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Stress-related problem — Clinical Guidelines

Overview

Stress-related problems encompass a range of psychological and physiological responses to perceived threats or challenges, impacting various occupational groups, particularly healthcare professionals, due to high work demands and risk environments. 2 3 5 7 15 20

Diagnosis

Symptom Assessment: Evaluate for symptoms such as anxiety, depression, fatigue, and physical complaints like headaches or gastrointestinal issues. 5 24 27

Occupational Factors: Consider work-related stressors including role overload, emotional labor, and work environment characteristics. 2 4 15

Screening Tools: Utilize screening instruments like the Distress Screener for early identification of distress among employees on sick leave. 26

Management

Multidisciplinary Approach: Implement multidisciplinary stress treatment programs involving psychological support, coaching leadership, and organizational interventions. 20

Relaxation Techniques: Introduce relaxation techniques such as autogenic relaxation and mindfulness practices to reduce stress levels. 18 38 39

Support Systems: Enhance perceived social support and instrumental support to buffer against stress and emotional exhaustion. 4 20

Occupational Interventions: Employ participative ergonomics and ergonomic modifications to mitigate physical and psychological stressors in the workplace. 36

Special Populations

Healthcare Professionals: Tailor interventions focusing on emotional labor, work engagement, and wellness programs specific to high-risk environments like anesthesiology and nursing. 2 3 5 22 27

Elderly and Pediatric Populations: Limited direct evidence; interventions should consider age-specific stressors and support systems. 1 15

Key Recommendations

Implement Multidisciplinary Stress Programs: Offer structured multidisciplinary interventions for employees on sick leave due to work-related stress. (Evidence: Strong 20)

Integrate Relaxation Techniques: Incorporate regular relaxation and mindfulness practices into workplace routines to improve well-being. (Evidence: Moderate 38 39)

Enhance Organizational Support: Strengthen perceived social and instrumental support mechanisms to mitigate stress impacts. (Evidence: Moderate 4 20)

Adopt Ergonomic Interventions: Use participative ergonomics to address physical and psychological stressors in the workplace. (Evidence: Moderate 36)

Monitor and Screen Regularly: Utilize validated screening tools like the Distress Screener for early identification and intervention in stressed employees. (Evidence: Moderate 26)

References

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Psychological care needs for frontline nurses during the COVID-19 pandemic: A qualitative study. Frontiers in public health 2022. link 6 Ong AM. Pondering the Pandemic's Problems: A Program Director's Perspective. Digestive diseases and sciences 2021. link 7 Gallo CG, Berkel C, Mauricio A, Sandler I, Wolchik S, Villamar JA et al.. Implementation methodology from a social systems informatics and engineering perspective applied to a parenting training program. Families, systems & health : the journal of collaborative family healthcare 2021. link 8 Bjerkeli PJ, Skoglund I, Holmgren K. Does early identification of high work related stress affect pharmacological treatment of primary care patients? - analysis of Swedish pharmacy dispensing data in a randomised control study. BMC family practice 2020. link 9 Hellhammer D, Meinlschmidt G, Pruessner JC. Conceptual endophenotypes: A strategy to advance the impact of psychoneuroendocrinology in precision medicine. 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European heart journal 2015. link 17 Di Tecco C, Ronchetti M, Ghelli M, Russo S, Persechino B, Iavicoli S. Do Italian Companies Manage Work-Related Stress Effectively? A Process Evaluation in Implementing the INAIL Methodology. BioMed research international 2015. link 18 Pearce L. Working on my own terms. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2013. link 19 Castaño PM, Stockwell MS, Malbon KM. Using digital technologies to improve treatment adherence. Clinical obstetrics and gynecology 2013. link 20 Netterstrøm B, Friebel L, Ladegaard Y. Effects of a multidisciplinary stress treatment programme on patient return to work rate and symptom reduction: results from a randomised, wait-list controlled trial. Psychotherapy and psychosomatics 2013. link 21 Peate I. Do as I say, not as I do. British journal of nursing (Mark Allen Publishing) 2012. link 22 Saadat H, Snow DL, Ottenheimer S, Dai F, Kain ZN. Wellness program for anesthesiology residents: a randomized, controlled trial. Acta anaesthesiologica Scandinavica 2012. link 23 Warriner RA, Hopf HW. The effect of hyperbaric oxygen in the enhancement of healing in selected problem wounds. Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 2012. link 24 Shoss MK, Shoss BL. Check-up time: a closer look at physical symptoms in occupational health research. Stress and health : journal of the International Society for the Investigation of Stress 2012. link 25 Simões R, Daniellou F, Nascimento A. From prescribed to real rotations: a means of collective protection for the health of workers in a soft drink factory. Work (Reading, Mass.) 2012. link 26 Braam C, van Oostrom SH, Terluin B, Vasse R, de Vet HC, Anema JR. Validation study of a distress screener. Journal of occupational rehabilitation 2009. link 27 Nyssen AS, Hansez I. Stress and burnout in anaesthesia. 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Stress-related problem