Socio-psychological effects of stress in organizations’ absenteeism problems

1 Introduction

Absenteeism can be defined as absence from work for various reasons, especially as an unplanned, often unjustified absence with a variety of motives [1–3].

Studies in developed countries have shown that the perception of one’s own health can have an effect on absenteeism [4] and that employees who are satisfied with their health have less inclination towards absenteeism [5]. In addition, the self-assessment of health can be a possible predictor of absence [6, 7].

Stress at work has become an increasing medical and economic problem for two reasons. First, because it involves a series of important consequences that affect the organizational behavior of employees and the success of the organization. Second, because it is related to overwork, discontent, conflicts, frustrations and changed employee behavior. Research in developing countries shows that 60–80% of outpatient visits may be related to stress [8], and are linked to all leading physical causes of death, such as heart disease, cancer, and stroke [9]. Additionally, stress is associated with the development of the two major mental health problems: depression and pathological aging [10]. The results of the extensive analysis of Lunau and associates have shown that psycho-emotional stressors at work are related to mental health [11].

Workplace stress is steadily expanding and is becoming a more important medical and economic problem that can involve: work overload, dissatisfaction, and the feeling that one’s efforts are not appreciated. In the contemporary business climate, powerful stressful factors include: the lack of time, poor interpersonal relations in organizations, exposure to changes, longer business hours, job insecurity, and a lack of possibilities for sufficient weekly and annual vacation [12]. Finally, stress has also been linked to several negative organizational outcomes, to the psychosomatic effects of stress, and to absenteeism [13]. According to the results of the International Social Surveys Program (ISSP), a higher level of stress among employees is recognized as a predictor of absence from work [14]. Absenteeism as a consequence is influenced by determinants of stress, and stress responses. Stress has been implicated as a factor of absenteeism and attitude toward work [15].

Occupational stress is influenced by work environment factors which may trigger a reaction and different psychological and somatic disorders [16–18]. Stress at work can be defined as a harmful physical and emotional response that arises when job demands are beyond the employer’s resources, capabilities or needs [19–21].

Individuals react differently to a problem or a stressor. Depending on their temperament, a person has a lower or higher level of tolerance to stress. The way people evaluate events and situations influences their responses.

In this sense, Anderzén and associates speak of the employee health and biologic stress markers [22]. According to Folkman and Lazarus’s theory, stress is a relating concept defined as a relationship between a person and their environment in which the person decides whether an aspect in that environment involves a threat, loss or challenge to his/her strength, and where typical changes of psychophysiological balance occur. The affirmative transactional stress model defines stress as an individual’s feeling in situations where the requirements he perceives exceed his potential. Stress is understood as a process in which all the elements are mutually related in two ways and subject to changes in interaction with one another [23].

Additionally, stress can be regarded as a syndrome of adaptation, which occurs when a situation is assessed as stressful and which, on a physiological level, initiates the adaptation mechanisms which imply neuro-endocrinological changes and the emotional changes related to those mechanisms.

A stressful experience implies a cognitive appraisal of the disjuncture between demand, which is regarded as the primary appraisal, and perception of personal possibilities to deal with that demand properly, which is regarded as the secondary appraisal [24].

Stress can also be seen from other baselines, for example, according to Hans Sely, stress can also be viewed as the alarm of an organism in a damaged homeostatic system which provokes a general and nonspecific neurophysiological reaction from one level to the next higher level of excitement [25].

With respect to the level of threat intensity, the sources of stress are traumas including dangerous, threatening events which are not categorized as everyday experiences. Sources of stress are also life events which are less threatening (when compared to traumatic events), but which can be of high intensity and varying duration, such as changes in the environment, the loss of a close person, divorce, or a serious disease.

Chronic stress occurs when we are exposed to minor, often imperceptible, repetitive traumatic events that after a long time disturb our psychophysical balance. Moreover, it often happens that chronic stress is associated with life events or business problems. Daily micro stressors are events with low threatening intensity but with frequent occurrence [26]. In organizations, employees are more likely to encounter micro stressors.

Occupational stress is caused by factors which originate from work processes or the business environment and which provoke the reaction of adaptation, accompanied by different psychological and somatic disorders [27]. Numerous factors causing stress in employees can be found in the modern way of doing business. Various studies have identified over 40 important possible factors of stress at work [28].

All these factors could be categorized as: internal factors which are related to poor working conditions, risks, and dangers; new technologies; conflicts and undefined roles in situations when employees are not certain about their duties and responsibilities; interpersonal relationships at work with subordinates, superiors or colleagues; stressful situations; bad organizational policies. Personal reaction to stressors depends primarily on the recognition of exposure or danger from the brain in the given situation. But this observation includes also physical health, emotional stability, the sense of self, and the duration of a given stressor [29].

In recent years, stress is considered the second most common health problem associated with work, affecting 28% of employed people from the countries of the European Union [30]. One interesting research was conducted on a sample of 2000 respondents from 23 different occupational fields, which were referred to as blue-and white-collar workers [31]. Those occupations were described with respect to the reaction of employees to psychological stress, employees’ blood pressure, heart rate, blood cholesterol level, personality dimensions (based on the two different defense mechanisms), and the psychological factors of discontent and anxiety. One of the most significant consequences of stress is the development of psychosomatic disorders. Psychosomatic disorders are diseases whose origin lies in psychological factors where functional changes of an organ or of the entire system are developed.

In the current working conditions, the development of psychosomatic disorders is on the increase, which indicates the necessity of studying the causes of stress and ways of experiencing particular stressful situations. A large number of employees in Serbia fear losing their jobs, while the results of research from other parts of the world indicate a positive correlation between employees’ stress levels and working conditions in organizations where insecurity and instability are predominant [32]. According to some research, there are indicators which suggest a relationship between daily stress and somatic disorders such as headaches, backaches, colds, sore throats, and mood shifts [33].

According to the research on the causes of stress, the most frequent stressors are related to interpersonal relationships, managers, and working conditions. Stressors can, basically, be of both social and of psychological nature. Sources of stress in law enforcement occupations have been shown to be related to organizational change, codes of conduct, and practical tasks [34].

Studies in organization shows that individuals with a lower level of stress will be more productive, more content and more motivated to work [35]. On the other hand, chronic, repeated, negative emotional responses often contribute to a high level of long-term stress [36]. The connection between the neurobiological and psycho physiological parameters of the individual in stressful experiences is thus linked to the behaviour in the organization, and very often absenteeism is one of the irrational ways of defending the individual from a negative reality. Psychological distress also proved to be a significant predictor of absenteeism in the results of the research of Negrin and his associates [37].

2 Methodology

The aim of this research was to determine whether the respondents recognized twenty-five different stress symptoms, by analyzing their self-evaluation, as well as by determining the connection between stress symptoms and general demographic indicators, the evaluation of personal health, and the existence of stressful events. The questionnaire that was used in the research included general demographic questions, and a scale depicting respondent’s stress levels. The questionnaires were filled out voluntarily, with the consent of the organizations’ managers. Research approval was obtained by the managementorganization.

The research sample consisted of a heterogenous group of people, and the study was carried out in the first half of 2018. The subjects of the research were given instructions for the work to be done, with special emphasis on the complete anonymity of the data gathered and the goal of the scientific research, after which they completed the surveys.

Employees who perform jobs in a production facility form the strength of an organization and therefore it is important to enable this group of employees to maximize productivity by reducing stress at work. The respondents were divided into five categories based on their age: 5.5% were under 30, 30.8% were between 30 and 40 years of age, 25.3% were between 41 and 50 years of age, 24.3% were between 51 and 60, and 14% of respondents were over 60.

According to their years of employment the following categories were formed: 20.9% of respondents had up to 5 years of employment in the current organization, 36.6% of respondents had up to 10 years of employment, 15.1% of them had 15 years of employment, 9.5% of them had 20 years of employment, 5.6% had 25 years of employment, 4.3% of respondents had up to 30 years of employment and 7.9% of them had more than 35 years of employment. The respondents had the following qualifications: 4.9% of them had completed only primary school, 42% of respondents graduated from high school, 17.3% had college qualifications, and 35.8% had a university degree. A managerial position was held by 34.4%. The following hypotheses were formulated: \begin description\item Hypothesis 1: Employees will exhibit physical and psychological stress symptoms.∥\item Hypothesis 2: There is a difference between the stress symptoms of employees who have different general demographic characteristics.∥\item Hypothesis 3: Stress symptoms increase with the accumulation of unpleasant events in personal and business life. \end description

Data processing was performed using the statistical software SPSS. Statistical analysis was limited to the correlation plan and ANOVA.

3 Results

The most common symptoms reported were: a feeling of exhaustion, a feeling of tiredness, nervousness, bad sleep, smoking and alcohol use, and bad concentration. The least exhibited symptoms were: asthma, stomach ulcers, heart disease, skin rashes (Table 1).

The correlational analysis showed that the symptoms that significantly correlated (at level p < 0.01) with stress were: age –0.179; length of employment –0.137; level of education –0.115, and self-evaluation of health condition –0.508. The age of respondents, as an indicator of stress symptoms, shows a linear distribution, meaning that the older the respondents were, the more pronounced their symptoms were. It was assumed that older respondents used non-functional ways of overcoming the stress. Results of the present study showed that younger respondents were more likely to approach the problem-solving process more seriously, to face obstacles, look for information, and come up with solutions. Ambition and readiness to make changes in the working environment are probably the stimuli for a more analytic approach. Reasons for respondents’ choices and questions of a cause and effect nature cannot be addressed by the correlational design of the present study. However, one possible explanation may be that the younger subjects have higher educational levels and a better understanding of how to overcome and solve problems.

The situation regarding years of employment and the age of respondents is similar to the previous one, and the differences are not so striking when older age groups are considered. The level of education shows the same results as the age of respondents –the higher the qualifications, the less obvious the symptoms –meaning that the differences changed proportionally.

The question ‘Did you have any particularly influential event in your personal life last year?’ was answered in the following way: 34.2% of respondents answered that there were no such events, 38% said that there was only one event of that kind, while 27.8% said that there were two or more such events. With respect to important events in the business context, 31.3% of the respondents experienced one such event, 16.4% had several important events and 52.3% of employees did not experience any important events in the business context. Evaluation of personal health showed positive characteristics where 25.1% of respondents believed that their health was excellent, 53.8% of respondents thought their health was generally good, 17.6% categorized their health as somewhere between good and bad, 2.8% of them described it as bad and 0.6% as very bad.

Table 2 shows the comparison of stress symptoms and the number of influential events in the private lives of the subjects. The results indicated that the degree to which the symptoms appeared was higher among those subjects who experienced a significant event in their private lives in the preceding year when compared to those who did not have such an experience. The results also indicated that there is no difference between those subjects who had one influential event in their private lives as compared to those who had two or more (Table 2).

The results in Table 3 show the comparison of stress symptoms and the frequency of significant unpleasant events at the workplace itself.

The results indicated that there was no difference between those subjects who did experience one significant unpleasant event in the previous year at the workplace, and those who did not.

However, there is a significant difference between those two groups (who did or did not experience a significant unpleasant even in the previous year at the workplace), and those who two or more significant events in the previous year at the workplace.

There is a significant correlation between stressful events and the expression of stress symptoms. The frequency of the occurrence of an important event has been shown to enhance the appearance of symptoms (Table 3).

There were no statistically significant differences in the expression of symptoms with respect to other categorical variables. In short, the results show that certain events which take place at work are likely related to the stress symptoms reported and to the psychosomatic disorders reported. The greater number of events the greater the number of undesired symptoms.

It is not possible to determine from the present study the number of stressful events that can be tolerated, or to determine the intensity of stressful events can be accepted without increasing stress related symptoms. Studies of stress and absenteeism in Serbia are rare, and have small sample sizes, and it is difficult to gain clear research indicators of both stress and absenteeism. The research of the Business Support Network in Serbia showed that in enterprises, absenteeism from the workplace is most often in case of illness (47%), then family problems (22%), professional stress (18%) and other personal reasons (13%), [38]. However, the situation in a society that is still struggling with transition unambiguously indicates a number of stressors in organizations. Some of the most common stressors in Serbia are unfavorable working conditions and job insecurity [39]. The percentage of unemployed citizens has been over ten percent for many years, and employment opportunities do not exist to the extent necessary, which contributes to employee uncertainty. It is quite difficult to measure many factors of stress and absenteeism in business, especially in unregulated business conditions. One of the disadvantages of the research is certainly the inability to identify all of the variables within the work environment.

However, changes in organizational and managerial mechanisms can most certainly decrease the number of undesired events which affect the health condition of employees.

The way in which an individual reacts to stress by facing a stressful situation or trying to overcome its influence affects the psychopathological manifestations of stress.

The prevention of stress at work requires a range of organizational changes in work organization and human resource management such as eliminating the overburdening of employees and resources, redesigning reward programs, implementing programs for showing approval and respect of employees’ activities, continuously working on communication.

Stress prevention at work in organizations can be distinguished as primary, secondary and tertiary prevention [40]. Primary prevention aims at the causes of stress and its possible effects on employees. Secondary prevention aims at providing training to employees for them to be able to recognize and reduce stress before it causes illness. Finally, tertiary prevention includes taking care of employees who have already become ill due to the stress at work.

The consequences arising from a company’s inability to reduce stress and the consequences of stress lead to many economic and human problems for employees which are primarily seen in increased expenses due to sick leave, dissatisfaction and reduction in the level of employees’ performance [41]. Since stress is a personal experience, everyone chooses the methods of overcoming it which are the most suitable to them. Overcoming stress strategies may be classified into three groups: (a) assessment-oriented stress approach includes: logical analysis and mental preparation, which includes exploring the problem and solving it in stages, cognitive redefinition, cognitive avoidance or denial –an event is denied, or less significance is attached to it than is really the case; (b) problem-oriented stress approach includes: searching for information on the event which has resulted in stress, taking problem-solving-oriented actions, recognizing alternative solutions –finding the means to change activities and find satisfaction in something else, and (c) emotion-oriented stress approach includes: affective regulation, emotional outbursts –use of crying, screaming; it also includes excessive smoking, taking medicines, and reconciling oneself with the situation. Benefits of stress reduction include better concentration, more stable moods, improved relationships, better physical health, and an increased sense of control of time and activity [42].

The nature of most middle managers’ jobs includes responsibility for creating the psychological climate within the organization, which includes fostering mutual relations and support. Managers are trained to guide their own professional and personal development so as to acquire knowledge and skills which make them competent in recognizing dysfunctional conditions in the business environment. However, research results have shown that 42% of doctors reported receiving no instruction regarding stress and health outcomes in medical education, 76% lacked confidence in their ability to counsel patients about stress, while 49% indicated a lack of referral sources [43]. The crucial thing for the development of both individuals and the organization is the creation of realistic objectives and of balance between the expectations regarding one’s career and the daily reality.

The individual consequences or effects of stress can be classified into the following categories: subjective effects (e.g. anxiety); behavioral effects (e.g. excessive use of drugs and alcohol); cognitive effects (e.g. inability to make good decisions); physiological effects (e.g. increased blood pressure); health effects (e.g. headaches). The organizational consequences of stress are manifested in direct and indirect costs. Direct costs include participation and membership -absenteeism, turnover, delays, strikes; accidents at work, irrational use of resources, and unplanned work breaks. Indirect costs include loss of vitality - low morale, low motivation, frustration, interruptions of communication - decreased contacts, distorted messages, low-quality relationships - distrust, disrespect, and poor decision-making. Therefore, organizations that produce stress conditions for their employees reduce the organization’s effectiveness, flexibility and competitive ability [44].

Practical improvements for stress prevention, according to the proposal of the Office of the International Labour Organization, include several aspects of work such as management and workplace justice, job requirements, job control, social support, physical environment, business and private life balance and working hours, respect for work, protection against offensive behavior, job security and information and communication flow [45].

5 Conclusion

Absenteeism must be seen through the macro-social level, the medium-organizational level the micro-level, and from the perspective of individuals. Generally viewed, absenteeism represents a significant psychosocial problem in organizations, and it is necessary to make a distinction between regulated and unregulated absences. Unregulated absences are actually unpredictable absences without obvious reason, and it is important to define these reasons [46].

In the search for the causes of absenteeism, it is also necessary to consider some positive outcomes of absenteeism, when it comes to individuals, which is the need to remove oneself from the negative working environment [47].

The present results showed significant differences in the existence of stress symptoms and the possible psychosomatic effect in relation to general demographic characteristics such as age, years of employment, self-assesment of health status, and the occurrence of an unpleasant event in the past. Although some of these results are expected, it is important to have these research findings documented so that a system of protection from stress might be established both at the personal and social level. The main limitation of the research relates to the selection of the questionnaire, which is generic and does not sufficiently indicate the personal problems that arise under the stress in the organization. Another disadvantage is the selection of a suitable sample because it was almost impossible to find a representative sample for our research. Despite the stated shortcomings, we believe that it is of great importance for both the organization and the employees to start considering the causes and consequences of stress, which would contribute to improvement in organizational performance. Results of a 15 country study in the European Union showed that 28% of workers feel stressed at work, and that this has a certain impact on their health [48].

Work patterns have a significant impact on the health and well-being of employees but also on the degree of absenteeism [49]. In our opinion, stress has increased in recent years as a result of numerous economic and political events in Serbia. Many employees have adapted to the changes sluggishly and with great difficulty, which also contributed to the level of stress and its consequences.

Despite several shortcomings –primarily, the lack of a more representative sample and certain limitations of the questionnaire –the present study has clearly shown the complexity of stress-related problems in Serbian organizations, where employees do not feel appreciated, and the consequences of those problems were evident in every segment of work. In addition to stress and its consequences, many other factors contribute to absenteeism in organizations, such as loose organizational structures and the mismanagement of human resources, very low profits, and the inability of employees to live a quality life with their current earnings. The questionnaire’s limitations included that the survey was generated by the authors, reliability, validity or reliability tests were not carried out, and cause and effect could not be assessed given the correlational design.

Absenteeism appears to be related to several psychosocial problems and its consequences are reflected not only in work results, but also in the psychological, social and health status of employees. The negative stress contributes to reducing the positive attitude of the employees towards the job it turns to absenteeism, turnover, anxiety and depression [50]. The relationship between stress and absenteeism with a non-managerial pattern of white collars was investigated, and the findings revealed the correlation between the previous absence and many causes of stress [51].

The reduction of stress and its consequences is one of the basic goals of modern organizations. In developed countries, organizations are dealing with primary, secondary and tertiary activities for stress prevention. The main problem is defining the causes of stress in the workforce and organizing tasks so as to reduce the risk of stress, and then increasing the empowerment of employees by giving more power to the employees themselves [52]. Secondary and tertiary activities are focused on the development of knowledge and skills to recognize stress and ways to avoid it in the future [53], and, if there are negative consequences, to provide employees with adequate assistance. Effective workplace stress management requires a deeper understanding of the complexity, problems and (negative) effects of stress that affect and shape the behavior of individuals and of business organizations, in general [54]. Absenteeism is one of the possible consequences of increased stress, whose existence has a direct impact on work results. Addressing stress issues within organizations and respecting and empowering employees will help improve working conditions and decrease absenteeism related to stress.

Conflict of interest

None to report.