2/5/2024

Stress, Health and

Sustainable Working
Life: Lecture 1

Our journey today

• Practical
– Get to know the team
– Safer space guidelines
– Learning goals
– Course organization
• Stress research:
– Definitions & history
– Why should we care about stress?
– Stress theories

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Our team: Teaching team

Helena Bieselt, MSc
• Supervisor for report
writing
• Tutorial 2
coordinator

Prof. Jessica de Bloom Francesco Vaccargiu

• Teaching assistant
• Course coordinator
• Lecturer
• Tutorial leader

Bart Gruppen
• Teaching assistant

Our team: Guest Gig work &

precarious work Stress physiology Stress in firefighters
speakers/lecturers

Maaike Stuiver & Martijn de Jonge

Terrence Zhang Dr. Peter Flach Veiligheidsregio Groningen

Diversity, inclusion
Recovery and Stress, diversity Stress in the Dutch Vitality at ING and social safety
off-job crafting and inclusion healthcare sector at UG

Dr. Julie Menard E. Wong Leo Sparreboom Alexander Stolze Ella Sebamalai
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My journey so far
• Born in Lingen
• BSc: Health Psychology
• MSc: Work and Organizational Psychology
• PhD: Radboud University
• 5 year post-doc period: Tampere University
• Professor at UG: HRM, Occupational Health and Wellbeing

Safer space guidelines

= requirements for creating a safe, equal and pleasant course environment
– Respect boundaries
– Recognize diversity in perspctives & value individual differences
– Value different competencies and skills
– Do your part to ensure our community is free from discrimination and harassment
• Get in touch with me if you need extra support or special arrangements
• Teach me to further increase inclusion during my course

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Things we will (hopefully) teach you

Upon completion of the course, students can…
1. define stress and explain how it affects individual workers, organizations and society.
2. identify different sources of stress at work and describe how these can particularly
impact specific groups of workers (e.g., teachers, healthcare workers).
3. evaluate the quality and efficiency of stress interventions based on major stress
theories.
4. select and implement an evidence-based individual stress management technique.
5. analyze sources and consequences of stress, and suggest theory-based interventions
to lower stress in a case study.

Manuals on Brightspace
1. Manual for entire course
2. Manual for writing report
3. Manual for break intervention

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How to pass the course?

• Min 5.5 on 1) report, 2) break
intervention and 3) exam
Break intervention (group)
• Exam at the end of the course: Digital, 15%

open book
• Weekly paper-pencil exam about Report (group)
45%
weekly topic
– 2 open questions, closed book
– Different questions for Tutorial 1 & Tutorial 2 Exam
40%
– 5 weekly exams have equal weight
– If you choose to take exam at the end of the
course, this grade will count

Lectures
• Weekly on-campus, live lectures
by experts who work in practice
• Matching course topic
questions

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Readings
• Weekly readings (2-3 papers)
• Note: also relevant for report & break
intervention
• Podcasts on readings
• Videos by researchers on core models
• Read/listen before lecture/tutorial

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Tutorials
• 1: Stress in student life
• 2: Job design
• 3: Gig and precarious work
• 4: Diversity & inclusion
• 5: Off-job crafting
• 6: Feedback mid-report
• 7: Break interventions
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Tutorials
• Exam (paper-pencil)
• Q&A about report, tips for report
• Practical exercises around weekly course topic

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Report on stress & recovery

• Working on a research project on stress in teachers
or health care workers
• Vulnerable to burnout: prevalence 5-30%
• Exhaustion in impairs…
– Students´ & patients´ health and well-being
• Societal and personal burden
• Recovery particularly challenging
– Little (break) autonomy
– Disturbances during breaks
– Permeable work-non work boundaries: working from home
(teachers)
– Shiftwork
– Emotional labour (faking and suppressing emotions)

Kyriacou, 2001
Shen et al., 2015
Unterbrink et al., 2012
Dicke et al., 2018
Skaalvik et al., 2011
Kalimo & Hakanen, 2000)

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Report on stress & recovery

1. Literature review: 3000 → max 2000 words; 1 theore cal model
2. Semi-structured qualitative interviews: 1 → 2
3. Integration literature review and interview insights: NEW
4. Proposal for intervention(s)
5. Reflection on teamwork: NEW
6. Mid-report (30%)
7. Providing & receiving feedback
8. Integration of feedback, intervention improvement & evaluation plan
9. Final report (70%)

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Break intervention
• See manual on Brightspace
• Brief intervention (+/- 10 minutes) to decrease individual stress.
• “evidence-based”: Theoretical underpinnings
• Effective (lowering stress) and efficient (realistic & cost efficient)
• Conducted during last tutorial or digitally submitted
• Graded by teacher (see criteria in manual)

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Organizational policies Job design

• Demand, control, support
Recovery & work- • Demands & resources
Effort & rewards
non-work balance •

Sustainable
working life
Leadership Diversity, inclusion,
behaviors psychological safety

Individual outcomes Organizational outcomes Societal outcomes

• Health • Reduced turnover • National health care costs
• Lower burnout • Improved performances • Healthy communities
• Higher work engagement • Improved productivity • …
• … • Reduced health care costs
• …
Day & Nielsen, 2017
Grawitch et al., 2014
Kelloway & Day, 2015
Salanova et al., 2005

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IGLOO Model
Organizational
policies
Recovery & work- Job design
non-work balance
Sustainable
Leadership working life Diversity, inclusion,
psychological safety
behaviors

I ndividual Job design

Recovery & work-
non-work balance

G roup Diversity, inclusion,

psychological safety

L eader Leadership
behaviors

O rganization Organizational
policies

(O verarching) Trends in society/working life

Nielsen, K., Yarker, J., Munir, F., & Bultmann, U. (2018). IGLOO: An integrated
framework for sustainable return to work in workers with common mental
disorders. Work & Stress

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Trends in working life (1)

• Work intensification
– 24/7 connectivity, global work
– Flexible work, work-home balance, telework
• Rising prevalance of burnout
– Disability benefits due to psychological problems:
– 11% in 1967, 30% in the 90´s and >40% after 2017
• Self-management & self-exploitation
• Alienating and competitive nature of capitalism
– Platform economies, self-employment (12%)
– Rising inequality: Temporary contracts, precarious work

UWV jaarverslagen
Afscheidsrede Prof. W. Schaufeli 2019
Arbobalans, 2018
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Trends in working life (2)

Demographic changes
• dual-career-families
• aging work force
• Shortages in specific sectors: construction, healthcare, teaching, ICT
Automation/AI
• Decrease of simple jobs
• Increase in jobs that require social & cognitive skills, lifelong learning © John Holcroft

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Post-work society
• Decoupling of work & income/livelihood
• Society of meaning (“Sinngesellschaft”)
• Radical change of work to be expected

Precht: Freiheit fuer alle

Srnicek: Inventing the future: Postcapitalism and a world without work
Dahrendorf: Wenn der Arbeitsgesellschaft die Arbeit ausgeht.
Susskind: World without work

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Models for HRM, well-being, performance

relationship
• Mutual gains: win-win, happy productive worker
• Behavioral / social exchange perspective
• Positive treatment by organizations must be reciprocated
• Conservation of resources: HRM-energy/resources-
performance Well-being

+
HRM practices
• Employee training
• High performance practices +
• Monitoring
• Family-friendly work practices
• …
+
Performance
Peccei & van der Voorde,2019
Blau, 1964

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Models for HRM, well-being, performance

relationship
• Conflicting outcomes: Labour process theory
• Management is under constant pressure to…
– reduce costs
– improve quality
– raise productivity & profitability
– lower unit labour costs
• At the expense of workers: work harder and under pressure Well-being
• Systematic exploitation
HRM practices
• Employee training -
• High performance practices -
• Monitoring
• Family-friendly work practices
+
• …
Performance
Delbridge & Turnbull, 1992
Thompson & Newsome, 2004

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Models for HRM, well-being, performance

relationship
• 66% of the models showed support for mutual gains perspectives
• 5 studies (out of 46) showed some evidence for conflicting
outcomes
• 22% showed no relationships or fragmented relationships
• Important limitations Well-being
– Small number of studies
– Single source data
+
HRM practices
– Cross-sectional • Employee training
– Individual OR unit performance • High performance practices +
• Monitoring
• Family-friendly work practices
• …
+
Performance
Peccei & van der Voorde,2019
Blau, 1964

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Origin & definitions

• Derived from Latin verb strictus, meaning “to
draw tight”
• Incorporated in French language: estresse,
meaning “narrowness, constriction, oppression”
• Middle English distress, denoting “hardship or
force exerted on a person”
• “A state of mental or emotional strain or tension
resulting from adverse or demanding
circumstances.”

Robinson, 2018
Oxford dictionary

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Stress research: History

From physiological/behavioristic perspectives…
• All the nonspecifically induced changes within a biologic system in response to an
aggressive outside agent, that is, the stressor
• Stress results from disturbance of homeostasis (i.e., body’s attempt to maintain
stable internal environment)
• Fight-or-flight (Cannon) & GAS (Selye)
• Allostatic Load Model
– Stability through change
– Allostatic state: Reset of setpoints due exposure to chronic demands
– Allostatic load: symptoms and pathology caused by chronic allostatic state
to psychological perspectives…
– Role and importance of cognition in experiencing stress

Selye, 1955
Cannon, 1932
Sterling & Eyer, 1988
McEwen, 1998
Robinson, 2018
British Medical Journal

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Stress is…
• an interaction of…
– features of the environment or events (=stressors)
– an individual’s response (psychological, physiological, and
behavioral) to environmental demands, threats, and
challenges (=strain)
• a particular relationship between the person and the
environment that is appraised by the person as
taxing or exceeding his or her resources and
endangering his or her well-being

Ganster & Rosen, 2013

Transactional model of stress: Lazarus & Folkman, 1984

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Stressors: Conditions, situations or events that cause strain

• Temporary, intermittent or chronic
• Type of stressors
– Physical stressors: heat, poor ergonomics, lighting
– Task-related stressors: repetitive tasks, workload
– Role stressors: role ambiguity, inter-role, intra-role
– Social stressors: bullying, conflicts, poor management
– Work schedule-related stressors: long work hours, shift work, availability
– Career-related stressors: unclear or unfair performance evaluation systems, job insecurity
– Stressful change processes: downsizing, merger or acquisition

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Challenge stressors Hindrance stressors

• Energizing • Constrain personal achievement
• Contributing to performance • Hindering an employee's goal
opportunities progress
• Opportunities for growth and – Interruptions
development – Poor equipment
– Job scope – Role conflicts
– Responsibility – Organizational constraints (e.g., job
– Workload insecurity, precarity)
– Time pressure

Challenge-Hindrance Stress Model (CHM), Cavanaugh et al., 2000

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Symptoms of stress

Physical Psychological Behavioral

• Fatigue • Burnout (exhaustion, cynicism, lack • Irritability
of accomplishment)
• Muscular tension • Withdrawal behaviors:
• Depression absenteeism, turnover
• Headaches
• Anxiety • Aggression
• Heart palpitations
• Irritability • Low work performance
• Sleeping difficulties
• Pessimism • Impatience
• Gastrointestinal problems
• Feelings of being • Disinterest
• Dermatological disorders
overwhelmed and unable
• Isolation
to cope
• Poor health behaviors (e.g.,
• Cognitive difficulties (e.g., eating, exercising, drug abuse)
concentration problems, mistakes)
• Risk taking (e.g., unsafe driving)

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Work and Health

Eurofund
European Working Condition Survey
European Agency for Safety and Health

• Why should we care?

Does your work affect your health?

Yes, mainly
negatively

Yes, mainly No
positively

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Work and Health

Hazard ratios for cardiovascular death by

levels of work characteristics (N=812 metal industry workers) Job stress and physical symptoms (k=79)

2,5

1,5

0,5

0
Job strain Job demands Job control Effort-reward
imbalance

Low Medium High

Kivimaeki et al, 2002

Nixon et al., 2011

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Dominguez et al., 2005

Malaspina et al., 2008
Yao et al., 2014
Hales & Barker, 2001

Transgenerational burden of stress

• Prenatal stress correlated with child’s…
– preterm birth
– metabolic disease
– cardiovascular disease
– psychopathology
• Maternal stress relates to problems in infant, potentially
crossing over to the next generations

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Effects of work-related stress

•High blood pressure
Physical health
•Cardiovascular
diseases
•Health complaints

Stress •Exhaustion: lack of energy,

Emotional weariness, lethargy, cynicism
well-being •Family conflicts

Hockey, 2013
Kivimäki et al., 2002 & 2006 •Loss of work motivation & work
Stansfeld & Candy, 2006
Work-related engagement
Ganster & Rosen, 2013
Bannai & Tamakoshi, 2014 outcomes •Low productivity & task performance
Podsakoff et al., 2007 •Low contextual performance
Nixon et al., 2011
Schaufeli et al., 2010
•Absenteeism & turnover

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Societal burden of stress

• Direct
– Medical (hospital admissions, physician fees, medication)
– Non-medical (insurance, litigation, travel costs, ...)

• Indirect
– Productivity loss (sickness absence, turnover, presenteeism, ...)

• Intangible
– Pain, suffering, loss of quality of life (willingness to pay?)

Total estimated costs of stress

Health care
and medical
costs

Productivity
related loss

Hassard et al., 2017

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Job-demand control support model (Karasek)

• Stress = demands x control

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Job-demand control support model (Karasek)

- Stress = demands x control
- Support added

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Job Demands Resources Model (Demerouti et al)

• Job demands linked to strain
• Job resources linked to work motivation
• Demands & resources interact
• Resources seem to be more important than
demands

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Effort-Reward Imbalance (Siegrist)

- Sociological theory grounded in reciprocity
- Rewards: money, esteem, career opportunities
- Imbalance (high effort, low rewards) = reduced health

Kivimaeki et al, 2002

Nixon et al., 2011

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Hazard ratios for cardiovascular death by levels of

work characteristics (N=812 metal industry workers)
2,5

1,5

0,5

0
Job strain Job demands Job control Effort-reward
imbalance

Low Medium High

Kivimaeki et al, 2002

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Person-Environment Fit (Caplan)

- Needs, motives and preferences of the worker
- Requirements of the job, skills and abilities of the worker
- Demands-ability fit and needs-supply fit

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Bad work? Good work?

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Plumber IT engineer
Work activities Work activities
• ??? • ???
Work context Work context
• Face-to-Face Discussions: % • Electronic Mail: %
• Exposed to Contaminants: % • Indoors: %
• Spend Time Using Your Hands: % • Sitting: %
• Telephone: % • Face-to-Face discussions: %
• Contact With Others: % • Work with Work group or Team: %
• Annual salary: • Annual salary:

Job demands Job demands

Job resources Job resources

%=Percentage people answering “every day”

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Plumber IT engineer
Work activities Work activities
• Getting Information • Getting information
• Interacting with computers • Identifying objects, actions, and events
• Making decisions and solving problems • Making decisions and solving problems
• Thinking creatively Work context
• Updating and using relevant knowledge • Electronic Mail: 93%
Work context • Indoors: 96%
• Face-to-Face Discussions: 67% • Sitting: 85%
• Exposed to Contaminants: 51% • Face-to-Face Discussions: 65%
• Spend Time Using Your Hands: 56% • Work With Work Group or Team: 62%
• Telephone: 57% • Annual salary: $107,600
• Contact With Others: 57% Job demands
• Annual salary: $52,590 • Sitting
Job demands • No boundaries between work, non-work
• Physical demands: heavy lifing, dirty conditions • Long working hours: 24/7 work attitude
• Irregular working hours, on call work • High work load
Job resources • Competitive work culture
• Practical, hands-on problems and solutions Job resources
• Boundaries between work & non-work • use abilities, achieve feeling of accomplishment
• Autonomy • prestige, social status
• Variety in job tasks • job security and good working condition
• Social support (collaboration with colleagues & clients) • Autonomy
• job security and career opportuities • Variety in job tasks

O*NET: https://www.onetonline.org/
%=Percentage people answering “every day”

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Bad work? Good work?

Tips: “The Circle” (D. Eggers), “Sapiens” & “Homo deus” (Y.N. Harari),
“Brave new world” (A. Huxley), Black mirror (BBC series)

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Example break intervention

• Snack on the table
• Some water/coffee if you have
• Developed by student team in 2021 in collaboration
with yoga teacher

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What: Mindfulness meditation

• Old wine in new bottles: Buddhist origins
• Mindfulness:
– self-regulation of attention to the conscious
awareness of one’s immediate experiences
(Awareness)
– while adopting an attitude of curiosity, openness, and
acceptance, non-judgemental (Acceptance)
• Mindfulness-based Stress Reduction (MBSR)
• Associated with small to medium decreases in…
– pain and other medical symptoms
– anxiety, depression, stress

Grossman et al., 2004

Bishop et al. 2004
Kabat-Zinn 1994
Bear, 2003

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Mindfulness meditation Lykins & Baer, 2009

Khoury et al., 2013
• Target group: Universal
• Strongest effects expected for: psychological well-
being (depression & anxiety); smaller effects for
physical symptoms (cortisol, heart rate)
• Short-term effects (1 session to days):
– negative psychological symptoms (stress
reactivity)
• Long-term effects (min 8 weeks-years):
– rumination, decreased fear of emotion, and
increased behavioral self-regulation
• Benefits: Easy to learn, cost effective

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Stress Test: Pre

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Stress Test: Post

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Schonfeld & Chang, 2017

Conclusions

• Work affects health, well-being and performance

negatively AND positively
• Stress is a fuzzy concept, difficult to define and
measure
• Stress theories: from behavioral models explaining
how stress affects the body to psychological
models explaining what factors cause stress and
why

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References
• Hassard, J., Teoh, K. R., Visockaite, G., Dewe, P., & Cox, T. (2018). The cost of work-related
stress to society: A systematic review. Journal of occupational health psychology, 23(1), 1.
• Afscheidsrede Schaufeli: https://www.3ihc.nl/whitepaper-de-waarde-van-bevlogenheid/
• UWV jaarverslag: https://www.uwv.nl/overuwv/Images/uwv-kwantitatieve-informatie-
2018.pdf
• Blatter B, Houtman I, Bossche S van den, Kraan K, Heuvel S van den (2005).
Gezondheidsschade en kosten als gevolg van RSI en psychosociale arbeidsbelasting in
Nederland. Hoofddorp: TNO.
• TNO monitor:
https://www.monitorarbeid.tno.nl/dynamics/modules/SPUB0102/view.php?pub_Id=1003
75&att_Id=4911
• Arbobalans:
https://www.monitorarbeid.tno.nl/dynamics/modules/SPUB0102/view.php?pub_Id=1005
96&att_Id=4911
• Peccei, R., & Van De Voorde, K. (2019). Human resource management–well-being–
performance research revisited: Past, present, and future. Human Resource Management
Journal, 29(4), 539-563. doi: https://doi.org/10.1111/1748-8583.1225

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