work “STRESS” AND HEALTH Factors to Consider Dr David Hartshorn Occupational Medicine Specialist
Outline Terminology. Positive elements of work. Negative elements of work. Relationship between work and psychology. Signs of strain or distress. Protective factors- resilience. Return to Work Consideration.
Occupational Medicine A medical specialty concerned with the interaction between health and work. How work affects health. How health affects work.
Terminology “stress”- means different things to different people. Stressor- the thing that is creating load. Strain- the state of being under load. Distress- being under load and unhappy about it. Illness- defined criteria.
Positive Elements of Work Stimulating-challenging. Meaningful. Prospects for advancement. Team work/social interaction. Recognition.
Potential Negative Elements High work load. Qualitative overload- skills mismatch. Deadline pressures. Long/irregular work hours. Work-life balance/conflict. Role or task uncertainty or ambiguity. Interpersonal conflict. Inherently unpleasant work. Low job control.
Models of Work and Psychology Demand-control-support model. Effort- reward model. Person-environment fit model- ability vs demand and aspiration vs supply.
How Does “Strain” or Distress Manifest? Physical effects Psychological effects. Cognitive effects.
Physical Effects Due to continued activation of “fight or flight”. Headache. Muscle tightness or pain. Fatigue. Gut upset. Appetite changes. Palpitations. Shortness of breath.
Psychological Effects Irritability Emotionally labile. Fatigue. Poor sleep. Anxiety/worry. Feeling overwhelmed. Low mood. Low motivation/energy.
Cognitive Effects Attention. Concentration. Forgetfulness. Decision making. Work quality- performance issues. Can create self reinforcing cycle.
Defined Illnesses Distress vs Mental illness. Is largely defined by the impact on social or occupational functioning. Criteria based diagnosis.
Protective Factors Demand-control-support model. Job control-decision latitude. Social supports- home and work. Coping style- problem focussed- resilience assets -(relationships /EQ /competence /optimism/coping skills). Open communication- team/manager. Leadership- walk the walk. .
Vulnerabilities Additional stressors away from work. Mal-adaptive coping styles- palliative, avoidant, emotional. Minimal social supports. High levels of “need for control” results in high intrinsic work demands.
Coping Styles Palliative. Emotional. Avoidant. Social. Problem focussed.
Return To Work Approach Treat the illness if present. Understand the contributing factors. Address those factors if possible- can anything change? Consider work and non work stressors. Consider the coping styles/resilience factors. Assess the level of function-work fitness.
Questions?