Assessment of occupational stress level among the diagnostic radiographers of Kandy District in Sri Lanka

Transcription

1 International Journal Of Perceptions in Public Health ISSN: (Online) Research Article Assessment of occupational stress level among the diagnostic radiographers of Kandy District in Sri Lanka Gamalendira.S 2, Rosairo.S 1, Anutheepa.A 2, Harshani. P.A.S 2 1 Faculty of Medicine, University of Peradeniya, Sri Lanka, 2 Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka Abstract Occupational stress is a complex bio psychosocial situation and has been recognized worldwide as a major health hazard for employees. There are no published studies identifying the occupational stress level among Radiographers in Sri Lanka. To assess the occupational stress level among the diagnostic radiographers of Kandy district in Sri Lanka. This was a descriptive study. Thirty diagnostic radiographers from seven government hospitals were evaluated using self-administered questionnaires. Stress level was assessed by occupational stress index method based on an individual score. The obtained results were statistically analyzed using Chi-Square test with MINITAB; Version The significant causes of stress and the activities which help to minimize the stress were found out from the results. Out of the thirty radiographers, 6% were in low stress level, 77% were in moderate stress level and 17% were in high stress level. Some of the factors which showed significant association with stress were high work load (92%), less salary (85%), working under tensed circumstances (75%), disturbance from colleagues and subordinates (82%), insufficient resources and employees (83%) and administrative pressures (75%). 72% of radiographers in the teaching hospitals and 100% of radiographers in the other hospitals were in moderate stress level. Counseling programs, installing new equipment with advancing technologies and training programs to improve the skills were some of the suggestions made to minimize the stress. About 77% of radiographers in Kandy district were experiencing moderate level of stress. High work load, inadequate payment, role conflict, resource inadequacy and administrative pressures were the common factors influencing the stress. Keywords: Occupational stress, Radiographers, Sources of occupational stress, Stress indicators, Work-related issues. Introduction Occupational stress is a complex bio psychosocial situation and has been recognized worldwide as a major health hazard for employees (Sun, Wu and Wang, 2011) Stress, in general, and occupational stress, in particular, is a fact of modern day life that seems to have been on the increase. The topic is, therefore, still popular, although it occupies academics and practitioners attention now for more than half a century (Pološki and Bogdanić, 2007). Numerous recent studies have explored work stress among health care personnel in many countries. Investigators have assessed work stress among medical technicians, radiation therapists, social workers, occupational therapists, physicians, and collections of health care staff across disciplines (Jennings, 2008.) Stress can be defined in several ways and it is important to use an approach which covers the different aspects of the concept. First of all, occupational stress has often been regarded as an aversive characteristic of the working (Smith, 2000.) Though psychologists cannot agree on one definition for the word stress, stress has the potential to discourage radiographers from practice and to cause brain drain in the profession (Nwadinobi et al, 2008) It is important to understand what is happening on a physiological level when you are feeling stressed. When you are feeling stressed your brain perceives a threat and then the fight or flight response is triggered. In potentially threatening situation, this response is invaluable and may save your life or the life of another (Stone et al, 2011). This study was done to identify occupational stress level among workers focusing on the radiographers in Sri Lanka whether they are being apart from the occupational stress or affected by the job. Similar studies have been done in other countries such as Nigeria, Philippine, Malaysia and India, but there are no published studies in Sri Lanka. The studies done in other countries showed that the radiographers were affected by the occupational stress. This study would help to assess the occupational stress level among the radiographers in Sri Lanka and to find the main causes of the stress. The results would be helpful to make suggestions or modifications to reduce the stress level among the radiographers who are under stress. This study helps to assess the occupational stress level among the diagnostic radiographers of Correspondence: Gamalendira S, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka sgamal07@gmail.com : Gamalendira et al. This is an Open Access article under the terms of Creative Commons Attribution License, which permits unrestricted non-commercial use, provided the original work is properly cited. 205

2 Kandy district in Sri Lanka in addition to this from the result can analyze factors and processes influencing stress and also can do few comparisons between each variable. Materials and methods This was a descriptive study. The study was carried out in radiographers who were working in the government hospitals in the Kandy district. According to the data taken from the department of health central province, there were seven hospitals functioning with radiology departments. Thirty radiographers were taken as the sample by random sampling method. Pretest was conducted prior to the actual data collection using five radiographers who were not part of the study and it was undertaken as a trial run to determine whether the questions were clear and to confirm the appropriateness of the questionnaire. A standard questionnaire (Srivatsa, and Singh, 1999) was used as a tool for data collection. It was a selfadministered questionnaire with three parts, Sections "one", "two" and three. Section "one" consists of some general questions focused on personal profile. Section "two" consists of scaled questions to rate different aspects of job stress and Section three consists of free comments on how job stress could be improved. The procedure was explained to the participants prior to administering the questionnaire. Written consent was taken individually and questionnaire was distributed. The volunteers who took part in the research were advised to answer the questions to the best of their knowledge. Each participant was given the questionnaire in their preferred language (Sinhala/Tamil/English). Collected data of each subject was recorded using data forms. The data obtained from the questionnaire was entered in an Excel worksheet and was analyzed by using the MINITAB Statistical Package (MINITAB; version 16.0). Independent Chi-square tests were done to find out the association between stress level and the factors influencing stress. The questionnaire contained 46 questions; each question had five options which are Absolutely True (5), Almost True (4), Partially True (3), Almost False (2), Absolutely False (1). The level of occupational stress was calculated by adding up the scores on all the statements. If answered absolutely true score will be 5. Based on individual points, data was entered on the data sheet which was divided into three stress levels which are (Occupational Stress Index Method) Below 115 Low stress level, Moderate stress level and Above 161-Highly stressed. Following variables were considered and analyzed in this study Age, Gender, Marital status, Work Place, Patients, Staff, Workload and Family/Social. Results The Table-1 is giving the most important outcome, relevant to the main objective of the study that is the frequency distribution of the defined stress levels. Out of the thirty radiographers who participated in the study by random sampling; two (6%) were in low stress level, twenty-three (77%) were in moderate level and five (17%) were highly stressed. Out of the 30 radiographers who participated in this study, twenty (66.7%) were males and ten (33.3%) were females. When considered the males 5% were in low level and 20% were in high stress level. 75% were in moderate stress level. In females 10% were in low stress level, 10% were in high stress level and 80% were in moderate stress level. In both gender, more than 75% were in moderate stress level. Chi square test showed that there was no significant difference in stress level between males and females. (p=0.714). Out of thirty radiographers, twenty-five (83.3%) were married and five (16.7%) were single. Among the twenty-five married radiographers 4% were in low stress level, 12% were in high stress level and 84% were in moderate stress level. Among the five radiographers who were not married, 20% were in low stress level, 40% were in moderate stress level and 40% were in high stress level. Chi square test showed that there was no significant difference in stress level between married and single. (p=0.099) The total number of thirty radiographers, who were included in this study, was divided into different age groups to analyze whether the age of the radiographer influenced the stress level. Twelve radiographers were in the ages between 26 and 35. Out of those 8.33% were in low stress level, 75% were in moderate level and 16.66% were in high level stress. Eleven radiographers were in the ages between 36 and 45. Out of those no one was in low stress level, 81.81% were in moderate level and18.18% were in high level stress. Six radiographers were in the ages between 46 and 55. One was in low stress level and one was in high stress level with the percentage of in each % were in moderate stress level. Only one person was identified in the age group of 56 to 65 who was under moderate stress level. The frequency of moderate stress level was high in all the age groups. Chi square test showed that there was no significant difference in stress level between different age groups. (p=0.907).to analyze different types of hospital due to very less number of radiographers in general and base hospitals, the numbers of radiographers from those hospitals were added and were categorized under other hospitals and the numbers of radiographers of all teaching hospitals were added to make comparison with teaching and other hospitals. In both categories of hospitals, most were in moderate stress level. Finally each question was tested and analyzed with independent Chi-square test to find out the association between stress and the question. P values less than or equal to 0.05 were considered to have sig- 206

3 nificant association and P values more than 0.05 were considered to have no association between them. Factors which had significant association with stress and the percentage of radiographers who were affected by each factor are given below. These results were obtained from the answers given to each question in the questionnaire- High work load 92% Contradictory instructions from other health professionals 72% Not considering their suggestions in the department 47% Getting less salary in comparison to the quantum of work 85% Work under tensed circumstances 75% Insufficient resources and employees 83% Co-operation not sought in solving the administrative problems at higher level 87% Disturbance from colleagues and subordinates 82% Fear of communicating disease from patients 50% Working with hurry due to excessive work load 83% Uncertainty and ambiguity of the scope of jurisdiction and authority s 88% No clear instructions and sufficient facilities regarding the new assignments 57% Opinions are not sought in framing important policies of the department 70% Less opportunity to develop aptitude and proficiency 87% Higher authorities not giving proper significance to the position and work 73% Unable to develop sufficient time to domestic and personal problems 63% Unsatisfactory working conditions from the point of view of welfare 71% Doing the work that ought to be done by others 50% Sudden new changes in procedures and policies 73% Unable to carry out the work with satisfaction due to excessive work load 58% The following factors did not show any significant association to the stress level- Insufficient and vague available information relating to job-role Adjust between political or group pressures and formal rules and regulations Monotonous nature of work Working at night Social status due to the job Fear of ionizing radiation/ lack of radiation protection Bearing responsibility for the progress of the department Co-operation of colleagues in solving administrative problems Disturbed and complicated life due to the job Discussion The analyzed data was discussed with the consideration of the particular objectives of this study. The result shows that most of the radiographers in Kandy district are experiencing moderate level stress. The above statement is said through the result of the study and with the assumption that the population is completely represented by the sample, which was 77% of the radiographers (23 out of 30) who were in this study are under moderate stress level. 17% (5 out of 30) of radiographers were severely affected by their occupation and categorized under high stress level. Only 6% (2 out of 30) of them were feeling stress in low level. With these findings, it might be said as majority of radiographers in Kandy district (94%) are experiencing remarkable occupational stress due to their job which expresses an unhealthy stage in providing maximum quality radiographic images and medical imaging services to the patients. The extent to which gender group was exposed to high levels of stress was measured in this study. 75% of males and 80% of females were under moderate stress level and the statistical analysis showed that there was no associa- Figure 1. Total points of each radiographer 207

4 tion between gender and stress level. A study done in Croatia by Decker, & Borgen, 1993, also showed that gender did not have a significant relationship with stress, strain, coping resources, or turnover intentions. The extent to which civil status was exposed to high levels of stress was also measured in this study. Out of 30 radiographers 84% were married and 16% were not married. Except one in each group rest of the radiographers were experiencing moderate and high level of stress. There was no significant association between marital status and stress level. The extent to which age group was exposed to high levels of stress was also measured in this study and the statistical analysis showed that there was no association between age groups and stress levels. But a study done at Virginia by Sharpley et al, in 1996 showed Staff between the ages 31 and 40 suffered the most from job stress. The results of this study may be true or this contradictory appearance may be due to less and improper distribution of the sample size to the each age group. The factors causing stress were identified from the answers to each question in the questionnaire, given by the radiographers. Regarding work load, 92% of radiographers reported that they have to do a lot of work in their job. Because of excessive work load 85% of radiographers felt that they are poorly paid for the job, 58% said that they are unable to carry out their assignments with satisfaction due to excessive work load and lack of time and 63% said that being too busy with official work they are unable to develop sufficient time to their domestic and personal problems. The results showed that the radiographers suffer a lot from unsatisfied administrative regulations in their job. Because 73% said that they faced difficulty when new procedures and policies are suddenly implemented in place of those already in practice, 57% said that they were not provided with clear instructions and sufficient facilities regarding new assignments, 75% said they were working under tensed circumstances, 87% said that their co-operations was poorly considered in solving administrative problems at higher levels, 88% said that they were unable to perform their duties owing to uncertainty and ambiguity of the scope of jurisdiction and 70% said that their opinions were not sought in making policies of the department. not satisfactory from the point of view of their welfare and convenience. At the same time 87% reported that they do not get ample opportunity to develop their aptitude and proficiency. Available information relating to job-role, political or other certain group pressures, monotonous nature of work, working at night, social status due to the job, bearing responsibility for the progress of the department, co-operation of colleagues in solving administrative problems and disturbed and complicated life due to the job were the factors which did not show any significant association to the stress level. An important fact found from the results was that only 27% of radiographers reported that they have fear about ionizing radiation. Rest strongly said that they have no fear about radiation though ionizing radiation causes biological effects on human body. This reflects that proper radiation protection measures are being implemented in the hospitals under study. In brief; High workload, less salary, role conflict, resource inadequacy, administrative pressures and dealing with colleagues and subordinates were the common external factors and skills, attitudes, personality and knowledge were the common personal factors that contributed to the stress of the radiographers. Conclusion About 77% of radiographers in Kandy district were experiencing moderate level of stress. 17% of radiographers were in high level of stress and 6% were under low level of stress. Gender, marital status and age of the radiographers in this study did not show any significant association to the stress level. Common factors that influenced the stress were high workload, inadequate payment, role conflict, resource inadequacy and administrative pressures. 72% of radiographers in teaching hospitals and all the radiographers (100%) in other hospitals were experiencing moderate stress level. Counseling programs, installing new equipment with advancing technologies and training programs to improve the skills were some of the suggestions made to minimize the stress. When consider the resources and facilities 83% said that stress increases due to insufficient number of employees and resources and 71% felt that working conditions were Table 1. Distribution of stress level N Stress Level Low Moderate High Maximum Point Minimum Point Mean

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