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Reflecting on a fabulous May 2021 and #IDM2021

As we come to the end of May 2021, I wanted to reflect on a few of the things which have come to fruition.

Of course early on we celebrated International Day of the Midwife 2021. Invest in midwives…The best is yet to come! #IDM2021

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#IDM2021

On this #IDM2021 (May the 5th) I was thrilled to be able to announce some awesome things we have been working on for some time now. First, I was able to share our @IolantheMidwife ‘Midwives Award’ won on #InternationalDayoftheMidwife for our work on Substance use in Midwifery populations. You can still participate in this research until September 2021 – Details below. Please share this link with midwifery teams: https://bit.ly/UKMidwivesPSU

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I was also able to share my appointment as #NursingNowChallenge midwifery champion!

Read more here: https://bit.ly/3h0t8X6

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I hope that this will be enable us to raise the profile of midwives around the world.

Furthermore, on the 6th May 2021 I had the privilege of being the invited speaker at the 102nd Irish Nurses & Midwives Organisation@INMO_IRL (@INMO_IRL) Annual Delegates Conference. #INMOADC. I shared our work ‘Exploring Problematic Substance Use in Nursing and Midwifery Populations’ – A warm audience as ever!

Thank you for having me.

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#INMOADC

Then on the 18th of May 2021 I tuned in to watch the policy dialogue presenting the findings from #SoWMy2021 to Member States in an effort to encourage sustainable investment in the midwifery workforce. This was a really inspiring event where I was able to make some really valuable connections – thank you.

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Other than May being my birthday month, May 2021 has been absolutely awesome. Moreover, I have been able to settle in in my new role as an RCM Fellow! Read more here

Buckinghamshire midwife awarded national honour

“Excited by what we may achieve together as this fellowship brings forward new opportunities…the best is certainly yet to come” says @SallyPezaro from @covcampus receiving RCM Fellowship #rcmedconf21 #education

Now that some of the restrictions are easing it seems that some publications are able to move forward again in the process of peer review. As such, I will be sharing some new publications with you all soon. I also have lots of bid writing plans for next month alongside teaching. A summer of collaborations ahead.

First, I am grateful for the opportunity to continue and finish journey with @OxfordSBS … because midwifery #LeadershipMatters

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Until next time…Look after yourselves and each other 

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Calling Midwives for Research Exploring their Substance Use One Year After the first UK Lockdown

A year ago, we surveyed over 600 midwives in the United Kingdom (UK) with regard to their substance use among other things. Data collection was halted early in response to the first lockdown of 2020 to avoid a distortion of results. Our findings are currently under peer review for publication.

Now, one year on, we are again looking for as many UK midwives as possible to complete and share this new survey, so that we may investigate what, if anything has changed.

All UK midwives are invited to complete this survey whether or not they participated in our last survey. They are also encouraged to participate whether or not they use substances. Please share the survey link widely.

Survey Link: https://bit.ly/UKMidwivesPSU

Please note: We will not be able to track or identify you in any way. As such, there will be no repercussions arise from anything you disclose. We are only interested in understanding, so please help us by keeping your responses anonymous throughout.

The aim of this new research is:

·         To identify the rate of problematic substance use (PSU) among midwives registered in the UK

·         To explore the leaving intentions of midwives registered in the UK

·         To explore the help seeking behaviours of midwives registered in the UK

·         To identify health risks among midwives registered in the UK

·         To measure work engagement within UK registered midwifery populations

Thank You on wooden blocks

Survey Link: https://bit.ly/UKMidwivesPSU

Access the entire project page here.

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Until next time…Look after yourselves and each other 🎓

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Boats On An Ocean

person in blue denim jeans with gray and black metal padlock

Looking at the lives of healthcare workers through the first wave of the COVID-19 pandemic, this project explores their ‘human’ experiences – in contrast to the public and media portrayal of them as ‘heroes’.

The audio artwork is the representation of the stories, experiences and emotions of eight healthcare workers from Coventry and across the UK, gathered during an online creative workshop. From this, we identified seven themes, including the theme of the ‘hero’ narrative. While some might consider the label of ‘hero’ as praise, many of our healthcare worker participants explained that it sometimes caused feelings of guilt. A shift in focus is needed to recognise the emotional and physical toll for individuals. Adequate support is needed to help healthcare workers find meaning in their experiences.

LINK: https://coventrycreates.co.uk/project/boats-on-an-ocean/

#BoatsOnAnOcean

#BoatsOnAnOcean – Our audio art piece showcased via the #CoventryCreates digital exhibition….#CityofCulture2021

Click here to see and hear this work

Great to work with @KerryWykes, @LouiseMoodyCU, @lizzesparkes, @YourOldChina & Bharti Patel to represent healthcare workers experiences of #COVID19 in this way!

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Until next time…Look after yourselves and each other 

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PhD opportunity exploring healthcare workers’ experiences & ethical dilemmas faced during the COVID-19 Pandemic through arts-based practice

6,000 nurses and midwives were recently asked why they had left the profession. …The main reason given was too much pressure leading to stress and poor mental health. This was before #COVID__19

It is now clear that we need to move beyond the narrative of heroes and remember that NHS workers are human.

Something needs to change… and that is #WhyWeDoResearch

🎓…. have you always dreamed about doing your PhD? We have an exciting PAID studentship opportunity for you!

Start your exciting ​#PhD journey with myself & Professor Louise Moody 🎓

“Exploring healthcare workers’ experiences & ethical dilemmas faced during the COVID-19 Pandemic through arts-based practice”

group of doctors walking on hospital hallway

Coventry University (CU) is inviting applications from suitably-qualified graduates for a fully-funded PhD studentship within the multi-disciplinary ‘Well-being and the Arts’ theme within the Centre for Arts, Memory and Communities.

The British Medical Association and Health Foundation have drawn attention to the impact the COVID19 pandemic is, and will continue to have in a variety of ways on NHS staff. The specific focus of this PhD research will be the difficult, ethical decisions healthcare workers have had to make when managing patients during the pandemic. Some examples of this include who to prioritise for treatment, whether to treat if PPE is unavailable, whether to return to NHS roles for those who have left the profession, and the need to separate patients from loved ones.

The project will explore the challenges and emotional impacts experienced by health care workers in relation to ethical decision making. The successful candidate will respond to these experiences through arts-practise as well as developing evidence-based recommendations for the support needs of staff.

The project is anticipated to involve the following activities:
– A scoping review of the literature
– Qualitative research to explore ethical dilemmas and the associated emotional impact using social media
– Arts-based practice to represent and communicate healthcare worker experiences
– Formation of recommendations regarding the support needs of healthcare workers

Training and Development

The successful candidate will receive comprehensive research training including technical, personal and professional skills.

All researchers at Coventry University (from PhD to Professor) are part of the Doctoral College and Centre for Research Capability and Development, which provides support with high-quality training and career development activities.

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Entry criteria for applicants to PHD

• A minimum of a 2:1 first degree in a relevant discipline/subject area with a minimum 60% mark in the project element or equivalent with a minimum 60% overall module average.
PLUS
the potential to engage in innovative research and to complete the PhD within a 3.5 years
• a minimum of English language proficiency (IELTS overall minimum score of 7.0 with a minimum of 6.5 in each component)

For more information and to apply, CLICK HERE

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Until next time…Look after yourselves and each other 💚💙💜❤

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EXPLORING PROBLEMATIC SUBSTANCE USE AMONG REGISTERED MIDWIVES – SURVEY

Due to #Coronavirus #COVID19 and this additional pressures this has placed on NHS staff, we have now closed this survey (earlier than planned). Thank you to all of those who responded. We hope to publish results as soon as we can.

recruitment poster PSU survey

There is a united level of concern for the health and wellbeing of midwives in the United Kingdom (UK), where recent research has shown that many experience work-related stress and burnout. Such experiences may lead to midwives being at particular risk of substance use/misuse. In fact, in a recent review of fitness to practise (FtP) cases, a number of those put before the Nursing and Midwifery Council (NMC) related to alcohol (n=208) and drug misuse (n=131).

Such episodes of addiction, alcohol and drug use are classed as individual health concerns. Yet, whilst they can leave a variety of healthcare professionals depleted, and both workplace safety and the safety of care compromised, relevant literature has thus far been largely dominated by the experiences and care of physicians. Consequently, researchers from Coventry University are now conducting the first nationwide study of registered midwives in relation to this issue.

Project Team:

The aims of this study are:

  • To investigate substance use among midwives registered in the UK
  • To explore the perceptions of midwives registered in the UK in relation to midwifery impairment
  • To explore perceptions of midwives registered in the UK in relation to organisational support
  • To identify incidents of midwifery impairment
  • To explore the help seeking behaviours of midwives registered in the UK with problematic substance use (PSU)
  • To identify health risks among midwives registered in the UK with PSU

We are very grateful to the Royal College of Midwives for supporting recruitment to this study.

 

For further information, or if you have any queries, please contact me, the lead researcher, Dr Sally Pezaro (sally.pezaro@coventry.ac.uk).

Twitter handle: @SallyPezaro

We are also very grateful to UNISON for sharing this survey with their members

@unisontweets

If you would like to follow the progress of work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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The History of the Midwife

 

The following post is a guest blog by Nicole Allen:

woman carrying newborn baby

We all know the process of childbirth, but it’s no less magical. Advances in science make the procedure very safe for both the baby and the mother in most countries. It’s routine for most hospitals, except in rare cases when the patient experiences complications. But this wasn’t always the case.

There are countless faces of midwives whose knowledge was passed on from generation to generation. Even today, there are would-be mothers in some parts of the world with no access to doctors who rely on midwives to deliver their babies.

“Midwife”, the common term used for a birthing assistant, comes from Middle English and literally means “with a woman”. In France, they call her (or him; there are male midwives) a “sage-femme” or “wise woman.” The profession predates the medical and nursing professions.

The Prehistoric Way of Giving Birth

Our many-time great-grandmothers birthed their babies with the help of midwives dating back at least as far as biblical times and probably before recorded history. The earliest evidence of the existence of midwifery can be traced back to an ancient Egyptian papyrus (1550 BC). This shows that midwives assisted women in child delivery for more than 2,000 years without assistance from trained professionals.

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The American Way of Giving Birth

In the early American colonies, children were birthed with the help of skilled and practised midwives who came from Britain, who in turn transferred these same skills to other women in an informal manner. Later, when West African midwives reached the shores of America to be used as slaves, they assisted in birth too.

After their emancipation, African-American midwives offered their care to poor women,  in the rural parts of the South and were called “granny midwives.”

The American Indian tribes women continued to practice their own cultural birthing tradition, too, which sometimes included a midwife, female friend or relative.

The family experience of home birth narrated by Dervla Murphy in the book Untangling the Maternity Crisis supported the fact that most childbirth during the early 1900s was done at home. She was delivered at home in 1931.

Childbirth then was a regular occurrence at home and did not stimulate anxiety. Midwives were a familiar neighborhood figure who carried a big black bag during the birth of a neighbor.

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The Medical Way of Giving Birth

In the last half of the 1800s, when medicine was professionalized in the US, midwifery became threatened as laws requiring formal education were slowly extended to midwives. Even though there were few midwifery schools, midwives were still needed and could not be totally eradicated since some doctors were unwilling to cater to poor populations. Some midwives continued to practice until the 1920s without government control.

It was in the 1910s and ’20s, the doctors started to lay down the foundation of a pathology-oriented childbirth medical model and usurp the traditional roles of midwives.

First, two studies found that the training most obstetricians received was poor and that hospitalization during birth would improve it. The poor, who most needed midwives, could go to charity hospitals instead. This would give the doctors more practice as well.

Then, in 1914, “twilight sleep”—delivery where the woman is anesthetized with a combination of morphine and scopolamine—was introduced. It was intended to relieve the pain and remove the memory of giving birth. This was widely accepted and desired by upper-class women.

About this time, a Dr. Joseph DeLee described childbirth as a destructive pathological process that damages the mother and the baby, and the only way to minimize this was through medically attended childbirth.

This claim made it impossible for midwives to facilitate child birth and made the use of ether, sedatives, forceps, and episiotomies routine. Child birth went from a physiological process to one in which the course of labor must be tightly controlled.

The value of midwives is being relearned, but there are new concerns.

Help for trauma

In more recent years, an aspect of the midwifery profession that is being looked into is the difficulties the midwives themselves experience during delivery. For instance, if s/he attends a traumatic birth, oftentimes s/he alone is there to handle it.

A 2015  study on the emotional and traumatic work of midwives and the commonly adversarial relationship with obstetricians (aptly titled “Midwives Overboard!”) shows that midwives may end up developing psychological and behavioral symptoms of distress, including compassion fatigue, post-traumatic stress disorder (PTSD), and secondary traumatic stress.

The United Nations Population Fund (UNFPA)’s increasing interest in the role of midwives underscores their importance in delivering children. Midwives play an important role in the achievement of its millennium development goals: reducing child mortality and eradicating maternal death. Midwives are a key element in the delivery of sexual, reproductive, maternal and newborn health (SRMNH) care worldwide, especially in rural areas.

To improve the delivery of patient care as well as the staff experience, maternity services must invest in the mental health and the well-being of all midwives, including nurse-midwives and obstetric nurses.

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Also check out this article: Oh baby: seven things you probably didn’t know about midwives

Author Bio:
Nicole is a freelance writer and educator based in the Michigan and believes that her writing is an extension of her career as a tutor. She covers many topics like travel, mental health and education. She is a key contributor at Chapters Capistrano where she covers topics like addiction recovery, holistic treatments and health education. When she isn’t writing, you might find Nicole running, hiking, and swimming. She has participated in several 10K races and hopes to compete in a marathon one day.

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Midwives experience domestic abuse too…so how can they be supported in the workplace?

On Thursday October 4th 2018, The Royal College of Midwives (RCM) launched a report entitled ‘Safe Places? Workplace Support for those Experiencing Domestic Abuse’ at its Annual Conference in Manchester Central.

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I was privileged to be asked to perform and write up the analysis for this report. The findings truly moved me. If you know my work at all, you will know that it is heavily focused upon securing the psychological wellbeing of midwives. This is because I do not believe that excellence in maternity care can be delivered to mothers and babies without the provision of effective support for midwives.

Findings here revealed that some midwives trained to recognise domestic abuse and support women, were sometimes not recognising that they themselves are victims of domestic abuse.

“I was allowed to stay overnight on my delivery suite to avoid going home to my abusive partner”

“I was made to feel I was a nuisance, constantly asking me and contacting me, pressurizing me in to coming back to work. I gave in and did but I was soon off again as I still wasn’t well, and I then left midwifery because I didn’t want to be dismissed. I didn’t receive any support that was effective for me”

“I have and was been treated very badly by my place of work, absolutely no support or care and compassion”

“I was given a specific senior midwife who I could go to for support, to discuss things at times when home was particularly bad and to deal with any sickness absence – helpful as one person knew what was going on and I could be truthful, especially about the reasons for sickness absence sometimes”

“All staff should be asked about domestic abuse or violence on a regular basis”

“Police and social services were unhelpful, and no support provided. Neither I nor my children were offered counselling or directed to appropriate services despite asking several times for help. One police officer even commented that due to my ethnicity I could handle the situation myself.”

person holding white printer paper

Based on the findings the RCM has put forward the following evidence-based recommendations. These will enable maternity service managers and NHS Trusts/Boards to support staff experiencing domestic abuse more effectively.

  • All NHS Trusts/Health Boards should develop specific policies to support who are victims of domestic abuse, aligned to existing guidance from the NHS Staff Council developed in 2017.
  • NHS Trusts/Health Boards should provide and publicise confidential domestic abuse support services for affected staff, including access to IDVAs, external counselling and legal services as appropriate.
  • NHS Trusts/Health Boards should ensure that all managers and supervisors are trained on domestic abuse issues, so that they can recognise signs of domestic abuse in their staff and confidently undertake their safeguarding obligations.
  •  NHS Trusts/Health Boards should ensure that staff at all levels are trained on domestic abuse issues and made aware of relevant workplace policies as part of their induction programme and continuous updating and are made aware of support services.

It was a pleasure to work with esteemed colleagues at the RCM to put this report together. Midwives and maternity support workers are a highly valued workforce whom we rely on to provide optimal care for mothers and babies. It is our sincere hope that this report will enable maternity service managers and NHS Trusts/Boards to support staff experiencing domestic abuse more effectively.

“Thank you to all of the midwives and maternity support workers who took part in this survey. The wellbeing of maternity staff is intrinsically linked with the safety and quality of maternity services. Your thoughts, feelings and experiences have helped us to arrive at a deeper understanding of the resources required to support those experiencing domestic abuse.”

woman carrying newborn baby

If you would like to follow the progress of work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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How does patient and public involvement work in research? An example exploring midwives’ workplace wellbeing.

Patient and public involvement or #PPI is defined by INVOLVE (part of, and funded by, the National Institute for Health Research) as: 

“Research being carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them. This includes, for example, working with research funders to prioritise research, offering advice as members of a project steering group, commenting on and developing research materials and undertaking interviews with research participants.”

three person pointing the silver laptop computer

In our latest publication, we explain how patient and public involvement works in maternity service research. Here, we asked childbearing women about their experiences in relation to the workplace wellbeing of midwives. We also asked them how they felt about new research looking to create and test an online intervention designed to support midwives. We did this via a discussion group, where participants were offered refreshments and remuneration for their time. Our aim was to answer the following questions:

  1. What are the perceptions of new mothers in relation to the barriers to receiving high quality maternity care?
  2. What are the perceptions of new mothers in relation to the psychological wellbeing of midwives working in maternity services?
  3. What are the perceptions of new mothers in relation to a research proposal outlining the development and evaluation of an online intervention designed to support midwives in work-related psychological distress?

These PPI activities helped us as researchers to do the following:

  • Better understand this research problem from the perspectives of new mothers
  • Validate the direction of future research plans
  • Explore new areas for data collection based on what really mattered to mothers and their babies
  • Improve upon the design of the proposed online intervention based on what really mattered to mothers and babies.

You can read our full methodology via the linked citation below:

Pezaro, Sally, Gemma Pearce, and Elizabeth Bailey. “Childbearing women’s experiences of midwives’ workplace distress: Patient and public involvement.” British Journal of Midwifery 26.10 (2018): 659-669.

This article was launched in the October edition of the British Journal of Midwifery at the Royal College of Midwives annual conference in 2018 .

white and black Together We Create graffiti wall decor

Put simply, the findings in relation to what participants said were analysed thematically and turned into meaningful insights or ‘PPI coutcomes’. In this sense, we used a co-design approach to inform the direction of new research. How did this work exactly? See figure below.

Figure 1. Overall findings

Initially, we considered that it may have been useful to include midwives in PPI activities, as they were to be the intended recipients of the intervention proposed. However, INVOLVE briefing notes state that:

“When using the term ‘public’ we include patients, potential patients, carers and people who use health and social care services as well as people from organisations that represent people who use services. Whilst all of us are actual, former or indeed potential users of health and social care services, there is an important distinction to be made between the perspectives of the public and the perspectives of people who have a professional role in health and social care services.”

A such, we could not include midwives in these PPI activities due to them having a ‘professional role in health and social care services’. Nevertheless, as midwives were the intended end users and direct beneficiary of the intervention proposed, we argued that they should “not necessarily be excluded from PPI activities simply because they treat patients”. This debate lends itself to further academic discussion and we welcome ideas on this going forward.

two person standing on gray tile paving

Both national and international strategies and frameworks relating to healthcare services tend to focus on putting the care and safety of patients first , yet these findings suggest that to deliver the best care to new mothers effectively, the care of the midwife must equally be prioritised. As such, we now intend to seek further funding to continue this work and secure excellence in maternity care.

If you would like to follow the progress of work going forward..

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Until next time…Look after yourselves and each other 💚💙💜❤

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Theories of work-related stress

There are many theories of work stress and general stress theories. I have been trying to get my head around just a few, and so I thought I would share them here for future reference on work stress theory. Perhaps these will help you in your job and career?…or perhaps help you as a leader or manager to support your employees. In any case, please share your top workplace tips for working productively…. I would love to see these theories used to make your workplace a happier one ❣

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Transactional theories of work-related stress

The most commonly used transactional theory suggests that stress is the direct product of a transaction between an individual and their environment which may tax their resources and thus threaten their wellbeing (Lazarus 1986, Lazarus and Folkman 1987). Yet a more recent version of this theoretical model suggests that it is the appraisal of this transaction that offers a causal pathway that may better express the nature of the underlying psychological and physiological mechanisms which underpin the overall process and experience of stress (Lazarus et al. 2001).

In this sense, any aspect of the work environment can be perceived as a stressor by the appraising individual. Yet the individual appraisal of demands and capabilities can be influenced by a number of factors, including personality, situational demands, coping skills, pervious experiences, time lapse, and any current stress state already experienced (Prem et al. 2017). One multidisciplinary review provides a broad consensus that stressors really only exert their effects through how an individual perceives and evaluates them (Ganster and Rosen 2013).

As such, the experience of workplace stress according to the transactional theory, is associated with exposure to particular workplace scenarios, and a person’s appraisal of a difficulty in coping. This experience is usually accompanied by attempts to cope with the underlying problem and by changes in psychological functioning, behaviour and function (Aspinwall and Taylor 1997, Guppy and Weatherstone 1997). In order to recognise these external and internal elements of workplace stress, Cox (1993) outlined another modified transactional theory. This theory represented the sources of the stressor, the perceptions of those stressors in relation to his/her ability to cope, the psychological and physiological changes associated with the recognition of stress arising, including perceived ability to cope, the consequences of coping, and all general feedback that occurs during this process.

Yet, as with all transactional theories of work-related stress, it is the concept of appraisal that has been criticised for being too simplistic and for not always considering an individuals’ history, future, goals and identities (Harris, Daniels and Briner 2004). Additionally, in his later works, Lazarus stressed that his transactional theories of stress failed to acknowledge the outcomes associated with coping in specific social contexts and during interpersonal interactions (Lazarus 2006a).

cooperate

Interactional theories of stress

Interactional models emphasise the interaction of the environmental stimulus and the associated individual responses as a foundation of stress (Lazarus and Launier 1978). For instance, the Effort-Reward Imbalance (ERI) theory posits that effort at work is spent as part of a psychological contract, based on the norm of social reciprocity, where effort at work is remunerated with rewards and opportunities (Siegrist 1996). Here, it is the imbalance in this contract that can result in stress or distress. Yet in contrast to transactional theories of stress, this imbalance may not necessarily be subject to any appraisal, as the stressor may be an everyday constant occurrence.

The Person-Environment Fit theory is one of the earliest interactional theories of work-related psychological distress, suggesting that work-related stress arises due to a lack of fit between the individual’s skills, resources and abilities, and the demands of the work environment (Caplan 1987, French, Caplan and Van Harrison 1982). Here, interactions may occur between objective realities and subjective perceptions and between environmental variables and individual variables. In this case, it has been argued that stress can occur when there is a lack of fit between either the degree to which an employee’s attitudes and abilities meet the demands of the job or the extent to which the job environment meets the workers’ needs (French, Rodgers and Cobb 1974).

Yet the Job Demand-Control (JDC) theory supposes that work-related stress can result from the interaction between several psychological job demands relating to workload such as cognitive and emotional demands, interpersonal conflict, job control relating to decision authority (agency to make work-related decisions) and skill discretion (breadth of work-related skills used) (Karasek Jr 1979). The JDC model is concerned with predicting outcomes of psychological strain, and workers who experience high demands paired with low control are more likely to experience work-related psychological distress and strain (Beehr et al. 2001).

However, the original concept of job demand and control was expanded in 1988 to become the Demand Control Support (DCS) theory, describing how social support may also act as a buffer in high demand situations (Johnson and Hall 1988). As social support as a coping mechanism can moderate the negative impacts of job stress, another later version of the JDC theory was developed to suggest that it is those individuals who experience high demands paired with low control and poor support who are most at risk of work-related psychological distress (Van der Doef and Maes 1999). These later versions of the JDC theory were developed, as earlier versions were considered to be too simplistic and ignorant of the moderating effects of social support upon the main variables. However, the perceived job demands and decision autonomy outlined in the JDC theory have been acknowledged as being key factors in determining the effects and outcomes of work on employees’ health (Cox, Griffiths and Rial-González 2000).

Allostatic Load Model of the Stress Process

Early psychological models of stress may be suitable for describing how environmental events generate stressful appraisals for individuals. Yet another theoretical model, devised via a multidisciplinary review of Work Stress and Employee Health identifies the intervening physiological processes that link stress exposure to health outcomes (Ganster and Rosen 2013). This Allostatic load model of the stress process builds on earlier cognitive appraisal models of stress and the work of Seyle (Seyle 1983) to describe the developments of allostasis in the process of stress. Allostasis is the process of adjustment for an individual’s bodily systems that serve to cope with real, illusory, or anticipated challenges to homeostatic (stable) bodily systems. This model proposes that continued overstimulation leads to dysregulation, and then to poor tertiary health outcomes. However, the sequence of this model has proven difficult to validate empirically. Additionally, this research is concerned with the psychological rather than the physical outcomes of work-related stress.

Allostatic Load Model of the Stress Process

Allostatic Load Model of the Stress Process

Another model of work stress has been developed in response to the Health and Safety Executive’s (HSE) advice for tackling work-related stress and stress risk assessments (Cousins* et al. 2004, HSE 2001). This model, developed by Cooper and Palmer underpins the theory and practice advocated by the HSE (Palmer, Cooper and Thomas 2003). This model explores the stress-related ‘hazards’ or sources of stress facing employees in the workplace. The acute symptoms of stress are also set out, and these symptoms relate to the organisation, as well as the individual. The negative outcomes are outlined for both an individual’s physical and mental health, however beyond this, outcomes are presented as financial losses for both the individual and the organisation.

Cooper and Palmer’s model of work stress

Cooper and Palmer_s model of work stress

Another model of work stress developed by Cooper and Marshall sets out the sources of stress at work, factors which determine how an individual may respond to such stressors, go on to experience acute symptoms, and eventually go on to reach the chronic disease phase affecting one’s physical and/or mental health (Cooper and Marshall 1976). This model is concerned with the long-term consequences of work-related stress, as well as the acute symptoms of, sources of, and the individual characteristics associated with work-related stress.

Cooper and Marshall’s model of work-related stress

Cooper and Marshall_s model of work-related stress

The Conservation of Resources (COR) Model

The above models all outline potential stressors or hazards relating to the workplace. Yet work-related stressors cannot always remain separate from general life stressors. Illustrating this, the Conservation of Resources (COR) Model, an integrated model of stress looks to encompass several stress theories relating to work, life and family (Hobfoll 1989). According to this theory, stress occurs when there is a loss, or threat of loss of resources. This is because individuals ultimately seek to obtain and maintain their resources, loosely described by the authors as objects, states, conditions, and other things that people value. Some of these stressors may relate to resources such as one’s home, clothing, self-esteem, relationship status, time and/or finances. In this context, work/relationship conflicts may result in stress, because resources such as time and energy are lost in the process of managing both roles effectively (Hobfoll 2001). This may in turn result in job dissatisfaction and anxiety, although other resources such as self-esteem may moderate such conflicts and stress (Hobfoll 2002). Such a model would be useful in the development of resource-focused interventions which aim to make changes in employees’ resources and subsequent outcomes (Halbesleben et al. 2014).

Understanding the Role of Resources in Conservation of Resources Theory

Basic Tenets of Conservation of Resources Theory

Principle 1 Resource loss is more salient than resource gain.

Principle 2 People must invest resources to gain resources and protect themselves from losing resources or to recover from resource loss.

Corollary 1 Individuals with more resources are better positioned for resource gains. Individuals with fewer resources are more likely to experience resource losses.

Corollary 2 Initial resource losses lead to future resource losses.

Corollary 3 Initial resource gains lead to future resource gains.

Corollary 4 Lack of resources leads to defensive attempts to conserve remaining resources.

(Halbesleben et al. 2014)

A Sample of Psychological Resources

Objects/ Conditions: Job Security Constructive Rewards, Reinforcement Contingencies, Inducements

Constructive: Autonomy, Decision Authority, Skill Discretion, Control Participation in Decision Making Opportunities for Professional Development Resilience

Social Support: (supervisor, coworker, organization, spousal, customer, etc.)

Energies: Time Away from Work, Recovery Experiences

Key: Self-Esteem, Self-Efficacy, Locus of Control, Core Self-Evaluation Conscientiousness, Emotional Stability

Macro: Family-Friendly Workplace Policies

(Halbesleben et al. 2014)

The Revised Transactional Model of Occupational Stress and Coping

One model combines both Lazarus’ transactional theory of stress and coping (Lazarus 1986) and Karasek’s JDC theory (Karasek Jr 1979) is the revised transactional model of occupational stress and coping presented by Goh and colleagues (Goh, Sawang and Oei 2010). This model demonstrates how individuals appraise, cope with and experience occupational stress. This process involves an individual firstly encountering a potential stressor and appraising their experience of it. Subsequently, this model demonstrates how the individual then goes on to a secondary phase of risk appraisal, where coping strategies are initiated in response to the individuals experience of the initial stressor. The model also outlines how immediate outcomes and outcomes after 2 to 4 weeks are involved throughout this process of stress and coping.

In this case, the model demonstrates a direct link between the primary appraisal of the stressor and primary stress outcomes, and also a direct link between the primary and secondary stress outcomes. This process demonstrates how the appraisals of stressful events can significantly impact on an individual’s experience of stress and its associated outcomes. This model also provides support to the effect of emotions on a person’s choice of coping strategy (Ficková 2002). Notably, this model posits that the experience of stress, coping and the development of negative outcomes can occur at different points in the process of occupational stress and coping, and can be triggered by both psychological and behavioural coping factors.

The Revised Transactional Model of Occupational Stress and Coping

This model is my personal favourite as it explains the process and experience of stress and appraisal, along with the outcomes of stress. Here, we can also see how each component relates to one another. These are just a few of the stress models out there. Some can be applied to life, and some to areas of the workplace. Are the two ever really separate?…If you have any more you would like me to add then please let me know. I hope these few give us all something to think about in the field of work-related stress research and practice.

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Until next time…Look after yourselves and each other 💚💙💜❤

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