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Stress at work

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This article has a correction. Please see:

• Errata - June 29, 2017
• Thomas Despréaux , chief resident 1 2 3 ,
• Olivier Saint-Lary , general practitioner , senior lecturer 4 5 ,
• Florence Danzin , psychiatrist 1 6 ,
• Alexis Descatha , occupational/emergency practitioner , professor 1 2 3
• 1 Occupational health unit, University hospital of Poincaré site, Garches, France
• 2 Versailles St-Quentin University, Versailles, France
• 3 CESP, U 1018 Inserm, Villejuif, France
• 4 Versailles Saint-Quentin en Yvelines, Faculty of Health sciences Simone Veil, Department of Family Medicine, Montigny le Bretonneux, France
• 5 Université Paris-Saclay, University Paris-Sud, Villejuif, France
• 6 Charcot Psychiatric Hospital, France
• Correspondence to O Saint-Lary olivier.saint-lary{at}uvsq.fr

What you need to know

Long working hours and strain at work contribute to stress, ill health, and increased risk of cardiovascular diseases, diabetes, and mental illnesses

Explore occupational factors such as an imbalance between effort and reward, work overload, bullying, and job insecurity

Workplace interventions, a short period of leave from work, and psychological treatment can be considered, alongside regular follow-up to assess how the patient is coping

A 55 year old senior executive presents with low back pain. He appears anxious. A reorganisation within his company has increased his workload and he has been working more hours but receiving no recognition from management. Last week he felt humiliated by a colleague. Since then he has not been able to sleep for more than a couple of hours each day.

Stress accounts for more than a third of all cases of work related ill health and almost half of all working days lost due to illness. 1 Internationally, systematic reviews and meta-analysis of observational data suggest that job strain and poorly functioning work environments are associated with the development of depressive symptoms. 2 3 4 A longitudinal cohort study from Norway found workplace bullying to be associated with subsequent suicidal ideation. 5 Long working hours are also associated with increased risk of stroke, heart disease, 6 and diabetes, 7 and poor lifestyle including inactivity, 7 smoking, 7 and risky alcohol use. 8

Patients might present with unexplained somatic symptoms, such as odd aches and pains, palpitations, loss of appetite, and loss of sleep. 9 10 Explore their symptoms and discuss any contributing factors in their work and personal life. The consultation can be long and difficult, as the patient might not volunteer all the information or draw the association with work stress. The objective of this first consultation is to perform a quick risk assessment and explore factors in the patient’s job that are contributing to stress.

What you should cover

The following questions are based on systematic reviews, and the experiences of clinicians and patients.

• the nature and duration of the patient’s presenting symptoms

• associated depressive symptoms, such as

o feeling down, low, or sad

o loss of interest in activities

o tiring easily

o lack of concentration

o changes in sleep and appetite

• feelings of hopelessness, (eg, a belief that the situation cannot improve) 11

• occupation, working environment, and stressors at work (box 1)

• the chronology of events, how the patient has coped so far, and if things have changed recently in their workplace. Typically, three phases are described 13 :

an initial (“serene”) phase, where the patient reports no particular difficulty

a “problem” phase, when obstacles and conflicts gradually appear and the patient tries to deal with the situation

a “crisis” phase, where s/he comes to see you

• protective factors for severity of outcome include a supportive family environment and financial wellbeing. Aggravating factors are familial isolation, being a single parent with young children, having financial difficulties, or being bound by a particular type of employment contract that forces the patient to stay in the same job. The latter can delay diagnosis, and limit the range of remedial options available.

• thoughts of ending their life or causing harm to themselves or others

• other medical illnesses, including diabetes, hypertension, cardiovascular events, or psychiatric disorders

• smoking, alcohol, and drug abuse

• family history of depression or mental disorders, which could increase the risk of depression and suicide

Box 1: Occupational factors for stress 2 12 13

Conflict of values (being asked to do a poor quality job or cut costs for a person who likes to keep high standards in their work)

Feeling insufficiently rewarded compared with the person’s assessment of their efforts (“effort-reward imbalance”)

Inability to make decisions about when or how to stop work

Lack of support from colleagues and management

Isolation at work (no cooperation between teams)

Work overload (working after hours) or insufficient workload (nothing to do)

Discrimination, humiliation, violence, bullying, and harassment at work

Cases of work related stress in the same company

Company situation in terms of finances, organisational changes, and employee turnover

Job insecurity, temporary employment status

Patients come to their doctor primarily to address their symptoms, but some will also want assistance and advice on how to cope with the situation at work.

Examination

Assess general appearance and look for signs of psychomotor agitation such as restlessness, rapid talking, and racing thoughts, or of psychomotor retardation such as apparent exhaustion and visible slowing of physical activity. These might indicate a mental illness or organic cause, such as a thyroid disorder.

Perform a quick general examination to look for fever, tachycardia, hypertension, and signs of thyroid disorder (which can be a differential diagnosis). Examine thoroughly for reported pain, though somatisation is likely.

What you should do

Investigation and management of physical and mental health diagnoses —Offer usual management of conditions such as depression. Consider immediate referral to psychiatry if the patient describes suicidal or aggressive thoughts or intentions.

Make the connection between the patient’s experience and work stress —For patients with work related stress and a variety of symptoms, acknowledge their situation and validate their feelings with a phrase such as, “I understand that you are suffering and that this feeling is arising from a stressful work environment.”

Offer a supportive setting to discuss and make progress in dealing with work stress —High quality evidence and guidelines for interventions to manage work related adjustment issues and stress are lacking. 14 Cognitive therapy, stepwise reintegration planning, and relaxation training can all be considered. 15 16 Therapy needs to be supportive, active, flexible, goal directed, and time bound. 10 12 14

Consider offering a second appointment—for example, if there is too much to cover. You might suggest that the patient brings a family member to the next appointment for support.

In the interim, you might ask the patient to reflect on their job and personal situation, and possibly to write a short description of their problems at work, the chronology of these problems, and their relationship to the patient’s symptoms. In our experience, some patients find this helps them reflect on the events, and it can help you understand their situation better. This will help to initiate discussion on strategies that the patient might employ to navigate their workspace going forward. Making contact with the workplace to modify work or reduce workload in collaboration with the employer can be helpful. Discuss whether the occupational health services or human resources division at the patient’s company could be involved. In some circumstances, patients might wish to seek compensation or take legal action. Explore if these are important for your patient and direct them to appropriate agencies or lawyers who can help with these matters.

Consider whether the patient wants or might benefit from time away from work including a “sick note.”

Schedule a follow-up visit to assess how the patient is coping with symptoms and workplace issues, and modify the approach accordingly.

Education into practice

What factors would you typically explore in the patient’s history to understand their working environment and stress? Does this article offer you ideas on how to do so differently?

Sometimes, asking the patient to write down their problems at work, the times at which the problems occurred, and the patient’s symptoms, is helpful. Are there ways in which you might consider using this or other techniques to help patients better organise their thoughts or understand them yourself?

Do you offer a second appointment, if there is too much to cover, or if the patient wishes to include a friend or family member?

In difficult cases, do you work in collaboration with mental health professionals as well as occupational health professionals?

How patients were involved in the creation of this article

Patients in our practice reported a need to rethink what they had experienced at work and to share this in writing. This helped them identify and clearly communicate the chronology of events. Based on their feedback we recommend encouraging patients to write about their work environment and factors contributing to stress, though this need not be mandatory.

A patient reviewed this article and attested that writing a two page memorandum would have been enormously helpful to identify problems at work and how they had escalated over time, and to come to terms with the situation.

We would like to thank Richard Carter for helping us to improve the language of this document.

We have read and understood BMJ policy on declaration of interests and declare that we have no competing interests.

Patient consent obtained.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

• ↵ Statistics—Work related stress, anxiety and depression statistics in Great Britain (GB). http://www.hse.gov.uk/statistics/causdis/stress
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ORIGINAL RESEARCH article

What makes employees’ work so stressful effects of vertical leadership and horizontal management on employees’ stress.

• 1 Institute of Psychology and Behavior, Henan University, Kaifeng, China
• 2 Social Psychology Laboratory, Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan

Work stress is a significant problem all over the world. In the present study, from the perspective of the combination of vertical and horizontal management, we investigated the relationships of managerial ethical leadership, mutual monitoring, and mutual support among employees’ work stress levels. A total of 307 white collar employees in Japan were asked to complete an online questionnaire on three separate occasions. The results showed that both ethical leadership and mutual support were negatively related to stress. In addition, mutual support mediated the relationship between ethical leadership and work stress. Further, mutual monitoring moderated the relationship between ethical leadership and work stress: when mutual monitoring was high, stress did not decline with more ethical leadership. These results may suggest that ethical leadership can reduce work stress both directly and through mutual support, indirectly. Additionally, the direct effect may be constrained under high monitoring situations. Practical implications and needed future research are also discussed.

Introduction

Employees’ work stress is a significant problem for organizations worldwide; for instance, United States organizations spend approximately 300 billion dollars per year addressing the consequences of stress ( American Institute of Stress, 2012 ). In Europe, the cost of work stress has reached 20 billion euros per year ( Levi and Levi, 2000 ). In Japan, in particular, 60.9% of employees have reported feeling strong anxiety or stress in their work (Japanese Ministry of Health, Labour, and Welfare, 2012 ); the word karoshi , which means “overwork death,” comes from Japanese ( Kanai, 2009 ). To tackle the work stress problem, the Japanese government has mandated that organizations with over 50 employees conduct stress checks annually at least once ( Ministry of Health, Labour, and Welfare, 2015 ). Nevertheless, at present, such efforts are failing to decrease Japanese workers’ stress ( Ministry of Health, Labour, and Welfare, 2015 ).

What makes employees’ work so stressful and what factors can buffer employees’ work stress? To address this issue, considerable research has focused on the effects of leadership on followers’ work stress. For instance, Skakon et al. (2010) have reviewed the relationship between leadership and followers’ work stress; in general, leaders’ work stress is positively related to followers’ work stress, while leaders’ behavior (e.g., leader’s supportive behavior, consideration behavior) and leadership style (e.g., transformational leadership) are negatively related to followers’ work stress. Whereas most research has stressed the effects on leadership (vertical management), it is still unknown how followers’ management (horizontal management; Ohno, 2005 ) functions elevate or reduce stress in the workplace, although it is assumed to strongly encumber workers’ lives ( Ohno, 2005 ). To our knowledge, there are no studies examining how vertical leadership and horizontal management interactively influence employees’ stress. Thus, from the prospective of the combination of vertical and horizontal management, the present study aims to explore the relationships between managerial ethical leadership, mutual monitoring, mutual support among followers, and their work stress.

The present study’s purposes are to (a) provide further evidence for the effect of ethical leadership on work stress, by examining the effects of ethical leadership on a series of general stress reactions, including anger, fatigue, anxiety, depression, and physical complaint(s); (b) discuss how ethical leadership can decrease work stress by examining the mediating effect of mutual support between ethical leadership and stress reactions; and (c) discuss conditions that may constrain the effects of ethical leadership, by examining interaction effects of ethical leadership and mutual monitoring on followers’ stress reactions. To examine these potential relations, a time-lagged design was applied in which ethical leadership was measured at time 1, followers’ mutual support and mutual monitoring at time 2, and stress at time 3. The framework of the present study is shown in Figure 1 .

Figure 1. Framework of the present study.

Ethical Leadership and Followers’ Work Stress

From the social learning perspective, ethical leadership is defined as “the demonstration of normatively appropriate conduct through personal actions and interpersonal relationships, and the promotion of such conduct to followers through two-way communication, reinforcement, and decision-making” ( Brown et al., 2005 ). In the definition of Brown et al. (2005) , people who are perceived to be ethical leaders model conduct that followers consider to be normatively appropriate (e.g., honesty, trustworthiness, fairness, and care), in turn making the leader a legitimate and credible role model. Ethical leadership comprises two components: the moral person and the moral manager ( Brown and Treviño, 2006 ). On the one hand, ethical leaders themselves exhibit ethical actions and are perceived to be honest, trustworthy, fair, and caring; on the other hand, ethical leaders talk about ethical rules explicitly and make them salient, set ethical standards, and reward ethical conduct—fostering and upholding ethics within their organizations.

Ethical leaders are those who show personal concern for followers and set high ethical standard in organizations ( Brown et al., 2005 ). Thus, ethical leadership is likely to play an important role in organizations that try to thoroughly implement stress prevention guidelines. According to conservation of resources (COR) theory, individuals seek to protect and promote their resources; perception of resource loss, threat to resources, and/or inability to gain new resources can result in stress responses ( Hobfoll, 1989 ). Resources are anything that people personally value: objects, conditions, personal characteristics, energy, etc. ( Halbesleben et al., 2009 ). Ethical leaders show personal concern, respect, and support for followers ( Kanungo and Conger, 1993 ; Treviño et al., 2003 ), share their power, and provide followers with voice ( Yukl, 2006 ). These aspects of ethical leadership provide important resources to followers, helping them deal with strain in the workplace.

The effectiveness of ethical leadership has gained the attention of researchers and practitioners. Prior work has shown that employee perception of ethical leadership is negatively related to workload, perception of poor conditions, bullying in organizations ( Stouten et al., 2010 ), and unethical acts ( Mayer et al., 2012 ). In addition, ethical leadership is positively related to task significance and job autonomy ( Piccolo et al., 2010 ), task and contextual performance ( Brown et al., 2005 ; Kalshoven and Boon, 2012 ), satisfaction ( Brown et al., 2005 ), and organizational commitment ( Den Hartog and De Hoogh, 2009 ). Furthermore, based on COR theory, Kalshoven and Boon (2012) and Zheng et al. (2015) have found that by providing resources to followers, ethical leadership is positively related to followers’ well-being and negatively related to followers’ exhaustion. In the present study, depending on the definition of ethical leadership, and consistent with prior studies (e.g., Brown et al., 2005 ; Stouten et al., 2010 ), we used the followers’ perception of ethical leadership to measure the ethical leadership. In addition, we used a specific series of stress reactions, including anger, anxiety, fatigue, depression, and physical symptoms as stress indicators, which are well established in Japan ( Kawahito et al., 2012 ). Overall, consistent with prior studies, we predict that:

Hypothesis 1: Ethical leadership is negatively related to employees’ work stress, including anger, anxiety, fatigue, depression, and physical symptoms.

Mediation Effects of Mutual Support

Followers’ work stress is not only affected by vertical management; horizontal management among coworkers may also play an important role. Ohno (2005) suggested that horizontal management consists of two elements: mutual support and mutual monitoring of coworkers. Mutual support was defined as workers supporting one another to achieve occupational goals and supporting one another in various aspects of their private lives; mutual monitoring was defined as workers monitoring one another’s performance, private circumstances, and other aspects of life, and knowing that they are subject to others’ monitoring ( Ohno, 2005 ).

In line with COR theory ( Hobfoll, 1989 ), support from coworkers can provide resources to followers, which can improve their total amount of resources. When employees perceive a loss of resources, threat to resources, or inability to gain new resources, others’ support can compensate for this loss. Therefore, support is expected to be negatively related to stress reactions. In addition, much work has shown that mutual support is positively related to job satisfaction, in-role job performance, organizational citizenship behavior, organizational commitment, and job involvement, and negatively related to burnout, fatigue, job tension, somatic symptoms, and turnover intention (e.g., Cohen and Wills, 1985 ; Rhoades and Eisenberger, 2002 ; Viswesvaran et al., 1999 ). In line with prior studies (e.g., Cohen and McKay, 1984 ; Jayaratne et al., 1988 ), we predict that:

Hypothesis 2 : Mutual support is negatively related to work stress, including anger, anxiety, fatigue, depression, and physical symptoms.

Based on Hypotheses 1 and 2, both ethical leadership and mutual support may negatively affect work stress. According to social learning theory ( Bandura, 1976 ), leaders are important role models for followers to observe and learn from. Ethical leaders are attractive, credible, and legitimate role models who engage in normatively appropriate behavior and make the ethics message salient ( Brown et al., 2005 ). Followers will then view ethical leaders as role models and learn from them; therefore, the personal concern component of ethical leadership will spread to followers. Followers may then show more concern about their coworkers, fostering mutual support across whole organizations. Therefore, ethical leadership may positively relate to mutual support. Taking Hypotheses 1 and 2 together, we predict that:

Hypothesis 3 : The relationship of ethical leadership and work stress is mediated by followers’ mutual support.

Moderating Effects of Mutual Monitoring

Following the definition of mutual monitoring, employees understand their coworkers’ jobs and see their performance in real time ( Barron and Gjerde, 1997 ). Therefore, employees are sensitive to the work status, quality, performance, and errors of their coworkers. On one hand, people in organizations are often reluctant to disclose their errors ( Michael, 1976 ); therefore, they have to pay attention to evaluations of them by others, and this may result in increased tension. On the other hand, mutual monitoring could coerce employees to act according to the “rule” in organizations. The Japan Business Federation (2017) showed that organizations where “overwork is common sense” or “overwork is virtue” fostered longer working hours. If overwork were routinely accepted in high-monitoring organizations, we would expect overwork to become even more accepted, increase, and become a norm. Long working hours, especially unpaid overwork, are positively related with work stress (e.g., Artazcoz et al., 2016 ; Yamashita et al., 2016 ); in these ways, mutual monitoring could increase employees’ stress both directly and indirectly, through promoting overwork. Thus, we predict that:

Hypothesis 4 : Mutual monitoring is positively related to work stress.

To our knowledge, there are few studies examining the interaction of leadership and monitoring on stress. Based on Hypothesis 1, ethical leadership can reduce followers’ work stress. However, effects of leadership vary from situation to situation ( Vroom and Jago, 2007 ); for instance, Loughry and Tosi (2008) attempted to examined followers’ monitoring in interaction with supervisory monitoring, and their results revealed that when leader’s monitoring was low, direct monitoring (conducted by coworkers) had a positive relationship with performance; when leader’s monitoring was high, direct monitoring (conducted by coworkers) showed no relationship with performance. However, as their work was focused on performance, effects of leadership and mutual monitoring on stress remain unclear.

In the present study, we predicted that ethical leadership may not just directly influence employees’ work stress, but could in fact be constrained by situations in terms of mutual monitoring. As a management function, Ohno (2005) indicated that mutual monitoring among employees is to some extent independent from leadership. Ethical leaders clarify responsibilities, expectations, and performance goals, so that followers know what is expected from them. Meanwhile, through knowledge sharing and communication, mutual monitoring may also form employees’ expectations of their coworkers ( Salas et al., 2005 ). In Japan, no one specific person in an organization generally has the authority and responsibility to make decisions; a bottom-up style of decision-making processes instead prevails ( Japan Cabinet Office, 2006 ), represented by “consensus decision-making” and “delegation of decision-making to middle management” ( Pudelko and Mendenhall, 2007 ). These features of the decision-making process in Japan may be one reason for the stronger influence of horizontal than vertical management. When followers are in low monitoring situations, workers need not to pay much attention to their coworkers’ monitoring, and norms developed by ethical leadership are dominant. Therefore, under low monitoring situations, followers could receive resources provided by ethical leadership and protect their own resources, as ethical leadership is negatively related with stress responses. However, when followers are in high monitoring situations, they both receive monitoring from their coworkers and deliver monitoring to their coworkers, and these two processes together enforce compliance with common rules. Norms shared among coworkers may weaken the effect of ethical leadership. As noted above, overwork is an implicit rule in Japan; when followers face the overwork norm from coworkers and extend their overwork time, they may exhaust resources provided by their ethical leaders or their own resources. Therefore, under high monitoring situations, followers could exhaust resources provided by ethical leadership, and ethical leadership may show no relations with stress responses. Above all, we predict that:

Hypothesis 5: The effects of ethical leadership on work stress may be moderated by mutual monitoring.

Materials and Methods

Participants and procedure.

This study was conducted among a broad sample of full-time employees in Japan, in a wide range of occupations. Participants were asked to answer a self-reported online questionnaire. The questionnaire used the forced choice approach, ensuring a dataset without missing data. The order of the items and scales was randomized for each participant. In order to test our hypotheses, the surveys were conducted three times; the first time, participants were asked to evaluate their immediate leader; 2 weeks later, they were asked to evaluate mutual support and mutual monitoring in the organization. Then, after 2 weeks, participants were asked to complete the work stress questionnaire.

At time 1, the questionnaires were distributed to 700 employees, and at time 2 and time 3, the 400 employees who returned the time 1 questionnaire were distributed another two questionnaires. In total, 307 employees (144 males and 163 females) completed all three questionnaires. The participants’ average age was 36.0 ( SD = 7.92). They were mostly working in sales and marketing (18.6%), office/administrative work (14.7%), and technical positions (11.7%). Their average organizational tenure was 8.5 years.

Ethical Leadership

This was measured with 10 items from the Japanese version of Brown et al. (2005) Ethical Leadership Scale ( Watanabe and Sakata, 2014 ), which is evaluated by followers to assess their direct leaders. An example item is “Listens to what employees have to say.”

Mutual Support and Mutual Monitoring

Both mutual support and mutual monitoring were measured by six items from Wang et al. (2016) . These items measured followers’ perception of monitoring and support in their organizations. For mutual support, an example item is “We are warm toward members who cannot work enough because of health or family problems.” For mutual monitoring, an example item is “We know we are watched by each other.”

Stress Reactions

These were assessed with 26 items from the Brief Job Stress Questionnaire ( Kawahito et al., 2012 ). The participants were asked to assess their stress reactions over the last month. Stress reactions include anger, fatigue, anxiety, depression, and physical symptoms.

Demographic items including gender, age, occupation, total number of employees in the company, tenure, and weekly unpaid overwork hours were recorded.

All items were rated on a five-point scale. For stress reactions, this ranged from 1 ( rarely ) to 5 ( frequently ); for other scales, from 1 ( not at all ) to 5 ( very much so ).

Data Analyses

Data analyses were conducted by SPSS 23.0 with process macro and AMOS 23.0. First, construct validity was examined and the common method variance was examined by confirmatory factor analyses. Then, correlation analyses were conducted to preliminarily examine the hypotheses. Because unpaid overwork is considered to have a strong correlation with stress responses, weekly unpaid overwork hours were controlled in the examination of hypotheses. The mediating effects of ethical leadership and mutual support were examined by hierarchical regression, bootstrap analyses, and structural equation modeling. The moderating effects of ethical leadership and mutual monitoring were examined by hierarchical multiple regression.

Construct Validity and Common Method Bias

Although our data were collected at three different times, the measures were evaluated by the same source. Before further testing the hypotheses, the construct validity and common method variance were examined by a series of confirmatory factor analyses. The measurement model—which allowed every item to load on its respective construct—was compared with two nested models. The measurement model consisted of eight factors: ethical leadership, mutual support, mutual monitoring, anger, anxiety, fatigue, depression, and physical symptoms; because mutual monitoring and mutual support were correlated with each other, both theoretically and practically ( Salas et al., 2005 ; Wang et al., 2016 ), the first nested model combined these two factors. In addition, in the original scoring system of stress responses, items for all stress responses were added together to calculate the total score for stress responses ( Kawahito et al., 2012 ). However, some reports indicated that the effects of antecedent factors may vary on anger, fatigue, anxiety, depression, and physical symptoms (e.g., Murakami et al., 2018 ). These studies asserted that these stress responses should be discussed separately. Therefore, we compared the factors of the second nested model, which combined these stress response factors. Results of the confirmatory factor analyses are seen in Table 1 ; as shown, the eight-factor measurement model showed acceptable goodness of fit [χ 2 (790) = 1635.12, p < 0.01, CFI = 0.90, RMSEA = 0.05, SRMR = 0.07] and had a better fit than other models. Combination with the stress reaction factors or the mutual monitoring and mutual support factors showed unacceptable goodness of fit.

Table 1. Comparison of confirmatory factor analysis.

Following the suggestion of Podsakoff et al. (2003) , the unmeasured latent method construct technique was also applied. On the basis of the original eight-factor structure, a latent method factor was constructed, and all items were allowed to load on it. The latent factor was uncorrelated with other factors. The variance explained by the latent method factor was 4%, which is lower than the 25% median score in published studies ( Williams et al., 1989 ). Furthermore, when constraining the latent method factor’s regression weight to 0, or setting estimation as free, the model fit does not change significantly (Δχ 2 = 39, n.s.; Richardson et al., 2009 ). These results provide further evidence that common method variance had little effect on the present study’s overall results.

Descriptive Statistics and Correlation Analyses

Table 2 presents descriptive statistics, Cronbach’s α, McDonald’s omega, and an intercorrelation matrix. As shown, ethical leadership generally had negative correlations with stress reactions ( r s = −0.13 to −0.28, p < 0.01); these results were consistent with Hypothesis 1. In line with Hypothesis 2, mutual support generally showed negative correlations with stress reactions (for anger, fatigue, anxiety, and depression, r s = −0.20 to −0.28, p < 0.01; and for physical symptoms, r = −0.15, p < 0.05). Mutual monitoring was negatively correlated with depression ( r = −0.15, p < 0.05) and slightly negatively correlated with fatigue ( r = −0.10, p < 0.10) and physical symptoms ( r = −0.11, p < 0.10), consistent with Hypothesis 4.

Table 2. Descriptive statistics and their correlations.

Mediating Effect of Mutual Support

In order to further test our hypotheses and better understand the effect of each independent variable, we conducted a series of hierarchical regression analyses for each of ethical leadership, mutual support, and work stress. In step 1, control variables (age, gender, and weekly unpaid overwork hours) were entered into the model; in step 2, mutual support was entered; and in step 3, ethical leadership was entered. When the other demographic variables were entered, the results did not show notable change. As controlling too many variables would decrease the power of the analysis ( Becker, 2005 ), in the present analysis, we used only age and gender as control variables. The results are shown in Table 3 .

Table 3. Effects of ethical leadership and mutual support on stress reactions.

In step 2, ethical leadership was negatively related with anger (β = −0.21, p < 0.01, Δ R 2 = 0.04, p < 0.01), fatigue (β = −0.11, p < 0.01, Δ R 2 = 0.01, p < 0.05, anxiety (β = −0.14, p < 0.01, Δ R 2 = 0.02, p < 0.10), and depression (β = −0.16, p < 0.01, Δ R 2 = 0.03, p < 0.01). Therefore, Hypothesis 1 was generally supported.

In step 3, controlling for ethical leadership, mutual support showed negative relations with stress reactions and explained additional R 2 . Results were as follows: anger (β = −0.14, p < 0.01, Δ R 2 = 0.02, p < 0.05), depression (β = −0.17, p < 0.01, Δ R 2 = 0.02, p < 0.01), and physical symptoms (β = −0.14, p < 0.01, Δ R 2 = 0.01, p < 0.05). However, mutual support showed no relations with fatigue and anxiety (β = −0.07, n.s.; β = −0.07, n.s.). These results suggest that Hypothesis 2 was partially supported. Furthermore, when mutual support was entered into the regression model, the relations between mutual support and stress became weaker than in the prior model. This result suggests that mutual support may mediate the relation between ethical leadership and stress; therefore, we conducted a series of bootstrap analyses ( N = 2000) for this potential relation. Results are shown in Figures 2 , 3 .

Figure 2. Standardized regression coefficients for the relationship between ethical leadership and anger as partially mediated by mutual support. ∗∗ p < 0.01, ∗ p < 0.05.

Figure 3. Standardized regression coefficients for the relationship between ethical leadership and depression as completely mediated by mutual support. ∗∗ p < 0.01.

The relationships between ethical leadership and depression was completely mediated by mutual support. The indirect effect was significant ( B = −0.08, SE = 0.04, p < 0.05, 95% CI [−0.18, −0.01]). The relationship between ethical leadership and anger was partially mediated by mutual support. The indirect effect was significant ( B = −0.13, SE = 0.07, p < 0.05, 95% CI [−0.20, −0.04]). Therefore, Hypothesis 3 was partially supported.

To further examine Hypothesis 3, with gender, age, and weekly unpaid overwork hours as control variables, ethical leadership as dependent variable, mutual support as mediating variable, and stress responses took its five dimensions as independent variables, structural equation modeling was conducted. The indirect effect was estimated by bootstrap ( N = 2000). The model showed acceptable goodness of fit [χ 2 (13) = 34.03, p < 0.01, CFI = 0.97, RMSEA = 0.08, SRMR = 0.04]. The results are shown in Figure 4 . As shown, ethical leadership showed a slight negative relation with stress responses and a positive relation with mutual monitoring (β = 0.50, p < 0.01). Mutual monitoring showed a negative relation with stress responses (β = −0.21, p < 0.01). Mutual monitoring mediated the relationship between ethical leadership and stress responses; the indirect effect was significant ( B = −0.07, SE = 0.02, p < 0.01, 95% CI [−0.11, −0.02]). Therefore, Hypothesis 3 was supported.

Figure 4. Result of relationship between ethical leadership and stress responses mediated by mutual support [χ 2 (13) = 34.03, p < 0.01. CFI = 0.97, RMSEA = 0.08, SRMR = 0.04]. ** p < 0.01, + p < 0.10.

Moderating Effect of Mutual Monitoring

In order to test Hypotheses 4 and 5, another hierarchical regression analysis was conducted. In step 1, control variables (age, gender, and weekly unpaid overwork hours) were entered into the model; in step 2, ethical leadership was entered; in step 3, mutual monitoring was entered; and in step 4, the two-way interaction term of ethical leadership and mutual monitoring was entered. The results are shown in Table 4 .

Table 4. Effects of ethical leadership and mutual monitoring on stress reactions.

Mutual monitoring showed no relation with stress reactions; therefore, Hypothesis 4 was not supported. Effects of the interaction between ethical leadership and mutual monitoring on stress reactions were significant for anxiety, depression, and physical symptoms (βs = 0.13–0.16, p s < 0.05). Therefore, Hypothesis 5 was partially supported.

Because the interaction effects of mutual monitoring and ethical leadership on stress reactions were significant, a series of simple slope tests was conducted. The results showed that when mutual monitoring was low, anxiety declined with more ethical leadership, while when mutual monitoring was high, anxiety did not decline with more ethical leadership ( Figure 5 ). Simple slope test results for depression showed the same pattern as anxiety. In addition, simple slope test results of physical symptoms were somewhat different: when mutual monitoring was low, physical symptoms declined with more ethical leadership, however, when mutual monitoring was high, physical symptoms increased slightly with more ethical leadership ( Figure 6 ). Overall, the effects of ethical leadership on stress reactions were constrained by mutual monitoring; therefore, Hypothesis 5 was generally supported.

Figure 5. Effect of interaction of EL and mutual monitoring on anxiety. ∗∗ p < 0.01.

Figure 6. Effect of interaction of EL and mutual monitoring on physical symptoms. ** p < 0.01, + p < 0.10.

Supplementary Analyses

When we determined the construct validity of the model, some model goodness-of-fit indexes were slightly higher than the recommended criterion (i.e., SRMR = 0.07; Wu, 2009 ). A curvilinear relation could decrease goodness of fit ( Kaplan, 1988 , 1989 ), and some studies have suggested that the relationship between ethical leadership and organizational citizenship behavior could be curvilinear (e.g., Stouten et al., 2013 ). Therefore, we examined the potential relationship between squared ethical leadership and mutual support.

Based on the CFA model, we added the squared ethical leadership items to this model, allowing them to load a new latent factor and this factor to correlate with other latent factors. When the new quadratic factor was added into the model, the model fit improved (χ 2 = 2424.54, df = 1238, CFI = 0.93, RMSEA = 0.05, SRMR = 0.05). Hierarchical regression analysis was conducted to examine the potential curvilinear relation between ethical leadership and mutual support. The result is shown in Table 5 .

Table 5. Curvilinear relation between ethical leadership and mutual support.

Ethical leadership was significantly related to mutual support (β = 0.51, p < 0.01); the quadratic effect of ethical leadership was also significant (β = 0.10, p < 0.05, Δ R 2 = 0.01, p < 0.05). Therefore, the curvilinear relation between ethical leadership and mutual support was significant.

To examine whether the curvilinear effect would influence our conclusion of the mediation effects, a series of bootstrap analyses ( N = 2000) was conducted. Age, gender, weekly unpaid overwork hours, and squared ethical leadership were controlled. The relationship between ethical leadership and depression was completely mediated by mutual support. The indirect effect remained significant ( B = −0.08, SE = 0.03, p < 0.05, 95% CI [−0.14, −0.02]). The relationship between ethical leadership and anger was partially mediated by mutual support. The indirect effect remained significant ( B = −0.08, SE = 0.03, p < 0.05, 95% CI [−0.15, −0.02]). It can therefore be concluded that the curvilinear effect did not change our results notably.

General Discussion

Japan is one of the most stressful countries in the world ( Ministry of Health, Labour, and Welfare, 2018 ). The present study took Japanese workers as a sample and examined the effects of both leadership from supervisor and horizontal management from coworkers with a time-lagged design. Specifically, the direct effect of ethical leadership on work stress, the mediating effect of mutual support, and the moderating effect of mutual monitoring were examined. Generally, the hypotheses were supported, and the time-lagged design helped us determine the causal relations between these variables to some extent.

The results were consistent with prior studies in which ethical leadership relates negatively to stress reactions (e.g., Zheng et al., 2015 ), and these effects were mediated by mutual support. Further, the mediating effects were supported by bootstrap analyses and SEM, which suggested that these results were robust. These results reveal that ethical leadership can reduce the work stress, and provided further evidence supporting the COR theory. However, there are also some novel discoveries in the present study. Contrary to our expectation, the relation between ethical leadership and physical symptoms was not significant. Physical symptoms were chronic stress reactions, which indicate exposure to strain over a long time. Based on social exchange theory, followers working with ethical leaders are more willing to contribute to the organization and have higher work involvement ( Den Hartog and Belschak, 2012 ). Therefore, followers may invest more resources of their own into the organization; this may potentially positively relate to work stress and counteract the negative effects of ethical leadership. Future studies need to test this potential relation.

Contrary to our expectation, mutual monitoring showed no relationship with stress. One possible reason is that mutual monitoring, as an important team function, is not done just to keep tabs on each other but also for better understanding of coworkers’ needs and to provide them with suitable help, encourage coworkers to conform to standards, and decrease errors in organizations ( Ohno, 2005 ; Salas et al., 2005 ). Furthermore, mutual monitoring motivates and enables workers to engage in behaviors that are beneficial to the organization, that is, to detect opportunities to assist, motivate, or encourage poorly performing coworkers or compensate for their poor performance ( LePine and Van Dyne, 2001 ; Loughry and Tosi, 2008 ). These components of mutual monitoring may provide resources to their coworkers and was negatively related to stress reactions. Meanwhile, being closely monitored may also connect with stress; Zhou (2003) showed that close monitoring by leaders may cause employees to be preoccupied with task-irrelevant concerns and fears, and it is plausible that being monitored by coworkers may have the same effect. Furthermore, as noted above, mutual monitoring involves setting standards and observing coworkers’ results, and this may lead to a high standard among followers, as these components of mutual monitoring may exhaust their resources. Therefore, taking these findings together, mutual monitoring showed no relation overall with stress reactions.

The results of interactions between ethical leadership and coworkers’ mutual monitoring expand prior ethical leadership research by revealing that monitoring did suppress the effects of ethical leadership on work stress. Both ethical leadership and mutual monitoring had management function aspects. Ethical leadership provided resources to followers, to buffer stress in the workplace. These effects were significant in the low monitoring situation. However, when mutual monitoring was high, the negative relations between ethical leadership and stress disappeared. This result was consistent with the work of Loughry and Tosi (2008) , in which followers’ performance increased with higher monitoring from leaders or from followers’ monitoring, however, it did not increase with the combination of high level of leader’s monitoring and high level of followers’ monitoring. As a fundamental team skill, monitoring in organizations means mature cooperation and teamwork to execute some of the leader’s functions. Ethical leaders show concern about followers’ health and make efforts to decrease overwork. However, followers may facilitate another standard: that overwork is normal, and that “one who goes home when everyone is working overtime is not ethical.” In this way, standards emerging from ethical leadership may be misunderstood by followers and result in negative consequences. Further work is needed to examine whether the norms shared by colleagues are consistent with the direction of action recommended by ethical leaders, and their effects on work stress.

Because of the decision-making process in Japanese management style ( Japan Cabinet Office, 2006 ; Pudelko and Mendenhall, 2007 ), in Japan, horizontal management from coworkers may have stronger influence than vertical management from leaders. The present work supported this inference, showing that the effects of ethical leadership on work stress were mediated by mutual support and constrained by mutual monitoring. Further evidence is needed by collecting data from Japanese employees to examine whether horizontal management has stronger influence than vertical management.

Theoretical and Practical Implications

With the combination of vertical and horizontal management perspectives, the present study contributes in both theoretical and practical areas.

Theoretically, first, prior studies either focused on the effects of leadership in the vertical mode or those of mutual support and mutual monitoring in the horizontal level. The present study connects these two approaches for a combined vertical and horizontal management. Second, whether from the vertical or the horizontal perspective, the present work was based on COR theory to examine the effects on stress responses and thus expanded the range of application of the theory. Third, the combination of vertical and horizontal approaches helped us clarify the effects and the influence mechanism(s) of antecedent factors on work stress, which could improve our understanding of these phenomena in the context of stress research.

Regarding practical lessons, first, leaders should act ethically, which includes integrity, trustworthiness, and honesty ( Brown et al., 2005 ; Kalshoven et al., 2011 ). Furthermore, leaders should set rules, standards, and codes of conduct, which provide guidelines for ethical behavior ( Beu and Buckley, 2001 ); leaders can also raise subordinates’ awareness of such guidelines, so that followers can know what is expected and act ethically, show concern for their coworkers, and foster mutual support in organizations. Followers should learn from their ethical leaders and keep support and monitoring at an appropriate level; as also suggested by Albon and Jewels (2014) , effective teams need members to maintain awareness of team functioning by monitoring fellow members’ work and catching mistakes, slips, or lapses. Third, for stress prevention, organizations should gain a comprehensive view of followers’ stress management and prevention. It is important to ensure that employees know that the purpose of monitoring is to provide suitable support among coworkers and improve their performance. It is best to avoid high levels of ethical leadership and monitoring simultaneously in organizations, and to ensure followers know the negative effects of monitoring, and improve their own psychological safety and that of their coworkers, to make monitoring less stressful. Followers should learn from their leaders’ ethics and provide suitable support to their coworkers. Furthermore, followers should restrain themselves to an appropriate level of mutual monitoring to avoid unnecessary tension with their coworkers.

Limitations and Future Studies

Some limitations of the research should be noted. First, mutual monitoring and mutual support are fundamental teamwork skills and a dynamic process that includes both monitoring (supporting) others and being monitored (supported) by others, however, the present study used only a single response source. Even though we randomized the order of the items and scales in the questionnaire and employed an unmeasured latent method construct technique to try to avoid common method variance, more data collected from team units and hierarchical linear model analyses could help us gain a better understanding of the effects of mutual monitoring. Future studies should use work group data to examine the effects of mutual monitoring at both individual and group levels.

Second, because our data were collected in Japan, the generalizability of these findings has to be considered carefully. One possible issue is that these results were intrinsically tied to current work circumstances in Japan. In addition, while efforts to reduce long working hours are beginning in Japan, many people still share the attitude that long working hours are the best way to preserve high work quality and take the burden off colleagues; this norm then engenders and is preserved by the institution of mutual monitoring. If this interpretation is correct, the present findings may be applied to other countries in which long working hours are seen as a virtue. Another possibility is that our findings reflect a limitation of ethical leadership regardless of working circumstances and culture. Some studies have demonstrated a curvilinear effect of ethical leadership: when leadership is too ethical, followers decrease organizational citizenship behaviors ( Stouten et al., 2013 ). Along distinct but analogous lines, our study showed that under certain conditions, ethical leadership may lead to worse health for employees, indicating the importance of finding ways to make mutual monitoring less stressful for employees under ethical leaders. Future study is necessary to address this issue.

Third, the initial measurement model did not fit the data well. Our supplementary analysis showed that the quadratic factor lowered the model fit, and the relationship between ethical leadership and mutual support may not be only linear, the curvilinear relationship was also significant. Furthermore, Pierce and Aguinis (2013) suggested that the relationship between positive leadership style and outcome variables may not be simply positive or nsegative; there may be a non-linear relationship as well. They have also proposed that researchers should pay more attention to the non-linear relationship. Our supplementary analysis provided further material for the non-linear relationship. Whereas the initial purpose of this study was to examine the relationships of managerial ethical leadership, mutual monitoring, and mutual support among employees with their work stress, we have not discussed in detail about the curvilinear relation. Whether a curvilinear relationship exists between ethical leadership and other consequence variables, how ethical leadership affects the consequence variables, and the mechanism of curvilinear relationship remains to be explored in future study.

These limitations notwithstanding, the present study provides interesting implications for both ethical leadership and work stress literatures. Prior research has mainly studied the positive outcomes of ethical leadership; our study instead focused on the combination of ethical leadership and horizontal management, and found that in general, effects of ethical leadership on work stress were mediated by mutual support and moderated by mutual monitoring.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the corresponding author, without undue reservation, to any qualified researcher.

Ethics Statement

This study was approved by the Research Ethics Committee of the Graduate School of Integrated Arts and Sciences, Hiroshima University.

Author Contributions

Under the direction of KS, WW generated the idea and designed the study, was the principal investigators for the study, and was the primary writer of the manuscript. The study was supported by a grant from KS. The writing and the framework of this manuscript was under the direction of YL and AK. All authors were involved in developing, editing, reviewing, and providing feedback for this manuscript and have given approval of the final version to be published.

This study was supported by a Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science Grant Number JP25380844.

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.

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Keywords : ethical leadership, mutual support, mutual monitoring, work stress, Japanese sample

Citation: Wang W, Sakata K, Komiya A and Li Y (2020) What Makes Employees’ Work So Stressful? Effects of Vertical Leadership and Horizontal Management on Employees’ Stress. Front. Psychol. 11:340. doi: 10.3389/fpsyg.2020.00340

Received: 20 July 2019; Accepted: 13 February 2020; Published: 19 March 2020.

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Copyright © 2020 Wang, Sakata, Komiya and Li. 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: Yongxin Li, [email protected]

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• Research article
• Open access
• Published: 21 May 2018

Work stress prevention needs of employees and supervisors

• Bo M. Havermans 1 , 2 ,
• Evelien P. M. Brouwers 3 ,
• Rianne J. A. Hoek 1 , 2 ,
• Johannes R. Anema 1 , 2 ,
• Allard J. van der Beek 1 , 2 &
• Cécile R. L. Boot 1 , 2  

BMC Public Health volume  18 , Article number:  642 ( 2018 ) Cite this article

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Work stress prevention can reduce health risks for individuals, as well as organisational and societal costs. The success of work stress interventions depends on proper implementation. Failure to take into account the needs of employees and supervisors can hinder intervention implementation. This study aimed to explore employee and supervisor needs regarding organisational work stress prevention.

Semi-structured telephone interviews were conducted with employees ( n  = 7) and supervisors ( n  = 8) from different sectors, such as the finance, health care, and services industry. The interviews focused on respondents’ needs regarding the prevention of work stress within an organisational setting. Performing thematic analysis, topics and themes were extracted from the verbatim transcribed interviews using Atlas.ti.

Both employees and supervisors reported a need for: 1) communication about work stress, 2) attention for determinants of work stress, 3) supportive circumstances (prerequisites) for work stress prevention, 4) involvement of various stakeholders in work stress prevention, and 5) availability of work stress prevention measures. Both employees and supervisors expressed the need for supervisors to communicate about work stress. Employees and supervisors reported similar psychosocial work factors that should be targeted for prevention (e.g., social support and autonomy). There was greater variety in the sub-themes within communication about work stress and supportive circumstances for work stress prevention in supervisor responses, and greater variety in the sub-themes within availability of work stress prevention measures in employee responses.

Conclusions

Both employees and supervisors were explicit about who should take part in communication about work stress, what prerequisites for work stress prevention should exist, and which stakeholders should be involved. These results can inform work stress prevention practice, supporting selection and implementation of interventions.

Trial registration

This study was registered in the Netherlands National Trial Register, trial code: NTR5527 .

Peer Review reports

Work stress is associated with physical and mental health risks [ 1 , 2 ]. In addition, it poses a financial burden to organisations and society at large, caused by productivity loss due to sickness absence, work disability benefits, and health care costs [ 3 , 4 ]. If work stress could be prevented or reduced, its detrimental consequences could also be curtailed.

Prevention of work stress is supported by the availability of effective organisational stress management interventions (SMIs), and successful implementation of these interventions. Effective interventions do exist [ 5 , 6 ], but they are not often used by organisations [ 7 ]. When SMIs are deployed, their usefulness depends greatly on proper implementation. Implementation is the extent to which the intervention is carried out as intended [ 8 , 9 ]. The failure to implement an intervention properly, reduces its chances of rendering the desired effect [ 8 , 10 , 11 ].

Failure to take into account the needs of employees and supervisors can drastically hinder implementation of SMIs, because they are central stakeholders. Intervention development draws from research on work stress determinants, many of which are psychosocial work factors, as experienced by employees and supervisors [ 12 , 13 ]. In widely used, hands-on approaches, such as participatory interventions [ 14 ] and intervention mapping [ 15 ], employees and supervisors work together with other stakeholders to select determinants of work stress to intervene upon. Employees and supervisors provide a valuable perspective, because they experience the current challenges in the organisation on a day-to-day basis. Reviews show that employees and their supervisors are often the main target population of SMIs [ 5 , 6 ].

Despite awareness of their importance, employee and supervisor needs in work stress prevention are often not met. In a study by Aust and colleagues [ 16 ], employees withheld their participation in the intervention, because they felt it focused too much on leadership development, and too little on their perceived need for employee involvement. Dahl-Jorgensen and Saksvik [ 17 ] found that supervisors who were sceptical or negative towards the intervention restricted the time employees could spend on formulating prevention needs, thereby preventing implementation of a critical part of the intervention. Biron and colleagues [ 18 ] found that supervisors failed to use a stress risk assessment tool because they felt no need for stress prevention in the first place.

A better understanding of the organisational work stress prevention needs of employees and supervisors can promote the development, selection and implementation of SMIs. Therefore, this study aimed to explore employee and supervisor needs regarding organisational work stress prevention.

Design and procedure

A total of 15 semi-structured telephone interviews was conducted with employees ( n  = 7) and supervisors ( n  = 8), between January and March 2016. Employees were defined as non-managerial workers. Supervisors were defined as the management level that is just above the non-managerial employees. The interview focused on respondents’ experiences with work stress within the context of their organisation, and on their needs regarding the prevention of work stress within that organisational context. Respondents were at work or at home at the time of the interviews. They were asked to sit alone during the interview, in a place in which they could speak freely.

Respondents were primarily recruited through the network of the authors. Recruitment was done face-to-face, by telephone, and/or by email. Purposive sampling [ 19 ] was used to select respondents. This purposive sampling was aimed at selecting a diverse sample with regard to key criteria gender, age, educational level, and profession. To be eligible for participation, respondents had to be 18 years of age or older, and had to perform paid work. To maximise diversity in the study sample, the researchers made sure to select respondents who worked in different sectors (e.g., finance, health care), and held different positions (e.g., caregiver, fitness instructor, occupational physician). Some of the potential respondents were contacted directly, while others were recruited by their manager. Reasons for non-participation were: complexity of the subject, feeling ill-equipped to talk about the subject, and lack of interest in the subject. Four people who were scheduled to participate dropped out ( n  = 3) or were excluded ( n  = 1). The reason for exclusion was that the interviewer knew the possible respondent personally.

Interviews were conducted by telephone. First, the study was introduced to the respondents through an information folder, which was distributed to them by mail. Beforehand, respondents were asked to fill out an informed consent form. If the respondents had no further questions, the interview was started. Respondents received a gift coupon of ten Euros for their participation. The study has been assessed by the Medical Ethical Committee of VU University Medical Center, Amsterdam, The Netherlands.

Interview protocol and interviewer

Different protocols were developed for employees and supervisors. The interview protocols consisted of a short introduction, and five questions (see Appendix ), and were developed using existing qualitative research literature [ 19 ], as well as organisational stress prevention literature [ 8 , 9 ]. The protocols were reviewed by all authors to assess face validity. For all questions, follow-up questions were formulated, to help the respondent elaborate on the subject. The follow-up questions were used only when necessary. The protocols were centred around the main theme: the respondent’s needs regarding work stress prevention. To make sure questions were clear to participants, a pilot test of three interviews (one supervisor, two employees) was conducted. This led to further clarification of items in the interview protocols. The first author (BMH) had had previous training in interviewing techniques and experience with interviewing, and conducted all interviews. The first author’s position was PhD Candidate, and he held a Master’s degree in Social Psychology. No relationship between the interviewer and the respondents existed prior to the study. No personal information was shared with respondents about the interviewer.

Data collection

The telephone interviews were recorded. The interviewer made notes during the interview. On average, interview duration was 26 min. Saturation of the data was considered by the coders (BMH and RJAH) and the second author (EMPB). Saturation focused on between-interview occurrence of variation in answers to the questions [ 20 , 21 ]. The interviews were conducted in two rounds to facilitate iteration, a reflexive process, in which collected data can be used to guide further data collection, or data analysis [ 22 ]. After the first round ( n  = 7), the recordings were inspected by both coders and the second author (EPMB), to see if adjustment of the interview protocols was necessary. This resulted in slight alterations of the protocols. For example, question 1 in both protocols was replaced with one of the follow-up questions (“What circumstances do you find important for the prevention or reduction of work stress?”). The altered protocols were used in the second (final) round ( n  = 8).

Data analysis

The interview recordings were transcribed verbatim by a professional transcription agency. Transcripts were cross-checked for accuracy. The explorative objective of this study called for an approach that facilitates ‘bottom-up’ or inductive interpretation. Thematic analysis was considered an appropriate research methodology [ 23 ]. In thematic analysis, the researcher systematically works through the texts to identify topics, which are clustered in themes that have particular relevance to the research question [ 19 ]. The coders used a bottom-up, inductive coding style. Initial descriptive codes were applied to the transcripts, themes were developed at a later stage. Coding was done in four rounds, with coding of four transcripts in round 1, 2, and 4, and coding of three transcripts in round 3. During the coding rounds, reappearing themes (between transcripts) were isolated, which supported increasing, but gradual abstraction and summation of the data. In the coding process, the coders made sure that deviation from existing codes was facilitated, so that new codes could be added to the codes found earlier. They did this by looking for data units that were different from the reappearing themes already included in the coding structure [ 21 ]. After every round, the two coders first discussed their findings together, and presented their codes to the second author (EPMB) for further reflection (thematic analysis). The coding scheme was adapted after every round, so that new themes could be added, and code names could be consolidated. The COREQ-checklist was used in reporting this study [ 24 ]. Data management, coding and analysis was conducted using ATLAS.ti, version 7.5.11.

Participants

The study sample consisted of eight females and seven males. Their age ranged from 29 to 63 years. Different sectors were represented in the study sample. Respondents worked in the finance ( n  = 7), health care ( n  = 5), and services sector ( n  = 3). Respondents had completed intermediate vocational education (n = 3), higher vocational education ( n  = 7), and university education ( n  = 5).

Main themes

Themes and sub-themes from employees and supervisors are presented in Table  1 . A five-theme structure was developed from the codes, which fitted both employee and supervisor responses. These main themes were 1) communication about work stress, 2) attention for determinants of work stress, 3) supportive circumstances for work stress prevention, 4) involvement of stakeholders in work stress prevention, and 5) availability of work stress prevention measures. All themes had sub-themes that represented different aspects of the main themes.

Communication about work stress

A need for communication about work stress was expressed by both the employees and the supervisors. They both felt that the supervisor should communicate about work stress with the employees. Employees indicated that the supervisor should routinely initiate communication about work stress in an individual setting or in a team setting, with topics ranging from individual work stress experiences to reporting on topics relevant to work stress in employee satisfaction surveys. This way, the supervisor would be aware of work stress challenges that employees experience in their daily work:

“[…] that my supervisor is aware of what their employee is working on, and regularly starts a conversation with them […]” (Respondent 3, employee)

Supervisors also felt that they should communicate about work stress. However, they were less clear than employees about who would be responsible for initiating the conversation between supervisor and employee. Supervisors felt it was their responsibility to listen closely to employees, and to engage them in conversation about work stress:

“[…] supervisors can reduce stress in employees by communicating, being clear and open towards employees […]” (Respondent 1, supervisor)

However, both employees and supervisors expressed a need for employees to feel safe to talk about work stress. Both employees and supervisors reported the lack of employees feeling safe to talk about work stress:

“If I would have the feeling that I could come to them [the organisation]. […] They [the organisation] only look at the numbers […] so I imagine that if I do something wrong, I am afraid I will be fired. It is a culture of fear.” (Respondent 13, employee)

“[…] that employees can express how they feel, even though it is very hard sometimes, and they do not feel safe to do so.” (Respondent 12, supervisor)

Communication about work stress might be problematic if employees do not feel safe to talk about it because they are afraid of repercussions. Perhaps, this is why supervisors said that they had the need for employees to indicate to the supervisor if they experienced work stress, giving responsibility for communication about work stress (at least partly) back to employees. In multiple instances, supervisors reported that they could not help employees if they kept experiences of work stress to themselves:

“I think the employee should clearly communicate about what is bothering him.” (Respondent 4, supervisor)

“I want employees to indicate they have work stress before it has gone on too long, so we can give them a few days off, rather than having them be on sick leave for longer periods of time” (Respondent 2, supervisor)

Finally, supervisors expressed the need for communication about work stress between employees and (higher) management to be facilitated (e.g., by stimulating employees to bring ideas to management, or by management visiting the work floor more often). According to supervisors, this could lead to increased awareness of employees’ experiences on the one hand, and increased transparency of higher management about developments within the organisation on the other hand. Except for facilitation of communication between employees and (higher) management, all communication sub-themes were about interactions between employee and supervisor. For the most part, they seem to look at each other for communication about work stress.

Attention for determinants of work stress

Respondents reported a need for attention for determinants of work stress. These determinants represented aspects of the work and the work environment that employees and supervisors felt should be targeted for work stress prevention. Both employees and supervisors indicated that they wanted attention for job demands:

“There should be more attention for work tasks, making sure that demands are not too high for employees” (Respondent 7, employee)

“[…] that it will benefit everyone, if employees experience a balance in workload, job demands.” (Respondent 9, supervisor)

Additionally, supervisors indicated that they experienced difficulty managing job demands, because it depended on factors that they could not control. Reported reasons for high job demands were: variability in production volume and personnel shortage:

“What I noticed was that we had insufficient budget for personnel, and that we needed more people than we had available” (Respondent 8, supervisor)

Employees and supervisors reported a need for attention for co-worker support. They felt that it was important to be able to depend on co-workers when there is much work to be done:

“Being able to depend on your co-workers, well, […] that would contribute in a positive way.” (Respondent 11, employee)

“When one team has a lot of work to do and another team does not, the less busy team can help the busy team out.” (Respondent 8, supervisor)

Both employees and supervisors indicated a need for attention for supervisor support. They stressed importance of help from supervisors with the work, and acknowledgement from supervisors and management for their work:

“When employees indicate that there are difficulties with work tasks, the supervisor should help resolve those issues” (Respondent 3, employee)

“I think that a pat on the back [from the supervisor] works much better than reprimanding [the employee]” (Respondent 11, employee)

“It is all about looking at the dynamic and acknowledging every employee, so that everybody feels they are important.” (Respondent 12, supervisor)

Another need reported by employees and supervisors was attention for autonomy/control. Employees emphasised a need for control over when they perform their working tasks, and over rostering and work days. Supervisors indicated a need for employees to have more control over their work schedule, but also expressed that this was sometimes difficult to achieve, suggesting that they did not always have the resources or skills necessary:

“I want to be able to determine at what time I perform my work tasks” (Respondent 3, employee)

“An obstacle is that employees have too little influence, for example, they have too little influence on the work schedule. I have been thinking about this for a year now, but it is very hard to fix.” (Respondent 5, supervisor)

Finally, employees indicated a need for more clarity about work tasks and expectations. Supervisors did not report this need. According to employees, clarity about work tasks and expectations would ensure that employees know what is expected of them. In addition, it would promote planning of work and accountability:

“I would like to have more information about what has to happen [in the near future]. If I don’t have that information, I have to do everything all at once at the last moment.” (Respondent 14, employee)

Supportive circumstances for work stress prevention

This theme contains the need that employees and supervisors expressed for circumstances that would be supportive to work stress prevention. These circumstances could be interpreted as prerequisites for more active work stress prevention (such as an intervention), and as situations that respondents indicated they needed in order to prevent them from experiencing work stress.

A shared need of employees and supervisors was a supportive organisational culture. Supervisors were explicit about this being a responsibility of the whole organisation, but especially for higher management. The supportive organisational culture was described as a feeling of unity throughout the organisation, constructive criticism, a focus on people instead of numbers or money, and the ability to put things into perspective:

“That is the most important thing, having that positive organisational culture, celebrate successes and making sure that you have a laugh every once in a while.” (Respondent 13, employee)

“I think there is a need for the entire organisation to understand that we are not working with employees and customers, but with people, […] that will create much more unity” (Respondent 1, supervisor)

Both employees and supervisors reported a need for sufficient budget to be made available by the organisation for work stress prevention.

Supervisors reported two additional supportive circumstances for work stress prevention. Firstly, they indicated a need for organisational support. Specifically, they reported a need for organisational support for their managerial decisions and for their management style (also with regard to work stress prevention):

“The organisation I work for gives me the opportunity to help balance [employees’] work and private life and that helps me to limit work stress” (Respondent 4, supervisor)

Secondly, supervisors indicated that in order to prevent work stress, they needed employees to be ‘ready for change’. This individual readiness for change was described as the awareness and acknowledgement of work stress being a problem, willingness to participate in (and not resisting) the prevention process. A situation was described in which the employee does not seem to acknowledge work stress; in another situation that was described, the employee acknowledged the presence of work stress, but did not want to use solutions provided:

“By not giving any signal of work stress, probably because they did not acknowledge it being there, the employee had a definite role in being burnt out. So it is necessary that the employee is aware of their capacity to work and the circumstances that can lead to sickness absence.” (Respondent 9, supervisor)

“He [the employee] does not really respond to the solutions that I have provided, like a stress management training, or scheduling skills, and I find that worrisome.” (Respondent 10, supervisor)

Involvement of stakeholders in work stress prevention

Employees and supervisors indicated a need for several different stakeholders to be involved in work stress prevention. A differentiation can be made between the stakeholders with respect to their being part of the organisation (i.e. internal stakeholders) or external to the organisation (i.e. external stakeholders). Examples of external stakeholders that respondents mentioned were companies that provide work stress management trainings, and occupational health professionals who can help with job redesign. Examples of internal stakeholders that employees and supervisors mentioned were: the job coach, human resources, and the occupational physician. Employees specifically mentioned that they wanted the occupational physician to be involved in an earlier stage of work stress prevention (i.e. primary or secondary prevention). Supervisors specifically mentioned the occupational physician and human resources:

“Only when the problem is already very severe and you cannot work anymore, only then the occupational physician is involved.” (Respondent 7, employee)

“I have approached human resources to ask what their policy was, what they had in mind [regarding work stress prevention]” (Respondent 1, supervisor)

“[The occupational physician] should preferably be involved before the employee is sick, so the employee indicates that things are not going well, and then we decide that contacting the occupational physician is a good idea.” (Respondent 2, supervisor)

Examples of external stakeholders that were mentioned by employees and supervisors were occupational health professionals, trainers, and physiotherapists.

Because of substantial prominence (being mentioned by almost all employees and several supervisors), higher management/CEOs are mentioned in a separate sub-theme, instead of being grouped with the internal stakeholders described earlier. Employees predominantly expressed an absence of sufficient involvement of higher management and/or the CEO in work stress prevention, whereas supervisor reports were more mixed:

“Top management should pay a lot more attention to stress and that their responsibility is to make sure that employees can work in health and safety.” (Respondent 13, employee)

“Luckily, our upper management is involved with the individuals working in the organisation, […] but in general, it is all about reports and statistics.” (Respondent 5, supervisor)

Employees reported a need for the supervisor to be involved in work stress prevention. Involvement of supervisors was characterised as: guiding the work stress prevention process, providing insight into work stress prevention options and availability of tools, helping to find sources of work stress and resources for healthy work:

“What I expect from my supervisor is that they help to find out where the work stress is coming from if the employee is unable to pinpoint it […], and take action if there is prolonged work stress.” (Respondent 14, employee)

Work stress prevention measures

Employees and supervisors expressed a need for work stress prevention measures. They shared a need for organisational measures, such as hiring more personnel to reduce workload, introducing protocols, better planning of work tasks/shifts:

“A better planning […] if we would discuss that more regularly, we could let more things run smoothly, and remove stressors that way.” (Respondent 15, employee)

“Good planning and accurate prediction of what workload we should expect and having a buffer for calamities.” (Respondent 8, supervisor)

Other than organisational measures, employees and supervisors did not share needs for measures. Employees indicated a need for exercise measures, such as going for walks or participating in sports. They also reported a need for employee-initiated action, or measures that they could use without depending on other stakeholders in the organisation, such as relaxation, exercises, and taking breaks regularly. Employees also expressed a need for team meetings with the supervisor that focus on work stress:

“It’s not like we have a meeting focusing on work stress alongside the employee satisfaction surveys, that look at the individual level, so we can make arrangements [for work stress prevention]” (Respondent 6, employee)

Lastly, employees expressed a need for competencies training aimed at coping with stress, setting boundaries, and dealing with changes:

“We do not have the knowledge and skills to switch from one [computer] system to the other in a day, for that, we need help, in a training.” (Respondent 14, employee)

Supervisors reported a need for measures that increase cooperation between the employee and the supervisor. Examples of such measures were facilitating asking of questions during team meetings, and working together to optimise the work atmosphere.

A diverse set of needs regarding work stress prevention was reported by the employees and supervisors who participated in the current study, illustrating that work stress prevention is a multi-faceted and complex challenge. At the same time, themes could be recognised from the responses, and commonalities between employees and supervisors could be found.

Both employees and supervisors reported a need for communication about work stress. Communication has been argued to facilitate awareness raising [ 25 ] and selection of SMIs [ 8 ]. It is represented in models for intervention evaluation [ 9 ], and has been found to be relevant in the SMI implementation process [ 26 ]. Employees were hesitant to initiate communication about work stress because they feared this would affect their position. This notion is illustrated strikingly by the second quote about a “culture of fear” under paragraph “Communication about work stress” in the results section. Moreover, previous research suggests that job insecurity has increased in the past decades [ 27 ]. As supervisors also expressed the need for employees to feel safe to talk about work stress and the need for employees to indicate if they experienced stress, an impasse becomes apparent. Supervisors can make less informed decisions about work stress prevention if employees give no indication of work stress, and employees are limited to more individual resources for work stress prevention that could strengthen their position and employability. Other barriers to communication about work stress may exist. For instance, in an assessment of factors relevant to stress and mental ill-health prevention, Moll [ 28 ] reported that stigma regarding mental health issues hindered communication about work stress. Stigma was one of multiple barriers to communication about mental health issues, creating a “web of silence”. Another example of a barrier to communication about mental health issues such as work stress is that supervisors might have insufficient knowledge about these issues [ 29 ]. Open communication about mental health issues within the context of the workplace can be very difficult [ 30 ]. However, the findings of the current study show that employees and supervisors did want a dialogue about work stress. Employees and supervisors reported this need independently from each other, as they did not belong to the same department, and in most cases not even to the same organisation. In addition, supervisors wanted higher management to participate in this dialogue as well.

Great overlap existed between employees and supervisors concerning the need for attention for determinants of work stress. This overlap existed regardless of the fact that the employees and the supervisors were not from the same departments (and in most cases not from the same organisations). They both reported the need for attention for job demands, co-worker and supervisor support, and autonomy/control. These psychosocial work factors are best represented in the job demands-control (support) model [ 12 , 31 ], and represent fundamental psychosocial challenges in maintaining a healthy workforce. An exception was the need for clarity about work tasks and expectations, which was reported by employees only. Lack of clarity of work tasks has been found to be associated with psychological distress [ 32 ]. Supervisors could prevent work stress in employees by helping them to express their expectations more clearly.

A need for supportive circumstances for work stress prevention was shared by employees and supervisors, but only for sub-themes “supportive organisational culture” and “sufficient budget”. Supervisors had a more varied need for supportive circumstances, at the level of the organisation (organisational support for supervisor) and at the level of the employee (readiness for change). The importance of organisational support and readiness for change has been stressed in existing literature [ 8 , 9 , 33 ]. Like the employees, supervisors reported a need for support regarding work stress prevention from their superiors in the organisation. Supervisors may sometimes feel trapped in between employees not willing to acknowledge work stress and participate in possible solutions on the one hand, and management unwilling to provide resources and support on the other hand. It serves as a reminder that different stakeholders (e.g., management/CEOs, social partners) should be involved for work stress prevention to succeed, as has been recommended in previous publications [ 8 , 9 , 25 , 34 ].

Within the main theme about the involvement of stakeholders in work stress prevention, employees and supervisors contended that the occupational physician (internal stakeholder) should be involved in the work stress prevention process. Until recently in Dutch health care, the occupational physician was mainly involved in tertiary prevention, or making sure that people return to work after sickness absence. In June 2017, new legislation from the Dutch Ministry of Social Affairs and Employment went into effect stating that occupational physicians should also advise organisations about work stress prevention, and not focus primarily on reduction of sickness absence [ 35 ]. Hopefully, this new legislation may pull the occupational physician more to the forefront of work stress prevention, possibly advising to employ professionals (e.g., trainers) or to deploy measures that can help the organisation and its employees to deal with work stress, which was another need employees and supervisors agreed upon. Even though both employees and supervisors reported a need for higher management/CEOs to be involved in work stress prevention, the need was much more prominent in employees. Research indicates that the extent to which employees feel that senior management finds a good psychosocial work environment to be important (i.e. psychosocial safety climate) [ 36 ] is negatively associated with work stress and a with psychological health problems [ 37 , 38 ]. The importance of visibility and involvement of higher management in work stress prevention is reconfirmed by the findings in the current study.

Employees and supervisors reported a need for organisational work stress prevention measures. It was the only sub-theme that they shared in the main theme “work stress prevention measures”. An argument for deployment of organisational-level interventions is the “hierarchy of controls”, which is a general principle in occupational health that states that the further upstream an intervention is, the greater the effect of the intervention will be [ 39 ]. It should be noted that the need expressed by employees for team meetings (including supervisor) about work stress would probably constitute cooperation between employee and supervisor. This indicates that there may have been more shared needs within the main theme “work stress prevention measures” beyond the need for organisational work stress measures. Involvement of different stakeholders and activities at different levels is in line with recommendations made for effective stress management and mental health promotion in employees [ 40 , 41 ]. In this regard, the needs reported in the current study suggest that an integrated approach to work stress prevention might be necessary. The fact that employees indicated a greater variety of needs for work stress prevention measures may be because they experience the challenges first-hand. This might give them better insight into which measures are necessary to combat work stress. The sub-themes reported by employees indicated that they felt at least in part responsible for work stress prevention: they indicated a need to learn to deal with work stress by taking part in competencies training, a need for employee initiated action, and a need for physical exercise. Still, finding appropriate measures seems to be a challenge for organisations [ 7 ], so greater insight of different stakeholders into the relevant options might be beneficial.

Strengths and limitations

A strength of this study was its selection of a diverse sample of employees and supervisors. The fact that employees and supervisors did not belong to the same departments or organisations may have encouraged respondents to freely speak about their needs, without expectations, and without fear for repercussions. For purposeful sampling, we used our professional network. This rendered a heterogeneous group, but because we recruited from our own network, there was a chance of bias. To prevent this bias, personal acquaintances of the interviewer were excluded. The qualitative approach facilitated spontaneous conceptualisation of new concepts relevant to work stress prevention. Moreover, the analysis phase was extensive and carefully planned, and was conducted by two authors (BMH and RJAH). Previous literature suggests a minimum of six to twelve interviews to reach saturation [ 42 ]. This criterion was met in the current study, with 15 interviews conducted. Moreover, commonalities and recurring themes were found (and agreed upon by coders BMH and RJAH, and second author EPMB) within groups in the diverse sample, indicating that saturation was reached, and that this study constitutes a viable exploration of work stress prevention needs.

The study also has limitations that should be taken into account. The main limitation of this research relates to generalizability. For example, our study contained no respondents of the lowest education level participated, and was conducted in the context of the Dutch social security system, which differs from that of other countries. However, generalizability was not the purpose of the study. As with other qualitative studies, the aim was to provide insight into a complex challenge of which more knowledge is urgently needed. The interview study approach, and diversity of our sampling, ensured inclusion of perspectives and experiences from a wide range of participants with different characteristics. This provides a multifaceted picture that would not have been available using surveys or other observational methods. Finally, no feedback on the findings was asked from respondents.

The fact that the interviews were conducted by telephone presents methodological strengths as well as limitations. On the one hand, respondents had more anonymity talking about the sensitive topic of work stress, possibly prompting less social desirable answers. On the other hand, more sensitive parts may have been picked up less by the interviewer, due to reduced registration of non-verbal communication. Sturges and Hanrahan compared face-to-face and telephone interviewing modes, and concluded that no significant data quality differences existed between the two modes [ 43 ]. This finding strengthens the position that for the current study, telephone interviews were appropriate.

Implications for research, practice, and policy

It should be noted that the interviews in this study focused on work stress prevention in employees, and not necessarily on supervisors’ own personal needs. Supervisors did express the need for support from their own superiors, but to get a more complete account of work stress challenges that are specific to supervisors and other important stakeholders, different questions should be asked, and in some cases, different stakeholder should be approached. In order to find more generalizable work stress prevention needs, this study could be carried out using a larger sample that is more diverse with respect to educational level, and that has more distinct levels of work stress. Findings of such research may assist translation of work stress prevention theory into practice, contributing to bridging the gap between work stress models and intervention implementation. Fortunately, exploration of work stress prevention needs plays a role in widely used frameworks for (occupational) health promotion, such as intervention mapping [ 15 , 44 ]. Still, intervention mapping is usually carried out within a single organisation, providing a view of occupational health challenges that is specific to that organisation. Population-based exploration may provide insights that can advance prevention practice in different ways than exploration within an organisation. Policy makers and research funding agencies could stimulate qualitative research of work stress prevention.

The findings of this study indicate that employees and supervisors have multifaceted work stress prevention needs. Despite the fact that employees and supervisors did not work at the same departments/organisations, their responses pointed at similar needs. At the same time, distinct differences existed between the two groups. As employees and supervisors are both key stakeholders in work stress prevention, mapping their needs could facilitate intervention implementation.

Abbreviations

Stress Management Intervention

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This study is part of a larger project (Stress Prevention@Work) that was funded by Dutch funding organisation ZonMw (reference number: 50–51510–98-302), received by the VU University Medical Center, Amsterdam, The Netherlands. The grant recipient was Prof. Allard J. van der Beek. ZonMw had no role in the design of the study and data collection, analysis and interpretation of the data, and in writing the manuscript.

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Havermans, B.M., Brouwers, E.P.M., Hoek, R.J.A. et al. Work stress prevention needs of employees and supervisors. BMC Public Health 18 , 642 (2018). https://doi.org/10.1186/s12889-018-5535-1

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• Published: 21 April 2024

The influence of environmental factors on the job burnout of physical education teachers in tertiary education

• KunZhan Li 1 ,
• XiaoShu Xu   ORCID: orcid.org/0000-0002-0667-4511 2 ,
• YunFeng Zhang   ORCID: orcid.org/0000-0002-9995-8432 3 &
• XinYu Xu   ORCID: orcid.org/0000-0002-2473-6157 2  

Scientific Reports volume  14 , Article number:  9126 ( 2024 ) Cite this article

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This study takes environmental factors and individual factors as variables to explore the deep internal mechanism of the impact of a comprehensive environment on higher education physical education (PE) teachers’ job burnout. Little research has been done on how environmental factors affect the internal mechanism of college and university PE teachers’ job burnout through individual factors (e.g., professional pressure and teaching efficacy). In this study, the participants were 231 PE teachers from seven comprehensive universities, and four questionnaires were administered to measure the participants’ job burnout, perceived overall environment, teaching efficacy, and occupational stress. Research has found that environmental factors have a significant negative impact on occupational stress, and occupational stress plays an important mediating role between environment and occupational burnout. Research has shown that differences in external environments lead to varying levels of personal stress among college physical education teachers, which in turn affects their level of occupational burnout. The study concludes that a good social, working, and living environment helps to reduce the work pressure on PE teachers, improves their sense of teaching efficacy, and inhibits the occurrence of teachers’ job burnout.

Introduction

Job burnout refers to the physical pressure and mental effort of employees to adapt to a demanding working environment 1 . Teachers’ job burnout has been described by Kyriacou as a syndrome caused by long-term teacher stress 2 , which is characterized by emotional, physical, and attitudinal fatigue. Poor occupational structure, low salary, and poor working conditions have been reported as the main factors leading to teachers’ dissatisfaction with their jobs and their willingness to leave 3 . The level of self-efficacy, social support, and job demand have significant effects on teachers’ job burnout 4 . First of all, self-efficacy and burnout have a positive direct impact: the higher the teacher’s self-efficacy, the higher the sense of burnout 5 . Because high self-efficacy can enable teachers to master multiple aspects of work at the same time, they feel tired. Secondly, teachers’ job burnout is positively related to job demand: the higher the job demand, the higher the burnout; and the lower the job demand, the lower the degree of job burnout 6 . Third, higher social support can lead to a higher sense of burnout. This is because while friends, peers, colleagues, leaders, and family are there to encourage or strongly support them 7 , the fact that these other people hope or expect teachers to complete their work on time and according to expectations and support goals will make them feel overwhelmed when performing and completing tasks.

Job burnout will not only affect the development of individual teachers but will also have a negative impact on higher institutions, students, and society. In addition to individual factors, environmental factors also have a significant impact on teachers’ job burnout 8 . For teachers, the professional environment mainly includes higher institutions’ environment, social environment, and family environment. Support from higher institutions and society can effectively alleviate teachers’ job burnout 9 . Previous research on the relationship between teachers’ professional environment and job burnout focuses mainly on the school environment 10 , however, school management, teacher-student relationships and other factors are closely related to teachers’ job burnout. For example, college teachers who have good interpersonal relationships have comparatively lower job burnout. Meanwhile, when teachers face pressure from numerous aspects, such as workload, examination pressure, and student management, it is likely to result in a sense of powerlessness and even frustration due to the limited resources. Previous studies have indicated that there are positive relationships between the occupational stress and teacher burnout. Previous studies have also indicated that there are positive relationships between the occupational stress and teacher burnout 11 Other environmental factors such as lack of social support and poor interpersonal relationships can also be sources of teachers’ stress 12 , and the greater the pressure, the more serious the job burnout of college teachers. The school environment, social environment, and the support of family and friends have a certain positive predictive effect on the teaching efficacy of college PE teachers, while self-efficacy is significantly negatively correlated with job burnout 10 . Job stress not only directly leads to job burnout, but also indirectly affects job burnout through teaching efficacy; that is, teaching efficacy plays an intermediary role between job stress and job burnout 13 .

Occupational stress refers to the unpleasant negative emotional experience experienced by teachers, which may lead to excessive physical and mental fatigue, nervousness, depression, or pain due to factors such as long working hours, heavy workload, and serious inappropriate student behavior 14 . Research shows that teaching is one of the most stressful professions. With the reform of education and the passage of time, the sources of work pressure for primary and secondary school teachers are also changing 15 . Firstly, teachers need to change their previous teaching content and work methods in accordance with national policy requirements, which undoubtedly increases their workload. Secondly, teachers face pressure from schools to evaluate their teaching quality and performance. On the other hand, burnout is conceptualized as “a state of physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding work environments”. It has been unanimously proven that chronic stress is implicit in the development of fatigue. Stress itself is believed to develop from the interaction between environmental and personal factors 16 .

Although there have been many studies on job satisfaction over the past few decades, there is little research on the job burnout of physical education teachers and how environmental factors affect it. There is a wealth of research on the influencing factors of teacher burnout. In addition to individual factors, environmental factors also have an important impact on teacher burnout. The professional environment of teachers mainly includes school environment, social environment, and family environment. School and social support can effectively alleviate the professional burnout of teachers. Most research on the relationship between teacher professional environment and occupational burnout focuses on the school environment, and factors such as school management and teacher-student relationships are closely related to teacher occupational burnout 17 . When exploring the relationship between environmental factors and job burnout, there is also little research on mediating influencing factors. It has been reported that the factors most consistently associated with teacher burnout in our study were teachers’ perceptions of the school’s safety and support and student attitudes to learning 18 . In terms of sociodemographic variables, gender and rural/urban teaching environment did not have significant impact on teacher burnout profiles, but professional experience did 19 . A recent reported has indicated that PE teachers have different levels of burnout, and their physical, organizational, and socio-cultural resources are closely related to their level of burnout. The needs that cause fatigue and stress have been identified as paperwork and bureaucracy, student related factors, and experiences related to the pandemic 20 . Therefore, this study aims to start from environmental factors, using individual factors as indirect influencing variables, and explore the deep-seated internal mechanism of the impact of comprehensive environment on the occupational burnout of college physical education teachers. More specifically, the first attempt is to explore the indirect effects of occupational stress and teaching efficacy in environmental factors on the occupational burnout of university physical education teachers. On this basis, the comprehensive effects of occupational stress and teaching effectiveness on the occupational burnout of college physical education teachers were further explored. Finally, strategies were proposed to reduce or avoid occupational burnout among physical education teachers. Three hypotheses are put forward as follows:

Occupational stress plays an intermediary role in the influence of environmental factors on the job burnout of college PE teachers.

Teaching efficacy plays a mediating role in the influence of environmental factors on college PE teachers’ job burnout.

Occupational stress and teaching efficacy play a chain intermediary role in the influence of environmental factors on college PE teachers’ job burnout.

Participants

The research design used a cross-sectional survey. In this study, a stratified sampling design was used to collect data from participants. Stratified sampling is considered the best method for collecting data because of its simple concept. Sampling is based on the assumption that each item in a group has an equal chance of being selected in the sample. Layered sampling is considered a reasonable method for collecting data in this study, as it ensures the accuracy of parameter estimation and the representativeness of each sample. Therefore, based on the 2020 China University Soft Science Ranking (Shanghai Ranking), we uniformly divide universities in Henan Province into five levels, which use hundreds of indicator variables (including research output and reputation factors) to comprehensively evaluate Chinese universities. The participating colleges and universities are randomly selected from each class. The guidelines for randomly selecting schools from each class are: (a) all classes are clearly distinguished from other classes, (b) all data for each class is consistent, which means that the samples selected from each class will represent the schools of that class. In order to evaluate the representativeness of the sample in demographic data, the overall demographic data (2019) was obtained from the Ministry of Education of China. Snowball sampling and criterion sampling methods were employed in the study.

The first author of this study received ethics approval from the Ethics Committee for Human Research, Zhengzhou Technology and Business University, and all methods were carried out in accordance with relevant guidelines and regulations. The participants in this study were informed of the research objectives two weeks before the interview. They were invited to provide data through an online questionnaire. Informed consent was obtained through the web-based survey software “Manjushin” provided by sojump.com. All survey responses were anonymous and all participation in the study was entirely voluntary. Participants were informed that completion of the survey would not have a direct impact on them, either in terms of gain or loss, as all data collected would be aggregated and disclosed in aggregate form only. When participants clicked on a survey, they were prompted to a page containing brief information about the survey and their rights to privacy and anonymity. They then just needed to click “Agree to Continue” to indicate their consent. The link shared with participants includes a questionnaire and instructions for filling it out. It also includes guidelines that inform teachers that their participation will be voluntary, anonymous, and confidential. Participants can fill out questionnaires on the online platform as needed. The inclusion criteria for participants were as follows: (1) currently working full-time at the selected institutions; and (2) have participated in PE teaching within the previous year. The criteria for elimination include: (a) regular reaction patterns; (b) Missing data; (c) Contradictory reactions to related projects (such as inconsistent reactions to homogeneous projects or consistent reactions to opposing projects). Benter and Chou indicated that the sample size should be 10 times the number of variables in the analysis 21 . Thus, the minimum sample size in our study was 200 which was considered sufficient to provide good statistical power.

Altogether, 240 college PE teachers from seven colleges and universities in Henan Province, China, took part in this study through the “Wenjuan Xing” platform on March 10–May 10, 2023. Among the 240 returned questionnaires, 231 were valid and 9 questionnaires were rejected. Among the valid responses, male teachers accounted for 64% and female teachers 36%; 77% of teachers were equipped with a graduate degree or above, and 23% an undergraduate degree; 39% of the participants had ten years’ working experience, 30% had worked for three to ten years, 22% had more than 21 years’ working experience, and the remaining 9% had less than two years’ working experience; and in terms of teachers’ professional position, professors accounted for 4%, associate professors for 19%, lecturers for 67%, and teaching assistants for 10%.

To have a comprehensive understanding of the current situation of teachers’ job burnout, and to explore the causes and influencing mechanism of teachers’ job burnout from environmental factors and individual factors, this study used four questionnaires to measure the degree of job burnout, the perceived overall environment, the level of teaching efficacy and the degree of professional pressure on college PE teachers. All questionnaires, originally in English, were translated into Chinese by a bilingual translation expert. They were then pilot tested for clarity and understandability with ten undergraduates, ensuring their validity and reliability.

Teachers’ job burnout adopted the Teacher Job Burnout Questionnaire (MBI-ES) compiled by Maleshi et al., which included three dimensions: emotional exhaustion (EE), depersonalization (DP), and low personal achievement (PA), with 21 questions. A 5-point scoring method was adopted, including: very non-conforming (1 point), relatively non-conforming (2 points), generally conforming (3 points), relatively conforming (4 points), and very conforming (5 points). The higher the score, the higher the degree of burnout. The questionnaire is considered to have good reliability, validity, and cross-cultural consistency. The internal consistency reliability is 0.83.

The environmental factors adopted the questionnaire compiled by previous study, which included the support of school, society, family, and friends. The school environment was composed of the following five dimensions: the influence of the principal, the development conditions provided by work, the school atmosphere, interpersonal relationships, and the material environment. There were 18 questions in total, with a 5-point scoring method, including: completely unqualified (1 point), unqualified (2 points), basically qualified (3 points), relatively qualified (4 points), and very qualified (5 points). The higher the score, the better the school environment. The questionnaire is widely used and is considered to have good reliability and validity. The internal consistency reliability of this study is 0.80.

Teachers’ teaching efficacy adopted the scale (TES) prepared by Yu et al., which included two dimensions: personal teaching efficacy (17 questions) and general education efficacy (10 questions). There were 21 questions, with a 4-point scoring method, including: completely correct (1 point), mostly correct (2 points), somewhat incorrect (3 points), and completely incorrect (4 points). The higher the score, the higher the teacher’s teaching efficacy. The internal consistency coefficient of the total table is 0.77, and the internal consistency coefficient of this study is 0.72.

College teachers’ occupational stress adopted the scale prepared by Li. The questionnaire included five dimensions: job security, teaching security, interpersonal relationship, workload, and work fun, with a total of 24 questions. It adopted a 4-point scoring method, including no pressure (1 point), mild pressure (2 points), moderate pressure (3 points), and severe pressure (4 points). The higher the score, the greater the pressure. The questionnaire is considered to have good reliability, and the internal consistency reliability of this study is 0.87.

Chain intermediary model was employed for this study. The collected data were processed in Zhengzhou, Henan Province, China. SPSS 22.0 software was used for descriptive statistical analysis, regression analysis and chain-mediated effect analysis. Normality of collected data was tested using the Kolmogorov–Smirnov test. Firstly, descriptive statistics and correlation analysis were conducted in SPSS 21.0 to explore the correlation between key variables. Secondly, the assumed model was tested using structural equation modeling (SEM) in Mplus 8.0. The data analysis for this study was divided into four steps: first, the common method deviation of the data was tested; second, the job burnout and the environment of college PE teachers were described and counted; third, regression analysis was used to explore the predictive relationship between environmental factors, occupational stress, teaching efficacy and job burnout; and fourth, the chain intermediary model between occupational stress and teaching efficacy was tested in the relationship between environmental factors and teachers’ job burnout. Chain mediation refers to how multiple intermediary variables show sequential characteristics, and the predictive variables have indirect effects on the outcome variables through the intermediary chain. Chain mediation can better reveal the complex internal mechanism of the relationship between variables. In the chain model below, X represents the predictive variable (environmental factors), M1 represents the intermediary variable 1 (occupational stress), M2 represents the intermediary variable 2 (teaching efficacy), and Y represents the dependent variable (job burnout). Based on the results of the national education survey, a confirmatory factor analysis (CFA) with maximum likelihood estimation was conducted to examine potential factor structures 22 . CFA utilized the Satora Bentler (SB) robust scaling method. The model fitting used the following four different methods: (1) SB scale chi square (χ 2 SB); (2) Standardized root mean square residuals; (3) The approximate root mean square error (RMSEA) of the SB scale; comparison fit index (CFISSB) with (4) SB Scale. These indices are used to determine whether the exported model conforms to the data. The following criteria are used to evaluate model fit: SRMR ≤ 0.08, RMSEA ≤ 0.08, CFI ≥ 0.90. After CFA, evaluate these factors to ensure they account for sufficient variance in the response. The reliability of the initial queues for EFA and CFA was evaluated using Cronbach α. The reliability of inventory generated by CFA is calculated as a coefficient ω.CFA was conducted in R version 4.1.1 using lavaan latent variable analysis package version 0.6.8 23 . The model includes three mediation paths: (1) β1β6, (2) β5β3, and (3) β1β2 β3 (Fig.  1 ).

Chain mediation model.

This study used self-report to collect data, which may have common methodological bias. Harman single factor test method was used to test the common method deviation of all variables. The results showed that the characteristic root of 22 factors was greater than 1, the first factor could only explain the critical standard of 20.79%, and less than 40% and the common method deviation was not significant.

From the average value of each variable, the average value of the three dimensions of job burnout was between 1.88 and 2.66; the average value was less than 3 points, indicating that the degree of job burnout was low. From the mean value of the three dimensions, the score of emotional exhaustion was the highest and the score of de-personalization was the lowest, indicating that college PE teachers had a certain degree of emotional exhaustion and lack of personal achievement. This result reflected the excessive emotional effort of college PE teachers and showed a lack of self-identity. Among the environmental factors, the family environment had the highest score, followed by the social environment, and the school environment had the lowest score. The score for the principal’s influence in the school environment was the lowest, which indicates that college leaders did not care enough about the work of PE teachers, resulting in the emergence of a low sense of personal achievement. The scores of each dimension of occupational stress were between 2.01 and 2.5, indicating that the overall level of occupational stress of PE teachers was not too serious. Among all dimensions, the score of the workload dimension was the largest and the score of the interpersonal relationship dimension was the lowest, indicating that the workload of college PE teachers was the main source of stress. The average value of PE teachers’ personal teaching efficacy was 4.35, and the average value of general education efficacy was 3.82, indicating that the overall level of PE teachers’ personal teaching efficacy was good. From the correlation between variables, job burnout had a significant negative correlation with environmental factors and teaching efficacy, and a significant positive correlation with occupational stress. This showed that environmental factors, occupational stress and teaching efficacy had an significant impact on teachers’ job burnout (Table 1 ).

Regression analysis of variables

The correlation between the variables was significant, indicating that the correlation was meaningful. Regression analysis can be used to further explore the relationship between variables; this study took job burnout as the dependent variable and environmental factors, occupational stress, and teaching efficacy as the independent variables for regression analysis. Relationship between Occupational Stress and Environmental Factor was caculated as the following: Occupational Stress = β 1  * Environmental Factor + ε, where β 1  = − 0.31 (Standard Error = 0.05, t = − 6.63, p  < 0.001). Relationship between teaching Effectiveness and both Environmental Factor and Occupational Stress was caculated as the following: Teaching Effectiveness = β 2  * Environmental Factor + β 3  * Occupational Stress + ε, where β 2  = 0.08 (Standard Error = 0.03, t = 2.72, p  < 0.01) β 3  = − 0.09 (Standard Error = 0.04, t = − 2.51, p  < 0.005). Relationship between Job Burnout and Environmental Factor, Occupational Stress, and Teaching Effectiveness was caculated as the following: Job Burnout = β 4  * Environmental Factor + β 5  * Occupational Stress + β 6  * Teaching Effectiveness + ε, where β 4  = − 0.02 (Standard Error = 0.02, t = − 0.67, p  > 0.05) β 5  = 0.22 (Standard Error = 0.03, t = 7.28, p  < 0.001) β 6  = − 0.45 (Standard Error = 0.06, t = − 7.97, p  < 0.001). The analysis found that the direct predictive effect of environment on job burnout was not significant (β = − 0.02, p  > 0.05), but it could negatively predict occupational stress (β = − 0.31, p  < 0.001), and it could positively predict the sense of teaching efficacy (β = 0.08, p  < 0.001). In addition, occupational stress could positively predict job burnout (β = 0.22, p  < 0.001), and negatively predict teaching efficacy (β = − 0.09, p  < 0.001). Teaching efficacy negatively predicted job burnout (β = − 0.45, p  < 0.001) (Table 2 ).

The relationship between environmental factors and job burnout

In order to further investigate the relationship between environmental factors and job burnout of college PE teachers, this study used SPSS macro compiled by Hayes to analyze the intermediary role of occupational stress and teaching efficacy in the impact of environmental factors on job burnout (Fig.  2 ).

The chain mediating effect of occupational stress and teaching efficacy.

Occupational stress and teaching efficacy played an intermediary role between environment and job burnout. The mediating effect was composed of three indirect effects: indirect effect 1 (− 0.070) through environment → occupational stress → job burnout; indirect effect 2 (− 0.034) by way of environment → teaching efficacy → job burnout; indirect effect 3 (− 0.013) produced by way of environment → occupational stress → teaching efficacy → job burnout. The three indirect effects accounted for 52.58%, 25.77%, and 10.04% of the total effects, respectively. The bootstrap 95% confidence interval of the three paths did not contain 0, indicating that the three indirect effects reached a significant level. The results showed that the chain mediation effect of occupational stress and teaching efficacy was significant, and the mediation effect of the three paths was different (Table 3 ).

This study aims to use quantitative methods, including four questionnaires, to investigate the impact of comprehensive environment on job burnout of college physical education teachers, in order to measure the degree of job burnout, overall environmental perception, teaching effectiveness level, and occupational stress level of college physical education teachers. Research has found that environmental factors have a significant negative impact on occupational stress, and occupational stress plays an important mediating role between environment and occupational burnout. Research has shown that differences in external environments lead to varying levels of personal stress among college physical education teachers, which in turn affects their level of occupational burnout. Environmental factors often considered as sources of teacher stress include external demands such as excessive workload, time pressure, lack of resources, paperwork, student behavior Organizational factors such as leadership support level and school atmosphere, as well as reviews around teacher efficacy 24 . Inconsistent results were reported when studying stress in the teaching population. For example, several studies have shown that early career teachers face a high risk of stress and burnout, and this risk is increasing. However, other researchers believe that the risk of burnout does not vary based on experience 25 . At various school levels, some studies have shown that primary school teachers experience greater stress and burnout than high school teachers, while OECD research shows that the trend is opposite across countries, indicating no significant overall difference in education levels 26 . Rajendran et al. found that there was no difference in the levels of emotional exhaustion and burnout between primary and secondary school teachers 27 , while De Nobile and McCormick did not distinguish between primary and secondary school teachers, but found that classroom teachers had greater stress than any other type of educator. Finally, some preliminary evidence suggests that teachers in urban areas report greater stress compared to rural teachers, but there is no difference in the level of burnout among these groups 28 . These evidences indicate that the environmental factors that affect the teaching pressure of college physical education teachers are the changes in their social environment and actual social status in terms of income and life, economic income status, family harmony, as well as the changes in the material and cultural environment of the school environment. However, when the pressure brought by the environment exceeds the capacity of teachers, if not effectively eliminated in a timely manner, it can lead to work fatigue. Therefore, this study indicates that a good social, school, and family environment is conducive to college physical education teachers actively facing work and life problems, thereby alleviating occupational stress and reducing the possibility of occupational burnout.

Teaching efficacy has a negative predictive effect on job burnout, and also plays a mediating role between environmental factors and job burnout. Previous studies have shown that the lower the sense of teaching effectiveness, the more severe the degree of job burnout 28 . A study targeting high school teachers found that one-third of them experience a high level of fatigue. The study also found evidence that an increase in fatigue is associated with low perceived efficacy (individual and collective) scores, low job satisfaction, and low career commitment. Furthermore, when teachers experience high levels of fatigue, their perception of the educational environment becomes less positive. Finally, the research findings indicate that perceived personal efficacy mediates the relationship between burnout and job satisfaction 29 . The results of this study further indicate that the environment can lead to an improvement or decrease in teaching effectiveness, and the improvement of teaching effectiveness has a positive impact on alleviating work fatigue. Therefore, when college physical education teachers feel that society and schools value sports and respect their profession, these teachers can recognize the importance of their profession, which will enhance their confidence and enable them to actively and effectively solve teaching problems, thereby reducing work fatigue. On the contrary, university physical education teachers who believe that physical education courses are marginalized by society and schools will have lower confidence. College physical education teachers with low self-efficacy may have unrealistic understanding of their subjective judgment of abilities and may doubt whether they can teach students well or handle relationships with them well. As a result, they were unable to complete their satisfactory work, leading to low mood Occupational stress and teaching effectiveness play a series of multiple mediating roles in the relationship between environmental factors and occupational burnout; Environmental factors affect the occupational burnout of college physical education teachers through the combined effect of occupational stress and teaching effectiveness. This discovery effectively validates the stress cognitive interaction theory, which emphasizes that work stress is an interactive process between individuals and the environment. Through personal cognitive assessment, potential stressors can become actual stressors, mainly influenced by self-efficacy. This means that individuals with low self-efficacy will convert potential sources of stress into actual stress. Based on the theory of stress cognitive interaction, the results of this study indicate that positive environmental factors can alleviate teachers’ occupational stress, enhance their problem-solving ability, improve their self-efficacy, and thus avoid professional burnout.

The survey results indicate a significant correlation between environmental factors, occupational stress, teaching effectiveness, and job burnout. The regression analysis results of this study further indicate that environmental factors do not have a significant direct predictive effect on job burnout, but have a significant predictive effect on occupational stress and teaching effectiveness. Both occupational stress and educational effectiveness can affect job burnout, further indicating a close relationship between variables. It has been found that teachers’ physical, organizational, and socio-cultural resources are closely related to their level of burnout. The needs that cause fatigue and stress have been identified as paperwork and bureaucracy, student related factors, and experiences related to the pandemic 30 . These findings indicated the complexity of involved factors contributing to burnout. Therefore, the intermediary effect analysis was used to further explore the relationship between variables, and it is found that the intermediary effect is produced through three indirect ways: through the independent effect of occupational stress; through the independent role of teaching efficacy; and through the joint effect of professional pressure and teaching efficacy.

Summary of main findings

This research delves into the profound psychological condition of burnout, a phenomenon with far-reaching implications for individuals and institutions, particularly within educational contexts such as schools. Drawing upon the framework of event system theory, this study thoroughly investigates the profound influence of environmental factors on job burnout among physical education (PE) teachers in colleges and universities. Additionally, it delves into the intricate psychological mechanisms that underpin this relationship.

To answer the research question “How do environmental factors, occupational stress, and teaching effectiveness interact to shape job burnout among physical education (PE) teachers in higher education?” the study enlisted 231 PE teachers from seven comprehensive universities as participants. They provided valuable insights through the completion of four questionnaires measuring job burnout, perceived overall environment, teaching efficacy, and occupational stress.

The survey outcomes unveiled compelling evidence of a substantial correlation among environmental factors, occupational stress, teaching effectiveness, and job burnout among PE teachers in higher education. These findings emphasize the multifaceted dynamics inherent in the academic environment.

Significantly, the regression analysis illuminated these relationships further. Particularly noteworthy is the significant influence of environmental factors on both occupational stress and teaching effectiveness. While environmental factors themselves may not directly foretell job burnout, their role in shaping the experiences of PE teachers within college and university settings is pivotal.

Furthermore, the study identified occupational stress and teaching effectiveness as critical determinants of job burnout, highlighting the intricate interdependence among these variables. This underscores the significance of environmental factors as indirect contributors to the multifaceted phenomenon of job burnout.

Implications

The findings of this study have profound industrial implications, particularly in highlighting the intricate link between psychological distress and physical health outcomes. The established connection between chronic psychological stress and physiological conditions such as hypertension, obesity, and other negative health behaviors underlines the urgent need for workplace interventions. These conditions contribute significantly to the global burden of cardiovascular diseases and overall mortality rates. Specifically, the research draws attention to the dire consequences of burnout as evidenced by the Maslach Burnout Scale, where high levels of burnout and emotional exhaustion are shown to markedly increase the risk of mortality.

The implications extend beyond educational settings, touching on various sectors where occupational stress is prevalent, notably in healthcare. The necessity for additional research into stress management techniques, such as Transcendental Meditation (TM), is underscored for environments where stress is an inherent part of the job. This not only highlights the need for sector-wide changes but also calls for a reassessment of organizational health policies to encompass mental well-being strategies.

Moreover, the study reveals that the perception of work stressors significantly influences health outcomes. This brings to light the importance of psychological resilience and perception management in mitigating occupational stress. Consequently, there is a compelling case for industries to invest in developing interventions that enhance career engagement and reduce perceived threats from the work environment. Such interventions should not only aim to modify environmental stressors but also bolster individual coping mechanisms, thereby improving overall job satisfaction and mental health.

Therefore, it is imperative for organizations, especially those in high-stress industries, to adopt a holistic approach to employee well-being. This involves creating supportive environments that reduce occupational stress and promote teaching effectiveness, thereby fostering better mental and physical health among employees. In particular, for Physical Education teachers, developing targeted interventions to enhance their sense of vocational calling and to manage stress could significantly alleviate job burnout, leading to improved educational outcomes and healthier work-life balances. The broader industrial implication is clear: a healthier workforce leads to a more productive and sustainable organizational environment.

Recommendations

To effectively mitigate educator burnout, it is imperative that organizations prioritize the enhancement of both the ecological and organizational environments within educational settings. This encompasses a concerted effort from both governmental bodies and educational institutions to integrate the experiences and insights of educators into the formulation of health and well-being policies. Emphasizing a bottom-up approach, where policies are informed by the firsthand experiences of those within the educational sector, could prove more efficacious than traditional top-down mandates. This approach should be complemented by capitalizing on the unique benefits and characteristics inherent to the sports discipline, encouraging peer exchanges, and fostering innovation and pedagogical reform across comparable institutions.

In addressing the issue of excessive educator workloads, a significant increase in the recruitment of qualified and experienced physical education teachers is essential. This strategy aims to distribute workloads more evenly, thereby preventing burnout resulting from overwork. Additionally, there is a critical need for the restructuring of evaluation and rewards systems within universities to better reflect the unique challenges faced by physical education teachers. Tailoring these systems to acknowledge the distinct nature of physical education will alleviate stress and contribute to a more rewarding career path.

Further, educational institutions must reconsider their criteria for professional advancement, especially under the unique demands of physical education. Ensuring adequate opportunities for career development can significantly reduce the anxiety associated with professional growth and job security. This should be coupled with proactive measures to manage and reduce work-induced stress, including the development of comprehensive strategies to identify and counteract the early signs of resource depletion and burnout among educators.

Finally, it is crucial to establish well-being and rehabilitation programs aimed at fostering psychological recovery and reducing teacher fatigue. Such initiatives should focus on enabling psychological detachment, promoting relaxation, and providing control mechanisms to manage work-related stress effectively. Supporting these programs with flexible work arrangements can offer educators the necessary space to recover from the demands of their profession, thereby enhancing overall job satisfaction and effectiveness.

By implementing these multi-faceted recommendations, educational institutions and policymakers can create a more supportive environment that not only improves the well-being and efficacy of physical education teachers but also positively impacts the educational experience for students.

Limitations

This study, while offering positive insights and contributions to theory and practice, faces several limitations. Firstly, the COVID-19 pandemic restricted interaction with participants, leading to a small sample size that may not fully represent the broader population. Despite using stratified sampling based on university rankings, the sample size’s limitations suggest the need for future studies to collect more data or employ different sampling methods, like simple random sampling. Secondly, the sample exclusively comprising Chinese higher education lecturers limits the generalizability of findings to other groups with distinct organizational cultures and expectations, such as those in the global higher education sector. This highlights the potential impact of cultural differences on factors like burnout or turnover intention, suggesting future research should explore the role of cultural background in job satisfaction and proactive personality regulation. Additionally, the study’s cross-sectional design hinders causal inferences about the relationship between work stress and burnout, indicating a need for longitudinal studies to establish stronger causal evidence. Another limitation is the lack of differentiation in individual factors like gender and teaching experience. Addressing this gap is crucial for understanding how resilience buffers teachers against negative work-related issues and contributes to their sustainable professional development.

Focus of future study

Further empirical research, especially qualitative research, can be conducted through intermediary tools to gain a better understanding of the role of educational worker burnout. Further experience and educational exams are crucial in investigating the mediating role of reducing burnout among educators. Further research should be conducted on the impact of career development and related educational factors to clarify their long-term impact on education.It is recommended that university leaders pay more attention to the important role of sports in the development of universities, take practical and feasible measures, and avoid the marginalization of sports in disciplinary construction, evaluation of key talents, and scientific research rewards.

Data availability

The data that support the findings of this study are available from the authors; however, restrictions apply to the availability of these data, so they are not publicly available. Interested researchers (who meet the criteria for access to confidential data) may contact the corresponding author of this paper for access to the datasets generated or analyzed during the current study.

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Acknowledgements

This research was jointly undertaken by Stamford International University in Thailand, Zhengzhou University of Business and Economics, and Wenzhou University. The authors thank all research participants and researchers involved in this study.

The corresponding author received the National Social Science Foundation of China for Education General Program (BGA210054) for this work.

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Conception and design of the study: K.L., X.X., Y.Z.; acquisition of data: K.L., X.X., Zhang; analysis of data: K.L.; interpretation of data: X.X., Y.Z.; work drafted by: K.L., X.X.; substantial revisions to the work: X.X., Y.Z. All contributing authors agree to be personally accountable for each author’s own contributions and for questions related to the accuracy or integrity of any part of the work.

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Li, K., Xu, X., Zhang, Y. et al. The influence of environmental factors on the job burnout of physical education teachers in tertiary education. Sci Rep 14 , 9126 (2024). https://doi.org/10.1038/s41598-024-59748-3

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Psychological Resources and Strategies to Cope with Stress at Work

Recursos psicológicos y estrategias de afrontamiento con estrés en el trabajo, edna rabenu.

1 School of Behavioral Sciences, Netanya Academic College, Netanya, Israel., School of Behavioral Sciences, Netanya Academic College, Netanya , Israel

2 School of Business administration, Bar-Ilan University, Ramat-Gan, Israel. , School of Business administration, Bar-Ilan University, Ramat-Gan , Israel

Introduction:

the choice of strategies to cope with stress has differential effects on individual and organizational outcomes (e.g. well-being and performance at work). This study examined to what extent individuals differing in their positive psychological resources (optimism, hope, self-efficacy and resilience) implement different strategies to cope with stress in terms of change, acceptance, or withdrawal from a source of stress in an organizational setting.

A questionnaire was filled out by 554 employees from different organizations representing a wide range of jobs and positions.

Structural Equation Modeling (SEM; χ 2 (7) = 27.64, ρ < .01, GFI = .99, NFI = .91, CFI = .93, RMSEA = .07)

Conclusion:

the results indicated that psychological resources (optimism, hope, self-efficacy and resilience) were positively related to coping by change and by acceptance and negatively related to withdrawal. The theoretical implications are discussed.

Introducción:

la elección de estrategias de afrontamiento al estrés, tiene efectos diferenciales en los resultados individuales y organizacionales (por ejemplo, el bienestar y el rendimiento en el trabajo). En este estudio se examinó hasta qué punto las personas que difieren en sus recursos psicológicos positivos (optimismo, esperanza, autoeficacia y resiliencia) implementan diferentes estrategias para hacer frente al estrés en términos de cambio, aceptación o retirada de una fuente de estrés en un entorno organizacional Método: 554 empleados de diferentes organizaciones que representan una amplia gama de puestos de trabajo y puestos respondieron un cuestionario.

Resultados:

modelado de ecuaciones estructurales (SEM; χ 2 (7) = 27.64, ρ < .01, GFI = .99, NFI = .91, CFI = .93, RMSEA = .07)

Conclusión:

Los resultados indicaron que los recursos psicológicos (optimismo, esperanza, autoeficacia y resiliencia) estaban relacionados positivamente con el afrontamiento por el cambio y por la aceptación, y negativamente relacionados con la retirada. Las implicaciones teóricas son discutidas.

1. Introduction

The perception of stress and the ability to cope with it are very much determined by an individual's personal characteristics (e.g. Pal & Bhardwaj, 2016 ). However, what differentiates people in the ways they cope with stress remains unclear. In the current research we hypothesize that optimism, hope, self-efficacy and resilience, psychological resources that make up positive psychological capital (PsyCap), are related to specific coping strategies. In particular, the relationship between hope and resilience with coping strategies is explored to help resolve the conceptual ambiguity between these variables and extend the limited research on these relationships in the workplace.

1.0.1 Strategies for coping with stress

Coping strategies are basic categories used to classify how people actually react to stress. The best known classification (Lazarus & Folkman, 1984 ) identified two major process-oriented functions of coping strategies: problem-focused coping and emotion-focused coping. In the former, the individual gathers information about what to do and takes steps to change the reality of the troubled person-environment relationship. The latter function is aimed at regulating the emotions associated with the stress situation. This can involve avoiding thinking about the threat or reappraising it, without changing the realities of the stressful situation ( Lazarus, 1999 ).

This classification of coping provided a broad practical framework for research and practice. Since then, many other classifications have emerged. These differ in terms of the number and range of coping categories (see Skinner, Edge, Altman, & Sherwood, 2003 ).

In this study, coping was broken down into three strategies (Clarify this reference). Change corresponds to problem-focused coping as in Lazarus and Folkman (1984) which is aimed at managing stressors. In change coping strategy, the individual actively seeks to solve the problem created by stress. Acceptance is included in emotion-focused coping ( Lazarus & Folkman, 1984 ). The individual accepts the stressor as a fact that cannot be changed and decides to adapt and adjust (his thoughts and feelings) to the stressful situation. Acceptance can also be theoretically classified as meaning-focused ( Folkman & Moskowitz, 2007 ). In this case people use their beliefs, values, and goals to find or remind themselves of the benefits of experiencing stress as a way of supporting coping. Withdrawal is also based on Lazarus and Folkman (1984) emotion-focused coping. The individual feels "trapped" in a stressful environment without being able (subjectively) to change it. Therefore, the individual withdraws physically and/or psychologically from the stressful work environment. For further explanation of the reasons for the distribution into three strategies (see Rabenu, Elizur, & Yaniv, 2015 ).

1.1 Positive psychological capital (PsyCap)

PsyCap is a multifaceted construct which includes beliefs about the self (self-efficacy) and personal resources including resilience, hope, and optimism. Specifically, PsyCap is the individual's positive psychological state characterized by having the confidence (self-efficacy) to take on challenging tasks and invest the effort needed to succeed in them. This includes, making positive attributions (optimism) about succeeding, persevering toward goals in order to succeed (hope) and persevering in the face of problems or difficulties, to transcend them (resilience) ( Luthans, Youssef-Morgan, & Avolio, 2015 ).

PsyCap is an evidence-based construct ( Luthans & Youssef-Morgan, 2017 ). In the organizational context, PsyCap has been shown to be positively related to job satisfaction, job engagement, well-being, mental health and employee performance and negatively related to stress, turnover intentions, substance abuse and counterproductive workplace behaviors ( Avey, Reichard, Luthans, & Mhatre, 2011 ; Aybas & Acar, 2017 ; Krasikova, Lester, & Harms, 2015 ; Rabenu, Yaniv, & Elizur, 2016 ). For a review, (see Newman, Ucbasaran, Zhu, & Hirst, 2014 )

1.2 Coping with Stress and psychological capital (PsyCap)

Three kinds of personal variables are especially important in shaping stress appraisals (and hence coping): goals, beliefs about the self and the world, and finally the individual's personal resources can be tapped in interactions with the environment ( Lazarus, 1999 ). Lazarus and Folkman (1984) argued that the ways people cope depend heavily on the resources available to them. The pooling of resources enables the coping process ( Westman, 2004 ).

The effort motif is central to both PsyCap ( Avey et al., 2011 ) and coping (Lazarus & Folkman, 1984 ). However, in PsyCap, which is considered a resource, effort is general and not focused on a specific situation. Conversely, in coping, effort is specific to the stressful situation. Support for this idea can be found in COR theory ( Hobfoll, 1989 ). According to this theory, even when not experiencing stress, people are motivated to obtain, retain and protect their resource reservoirs. Westman (2004) found that each coping blend is based on both acquiring new resources and preventing the loss of resources. This further supports the idea that PsyCap precedes coping because general motivation is translated into specific efforts to cope with the stress. It goes without saying that there is a feedback cycle between resources and coping. A pool of resources enables the coping process while the later affect the content and quantity of the pool of resources ( Westman, 2004 ).

1.3 Coping with stress and the psychological resources that make up positive psychological capital (PsyCap)

1.3.1 psycap self-efficacy.

PsyCap efficacy is defined as the individual's confidence in his or her abilities to summon the cognitive resources, motivation, and actions needed to succeed in a task ( Luthans et al., 2015 ). Self-efficacious people set high goals for themselves, welcome and thrive on challenges and persevere in the face of obstacles ( Luthans et al., 2015 ).

Self-efficacy has been shown in the literature to be particularly important as a coping resource ( Holahan, Moos, & Schaefer, 1996 ). A longitudinal study exploring coping strategies of workers during a merger found that self-efficacy positively predicted the use of problem-focused coping but did not predict coping by avoidance ( Amiot, Terry, Jimmieson, & Callan, 2006 ).

Accordingly, we hypothesized: H1 - Self-efficacy will be positively related to coping by changing the source of stress.

1.3.2 PsyCap optimism

Optimists attribute positive events to personal, permanent, and pervasive causes, and negative events to external, temporary, and specific factors. On the other hand, pessimists attribute positive events to external, temporary, and specific attributes and negative events to personal, permanent, and pervasive causes ( Seligman, 1998 ). Thus, optimists are positive and confident about their future even when confronted with negative events while pessimists tend to blame themselves for the negative aspects of their lives, and suppress their own growth opportunities ( Luthans et al., 2015 ).

Optimism has been shown to be an especially important resource for coping ( Holahan et al., 1996 , p.31). Optimism has been associated with greater use of problem-focused coping strategies (especially when the situation is within their control), and less use of emotion-focused strategies (e.g. Epstein-Mathias, 2003 ; Luthans et al., 2015 ). Optimists are less likely to cope by withdrawal (disengagement, avoidance, etc.; see for example Carver & Connor-Smith, 2010 ).

Optimists attribute negative events (such as chronic stress at work) to external, temporary, and specific factors ( Seligman, 1998 ) and they continue to look favorably and confidently toward the future ( Luthans et al., 2015 ). Accordingly, optimism is positively associated with vigor and dedication ( Wang, Liu, Zou, Hao, & Wu, 2017 ). In contrast, pessimists tend to more passive reactions such as denial, escape, fatalism or cognitive avoidance ( Luthans et al., 2015 ). This led to the following hypothesis:

H2 - Optimism will be negatively related to coping by withdrawal from the source of stress.

1.3.3 PsyCap hope

? defined hope as "a positive motivational state that is based on an interactively derived sense of successful (1) agency (goal-directed energy) and (2) pathways (planning to meet goals)" (p. 287). Accordingly, hope is a cognitive state in which an individual sets challenging (but realistic) goals, and then strives for them with determination and energy ( Luthans et al., 2015 ).

Hope appears in the literature as a coping strategy or as a resource for coping. Korner (1970) referred to hope as a tool for emotional coping with distress, similar to mechanisms of defense. Similary, Lazarus (1999) described hope as an aspect of emotional coping strategy, but also as a state of mind. Many see hope as a personal characteristic or resource that affects the way the individual's copes (e.g. ? ). The perception of hope as a resource has become more dominant, especially in light of the transition from a more emotion based to a more cognitively based definition. Here, hope is defined within the cognitive definition of PsyCap.

The connection between hope and stress in the workplace has received little if any attention in research, but there is compelling evidence from hope research in other contexts (e.g., clinical and sports psychology) which suggests that hope may be a positive resource in stressful situations ( Avey, Luthans, & Jensen, 2009 ). Hope may have an impact on individual coping with stress by increasing the motivation to cope with a given situation. It may also operate and through cognitive change by causing an appraisal of the situation as less threatening ( Lazarus & Cohen-Charash, 2001 ). Individuals high in hope can produce alternatives for achieving their goals when the original ways are blocked ( Snyder, Rand, & Sigmon, 2002 ). Their willpower and persistence motivate the search for new ways (Snyder, 2002). Therefore, high hope individuals in stressful situations have the ability to find alternatives for action that arouse their energy and engender a sense of control rather than helplessness. Their willpower to achieve their goals in the face of obstacles/challenges leads them to cope successfully with various difficulties including stress due to changing circumstances and/or adapting to stressful situations. Behavioral or psychological withdrawal from work is not consistent with goal achievement but rather with helplessness, which does not characterize those high on hope. We thus hypothesized that among individuals in stressful situations, being high on hope, should decrease withdrawal from the workplace.

H3 - Hope will be negatively related to coping by withdrawal from the source of stress.

1.3.4 PsyCap resilience

Resilience is a dynamic process of positive adjustment or adaptation to adversity ( Luthans, Vogelgesang, & Lester, 2006 ). Resilience also refers to the ability to return to the previous level of functioning ( Carver, 1998 ) and not just "survive" but even thrive in a changing environment, (Luthans et al., 2015). According to Hobfoll (2011) , resilience refers to people's ability to withstand the most negative consequences of stressful challenges and remain vigorous, committed and engaged in important life tasks. In other words, resilience is a resource (an ability or potential) that allows individuals to withstand or recover from major stress ( Hobfoll, 2011 ).

Although coping and resilience have been explored as separate areas, coping can be confused with resilience since there is no general agreement about the concept of resilience (e.g. Rabenu et al., 2016 ). Therefore, we would like to clarify the differences between the two concepts (coping and PsyCap Resilience) before sharing our hypotheses. First, resilience is frequently defined as obtaining good results following exposure to adversity (e.g. Carver, 1998 ). Also, researchers emphasize subsequent growth (e.g. Luthans et al., 2015 ). However, coping is defined independently of its outcomes. That is, coping refers to efforts made to manage demands, regardless of their subsequent success ( Folkman, 1984 ).

Second, according to Luthans et al. (2015) "PsyCap resilience is not just a minimal coping or neutralizing agent for difficult times" (p.155). In other words, resilience is an extensive process and not specific and short term as coping.

Luthans et al. (2015) simulated the risk to vaccination and speculated that approach-coping techniques would be more positively associated with resilience, whereas avoidance-coping techniques would be associated with a negative impact on resilience (see also Holahan et al., 1996 ).

In order to thrive, people need to cope, at least partially, with the problem itself (coping by change). High-resilience individuals experience more positive emotions and less negative ones ( Smith, Tooley, Christopher, & Kay, 2010 ), so they can effectively engage in problem-focused coping ( Folkman, 1984 ). However, it requires significant internal work to emerge reinforced from moments of crisis. It has been suggested that a great deal of coping is done through the self: accepting the source of stress and adjusting to the demands. We would like to emphasize here the definitions of resilience as positive adjustment and adaption to adversity (e.g. Luthans et al., 2006 , 2015; Masten & Wright, 2010 ). The high resilience individual's use of positive emotions as a strategy for coping with stress over time may make it automated, thus requiring minimal attention or cognitive effort, which is extremely beneficial in coping ( ? ). If so, there should be a relationship between resilience and coping through change, and an even stronger relationship between resilience and coping through acceptance. Moreover, as an individual's coping ability shows wider range and variety (that is coping repertoire- the total number of different coping strategies used by the individual) it should give the individual more protection ( Epstein-Mathias, 2003 ). Since resilience refers to the ability to recover and thrive, not just "survive", it should increase the use of both change and acceptance. Thus, we hypothesized:

H4a - Resilience will be positively related to coping by changing the source of stress.

H4b - Resilience will be positively related to coping by accepting the source of stress.

Figure 1 depicts the model and its hypotheses.

2.0.1 Sample and procedure

The sample was made up of 554 employees in organizations in Israel, representing a wide range of jobs; 51% female and 49% male. Ages ranged from 18 to 67 (M = 37.8, SD = 9.57). Duration of employment in the organization was between two weeks and 45 years (average = 8.18, SD = 8.08), and in their current job between two weeks and 35 years (M = 4.46, SD = 5.07). Of the respondents, 44% worked in the hi-tech industry, 13% in traditional industries, 31% in services, and 12% in other industries; 20% were employed in public institutions, 73% in private organizations, and 7% in other settings (NGOs, etc.). Forty-four percent held various levels of managerial positions, and 56% were not managers.

The participants were sampled in three ways: 100 hardcopy questionnaires were filled out by Business Management or Behavioral Sciences graduate students at Netanya Academic College (delivered by the researcher); 459 questionnaires were distributed by a "snowball" method convenience sample, of which 367 were filled out electronically by means of a designated online questionnaire. The remaining 92 questionnaires were distributed by hardcopy. Five questionnaires were not fully completed, and were excluded from the sample.

2.0.2 Measures

2.0.3 coping questionnaire - special methodology.

Rabenu et al. (2015) pointed to the need to create a new coping questionnaire in response to criticism of the ways in which coping items in validated questionnaires were derived (from theory or somewhat arbitrarily) and worded ( Dewe, O'Driscoll, & Cooper, 2010 ). In addition, statistical analyses of coping strategies can be improper. For most researchers, factor analysis is the preferred tool to create coping components. Nevertheless, researchers over the years have raised a number of concerns about the data-reduction features of this technique, especially whether using factor loadings as a method for including or excluding coping items reduces the comprehensiveness of the measures (see Dewe et al., 2010 ). Therefore, we wrote a structured self-report questionnaire to assess ways of coping with stress. The questionnaire was constructed based on Facet Theory ( Elizur, 1984 ). A facet is "a classification of item domains of a given content universe according to some rule" (p.380).

Based on the literature, we differentiated two basic independent facets to define the coping with stress domain: A -modalities of coping (including the cognitive, emotional and instrumental coping elements), and B - direction of coping (including the change, acceptance and withdrawal elements). Sample items are: During stressful situations at work I: "Re-evaluate the situation as positive", and I: "Look for another job". Items were answered on a 6 point Likert-type scale (1 = Very infrequently; 6 = Very frequently).

The empirical results from a Similarity Structure Analysis (SSA) ( Elizur, 1984 ) supported the construct as highly valid ( Rabenu et al., 2015 ). An exploratory Factor Analysis yielded three factors (eigenvalue > 1) that explained 57.82% of the variance, and represented the elements "withdrawal", "change", and "accept" the source of stress. The Cronbach's alpha was .65 (10 items). The Cronbach's alphas for the elements were: change (3 items) α = .71, accept (3 items) α = .53 and withdrawal (4 items) α = .76.

It is difficult to achieve high item reliability because the items express various modalities (Facet A) and partially contradictory coping directions (Facet B), although all of them examine coping as a whole. Guttman (1946) showed that low reliability is to be expected under certain conditions, for instance as a function of the type of data.

2.0.4 Psychological Capital (PsyCap) Questionnaire (PCQ)

PsyCap was measured with twenty-four items ( Luthans et al., 2015 ) to test self-efficacy, optimism, hope, and resilience. Each of the four components of PsyCap was measured by 6 items. The resulting score represents an individual's level of positive PsyCap. We translated the PCQ and had it back translated into English by an independent specialist. The back translation was reviewed by Prof. Luthans to assure that the PCQ items were translated properly. Sample items are: "I feel confident presenting information to a group of colleagues" (efficacy), "I feel there are lots of ways around any problem" (hope), "I usually manage difficulties one way or another at work" (resilience), "I always look on the bright side of things regarding my job" (optimism). Items were answered on a 6-point Likert-type scale (1 = Strongly Disagree; 6 = Strongly Agree).

The reliability of the original PCQ questionnaire was α = 0.90. However, the results for optimism (α = .59) and resilience (α = .74) were lower than the ones reported by the developers of the questionnaire. Further examination found that one question reduced the reliability of the resilience variable, and three questions reduced the reliability of optimism. All were subsequently removed. The Cronbach's alpha then became .92.

2.0.5 Background Questionnaire

Demographic variables (age, gender, family status, number of children, and level of education) as well as organizational variables (seniority in the organization, seniority in the current job, employment setting, industry, management, and team work) were examined.

Table 1 presents the mean scores, standard deviations, and inter-correlations of the study variables as well their reliabilities.

Notes: n = 554. * ρ < .05, ** ρ < .01.

Coping by change showed a correlation with coping by acceptance. In other words, change and acceptance tended to be aligned, and the higher the coping by change, the higher the coping by acceptance. On the other hand, there was no significant correlation between coping by withdrawal and the other modes of coping.

PsyCap capacities were correlated weakly with coping by change, more strongly with coping by acceptance, and negatively with coping by withdrawal

3.0.1 Structural Equation Modeling

We performed Structural Equation Modeling (SEM) with AMOS version 7 to examine the hypotheses. SEM analysis examines the degree to which the proposed model fits the research data, and examines the model as a whole. The results are presented according to McDonald and Ho (2002) .

Figure 2 depicts the model as a whole. Several measures of approximation were employed. In the Normed Fit Index (NFI), the Goodness-of-Fit Index (GFI), and the Comparative Fit Index (CFI) a degree of fit above 0.90 is considered sufficient ( McDonald & Ho, 2002 ). The approximation measures found here were above 0.90, and therefore met the approximation criteria (GFI = .99, NFI = .91, CFI = .93). In addition, lack-of-fit was measured by the RMSEA (root mean square error of approximation), where the value of a suitable fit should be lower than 0.1 ( Jöreskog & Sörbom, 1989 ). In the current study, the results for lack-of-fit were sufficient (RMSEA = .07). It is recommended that χ 2 /df be less than 2; this was not the case in this study A χ 2 test to examine the difference between the model and the data found the X 2 to be significant; i. e., a statistical difference between the proposed model (SEM) and the resulting data of: X 2 (7) = 27.64, p < .01 ( McDonald & Ho, 2002 ). The percentage of variance of the endogenous variables explained by the model was reasonable, between 2. 4% and 16. 1% for the coping variables.

As shown in Figure 2 , Structural Equation Modeling (SEM) generally confirmed the validaty of the research model. Self-efficacy affected coping by change (hypothesis H1 confirmed); hope negatively affected coping by withdrawal (hypothesis H3 confirmed); and resilience affected coping by acceptance and coping by change (hypotheses H4b, and H4a confirmed).

Contrary to expectations, optimism did not have an effect on withdrawal (refuting hypothesis H2). The relationships between self-efficacy, hope, optimism, and resilience were expected in light of their relationship as multiple components of one structure, namely PsyCap. Moreover, there was a significant association between coping by acceptance and change, and between coping by withdrawal and change. There was no association between coping by acceptance and withdrawal.

4. Discussion

The research model assumed that the psychological capital capacities of self-efficacy, optimism, hope and resilience, would serve as a personal resource for coping, since coping evolves from resources and resources precede and influence coping ( Lazarus & Folkman, 1984 ). The basic premise was that the more psychological resources the individual has, the more he or she will choose coping by change and/or acceptance rather than withdrawal. These hypotheses were confirmed.

As hypothesized, the highest correlation between psychological resources and coping by change was found for self-efficacy. Individuals high in self-efficacy were disposed to view stress as a challenge to be overcome, and tend toward action and problem-focused coping. Nevertheless, all the psychological resources related significantly to coping by change. Consequently, the locus of control (in self-efficacy, optimism, and hope), viewing stress as a challenge (in self-efficacy and hope), and a strategic-pragmatic approach (in resilience) may lead to coping by changing the stressor.

Coping by acceptance was moderately correlated with each of the psychological resources, whereas the main contributors were resilience (as hypothesized) and optimism (not hypothesized). The ability to adapt, relearn, and be flexible, (resilience), as well as the expectation that good things will happen in the workplace (optimism), may lead to coping by acceptance. The relationship of withdrawal to each of the psychological resources was very low and negative. Thus, creativity in finding new ways to cope in the workplace (hope), faith in one's ability to be successful at work (self-efficacy and hope), and perseverance (hope and resilience) may help individuals high in psychological resources avoid withdrawal.

As hypothesized, hope was negatively correlated with coping by withdrawal. Behavioral or psychological withdrawal from work is not consistent with achieving goals firmly but rather with helplessness. Optimism, contrary to the hypothesis, was found to have close to a zero correlation with withdrawal. The findings showed that optimism was mainly related to acceptance.

Although not predicted, all the psychological resources (self-efficacy, optimism, hope and resilience) correlated more strongly with coping by acceptance than with coping by change. In addition, resilience affected acceptance more than any of the resources affected coping. Consequently, psychological resources may prompt the individual to adapt to demands while framing the situation in a more positive way, rather than trying to change the stressors.

One way of accounting for these findings is to consider that the type of stress serves as a moderator of the relationship between psychological resources and coping. As suggested by (Eden 2011; quoted in Pines, 2011 ), the changeableness and continuity of stress can affect the direction of coping. In changeable situations with ongoing stress, direct-active coping is preferable, but when the stressor cannot be changed, direct-active action is not feasible. People can find temporary (by means of venting or diversion) or permanent (by means of self-change) relief, and adjust to the situation. The present study addressed chronic work stress as the object of coping. However, the interviewees may experience these stressors as fixed, such that the most efficient coping direction would be acceptance rather than change or withdrawal. If other stressors that are perceived as changeable had been examined, we might have found stronger relationship between psychological resources and change than between psychological resources and acceptance.

An alternative explanation is to consider that psychological capital, unlike human or social capital, primarily affects an individual's psychological abilities. The coping direction that requires the most personal psychological work is acceptance. Psychological capital deals with who you are now and who you will become in the future ( Luthans et al., 2015 ). Hence, psychological capital identifies a transformation from one's actual self to one's possible self. Thus, acceptance may enable greater psychological growth than change, and much more than withdrawal when coping involves finding meaning that through an examination of values and goals. It is therefore possible that the relationship of psychological capital resources with acceptance is more powerful its relationship with other coping directions for various types of stress. This should be examined in future research.

4.0.1 Limitations and suggestions for future research

The present study has a number of limitations. The first is a methodological limitation: the data were gathered by means of self-report questionnaires; therefore, a report bias is possible. "Hard" measures of coping could improve the research (for example, examining avoidance coping by counting absences, etc.). Another problem concerns the correlations between the research variables, which were filled out by the same subjects.

The second limitation is that the coping questionnaire contained few items, which could compromise its reliability. In addition, it was developed by the researchers, and the tool should be tested and validated in other studies.

The third limitation is that all the research variables were examined simultaneously. Information about changes to the variables over time (longitudinal research) was not collected. This information is important when addressing dynamic variables.

Psychological capital resources significantly affected the coping directions studied here. Future work should investigate how it affects the stages before coping; namely, the initial appraisal stage (whether a certain situation is challenging or threatening) and the secondary appraisal (what the individual's resources are). The relationship between coping at the time of the stress event (as in this study), proactive coping (involving the accumulation of resources that might be useful if a threat occurs), and Psychological resources should be examined. In addition, self-efficacy was the most highly correlated with coping by change. Future work should consider the relationship between coping with stress and self-efficacy. As far as we know this concept has yet to be investigated.

5. Conclusion

The relationship between various forms of coping (by change, acceptance, and withdrawal) and positive psychological resources (self-efficacy, hope, optimism, and resilience) was examined and found to be significant. The present study contributes to explorations of new relationships between coping and psychological capital, and shows that increased conceptual accuracy can distinguish between psychological capital capacities (especially hope and resilience) and measurements of coping.

6. Acknowledgment

The authors acknowledge the valuable contribution of the late Prof. Dov Elizur to this research. Elizur, who passed away in September 2015, was part of the supervising team of the first author's PhD dissertation. He was a very special person and very dear to both of us. He will be in our hearts forever.

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16 Causes of Workplace Stress & How to Prevent Its Effects

• Are you falling behind with your work commitments?
• Snappy with loved ones and having trouble sleeping?
• Are you working long hours yet not getting enough done?

If your job demands more than you can deliver, you could be experiencing workplace stress (Schwartz & McCarthy, 2014). According to the American Psychological Association (2018), “everyone who has had a job has, at some point, felt the pressure of work-related stress.”

While seemingly inevitable, we can do much to prevent stress and reduce its effects. This article explores many of the causes and introduces practical measures that help.

Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free . These science-based exercises will equip you and your clients with tools to better manage stress and find a healthier balance in your life.

This Article Contains:

The psychology of workplace stress, symptoms of workplace stress: 3 examples, 16 possible causes of stress at work, 5 negative effects of workplace stress, how to manage stress according to research, 9 tips to prevent workplace stress, our stress-relief resources & more, a take-home message.

“Stress is one of the major reasons employees cite for their absence from work, and stress-related absence is increasing.”

Neenan, 2018, p. 92

Unfortunately, chronic stress is all too common in the workplace. According to the American Psychological Association’s (2020) annual Stress in America survey , work is consistently cited as one of the top sources of stress in people’s lives.

What is stress?

It is important to begin by understanding what we mean by the term stress.

Definitions of stress typically fall into three categories (Gross, 2020, p. 199):

• “Stress as a stimulus. ”
• “Stress as a response. ”
• “Stress as an interaction between an organism and its environment.”

Each category is a good match for the three models of stress most often used in research (Gross, 2020):

• Engineering model Suggests that external stressors ( stimuli ) produce a stress reaction in the individual. Stress is what happens to the person, not within the person.
• Physiological model Focuses on what happens within the person in response to the stress.
• Transactional model A blend of the other two models concerned with the relationship between the person and the environment.

This article mainly focuses on the transactional model, looking at what causes workplace stress ,  its effects , and how we cope.

Workplace stress

According to former associate director of the Centre for Stress Management and Cognitive-Behavioral Therapist Michael Neenan (2018), stress is the result of pressures exceeding our ability to cope with them.

If we experience too much stress in the workplace, we become psychologically overwhelmed and unable to avoid the tensions found in our jobs (American Psychological Association, 2018).

Resilience and stress

Psychology literature broadly agrees that resilience offers a buffer against stress (Rutter, 1985, 2012).

While the popular view of resilience concerns bouncing back from adversity or stressful situations, Neenan (2018) suggests that building resilience requires us to face adversity, handle it, and ultimately return stronger.

Most importantly, resilience and the capacity to handle stress are for everyone , not just the extraordinary few (Neenan, 2018). Crucially, resilience can be learned and grown using lessons from Cognitive-Behavioral Therapy (CBT).

CBT’s strength in handling stress and difficult situations involves recognizing what can be changed and what cannot (yet), as follows (modified from Neenan, 2018):

• If you can change some, or all, of the situation, then take the required steps to do so.
• If you cannot change any aspect of the situation, then make every effort to change your emotional reaction to it.
• If you can change some or all of the situation, but your degree of emotional distress means you can’t see that as an option, then moderate that distress before taking practical problem-solving steps.

This CBT approach (along with other therapeutic treatments) has proven successful in managing difficult situations while handling and reducing stress.

After all, “you can’t always avoid the tensions that occur on the job. Yet you can take steps to manage work-related stress” (American Psychological Association, 2018).

With more people working remotely and able to work anytime and anywhere, there is even more spillover of workplace stress into our home lives (Stitch, 2020).

“A stressful work environment can contribute to problems such as headache, stomachache, sleep disturbances, short temper, and difficulty concentrating.”

American Psychological Association, 2018

Over time, the symptoms of workplace stress may become chronic, damaging physical and mental health.

Prolonged occupational stress resulting from extended, frequent, or intense stressors leads to distress, occurring in one or more of the following forms (Quick & Henderson, 2016).

Medical distress

The impact of long-term stress on the body is profound and well documented. Research has linked shift work, hazardous working conditions, and social hazards (all factors known to increase stress) with cardiovascular disease.

Other studies indicate that stress is an important factor in “the onset of cancers and having an indirect role in worsening the disease and limiting recovery” (Quick & Henderson, 2016, p. 3).

Surprisingly, an increased risk of physical injuries – the fourth leading cause of death – has also been linked to stress.

Psychological distress

Two of the leading and most severe psychological impacts of stress include the increased likelihood of anxiety and depression (Quick & Henderson, 2016).

Depression is ranked as one of the most significant factors in illness, disease, and loss of productivity in the workplace, affecting around 16% of adults (Quick & Henderson, 2016). Prolonged stress can also lead to anxiety disorders and burnout, with high costs to the individual and the organization.

Behavioral distress

Stress is also a significant factor in behavioral distress, increasing drug use, including reliance on tobacco, alcohol, and prescription and illicit drugs.

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Stress at work has many causes, often specific to the individual and the workplace. Common workplace stressors include (American Psychological Association, 2018; Neenan, 2018):

• Longer working hours impacting work–life balance
• Job insecurity
• Excessive and tiring commutes
• Increasing work demands
• Unrealistic deadlines
• Limited opportunities for growth, development, or advancement
• Challenging or difficult colleagues
• Too many meetings
• Email overload
• Incompetent or uncaring managers and supervisors
• Meaningless targets
• Constantly changing technology
• Lack of social support
• Insufficient control over job-related decisions
• Conflicting job demands and unclear performance expectations

In most cases, multiple stressors combine to produce our work-related stress, differing in severity through the day and even our career.

While the highest performers can often survive and thrive in stressful environments, stress remains overwhelming and damaging for the rest of us (Kovacs, 2007).

The adverse effects of workplace stress can take many forms, including the following (Contrada & Baum, 2011):

Unhealthy eating

Research shows that stress impacts not only our physiology, but also our behavior. High levels of stress can be associated with both increased (e.g., saturated fat consumption) and decreased (e.g., overall calories) food intake (Contrada & Baum, 2011).

Studies in adolescents and adults have also shown they consume more snacks when stressed (Contrada & Baum, 2011).

Recreational drug use

Stress is associated with a marked increase in recreational drug use – legal (e.g., alcohol, nicotine, and caffeine) and illegal (e.g., heroin and cocaine). While the exact reasons for the association may vary, they may include the belief that drug use can reduce stress. Further complicating matters, physical and psychological reactions to abstaining from previously self-administered drugs can increase stress as a symptom of withdrawal (Contrada & Baum, 2011).

Burnout & workplace stress

Prolonged stress in the workplace often leads to burnout and is particularly likely in suppliers of critical services to the public. During natural disasters or health crises, healthcare and emergency service workers often work long hours over many days and weeks, reporting severe psychological distress (Moss, 2021).

Can workplace stress cause depression?

Workplace stress has a significant impact on the incidence and duration of depression. However, research has found that improving workers’ ability to cope and manage stressful situations through stress management programs (including cognitive-behavioral approaches) reduces absence rates due to sickness and staff turnover, and eases depressive symptoms (Mino, Babazono, Tsuda, & Yasuda, 2006).

Negative effects at the company level

While stress can be harmful to the employee, it also has the potential to damage the company due to increased staff absence due to sickness, poor productivity, high turnover, low morale, poor motivation, and increased employee complaints (Attridge, 2017).

The American Institute of Stress estimates the cost of stress to U.S. industry to be over $300 billion annually.

The cost of workplace stress – and how to reduce it – Rob Cooke

The American Psychological Association (2018) offers several research-based techniques for managing stress, at work and beyond:

• Track your stressors. Keep a journal and track situations that create the most stress over several weeks and how you handle them. What are you thinking? How does it feel? In what environments do the stressors (people, circumstances, physical) appear? You are looking for patterns in what is causing stress and how you react.
• Develop healthy, helpful, and positive responses. We often rely on unhealthy choices to cope with stress: fast food, alcohol, or a cigarette. Look for healthy ways to de-stress, such as exercising (even a fast walk will help), getting into nature, meeting with friends, meditation, or yoga. Good sleeping habits are also essential.
• Establish boundaries. In our always available online world, it is increasingly important to set clear work–life boundaries. Don’t check emails after your evening meal or over the weekend. Agree to only talk (or vent) about work for 30 minutes when at home .
• Recharge and switch off. We need time to reach our pre-stress balance. Walking after work (whether working remotely or in the office) or using the commute to listen to music or an audiobook can encourage the transition between work and home life. Such practices can help by bookending the workday, disconnecting, and focusing on non-work activities.
• Learn how to relax. While it sounds easy, learning to relax may take practice until it becomes a habit. Find ways to experience the present moment, perhaps using breathing exercises, mindfulness techniques, savoring a meal , or listening to music.
• Talk to your supervisor. It is in your boss’s interest for you to be happy, healthy, and in a positive and productive working environment. Talk to your manager to develop a realistic plan for managing or removing stressors. Being given more meaningful tasks may help.
• Seek support. Support is often all around us when we look. Friends, family, and employee support programs can help you manage stress and adopt more healthy coping mechanisms.

Stress doesn’t always need to be bad. By encountering stress and learning how to cope, we can grow and develop greater resilience to make future situations less difficult. Remember, “resilience is about managing emotions, not suppressing them” (Neenan, 2018, p. 9).

The following tips help reduce the likelihood of feeling overloaded and overwhelmed (modified from Halvorson, 2014):

• Practice self-compassion , permitting yourself to make mistakes. Rather than dwell on the past, learn from it and improve your performance.
• Picture the overall goal or purpose and reflect on the why behind your behavior. You will be more likely to stop and plan rather than burn too much energy on being busy.
• Use routines whenever possible. Each new task and choice takes time and creates mental tension, so find ways to reduce the number of decisions.
• Interesting activities replenish energy. Being curious and finding something that captivates you will help you recharge.
• Add when and where to every item on your task to avoid the week slipping away without getting everything done on time.
• Consider situations and events that trigger stress. Come up with a set of if–then plans (e.g., “ If X happens, I will do Y .”). Planning for the worst will leave you prepared and less stressed if it happens.
• Striving for perfection can lead to procrastination and even burnout. Focus on being good and on improving, rather than setting standards you can’t meet.
• Reflect on past successes and the progress you have already made. You have come a long way; give yourself the credit you deserve.
• Recognize what motivates you. Life is full of opportunities; find what excites you and apply yourself to the challenge.

17 Exercises To Reduce Stress & Burnout

Help your clients prevent burnout, handle stressors, and achieve a healthy, sustainable work-life balance with these 17 Stress & Burnout Prevention Exercises [PDF].

Created by Experts. 100% Science-based.

Before looking at a sample of the many worksheets and exercises we have available, you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free .

These science-based exercises were sourced from our Positive Psychology Toolkit© , an online collection of over 400 mindfulness-based exercises, interventions, and tests. They will equip you and your clients with tools to better manage stress and find a healthier balance in life.

For some additional free stress-relief tools to help you or your client better manage stress, check out the following:

• Squeeze and Release This group activity helps participants discover the energizing potential of positive stress, known as  eustress , which can help improve motivation, performance, and emotional wellbeing.
• Coping With Stress This two-part exercise invites clients to list experienced physiological and emotional symptoms of stress and brainstorm strategies to reduce, cope with, or eliminate these sources of stress.
• Coping: Stressors and Resources This worksheet helps clients identify past, present, and future stressors and link them with coping resources they can use to overcome them.
• Identifying Your Stress Resources This worksheet helps clients identify external resources they can connect with and draw strength from during stressful times.
• One Hour Stress Plan This worksheet provides a 60-minute action plan for dealing with intense demands, helping clients work systematically through a list of tasks that require their most urgent attention.

17 Stress & Burnout Prevention Exercises If you’re looking for more science-based ways to help others manage stress without spending hours on research and session prep, check out this collection of 17 validated stress management tools for practitioners . Use them to help others identify signs of burnout and create more balance in their lives.

Stress affects us all. While a certain amount of pressure in the workplace can be invigorating and even exciting, too much for too long can damage our physical and mental wellbeing.

Increased stress potentially leads to cardiovascular disease, cancer, poor sleep, difficulty concentrating, damage to relationships, and more (American Psychological Association, 2018; Quick & Henderson, 2016).

Psychological distress is also a significant factor in burnout and can lead to depression and other mental health issues.

For employers, having a stressed staff results in lost productivity, absenteeism, and the risk of accidents and legal proceedings.

It doesn’t have to be this way. Stress can be managed and even become positive by addressing, reducing, or removing some of the causes; establishing boundaries between work and life outside; and allowing staff to recharge.

Review the theoretical background to stress, understand its causes (for you or your client), and adopt tools and techniques that reduce feelings of being overloaded and overwhelmed. Over time, it is possible to form helpful habits, discard old negative ones, and change our relationship to stress.

We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free .

• American Psychological Association. (2018). Coping with stress at work . http://www.apa.org/topics/healthy-workplaces/work-stress
• American Psychological Association. (2020). Stress in America: A national mental health crisis.  Retrieved August 26, 2021, from https://www.apa.org/news/press/releases/stress/2020/sia-mental-health-crisis.pdf
• Attridge, D. (2017). Effects of work-related stress . University of Cambridge Human Resources. Retrieved August 26, 2021, from https://www.hr.admin.cam.ac.uk/policies-procedures/managing-stress-and-promoting-wellbeing-work-policy/policy-statement/effects
• Contrada, R. J., & Baum, A. (2011). The handbook of stress science: Biology, psychology, and health . Springer.
• Gross, R. D. (2020). Psychology: The science of mind and behaviour . Hodder and Stoughton.
• Halvorson, H. (2014). Nine ways successful people defeat stress. In HBR guide to managing stress at work (pp. 1–11). Harvard Business Review Press.
• Kovacs, M. (2007). Stress and coping in the workplace . The British Psychological Society. Retrieved August 25, 2021, from https://thepsychologist.bps.org.uk/volume-20/edition-9/stress-and-coping-workplace
• Mino, Y., Babazono, A., Tsuda, T., & Yasuda, N. (2006). Can stress management at the workplace prevent depression? A randomized controlled trial. Psychotherapy and Psychosomatics , 75 (3), 177–182.
• Moss, J. (2021). Rethinking burnout. In HBR guide to beating burnout (pp. 1–13). Harvard Business Review Press.
• Neenan, M. (2018). Developing resilience: A cognitive-behavioural approach . Routledge.
• Quick, J., & Henderson, D. (2016). Occupational stress: Preventing suffering, enhancing wellbeing. International Journal of Environmental Research and Public Health , 13 (5), 459.
• Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance in psychiatric disorder. British Journal of Psychiatry , 147 (1), 598–611.
• Rutter, M. (2012). Resilience as a dynamic concept. Development and Psychopathology , 24 (2), 335–344.
• Schwartz, T., & McCarthy, C. (2014). Manage your energy not your time. In HBR guide to managing stress at work (pp. 53–80). Harvard Business Review Press.
• Stitch, J. (2020). A review of workplace stress in the virtual office. Intelligent Buildings International , 12 (3), 208–220.

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How Volunteering Improves Mental Health

February 02, 2022

By Trish Lockard

While sitting in a waiting room at a doctor’s office in 2014, I struck up a conversation with the woman sitting next to me. As we got acquainted, she told me she was deeply involved with an organization called the National Alliance on Mental Illness (NAMI). I hadn’t heard of it, but I was intrigued because I was not a stranger to mental illness.

My maternal grandmother experienced debilitating depression for years, culminating in her suicide in 1939. My mother was diagnosed with depression and experienced what I believe was PTSD, following her own mother’s suicide. I had grappled with mental health challenges myself, and I had been taking medication for depression and anxiety disorders for many years.

As I learned about NAMI that day, I knew instinctively this was an organization to which I could happily devote my time and energy. I had always shied away from volunteerism because no cause had ever inspired the passion required to keep me motivated. Now, eight years later, I am still a NAMI member and vocal activist for mental health.

With some personal reflection and review of scientific literature, I’ve come to understand that volunteering itself can be an act of self-care.

The Benefits of Volunteerism

Naturally, the dialogue surrounding activism and volunteerism centers on how others will benefit from volunteer work that you do. But years of research demonstrate that there are benefits for volunteers themselves. Whether you are a family member or caregiver for someone with a mental health condition — or have the lived experience yourself — volunteering can be a positive step toward improving your health and yield many benefits:

• Reducing Stress My work with NAMI demonstrates the ways in which volunteering can counteract the effects of stress, anger and anxiety. This kind of work was my first exploration into long-term volunteerism — and, as is my nature, I sometimes felt a little anxious as I prepared to lead an affiliate board meeting or teach or speak to a group on behalf of NAMI. But I always rose to the occasion because the cause mattered so greatly to me. And afterward, I would feel exhilarated and thrilled by my accomplishments. Gradually, my focus on the work, and the gratitude I received from it, surpassed other issues in my life that caused negative emotions. There was too much to accomplish and too much to look forward to for me to feel down. Ultimately, I noticed that I slept better at night with the knowledge that I was part of a greater good.
• Increasing Happiness Research has found a correlation between volunteering and happiness. A 2020 study conducted in the United Kingdom found those who volunteered reported being more satisfied with their lives and rated their overall health as better. Respondents who volunteered for at least one month also reported having better mental health than those who did not volunteer.
• Developing Confidence Volunteering is an opportunity to develop confidence and self-esteem. Your role as a volunteer can also give you a sense of pride and identity, something that can be hard to come by for people with a mental health diagnosis. The better you feel about yourself, the more likely you are to have a positive view of your life and future. Moreover, I’ve found that the sense of accomplishment from serving others can raise self-esteem and self-confidence.

I served for years as the president of my local NAMI affiliate’s board. I was the family and caregiver support group facilitator and, to this day, offer my services as a NAMI Family-to-Family certified instructor. My passion for offering education and support for people with lived experience and their families hasn’t waned because the need hasn’t waned.

Getting Started Volunteering

In 2018, my long-time friend, psychologist Terri L. Lyon, hoped to create an easy-to-follow roadmap for people to identify the cause they are most passionate about (because focusing on one issue is more effective) and determine how to use the gifts they already possess to make a difference for that cause. With me as her editor, she published the book “ What’s On Your Sign? ” in which she introduced her unique “5-Step Activism Path.” The steps are:

• Find your passion by creating a vision of how you want to change the world
• Identify the unique gifts you can bring to this activism
• Craft a unique activism opportunity ideally suited to you
• Monitor your long-term effectiveness
• Stay motivated and avoid burnout

Perhaps these steps seem intimidating at first glance — but with reflection and time, they can lead to a meaningful new path. One example of following these steps is Knoxville jewelry artist, Christinea Beane . As someone with mental illness, Christinea makes jewelry for other people struggling with their mental health, to offer hope, raise awareness and remind them that they are not alone.

As I address in the book I co-wrote with Dr. Lyon, “Make a Difference with Mental Health Activism,” we can’t underestimate the personal and wide-reaching impacts of volunteering and activism, particularly in the mental health field. Your work could not only boost your emotional well-being, it could also be a critical step toward ending stigma, achieving parity, and increasing mental health services and support. You can make a difference.

Trish Lockard has been a volunteer for NAMI Tennessee since 2014. Mental health care became her personal passion following her family’s experience with mental illness. Trish is a nonfiction editor, specializing in memoir, and a nonfiction writing coach at Strike The Write Tone . Contact Trish at [email protected] .

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What the data says about abortion in the U.S.

Pew Research Center has conducted many surveys about abortion over the years, providing a lens into Americans’ views on whether the procedure should be legal, among a host of other questions.

In a  Center survey  conducted nearly a year after the Supreme Court’s June 2022 decision that  ended the constitutional right to abortion , 62% of U.S. adults said the practice should be legal in all or most cases, while 36% said it should be illegal in all or most cases. Another survey conducted a few months before the decision showed that relatively few Americans take an absolutist view on the issue .

Find answers to common questions about abortion in America, based on data from the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute, which have tracked these patterns for several decades:

How many abortions are there in the U.S. each year?

How has the number of abortions in the u.s. changed over time, what is the abortion rate among women in the u.s. how has it changed over time, what are the most common types of abortion, how many abortion providers are there in the u.s., and how has that number changed, what percentage of abortions are for women who live in a different state from the abortion provider, what are the demographics of women who have had abortions, when during pregnancy do most abortions occur, how often are there medical complications from abortion.

This compilation of data on abortion in the United States draws mainly from two sources: the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute, both of which have regularly compiled national abortion data for approximately half a century, and which collect their data in different ways.

The CDC data that is highlighted in this post comes from the agency’s “abortion surveillance” reports, which have been published annually since 1974 (and which have included data from 1969). Its figures from 1973 through 1996 include data from all 50 states, the District of Columbia and New York City – 52 “reporting areas” in all. Since 1997, the CDC’s totals have lacked data from some states (most notably California) for the years that those states did not report data to the agency. The four reporting areas that did not submit data to the CDC in 2021 – California, Maryland, New Hampshire and New Jersey – accounted for approximately 25% of all legal induced abortions in the U.S. in 2020, according to Guttmacher’s data. Most states, though,  do  have data in the reports, and the figures for the vast majority of them came from each state’s central health agency, while for some states, the figures came from hospitals and other medical facilities.

Discussion of CDC abortion data involving women’s state of residence, marital status, race, ethnicity, age, abortion history and the number of previous live births excludes the low share of abortions where that information was not supplied. Read the methodology for the CDC’s latest abortion surveillance report , which includes data from 2021, for more details. Previous reports can be found at  stacks.cdc.gov  by entering “abortion surveillance” into the search box.

For the numbers of deaths caused by induced abortions in 1963 and 1965, this analysis looks at reports by the then-U.S. Department of Health, Education and Welfare, a precursor to the Department of Health and Human Services. In computing those figures, we excluded abortions listed in the report under the categories “spontaneous or unspecified” or as “other.” (“Spontaneous abortion” is another way of referring to miscarriages.)

Guttmacher data in this post comes from national surveys of abortion providers that Guttmacher has conducted 19 times since 1973. Guttmacher compiles its figures after contacting every known provider of abortions – clinics, hospitals and physicians’ offices – in the country. It uses questionnaires and health department data, and it provides estimates for abortion providers that don’t respond to its inquiries. (In 2020, the last year for which it has released data on the number of abortions in the U.S., it used estimates for 12% of abortions.) For most of the 2000s, Guttmacher has conducted these national surveys every three years, each time getting abortion data for the prior two years. For each interim year, Guttmacher has calculated estimates based on trends from its own figures and from other data.

The latest full summary of Guttmacher data came in the institute’s report titled “Abortion Incidence and Service Availability in the United States, 2020.” It includes figures for 2020 and 2019 and estimates for 2018. The report includes a methods section.

In addition, this post uses data from StatPearls, an online health care resource, on complications from abortion.

An exact answer is hard to come by. The CDC and the Guttmacher Institute have each tried to measure this for around half a century, but they use different methods and publish different figures.

The last year for which the CDC reported a yearly national total for abortions is 2021. It found there were 625,978 abortions in the District of Columbia and the 46 states with available data that year, up from 597,355 in those states and D.C. in 2020. The corresponding figure for 2019 was 607,720.

The last year for which Guttmacher reported a yearly national total was 2020. It said there were 930,160 abortions that year in all 50 states and the District of Columbia, compared with 916,460 in 2019.

• How the CDC gets its data: It compiles figures that are voluntarily reported by states’ central health agencies, including separate figures for New York City and the District of Columbia. Its latest totals do not include figures from California, Maryland, New Hampshire or New Jersey, which did not report data to the CDC. ( Read the methodology from the latest CDC report .)
• How Guttmacher gets its data: It compiles its figures after contacting every known abortion provider – clinics, hospitals and physicians’ offices – in the country. It uses questionnaires and health department data, then provides estimates for abortion providers that don’t respond. Guttmacher’s figures are higher than the CDC’s in part because they include data (and in some instances, estimates) from all 50 states. ( Read the institute’s latest full report and methodology .)

While the Guttmacher Institute supports abortion rights, its empirical data on abortions in the U.S. has been widely cited by  groups  and  publications  across the political spectrum, including by a  number of those  that  disagree with its positions .

These estimates from Guttmacher and the CDC are results of multiyear efforts to collect data on abortion across the U.S. Last year, Guttmacher also began publishing less precise estimates every few months , based on a much smaller sample of providers.

The figures reported by these organizations include only legal induced abortions conducted by clinics, hospitals or physicians’ offices, or those that make use of abortion pills dispensed from certified facilities such as clinics or physicians’ offices. They do not account for the use of abortion pills that were obtained  outside of clinical settings .

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The annual number of U.S. abortions rose for years after Roe v. Wade legalized the procedure in 1973, reaching its highest levels around the late 1980s and early 1990s, according to both the CDC and Guttmacher. Since then, abortions have generally decreased at what a CDC analysis called  “a slow yet steady pace.”

Guttmacher says the number of abortions occurring in the U.S. in 2020 was 40% lower than it was in 1991. According to the CDC, the number was 36% lower in 2021 than in 1991, looking just at the District of Columbia and the 46 states that reported both of those years.

(The corresponding line graph shows the long-term trend in the number of legal abortions reported by both organizations. To allow for consistent comparisons over time, the CDC figures in the chart have been adjusted to ensure that the same states are counted from one year to the next. Using that approach, the CDC figure for 2021 is 622,108 legal abortions.)

There have been occasional breaks in this long-term pattern of decline – during the middle of the first decade of the 2000s, and then again in the late 2010s. The CDC reported modest 1% and 2% increases in abortions in 2018 and 2019, and then, after a 2% decrease in 2020, a 5% increase in 2021. Guttmacher reported an 8% increase over the three-year period from 2017 to 2020.

As noted above, these figures do not include abortions that use pills obtained outside of clinical settings.

Guttmacher says that in 2020 there were 14.4 abortions in the U.S. per 1,000 women ages 15 to 44. Its data shows that the rate of abortions among women has generally been declining in the U.S. since 1981, when it reported there were 29.3 abortions per 1,000 women in that age range.

The CDC says that in 2021, there were 11.6 abortions in the U.S. per 1,000 women ages 15 to 44. (That figure excludes data from California, the District of Columbia, Maryland, New Hampshire and New Jersey.) Like Guttmacher’s data, the CDC’s figures also suggest a general decline in the abortion rate over time. In 1980, when the CDC reported on all 50 states and D.C., it said there were 25 abortions per 1,000 women ages 15 to 44.

That said, both Guttmacher and the CDC say there were slight increases in the rate of abortions during the late 2010s and early 2020s. Guttmacher says the abortion rate per 1,000 women ages 15 to 44 rose from 13.5 in 2017 to 14.4 in 2020. The CDC says it rose from 11.2 per 1,000 in 2017 to 11.4 in 2019, before falling back to 11.1 in 2020 and then rising again to 11.6 in 2021. (The CDC’s figures for those years exclude data from California, D.C., Maryland, New Hampshire and New Jersey.)

The CDC broadly divides abortions into two categories: surgical abortions and medication abortions, which involve pills. Since the Food and Drug Administration first approved abortion pills in 2000, their use has increased over time as a share of abortions nationally, according to both the CDC and Guttmacher.

The majority of abortions in the U.S. now involve pills, according to both the CDC and Guttmacher. The CDC says 56% of U.S. abortions in 2021 involved pills, up from 53% in 2020 and 44% in 2019. Its figures for 2021 include the District of Columbia and 44 states that provided this data; its figures for 2020 include D.C. and 44 states (though not all of the same states as in 2021), and its figures for 2019 include D.C. and 45 states.

Guttmacher, which measures this every three years, says 53% of U.S. abortions involved pills in 2020, up from 39% in 2017.

Two pills commonly used together for medication abortions are mifepristone, which, taken first, blocks hormones that support a pregnancy, and misoprostol, which then causes the uterus to empty. According to the FDA, medication abortions are safe  until 10 weeks into pregnancy.

Surgical abortions conducted  during the first trimester  of pregnancy typically use a suction process, while the relatively few surgical abortions that occur  during the second trimester  of a pregnancy typically use a process called dilation and evacuation, according to the UCLA School of Medicine.

In 2020, there were 1,603 facilities in the U.S. that provided abortions,  according to Guttmacher . This included 807 clinics, 530 hospitals and 266 physicians’ offices.

While clinics make up half of the facilities that provide abortions, they are the sites where the vast majority (96%) of abortions are administered, either through procedures or the distribution of pills, according to Guttmacher’s 2020 data. (This includes 54% of abortions that are administered at specialized abortion clinics and 43% at nonspecialized clinics.) Hospitals made up 33% of the facilities that provided abortions in 2020 but accounted for only 3% of abortions that year, while just 1% of abortions were conducted by physicians’ offices.

Looking just at clinics – that is, the total number of specialized abortion clinics and nonspecialized clinics in the U.S. – Guttmacher found the total virtually unchanged between 2017 (808 clinics) and 2020 (807 clinics). However, there were regional differences. In the Midwest, the number of clinics that provide abortions increased by 11% during those years, and in the West by 6%. The number of clinics  decreased  during those years by 9% in the Northeast and 3% in the South.

The total number of abortion providers has declined dramatically since the 1980s. In 1982, according to Guttmacher, there were 2,908 facilities providing abortions in the U.S., including 789 clinics, 1,405 hospitals and 714 physicians’ offices.

The CDC does not track the number of abortion providers.

In the District of Columbia and the 46 states that provided abortion and residency information to the CDC in 2021, 10.9% of all abortions were performed on women known to live outside the state where the abortion occurred – slightly higher than the percentage in 2020 (9.7%). That year, D.C. and 46 states (though not the same ones as in 2021) reported abortion and residency data. (The total number of abortions used in these calculations included figures for women with both known and unknown residential status.)

The share of reported abortions performed on women outside their state of residence was much higher before the 1973 Roe decision that stopped states from banning abortion. In 1972, 41% of all abortions in D.C. and the 20 states that provided this information to the CDC that year were performed on women outside their state of residence. In 1973, the corresponding figure was 21% in the District of Columbia and the 41 states that provided this information, and in 1974 it was 11% in D.C. and the 43 states that provided data.

In the District of Columbia and the 46 states that reported age data to  the CDC in 2021, the majority of women who had abortions (57%) were in their 20s, while about three-in-ten (31%) were in their 30s. Teens ages 13 to 19 accounted for 8% of those who had abortions, while women ages 40 to 44 accounted for about 4%.

The vast majority of women who had abortions in 2021 were unmarried (87%), while married women accounted for 13%, according to  the CDC , which had data on this from 37 states.

In the District of Columbia, New York City (but not the rest of New York) and the 31 states that reported racial and ethnic data on abortion to  the CDC , 42% of all women who had abortions in 2021 were non-Hispanic Black, while 30% were non-Hispanic White, 22% were Hispanic and 6% were of other races.

Looking at abortion rates among those ages 15 to 44, there were 28.6 abortions per 1,000 non-Hispanic Black women in 2021; 12.3 abortions per 1,000 Hispanic women; 6.4 abortions per 1,000 non-Hispanic White women; and 9.2 abortions per 1,000 women of other races, the  CDC reported  from those same 31 states, D.C. and New York City.

For 57% of U.S. women who had induced abortions in 2021, it was the first time they had ever had one,  according to the CDC.  For nearly a quarter (24%), it was their second abortion. For 11% of women who had an abortion that year, it was their third, and for 8% it was their fourth or more. These CDC figures include data from 41 states and New York City, but not the rest of New York.

Nearly four-in-ten women who had abortions in 2021 (39%) had no previous live births at the time they had an abortion,  according to the CDC . Almost a quarter (24%) of women who had abortions in 2021 had one previous live birth, 20% had two previous live births, 10% had three, and 7% had four or more previous live births. These CDC figures include data from 41 states and New York City, but not the rest of New York.

The vast majority of abortions occur during the first trimester of a pregnancy. In 2021, 93% of abortions occurred during the first trimester – that is, at or before 13 weeks of gestation,  according to the CDC . An additional 6% occurred between 14 and 20 weeks of pregnancy, and about 1% were performed at 21 weeks or more of gestation. These CDC figures include data from 40 states and New York City, but not the rest of New York.

About 2% of all abortions in the U.S. involve some type of complication for the woman , according to an article in StatPearls, an online health care resource. “Most complications are considered minor such as pain, bleeding, infection and post-anesthesia complications,” according to the article.

The CDC calculates  case-fatality rates for women from induced abortions – that is, how many women die from abortion-related complications, for every 100,000 legal abortions that occur in the U.S .  The rate was lowest during the most recent period examined by the agency (2013 to 2020), when there were 0.45 deaths to women per 100,000 legal induced abortions. The case-fatality rate reported by the CDC was highest during the first period examined by the agency (1973 to 1977), when it was 2.09 deaths to women per 100,000 legal induced abortions. During the five-year periods in between, the figure ranged from 0.52 (from 1993 to 1997) to 0.78 (from 1978 to 1982).

The CDC calculates death rates by five-year and seven-year periods because of year-to-year fluctuation in the numbers and due to the relatively low number of women who die from legal induced abortions.

In 2020, the last year for which the CDC has information , six women in the U.S. died due to complications from induced abortions. Four women died in this way in 2019, two in 2018, and three in 2017. (These deaths all followed legal abortions.) Since 1990, the annual number of deaths among women due to legal induced abortion has ranged from two to 12.

The annual number of reported deaths from induced abortions (legal and illegal) tended to be higher in the 1980s, when it ranged from nine to 16, and from 1972 to 1979, when it ranged from 13 to 63. One driver of the decline was the drop in deaths from illegal abortions. There were 39 deaths from illegal abortions in 1972, the last full year before Roe v. Wade. The total fell to 19 in 1973 and to single digits or zero every year after that. (The number of deaths from legal abortions has also declined since then, though with some slight variation over time.)

The number of deaths from induced abortions was considerably higher in the 1960s than afterward. For instance, there were 119 deaths from induced abortions in  1963  and 99 in  1965 , according to reports by the then-U.S. Department of Health, Education and Welfare, a precursor to the Department of Health and Human Services. The CDC is a division of Health and Human Services.

Note: This is an update of a post originally published May 27, 2022, and first updated June 24, 2022.

Support for legal abortion is widespread in many countries, especially in Europe

Nearly a year after roe’s demise, americans’ views of abortion access increasingly vary by where they live, by more than two-to-one, americans say medication abortion should be legal in their state, most latinos say democrats care about them and work hard for their vote, far fewer say so of gop, positive views of supreme court decline sharply following abortion ruling, most popular.

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4 Reasons Why Managers Fail

• Swagatam Basu,
• Atrijit Das,
• Vitorio Bretas,
• Jonah Shepp

Nearly half of all managers report buckling under the stress of their role and struggling to deliver.

Gartner research has found that managers today are accountable for 51% more responsibilities than they can effectively manage — and they’re starting to buckle under the pressure: 54% are suffering from work-induced stress and fatigue, and 44% are struggling to provide personalized support to their direct reports. Ultimately, one in five managers said they would prefer not being people managers given a choice. Further analysis found that 48% of managers are at risk of failure based on two criteria: 1) inconsistency in current performance and 2) lack of confidence in the manager’s ability to lead the team to future success. This article offers four predictors of manager failure and offers suggestions for organizations on how to address them.

The job of the manager has become unmanageable. Organizations are becoming flatter every year. The average manager’s number of direct reports has increased by 2.8 times over the last six years, according to Gartner research. In the past few years alone, many managers have had to make a series of pivots — from moving to remote work to overseeing hybrid teams to implementing return-to-office mandates.

• Swagatam Basu is senior director of research in the Gartner HR practice and has spent nearly a decade researching leader and manager effectiveness. His work spans additional HR topics including learning and development, employee experience and recruiting. Swagatam specializes in research involving extensive quantitative analysis, structured and unstructured data mining and predictive modeling.
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• Jonah Shepp is a senior principal, research in the Gartner HR practice. He edits the Gartner  HR Leaders Monthly  journal, covering HR best practices on topics ranging from talent acquisition and leadership to total rewards and the future of work. An accomplished writer and editor, his work has appeared in numerous publications, including  New York   Magazine ,  Politico   Magazine ,  GQ , and  Slate .

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