Work related stress

Dr. Ruwan M. Jayatunga MD

Annually a large numbers of employees undergo health related problems following work related stress.

This is an invisible phenomenon which has to be considered very seriously by the health authorities. Unfavourable work conditions, over work, work place harassments lead to various stress related illnesses among the employees.

The right to work is fundamental to all humans according to the Universal Declaration of Human Rights issued by the UN. Work satisfies the human desire to be productive member of society and to have a purpose in life.

When these rights are violated workers experience different types of stress related conditions and naturally their productivity decrease. This is a nation wide problem that is not addressed in a larger scale.

Burnout

Burnout is a frequent manifestation of job related stress. Burnout is defined as a state of physical emotional and mental exhaustion that results from long term involvement in work situations that are emotionally demanding.

Burnout is commonly associated with work situations in which a person feels over worked, under appreciated and confused about expectations and priorities given responsibilities that are not commensurate with pay increase about lay offs and over committed with work responsibilities.

Contributors to burnout include excessive amount of work, role conflict and the perception of being unfairly treated on the job.

Adjustment disorders

Anxiety related disorders especially Adjustment Disorder are common among the workers that undergo severe job related stress.

Adjustment disorders generally develop within a month or so after a significant life changes loss or event. it is a short term condition that occurs when a person is unable to cope with or adjust to particular source of stress.

An adjustment disorder can have a wide variety of symptoms which may include stress related physical symptoms (unspecified headaches, backaches, palpitations etc) mild to moderate depression and behavioral changes.

Sometoform Disorders

As a result of work related stress people can develop various types of sometoform disorders as well. Sometoform disorders are physical ailments with no authentic basis.

Unspecific headaches, joint pains, stomach problems etc are common among the affected personnel. They have long history of medical treatment with a wide range of investigations and associated symptoms of depression and anxiety.

Stress and trauma are concept used in both medical and psychological literature to refer to unusual events, significant change or treat demanding special bio-behavioral or psychological adaptive responses by the individual in order to maintain psycho physiological equilibrium and well-being. The stressor is the event that triggers the change or the threat.

Negative stress coping methods

When facing work related stress people often go in to negative stress coping methods such as high intake of alcohol, cigarette smoking and sometimes substance abuse. These types of negative stress coping methods lead to a wider range of medical problems.

Uncontrolled stress

Job related stress is a state of tension that is created when a person responds to the demands and pressure that come from work. Uncontrolled stress can lead to hypertension, and heart problems as well. Therefore severe stress factors generated in the work places must be controlled.

Overcoming work related stress

In the mean time we must forget that there have been a number of suicides following work related stresses. In order to prevent this type of catastrophes active measures must be implemented.

Positive man management, creating favourable working environments, introducing counselling services can overcome the negative effects of work related stress.

In many respects:

Regionally our healthcare service an example to others

Prof. Lalitha Mendis who was inducted in office as President of the Sri Lanka Medical Association (SLMA) on Monday (January 14) has made this observation in an article. She had written in the SLMA news bulletin of September 2006 on the theme - National Health Policy.

In this article writing as the Chairperson of the SLMA National Health Policy. Committee she states: “Sri Lanka’s National Health Service is a massive operation involving nearly 600 hospitals 60,000 patient beds and 100,000 employees, operating on a shoestring budget of only 1.8 of the GDP.

“However in many respects it stands out as an example in the region which can be perfected to be our national pride with added cost effective measures. State-of-the-art general and financial management and an elevated level of professionalism”.

Why yet another health policy document

Referring to the National health Policy she writes, “It may be asked why Sri Lanka which has had especially in the last fifteen years or so, a surfeit of health policy documents, strategic frameworks, task force documents and master plans should need yet another health policy document. Notwithstanding the fact that the Ministry of health has indeed made progress and achieved much in recent times.

It was felt that with regard to previous documents, there had been a failure of implementation of accepted policies in a systematic and time based manner. “Furthermore that the monitoring of progress made had been poor.

Also the health needs of the nation are in a continuous state of flux and this warrants frequent periodic evaluation, followed by reprioritisation of policies and action eg. a reprioritisation was required when the tsunami occurred and perhaps now, in the face of the recent increase of Internally Displaced Persons (IDPS). The relative importance of different causes of mortality and morbidity may change.”

Reasons for SLMA document

“These were some of the reasons for the SLMA developing yet another national health policy document. The document was circulated to all professional colleges and the Organisation of Professional Associations (OPA) and finalised after a joint meeting with these bodies.

Thus the SLMA-NHP document is published in this newsletter as the collective vision of doctors of how the Health Ministry should progress. Health policy and its outcomes are the concern of many is born out by the fact that the 2006 annual session of the OPA was devoted entirely to “Health in Sri Lanka Challenges and Responses.”

Permanent standing committee

The document contains general directional policies from which operational policies should flow.

There are clear recommendations for the setting up of a permanent standing committee with representatives from the SLMA and Ministry of health to monitor progress of operational policy formulation and implementation.

Public-private partnership

The main thrust of the SLMA document is on equity of distribution of healthcare inclusive of vulnerable population groups, IDPs and victims of disasters, empowering of the community and investing more on preventive services, enhancement of primary care leading to a national scheme of general practice and referral system combating malnutrition, human resource development and medical and allied medical personnel in keeping with contemporary and projected need efficient management of financial and human resource, establishment of state-of-the-art management information system, and the encouragement of private-public partnership.

Our Medical Crossword

A way forward in health education:

At our 30th Healthwatch Medical Crossword draw held last week at Galle Face Hotel, Colombo, Nestle Lanka commended this novel health education.

It was described feature, which is one of our own creations in using the crossword feature in the daily press media specifically for health education as a very effective and motive way forward in health education introduced by the daily press (Daily News) for the first time in Sri Lanka and could be in the world too Mr. Stuart Young (Managing Director) of Nestle Lanka (Ltd) said at the 30th Medical crossword draw where he was the chief guest.

Young and Jessica Tumao (AOA) Nestle Health Care Nutrition who was the guest of honour at this event both took copies of the Daily News Medical page where the article on - Choosing your life’s Partner correctly in the medical way was published.

Healthwatch Medical crossword

No. 30 Prize Winners

The following are the prize winners of Health Watch Medical Crossword No. 30 (sponsored by Nestle Health Care Nutrition). The winners were picked at the crossword draw held on Monday January 7, at 11 am at the Lotus Lounge Galle Face Hotel, Colombo with Mr. Stuart Young, Managing Director Nestle Lanka Ltd. as the Chief Guest.

1st Prize: Rs. 3,000

N. Samsudeen (Entry No. EL 23)
210 Park Rd. Colombo 5.

2nd Prize: Rs. 2,000
Zakeena Soeb (Entry No. 1)
19 Skelton Rd. Colombo 5 (an A/Level Science Student).

3rd Prize Rs. 1,000

Chiara Alles Ramachandra (Entry No. 3)
49, Horton Place, Colombo 7.

(She is a full member (MCIM) of the Chartered Institute of Marketing U.K.)

Consolation Prizes (of one month supply of R/H)

(1) Lakshmi Samaranayake (Entry No. EL 10) Colombo 5. (2) Indra Padmini Gunaratne (Entry No EL 1) Yakkala. (3) Darshana Abeysinghe (Entry No. 6) Hokandara.

Consolation Prizes of Rs. 1,000 each (in gift vouchers) from Healthy Life (Pvt) Ltd. Colombo 3.

The winners were picked by
Dr. Thivanka Karawita.

(1) Entry No. 17: Nalinie de Croos, No. 27, Rukmani Devi Mawatha, Negombo.

(2) Entry No. 3: R. K. Nathaniel, 21 1/2, 8th Lane, Colombo 3.

(3) Entry No. 18: P. S. de Croos, No. 27, Rukmani Devi Mawatha, Negombo.