1.

INTRODUCTION

1.1 INTRODUCTION ABOUT THE STUDY

1.1.1 MEANING OF STRESS

Stress is defined as an upset in the body’s balance due to physical, mental or

emotional stimuli. Stress manifests itself in different ways including fatigue, chronic
headaches, irritabilities, heart diseases, low self-esteem and diminished sex drive. Such
adverse reactions are seen to contribute to mental and physical illness and several problems.

1.1.2 DEFINITION OF STRESS

According to the father of stress of research, Dr. Hans selye “stress is the space of
life; the absence of stress in death. Stress is defined as an adaptive response to an external
situation that results in physical, psychological, and behavioral deviations for organizational
participants. Stress is understood as an individual reaction to a disturbing factor in the
environment.

1.1.3 TYPE OF STRESS

 Stress based on effects

 Stress based on time period or duration

1.1.3.1 STRESS BASED ON EFFECTS

 Good Stress – Eustress:

Is positive, desirable stress that keeps life interesting and helps to motivate and
inspire people. Eustress involves successfully managing stress even if the individual is
dealing with a negative stressor. It implies that a certain amount of stress is useful,
beneficial and even good for health.
 Bad Stress or Distress:
Refers to the negative effects of stress that drains an individual out of his energy
and goes beyond his capacities to cope. This is a situation of “high stress” distress
showing a drastic negative change in performance. The possibility of role overload may
force the individual to commit errors, make him indecisive and cause irritation in him at
the slightest pretext. There may be a case of “no stress” distress also. Role

1
underutilization creating boredom, decreased motivation, absenteeism and apathy are all
signs of “no stress” distress. It is undesirable negative stress.
 Over Stress - Hyper stress:

Means too much stress. It can lead to physical and emotional breakdown. Work
overload can be a common source of over stress.

 Under Stress - Hypo stress:

Refers to too little stress leading to boredom, lethargy and frustration. Work under
load and no work at all may lead to hypo stress in some situations.

1.1.3.2 STRESS BASED ON TIME PERIOD OR DURATION

 Acute Stress:

It is the result of short term stressors. It is usually quite Intense initially and then
disappears quickly. It can be exciting and stimulating in small doses, but too much leads to
fatigue. People, who experience this stress, tend to be over aroused, irritable, anxious and
tense. Its symptoms include tension, headaches, migraines, digestive disorders, hypertension,
chest pain and heart disease

 Chronic stress:
It is a long term stress usually resulting from nagging problems. In case of
chronic stress, an individual’s physiological and psychological resources are depleted.
Chronic stress can lead to self-killing, recklessness, heart attack, violence and also
condenses the quality of life
1.1.4 REMEDIES FOR STRESS
Stress in the workplace is often referred to as occupational stresses. The basic
rationale underpinning the concept is that the work situation has certain demands, and
that problems in meeting these can lead to illness or psychological distress. Occupational
stress is a major health problem for both individual employees and organizations, and
can lead to burnout, illness, labour turnover, absenteeism, poor morale and reduced
efficiency and performance. Stress is part of everyday life for health professionals such
as nurses, physicians, and hospital administrators since their main responsibility focuses
upon providing help to patients who are usually encountering life crises. Typically,
nurses from both public and private hospitals report a similar pattern of stressful
experiences.

2
 Nurses normally plan their time schedule to manage occupational stress. In
addition to that they augment their family bondage, sharing their grievances and
feelings with peers, work group and subordinates. In addition to that they involve in
the area of mini exercises, relaxation reservoirs and so on. In order to assist the
nurses to manage occupational stress organizations also engage in the periodical
training, counseling, reschedule the work, flexible working hours, family care plans,
holidays with salary, special trips, establishing relaxation centers and so on.

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 1.2 INDUSTRIAL PROFILE

1.2.1 INTRODUCTION ABOUT HEALTH CARE INDUSTRY

The health care industry, or medical industry, is the sector of the economic system
that provides goods and services to treat patients with curative, preventive, rehabilitative,
palliative, or, at times, unnecessary care. The modern health care sector is divided into many
sub-sectors, and depends on interdisciplinary teams of trained professionals and
paraprofessionals to meet health needs of individuals and populations. The health care
industry is one of the world's largest and fastest-growing industries. Consuming over 10
percent of gross domestic product (GDP) of most developed nations, health care can form an
enormous part of a country's economy.

As a basic framework for defining the sector, the United Nations' International
Standard Industrial Classification (ISIC) categorizes the health care industry as generally
consisting of:

1. Hospital activities;

2. Medical and dental practice activities;

3. Other human health activities

This third class involves activities of, or under the supervision of, nurses, midwives,
physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health
facilities, or other allied health professions, e.g. in the field of optometry, hydrotherapy,
medical massage, yoga therapy, music therapy, occupational therapy, speech therapy,
chiropody, homeopathy, chiropractic, acupuncture, etc.

The Global Industry Classification Standard and the Industry Classification

Benchmark further distinguish the industry as two main groups:

1. Health care equipment & services

2. Pharmaceuticals, biotechnology and related life sciences.

4
1.2.1.1 HEALTH CARE EQUIPMENT & SERVICES

Health care equipment and services comprise companies and entities that provide
medical equipment, medical supplies, and health care services, such as hospitals, home health
care providers, and nursing homes. The second industry group comprises sectors companies
that produce biotechnology, pharmaceuticals, and miscellaneous scientific services.

Other approaches to defining the scope of the health care industry tend to adopt a
broader definition, also including other key actions related to health, such as education and
training of health professionals, regulation and management of health services delivery,
provision of traditional and complementary medicines, and administration of health
insurance.

A health care provider is an institution (such as a hospital or clinic) or person (such as

a physician, nurse, allied health professional or community health worker) that provides
preventive, curative, promotional, rehabilitative or palliative care services in a systematic
way to individuals, families or communities.

The World Health Organization estimates there are 9.2 million physicians, 19.4
million nurses and midwives, 1.9 million dentists and other dentistry personnel, 2.6 million
pharmacists and other pharmaceutical personnel, and over 1.3 million community health
workers worldwide, making the health care industry one of the largest segments of the
workforce.

There have been a number of noteworthy initiatives taken up by the Indian

government to boost the healthcare sector in the country. These initiatives focus on
investment that is closely linked to providing better medical infrastructure, rural health
facilities etc.

• 100 per cent foreign direct investment (FDI) is permitted for health and medical
services under the automatic route

• The National Rural Health Mission (NHRM) had allocated US$ 10.15 billion for the up
gradation and capacity enhancement of healthcare facilities

• Moreover, in order to meet revised cost of construction, in March 2010 the

Government allocated an additional US$ 1.23 billion for six upcoming AIIMS-like
institutes and up gradation of 13 existing Government Medical Colleges

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1.2.1.2 PHARMACEUTICALS, BIOTECHNOLOGY AND RELATED LIFE
SCIENCES.

The pharmaceutical and biotechnology industry produce drugs and other products that
help people and animal live healthier lives, recover from injuries, and fight illness. From its
humble origins in local pharmacies and apothecaries that prepared “home remedies” during
the middle ages, the pharmaceutical and biotechnology industry has grown into one of the
leading industries in the world today. It is a home to cutting edge biological and chemical
research, and offers opportunities for the people across a wide spectrum of careers from
scientists ,physicians, and engineers to marketing and sales workers and human resource
professionals.

• Make difference in the world. Whether you’re working in the laboratory, in an office,
or on a sales call, you’re helping people live healthier and happier lives.

• Be on the cutting edge of science. Many people in the pharma /biotech industry love
the high tech environment and the fact that no two days are the same.

• Good opportunities for advancement. With the right educational background and
experience you can be prepared for opportunities for advancement in career

1.2.2 HEALTH CARE INDUSTRY IN INDIA

India’s healthcare providers however cannot afford to rest on their laurels as they will
soon face tough competition for medical tourists internationally. Like other South Asian
nations like Malaysia, Singapore, and Thailand, India has been quick enough to assess the
lucrative marketplace within the healthcare sector, following which there has been heavy
investments both from the government and the private sector to meet the rising demands in
healthcare industry.

An enormous amount of private capital will be required in the coming years to

enhance and expand India’s healthcare infrastructure to meet the needs of a growing
population and an influx of medical tourists. Currently India has approximately 860 beds per
million. This is only one-fifth of the world average, which is 3,960, according to the World
Health Organization. It is estimated that 450,000 additional hospital beds will be required by
2010—an investment estimated at $25.7 billion. The government is expected to contribute
only 15-20% of the total, providing an enormous opportunity for private players to fill the

6
gap. Recently we have seen many new investments in healthcare infrastructure facilities in
India. For instance, ICICI Venture, the country’s largest private equity fund, has invested
$8.6 million in a chain of diagnostics facilities, along with Metropolis Health Services Ltd.
And in 2006, General Electric announced a $250 million investment in infrastructure and
healthcare projects in India.

With the advent of private insurance and the emergence of India as a medical tourism
destination, there also has been a surge of growth in so-called “super specialty” hospitals,
which have teams of specialists, sophisticated equipment, links to other medical centers, and
the ability to treat a broad range of ailments.

Some of these new facilities, such as the Rajiv Gandhi Super Specialty Hospital, are
public-private partnerships. Government fiscal constraints are driving the growth of PPPs to
help meet India’s growing demand for healthcare infrastructure. Such partnerships have
gained legitimacy worldwide in recent years as a major strategy for health sector
development. In addition to participating in infrastructure PPPs, opportunities are emerging
for foreign companies to create super-specialty hospitals in collaboration with Indian
corporations. For instance, Wockhardt hospitals Group has partnered with Harvard Medical
International to create a chain of super specialty hospitals in India. Two hospitals, in Mumbai
and Bangalore, are attracting large volumes of medical tourists from the UK and US. In
addition to a deteriorating physical infrastructure, India faces a huge shortage of trained
medical personnel, including doctors, nurses and especially paramedics, who may be more
willing than doctors to live in rural areas where access to care is limited. There is an
immediate need for medical education and training, which could provide additional
opportunities for private sector providers or public-private partnerships.

The Indian healthcare sector can be viewed as a glass half empty or a glass half full.
The challenges the sector faces are substantial, from the need to improve physical
infrastructure to the necessity of providing health insurance and ensuring the availability of
trained medical personnel. But the opportunities are equally compelling, from developing
new infrastructure and providing medical equipment to delivering Tele-medicine solutions
and conducting cost-effective clinical trials. For companies that view the Indian healthcare
sector as a glass half full, the potential is enormous.

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 1.3 COMPANY PROFILE

1.3.1 INTRODUCTION ABOUT NADAKKAVIL HOSPITAL

Nadakkavil Hospital was established on 1989 with limited facilities under the
guidance of Dr Mohammed Ali N. Nadakkavil Hospital is a well -acclaimed health enterprise
and one of the leading healthcare systems in Malabar, assures comprehensive health care
service with global standard. The hospital is renowned for its quality excellent medical
expertise, nursing care and quality diagnostic services. Nadakkavil Hospital is one of the
busiest accident&emergency care centre in the MalapPuram district, catering to
approximately about 10000 acute emergencies every year and has now been recognized as a
Multi Specialty Hospital with ISO certificate(9001-2015) with all the Facilities and round the
clock services to care for 150 inpatients.

It is well equipped with triage beds, observation areas, which manage all forms of
medical , surgical, orthopedic ,pediatric , nephrological etc .With excellent backup of Our
specialty departments like Orthopedics, Gynecology, Pediatrics, General Medicine, ENT,
Nephrology, Psychiatry, and General Surgery there are absolutely no short -comings in
providing excellent medical treatment. Nadakkavil Hospital has well-equipped 24-hour
Casualty and Trauma care unit, Operation Theatres, Medical Intensive care unit, Neonatal
Intensive Care Unit, Kidney Dialysis Unit, Labour Rooms, Laparoscopic and arthroscopic
surgery, Orthopedic Intensive Care Unit, Orthopedic Operation Theatres, Computerized Bar-
coded Pharmacy, Computerized Fully automatic Laboratory, Physiotherapy Unit ,mobile
ambulance facilities and Home Care Services.

Nadakkavil Hospital Valanchery, Kerala Celebrates the 25th year of service to

humanity. Nadakkavil Hospital is an establishment committed to provide easy access to
superior quality and, cost-effective treatment to all class of people.

The Hospital also entertain various social commitments like distribution of medicines
to patients in association with palliative care units, medical camps in rural areas, surgery for
poor patients on half pay basis, etc.

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1.3.2 BOARD OF DIRECTORS

Managing Director

Dr .Muhammed ali

General Manager and HR Manager

Muhammed Abdurahiman

1.3.3 MILESTONES

• 1992 : Inaugurated 10 bedded Shamsul Ulama Mission hospital by M.K Thangal

Karthala.

• 1993 : Commenced first trauma care centre.

• 1994 : Started radiology department.

• 1994 : Inaugurated first ortho care facilities.

• 1995 : Commenced Ambulance facilities.

• 1995 : Started Medical Legal Cases.

• 1998 : Started physiotherapy.

• 1998 : Inaugurated dental care .

• 2003 : Started USG.

• 2008 : Started well Equipped Dialysis Unit.

• 2014 : Started CT Scan facility

• 2014 : Inaugurated Eye Care facilities.

• 2015 : Started Homeo Department

• 2016 : Started 3D,4D Ultra sound Scanning & special X-Ray Studies

• 2016 : Inaugurated Wellness Lab

• 2016 : Started Audiology Facilities

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 • 2017 : Commenced Bike Ambulance Facilities

• 2017 : Started Homecare Services

• 2017 : Inaugurated Urology Department

• 2017 : Started FNAC Facilities

• 2017 : Started Digital Radiography Facilities

• 2017 : Cardiology Department Re- Opened

• 2017 : Accreditation of ISO 9001:201

1.3.4 VISION

To provide a continuum of high-quality, cost-effective services in order to improve

the health status of those we serve at an affordable cost by a team of extremely dedicated
medical professionals supported by the most innovative medical technologies.

1.3.5 MISSION

Nadakkavil hospital mission is to provides our patients, their families and our
community with extraordinary healthcare service; to ensure peace of mind through high
quality, compassionate treatment; and to deliver care beyond their expectations.

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 2. REVIEW OF LITERATURE

1. Weiman (1977)1 “A Study of Occupational Stressors and the Incidence of

Disease/ Risk”espoused: “Occupational stress is the sum total of factors experienced
in relation to work which affect the psychosocial and physiological homeostasis of the
worker. The individual factor is termed a stressor and stress is the individual worker‟s
reaction to stressors.” Job or work, is an important part of life and also one of the
major causes of stress. Various organizational related variables have been found to be
the reason behind the workplace stress.

2. Caplan (1985)2, Psychosocial stress in work. Reported the factors like supervisory
climate, co-workers, and time pressures, pressures for conformity which affect the
mental and physical health of employees. Low control over the work environment,
decreased participation in decision making about conditions of work, unpredictability
of events, both too little and too much complexity in work, role ambiguity, and
excessive workload, responsibility for persons, role conflict, and lack of social
support are found to affect the well-being of employees at the work place. With more
exposure to these factors over a period of time, employees face more emotional and
physiological trauma.
3. Kasl (1987),3 Methodologies in stress and health: Past difficulties, present
dilemmas, future directions. also supported the view point and observed: "It has
been impossible to identify and agree upon a criterion, or more appropriately a set of
criteria, for identifying the presence of a state of stress and then calibrating its
intensity and duration.” If it was found difficult to determine stress, then in this
scenario how can one attempt to measure it.

1
Weiman, C. (1977). “A Study of Occupational Stressors and the Incidence of Disease/ Risk” Journal of
Occupational Medicine, Vol.19, No 2, February, pp.119-122.
2
Caplan, Robert D. (1985). Psychosocial stress in work. Management and Labour Studies, Vol.10, No. 2, pp. 63-
76.
3
Kasl, S.V. (1987). Methodologies in stress and health: Past difficulties, present dilemmas, future directions. In
S. Kasl (ed) Stress and Health: Issues in Research Methodology, Chichester, John Wiley.

11
 4. A study on stress and coping relationship in the medical environment, investigated by
Zevon, Donnelly and Starkey (1990)4 Stress and coping relationships in the
medical environment: A natural experiment. They examined the coping responses
of nurses in a bone marrow transplant unit who were exposed to a stressful series of
events. Significant differences in reactions to stress were observed; these differences
were related to factors such as coping strategies, job involvement, role conflict, and
home/ work conflict.
5. A study of stress experienced by physicians and nurses in the cancer ward by
Ullrich and FitzGerald (1990)5 found interpersonal difficulties, whether on or off the
job, related to physical distress among nurses. For doctors, dissatisfaction with the job
and working conditions related to general depression. Certain characteristics of the
caregiver (sex, profession, age) and the institutional environment (e.g. presence of
trainees, size of institution) were also linked with stress and complaint levels.
6. A study of routilization of job context and job content as related to employees‘
quality of working life. A study of Canadian nurses was conducted by Baba and
Jamal (1992)6. Result revealed that workers assigned to rotating shifts are prone to
higher job stress and strain, physical and emotional health problems and exhibit more
sub marginal work behaviors than do workers who are assigned permanently today,
afternoon or even night shifts.
7. Quick, Murphy, Hurrel and Orman, (1992)7 Stress and well-being at work:
Assessments and interventions for occupational mental health.Occupational stress
is increasingly a significant source of economic loss and an important occupational
health problem. Occupational stress may produce both physiologic and overt
psychological disabilities. Nevertheless it may also cause subtle manifestation of
morbidity that can affect productivity and personal well-being of an employee.
8. Kirkcaldy and Martin, (2000)8 job stress and satisfaction among nurses :These
stressors included patient difficulties and unexpected patient outcomes such as death
4
Zevon, M. A., Donnelly, J. P., & Starkey, E. A. (1990). Stress and coping relationships in the medical
environment: A natural experiment. Journal of Psychosocial Oncology, 8 (1), 65-77.
5
Ullrich, A., & FitzGerald, P. (1990). Stress experienced by physicians and nurses in the cancer ward. Social
Science and Medicine 1982, 31 (9), 1013-1022.
6
Baba, V. V. & Jamal, M. (1992). Routinization of job context and job content as related to employees‘ quality
of working life: A study of Canadian nurses. Journal of Organizational Behavior, 12(5), 367-465
7
Quick, J. C., Murphy, L. R., & Hurrell, J. J., Jr. (Eds.). (1992). Stress and well-being at work: Assessments
and interventions for occupational mental health. Washington, DC: American Psychological Association

8
Kirkcaldy, B.D., and Martin, T. 2000 job stress and satisfaction among nurses: individual difference.
Stress medicine, 16(2) , pp 77-89

12
 of a patient on the operating table. Lack of competence and confidence in the nursing
role has also been recognized as a stressor.
9. Gueritault-Chalvin & Demi (2000)9 Work related stress and occupational
burnout in AIDS caregivers: test of a coping model with nurses providing AIDS
care.found that nurses experience eight specific sub clusters of stressors such as
death, personnel, institutions, biohazards, informing patients, challenging patients and
families and treatment dilemmas. It was found thet nurses experiencing stress from
their workplace use avoidance, planful problem solving, and wishful thinking as
coping strategies, whereas stress originating from patient care was dealt with by using
positive appraisal and acceptance coping strategies.
10. Michie, (2002)10 “Causes and management of stress at work” Unhealthy (high
stress ridden) organizations do not get the best from their workers and this may affect
not only their performance in the increasingly competitive market but eventually even
their survival
11. McVicar (2003)11 Workplace stress in nursing: reviewed literature on workplace
stress among nurses and found that workload; emotional costs of caring and
professional conflicts are the most reported stressors among nurses. He concluded that
there is lack of the understanding of relationship between practice area of nurses and
sources of stress.
12. Vahey, Aiken, Soloane, Clarke and Vergas (2004)12 Nurses burnout and Patient
satisfaction investigated nurse‘s burnout and patient satisfaction. They found that
nurse‘s burnout is a significant factor influencing patient satisfaction with care, and it
identifies modifiable characteristics of nurses work environment that contribute to
nurses‘ burnout.

13. A study of the relationship of emotional intelligence to burnout and job satisfaction among
nurses in early nursing practice was conducted by Farmer (2004) 13. The study hypothesized
that emotional intelligence would be an individual ability that would influence burnout and
9
Gueritault-Chalvin, V., Kalichman, S. C., Demi, A., & Peterson, J. L. (2000). Work related stress and
occupational burnout in AIDS caregivers: test of a coping model with nurses providing AIDS care. AIDS Care,
12(2), pp 149-161.
10
Michie, S. (2002). Causes and management of stress at work. Occup. Environ. Med, ILO. Vol. 59: pp. 67-72.
11
Mc Vicar A. (2003) Workplace stress in nursing: a literature review. Journal of Advanced Nursing.;
44(6): pp 633–42.
12
Vahey, D. C., Aiken, L. H., Soloane, D. M., Clarke, S. P., & Vergas, D. (2004). Nurses burnout and Patient
satisfaction. Medical Care, 42 (2), II, pp 57-66.

13
 job satisfaction. The 72 result revealed that overall emotional intelligence may have a
minimal role in the prevention or amelioration of burnout the result also substantiates the
pervasive nature of stress and its relevance to nursing
14. Richards (2006)14 The prevalence of nursing staff stress on adult acute
psychiatric in-patient wards. was to review the prevalence of low staff morale,
stress, burnout, job satisfaction and psychological well-being amongst staff working
in in-patient psychiatric wards. Most of the studies did not find very high levels of
staff burnout and poor morale but were mostly small, of poor quality and provided
incomplete or non-standardized prevalence data. The prevalence of indicators of low
morale on acute in-patient mental health wards has been poorly researched and
remains unclear.
15. Colligan, Thomas W., Colligan MSW., and Higgins M. (2006). Workplace stress
- Etiology and consequences. claim that often a stressor leads the body to have a
physiological reaction which can strain a person physically as well as mentally. These
authors further maintain that a variety of factors are found to contribute to workplace
stress such as negative workload, isolation, lack of autonomy, extensive hours
worked, toxic work environments, difficult relationships among co-workers and
management, harassment, management bullying, and lack of opport15unities or
motivation to advancement in one‟s skill level.

16. According to Ahmady et al. (2007)16 Organizational role stress among medical
school faculty members in Iran: Dealing with role conflict, the most role-related
stressors and forms of conflict among faculty members of Iranian medical schools

13
Farmer, S. (2004). The relationship of emotional intelligence to burnout and job satisfaction among practice.
A dissertation submitted to the faculty of the University of Utah in partial fulfillment of the requirements for
the degree of doctor of philosophy.[College of Nursing. The University of Utah].
14
Richards, D. A., Bee, P., Barkham, M., Gilbody, S. M., Cahill, J., & Glanville, J. (2006). The prevalence of
nursing staff stress on adult acute psychiatric in-patient wards. Social psychiatry and psychiatric epidemiology,
41(1), pp 34-43.
15
Colligan, Thomas W; Colligan MSW, & Higgins M. (2006). Workplace stress - Etiology and consequences.
Journal of Workplace Behavioral Health, Vol. 21 (2), pp. 89 - 97.

16
Ahmady, S., Changiz, T., Masiello, I., and Brommels, M., (2007). Organizational role stress among medical
school faculty members in Iran: Dealing with role conflict, BMC Med Educ. Vol.(7), P. 14

14
 include too many tasks and everyday work load; conflicting demands from colleagues
and superiors; incompatible demands from their different.
17. Schwarzer, (2009) 17Stress and coping resources: Theory and review. explained
that "Stress cannot result from any opportunity/challenge/ constraint/demand,
whatsoever; unless its outcome is perceived to be both important and uncertain at the
same time" Moderate level of stress is in fact necessary for an individual to stay alert
and active. Stress is also additive.
18. A study of work and emotional exhaustion was conducted by Astrauskaite,
Perminas and Kern (2010)18 Sickness, colleagues' harassment in teachers' work
and emotional exhaustion. The study indicated that work harassment could be an
important aspect in teacher's health. The seriousness of the work harassment
phenomenon may be supported by the results showing that teachers who witnessed
others being harassed experienced a higher level of emotional exhaustion.
19. Dyrbye et al. (201119) Relationship between work-home conflicts and burnout
among American surgeons: a comparison by sex. It was found that work-home
conflicts appear to be a major contributor to surgeon burnout and are more common
among women surgeons. Although the factors contributing to burnout were
remarkably similar among women and men surgeons, the women were more likely to
experience work-home conflicts than were their male colleagues.

20. A study of revisiting job satisfaction and burnout in community mental health
teams was conducted by Onyett, Pillinger and Muijen (2011) 20.They concluded
that although many studies report high levels of emotional exhaustion, there is no
evidence for a decline in morale. Morale tends to vary across discipline and site
location. Lack of resources and workload pressures remain the most consistent source
of concern among staff.
17
Schwarzer, R. (2009). Stress and coping resources: Theory and review. Berlin, Freie University. Retrieved
from http://web.fu-berlin.de/gesund/ publicat/ehps_cd/ health/stress.htm
18
Astrauskaite, M., Perminas, A., & Kern, R.M. (2010).Sickness, colleagues' harassment in teachers' work
and emotional exhaustion. Medicia (Kaunas), 46 (9), 628-634.
19
. Albion MJ, Fogarty GJ, Machin MA. (2005) Benchmarking occupational stressors and strain levels for rural
nurses and other health sector workers. Journal of Nursing Management. Sep; 13(5):pp 411-8.
20
Onyett, S., Pillinger, T. & Muijen, M. (2011). Job satisfaction and burnout among members of
community mental health team. Journal of Mental Health, 6 (1), 55-66.
15
 3. RESERCHMETHODOLOGY
3.1 TITLE OF THE PROJECT
A study on occupational stress among nurses special reference with Nadakkavil
Hospital and Scanning Centre, Valanchery
3.2 RESEARCH DESIGN:
In this study research design is descriptive in nature descriptive research involves
survey of facts, findings and enquiries of different kinds. The major purpose of descriptive
research is description of the state of affairs as it exists at present the main characteristics of
this method of the research are that the researcher has no control over the variables.
3.3 OBJECTIVE OF THE STUDY
1. To study the causes of stress in their job
2. to study the level of stress among nurses
3. To analyze the effect of such stress in their productivity and satisfaction
4. To suggest suitable solution to them for managing stress
3.4 NEED OF THE STUDY
In the past decade, the news headlines have definitely made it clear that the need for
stress management should be one of the top agendas in modern days of society.
Living today is lot tougher than it was even in the days of the great depression. its
been coming out in many ways such as head ache, hyper tension. others find sleep disorders
during busy days.
Today stress management is important in everyone’s lives. its necessary for long
happy lives with less trouble that will come about. there are many ways to deal with stress
ranging from the dealing with the causes of stress to simply burn of its effects
3.5 SCOPE OF THE STUDY
Nursing is an inherently stressful profession with long working hours, ethical
dilemmas, difficult patients and conflicting demands. Professionally, in true sense the nurses
are on 24- hour duty. The physical and psychological demands of the profession often make
nurses more vulnerable to high levels of stress. The effects of stress on practice are evidenced
as increased errors in prescribing, lack team spirit, more patients’ complaints and sickness
absence. So it is necessary to study the causes and impacts of occupational stress among
nurses in Nadakkavil Hospital and Scanning Centre, Valanchery for reducing their stress and
suggest strategies and programs for it.

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3.6 TYPE OF DATA USED FOR THE STUDY
Both primary data and secondary data were used for the study.
3.6.1 SOURCES OF DATA
I. Primary data: Primary data were collected by distributing printed questionnaire to
the employees of Nadakkavil Hospital and Scanning Centre, Valanchery
II. Secondary data: secondary data were collected from respected websites, journals and
magazines
3.7 POPULATION:
The population of the study was employees of Nadakkavil Hospital and Scanning
Centre, Valanchery
3.8 SAMPLING SIZE:
Sample size used for the study was 50 employees of Nadakkavil Hospital and
Scanning Centre, Valanchery
3.9 SAMPLING TECHNIQUE
This study has used convenience sampling methods
3.10 STATISTICAL TOOLS
 PERCENTAGE ANALYSIS
 CHI SQUARE TEST
 CORRELATION CO-EFFICIENT
3.10.1 PERCENTAGE ANALYSIS
In case multiple questions the responses were categorized based on the nature and
percentage is calculated for each category. the percentage analysis is the analysis of ration of
a current value to base value with the result multiplied by 100.
No of respondent
Percentage of respondent = ×100
Total number of respondent
3.10.2 CHI SQUARE TEST
Chi square test is applied in statistics to test the goodness of fit to verify the
distribution of observed data with assumed theoretical distribution. Therefore, it is a measure
to study the divergence of actual and expected frequencies. It has great use in statistics,
especially in sampling studies, and the extent to which the difference can be ignored, because
of fluctuations in sampling.

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Calculation of expected value
E=∑oij ∕ N
χ²=∑(O-E)²/E,
where χ²=chi square
∑=notation meaning “the sum of”
O=observed frequency
E=expected frequency
3.10.3 CORRELATION CO-EFFICIENT
It measure the relationship between two variable and denoted by r.the numerical value
of the correlation coefficient indicates the degree of relationship that exist between the
variable. A positive correlation indicates to which those variable increase or decrese in
parallel. A negative correlation indicates the extent to wich one variable increase as the other
decreases
The correlation lies between +1 and -1
r= n(∑xy)-(∑x) (∑Y)

√[n∑x²˗(∑x²)][n∑y²˗(∑y²)]
3.11LIMITATIONS OF THE STUDY
• Employees were not willing to answer the questions completely due to their busy
works.
• The study is limited to the employees of Nadakkavil Hospital and Scanning Centre,
Valanchery and therefore findings of the study cannot be extended to other areas.
• Convenient sampling has been used in the study and it has its own limitations..
• The time duration of the study was very short
3.12 PERIOD OF THE STUDY
The study was conducted during the time period from 26th May-26th June 2019.

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