers an overview of the occupational psychology literature on workplace stress, focussing on the job demands–resources or JD-R model, developed by Demerouti et al., and highlighting two important points: first, that stress at work is not just about excessive job ‘demands’ but also about inadequate ‘resources’ to cope with those demands; second, that stress-related ill-health is not just a matter of vulnerability on the part of the individual worker, but is also about the way in which the workplace is organised. The article then draws on these insights to offer a critique of the way in which health and safety law and tort law approach workplace stress, arguing that both bodies of law are overly focussed on treating stress as a matter of individual vulnerability. It concludes by drawing out some broader implications of the occupational psychology literature for areas of employment law less obviously related to workplace stress, and for casual or platform working.

Stress is a significant practical problem in modern workplaces. Although stress is not itself a diagnosable medical condition, it can cause both mental and physical health problems. According to the Health and Safety Executive (HSE), more than half of all working days lost to ill health each year are attributed to stress, depression or anxiety. 1 Stress is gendered, with women between the ages of 25 and 44 being significantly more likely to report work-related stress than men of the same age. 2 And it has a particularly high impact on the public sector, being more prevalent in public administration, health care and education than in other parts of the economy. 3 Polls of workers suggest that the most common causes of stress are high workloads, the way people are managed, and inability to achieve a satisfactory work–life balance. 4 It seems likely that the last of these helps to explain the greater prevalence of stress among women, given the double burden of juggling work with significant caring responsibilities many women in the relevant age group will experience. 5

It is too early to say what the impact of the Coronavirus pandemic will be on workplace stress, but it seems likely that it will significantly exacerbate the problem in many cases. Sadly, it is already apparent that there will be large-scale redundancies as a result of the pandemic, something which is generally regarded by psychologists as a highly stressful life event in itself. 6 For those who have been fortunate enough to stay in work, greater flexibility to work from home has been a benefit for some, but new sources of workplace stress have also presented themselves, including the risk of catching the virus, fears about future redundancies, and the added challenges of juggling work with home-schooling and childcare, again with emerging evidence of gendered impact. Further work will be needed to investigate these effects.

Despite the day-to-day reality of stress at work both pre- and post-pandemic, the legal literature on the subject is relatively limited, albeit with some notable exceptions. 7 Of course, there has been some interest in the cases dealing with what the courts term ‘psychiatric injury’ at work, a type of injury which often stems from employees being placed in stressful situations. 8 And more recently, there has been some important scholarship on mental health at work, which may include mental ill-health caused by stress at work, from the perspective of disability discrimination law in particular. 9 Nevertheless, a broader analysis of the law’s approach to workplace stress is long overdue.

In the first part of this article, I will offer an overview of the psychology literature on workplace stress, in order to develop a clearer understanding of the psychological processes involved when a worker develops a health problem because of stress at work. This is an important exercise because, too often, it is tempting to rely on personal experience and anecdote as our starting-point for thinking about stress. Two key points emerge from this literature. First, although we tend to think about stress-related ill-health as stemming from ‘stressors’, such as long working hours or high workloads, psychologists focus on a combination of factors, some of which place demands on the worker and some of which help the worker to cope with those demands. Problems arise when demands and resources are not properly balanced. Second, the worker’s own ‘vulnerability’ or ‘resilience’ is only one factor among many: from a psychological perspective, workplace stress is also viewed as a matter of workplace structure and organisation.

In the second part of the article, I consider two areas of law typically thought of as being concerned with workplace stress: health and safety law and tort law. The HSE’s approach to workplace stress is well-informed by the psychology literature and in many respects asks the right set of questions. 10 However, it is not clear that asking a manager to complete a ‘stress risk assessment’, for example, will in practice generate the kinds of profound structural change that might be needed to combat stress. Tort law’s approach to workplace stress tends to focus rather too heavily on the individual worker, particularly through the foreseeability test. 11 The employer is only liable where it could have foreseen that the worker would develop a health problem, and this in turn usually depends on the worker having taken time off work on a previous occasion because of stress-related ill-health. This treats stress as a matter of individual vulnerability and largely ignores the role of broader structural factors such as how the workplace is managed.

In the third part of the article, I develop the idea of thinking about workplace stress as structural matter in two related directions, to identify questions for future research. One is to examine the role of areas of law not obviously related to stress in providing working people with a ‘resource’ to combat stress. This offers another way of thinking about the justifications for employment law. The other is to examine the situation of casual or platform workers. These workers have tended to be overlooked in the psychology literature, which usually focuses on employees in ‘traditional’ jobs and workplaces, and their legal entitlements under both health and safety law and tort law are somewhat uncertain. But their working arrangements lack many of the structures associated with tackling stress, offering another reason to be concerned about the rise and rise of these forms of working in the modern economy.

In this section, I offer a review of some of the psychology literature on occupational stress and some of the empirical evidence about its prevalence in UK workplaces. My aim is to ground the discussion of the law in a sound understanding of the science.

An important caveat at the outset is that this literature deals principally with stress generated within the workplace. Many workers experience stress at work because of non-work factors, such as family problems, which in turn make it more difficult for them to cope at work. 12 Of course, the workplace may be more or less accommodating of these issues—through policies around working time or emergency leave, for example—and it may be difficult to untangle the precise combination of causes of an individual’s difficulties. 13 But issues surrounding non-work stress will not be my main focus.

A. Definition

The dictionary definition of stress is a state of mental or emotional strain brought on by external pressures. 14 Psychologists point out that stress is not inherently negative: for example, feeling a bit nervous before a big event, such as a sporting or dramatic performance, may aid alertness and focus because the stress triggers the production of adrenaline as part of the body’s ‘fight or flight’ response. 15 This type of positive stress is sometimes referred to as ‘eustress’. 16

But the type of stress (or ‘distress’ 17 ) with which I am concerned is the negative type: where the external pressures overtop the individual’s capacity to cope. 18 This may be either acute—in response to a specific, devastating event—or chronic—involving sustained pressure over the longer term. Within psychology, there are various ‘scales’ of acute ‘stressors’ which assign values to different types of event (bereavement, divorce or moving house, for example) in order to calculate the extent to which a person is at risk of an adverse reaction to the particular combination of stressors they face at any given time. 19 Not surprisingly, losing one’s job is high on these scales, though problems within the workplace also feature. However, as we shall see, many of the cases on stress at work have been concerned less with particular catastrophic events and more with stress in its chronic form, for example, where the stressor is an unmanageable workload persisting over many months or years.

Importantly, being stressed is not, strictly speaking, itself a diagnosable psychological condition, but it can lead to the development of psychological conditions such as anxiety or depression. 20 Stress is also widely believed to be a factor in physical ill-health, ranging from increased susceptibility to coughs and colds, to the development of heart disease. 21 This is thought to be because the body’s physiological responses to stress, such as raised blood pressure and heightened immune responses, can become harmful if they cannot be regulated and brought back to normal after a short period of time.

B. Models of Occupational Stress

Occupational psychologists have developed a number of different models to help explain workplace stress. The demand-control model (DCM) associated with Karasek predicts that workers will experience stress where they have high demands placed upon them, particularly a heavy workload with deadlines, coupled with a lack of control over how they organise their working day. 22 The effort-reward imbalance (ER-I) model predicts that workers will experience stress where the effort they put in at work is not acknowledged through appropriate rewards, which might include pay or promotion prospects. 23 A difficulty with both these models is that while there is empirical evidence to support their claims, they are overly simple, focussing on one or two dimensions of what tends to be a highly complex problem in practice. 24 Probably a more popular model in the literature today is the job demands—resources or JD-R model, developed by Demerouti et al. 25 This takes account of a much wider variety of factors which may generate or help to guard against stress, and offers a more subtle account of the psychological processes at work. I have chosen to focus on this model largely because I find its nuanced explanation more persuasive, but also because space precludes a full overview of all the available approaches.

Under the JD-R model, job ‘demands’ include, most obviously, workload, but can also refer to other factors like unpleasant working environments or hostility from customers. 26 Excessive job demands can cause negative consequences for the worker such as exhaustion or ‘burnout’. Job ‘resources’ refers to a variety of factors that motivate or support workers in doing their jobs, including pay, job security, autonomy, voice and supportive colleagues or managers. 27 Job resources generate positive outcomes, typically labelled ‘work engagement’. The idea is that the resources available to the individual will help them to feel motivated or ‘engaged’ in their job. As Bakker and Demerouti explain, ‘[J]ob demands and resources are the triggers of two fairly independent processes, namely a health impairment process and a motivational process’. 28 However, the two processes are not entirely unconnected, because job resources—as well as generating motivation in themselves—can also serve as a ‘buffer’ against the negative consequences of job demands, such as burnout. 29 It seems likely that the efficacy of any particular resource in addressing job demands will depend on the nature of those demands. For example, if a worker has to confront highly emotional situations every day, supportive colleagues and managers are likely to be more relevant in addressing this particular job demand than a pay rise, for example, whereas overtime pay might provide some encouragement in the event of a short-term surge in demand. 30

Having outlined the JD-R model, it may be helpful to say a bit more about job demands and resources in themselves. It is important to note at the outset that demands and resources are not watertight analytical categories: something that is identified as a demand in one workplace may be experienced as a resource in another, or perceived differently by different groups of workers. 31 I offer some examples of this below.

Demands are the easiest to explain, and tend to be used to cover four main types of demand: workload, work/life balance, physical environment and emotional engagement. 32 Demands are not inherently a bad thing—after all, a key objective of the employment relationship is the exchange of work for pay, and from that perspective the ‘demands’ are what the employer is seeking to get out of the relationship. Some of the literature distinguishes ‘demands’ or ‘threats’ (negative) and ‘challenges’ (positive) in order to clarify this point. 33 Problems only arise when the demands are excessive, or insufficiently buffered by resources, or both. It is also worth noting that the nature of the demands experienced by workers is likely to vary from job to job, and one of the strengths of the JD-R model, according to its proponents, is its ability to be used in a variety of different work settings. 34 For example, the relevance of emotional engagement is likely to be higher in, for example, teaching or nursing, than it is in manufacturing, where workload and features of the physical environment (heat, noise, poor air quality and so on) may be more of an issue.

Resources are more complex. A useful framework is the individual, group, leadership, organisational or ‘IGLO’ classification set out by Nielsen et al. 35 This identifies the four main levels at which resources might be present. At the level of the individual worker, the worker’s personal resilience is important. This includes resources such as ‘self-efficacy’ (used in psychology to denote a person’s belief in their own capacity to succeed in a particular situation), self-esteem and optimism. 36 Obviously, the key point here is that workers’ personal traits affect their response to job demands, which explains why it is common to find that not all workers in a group faced with the same, overwhelming job demands will develop burnout over time. This is not in any sense to ‘blame’ workers for their situations, but rather to acknowledge the variety of human responses, in the same way that not everyone will develop a physical injury in response to heavy lifting or sitting at a desk all day. In recent years, another ‘individual’ factor, which has attracted attention in the literature, is ‘job crafting’. 37 This is the ability of the individual to make some adaptations to their day-to-day work to suit their interests and preferences. For example, a worker who enjoys teaching others might informally take on the role of training new members of staff, even though this role is not formally assigned by the employer. Allowing workers some scope to do this can have positive effects on their well-being.

Turning now to the ‘group’ level, the focus here is on the positive impact that a worker’s relationship with their team can have on their well-being. 38 A key factor here is the social support that team members are able to provide for each other. At the ‘leadership’ level, attention has focussed on the nature of the relationship between a manager and their team, and on the effect of different management styles. 39 For example, managers might motivate their teams in different ways—by promising rewards, such as pay rises, or through softer measures such as providing encouragement—and these can be studied for their impact on well-being.

At the organisational level, a particularly popular focus of the literature over many years has been ‘autonomy’. 40 This is the idea that giving workers some scope to determine parameters such as when and in what order they complete their work tasks increases their satisfaction and motivation at work. There are numerous studies establishing a relationship between autonomy and well-being, and of course for many people, though by no means everyone, repetitive, monotonous work is less likely to be satisfying. Some more recent studies have, however, begun to question this relationship given the potential for highly autonomous workers to experience constant and conflicting demands, for example, when they are expected to monitor work emails at all times, but this phenomenon does not necessarily undermine the general point about the value of autonomy. 41 Other job characteristics of relevance to worker well-being include: job tasks requiring a variety of different skills, being able to complete a whole task rather than just a component part, and the task itself having value or meaning, such as a positive impact on other people. 42 A body of literature further suggests that various human resources (HR) practices can have a positive impact. 43 These include providing clear feedback on performance, rewarding good performance, and offering training. Job security has also been a popular topic for analysis and the evidence suggests a positive relationship between job security and worker well-being. 44

There have been numerous empirical studies designed to test the JD-R model’s predictions. 45 Most of these use surveys of workers in particular sectors to identify the demands placed upon them and the resources available to them, and the causal link between the demands and resources on the one hand, and the outcomes for workers. 46 A smaller group of studies uses observation to verify workers’ explanations of their experiences. 47 There has also been a more recent push towards longitudinal studies, in which the same workers are surveyed on several occasions over time, acknowledging the fact that the development of—or prevention of—workplace stress is a long-term phenomenon. 48 The various processes envisaged by the JD-R model, such as the buffering role of resources, are well-supported by the empirical evidence, though of course there are ongoing attempts to refine the model. A particular problem, as pointed out by Schaufeli and Taris, is that the model’s breadth is both a strength and a weakness: it can be adapted to a variety of different contexts, but studies ‘testing the model’ in practice usually test different subsets of factors and may therefore be examining quite different things. 49

C. Relevance for Law

This review of the occupational psychology literature offers a number of useful insights into workplace stress. Two messages are particularly important. First, from this perspective, workplace stress is not solely an issue about the individual worker’s susceptibility to particular stressors. Although an individual’s resources are relevant, the way in which the workplace is organised and managed is also an important consideration. 50 Studies cannot easily establish the relative significance of these different factors, but they do demonstrate the basic point that stress is as much a structural as a personal phenomenon. Second, although excessive workplace demands, particularly high workloads, are a key factor leading workers to experience stress, the presence or absence of job resources is also highly relevant. A heavy workload is more likely to result in negative outcomes for the worker if it is coupled with, for example, low pay, tedious work and unsupportive management.

Before applying these insights to the legal materials, it is important to note the risks of taking ideas from one discipline and applying them in another. One potential problem is that the purposes of the two disciplines may be radically different. Occupational psychologists seek to understand and model workplace stress primarily in order to design interventions to tackle it. 51 These might be structural interventions aimed at employing entities, or therapeutic interventions aimed at workers. From this perspective, understanding the causes of stress and its negative consequences, such as exhaustion and burnout, is essential in understanding how to remove, reduce or address these causes. This understanding can be quite wide-ranging in nature. Presumably, employers can then decide—on a cost-benefit basis, for example—which interventions they consider to be worth pursuing. In this regard, there may be a bias towards organisational rather than individual interventions, which can be implemented by occupational health and HR professionals across an organisation at relatively low cost. As we shall see, although the law does have some preventative aims, its purposes are more complex.

Another factor to bear in mind is that what we might term the ‘preoccupations’ of the two disciplines may be quite different. The psychology literature tends to focus on larger, more traditional workplaces, again, perhaps because of the audience of occupational health and HR professionals who are more likely to be working in big firms. There is relatively little analysis of the JD-R model in contexts which seem very immediately and obviously problematic to lawyers, such as employment via internet platforms, or workplaces with a high proportion of casual workers. 52 One might reasonably hypothesise that workers in these workplaces may be more prone to ‘distress’ because of factors such as monotonous or repetitive work, a lack of control over the working day when working ‘on demand’, and difficulties accessing support from managers and colleagues when working sporadically or remotely. But, with the exception of a few studies of temporary workers, it appears that relatively little research has been carried out in these contexts. I return to the significance of this in section 3, below.

In this section, I will examine the law’s treatment of stress. This presents an immediate problem in view of the literature just considered. How can we sensibly define the law relating to stress? On one view, we could include almost any area of law that is intended to promote what we might term, following the ILO, ‘decent work’. 53 For example, legislation designed to promote collective bargaining or consultation should improve workers’ sense that they have a voice at work, which is one of the ‘job resources’ of value in buffering against stress. But this approach would not make for a practical article. The alternative is to focus on those areas of law which deal explicitly with preventing or remedying stress, the principal examples being health and safety law and tort law. 54 This will be my strategy here, though I will return to the broader point about decent work in section 3.

Before getting into the detail, it is worth pausing to consider what these various bodies of law are designed to do, since there is some diversity even within the narrower focus. Health and safety law has an explicitly preventative focus. It places duties upon employers and others to assess the risks to health within their business and to take reasonable steps to prevent workers and others from suffering illness or injury as a result. HSE is responsible for enforcing the law, which can include investigating incidents and prosecuting employers in the most serious cases. In recent years, HSE has had a particular focus on workplace stress, no doubt because of the evidence indicating that a high proportion of working days lost to ill-health are nowadays lost to stress-related problems. Tort law allows employees to seek compensation from their employer where they have suffered physical or ‘psychiatric’ injury at work due to the employer’s negligence. 55 This may be relevant where the employee has suffered mental or physical ill-health as a result of workplace stress. Although the primary focus of this body of law is providing the injured employee with a remedy for losses suffered, it is often suggested that it might also indirectly perform a deterrent function. Employers who are aware of the prospect of litigation in this area might take steps to protect themselves against liability, some of which may benefit employees.

The closest alignment between the occupational psychology literature and the law is therefore in the field of health and safety, where there is a clear focus on identifying potential causes of stress and taking steps to address them. The connection in relation to tort law is less obvious, but still present. Deciding whether the employer has been negligent involves deciding whether the employer has breached its duty of care towards the employee, which in turn requires a judgment about the preventative steps the employer should have taken. However, it will be argued here that both bodies of law take a strongly individualistic approach to workplace stress, treating it primarily as a matter of individual vulnerability rather than as a reflection of the way the workplace is organised and managed.

A. Health and Safety

In this section, I outline the law relating to health and safety as it applies to workplace stress, and the guidance on the topic developed by HSE. I argue that the guidance, while well-designed in general terms, is more likely in practice to result in minor changes to an individual’s job than in broader structural change in the workplace. There are also concerns about the enforcement of health and safety law and its proper application to the full variety of working relationships, not just to employees.

Under section 2(1) Health and Safety at Work etc Act 1974, ‘It shall be the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all his employees’. 56 A failure to discharge this duty is a criminal offence under section 33. There are further duties to put in place a policy on health and safety 57 and to engage in consultation with trade union or other representatives. 58 Under the Management of Health and Safety at Work Regulations 1999, r. 3, the employer is placed under a duty to conduct a risk assessment. 59 This is central to ensuring that the employer gives consideration to the specific risks arising in the workplace and takes steps to prevent them. The ‘principles of prevention’ are derived from EU law 60 and are given effect by r. 4 and Schedule 1, and include the following matters of potential relevance to workplace stress:

(d) adapting the work to the individual, especially as regards the design of workplaces, the choice of work equipment and the choice of working and production methods, with a view, in particular, to alleviating monotonous work and work at a predetermined work-rate and to reducing their effect on health
 (g) developing a coherent overall prevention policy which covers technology, organisation of work, working conditions, social relationships and the influence of factors relating to the working environment; (h) giving collective protective measures priority over individual protective measures


While the employer’s duty is, of course, to comply with the law, HSE plays an important role in providing detailed guidance on how the law should be applied and interpreted in particular contexts, and in setting priorities for enforcement. Thus, HSE’s approach to workplace stress is likely to be highly influential when employers are seeking to understand what the law requires of them in practice.

HSE first issued guidance on protecting employees’ physical and mental health from the effects of workplace stress in 1995, 61 and now has a sophisticated set of ‘management standards’ to tackle stress at work. 62 The management standards are set out on HSE’s website as follows:

Demands—this includes issues such as workload, work patterns and the work environment Control—how much say the person has in the way they do their work Support—this includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues Relationships—this includes promoting positive working to avoid conflict and dealing with unacceptable behaviour Role—whether people understand their role within the organisation and whether the organisation ensures that they do not have conflicting roles Change—how organisational change (large or small) is managed and communicated in the organisation 63

It is immediately apparent that these standards have been developed in the light of the psychology literature. 64 Demands are expressly included, and also feature within some of the other headings, for example, in the focus on role conflict and dealing with unacceptable behaviour (which might include violence or emotional demands from customers, for example). And resources are also present, covering all levels of the organisation, from the worker’s immediate colleagues to senior management.

HSE has published a ‘workbook’ to support employers to fulfil their statutory duty to conduct a risk assessment and take preventative steps in relation to stress. 65 This advises various common-sense steps, such as setting up a working group, surveying the workforce, and drafting and publicising a policy. It focuses in particular on organisation-wide activities, though it also highlights the importance of conducting individual risk assessments where it is apparent that a particular employee is at risk. This is supplemented an Indicator Tool, which can be used to survey the workforce, 66 and by further guidance documents such as an ‘example stress policy’, 67 a leaflet entitled ‘are you doing enough’, 68 and the Talking Toolkit to support conversations about stress. 69 My concern is that—despite HSE’s best efforts to ensure a structural focus—the end result is more likely to be a series of small-scale changes to individuals’ jobs.

One example is the treatment of ‘control’. As we have seen, having greater autonomy over the organisation of the working day and the work itself may act as a buffer against stress. The Workbook identifies the following as ‘what should be happening’:

Where possible, employees have control over their pace of work, eg have a say over when breaks can be taken. Employees are encouraged to use their skills and initiative to do their work. Where possible, employees are encouraged to develop new skills to help them undertake new and challenging pieces of work. The organisation encourages employees to develop their skills. Employees are consulted over their work patterns. 70

It offers further practical suggestions for achieving these objectives and some ‘dos and don’ts’ for employers. 71 However, the Workbook shies away from proposing any profound structural changes. For example, it identifies ‘project meetings, one-to-ones, performance reviews’ as suitable forums in which to give staff the chance to have a say in how their work is organised. 72 These are, of course, good ideas, but they are likely to involve either individual employees or small groups. There is no suggestion of, for example, holding a workplace-wide review of working time and flexible working policies (in the light of legal requirements and best practice) to identify whether more people could work flexibly or from home across the organisation as a whole. In turn, this puts pressure on individual employees to make a case for change for themselves.

Similarly, under the heading of ‘demands’, the Workbook identifies ‘what should be happening’ as follows:

The organisation provides employees with adequate and achievable demands in relation to the agreed hours of work. People’s skills and abilities are matched to the job demands. Jobs are designed to be within the capabilities of employees. Employees’ concerns about their work environment are addressed. 73

Again, these are important objectives, but the suggested ways of achieving them focus largely on holding meetings with individuals to discuss work plans, workload and how to prioritise. 74 There is no discussion of, for example, whether the employer has enough staff to meet demands, which is a particular issue in the public sector after years of austerity, or how demands themselves might be managed. The risk is that the focus shifts too readily to the individual’s ability to cope with their workload, whatever that workload might be.

While it is always to be hoped that good employers will make an effort to comply with health and safety standards regardless of how they are enforced, the prospect of investigation and enforcement has a role to play in raising the profile of such standards and encouraging less enthusiastic employers to take them seriously. But HSE has limited resources and a wide range of responsibilities, and although it has occasionally used its formal enforcement powers in relation to stress, 75 I have been unable to find any recent examples. 76 In 2019, HSE updated its guidance on investigations to state:

HSE will consider investigating concerns about work-related stress where: There is evidence that a number of staff are currently experiencing work-related stress or stress-related ill health, (i.e. that it is not an individual case), but
 HSE would expect concerns about work-related stress to have been raised already with the employer, and for the employer to have been given sufficient time to respond accordingly. 77

It is worth noting that stress-related illnesses are not reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), so the main route for prompting investigation by HSE would be a complaint, presumably from the affected workers or their trade union. 78 It is unclear whether any investigations have been undertaken as a result of the change in guidance.

Moreover, formal enforcement powers are something of a blunt instrument and are unlikely to be used to deal with less serious cases. This can be illustrated by reference to the improvement notice issued to the West Dorset General Hospitals NHS Trust in 2003. According to information released by HSE, the Trust had no risk assessment in place and no stress management policy, despite evidence of stress-related absences and high workloads, and had signalled that it had no intention of making stress a priority for another twelve months. 79 Under the well-known Ayres and Braithwaite ‘enforcement pyramid’, this was a classic case for formal enforcement because there did not appear to be any evidence of willingness to comply on the part of the employer. 80 While it is, of course, sensible to reserve limited enforcement resources for the most serious cases, this means that employers who make some effort to comply are unlikely to be troubled by the enforcement process, and there is little regulatory pressure on them to improve.

An alternative option is to allow working people themselves to enforce health and safety law through the civil courts. Since 2013, this possibility has been limited by section 69 Enterprise and Regulatory Reform Act 2013, which amended section 47 Health and Safety at Work etc. Act 1974 so that an action for breach of statutory duty is only available where the relevant health and safety regulations expressly so provide. However, claims may still be brought in negligence—discussed further below—and the courts often draw on health and safety law to determine whether the employer is in breach at common law. This is particularly true in relation to the employer’s approach to risk assessments. 81

Another limitation of health and safety law is uncertainty about its personal scope, and the extent to which employers owe duties to working people who are not employees. This issue was addressed recently in the IWGB case. 82 It was held that the EU Framework Directive, Article 3, 83 required Member States to implement health and safety protections for ‘workers’ as defined in EU free movement and equal pay law. 84 This meant that the UK’s use of the term ‘employee’ in the 1974 Act and other implementing measures was insufficient. 85 The judge thus held that the government had failed properly to implement Articles 8(4) and (5) of the Framework Directive (the right to leave the workplace in a situation of imminent danger) 86 and Article 3 of the Personal Protective Equipment (PPE) Directive (the employer’s duty to provide PPE) 87 with respect to workers, because these are rights currently available to employees only. However, the picture was more complex in relation to the general health and safety duties intended to be imposed on employers under Articles 5(1) and 6(1) of the Framework Directive. While these are implemented for employees only under section 2 of the 1974 Act, the judge was satisfied that these provisions of the Directive had nevertheless been properly implemented because section 3 made equivalent provision for ‘persons not in [the employer’s] employment who may be affected’ by the conduct of the employer’s business, which included workers (and others).

From the perspective of stress, this ruling puts beyond doubt the point that the employer should consider the needs of workers as well as employees when developing a policy on stress, conducting risk assessments and taking preventative steps. Although HSE has long taken the view that health and safety law is broad in scope, 88 there is now an urgent need for it to revisit and update its workplace stress guidance to ensure that it is relevant to different types of working arrangement. The current guidance tends to assume that it is being applied in a workplace with very traditional employer/employee relationships. For example, there is a strong emphasis on training, both to provide opportunities for staff to develop their careers, and to help them deal with difficult situations, 89 but it seems unlikely in practice that much training would be on offer for workers with short-term casual contracts. More profoundly, there is a major structural question about the extent to which precarious working arrangements of various kinds are inherently likely to put working people at a greater risk of stress-related ill-health, regardless of their specific design. I return to this point below.

To sum up, the HSE’s management standards have clearly been drafted based on psychological research, but the more detailed guidance provided by HSE is unambitious. There is a tendency for bold statements about demands, control and other factors to collapse into minor changes to a particular individual’s working experience. There are also questions about the extent to which the management standards are relevant to working people who are not in traditional ‘employee’ relationships and whether they are effectively enforced. At least three areas can be identified for reform. First, HSE’s guidance should be redrafted to emphasise the importance of considering structural changes within the employing entity to reduce the risk of stress before making adjustments to individuals’ jobs. Second, greater priority should be given to workplace stress in HSE’s enforcement activity. Although HSE clearly cannot tackle every case of stress, occasional use of its formal powers in serious cases would raise the profile of stress as a significant workplace issue. Third, new guidance is urgently needed to help employers consider suitable preventative steps to tackle the stress experienced by people in non-standard working relationships.

B. Tort Liability

Another body of law with an obvious role to play in dealing with stress at work is the law of tort. At common law, the employer is under a duty to take reasonable care to protect its employees 90 from injury at work. 91 This duty arises both in the law of negligence, because of the nature of the employment relationship, 92 and as an implied term of the contract of employment. 93 As we have seen, stress itself is not a diagnosable condition, so there is no liability in respect of stress per se, but claims may be brought where the employee has developed a physical or mental illness as a result of workplace stress. 94 Most of the reported cases relating to stress in fact concern mental illness, which is referred to by the courts as ‘psychiatric injury’. 95 I will argue in this section that the law’s approach is highly individualistic, focussing largely on the particular employee’s response to the circumstances and how their ‘vulnerabilities’ might have been managed, rather than on the broader structural factors at play. This perpetuates an unhelpful narrative about workplace stress, which is not consistent with the psychology literature.

One manifestation of this is in the courts’ approach to ‘foreseeability’. 96 Foreseeability is regarded as relevant to establishing whether the employer has breached its duty of care (alongside the seriousness of the injury to the employee and the cost of taking precautions to prevent it) and, to some extent, to establishing causation (whether the employee’s illness was a result of their work situation). The key question is what the employer could or should have predicted based on its knowledge of the situation. The courts begin from the premise that no job is inherently likely to cause ‘psychiatric injury’:

The notion that some occupations are in themselves dangerous to mental health is not borne out by the literature to which we have already referred: it is not the job but the interaction between the individual and the job which causes the harm. 97

This contrasts with the position in relation to physical injury, where it is recognised that some jobs—in the police or the fire service, for example—do carry greater risk, though workers in those services are taken to have accepted the risks inherent in their job not attributable to their employer’s negligence. 98 It is, of course, true that not every employee will develop ‘psychiatric injury’ as a result of a stressful work situation: in most of the cases before the courts, it is apparent that other employees in the same workplace facing the same conditions have not become ill as a result. But this is the starting-point for the courts’ focus on the individual.

Very occasionally, it is possible to establish liability on the basis of a ‘single stressful event’: where the workplace problem that caused the injury was so extreme that it was foreseeable that any employee of ‘ordinary robustness’ might suffer ‘psychiatric injury’ as a result. This was argued in the Yapp case, in which a diplomat was suddenly withdrawn from his posting without being given an opportunity to challenge allegations which subsequently turned out to be unfounded. 99 It was held that while the argument was available in principle, it was not made out in Yapp itself, because the employer’s action was not so extreme as to make the ‘psychiatric injury’ foreseeable in the absence of any known prior vulnerability on the part of the claimant. 100 However, a version of the argument succeeded in Melville , in which the claimant was a prison officer who was occasionally called upon to deal with suicides at the prison where he worked. 101 The Home Office had a procedure for supporting staff who had been in this situation but it had not been implemented properly in relation to the claimant. 102 The Court of Appeal upheld the judge’s finding that the Home Office was liable. The Home Office had in fact foreseen that prison officers might suffer psychiatric injury when dealing with suicides and it did not matter that this was in relation to all staff rather than the particular claimant. It was in the nature of a traumatic event that the claimant would show no signs of vulnerability before the event occurred.

However, where the claim relates to more general stressors, such as workload, it is necessary to show that the employer was aware of what the courts refer to as a particular vulnerability on the part of the claimant in order to establish that the ‘psychiatric injury’ was foreseeable. In most successful claims, this is done by demonstrating that the employer had been put on notice by a previous episode of stress-related ill-health. For example, in Walker , the first case in which an employer was found liable for ‘psychiatric injury’, it was crucial that the employee, a social work manager, had suffered two breakdowns as a result of his heavy workload. 103 After the first breakdown, he returned to work and was provided with additional support, but this was soon withdrawn, with the result that he suffered further ill-health and was ultimately unable to work again. It was held that the employer was not liable for the first breakdown, on the basis that it could not have been foreseen, but was liable for the second. Some of the more recent cases have relaxed this approach to some extent, finding that injury was foreseeable where the employee had clearly and repeatedly notified the employer of concerns about stress and workload, without suffering a breakdown or taking time off. 104 Nevertheless, the requirement remains that the employer should be aware of vulnerability on the part of the particular employee.

Crucially, although the employee’s work situation is relevant in establishing foreseeability, it does not appear that it could ever be sufficient. In the well-known Hatton guidelines, a number of factors relating to the work situation feature in guideline 5, as follows:

Is the workload much more than is normal for the particular job? Is the work particularly intellectually or emotionally demanding for this employee? Are demands being made of this employee unreasonable when compared with the demands made of others in the same or comparable jobs? Or are there signs that others doing this job are suffering harmful levels of stress? Is there an abnormal level of sickness or absenteeism in the same job or the same department? 105

However, the remainder of the guideline summarises factors demonstrating the vulnerability of the individual employee and it is clear from the judgment as a whole that these are regarded as much more important in establishing foreseeability. Indeed, a clear contrast between stress cases (apart from those involving a ‘single stressful event’) and other types of case is that foreseeability must be established in relation to the particular claimant rather than just a class of persons to which the claimant belongs.

The (unintentional) effect of the courts’ approach is to construct a narrative that employees who develop ‘psychiatric injury’ as a result of stress do so because they are particularly vulnerable, and to downplay the role of workplace factors such as workloads, long working hours or lack of sympathy from management. The deterrent effect of tort law is, of course, controversial and contested. But to the extent that it does exist, this approach largely absolves employers of the need to think about how the design of a particular job may be causing or contributing to the stress experienced by the employee.

Another element of establishing breach of the employer’s duty of care is a consideration of what precautions the employer could have taken, but failed to take, in order to protect the employee. As we saw above in the discussions of both Walker and Melville , employers are particularly likely to be held liable in cases where it is apparent that they decided what precautions were required but then failed to implement their own decision. 106 In less clear-cut cases, the judge must identify with some precision the precautions the employer should have taken, considering its size and administrative resources (with clear echoes of unfair dismissal law) and their likelihood of success. 107 The Court of Appeal in Hatton provided a non-exhaustive list of steps, including ‘giving the employee a sabbatical; transferring him to other work; redistributing the work; giving him some extra help for a while; arranging treatment or counselling; providing buddying or mentoring schemes to encourage confidence; and much more’. 108 Again, the focus is largely on steps to remedy the perceived vulnerability of the individual, rather than on reshaping the work or the workplace.

Perhaps the high-point of this emphasis on the individual is the idea that the employer’s provision of an occupational health service is likely to be a sufficient precaution in most cases. Again, this is clear from Hatton :

an employer who tries to balance all these interests by offering confidential help to employees who fear that they may be suffering harmful levels of stress is unlikely to be found in breach of duty: except where he has been placing totally unreasonable demands upon an individual in circumstances where the risk of harm was clear. 109

This is problematic from the perspective of the literature considered in the first part of this article. While there is nothing wrong with providing an occupational health service, it again tends to ‘individualise’ the problem of workplace stress. It is treated as a matter to be addressed by providing the employee with advice, rather than by restructuring the work or the workplace to make the employee’s situation less stressful. In some workplaces, such as that in Melville , the nature of the work cannot be changed, and the provision of support becomes essential. But in other cases, restructuring should be the employer’s first port of call. 110 The Court of Appeal in Hatton added the important qualification about intolerable pressures, indicating that occupational health provision is not the answer in every situation. This was borne out in Daw , where the court held that the only effective precaution the employer could have taken was to reduce the claimant’s workload. 111 The provision of an occupational health service and the claimant’s decision not to use it were held to be irrelevant in that case. Nevertheless, there is a worry that cases like Daw are the exception rather than the rule, so that the message about stress and individual vulnerability is reinforced.

To sum up, tort law constructs a narrative that ‘psychiatric injury’ caused by stress at work is largely a matter of vulnerability on the part of the claimant employee. This is illustrated by the way in which foreseeability is interpreted and applied, and by the emphasis on counselling as a sufficient precaution in most cases. This inhibits tort law’s capacity to fulfil its secondary goal of prompting employers to take preventative measures, such as redesigning jobs and workplaces to make them less stressful for their employees. To align the law more closely with what we know about stress from the JD-R model, the courts ought to place more emphasis on the predictive value of the work situation when considering foreseeability for the purposes of determining whether the employer is in breach (and, ideally, accept that foreseeability of stress-related psychiatric injury need only be established in relation to a class of persons to which the claimant belongs), and acknowledge that the employer’s obligation to take preventative steps should include reorganising the work, where possible, as well as providing support to individuals.

So far, the discussion has focussed on how a psychologically-informed understanding of stress might help us to critique and develop those bodies of law dealing explicitly with workplace stress, such as health and safety law or tort law. But the insight that the way in which workplaces and working lives are structured and organised is a key factor in either generating or combating stress at work has much broader implications too. These will be the focus of this section. I will develop two points. First, to tackle workplace stress in a comprehensive manner, many other bodies of law also need to be considered, including some that we would not normally think of as having any relationship to workplace stress at all. Second, the organisational and structural causes of stress seem likely to have significant implications for workplaces that are not arranged along ‘traditional’ lines, such as workplaces with significant use of casual work or platforms in the gig economy. Both of these points do, of course, raise huge issues, so I will need to confine myself to offering an overview and suggesting some questions for further research.

A. Other Areas of Law

There are many different ways of illustrating the argument that a legal regime promoting ‘decent work’ has a significant role to play in combating workplace stress, but for reasons of space, I will offer just two examples: working time and trade union representation in the workplace. The examples are contrasting in the sense that the relationship with tackling stress is much more obvious in the case of working time than it is in the case of trade union representation. Thinking about these bodies of law from the perspective of stress sheds new light on how they might be justified and interpreted.

The relationship between stress and hours of work may be obvious, but the mechanisms involved are complex. In many workplaces, long hours working is a ‘coping strategy’ for dealing with the fact that the amount of work to be done (the ‘demands’ of the job) far exceeds what can be accomplished in ‘normal’ working hours. 112 This may not be a problem if it is only occasional and foreseeable—a surge in demand in a retail business just before Christmas, for example—but long-term or unpredictable long-hours working can be a significant stressor. Long-term long-hours working impedes workers’ ability to spend time resting and recuperating, and can generate a sense of deep dissatisfaction through the inability ever to feel on top of job demands.

The Working Time Regulations (WTR) 1998 113 do, of course, have a health and safety objective at their heart, since they implement a Directive based on the EU’s health and safety competence. 114 In addition to the various enforcement mechanisms in the Regulations themselves, they have come to play a role in tort claims relating to workplace stress. Where the employer knows that the employee is working significantly in excess of the 48-hour limit, this can be relevant to the question whether the employee’s stress-related illness was reasonably foreseeable, particularly if the employee has refused to sign an opt-out and has complained about excessive hours. 115 However, thinking about the WTR from the perspective of stress adds a new dimension to the old argument about the legitimacy of the opt-out. The opt-out has long been controversial, in particular because of the likelihood that many workers will have no choice but to sign an opt-out as a condition of getting or keeping a job, so that the genuineness of any ‘consent’ they might have given can be called into question. 116 But from a stress perspective, the worry is that the opt-out might legitimise long-hours working as a means of coping with excessive workloads, rather than forcing the employer to tackle the cause of the problem, either by reassigning or reorganising work or by helping workers to manage their workloads more effectively. In particular, because the opt-out once signed remains valid for the duration of the employment, there is no obvious means of forcing the employer to review the situation to assess the impact of long-hours working on the worker over time.

A less obvious example of a body of law with relevance to workplace stress is that relating to trade union recognition and collective bargaining. On a simple level, collectively bargained terms and conditions are likely to ensure that workers are better paid for their efforts, which under some older models is considered to be a good protection against workplace stress. On a more sophisticated view though, a trade union presence in the workplace can help to give workers a voice on a variety of fronts: for example, in managing demands, such as excessive workloads, or securing resources, such as better training or support services. Empirical evidence suggests that unionised workplaces offer a wider variety of mechanisms for workers to articulate their concerns. 117 Perhaps most importantly, trade union representatives can play a significant role in coping with change in the workplace, which can be a significant source of stress for workers, particularly if they do not know what is happening and do not feel that their interests are being represented. For example, where unions are strong, employers might be more willing to respond to a need to improve productivity by training and empowering workers rather than by developing ever more aggressive performance monitoring strategies. 118

Of course, this is not to suggest that dealing with workplace stress should be regarded as a principal justification for policies to promote trade union membership or to support collective representation at work. But it does highlight a hidden cost of the failure to make these policies a central plank of labour policy in the UK over the past few decades. As workplaces have become more individualistic, there are fewer institutions in place to serve as ‘buffers’ against the kinds of job demands that can lead to stress-related illness. Both workers and, ultimately, employers have suffered as a result.

B. Casual or Platform Work

A thread running throughout this article has been a concern about the situation of working people who are not employees in ‘traditional’ jobs. This group tends to be under-represented in occupational health research, and faces uncertainties about legal entitlements. One of the key indicators of stress levels in the economy—working days lost through sickness absence due to stress—does not cover casual workers for whom the concept of a ‘sick day’ does not exist. What I want to highlight here is the extent to which temporary, casual or ‘gig’ work is likely to involve a combination of high demands and low resources, not just as a matter of a particular context at a particular time, but as a matter of the inherent structure of the job.

Of course, it is important to be careful about sweeping generalisations covering large numbers of differently-situated working people. However, we could reasonably hypothesise that some of the key problems associated with distress at work are likely to be more present in on-demand working of various kinds than they are in traditional jobs. 119 For present purposes, four examples will suffice. First, as we have seen, job insecurity has been shown to be a predictor of distress, and this is inherent in temporary or casual working. Second, constant work availability is associated with negative outcomes for permanent employees—for example, being expected to respond to work calls outside normal working hours—which might suggest that being called upon to work unpredictably and at short notice will also be a stressor for casual workers in particular. Third, having control over work tasks is a key resource which can buffer against stress, but this is wholly absent in some parts of the ‘gig’ economy where, once the worker has logged on to an app, their every move is governed by the app’s dictates. Fourth, having supportive colleagues is another buffering resource, but this is less likely to be present among dispersed workers who may not be able to meet each other very easily to develop a sense of community, and may be more obviously in competition with each other for the available work.

In practice, some of these hypotheses are not entirely borne out by the literature. One key example is around job insecurity. Here, the evidence tends to suggest that permanent employees react more strongly to job insecurity than do temporary workers. 120 However, the reason for this is significant. Permanent employees expect a high level of job security, so rumours that jobs may be at risk (for example) have a particularly harmful effect because they breach those expectations, taking away one of the valuable things about having a permanent job. Temporary workers experience this form of distress much less readily because they have lower expectations of security in the first place. Another key variant is the relationship between the individual’s job and other activities. For example, there is evidence to support the view that workers with ‘gig’ economy jobs are happier where the job is not their sole source of income or sole activity. 121 So a student doing a delivery job at weekends to make some extra money is likely to experience this very differently to someone doing the delivery job as their main job to support their family. The ‘gamification’ of some gig economy jobs—where completing a task quickly is rewarded in some way, as if it were a computer game—plays into this distinction, by making unskilled and potentially tedious work ‘fun’ for people who do not depend on it.

However, the literature exploring stress among gig economy workers is very much in its early stages of development, and there is relatively little material on more long-standing but similar phenomena such as temporary or casual working, so there is a lot more research to be done. From a legal perspective, it would be helpful to see greater dialogue between lawyers and psychologists on the most appropriate way to frame research questions about different forms of working.

My aim in this article has been to draw attention to a difference of emphasis between the psychology literature on stress and the legal approach. While the law tends to treat stress as a matter of individual vulnerability, to be addressed through tweaks to a person’s job or the provision of counselling, the psychology literature opens up the idea that a much broader range of factors can have an effect—positive or negative—on stress at work and its negative health effects. These are principally concerned with the way in which work is organised and managed—factors such as employee voice, support from colleagues or job security, for example—with the individual’s own susceptibility occupying a much less prominent place in the analysis. I draw three conclusions from this work.

First, the law should be more open to the idea that stress can have structural causes and that strategies to prevent or reduce the prevalence of stress should focus on structural change as well as support for individuals. This might be relevant in several different ways. For example, in risk assessments, greater emphasis might be placed on reviewing and altering workplace practices that contribute to stress—such as job insecurity or the lack of a mechanism for employee voice—as well as on factors relating to the individual’s job. In tort litigation, the courts could be more open to the idea that poor workplace practices may, in some cases, make harm foreseeable even where the affected individual had not shown previous signs of stress-related ill-health.

Second, we should be more aware of the role of worker well-being as a potential secondary justification for various elements of labour law. I do not wish to suggest that well-being can displace other more familiar justifications, such as inequality of bargaining power, dignity or human rights, but rather that it adds another important dimension to a multi-faceted approach to justifying labour law. Many elements of labour law—controls on working hours, rights relating to trade union recognition, protection against unfair dismissal and so on—can be seen as having a positive effect on employee well-being by buffering against stress. An attraction of well-being as a justification is that it is effective from multiple perspectives: it is an aspect of the dignity of working people, it benefits employers because happy and healthy workers are likely to be more productive, and it benefits the state because there should be less call on sickness benefits or healthcare services if workers are well-cared-for at work. Of course, it is incomplete—any one intervention is not likely to be transformative in its own right—but it should be given greater consideration than at present. This is potentially particularly important in relation to the gig economy, where harm to workers’ health and well-being is a significant argument against being allowed systematically to dispense with the normal protective structures of employment law.

Third, there is an urgent need for further research on the psychological effects of work in the ‘gig economy’ and of casual work more generally. I drew attention earlier to the limited range of psychology literature on this topic and the general tendency to focus on standard long-term employment relationships when examining employees’ responses to demands and resources at work. There are good reasons to believe that casual work may have negative effects on workers’ well-being, both because of its inherent uncertainty and irregularity and because of the knock-on consequences of that uncertainty, such as difficulties in organising workers or providing them with support from colleagues. But—as the example of temporary work and job insecurity shows—the picture is not entirely straightforward and it would be preferable to have more evidence from which reliable conclusions could be drawn.

I would like to thank Hugh Series and the Editor and referees for comments on an earlier draft, and participants in the Industrial Law Society’s online conference in September 2020 and the University of Haifa’s faculty seminar in January 2021 for their input. Responsibility for errors and omissions remains my own.

Health and Safety Executive, Work-Related Stress, Anxiety or Depression Statistics in Great Britain, 2019 (October 2019), drawing on data from the Labour Force Survey and the Health and Occupation Research Network for general practitioners. In 2018–19, stress, depression or anxiety accounted for 44% of work-related ill health and 54% of working days lost.

ACAS, Stress and Anxiety at Work: Personal or Cultural? (May 2019).

See, for example, A. VÀÀnĂ€nen et al., ‘The Double Burden of and Negative Spillover Between Paid and Domestic Work: Associations with Health Among Men and Women’ (2005) 40 Women and Health 1–18.

See T.H. Holmes and R.H. Rahe, ‘The Social Readjustment Rating Scale’ (1967) 11 Journal of Psychosomatic Research 213, 216.

Two leading scholars in the area are Brenda Barrett and Graeme Lockwood. See, for example, B. Barrett, ‘Should Employers Be Held More Responsible for Stress at the Work Place?’ (2011) 11 Contemporary Issues in Law 37; ‘Psychiatric Stress – An Unacceptable Cost to Employers’ (2008) 1 Journal of Business Law 64; Graeme Lockwood et al., ‘An Assessment of Employer Liability for Workplace Stress’ (2017) 59 International Journal of Law and Management 202.

See, for example, P. Handford, ‘Psychiatric Injury in Breach of a Relationship’ (2007) 27 Legal Studies 26, setting the employment cases in their broader context.

See, for example, M. Bell, ‘Mental Health at Work and the Duty to Make Reasonable Adjustments’ (2015) 44 ILJ 194; G. Lockwood et al., ‘Mental Health Disability Discrimination: Law Policy and Practice’ (2014) 14 International Journal of Discrimination and the Law 168.

See Barrett (2008), above n.7, 66–7.

Walker v Northumberland CC [1995] ICR 702.

See, for example, M. Hudson, The Management of Mental Health at Work (London: ACAS, November 2016), 2.1.

Relevant legislation includes Working Time Regulations 1998 (SI 1998/1833); Employment Rights Act 1996, s 57A.

https://www.lexico.com/definition/stress (last visited 24 March 2021).

Known as the Yerkes-Dodson law: RM Yerkes and JD Dodson, ‘The Relation of Strength of Stimulus to Rapidity of Habit-Formation’ (1908) 18 Journal of Comparative Neurology and Psychology 459.

A term coined by H. Selye, Stress without Distress (Philadelphia: JB Lippincott Co, 1974).

RS Lazarus and S Folkman, Stress, Appraisal and Coping (New York: Springer 1984), 21.

See, generally, American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders: DSM-5 , 5th edn (Washington: American Psychiatric Publishing 2013). The lines are blurred somewhat by the World Health Organisation’s International Statistical Classification of Diseases and Related Health Problems , 10th Revision (Geneva: WHO, 2019), which includes as code F43 a category of diagnosable disorders labelled ‘reaction to severe stress and adjustment disorders’, though these tend to be triggered by acute stressors.

See, for example, AE Nixon et al., ‘Can Work Make You Sick? A Meta-Analysis of the Relationships between Job Stressors and Physical Symptoms’ (2011) 25 Work and Stress 1; N. Schneiderman et al., ‘Stress and Health: Psychological, Behavioral, and Biological Determinants’, (2005) 1 Annual Review of Clinical Psychology 607.

See, for example, RA Karasek, ‘Job Demands, Job Decision Latitude, and Mental Strain: Implications for Job Design’ (1979) 24 Administrative Science Quarterly 285; R Karasek and T Theorell, Healthy Work: Stress, Productivity, and the Reconstruction of Working Life (New York: Basic Books 1990).

For example, J Siegrist, ‘Adverse Health Effects of High Effort-Low Reward Conditions’ (1996) 1 Journal of Occupational Health Psychology 27.

AB Bakker and E Demerouti, ‘The Job Demands‐Resources Model: State of the Art’ (2007) 22 Journal of Managerial Psychology 309, 311–2.

E Demerouti et al., ‘The Job Demands-Resources Model of Burnout’ (2001) 86 Journal of Applied Psychology 499; AB Bakker et al., ‘Job Resources Buffer the Impact of Job Demands on Burnout’ (2005) 10 Journal of Occupational Health Psychology 170; Bakker and Demerouti (2007), above n.24; AB Bakker and E Demerouti, ‘Job Demands-Resources Theory: Taking Stock and Looking Forward’ (2017) 22 Journal of Occupational Health Psychology 273.

Demerouti et al. (2001), above n.25, 501.

Ibid. 501–2.

AB Bakker and E Demerouti, ‘Job Demands-Resources Theory’ in PY Chen and C Cooper (eds), Wellbeing: A Complete Reference Guide (Chichester: John Wiley & Sons, 2014), 45.

Bakker and Demerouti (2007), above n.24, 314–5.

WB Schaufeli and TW Taris, ‘A Critical Review of the Job Demands-Resources Model: Implications for Improving Work and Health’ in GF Bauer and O HĂ€mmig (eds), Bridging Occupational, Organizational and Public Health: A Transdisciplinary Approach (Dordrecht: Springer 2014).

For example, Schaufeli and Taris, above n.31; A van den Broeck et al., ‘Not all Demands are Equal: Differentiating Job Hindrances and Job Challenges in the Job Demands-Resources Model’ (2010) 19 European Journal of Work and Organizational Psychology 735.

Above n.28, 45.

K Nielsen et al., ‘Workplace Resources to Improve Both Employee Well-Being and Performance: A Systematic Review and Meta-Analysis’ (2017) 31 Work and Stress 101, 102.

See D Xanthopoulou et al., ‘The Role of Personal Resources in the Job Demands-Resources Model’ (2007) 14 International Journal of Stress Management 121, 123–4; D Xanthopoulou et al., ‘Work Engagement and Financial Returns: A Diary Study on the Role of Job and Personal Resources’ (2009) 82 Journal of Organizational and Occupational Psychology 183.

For example, A Wrzesniewski and JE Dutton, ‘Crafting a Job: Revisioning Employees as Active Crafters of their Work’ (2001) 26 Academy of Management Review 179.

For example, P Torrente et al., ‘Teams Make it Work: How Team Work Engagement Mediates between Social Resources and Performance in Teams’ (2012) 24 Psicotema 106.

For an overview, see J Skakon et al., ‘The Impact of Leaders on Employee Stress and Affective Well-Being: A Systematic Review of Three Decades of Empirical Research’ (2010) 24 Work and Stress 107.

For example, Karasek, above n.22; B Schreurs et al., ‘Job Insecurity and Employee Health: the Buffering Potential of Job Control and Job Self-Efficacy’ (2010) 24 Work and Stress 56.

See S Schieman and MC Young, ‘Are Communications about Work Outside Regular Working Hours Associated with Work-to-Family Conflict, Psychological Distress and Sleep Problems?’ (2013) 27 Work and Stress 244; A VÀÀnĂ€nen and M Toivanen, ‘The Challenge of Tied Autonomy for Traditional Work Stress Models’ (2018) 32 Work and Stress 1.

A well-known paper on this topic is JR Hackman and GR Oldham, ‘Motivation through the Design of Work: Test of a Theory’ (1976) 16 Organizational Behavior and Human Performance 250.

For an overview of studies in this area, see K van De Voorde et al., ‘Employee Well-Being and the HRM–Organizational Performance Relationship: A Review of Quantitative Studies’ (2012) 14 International Journal of Management Reviews 391.

For example, Schreurs, above n.40.

For useful meta-analyses, see ER Crawford et al., ‘Linking Job Demands and Resources to Employee Engagement and Burnout: a Theoretical Extension and Meta-Analytic Test’ (2010) 95 Journal of Applied Psychology 834; JRB Halbesleben, ‘A Meta-Analysis of Work Engagement: Relationships with Burnout, Demands, Resources and Consequences’ in AB Bakker and MP Leiter (eds), Work Engagement: a Handbook of Essential Theory and Research (New York: Psychology Press 2010).

For example, AB Bakker et al., ‘Dual Processes at Work in a Call Centre: an Application of the Job Demands-Resources Model’ (2003) 12 European Journal of Work and Organizational Psychology 393; AB Bakker et al., ‘A Multigroup Analysis of the Job Demands-Resources Model in Four Home Care Organizations’ (2003) 10 International Journal of Stress Management 16.

For example, Demerouti et al. (2001), above n.25.

For an overview, see T Lesener et al., ‘The Job Demands-Resources Model: A Meta-Analytic Review of Longitudinal Studies’ (2019) 33 Work and Stress 76.

Schaufeli and Taris, above n.31.

See G Tinline and C Cooper, ‘Work-Related Stress: The Solution Is Management Not Mindfulness’ (2019) 48 Organizational Dynamics 93. It is perhaps telling that early versions of the JD-R model did not include individual resources at all and that this is a later addition to the model: see Bakker and Demerouti, above n.28; Schaufeli and Taris, above n.31.

For example, Bakker and Demerouti, above n.28, 53–8; T Cox et al., Organisational Interventions for Work Stress: A Risk Management Approach (London: HSE Books, 2000); C Mackay et al., ‘“Management Standards” and Work-Related Stress in the UK: Policy Background and Science’ (2004) 18 Work and Stress 91; Nielsen, above n.35, 115.

See C Bernhard-Oettel et al., ‘Comparing Three Alternative Types of Employment with Permanent Full-Time Work: How Do Employment Contract and Perceived Job Conditions Relate to Health Complaints?’ (2005) 19 Work and Stress 301; M Clarke et al., ‘“This Just Isn’t Sustainable”: Precarious Employment, Stress and Workers’ Health’ (2007) 30 International Journal of Law and Psychiatry 311; L HĂŒnefeld et al., ‘Job Satisfaction and Mental Health of Temporary Agency Workers in Europe: A Systematic Review and Research Agenda’ (2020) 34 Work and Stress 82.

https://www.ilo.org/global/topics/decent-work/lang--en/index.htm (last visited 24 March 2021).

Disability discrimination law may also be relevant where a worker develops a disability as a result of stress at work, or where stress exacerbates an existing disability (above n.9), but for reasons of space, I will not consider this in detail here.

Many people regard the term ‘psychiatric injury’ as unhelpful but I use it here because it is used by the courts. It is used to distinguish feelings such as grief or shock from more serious problems for which compensation may be sought.

I discuss the significance of the definition of ‘employee’ further below.

Section 2(3).

Section 2(4)–(7).

SI 1999/3242.

Council Directive 89/391/EC on the introduction of measures to encourage improvements in the health and safety of workers at work (‘the Framework Directive’), Article 1.

Health and Safety Executive, Stress at Work: A Guide for Employers (London: HSE Books, 1995).

https://www.hse.gov.uk/stress/standards/ (last visited 24 March 2021). There is also a European social partner framework on stress (European Trade Union Confederation et al., Framework Agreement on Work-Related Stress (24 March 2021)), and a UK equivalent (Confederation of British Industry et al., Work Related Stress – A Guide (2005).

For evaluation, see K Nielsen et al., ‘Conducting Organizational-Level Occupational Health Interventions: What Works?’ (2010) 24 Work and Stress 234. For examples of research supported, commissioned or published by HSE, see T Cox, Stress Research and Stress Management: Putting Theory to Work (London: HSE Books, 1993); Cox et al. (2000), above n.51; Mackay et al. (2004), above n.51; R Cousins et al., “Management Standards” and Work-Related Stress in the UK: Practical Development’ (2004) 18 Work and Stress 113; JA Edwards et al., ‘Psychometric Analysis of the UK Health and Safety Executive’s Management Standards Work-Related Stress Indicator Tool’ (2008) 22 Work and Stress 96.

HSE, Tackling Work-Related Stress Using the Management Standards Approach: A Step-By-Step Workbook (March 2019).

HSE, Management Standards Indicator Tool (nd), available at https://www.hse.gov.uk/stress/resources.htm (last visited 24 March 2021) under the ‘tools, templates and checklists’ tab.

Available at https://www.hse.gov.uk/stress/resources.htm (last visited 24 March 2021) under the ‘tools, templates and checklists’ tab.

HSE, Talking Toolkit: Preventing Work-Related Stress (nd), available at: https://www.hse.gov.uk/stress/index.htm (last visited 24 March 2021).

Above n.65, 49.

An improvement notice relating to workplace stress was issued to West Dorset General Hospitals NHS Trust in 2003 and to United Lincolnshire Hospitals NHS Trust in 2009: see N. Paton, ‘HSE issues improvement notice to NHS trust’, Personnel Today, 17 March 2009.

There are searchable registers of notices and prosecutions at: https://www.hse.gov.uk/enforce/convictions.htm (last visited 24 March 2021).

See https://www.hse.gov.uk/stress/reporting-concern.htm (last visited 24 March 2021), and B Liversedge, ‘HSE announces it will inspect stress “if criteria are met”, Safety Management (24 March 2021), available at: https://www.britsafe.org/publications/safety-management-magazine/safety-management-magazine/ (last visited 24 March 2021).

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013, SI 2013/1471.

See https://www.hse.gov.uk/foi/releases/westdorsetgen.pdf (last visited 17 August 2020).

I Ayres and J Braithwaite, Responsive Regulation: Transcending the Deregulation Debate (Oxford: OUP, 1992).

Kennedy v Cordia (Services) LLP [2016] UKSC 6, [2016] ICR 325, [110].

R (Independent Workers’ Union of Great Britain) v Secretary of State for Work and Pensions [2020] EWHC 3050 (Admin).

Above n.60.

Above n.82, [82]–[83].

Health and Safety at Work etc Act 1974, s 53(1).

Above n.60, and see Employment Rights Act 1996, ss 44 and 100. The government is, at the time of writing (March 2021), proposing to amend s 44. See the draft Employment Rights Act 1996 (Protection from Detriment in Health and Safety Cases) (Amendment) Order 2021.

Directive 89/656/EC on the use of personal protective equipment.

See https://www.hse.gov.uk/enforce/enforcementguide/investigation/status-intro.htm (last visited 24 March 2021) and Lane v Shire Roofing [1995] IRLR 493.

Above n.65, Appendix 6.

There is virtually no case law considering other types of employment relationship, though Freedland makes a strong case for extending the duty, at least in modified form, to workers and others: M Freedland, The Personal Employment Contract (Oxford: OUP, 2005), 152.

An oft-cited summary is that provided by Swanwick J in Stokes v Guest, Keen and Nettlefold (Bolts and Nuts) Ltd. [1968] 1 WLR 1776, 1783.

See S Deakin and Z Adams, Markesinis and Deakin’s Tort Law , 8th edn (Oxford: OUP 2019), 123.

See Yapp v Foreign and Commonwealth Office [2014] EWCA Civ 1512, [2015] IRLR 112 for guidance on managing the differences between claims in contract and tort in this context.

An empirical study by Lockwood et al., above n.7, showed that very few claims in fact succeed.

This terminology is arguably unhelpful, but I use it for consistency with the case law. For a powerful critique of the requirement, see R Mulheron, ‘Rewriting the Requirement for a “Recognized Psychiatric Injury” in Negligence Claims’ (2012) 32 OJLS 77. For an analysis of the law in work and non-work cases, see D Nolan, ‘Psychiatric Injury at the Crossroads’ [2004] JPIL 1.

Hatton v Sutherland [2002] EWCA Civ 76, [2002] ICR 613, [23] (Hale LJ).

Hatton , above n.96, [24], referring to Law Commission and HSE materials cited at [3]–[10].

Ibid. [12].

Yapp , above n.93.

Ibid. [119]–[133], and see also Piepenbrock v London School of Economics and Political Science [2018] EWHC 2572 (QB), [2018] ELR 596.

One of the cases heard with Hartman v South Essex Mental Health and Community Care NHS Trust [2005] EWCA Civ 6, [2005] ICR 782, [126]–[138].

Although this might seem to create a perverse incentive not to ‘foresee’ injuries, the employer would have had a strong argument that it had not breached its duty of care had it implemented its own policy properly: ibid. [136].

Above n.11.

For example, Daw v Intel Corp (UK) Ltd [2007] EWCA Civ 70, [2007] ICR 1318; Dickins v O2 Plc [2008] EWCA Civ 1144, [2009] IRLR 58.

Hatton , above n.96, [43]. Breaches of health and safety law are relevant in negligence cases but do not obviate the need to establish all the usual elements of the claim, a point neatly illustrated by Bailey v Devon Partnership NHS Trust (QB, 11 July 2014, unreported).

Above nn 11 and 101, respectively.

Hatton , above n.96, [43], points 9 and 13.

Ibid. [33].

Ibid. [34].

Above n.101.

Above n.104.

For an early case tackling the issue from a contractual perspective, see Johnstone v Bloomsbury HA [1992] QB 333 (CA).

Above n.13.

Article 118a of the Treaty Establishing the European Community, now Article 153 TFEU, provided the basis for successive Working Time Directives, the latest being Directive 2003/88/EC.

Hone v Six Continents Retail Ltd [2005] EWCA Civ 922, [2006] IRLR 49; but cf Sayers v Cambridgeshire CC [2006] EWHC 2029 (QB), [2007] IRLR 29.

For empirical evidence and discussion, see C Barnard et al., ‘Opting Out of the 48-Hour Week: Employer Necessity or Individual Choice? An Empirical Study of the Operation of Article 18(1)(b) of the Working Time Directive in the UK’ (2003) 32 ILJ 223, 245–8.

See, for example, J Benson, ‘Employee Voice in Union and Non-union Australian Workplaces’ (2000) 38 British Journal of Industrial Relations 453. However, it is important to acknowledge that stress is a significant problem in the UK public sector, which is highly unionised, suggesting that union voice may not always be a sufficient buffer against, for example, high levels of demand caused by budget cuts.

See V Doellgast, ‘Collective Voice under Decentralized Bargaining: A Comparative Study of Work Reorganization in US and German Call Centres (2010) 48 British Journal of Industrial Relations 375.

See the literature cited at n.52 above.

N de Cuyper and H de Witte, ‘Job Insecurity in Temporary Versus Permanent Workers: Associations with Attitudes, Well-Being, and Behaviour’ (2007) 21 Work and Stress 65.

Clarke et al., above n.52.

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ORIGINAL RESEARCH article

Work stress, mental health, and employee performance.

\nBiao Chen

  • 1 School of Business, Zhengzhou University, Zhengzhou, China
  • 2 Henan Research Platform Service Center, Zhengzhou, China

The COVID-19 pandemic outbreak—as a typical emergency event—significantly has impacted employees' psychological status and thus has negatively affected their performance. Hence, along with focusing on the mechanisms and solutions to alleviate the impact of work stress on employee performance, we also examine the relationship between work stress, mental health, and employee performance. Furthermore, we analyzed the moderating role of servant leadership in the relationship between work stress and mental health, but the result was not significant. The results contribute to providing practical guidance for enterprises to improve employee performance in the context of major emergencies.

Introduction

Small- and medium-sized enterprises (SMEs) are the key drivers of economic development as they contribute >50, 60, 70, 80, and 90% of tax revenue, GDP, technological innovation, labor employment, and the number of enterprises, respectively. However, owing to the disadvantages of small-scale and insufficient resources ( Cai et al., 2017 ; Flynn, 2017 ), these enterprises are more vulnerable to being influenced by emergency events. The COVID-19 pandemic outbreak—as a typical emergency event—has negatively affected survival and growth of SMEs ( Eggers, 2020 ). Some SMEs have faced a relatively higher risk of salary reduction, layoffs, or corporate bankruptcy ( Adam and Alarifi, 2021 ). Consequently, it has made employees in the SMEs face the following stressors during the COVID-19 pandemic: First, employees' income, promotion, and career development opportunities have declined ( Shimazu et al., 2020 ). Second, as most employees had to work from home, family conflicts have increased and family satisfaction has decreased ( Green et al., 2020 ; Xu et al., 2020 ). Finally, as work tasks and positions have changed, the new work environment has made employees less engaged and less fulfilled at work ( Olugbade and Karatepe, 2019 ; Chen and Fellenz, 2020 ).

For SMEs, employees are their core assets and are crucial to their survival and growth ( Shan et al., 2022 ). Employee work stress may precipitate burnout ( Choi et al., 2019 ; Barello et al., 2020 ), which manifests as fatigue and frustration ( Mansour and Tremblay, 2018 ), and is associated with various negative reactions, including job dissatisfaction, low organizational commitment, and a high propensity to resign ( Lu and Gursoy, 2016 ; Uchmanowicz et al., 2020 ). Ultimately, it negatively impacts employee performance ( Prasad and Vaidya, 2020 ). The problem of employee work stress has become an important topic for researchers and practitioners alike. In this regard, it is timely to explore the impact of work stress on SME problems of survival and growth during emergency events like the COVID-19 pandemic.

Although recent studies have demonstrated the relationship between work stress and employee performance, some insufficiencies persist, which must be resolved. Research on how work stress affects employee performance has remained fragmented and limited. First, the research into how work stress affects employee performance is still insufficient. Some researchers have explored the effects of work stress on employee performance during COVID-19 ( Saleem et al., 2021 ; Tu et al., 2021 ). However, they have not explained the intermediate path, which limits our understanding of effects of work stress. As work stress causes psychological pain to employees, in response, they exhibit lower performance levels ( Song et al., 2020 ; Yu et al., 2022 ). Thus, employees' mental health becomes an important path to explain the relationship mechanism between work stress and employee performance, which is revealed in this study using a stress–psychological state–performance framework. Second, resolving the mental health problems caused by work stress has become a key issue for SMEs during the COVID-19 pandemic. As the core of the enterprise ( Ahn et al., 2018 ), the behavior of leaders significantly influences employees. Especially for SMEs, intensive interactive communication transpires between the leader and employees ( Li et al., 2019 ; Tiedtke et al., 2020 ). Servant leadership, as a typical leader's behavior, is considered an important determinant of employee mental health ( Haslam et al., 2020 ). Hence, to improve employees' mental health, we introduce servant leadership as a moderating variable and explore its contingency effect on relieving work stress and mental health.

This study predominantly tries to answer the question of how work stress influences employee performance and explores the mediating impact of mental health and the moderating impact of servant leadership in this relationship. Mainly, this study contributes to the existing literature in the following three ways: First, this research analyzes the influence of work stress on employee performance in SMEs during the COVID-19 pandemic, which complements previous studies and theories related to work stress. Second, this study regards mental health as a psychological state and examines its mediating impact on the relationship between work stress and employee performance, which complements the research path on how work stress affects employee performance. Third, we explore the moderating impact of servant leadership, which has been ignored in previous research, thus extending the understanding of the relationship between the work stress and mental health of employees in SMEs.

To accomplish the aforementioned tasks, the remainder of this article is structured as follows: First, based on the literature review, we propose our hypotheses. Thereafter, we present our research method, including the processes of data collection, sample characteristics, measurement of variables, and sample validity. Subsequently, we provide the data analysis and report the results. Finally, we discuss the results and present the study limitations.

Theoretical background and hypotheses

Work stress and employee performance.

From a psychological perspective, work stress influences employees' psychological states, which, in turn, affects their effort levels at work ( Lu, 1997 ; Richardson and Rothstein, 2008 ; Lai et al., 2022 ). Employee performance is the result of the individual's efforts at work ( Robbins, 2005 ) and thus is significantly impacted by work stress. However, previous research has provided no consistent conclusion regarding the relationship between work stress and employee performance. One view is that a significant positive relationship exists between work stress and employee performance ( Ismail et al., 2015 ; Soomro et al., 2019 ), suggesting that stress is a motivational force that encourages employees to work hard and improve work efficiency. Another view is that work stress negatively impacts employee performance ( Yunus et al., 2018 ; Nawaz Kalyar et al., 2019 ; Purnomo et al., 2021 ), suggesting that employees need to spend time and energy to cope with stress, which increases their burden and decreases their work efficiency. A third view is that the impact of work stress on employee performance is non-linear and may exhibit an inverted U-shaped relationship ( McClenahan et al., 2007 ; Hamidi and Eivazi, 2010 ); reportedly, when work stress is relatively low or high, employee performance is low. Hence, if work stress reaches a moderate level, employee performance will peak. However, this conclusion is derived from theoretical analyses and is not supported by empirical data. Finally, another view suggests that no relationship exists between them ( Tănăsescu and Ramona-Diana, 2019 ). Indubitably, it presupposes that employees are rational beings ( Lebesby and Benders, 2020 ). Per this view, work stress cannot motivate employees or influence their psychology and thus cannot impact their performance.

To further explain the aforementioned diverse views, positive psychology proposes that work stress includes two main categories: challenge stress and hindrance stress ( Cavanaugh et al., 2000 ; LePine et al., 2005 ). Based on their views, challenge stress represents stress that positively affects employees' work attitudes and behaviors, which improves employee performance by increasing work responsibility; by contrast, hindrance stress negatively affects employees' work attitudes and behaviors, which reduces employee performance by increasing role ambiguity ( Hon and Chan, 2013 ; Deng et al., 2019 ).

During the COVID-19 pandemic, SMEs have faced a relatively higher risk of salary reductions, layoffs, or corporate bankruptcy ( Adam and Alarifi, 2021 ). Hence, the competition among enterprises has intensified; managers may transfer some stress to employees, who, in turn, need to bear this to maintain and seek current and future career prospects, respectively ( Lai et al., 2015 ). In this context, employee work stress stems from increased survival problems of SMEs, and such an external shock precipitates greater stress among employees than ever before ( Gao, 2021 ). Stress more frequently manifests as hindrance stress ( LePine et al., 2004 ), which negatively affects employees' wellbeing and quality of life ( Orfei et al., 2022 ). It imposes a burden on employees, who need to spend time and energy coping with the stress. From the perspective of stressors, SMEs have faced serious survival problems during the COVID-19 pandemic, and consequently, employees have faced greater hindrance stress, thereby decreasing their performance. Hence, we propose the following hypothesis:

H1 . Work stress negatively influences employee performance in SMEs during the COVID-19 pandemic.

Work stress and mental health

According to the demand–control–support (DCS) model ( Karasek and Theorell, 1990 ), high-stress work—such as high job demands, low job control, and low social support at work—may trigger health problems in employees over time (e.g., mental health problems; Chou et al., 2015 ; Park et al., 2016 ; Lu et al., 2020 ). The DCS model considers stress as an individual's response to perceiving high-intensity work ( Houtman et al., 2007 ), which precipitates a change in the employee's cognitive, physical, mental, and emotional status. Of these, mental health problems including irritability, nervousness, aggressive behavior, inattention, sleep, and memory disturbances are a typical response to work stress ( Mayerl et al., 2016 ; Neupane and Nygard, 2017 ). If the response persists for a considerable period, mental health problems such as anxiety or depression may occur ( Bhui et al., 2012 ; Eskilsson et al., 2017 ). As coping with work stress requires an employee to exert continuous effort and apply relevant skills, it may be closely related to certain psychological problems ( Poms et al., 2016 ; Harrison and Stephens, 2019 ).

The COVID-19 pandemic has disrupted the normal operating order of enterprises as well as employees' work rhythm. Consequently, employees might have faced greater challenges during this period ( Piccarozzi et al., 2021 ). In this context, work stress includes stress related to health and safety risk, impaired performance, work adjustment, and negative emotions, for instance, such work stress can lead to unhealthy mental problems. Hence, we propose the following hypothesis:

H2 . Work stress negatively influences mental health in SMEs during the COVID-19 pandemic.

Mediating role of mental health

Previous research has found that employees' mental health status significantly affects their performance ( Bubonya et al., 2017 ; Cohen et al., 2019 ; Soeker et al., 2019 ), the main reasons of which are as follows: First, mental health problems reduce employees' focus on their work, which is potentially detrimental to their performance ( Hennekam et al., 2020 ). Second, mental health problems may render employees unable to work ( Heffernan and Pilkington, 2011 ), which indirectly reduces work efficiency owing to increased sick leaves ( Levinson et al., 2010 ). Finally, in the stress context, employees need to exert additional effort to adapt to the environment, which, consequently, make them feel emotionally exhausted. Hence, as their demands remain unfulfilled, their work satisfaction and performance decrease ( Khamisa et al., 2016 ).

Hence, we propose that work stress negatively impacts mental health, which, in turn, positively affects employee performance. In other words, we argue that mental health mediates the relationship between work stress and employee performance. During the COVID-19 pandemic, work stress—owing to changes in the external environment—might have caused nervous and anxious psychological states in employees ( Tan et al., 2020 ). Consequently, it might have rendered employees unable to devote their full attention to their work, and hence, their work performance might have decreased. Meanwhile, due to the pandemic, employees have faced the challenges of unclear job prospects and reduced income. Therefore, mental health problems manifest as moods characterized by depression and worry ( Karatepe et al., 2020 ). Negative emotions negatively impact employee performance. Per the aforementioned arguments and hypothesis 2, we propose the following hypothesis:

H3 . Mental health mediates the relationship between work stress and employee performance in SMEs during the COVID-19 pandemic.

Moderating role of servant leadership

According to the upper echelons theory, leaders significantly influence organizational activities, and their leadership behavior influences the thinking and understanding of tasks among employees in enterprises ( Hambrick and Mason, 1984 ). Servant leadership is a typical leadership behavior that refers to leaders exhibiting humility, lending power to employees, raising the moral level of subordinates, and placing the interests of employees above their own ( Sendjaya, 2015 ; Eva et al., 2019 ). This leadership behavior provides emotional support to employees and increase their personal confidence and self-esteem and thus reduce negative effects of work stress. In our study, we propose that servant leadership reduces the negative effects of work stress on mental health in SMEs.

Servant leadership can reduce negative effects of work stress on mental health in the following ways: Servant leaders exhibit empathy and compassion ( Lu et al., 2019 ), which help alleviate employees' emotional pain caused by work stress. Song et al. (2020) highlighted that work stress can cause psychological pain among employees. However, servant leaders are willing to listen to their employees and become acquainted with them, which facilitates communication between the leader and the employee ( Spears, 2010 ). Hence, servant leadership may reduce employees' psychological pain through effective communication. Finally, servant leaders lend employees power, which makes the employees feel trusted. Employees—owing to their trust in the leaders—trust the enterprises as well, which reduces the insecurity caused by work stress ( Phong et al., 2018 ). In conclusion, servant leadership serves as a coping resource that reduces the impact of losing social support and thus curbs negative employee emotions ( Ahmed et al., 2021 ). Based on the aforementioned analysis, we find that servant leaders can reduce the mental health problems caused by work stress. Hence, we propose the following hypothesis:

H4 . Servant leadership reduces the negative relationship between work stress and mental health in SMEs during the COVID-19 pandemic.

Methodology

Data collection and samples.

To assess our theoretical hypotheses, we collected data by administering a questionnaire survey. The questionnaire was administered anonymously, and the respondents were informed regarding the purpose of the study. Owing to the impact of the pandemic, we distributed and collected the questionnaires by email. Specifically, we utilized the network relationships of our research group with the corporate campus and group members to distribute the questionnaires. In addition, to ensure the quality of the questionnaires, typically senior employees who had worked for at least 2 years at their enterprises were chosen as the respondents.

Before the formal survey, we conducted a pilot test. Thereafter, we revised the questionnaire based on the results of the trial investigation. Subsequently, we randomly administered the questionnaires to the target enterprises. Hence, 450 questionnaires were administered via email, and 196 valid questionnaires were returned—an effective rate of 43.6%. Table 1 presents the profiles of the samples.

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Table 1 . Profiles of the samples.

Table 1 shows the descriptive statistics of the sample. Based on the firm size, respondents who worked in a company with 1–20 employees accounted for 9.2%, those in a company with 21–50 employees accounted for 40.8%, those in a company with 51–200 employees accounted for 38.8%, and those in a company with 201–500 employees accounted for 11.2%. Regarding industry, the majority of the respondents (63.8%) worked for non-high-technology industry and 36.2% of the respondents worked for high-technology industry. Regarding work age, the participants with a work experience of 3 years or less accounted for 32.1%, those with work experience of 3–10 years accounted for 32.7%, and those with a work experience of more than 10 years accounted for 35.2%.

Core variables in this study include English-version measures that have been well tested in prior studies; some modifications were implemented during the translation process. As the objective of our study is SMEs in China, we translated the English version to Chinese; this translation was carried out by two professionals to ensure accuracy. Thereafter, we administered the questionnaires to the respondents. Hence, as the measures of our variables were revised based on the trial investigation, we asked two professionals to translate the Chinese version of the responses to English to enable publishing this work in English. We evaluated all the items pertaining to the main variables using a seven-point Likert scale (7 = very high/strongly agree, 1 = very low/strongly disagree). The variable measures are presented subsequently.

Work stress (WS)

Following the studies of Parker and DeCotiis (1983) and Shah et al. (2021) , we used 12 items to measure work stress, such as “I get irritated or nervous because of work” and “Work takes a lot of my energy, but the reward is less than the effort.”

Mental health (MH)

The GHQ-12 is a widely used tool developed to assess the mental health status ( Liu et al., 2022 ). However, we revised the questionnaire by combining the research needs and results of the pilot test. We used seven items to measure mental health, such as “I feel that I am unable (or completely unable) to overcome difficulties in my work or life.” In the final calculation, the scoring questions for mental health were converted; higher scores indicated higher levels of mental health.

Servant leadership (SL)

Following the studies by Ehrhart (2004) and Sendjaya et al. (2019) , we used nine items to measure servant leadership, including “My leader makes time to build good relationships with employees” and “My leader is willing to listen to subordinates during decision-making.”

Employee performance (EP)

We draw on the measurement method provided by Chen et al. (2002) and Khorakian and Sharifirad (2019) ; we used four items to represent employee performance. An example item is as follows: “I can make a contribution to the overall performance of our enterprise.”

Control variables

We controlled several variables that may influence employee performance, including firm size, industry, and work age. Firm size was measured by the number of employees. For industry, we coded them into two dummy variables (high-technology industry = 1, non-high-technology industry = 0). We calculated work experience by the number of years the employee has worked for the enterprise.

Common method bias

Common method bias may exist because each questionnaire was completed independently by each respondent ( Cai et al., 2017 ). We conducted a Harman one-factor test to examine whether common method bias significantly affected our data ( Podsakoff and Organ, 1986 ); the results revealed that the largest factor in our data accounted for only 36.219% of the entire variance. Hence, common method bias did not significantly affect on our study findings.

Reliability and validity

We analyzed the reliability and validity of our data for further data processing, the results of which are presented in Table 2 . Based on these results, we found that Cronbach's alpha coefficient of each variable was >0.8, thus meeting the requirements for reliability of the variables. To assess the validity of each construct, we conducted four separate confirmatory factor analyses. All the factor loadings exceeded 0.5. Overall, the reliability and validity results met the requirements for further data processing.

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Table 2 . Results of confirmatory factor analysis and Cronbach's alpha coefficients.

To verify our hypotheses, we used a hierarchical linear regression method. Before conducting the regression analysis, we performed a Pearson correlation analysis, the results of which are presented in Table 3 .

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Table 3 . Descriptive statistics and correlation analysis.

In the regression analysis, we calculated the variance inflation factor (VIF) of each variable and found that the VIF value of each variable was <3. Hence, the effect of multiple co-linearity is not significant. The results of regression analysis are presented in Tables 4 , 5 .

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Table 4 . Results of linear regression analysis (models 1–6).

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Table 5 . Results of linear regression analysis (models 7–9).

Table 4 shows that model 1 is the basic model assessing the effects of control variables on employee performance. In model 2, we added an independent variable (work stress) to examine its effect on employee performance. The results revealed that work stress negatively affects employee performance (β = −0.193, p < 0.01). Therefore, hypothesis 1 is supported. Model 5 is the basic model that examines the effects of control variables on mental health. In model 6, we added an independent variable (work stress) to assess its effect on mental health. We found that work stress negatively affects mental health (β = −0.517, p < 0.001). Therefore, hypothesis 2 is supported.

To verify the mediating effect of mental health on the relationship between work stress and employee performance, we used the method introduced by Kenny et al. (1998) , which is described as follows: (1) The independent variable is significantly related to the dependent variable. (2) The independent variable is significantly related to the mediating variable. (3) The mediating variable is significantly related to the dependent variable after controlling for the independent variable. (4) If the effect of the independent variable on the dependent variable becomes smaller, it indicates a partial mediating effect. (5) If the effect of the independent variable on the dependent variable is no longer significant, it indicates a full mediating effect. Based on this method, in model 4, mental health is significantly positively related to employee performance (β = 0.343, p < 0.001), and no significant correlation exists between work stress and employee performance (β = −0.016, p > 0.05). Hence, mental health fully mediates the relationship between work stress and employee performance. Therefore, hypothesis 3 is supported.

To verify the moderating effect of servant leadership on the relationship between work stress and mental health, we gradually added independent variables, a moderator variable, and interaction between the independent variables and moderator variable to the analysis, the results of which are presented in Table 5 . In model 9, the moderating effect of servant leadership is not supported (β = 0.030, p > 0.05). Therefore, hypothesis 4 is not supported.

For SMEs, employees are core assets and crucial to their survival and growth ( Shan et al., 2022 ). Specifically, owing to the COVID-19 pandemic, employees' work stress may precipitate burnout ( Choi et al., 2019 ; Barello et al., 2020 ), which influences their performance. Researchers and practitioners have significantly focused on resolving the challenge of work stress ( Karatepe et al., 2020 ; Tan et al., 2020 ; Gao, 2021 ). However, previous research has not clearly elucidated the relationship among work stress, mental health, servant leadership, and employee performance. Through this study, we found the following results:

Employees in SMEs face work stress owing to the COVID-19 pandemic, which reduces their performance. Facing these external shocks, survival and growth of SMEs may become increasingly uncertain ( Adam and Alarifi, 2021 ). Employees' career prospects are negatively impacted. Meanwhile, the pandemic has precipitated a change in the way employees work, their workspace, and work timings. Moreover, their work is now intertwined with family life. Hence, employees experience greater stress at work than ever before ( Gao, 2021 ), which, in turn, affects their productivity and deteriorates their performance.

Furthermore, we found that mental health plays a mediating role in the relationship between work stress and employee performance; this suggests that employees' mental status is influenced by work stress, which, in turn, lowers job performance. Per our findings, due to the COVID-19 pandemic, employees experience nervous and anxious psychological states ( Tan et al., 2020 ), which renders them unable to devote their full attention to their work; hence, their work performance is likely to decrease.

Finally, we found that leaders are the core of any enterprise ( Ahn et al., 2018 ). Hence, their leadership behavior significantly influences employees. Per previous research, servant leadership is considered a typical leadership behavior characterized by exhibiting humility, delegating power to employees, raising the morale of subordinates, and placing the interests of employees above their own ( Sendjaya, 2015 ; Eva et al., 2019 ). Through theoretical analysis, we found that servant leadership mitigates the negative effect of work stress on mental health. However, the empirical results are not significant possibly because work stress of employees in SMEs is rooted in worries regarding the future of the macroeconomic environment, and the resulting mental health problems cannot be cured merely by a leader.

Hence, due to the COVID-19 pandemic, employees experience work stress, which precipitates mental health problems and poor employee performance. To solve the problem of work stress, SMEs should pay more attention to fostering servant leadership. Meanwhile, organizational culture is also important in alleviating employees' mental health problems and thus reducing negative effects of work stress on employee performance.

Implications

This study findings have several theoretical and managerial implications.

Theoretical implications

First, per previous research, no consistent conclusion exists regarding the relationship between work stress and employee performance, including positive relationships ( Ismail et al., 2015 ; Soomro et al., 2019 ), negative relationships ( Yunus et al., 2018 ; Nawaz Kalyar et al., 2019 ; Purnomo et al., 2021 ), inverted U-shaped relationships ( McClenahan et al., 2007 ; Hamidi and Eivazi, 2010 ), and no relationship ( Tănăsescu and Ramona-Diana, 2019 ). We report that work stress negatively affects employee performance in SMEs during the COVID-19 pandemic; thus, this study contributes to the understanding of the situational nature of work stress and provides enriching insights pertaining to positive psychology.

Second, we established the research path that work stress affects employee performance. Mental health is a psychological state that may influence an individual's work efficiency. In this study, we explored its mediating role, which opens the black box of the relationship between work stress and employee performance; thus, this study contributes to a greater understanding of the role of work stress during the COVID-19 pandemic.

Finally, this study sheds light on the moderating effect of servant leadership, which is useful for understanding why some SMEs exhibit greater difficulty in achieving success than others during the COVID-19 pandemic. Previous research has explained the negative effect of work stress ( Yunus et al., 2018 ; Nawaz Kalyar et al., 2019 ; Purnomo et al., 2021 ). However, few studies have focused on how to resolve the problem. We identify servant leadership as the moderating factor providing theoretical support for solving the problem of work stress. This study expands the explanatory scope of the upper echelons theory.

Practice implications

First, this study elucidates the sources and mechanisms of work stress in SMEs during the COVID-19 pandemic. Employees should continuously acquire new skills to improve themselves and thus reduce their replaceability. Meanwhile, they should enhance their time management and emotional regulation skills to prevent the emergence of adverse psychological problems.

Second, leaders in SMEs should pay more attention to employees' mental health to prevent the emergence of hindrance stress. Employees are primarily exposed to stress from health and safety risks, impaired performance, and negative emotions. Hence, leaders should communicate with employees in a timely manner to understand their true needs, which can help avoid mental health problems due to work stress among employees.

Third, policymakers should realize that a key cause of employee work stress in SMEs is attributable to concerns regarding the macroeconomic environment. Hence, they should formulate reasonable support policies to improve the confidence of the whole society in SMEs, which helps mitigate SME employees' work stress during emergency events like the COVID-19 pandemic.

Finally, as work stress causes mental health problems, SME owners should focus on their employees' physical as well as mental health. Society should establish a psychological construction platform for SME employees to help them address their psychological problems.

Limitations and future research

This study has limitations, which should be addressed by further research. First, differences exist in the impact of the pandemic on different industries. Future research should focus on the impact of work stress on employee performance in different industries. Second, this study only explored the moderating role of servant leadership. Other leadership behaviors of leaders may also affect work stress. Future research can use case study methods to explore the role of other leadership behaviors.

This study explored the relationship between work stress and employee performance in SMEs during the COVID-19 pandemic. Using a sample of 196 SMEs from China, we found that as a typical result of emergency events, work stress negatively affects employees' performance, particularly by affecting employees' mental health. Furthermore, we found that servant leadership provides a friendly internal environment to mitigate negative effects of work stress on employees working in SMEs.

Data availability statement

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

Ethics statement

Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent from the patients/participants or patients/participants legal guardian/next of kin was not required to participate in this study in accordance with the national legislation and the institutional requirements.

Author contributions

BC: conceptualization, methodology, writing—original draft, and visualization. LW: formal analysis. BL: investigation, funding acquisition, and writing—review and editing. WL: resources, project administration, and supervision. All authors contributed to the article and approved the submitted version.

This research was supported by the major project of Henan Province Key R&D and Promotion Special Project (Soft Science) Current Situation, Realization Path and Guarantee Measures for Digital Transformation Development of SMEs in Henan Province under the New Development Pattern (Grant No. 222400410159).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: COVID-19, work stress, mental health, employee performance, social uncertainty

Citation: Chen B, Wang L, Li B and Liu W (2022) Work stress, mental health, and employee performance. Front. Psychol. 13:1006580. doi: 10.3389/fpsyg.2022.1006580

Received: 29 July 2022; Accepted: 10 October 2022; Published: 08 November 2022.

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Copyright © 2022 Chen, Wang, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Biao Li, lib0023@zzu.edu.cn

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Annotative Bibliography

Colligan, W.T, Higgins, M.E,(2005). Workplace stress: Etiology and the Consequences. Journal of Workplace Behavioral Health. Vol. 21(2) 2005. This journal focuses on workplace stress by identifying factors that contributes to stress at workplace and the resultant impact of stress on employees productivity and personal life. Managers can play a critical role in reducing or eliminating stress on epmloyess by creating a conducive work environment, providing employees assistance program in stress management and identifying and reducing work tension between individuals or groups in a work setting. This would results to improved productivity and improved workplace dynamic. Richardson, M.K, Rothstein, R.H, (2008). The Effects of Occupational Stress Management Intervention Programs: A Meta-Analysis. Journal of Occupational Health Psychology. New York. Vol. 13, No. 1, 69-93. This article looks at the different Stress Management Intevention (SMI) programs used by organizations and their effectiveness in managing stress at work. A stress management intervention is a program that seeks to reduce work-related stressors so as to minimize the negative results of exposure to these stressors. To determine how effective the SMI implemented in an organization is, researchers can examine the outcomes at organizational level in terms of productivity or at individual level by observing the psychological or physiological measures. Michie, S., (2002). The Causes and management of Stress at Work. Occupational Environment Medic. London. Vol. 59, 67-72. In this journal, Michie looks at some causes of stress at work and how it can be managed. Stress at work can be caused by internal factors at work such as the pressure of work deadlines, job insecurity, complex tasks, long working hours, poor relationships at work between employees, work overload or external factors such as family demands or long commuting hours. This is in employer’s long term economic interests to help minimize or eliminate stress. Since stress is likely to lead to high workers turnover, absence, early retirement, reduced productivity as well as client satisfaction. The stress can be managed at individual level like training and psychological services like clinical or occupational counseling, or at organizational level interventions like restructuring work or providing psychological support such as social supports or simply employees participation in decision-making processes. Saha D, Sinha R, Bhavsar K., (2011, April 15). Understanding the Job Stress among Healthcare Staff. Online Journal of Health and Allied Sciences. Mangalore, South India.Vol 10 (1) 2011. This research article evaluates the sources of job stress among healthcare workers to identifying measures on how best to reduce work-related stress. Small payment of employees and work overload were found to contribute immensely towards stress at work. The working conditions are the primary source of stress but with a sound management intervention such as proper workload management, adequate staffing, improved payment, recognition of efforts along with ongoing training and stress management support would improve the productivity of the workforce.

Introduction

Workplace stress is defined as the change in an individual’s physical or mental state in reaction to shifts in the work environment that pose a challenge or harm to that individual.This applies in particular when the job requests do not match the worker’s capabilities, resources, and needs. Stress can be divided into two categories; that is eustress also known as positive or good stress with positive effects on an individual. The second category, on the other hand, is distress which comes with adverse effects. Globally documented as a challenge to personal physicall and mental health,besides organizational health, stressed employees are usually found to be unhealthy, less motivated, less productive and less safe at work. An organization’s competitiveness in the market is determined by the productivity of its' workforce. It is, therefore, necessary for managers in an organization to make proper interventions and help manage the well-being of employees and provide support to them whenever in stress so as to realize their maximum potential and productivity in their work. Better employment practice should include evaluating the risk of stress amongst employees, identify causes of stress at work and determine who is at risk to be affected and finally deciding what can be done to prevent stress at work.

Stress is not only a bodily response to a difficult or stressful condition. It is a contact between that individual and the source of demand within their environment (Colligan and Higgins, p 92). Different factors contribute to workplace stress. These factors are associated with workplace stress and health risks. They can be categorized as those brought about due to the content of work and those related to the social and organizational setting of work. Example of factors associated with the job include work overload, pressure to meet deadlines, the complexity of tasks, long working hours and poor physical work conditions like space (Miche, p3). The role of the employee in an organization regarding responsibility also contributes to stress, as there are times where workers in an organization are required to perform multiple functions simultaneously, particularly when the work is unclear, and there are conflicting roles and boundaries. Other causes pertain to the promotion at workplace, work security, and career development, especially in the current time of technological changes where employees’ roles could be phased out by inventions that limits opportunities for their creativity. Aside from that, interpersonal relationships between workers in the workplace and group dynamics have been found to be among primary factors of stress. The staff’s emotional, behavioral, physiological and cognitive response to stress is directly related to the characteristic of the cause of stress, the resources available to the employee to prevent pressure, as well as the employee’s personal characteristics. Based on this, individuals can react differently to stressors in an organization. To some, stress can propel them to achieve their personal goals and come out shining through the challenging moments. However, to some individuals, it can be burdensome with significant impact on their mental, emotional and physical well-being. It is important therefore for managers to understand the causes of stress and strategies that can be implemented to help prevent or overcome them. This would result in improved employee’s performance and productivity. Even though stress at work can be external, for example, family demands or any other personal problems at home, it is advisable to the managers to show social support and care in such moments. Such encouragement or aid in time of need would still enable the employees to perform productively at work.

Recommendations

As a recommendation, to reduce or eliminate the stress within the work force, it is vital for every organization to have a Stress Management Intervention program. These interventions can be grouped into primary, secondary or tertiary interventions (Richardson and Rothstein, p70). In primary interventions, the sources of stress at work are identified. After the identification, the working conditions of the employees are changed or improved, creating a conducive environment that enables them to be productive without any undue pressure. An example, in this case, is reducing the workload by distributing work among employees or employing adequate staff to cater for the job demands (Saha, Sinha, and Bhavsar, p4). Managers should do a job analysis to determine the number of resources and skills required to complete a given task before assigning the work correctly. Where the organization falls short of the necessary manpower or financial capability to hire new resources, the work can be subdivided into small tasks and assigned to different employees with regards to their skills. The organization structure can also be altered in terms of management, in either the supervision or transfer of employees to departments they best fit in based on their skills to ease the complexity of work, flow of information in addition to distributed decision making with the focus on removing stressors from the workplace. When it comes to secondary interventions, the focus is to reduce the severity of stress symptoms by helping employees improve their transaction with the environment. This is the widely used intervention that has proven positive results based on their outcomes .Here managers provide employees with access to stress management programs or health services to help them manage stressful situations in the form of training. Employees will be trained how to use behavioral skills like the change of diet, deep-breathing, meditation, exercise, time management, goal setting and relaxation methods to get rid of the psychological and physical side effects of stress. The tertiary interventions are almost similar to the Secondary one though here programs are not just to take employees through training that can reduce stress symptoms; they are also meant to treat the health conditions of workers through free and confidential access to qualified health professionals.

Stress in the workplace has a cost to both an employee in an organization as well as the organization as a whole regarding psychological, physiological and financial costs. The performance of the employees goes hand-in-hand with the prevailing work conditions besides the well-being of an individual. Heart diseases, immunosuppression, and chronic pain are some of the physical disorders of stress that affect productivity in an employee. Depression, persistent anxiety, pessimism, and resentment are psychological disorders associated with workplace stress. The stress can lead to hostility between employees or with their managers, interpersonal conflict, small production, high staff turnover or low morale in the workplace. The cognitive behavioral training designs to educate staffs on the role of their beliefs and emotions in managing demanding situations and to provide them with skills necessary to revise their opinions to facilitate adaptive coping is touted to be one of the best intervention to alleviate stress. Successful interventions should involve both an employee and the organization by providing training that helps one to identify the stress and the cause, the approach or method to be used to tackle them. Collaborative decision-making processes and problem-solving processes in an organization increases support and improve communications in an organization reducing frictions between employees or workgroups besides on-the-job training on how to cope with stress and resolve conflicts. By creating a conducive work environment and providing social support to employees in distress, the management can be able to motivate their staff to reach their full potential with significant improvement in production. This, in turn, translates into a competitive organization in the market with a healthy workforce.

Colligan, W.T, Higgins, M.E,(2005). Workplace stress: Etiology and the Consequences. Journal of Workplace Behavioral Health. Vol. 21(2) 2005. Richardson, M.K, Rothstein, R.H, (2008). The Effects of Occupational Stress Management Intervention Programs: A Meta-Analysis. Journal of Occupational Health Psychology. New York. Vol. 13, No. 1, 69-93. Michie, S., (2002). The Causes and management of Stress at Work. Occupational Environment Medic. London. Vol. 59, 67-72. Saha D, Sinha R, Bhavsar K., (2011, April 15). Understanding the Job Stress among Healthcare Staff. Online Journal of Health and Allied Sciences. Mangalore, South India.Vol 10 (1) 2011.

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How can you manage stress when talking to higher-ups at work? Ask HR

The anxiety that comes when speaking with high-ups at work is a common issue.

Johnny C. Taylor Jr. tackles your human resources questions as part of a series for USA TODAY. Taylor is president and CEO of the Society for Human Resource Management, the world's largest HR professional society and author of "Reset: A Leader’s Guide to Work in an Age of Upheaval.”

Have a question? Submit it here .

Question: I occasionally brief our senior management. I get nervous when speaking to higher-level managers and executives at my job. I worry I'll get fired if I make a mistake or say something wrong. How can I address my anxiety when talking to higher-ups? – Jameer

Answer: The anxiety that comes when briefing senior management is a common concern. I commend you for actively seeking ways to address it. Here are some strategies to help:

Know your audience. Understand the priorities, expectations and interests of the senior managers you’re briefing. If you need additional clarification, consult with your manager for insights. Knowing your audience helps tailor your communication to resonate with their concerns. Taking time to know your audience personally before and after the presentation also helps humanize them and reduces anxiety.

Organize your thoughts. Define the primary goal of your brief and outline key points to keep you focused. Visual aids can convey information effectively and maintain the audience's attention. A well-organized presentation can boost your confidence.

Practice, practice, practice. Practice your presentation multiple times to familiarize yourself with the content. Research topics thoroughly and anticipate potential questions from your audience. The more you practice, the more confident you’ll become in delivering your message.

Take deep breaths. Incorporate deep breathing exercises and positive affirmations to calm your nerves before the briefing. Remind yourself of the preparation you’ve done and replace negative thoughts with self-assurance.

Ask for feedback. Share your presentation with colleagues or mentors in advance. Honest opinions can provide valuable insights into areas for improvement. Record yourself to evaluate your body language and tone, making adjustments as needed. If possible, seek feedback from senior managers directly. Knowing you’re delivering the information they need will reinforce your confidence. 

Talk to your manager. If you’re worried about making a mistake and fear potential consequences, have an open and honest conversation with your manager. They can provide guidance, reassurance and support, helping to alleviate your concerns.

Tap human resources support. If anxiety persists despite your efforts, reach out to your HR department. They may offer additional tools, resources, or professional development opportunities to help you manage anxiety and enhance your presentation skills.

Remember, being anxious means you care and want to get it right. Channel your nervous energy into your preparation. When you are primed to deliver an engaging and informative presentation that the audience values, it will boost your confidence and greatly reduce your anxiety so you can successfully navigate senior management briefings. Taking proactive steps and seeking support will contribute to your professional growth.

Artificial intelligence How to use AI in the workplace? Ask HR

My career in industrial product design veered into sales and account management positions, where I have been for the last four and a half years. I am contemplating a return to product design. What should I consider in returning to my former career? – Derek

Considering a return to your former career in industrial product design is a significant decision, and careful preparation is key to ensuring a successful transition. Here are some essential considerations:

Reflect on motivation: Reflect on your motivation for returning to industrial product design. Consider the aspects you enjoyed and disliked in your previous roles. Assess how returning to product design aligns with your long-term goals, aspirations, work-life balance, and financial considerations.

Stay informed: Since your last product design position, the industry may have evolved, incorporating new technologies like artificial intelligence. Stay informed about the latest trends, tools, and practices in industrial product design. Professional associations, such as the Industrial Designers Society of America, and online networks like LinkedIn can provide valuable insights.

Fill knowledge gaps: Identify gaps in your knowledge and skills and proactively address them through training, research, and networking. Online courses, webcasts, podcasts, articles, and networking events can help you stay updated, speak the industry's latest language, and understand how technological advancements and new practices have shaped the field.

Research job landscape: Explore job boards to understand the landscape of industrial product design positions. Familiarize yourself with the latest job duties and pay ranges. Use this information to tailor your resume and cover letters, emphasizing how your experience in sales and account management has prepared you for this career change.

Highlight transferable skills: Showcase the skills and experiences gained in your sales and account management roles that are transferable to industrial product design. Emphasize accomplishments that demonstrate your ability to adapt, communicate effectively, and understand client needs – all valuable in the design process.

Seek a mentor or coach: Consider seeking guidance from a mentor or career coach who can provide support and insights as you realign your skills and abilities. Their expertise can be invaluable in navigating the challenges of transitioning back into product design.

Be prepared for adjustments: Recognize that there may be challenges or adjustments in transitioning back to product design. Be open to learning, seek feedback from your professional network, recruiters, and interviewers, and adjust your approach as needed.

Continuous learning: Approach each step of the process as a learning experience. Request feedback, consider suggestions, and adapt accordingly. Continuous learning and improvement will contribute to your success in pursuing a passion that aligns with your career goals.

Best of luck as you embark on this journey to return to industrial product design. May it bring you fulfillment and success in your chosen career path.

Workplace bully What is the best way to handle bullying at work? Ask HR

I have an invisible disability. Flying is extra stressful, and other travelers don't understand why.

  • Andrea McKenna Brankin is an American mom who lives in Singapore with her husband and daughter.
  • She has bipolar disorder and finds traveling between the US and Asia stressful.
  • Lavender oil, exercise, and Harry Potter have all helped her reduce stress while traveling.

Insider Today

I was at the airport, and lines were building up at the entrance to the jetway. There had already been several delays and I was getting nervous. Would I miss my connection? Would there be enough overhead space for my bags? Will they serve water? These questions vexed me for what felt like an eternity until I finally heard the announcement that we'd be boarding soon. When the airline called boarding for people with disabilities , I felt a sigh of relief. Although the check-in person looking at me questioningly — my disability is invisible.

Traveling can be stressful for everyone, but even more so for me, as I have bipolar disorder . External stressors like delays and even snarky passengers make dealing with the condition much harder. But it's something I've had to learn to manage, especially after my husband and I moved from Chicago to Singapore 12 years ago. I travel between the US and Asia at least twice a year, along with regional travel in both the States and Southeast Asia. These flights range between 90 minutes to almost 20 hours.

Bipolar is a mood disorder that affects more than 40 million people worldwide, according to the World Health Organization . The condition is characterized by extreme mood swings between depression and mania and can affect behavior, especially in high-stress environments.

I take a variety of medications to keep these swings and symptoms — like high anxiety and paranoia — at bay. I need the meds every day, so it's always the first thing on my packing list. This presents the first of several challenges I've unpacked over the years.

I make an effort to avoid medication mishaps

When I travel, I have to carry enough medication to last the whole trip, plus extra in case of delays. Many of my trips are long, especially the ones to the US, so it can take up a lot of space. Whether short or long, it's important for me to carry a letter for customs, written and signed by my psychiatrist.

The letter describes what my medications are — as well as the doses and why I take them — in the event that I get stopped. This is because mood-altering drugs — called psychotropics — are noted as illegal without a prescription. Many countries, including Singapore and the US, have strict laws on carrying this kind of medication.

I've managed to plan ahead the best way I can, always packing the letter in my carry-on, carrying enough meds for at least two extra weeks, and having a doctor on call in case I need more.

Being bipolar and a mom adds another layer of stress

Traveling with children is stressful . Full stop. Other travelers don't want to be around you in case of crying, airline staff get fed up with having to do more for you, and you yourself don't get much rest at all. These challenges are exponential with bipolar disorder because stress, especially with other people, is a real trigger.

On more than one occasion, I've been treated poorly as a traveling mom. The most unbelievable was when a flight attendant handed me a large garbage bag and told me it was for my baby's diapers. "So, I have to keep the diapers at my seat in this bag?" I asked. She explained that leaving diapers in the bathroom bothered other passengers. I was seated in business class when this happened and handed the bag back to her and said, "Talk to my husband about it. He paid for the business class tickets."

I manage this part of flying by being very prepared as a mom, with supplies like extra diapers, toys, headphones, snacks, and clothes. One nightmare flight had me tending to my daughter every 10 minutes for 14 hours. But as my kid grows up — she's nearly 12 — traveling is getting easier. Just her being able to operate her own devices and seat TV was a game changer.

Being prepared for the trips with bipolar disorder means eating well and getting a lot of good rest and exercise before the trip. The body releases endorphins when you exercise, and it's also been said to combat stress, according to Healthline . I also make sure my meds and symptoms are in order. I bring lavender oil for inhaling as well as lots of skincare products to do some self-care along the way.

Quality time with the family makes it worth all the hassle

One of the biggest overall challenges of traveling with bipolar disorder is jet lag . It screws up your biorhythms, sleep, eating, and meds schedule. As my prescription includes day and night medication, it took me a while to figure out how and when to take each when I was crossing the international date line. I now focus on taking the night meds and sometimes double up on the mood stabilizers.

I don't use sleeping pills, but I do take melatonin a few days before a long flight and continue for as long as needed once I arrive. My family has tried all different flight times to make it easier for me — from arriving at dawn to arriving at 9 p.m. to see which works better. Honestly, no time is perfect. But if I take good care of myself before the trip, I'm usually in a good place mentally and physically to start my vacation.

Whether I can sleep or not, I rely heavily on distractions. I can't manage to read books, but I do watch movies, specifically Harry Potter. Downloaded on my phone or on the seat TV, the Harry Potter series includes seven films with more than 15 hours of viewing time. That almost gets me all the way from Singapore to San Francisco. Mischief managed.

Having bipolar disorder always presents daily challenges whether I'm in the air or on the ground. But I think I'm handling it pretty well. The ultimate goal is to be with my family, and that's always worth the effort.

Got a personal essay about living abroad or parenting that you want to share? Get in touch with the editor: [email protected] .

Watch: Airports are using therapy dogs to calm stressed-out holiday travelers

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  • v.8(1); 2017 Mar

The Impact of Job Stress and Job Satisfaction on Workforce Productivity in an Iranian Petrochemical Industry

Naser hoboubi.

1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Occupational Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

Alireza Choobineh

3 Research Center for Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

Fatemeh Kamari Ghanavati

Sareh keshavarzi.

4 Department of Epidemiology, School of Health, Shiraz University of Medical Science, Shiraz, Iran

Ali Akbar Hosseini

5 Health, Safety and Environment (HSE) Department, Zagros Petrochemical Company, Pars Especial Economic Zone, Iran

Job stress and job satisfaction are important factors affecting workforce productivity. This study was carried out to investigate the job stress, job satisfaction, and workforce productivity levels, to examine the effects of job stress and job satisfaction on workforce productivity, and to identify factors associated with productivity decrement among employees of an Iranian petrochemical industry.

In this study, 125 randomly selected employees of an Iranian petrochemical company participated. The data were collected using the demographic questionnaire, Osipow occupational stress questionnaire to investigate the level of job stress, Job Descriptive Index to examine job satisfaction, and Hersey and Goldsmith questionnaire to investigate productivity in the study population.

The levels of employees' perceived job stress and job satisfaction were moderate-high and moderate, respectively. Also, their productivity was evaluated as moderate. Although the relationship between job stress and productivity indices was not statistically significant, the positive correlation between job satisfaction and productivity indices was statistically significant. The regression modeling demonstrated that productivity was significantly associated with shift schedule, the second and the third dimensions of job stress (role insufficiency and role ambiguity), and the second dimension of job satisfaction (supervision).

Corrective measures are necessary to improve the shift work system. “Role insufficiency” and “role ambiguity” should be improved and supervisor support must be increased to reduce job stress and increase job satisfaction and productivity.

1. Introduction

The nature of work has changed considerably in many sectors of industry over the past decades [1] . Modern organizations consider job stress and job satisfaction of their employees as two important workplace issues [2] . According to recent studies, occupational stress accounts for 50–60% of all lost working days [3] . Work-related stress is considered to be harmful when physical and emotional responses occur when there is a mismatch between job requirements and the workers' capabilities, resources, or needs [4] . Most researchers agree that workplace factors can cause work-related stress [5] . These factors are divided into physical and psychosocial hazards. Exposure to physical hazards in the workplace can be associated with anxiety that, in turn, drives experiencing work-related stress. Psychosocial hazards include factors related to work design, organization, and management, together with workplace social structure that can have negative effects on individuals [6] . Work-related stress usually influences individual and organizational issues including behavioral, mental, as well as physical outcomes, performance, job satisfaction, and organizational commitment [7] .

Applied research indicates strong correlations between dimensions of workplace, stress, and job satisfaction. High levels of work stress are associated with low levels of job satisfaction. Job stressors are predictive for job dissatisfaction and a greater propensity to leave the organization [8] .

Job satisfaction is the affective orientation that an employee has towards his/her work. It can be considered as an overall feeling about the job or as a related constellation of attitudes about various aspects of the job [9] . There is growing evidence that current trends in employment conditions may have negative effects on job satisfaction and deteriorate the physical and mental health of employees [10] . Affective disposition on job satisfaction consists of two facets: positive affectivity and negative affectivity. High energy, eagerness, and pleasurable involvement represent positive affectivity while distress, unpleasant involvement, and nervousness show negative affectivity [11] .

Work-related stress is a vital factor to job satisfaction. When functioning as a motivator, work-related stress results in creativity and satisfaction and consequently removes boredom and mundanity. Stress leads to aggression and low job satisfaction when it functions as a negative factor [2] . Job satisfaction may protect workers from stressors. Satisfaction is a regulating factor for stress. During the neoclassical period (1920–1950), theories supported the fact that employees' satisfaction directly affected productivity. They believed that there was a cause-effect relationship between satisfaction and productivity. This answered the question why organizations tried to improve their employees' productivity by different ways. These two factors (work-related stress and job satisfaction) may have a negative impact on the productivity of a working group and consequently cause an added cost to expenses of a company [2] . The analysis of the present situation at the international level has revealed, among others, the necessity of improving work quality and productivity, as well as providing safety and health in the work place [12] .

The petrochemical industry is an important industry in Iran from the viewpoints of economics and employment. There are critical jobs in the petrochemical industry, such as control room operation, maintenance, site operation, firefighting, etc. In such an industry, job stress and dissatisfaction may have a negative impact on productivity and safety of employees.

Given the above, since there is little study on such issue among petrochemical employees, the present study was carried out to investigate the impact of job stress and job satisfaction on employees' productivity in an Iranian petrochemical company.

2. Materials and methods

This cross-sectional study was conducted from October 2014 to May 2015, in an Iranian petrochemical company with 325 employees, located at Asalouyeh, in the southern part of Iran in which methanol was produced as the final product. The sample size was determined with reference to a study by Naqvi et al [13] . Taking the β (power) of 80% and α (the first type error) = 5% into consideration, using Medcalc software (MedCalc Software bvba, Ostend, Belgium) the sample size was calculated to be 125. Participants were randomly selected from the personal list provided by the company.

2.1. Data gathering tools

An anonymous self-administered questionnaire was used to collect the required data for each participant. The questionnaire consisted of the following four parts:

(1) a demographic questionnaire was used for collecting personal details including age, weight, height, work experience, daily work hours, gender, marital status, level of education, type of employment and working schedule; (2) the Persian version of Osipow occupational stress inventory was used to investigate the level of job stress among the study population. Occupational stress was measured by six subscales, i.e., role overload, role insufficiency, role ambiguity, role boundary, responsibility, and physical environment. Each subscale contains 10 items. There are 60 items in total in the scale. Each item is scored on a 5-point Likert scale (1 = never, 2 = occasionally, 3 = sometimes, 4 = usually, and 5 = most of the time). A high subscale score depicts a greater level of role stressor. The obtained scores are classified as: low (10–19), low-moderate (20–29), moderate-high (30–39), and high (40–50) [14] . The total score of the job stress questionnaire is also divided into four levels, as follows: low (60–119), low-moderate (120–179), moderate-high (180–239), and high (240–300) [14] . The validity and reliability of this questionnaire were assessed in a study by Sharifian et al [15] and cronbach alpha coefficient was calculated to be 0.83; (3) the Persian version of Job Descriptive Index (JDI) was used to investigate job satisfaction. The JDI consists of 39 items in five subscales, i.e., work (10 items), pay (6 items), promotion (5 items), supervision (8 items), and coworkers (10 items). Each part measures one particular area of job satisfaction. A response was collected to each item on a 5-point Likert scale (1 = never, 2 = occasionally, 3 = often, 4 = usually, and 5 = most of the time). The scores of each subscale were added together for each respondent to obtain a JDI total score reflecting the overall job satisfaction. No cutoff point has been reported to define the upper and the lower limits of job satisfaction index in the scientific literature, therefore, we used the minimum and the maximum attainable scores of JDI (39–195) to judge about the level of job satisfaction in the study population. Regarding this, if the mean score of JDI was near the lower limit score (39), near the midpoint (117), and near the upper limit score (195), job satisfaction was considered as low, moderate, and high, respectively. The validity and reliability of this questionnaire were assessed in a study by Norbakhsh and Mirnaderi in which the cronbach alpha coefficient was 0.88 [16] ; and (4) the Persian version of the Hersey and Goldsmith questionnaire was applied to investigate workers' productivity. This questionnaire consists of 26 items in seven subscales: ability (3 items), occupational identification (4 items), organization support (4 items), motivation (4 items), performance feedback (4 items), credit (4 items), and environment compatibility (3 items). Each item was scored on a 5-point Likert scale (1 = never, 2 = occasionally, 3 = often, 4 = usually, and 5 = true most of the time). Similar to JDI, no cut-off point has been indicated to define the upper and the lower limits for productivity index in the scientific literature, therefore, the minimum and the maximum attainable scores of this index (29–130) were used to judge about the level of productivity of the study population. Based on this, if the mean score of productivity score was near the lower limit score (29), near the midpoint (79.5), and near the upper limit score (130), productivity was considered as lower, moderate, and high, respectively. The validity and reliability of this questionnaire were assessed in a study by Nasirpour et al [17] in which the cronbach alpha coefficient was 0.81.

2.2. Data analysis

Upon completion of the field survey and data collection, data were transferred into the computer for statistical analysis. Statistical analyses were performed using SPSS version 19 (IBM, Armonk, NY, USA). Pearson correlation analysis was used to examine the relationship between quantitative variables such as stress, job satisfaction, and productivity scores. To assess the factors affecting productivity, linear regression analysis was applied. In all tests, the significance level was set at 0.05.

Table 1 summarizes personal details of the employees who participated in the study. According to Table 1 , mean age of the study participants was 30.95 ± 5.26 years, ranging from 22 years to 48 years. The employees' mean work experience was 7.04 ± 3.81 years (1–21 years). A large majority of the participants had university education (73.6%). Some 70.4% of the study population was married and 55.2% of the participants were shift workers.

Table 1

Demographic characteristics of the employees studied ( N  = 125)

Data are presented as n (%)

According to Table 2 , the mean score of job stress was calculated to be 181.27 ± 24.17 indicating “moderate-high” level of stress. One-way ANOVA, independent t test and Pearson coefficient statistical procedures did not show any significant relationship between the mean job stress score and demographic characteristics of the participants. Additionally, the statistical analyses revealed no significant relationship between the mean scores of job stress and job satisfaction ( p  = 0.152) and productivity.

Table 2

Statistical analyses for assessment indices ( N  = 125)

The mean job satisfaction score was found to be 129.96 ± 18.84 indicating “moderate” level of job satisfaction. One-way ANOVA test showed a significant U shape relationship between the mean score of job satisfaction and age ( p  = 0.024). A post hoc test indicated that there was a significant difference in job satisfaction means score among the three age groups, such that the mean job satisfaction score in the 31–38 years age group was lower than those of the other two groups (i.e., 22–30 years and 39–48 years). Independent t test also showed that the mean job satisfaction score was significantly higher in married individuals than in single individuals ( p  = 0.009).

The mean score of productivity index was found to be 70.52 ± 11.89, indicating “moderate” level of productivity. A one-way ANOVA test showed a significant relationship between the mean productivity score and the third dimension of job stress (role ambiguity) ( p  = 0.0001). The mean score of productivity index showed a direct significant relationship with the first, the second, and the third dimensions of job satisfaction index (work, supervision, and coworkers) ( p  < 0.05). This indicated that higher scores of the mentioned dimensions of job satisfaction index were related to higher productivity.

Also, an independent t test indicated that the mean score of productivity index was significantly lower in shift workers than in fixed day workers ( p  = 0.024). No statistical significant relationship was found between the mean score of productivity index and other demographic characteristics.

In order to investigate the correlation between job stress and job satisfaction indices and productivity index in the study participants, Pearson correlation coefficient was used. The result of this analysis showed that although the correlation between job stress index and productivity index was not statistically significant ( p  > 0.05), the correlation between job satisfaction index and productivity index was statistically significant ( p  = 0.04). This relationship was positive and the correlation coefficient ( r  = 0.37) indicated a weak correlation between these two variables. This means that with an increase in the mean job satisfaction score, the mean productivity score would increase.

In order to investigate factors affecting productivity index, multiple linear regression analysis was used. Based on the results of one-way ANOVA and univariate analyses, it was found that work schedule (shift or fixed), working hours, the second, the third, and the sixth dimensions of job stress index (role insufficiency, role ambiguity, and physical environment) and the first, the second, the third, and the fourth dimensions of job satisfaction index (work load, supervision, coworkers, and promotion) were eligible to enter the linear regression model ( p  < 0.25) [18] .

The results of regression modeling revealed that the variables of shift schedule, the second and the third dimensions of job stress (role insufficiency and role ambiguity), and the second dimension of job satisfaction (supervision) remained in the model. According to the coefficient of determination ( R 2 ), 22.3% of the changes related to productivity index could be explained by current variables ( Table 3 ). The final score of the job stress index is classified into four levels (low, low-moderate, moderate-high, and high). That is why a dummy variable was defined in order to correctly interpret the dimensions of stress; low job stress was regarded to be the base in the model.

Table 3

Regression model indicating factors with influence on employees' productivity

4. Discussion

The results showed that the mean productivity score in shift workers was significantly lower than that of fixed day workers, which was in line with the results of other studies [19] , [20] , [20] . This decline may be due to factors such as health problems, impaired social life, sleep disorders, and circadian misalignment during shift work [21] . One reason could be that when people work outside of their normal sleep-wake cycle, a mismatch occurs between the body's biological clock and events taking place in the environment, and consequently affects the individual's activities [22] .

The results showed a U shape significant relationship between the mean job satisfaction score and age, so that the mean job satisfaction score in the 31–38 years age group was significantly lower than those of the two other age groups ( i.e., 22–30 years and 39–48 years). This finding is in agreement with the results of other studies [23] , [24] . One possible reason is that young people are highly motivated during the first years of employment which can lead to a high job satisfaction. This level of job satisfaction declines during the middle years of employment due to job repetitiveness and job restrictions; after this period, job satisfaction continuously increases with age [24] . This increase is justified based on Herzberg's “modified expectation” theory. On the basis of this theory, when age and job experience increase, the individual's expectations of her/his work begin to become more realistic. This may result in job satisfaction increment. In a study, a direct linear relationship was reported between age and job satisfaction which was not in agreement with Herzberg's hypothesis of the U-shaped relationship between these variables [25] .

The results of the present study showed that job satisfaction in married individuals was higher than single ones, which was in agreement with the results of some other studies [26] , [27] . According to Bowen, single young people hesitate in decision-making on how to keep their jobs and do not know whether they have selected the jobs they are currently working in for their entire life or just for a certain period. Thus, job satisfaction in these individuals is lower than in older and married ones [27] . It is to be noted that these findings are not consistent with the results of other studies [28] , [29] , [30] .

The results demonstrated a significant negative relationship between role insufficiency and productivity in such a way that when role insufficiency increased, productivity decreased. Meleis [31] defined role insufficiency as any kind of problem in identifying the role, playing a role, or role-related goals understood by the individual or others. This finding is similar to a study by Wu et al [32] . In this study, role insufficiency was determined as one of the factors which had a direct and significant impact on depression. Depression is a common mental health problem in the world which increases employees' absenteeism and reduces productivity [32] . It was also reported in a study that increased job stress was associated with increased role insufficiency [33] . Increased stress can lead to reduced job satisfaction and productivity of individuals [2] .

The present study showed that there was a significant negative relationship between role ambiguity and productivity such that increased role ambiguity would cause reduced productivity in individuals. Role ambiguity is a state during which individuals have no clear and direct understanding about their roles in the organization [34] . It appears when the duties are not clearly defined for the individual and she/he is frightened of doing things or accepting responsibility. Role stressors mainly include role ambiguity and role conflict which can lead to increased employees absenteeism and frequent work delays, increase in employees' turnover and reduced workforce productivity [35] . In a study by Rizwan et al, a significant positive relationship was observed between role ambiguity and job stress such that role ambiguity was reported to cause 15% increase in job stress [28] . Increased job stress is accompanied with reduced performance and job satisfaction, which finally leads to lower productivity of individuals and increased costs incurred by the organization [2] .

The results of the regression modeling indicated that supervision could have an effective role in increasing productivity, which was in agreement with the results of a study by Frimpong et al [36] . In this study, a strong interaction was reported between the workers' perceived supervisor support and productivity, in such a way that workers who were not supported by their supervisors had lower productivity as compared to those who were provided with adequate support [36] . Providing appropriate support in the workplace by the supervisor would cause reduced stress on the individuals and protect her/him against adverse effects of job demands, job dissatisfaction, and depression [33] .

4.1. Limitations

Regarding the cross-sectional nature of the present study and data gathering based on self-report, the findings should be considered cautiously. In the self-report method, there may be problems will deception, denial, or recall. Additionally, in this study job stress and productivity were not examined using objective methods. The results of the study could be more conclusive if objective measures were included.

5. Conclusion

The findings of the present study showed that the employees' perceived job stress and job satisfaction were moderate-high and moderate, respectively. Also, their productivity was assessed as moderate. According to the study results, shift working, “role insufficiency”, and “role ambiguity” were determined as the contributing factors for reduced productivity; “supervision support” was also found to be an effective factor for increased productivity. Based on the study findings, to achieve lower job stress, higher job satisfaction, and productivity in the workplace, the following supportive measures are recommended:

  • • Identifying and optimizing the factors influencing job stress and job satisfaction
  • • Providing direct staff support by management
  • • Employing individuals according to their expertise and abilities
  • • Providing exact definition and description of jobs for employees
  • • Selecting fit employees for shift working

Conflicts of interest

All authors have no conflicts of interest to declare.

Acknowledgments

This study was financially supported by Shiraz University of Medical Science (grant no. 93-01-42-7387). The authors wish to thank all petrochemical employees who participated in this study.

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