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RESEARCH PROPOSAL

The pervasiveness of job stress & its relationship with the Work Performance
(A Comparative cross sectional study of Doctors in Rehman Medical Institute & North West frontier Hospital, Hayatabad Peshawar)

Submitted By

Basit Ahmad M S (Management Sciences) Supervisor Dr. Qadar Bakhsh Baloch

Department of Management Sciences Qurtuba University of Science & Information Technology (Peshawar Campus

The Prevalence of Job Stress & its Relationship with the Work Performance
(A Comparative cross sectional study of Doctors in Rehman Medical Institute & North West frontier Hospital, Hayatabad Peshawar)

Basit Ahmad

Research Background With the rapid change in the competitive environment in the corporate world, work place environment are becoming tensed and demanding, expecting more from their employees in term of quality of work, quantity of out put to increase organizational productivity. Therefore, it is upon every organization to attain and maintain competitive edge by modifying employees expectations visa vise organizational productivity level within the competitive market (Elizabeth Kendall et al., 2003). However, the end pressure is felt upon individuals at all levels of organization. Thats the reason that performance targets are becoming tougher to meet with each succeeding year and the management staff is experiencing difficulty in fulfilling the challenge (W.F. Swee et al., 2007). The impact of stress is costly there in terms of its personal, financial and organizational cost and the causes of high stress are the monotonous and uninteresting jobs being performed by the employees in the selected organizations (Madhu Rathore et al., 2009). It has further been found that the job stress exert negative impacts upon the employees physical and mental well being and the job satisfaction level. The job satisfaction is directly related the productive work performance.

The development of job stress amongst employees mostly leads to job satisfaction related problems and in turn results in to deteriorating work performance. And the degradation in employees work performance pulls down the level of organizational productivity. Michael Porter in his most commonly cited Five Forces Industrial Analyses Model calls this stage of industrial rivalry critical for the productivity based

survival of the business firms. The tensed industrial rivalry puts down heavy stress on the employees, eroding performance at work and thus lowering down the productivity of the health unit. Further more, the employees in combination with job stress and mental health problems also develop certain other general health related problems in shape of high blood pressure, cancer, diabetics, stomach ache, anxiety, depression, ulcers, and somatic problems etc. The effects of such like related problems are alarming because the health units which have sicker employees will face more absenteeism, higher health costs and resultant lower productivity. Therefore it is essential to trace the occurrence of job stress & its relationship with the job satisfaction among the doctors which are working in different managerial and specialists/ physicians cadre especially those who are the in charge of their respective departments. Once the occurrence of job stress and its relationship with job satisfaction and productive performance will be searched out, various possible solutions can be made for controlling the occurrence of job stress and resultant job satisfaction and performance related problems among the doctors of health units of private sector of Pakistan in general and Hayatabad, Peshawar in particular. .

Research Problem Rehman Medical Institute and North West Hospitals are part of one strategic group positioned as leader and challenger in the competitive business environment. The stress ultimately leads to development of job satisfaction related problems among the doctors working there. The competitiveness is shaping work place environment accordingly. Besides, other fork force doctors of these hospitals are also being affected from the stress being generated out of this intense competition and other work related environment. The most common negative work demands exists in shape of work over load, odd working timings, poor working environment (not ergonomically standardized), over crowdedness, role conflict, and restrictive organizational cultures, etc. The intensity of stress is causing strain on their level of job satisfaction and degree of work performance.

Therefore, there is a need to conduct a research study to diagnose the causes of prevalence stress amongst doctors so as to recommend measures to overcome these causes in order to improve the declining level of work performance.

Research Objectives The present study will investigate the pervasiveness of job stress & its relationship with job satisfaction of the management and the doctors working in the two private sector hospitals namely; Rehman Medical Institute and North West Hospital Hayatabad, Peshawar. The study would diagnose the relationship of job stress & job satisfaction and work performance related problems by keeping in mind the individual personal characteristics like (age, gender, martial status, number of children, income level, and education level), Job characteristics like (nature of work, type of department, job position, working hours, and length of service), and the organizational working environments like conflict at work, work over load, intense hear/noise, poor light/air, exposure to dangerous substances,

employment opportunities, and social support from boss/colleagues for an indepth understanding. After measuring level of job stress and finding its related association with the job satisfaction and work performance of each health unit, the results will be compared to find out state of job stress at each hospital. To recommend measure to control the increasing stressors with a view to recommend dimensions of stress free work place and work performance.

Research Hypotheses H-1: There is a relationship between management role and job stress.

H- 2: There is a relationship between relationship with others and job stress H-3: H- 4: There is a relationship between home-work interface and job stress. There is a relationship between workload pressure and job stress.

H- 5: There is a relationship between job role ambiguity and job stress. H- 6: There is a relationship between performance pressure and job stress.

H- 7: There is a negative relationship between job stress and job satisfaction. H-8: Stress and performance have a positive, linear relationship: At low levels of stress, individuals do not face any challenge and thus are unlikely to improve performance. At moderate levels of stress, individuals experience some amount of challenge and average performance is likely to occur. In contrast, high levels of stress result in both optimal challenge and performance. H-9: Stress and performance have a negative, linear relationship. Stress is viewed as dysfunctional to both individuals and organizations. Individuals faced with stress spend time coping or engaging in undesirable activities such as sabotage or wasting time. H-10: Job Stress has a direct (U-shaped) relationship with performance: Employees with low level of stress are not aroused for high performance out put, whereas, employees with high level of stress use their energy in coping with stresses rather than directing efforts towards enhancement of performance. Thus, performance is high when a moderate amount of stress is present. Under conditions of moderate stress, individuals are not only activated to perform, but devote substantial energy towards performance enhancement rather than coping with stresses. H-11: Stress does not result from a single element of the work environment, but is instead the joint effects of work demands and the range of decision-making opportunities that are available to an individual.

Research Significance
The present study will be significant because it will lead to an in-depth understanding of the different dimensions of job related stress and its association with the job satisfaction and work performance of the doctors working in the two private sector health units located phase-5, Hayatabad Peshawar. This study will integrate a broader set of antecedent variables of job stress such as individual, job related plus organizational variables and will then trace the relationship of job stress with the mental health of the hospitals management and the doctors working there. It can consequently help the managers as well as health care professionals to better understand work related health problems and related job dissatisfaction and help them better deal with such like problems.

Research Methodology The present study is about diagnosing the pervasiveness of job stress and its relationship with the job satisfaction and work performance of the employees at work place. The research population is spread over the management and the doctors of two private sector health units namely; RMI and the North West Hospital located at phase-5 Hayatabad, Peshawar. The research has two stage investigations; firstly finding of the pervasiveness of the job stress amongst the doctors/ management of the hospitals subject of research and then finding the association of job stress with the level of job satisfaction and work performance of these doctors and managers. The research will be combination of descriptive, exploratory and the causal nature of research. Firstly a descriptive research will be tracing the pervasiveness of job stress among the employees in order to lay down the theoretical foundations for the subsequent research investigation. The descriptive research will help ascertain and be able to describe the characteristics of the variables of interest in a situation (Donald R Cooper et al., 2003). The exploratory phase of this research would diagnose the existence and level of stress pervasiveness amongst the doctor & managers in the selected hospitals or otherwise. The results would be then co-related to establish the relationship between the pervasiveness of the job stress with the job satisfaction and the work performance. The co-relational approach will be applied here because the main concern of this study is not to detect the causes of job satisfaction related problems among the managers but to predict the relationship between Job stress and job satisfaction and the work performance related problems. Further more one of the objective of descriptive studies is to find relationship between set of variables. Other salient of the research methodology would be as follow: Population: Doctors and the managers of the two selected hospitals (private sectors) namely; RMI and the North West hospital, phase 5, Hayatabad, Peshawar. Nature of Data: The research would be making use of both types of data

i.e. primary as well as secondary sources of information Research Instrument: The primary sources would be explored for information through administering them a set of questionnaire and holding structured interview with the selected focus group out of the population under study. These research instrument would be aimed in exploring the variables; Individual personal characteristics like (age, gender, martial status, number of children, income level, and education level) Job characteristics like (nature of work, type of department, job position, working hours, and length of service), and the organizational working environments like conflict at work, work over load, intense hear/noise, poor light/air, exposure to dangerous substances, employment opportunities, and Social support from boss/colleagues for an in-depth

understanding. Research analyses: The data once collected, collated, edited, tabulated, would

be subject to four tiers of analyses as follow: Measuring significance level of the stress, stressors, level of job satisfaction and the satisfiers with the help of Chai-Square test Finding out associated relationship between the stress and the job satisfaction and the work performance with the help of corelational tests Conducting comparative analyses between the level of job stress, job satisfaction and work performance amongst the doctors & managers of the two hospitals. The statistical tools as pointed out above would be employed by using SPSS.

Conceptual Framework

Review of the Literature & Theoretical Frame work

Definition of Job Stress: Stress can be defined as the reaction of individuals to demands or
stressors imposed upon them. It refers to situations where the well-being of individuals is detrimentally affected by their failure to cope with the demands of their environment (Erkutlu et al., 2006). Richard Lazarus and Susan Folkman suggested in 1984 that stress can be thought of as resulting from an imbalance between demands and resources or as occurring when pressure exceeds one's perceived ability to cope.

Causes of Job stress The National Institute for Occupational Safety and Health (NIOSH) job stress model suggests that job stress is a mixture of stressful job conditions mixed in with individual and situational factors. The primary factor that influences workplace stress is stressful job conditions which include; the design of tasks, management styles, interpersonal relationships, work roles, career concerns and environmental concerns. Individual factors includes; the ability to adopt a positive mental attitude, optimism and a positive outlook in the face of stress. Whereas, Situational factors include; a supportive home and/or work environment, or having adequate work life balance.

Healthy Work place:

Job Stress Models

Cooper, C. L., Marshalls Job Stress Model : Main components of the work-stress process are potential sources of stress (stressors), factors of individual differences (moderators/mediators),

and consequences of stress (strain) (Lu et al., 2003).

Stressors (job-related and extra-

organizational) are objective events, stress is the subjective experience of the event, and strain is the poor response to stress. Accordingly, the nature and effects of stress might be best understood by saying that some environmental variables (stressors), when interpreted by the individual (cognitive interpretation), may lead to stress (Dua, 1994).

Fred Luthans Model of job stress:

According to Fred Luthans the antecedents of job stress

effecting todays organizations are both from inside as well as outside of organization. Extra organizational stressors: Taking the open system perspective of an organization it is clear that job stress is not limited to things that are present inside organization. In fact the recent research study found that the stressors outside the work place were related to negative affect & feelings on the job. The extra organizational stressors include things like societal/technical change, globalization, the family situations, economic and financial conditions, race, class, and community conditions. Organizational stressors: Beside the potential stressors that occur outside the organization,

there are also some stressors which are present within the organization itself. The organizational stressors have been divided in to administrative policies and strategies, organizational structure and design, organizational processes and working conditions. Individual stressors: The stressors so far as been discussed (extra organizational,

organizational and group) all eventually goes to the individual level. There is agreement on possible situational dimensions and individual dispositions that may affect stress outcomes. For example, individual disposition such has type (A) personality pattern, personal control; learned helplessness and psychological hardness may all affect the level of stress someone experiences Group stressors: The group stressors can be categorized in to two areas:

Lack of group cohesiveness: the group cohesiveness is very important to employees, especially at lower levels of organizations. If the employee is deprived from this cohesiveness then this condition can be very stressful.

Lack of social support: employees are greatly affected by the support f one or more members of a cohesive group. There is a research that proves that lack of social support is so harmful that it accounts for some health care costs.

Consequences of Job stress Stress produces a range of undesirable, expensive, and debilitating consequences (Ross, 2005), which affect both individuals and organizations. In organizational setting, stress is nowadays becoming a major contributor to health and performance problems of individuals, and unwanted occurrences and costs for organizations (Nina Poloski Vokic, et al., 2007). Consequences of occupational stress can be grouped into those on individual and those on organizational level. On the individual level, there are three main subgroups of strains. Unwanted feelings and behaviors Physiological diseases (Poor Physical Health) Psychological diseases (Poor Emotional (Mental) Health) Organizational symptoms - such as discontent and poor morale among the workforce, Performance/productivity losses, low quality products and services, poorer relationships with clients, suppliers, partners and regulatory authorities, losing customers. Organizational costs - such as costs of reduced performance/productivity (lack of added value to product and/or service), high replacement costs in connection with labor turnover (increase in recruitment, training and retraining costs).

Out Line Organization:

follow:

The research report would be arranged in to six chapters as

Chapter one would introduce the research report/ theses Chapter two would present review of the related literature Chapter three would explain the research methodology followed during the course of research. Chapter four would contain data collected through primary as well as secondary sources of information Chapter five would present analyses of the research, lay down the research findings and comparative results Chapter six would offer recommendation matching to the research findings. Annexure & appendices would contain any additional documents like; set of questionnaire, sample frame list or the Human resource inventory of the hospitals.

References

Chalmers, B. E. (1981). A selective review of stress: Some cognitive approaches taken a step further. Current Psychological Reviews. Cooper, C.L., & Marshall, J. (1976). Occupational sources of stress : A review of literature relating to coronary heart disease and mental health. Journal of Occupational Psychology, 49. French, J.R.P., Jr., & Caplan, R.D. (1972). Organizational stress and individual strain. In A.J. Marrow (Ed.). The failure of success. New York : Kahn, R.L., Wolfe, D.M., Quinn, R.P., Snoek, J.D., & Rosenthal, R.A. (1964). Organizational stress : Studies in role conflict and ambiguity. New York Lazarus, R.S., & Folkman, S. (1984). Stress, Appraisal and Coping. New York: Springer McGrath, J.E. (1970). Social and psychological factors in stress. New York : Holt, Rinehart & Winston. Schnall PL, Landsbergis PA. Job Strain and Cardiovascular Disease. Ann. Rev. Public Health 1994, 15:381-411.

Vinokur, A., & Selzer, M.L. (1975) Desirable versus undesirable life events : Their relationship to stress and mental distress. Journal of Personality and Social Psychology, 32. Yerkes, R.M. & Dodson, J.D. (1908). The relation of strength of stimulus to rapidity of habitformation. Journal of Comparative Neurology and Psychology, 18.