Effect of a Brief Stress Management Education Workshop on the Stress Knowledge of White-collar and Blue-collar Employees: A Pilot Study

A sample of 70 white-collar and blue-collar employees participated in a one hour stress management training workshops about the definition and causes of stress, work-related stress, strategies for managing stress, and creation of a personal stress management action plan. The stress management workshop knowledge test was administered pre- and post-intervention to analyze the causes and signals of stress, ways to manage stressful situations, and strategies for managing stress.

Results indicated that there was a significant increase in post-test mean knowledge scores as a result of the intervention. It seems that a brief workplace stress management education workshop could improve stress prevention knowledge in both blue- and white-collar employees.

Introduction

Stress and stressors

“There is no definition of stress that everyone agrees on, what is stressful for one person may be pleasurable or have little effect on others, and we all react to stress differently” (American Institute of Stress, n.d.). Stress, the physical, mental, or behavioral reaction to a situation or event, is considered a normal part of life; however, there is a threshold in which too much stress can have negative impact on a person’s health. A person’s productivity is a bell-shaped curve. The normal, good stress that motivates a person to accomplish daily tasks is called eustress, which increases productivity until the apex of the curve. At the apex, eustress becomes distress, and productivity decreases. The apex of the curve is called the comfort zone (Albrecht, 1986).

When the body perceives a stressor, there is a physical and neurological response. Stress acts on the hypothalamic-pituitary-adrenal or HPA axis. The HPA system stimulates the release of hormones in response to stress. The General Adaptation Syndrome (GAS), developed by Han Selye, describes the response pattern that is universal to both positive and negative stressors (Selye, 1950). The first stage is the alarm reaction in which the hypothalamus releases hormones to stimulate the pituitary gland and adrenal glands. These glands invoke the fight-or-flight response that prepares the body to fight the stressor or flee the situation. The second phase is the stage of resistance; if the stress continues, the body will develop a new level of homeostasis where the body is less resistant to disease and injury than normal. The final phase is the stage of exhaustion. If stress continues too long, extreme exhaustion, which distorts perceptions and rational thinking, can result. If a person persists at the stage of exhaustion, they can be described as chronically stressed. Once triggered, these hormones can turn off the hormones regulating growth, reproduction, metabolism, and immunity (Bock & Weeks, 2002).

Many individuals experience episodes of this chronic, long-term psychological stress throughout their lives. The results of chronic stress can manifest itself in the form of a physiological condition, making stress a serious health concern. Although everyone may be at risk, people possess a variety of responses to stress. Different traits and characteristics such as genetic predisposition, personality traits, social networks, duration of stressors, job, education level, and even marital status can play protective roles or increase risk factors (Stress, 2001).

In moderation, stress can be beneficial. In the short term, the physiological affects mentioned above can make an individual more alert and direct blood flow and nutrients to the areas that need it most. Conversely, without adequate and healthy management of stress or if external stressors remain chronic, stress is known to have many adverse health effects. The most well-known and prominent consequence is heart disease, but sleep disorders, stroke, immune-deficiency disorders, cancer, gastrointestinal problems, diabetes, skin conditions, and conditions affecting the teeth and gums can all be negatively affected by stress (Stress, 2001).

The American Institute of Stress stated that, “Job stress is far and away the leading source of stress for adults” (American Institute of Stress, n.d.). Two professions that have increased exposure to stressors are educators and physical laborers. Working with at-risk youth, in either alternative education or juvenile detention setting, places additional burdens on teaching staff. If exposure to a stressful environment continues too long, a teacher may become burned-out. From the psychological perspective, burnout is an individual’s inability to handle stressors (Maslach, Schaufeli, & Leiter, 2001). Teachers experience many episodes of student disrespect, verbal abuse, and nonfatal crimes (National Center for Education Statistics, 2004; National Center for Education Statistics, 2004b). Even teachers, who were not victims of violence but who only worried about attacks, may have trouble teaching and leave the profession (Elliott, Hamburg, & Williams, 1998).

Physical laborers have less emotional stress but more physical stress placed on the body. Daily stressors for these employees include more physical demands such as lifting 50+ pounds and exposure to weather. Additional stressors include unexpected events, anxiety about work, and anger about situations that are beyond their control (Griffin-Blake, Alarcon-Yohe, Grady, & Liburd, n.d.). Physical plant employees in the university setting are generally responsible for maintaining the aesthetic appeal of a campus as well as housekeeping, moving equipment, controlling key access, maintaining the recycling program, and controlling the boiler system (Truman State University, n.d.). Specifically, for blue-collar workers, such as university physical plant workers, key stressors also include worker alienation and control or authority matters (Griffin-Blake et al., n.d.).

For these employees and for all employees, especially those with high job expectations and dangerous physical conditions, problems dealing with stress at work are most associated with health complaints (Albrecht, 1986). Because over 25 percent of workers view their job as their primary life stressor (Centers for Disease Control and Prevention, n.d.), the National Institute for Occupational Safety and Health (NIOSH) Model of Job Stress recommends stress management training to help employees deal with these workplace stressors. Over half of large companies now provide this type of training to their employees to rapidly reduce stress symptoms (Centers for Disease Control and Prevention, n.d.).

The purpose of this study was to examine whether a brief workplace stress management education workshop improved the knowledge of stress prevention in university physical plant employees as well as in employees working with at-risk youth in a juvenile detention facility. Both groups of employees had never had access to this type of workplace training intervention.

Methods

Sample

A sample of employees who worked as teaching staff in a juvenile justice facility and as laborers at a college physical plant were contacted and asked to participate in the stress management workshop because of their high exposure to stressors. After IRB approval of the study and consent of each of the participants, 37 employees (21 white-collar office/teaching staff of a juvenile justice facility and 16 blue-collar workers from a college physical plant) volunteered to participate in the study. All participants, both white- and blue-collar workers, were white and middle-aged from rural northeast Missouri. The white-collar employees worked in the offices of a facility that housed an assessment unit and a detention unit for juvenile offenders aged 12 to 17. The juveniles who reside at the facility had been ordered into protective custody for short-term residency until permanent accommodations could be made for them. The blue-collar employees were responsible for general upkeep of the grounds, building maintenance and repair, boiler plant operation, and cleaning at a college campus.

Procedure

During spring 2008, instructors for the workshops were trained in the American Red Cross Workplace Training: Managing Stress Module (American National Red Cross, 2000) to prepare them to teach workshops to the employee participants. During fall 2008, the instructors scheduled and taught two workshops to accommodate the work shifts of the juvenile facility staff and the physical plant employee participants.

The hour-long workshops for the participants covered the following topics: stress management training survey pre-test, definition of stress, causes of stress, work-related stress, general strategies for managing stress, and stress management training survey post-test. General strategies for stress management were presented using active-learning teaching strategies and included “Examine-Prepare-Take Action” steps as well as exercise and overall health improvement tips. Participants were then asked to create individualized stress management action plans which included three steps that pin-point stressors and reveal ways to make changes in life habits to reduce those stressors to deal with their top life stressors.

Instrument

Prior to and immediately following each of the workshops, the participants completed the American Red Cross Managing Stress Self-Assessment quiz. The quiz consisted of 10 true-false questions about causes and signals of stress, ways to manage stressful situations, and strategies for managing stress (Appendix 1). This instrument was utilized because it was created by the American Red Cross specifically to assess knowledge of the material covered and was designed to be the concluding activity of the workshop. The diminished reliability (Cronbach’s Alpha =.315) may have been influenced by the limited sample size. Participants were asked to create their own three-part stress management action plan. The format of the plan focused on identifying the problem, preparing to implement a change to reduce the stressor, and finally taking action and evaluating the chosen action. This allowed the participants to individualize the workshop for their specific needs.

Analysis

A repeated measures design, with the workshop as the intervention, was used in this study. A paired-samples t test was then used to compare mean pre-test stress management workshop knowledge scores to mean post-test stress management workshop knowledge scores of all of the participants. An independent-samples t test was then used to evaluate whether the mean knowledge test scores for the white-collar participants differed significantly from the blue-collar participants’ test scores. In addition, a completed three-part stress management action plan for each participant was reviewed for usability and practically.

Results

For all participants, the mean stress management workshop knowledge post-test score increased from 8.86 of a possible 10 points to 9.70 of a possible 10 points on the post-test; an increase of .84 points. Results indicated that the mean pre-test score (M=8.86, SD=2.30) was significantly different than the mean post-test score (M=9.70, SD=.618), t(36)=-2.31, p<.05. In addition, all (37/37, 100%) of the participants created their individualized, three-part stress management action plans. The stress management action plans were examined for universal themes. Common themes within most participants’ action plans included: removal from the stressful situation, better planning to avoid or diminish the effects of the stressor, and improved communication among supervisors and subordinates.

An independent-samples t test was then conducted to evaluate whether mean stress management workshop knowledge scores for those in the white-collar group differed significantly from those in the blue-collar group. The mean pre-test score (M=9.00, SD=2.19) of the white-collar participants was not significantly different than the mean pre-test score (M=8.63, SD=2.50) of the blue-collar participants; and the mean post-test score of the white-collar participants (M=9.71, SD=.463) was not significantly different than the mean post-test score of the blue-collar participants (M=9.69, SD=.793). In addition, there was no significant difference for the percent of change for any of the individual questions.

Discussion

Although different job classifications may have higher instances of job stress, in this study there seemed to be no significant difference between the knowledge levels of the blue-collar and the white-collar participants either before the workshops or after the workshops. This may have occurred because the employees volunteered to attend the workshops and participate in the study. Volunteer samples may be biased because volunteers tend to be better educated and have higher social class status than non-volunteers (Gall, Gall, & Borg, 2007). In this study, when white-collar participants were compared to blue-collar participants, they recorded similar results on the pre-post tests. Possibly, the blue-collar participants who volunteered for the study may have been higher-level, blue-collar workers with more education and higher social class than those who did not volunteer, making them more similar in background to the white-collar employees.

It seems, however; that all employees, both in high- and low-level positions, experience stressful events at the workplace (American National Red Cross, 2000). White-collar workers are more likely to experience work-related stress, rather than injury due to physical stress, while the opposite is true for blue-collar workers (Webster & Bergman, 1999). White-collar professions are more at risk for emotional and situational stressors, while blue-collar professions frequently experience physical stressors. Even though blue- and white-collar jobs have different stressors and stress levels, the awareness of stressors is comparable between the two groups. Despite the different stressors, the skills needed to manage and cope with stress are also comparable between the two groups. Both groups were able to successfully complete their stress management plans to help reduce the effect of stressors in the future.

Limitations

Both groups of participants also scored relatively high on the pre-test (white-collar 9.00/10 and blue-collar 8.63/10). They may have already been informally educated about stress and stress management from the media or others they associate with at home or at work. The American Red Cross Managing Stress Self-Assessment quiz, too, may have had an inadequate ceiling for top scores; allowing only a small gain on the post-test (Gall, Gall, & Borg, 2007). The short length of the quiz, too, and the use of just true-false questions may have lead to low test reliability. Increasing the instrument’s reliability by adding more questions and using multiple-response or constructed response items is recommended if the instrument is to be used in future stress management educational workshops. In addition, the small sample size as well as the selection of the sample from an office and a physical plant setting may decrease the ability to generalize results.

Implications for health education practice

Chronic job stress may have adverse affects, such as reduced growth hormone levels, decreased immunity, and slowed metabolic rates. Furthermore, chronic stress, which affects an employee’s ability to function at the workplace, has been related to decreases in job productivity and increases in healthcare costs (American National Red Cross, 2000). Because stress management training at the workplace is encouraged and many large companies provide this service to their employees, it is interesting to note that no prior workshops were ever conducted with these employee groups. The staff or their supervisors may not have been aware that they or their employees experienced job-related stress that should be monitored and managed. Based on the results of this pilot study, it is recommended that brief stress management educational workshops be provided to all employees in both facilities, both blue- and white-collar workers, in order to encourage employees to take an active role in managing their own stress.

The stress management training workshop was a pilot study, which will be further expanded in subsequent studies. Restructuring the testing instrument, the American Red Cross Managing Stress Self-Assessment quiz, into a multiple-choice form instead of true/false could provide more reliable results. In addition to the instrument change, the expansion of the stress management training to more employees in a variety of backgrounds should be implemented.

Many employees view their work and their workplace as key stressors in their lives. If a worker does not cope with and reduce the stimulus for the stressor, they may become chronically stressed. Different characteristics, including job and education levels, put employees at higher risk for stress-related health concerns (Stress, 2001). It seems that a brief workplace stress management education workshop, which focuses on general strategies for stress management as well as creation of stress management action plans, could improve the knowledge of stress prevention in employees.

Acknowledgement: The training portion of this project was funded through a Project Grant from the National Office of Eta Sigma Gamma.

References

Albrecht, K. (1986). Stress and the Manager: Making it Work for You. New York: Simon and Schuster

American Institute of Stress (n.d.). Retrieved December 12, 2008 from: http://www.stress.org.

American Red Cross. (n.d.). The American Red Cross Online. Retrieved December 10, 2008, from: http://www.redcross.org

Bock, R., & Weeks, M. (2002). NIH backgrounder: Stress system malfunction could lead to serious, life threatening disease. Retrieved November 15, 2008, from National Institutes of Health Web site: http://www.nih.gov/news/pr/sep2002/nichd-09.htm

Centers for Disease Control and Prevention. (n.d.). Stress at work. Retrieved December 10, 2008, from: http://www.cdc.gov/niosh/stresswk.html#b

Elliott, D.S., Hamburg, B.A., & Williams, K.R. (1998). Violence in American Schools: An Overview. In D.S. Elliott, B.A. Hamburg, & K.R. Williams (Eds.), Violence in American Schools (pp. 3–28). New York: Cambridge University Press.

Gall, M., Gall, J., & Borg, W. (2003). Educational research: An introduction. Upper Saddle River, NJ: Allyn and Bacon.

Griffin-Blake, S., Alarcon-Yohe, M., Grady, M., & Liburd, L. (n.d.) Impact of Job Stress on Female Blue-Collar Workers. Center for Disease Control and Prevention. Retrieved on December 16, 2008, from http://www.dhpe.org/ImpactOfJobStressOnFemalBlueCollarWorkers.pdf

Maslach, C., Schaufeli, W., & Leiter, M. (2001). Job Burnout. Annual Review of Psychology. 52, 397-422

National Center for Education Statistics. (2004). Indicators of School Crime and Safety: 2004 Discipline Problems Reported by Public Schools. Retrieved on November 13, 2008, from http://nces.ed.gov/pubs2005/crime_safe04/indicator_09.asp

National Center for Education Statistics. (2004b). Indicators of School Crime and Safety: 2004 Discipline Problems Reported by Public Schools. Retrieved on November 13, 2008, from http://nces.ed.gov/pubs2005/crime_safe04/indicator_16.asp

Selye, H. (1950). Stress and the General Adaptations Syndrome. British Medical Journal. Retrieved on December 16, 2008, from http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2038162&blobtype=pdf

Stress. (2001, September), Retrieved October 13, 2007 from Health Source - Consumer Edition database.

Truman State University. (n.d.) Physical Plant: Services. Retrieved on December 15, 2008, from http://physicalplant.truman.edu/services.asp

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Appendix 1: American Red Cross Managing Stress Self-Assessment

T F 1. Too much stress can lead to disease and conditions such as high blood pressure, headaches, fatigue, and anxiety

Effect of a Brief Stress Management Education Workshop on the Stress Knowledge
of White-collar and Blue-collar Employees: A Pilot Study

Jenna Osseck
Joan Scacciaferro
Deirdra Frausto
Carol Cox*

Truman State University

Abstract

Introduction

Stress and stressors

Methods

Sample

Procedure

Instrument

Analysis

Results

Discussion

Limitations

Implications for health education practice

References

Appendix 1: American Red Cross Managing Stress Self-Assessment

Effect of a Brief Stress Management Education Workshop on the Stress Knowledge of White-collar and Blue-collar Employees: A Pilot Study

Jenna Osseck Joan Scacciaferro Deirdra Frausto Carol Cox*

Truman State University

Abstract

Introduction

Stress and stressors

Methods

Sample

Procedure

Instrument

Analysis

Results

Discussion

Limitations

Implications for health education practice

References

Appendix 1: American Red Cross Managing Stress Self-Assessment

Effect of a Brief Stress Management Education Workshop on the Stress Knowledge
of White-collar and Blue-collar Employees: A Pilot Study

Jenna Osseck
Joan Scacciaferro
Deirdra Frausto
Carol Cox*