Dissertations / Theses on the topic 'Psychiatrists Australia Job stress'

The purpose of this study was to establish the frequency of problems that members of Police Force X experience or have experienced, and to determine which source of counselling the members of Police Force X would prefer most for each problem. A single stage sample design was used for this study. Two hundred non-commissioned police officers were randomly selected and were mailed a questionnaire through the police department's in-house mail system. One hundred and fifteen police officers returned completed and usable questionnaires. With the exception of an under representation of female police officers, the sample was representative of the population. The analysis of data showed that the five most frequent problems reported by the respondents were anxiety that interferes with the enjoyment of life, alcohol abuse, depression, financial problems, marital problems and sleep disturbance (these problems are presented in alphabetical order, and not in order of frequency). Further, for thirteen of fifteen presented problems the majority of respondents selected outside psychiatrist or psychologist as the most preferred source of counselling. For the problem of boredom and alienation members were equally divided between outside psychiatrist or psychologist and peer counselling as the most preferred source of counselling. The study concluded with a discussion of practical implications and recommendations for further research were presented.
Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate

This study investigated the presence of occupational stress among teachers. It did not set out to identify and explain variables associated with stress among teachers, rather the study focussed on the multitude of variables identified in the literature and sought to include these in a more extensive causal model. The study was conducted in two main stages. Firstly, a cross-sectional survey investigated the presence of stress among 230 teachers, as measured by Psychological Stress, Physical Health, Job Satisfaction and & desire to Leave their Job. The survey obtained information on stress outcome variables (Psychological Stress, Physical Health, Job Satisfaction and Wanting to Leave), biographical information, personality (Hardiness, Type A Behaviour, Locus of Control, Extraversion and Neuroticism), psycho-social variables, (Social Support, Problem Solving, Emotional Coping mechanisms and Self Esteem) and work and life stressors (Role Conflict, Role Ambiguity, Job Responsibility, Job Future Ambiguity, Underutilization of Skill, Inequity of Pay, participation in Decision Making, Administrative Support, Relationships with Peers, Extra Work, Wanted Extra Work, Workload, Work Hours and major Life Events). Causal models using path analysis were then generated to account for the relationships found within the data. Secondly a longitudinal study over six months was conducted on 242 teachers. The causal models generated in the first study were re-tested on this second group of teachers, both cross-sectionally and longitudinally. Furthermore the importance of existing levels of stress in the prediction of future stress was assessed. Finally a three year follow up was conducted on the survey's participants. The results of the investigations revealed that:-(i) the utility of demographic information in the stress process was inconsistent. (ii) that among measures of work stressors there are replication and redundancies. (iii) that the different stress outcome measures had different predictors. (iv) that the best fitting causal models for the stress process were direct effect models. (v) that existing stress levels am an important factor in the prediction of future stress levels. (vi) that those teachers who indicated a desire to leave teaching and/or were experiencing psychological stress, were more likely to leave teaching three years later. (vii) that there is a need to standardize both the outcome and predictor variables used in stress research. The implications of these results were then discussed as were areas for future research.

The aim of this study is to investigate the prevalence and sources of self- reported occupational stress among primary school teachers in Western Australian Government schools. Five specific objectives form the basis of this study. First, the study develops an instrument which measures the perceived levels of occupational stress and reveals the sources of such stress. Second, the study applies this instrument to determine the perceived levels, and sources, of occupational stress among primary school teachers in metropolitan Perth. Third, the study investigates differences in the perceptions of stress and stressors when categorised by socio-biographical characteristics of teachers. Fourth, the study investigates the relationship between occupational stress and satisfaction. Fifth, path analysis techniques are used to test the adequacy of a stress-stressor model derived from a priori assumptions and temporal sequence. A qualitative meta-analysis reveals characteristics of the literature which discursive reviews may omit. Such characteristics include trends in research interest in the topic of teacher stress over time and geographical area, the balance between types of studies, the relationship between types of studies, aspects of teacher stress and geographical area, findings of the studies, and determining categories into which the findings can be examined. Definitions of stress and burnout, definitions of teacher stress and teacher burnout, reasons for concern about teacher stress and teacher burnout, the prevalence of stress in the teaching profession, sources of stress in the teaching profession, perceptions of stress and stressors when categorised by socio-biographical characteristics, and the relationship between stress and occupational satisfaction are the areas from which information is accessed for the literature review. Prior to the development of a conceptual framework, the purpose of such a framework is discussed. The conceptual framework itself is developed from two broad areas. These include teacher stress and corporate management theory. The role of and contribution made by the present study to each of these areas is explained. The methodology of the present study is discussed in six broad areas. These include the preparatory phase, the sampling procedure, development of the research instrument ethical considerations, data collection, and data analysis. The process of structural equation or causal modelling forms the final section of this chapter. The outcomes which emerged from the study are analysed in relation to both the quantitative and qualitative data obtained during the investigation. In respect to the former these outcomes include the prevalence of stress among the teachers who participated in the study, differences in the numbers of responses in stress level categories, the perceived sources of stress, the identification of stress factors, differences In responses to perceptions of stress and stress factors when categorised by socio-biographical characteristics, analyses of the multi-item scales used in research instrument, the relationship between occupational stress, satisfaction and attitude towards teaching, and the development of a causal model of teacher stress. The qualitative information is discussed initially in terms of the socio-biographical characteristics of the teachers who were interviewed, as well as their perceived levels of occupational stress and satisfaction. Other information which is examined includes the perceived attitude of the Ministry of Education and/or Government of Westem Australia towards teachers, the nature of the identified stressful events, the incremental nature of normally non-stressful events, assessment of the research instrument and other information obtained during the data collection phase. The study concludes by summarising the entire research process, making implications based on the findings and suggesting areas for further research.

The level of burnout among a sample of Western Australian psychologists and a comparison of scores to the American normative sample of mental health workers was investigated. The study was also particularly interested to explore whether issues pertinent to the forensic psychologist were predictive of burnout. Burnout was measured by the Maslach Burnout Inventory (MBI), which comprises three components: emotional exhaustion, depersonalization and low personal accomplishment The study explored whether characteristics in relation to the psychologist, the client and the workplace had predictive value for the level of burnout. Variables considered across these characteristics were age and gender, client problem type and voluntary status of the client and work setting and caseload, respectively. Within these, variables considered more likely to occur within the forensic psychologist's work included, working predominantly with behavioural problems, involuntary clients and within a prison setting. Participants included 90 psychologists from a variety of work settings in Western Australia. The sample were found to be experiencing greater emotional exhaustion, but less depersonalization and particularly less burnout attributable to low personal accomplishment than their American counterparts. Despite the finding that over one fifth of the sample were experiencing emotional exhaustion, the overall prevalence of burnout across the components, particularly in relation to personal accomplishment, was low. In relation to the predictive value of the variables considered, multiple regression analyses were conducted for each burnout component. Findings suggest that working with clients in relation to behavioural issues, but particularly being a female had a significant main effect on burnout attributable to emotional exhaustion. Gender appears to be a significant predictor independently of all other variables considered. Further, findings suggest that working greater hours with clients could provide a buffering effect on burnout attributable to low personal accomplishment. None of the variables considered had any impact on depersonalization. Working in a prison setting and with involuntary clients did not predict burnout. Although working with predominantly behavioural issues is associated with forensic work, the overall findings challenge the assumption that psychologists working within the forensic arena are at increased risk of burnout

There is no official avenue in nursing for the reporting of incidences of covert violence to staff and so they remain unrecorded and often stressful. This study sought to collect data from currently employed nurses concerning covert violence in their workplace, and to collate the information to obtain a valid assessment of this hidden problem. A qualitative methodology was used to report on the experiences of nurses in relation to covert violence directed at them by their peers, other health professionals, patients and patients' families. The participants were all registered nurses employed by a suburban health service. Each was given an open-ended questionnaire to: 1. establish the participant's position and professional experience within the Health Service, 2. request for incidences regarding the various forms of covert violence encountered by them in the workplace, 3. describe how they dealt with such episodes It is anticipated that this study will lead to an acknowledgement of, and interventions to prevent, such forms of violence. It is also anticipated that minimising the occurrence of covert violence will improve nursing productivity, provide greater job satisfaction for nurses, and promote savings in terms of less staff absenteeism, Workers' Compensation insurance claims and staff turnover.

The purpose of this study was to consider the pastoral care needs of Churches of Christ ministers working in parishes, propose some directions that a programmed approach to that pastoral care could take, and outline the kinds of desired outcomes to be looked for among them in Western Australia. It was demonstrated that, as with other helping professionals within the Human Services domain, ministers experience stressors which impinge on their well-being and their effectiveness as care-givers. This study examined the different contexts within which ministers must function, examining the complexities of their duties, the hazards they face and the effects these have on their well-being and the performance of their duties within their professional and personal lives. The study looked at how to respond to the needs of this workforce, proposing some directions in which the program of pastoral care could take at each of the three levels identified as significant, the structural level, the professional level and the personal level. These were proposed in the context of an articulation of the desired outcomes that should result from the establishment of those systems of care. Finally, consideration was given to possible evaluators that would demonstrate the extent to which those desired outcomes had been achieved. While these were not the primary focus of the study, consideration of evaluators is a necessary adjunct to any programmatic approach to pastoral care.

Generic models of job stress, such as the Job Strain Model (JSM), have recently been criticised for focusing on a small number of general work characteristics while ignoring those that are occupation-specific (Sparks & Cooper, 1999). However this criticism is based on limited research that has not examined the relative influence of all three dimensions of the JSM - job demand, job control and social support - and job-specific stressors. The JSM is the most commonly used model underpinning large-scale occupational stress research (Fox, Dwyer, & Ganster, 1993) and is regarded as the most influential model in the research on the psycho-social work environment, stress and disease in recent times (Kristensen, 1995). This thesis addresses the lack of information on the relative influence of the JSM and job-specific stressors by assessing the capacity of an augmented JSM to predict the strain experienced by managers and professional Australian footballers. The augmented JSM consisted of job-specific stressors in addition to the generic components of the model. Managers and professional Australian footballers represent two very different occupational groups. While the day-today roles of a manager include planning, organising, monitoring and controlling (Carroll & Gillen, 1987), the working life of a professional Australian footballer revolves around preparing for and playing football (Shanahan, 1998). It was expected that the large differences in the work undertaken by managers and professional Australian footballers would maximise the opportunities for identifying job-specific stressors and measuring the extent that these vary from one group to the next. The large disparity between managers and professional footballers was also used to assess the cross-occupational versatility of the JSM when it had been augmented by job-specific stressors. This thesis consisted of three major studies. Study One involved a survey of Australian managers, while studies Two and Three focused on professional Australian footballers. The latter group was under-represented in the literature, and as a result of the lack of information on the stressors commonly experienced by this group, an in-depth qualitative study was undertaken in Study Two. The results from Study Two then informed the survey of professional footballers that was conducted in Study Three. Contrary to previous research examining the relative influence of generic and job-specific stressors, the results only provided moderate support for augmenting the JSM with job-specific stressors. Instead of supporting the versatility of the augmented JSM, the overall findings reinforced the broad relevance of the original JSM. Of the four health outcomes measured in Studies One and Three, there was only one - the psychological health of professional Australian footballers - where the proportion of total variance explained by job-specific stressors exceeded 13%. Despite the generally strong performance of the JSM across the two occupational groups, the importance of demand, control and support diminished when examining the less conventional occupation of professional football. The generic model was too narrow to capture the highly specific work characteristics that are important for this occupational group and, as a result, the job-specific stressors explained significantly more of the strain over and above that already provided by the generic model. These findings indicate that when investigating the stressors experienced by conventional occupational groups such as managers, the large amount resources required to identify job-specific stressors are unlikely to be cost-effective. In contrast, the influence of the more situation specific stressors is significantly greater in unconventional occupations and thus the benefits of identifying these non-generic stressors are more likely to outweigh the costs. Studies One and Three identified strong connections between job-specific stressors and important characteristics of the occupation being studied. These connections were consistent with previous research and suggest that before attempting to identify job-specific stressors, researchers need to first become familiar with the nature and context of the occupation. The final issue addressed in this thesis was the role of work and non-work support. The findings indicate that the support provided by supervisors and colleagues was a significant predictor of wellbeing for both managers and professional footballers. In contrast, the level of explained strain accounted for by non-work support was not significant. These results indicate that when developing strategies to protect and enhance employee well-being, particular attention should be given to monitoring and, where necessary, boosting the effectiveness of work-based support. The findings from this thesis have been fed back to the management and sporting communities via conference presentations and peer-reviewed journals (refer pp 220-221). All three studies have been presented at national and international conferences and, overall, were well received by participants. Similarly, the methods, results and major findings arising from Studies One and Two have been critiqued by anonymous reviewers from two international journals. These papers have been accepted for publication in 2001 and 2002 and feedback from the reviewers indicates that the findings represent a significant and unique contribution to the literature. The results of Study Three are currently under review by a sports psychology journal.

There is empirical evidence that workplace violence is increasing, particularly in settings where health care professionals such as psychologists are employed, and often these incidents are perpetrated by clients. Given that client violence can have wide ranging and serious consequences, it is not surprising that researchers are focussing on this issue. One notable finding is that psychologists feel that they do not have the training or confidence to manage the violent behaviour of clients. A review of the relevant literature was undertaken to determine why psychologists feel ill prepared for such incidents. Whilst there is a wide range of definitions of client violence, it appears that many of the professionals’ concerns about various forms of client behaviour go beyond these definitions of violence. There is an array of client behaviours that make professionals feel their wellbeing is at risk which fall outside the general definition of violence. Consequently, the term client threats may be more appropriate. There is no research in which psychologists were directly asked what client interactions they perceived as putting their wellbeing at risk and, without this information, professional advice to them may not be effective. The purpose of this research project was to determine psychologists’ experiences and perceptions of client threats. Stage 1 included interviews with 45 psychologists which indicated that their experiences and perceptions of client threats could be best conceptualised by developing a preliminary theory of client threat. In stage 2 a Delphi approach, with a panel of experts, helped formulate a modified Client Threat Theory that proposes a three phase model outlining the process through which psychologists experience these threats. This theory begins with a client behaviour being observed and conceptualised as a threat (activation phase), then influential factors are assessed (risk assessment), and lastly a management plan is formulated and applied in response to the threat (execution phase). This research project also provides a detailed understanding of how the participating psychologists experienced client threats. It was discovered that threatening experiences were triggered by more than violent client behaviours and that a term broader than violence was needed to encompass these experiences. The types of threats reportedly experienced by participants were physical, sexual, verbal, psychological, reputational, and financial in nature. Participants also reported feeling threatened when they perceived that a client behaved in a threatening manner towards people known to them, such as colleagues and family members. This provides a basis from which future researchers could develop a comprehensive definition and theory of client threat, along with efficient and effective tools to reduce its occurrence and deal with it more effectively.

This research program on burnout and work environment perceptions in personnel working directly with unemployed individuals in Australia is reported in three studies. Using a survey methodology and taking a quantitative approach, burnout was investigated using the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1986) on two occasions, before and after the privatisation of Australia's employment services industry (Job Network). The most widely accepted survey instrument measuring burnout (Lee & Ashforth, 1996), the MBI defines this stress related syndrome in terms of three subscales, Emotional Exhaustion, Depersonalisation and Personal Accomplishment. Perceptions of the work environment experienced by employment service staff were concurrently surveyed using the Real form of the Work Environment Scale (Moos, 1994). Heeding advice of researchers from the job stress area (e.g., Mccrae, 1990), this program of research also concurrently investigated the personality trait Neuroticism, the disposition to perceive and report negative experiences. In 1995, burnout in two groups of public sector personnel engaged in assisting individuals experiencing unemployment were compared. Staff employing a case management style of service delivery and staff engaging in an over-the-counter production-line style of service were surveyed and their responses on the MBI, the WES and the Neuroticism subscale of the revised short form edition of the Eysenck Personality Questionnare (EPQR/ s; Eysenck & Eysenck, 1991) compared. As hypothesised, case managers reported significantly higher burnout scores on all three subscales of the MBI, and perceptions of higher work pressure. The personality trait Neuroticism was found to account for significant variance in the burnout scores of the public sector respondents. The second study was conducted in 1999 after the full privatisation of the Australian employment services industry. At this time (T1 ), burnout in case managers throughout Australia was investigated with a postal survey which sampled 86 case managers from 38 different private sector organisations providing case management services to the long-term unemployed. The same respondents were surveyed again after six months (T2}. Study 2 demonstrated that case manager burnout levels in the new Job Network were significant. The design also allowed for the prediction of future burnout (T2) from personality and work environment data collected at an earlier time (T1) to be correctly modelled. As hypothesised Neuroticism was a significant predictor of all three MBI subscales both at T1 and T2. In what amounts to a comparison of public and private sector personnel, the third study compared the burnout levels and work environment perceptions of case managers surveyed in 1995 with the responses of case managers surveyed in 1999. Case managers from the public and private sector reported similar high levels of Emotional Exhaustion and Depersonalisation. Private sector case managers also reported significantly higher mean Personal Accomplishment scores, corresponding to a lower mean burnout level, and significantly higher levels of involvement and commitment to their work than public sector case managers. The results of these studies addressed a significant gap in the burnout literature which had hitherto failed to report investigations into employment service personnel, and highlighted the importance of considering the personality trait of Neuroticism in future burnout research. Results were discussed in the contexts of the evaluation of the current Job Network and the process model of burnout (Leiter, 1993).

Over recent decades, there has been growing recognition that workplace bullying is a pervasive and harmful feature of modern workplaces. In the Australian nursing context, bullying is reported as a common form of aggression. While acknowledged as a concerning issue, there is little substantive data on the meaning of bullying or how it affects the private or professional lives of Australian nurses. The aim of this study was to address this gap by investigating the nature, extent and consequences of bullying in the Australian nursing workplace. A three-stage sequential mixed method design was adopted for the study. The first stage involved in-depth, semi-structured, qualitative interviews with 26 nurses with experience of workplace bullying. Content analysis of the interview transcripts using the NVivo software program identified four major categories, and a number of minor categories and sub-categories. These categories formed the basis of a survey instrument developed for use in the second stage of the study. The second stage of the study established the validity, reliability and factor structure of the newly developed instrument. Exploratory factor analysis (EFA) using the Statistical Package for the Social Sciences (SPSS) software identified seven coherent latent factors, which underpinned the experience, consequences, and organisational features associated with workplace bullying. The EFA identified reliable measures of the seven latent factors and two scales were refined entitled the Bullying Acts and Consequences Scale and the Organisational Processes Scale. The third stage of the study employed the survey instrument validated in the previous stage of the study with a cross-sectional randomised sample of the Australian nursing workforce. Analysis of the survey data identified that bullying occurred across all sectors of the nursing workforce, with no correlations between experiencing bullying and demographic and employment characteristics. In addition to describing the nature, extent and consequences of bullying, confirmatory factor analysis (CFA) was used on the data from the national survey to further refine the scales developed in the previous stage of the study. These two scales were refined into one multidimensional scale entitled the Organisational Predictors and Consequences of Bullying Scale (OPCBS). The final step in the analysis of the national survey data involved structural equation modeling (SEM) using the AMOS software program. The modeling established that the four organisational factors measured in the study were associated with bullying and the measured consequences. The significant contributions of this study include the finding that organisational features rather than individual characteristics influence the experience of bullying in the nursing workplace, and the development of valid and reliable measures of bullying behaviours, associated organisational features and the consequences of bullying.
Doctor of Philosophy (PhD)

The central issue of this thesis is the problem of stress in social work education, and its contribution to subsequent burnout in social work practitioners. To investigate this problem, the study was structured according to five interrelated key research questions, as outlined in Chapter One. The first research question asks to what extent what Tobin and Carson (1994) have referred to as "insidious pervasive stresses" emanate from the following sources: (i) professional identity formation process (social work idealised image and role value conflict); (ii) the reasons students chose social work; (iii) students' performance expectations; and (iv) stresses from the course that are part of the professional education process. The second research question examines the extent to which the kind and level of course related stress experienced by social work students explains the variation in their physical and psychological health. The third research question aims to determine if there is a difference in the level of physical and psychological health of Australian social work students and Australian social work practitioners. The fourth research question examines whether the physical and psychological health of social work practitioners is negatively correlated with the magnitude of burnout experienced. The fifth research question considers the extent to which social work practitioners' age, job satisfaction, years of experience and average working hours, in addition to burnout, explain the variation in their physical and psychological health. In addition to these five key research questions, a series of clarifying, supporting or elaborating questions are developed in the literature review (Chapter Two). Where appropriate, they have been converted into substantive operational hypotheses in Chapter Three, which details the study's methodology. Chapter Four (Student Results) presents the results of the questionnaires administered in relation to aspects of their social work course. Chapter Five (Practitioners and Students: Comparative Results and Predictive Analysis) compares the physical and psychological health of social work students with the health of social work practitioners, and provides a predictive analysis of the variations of the health of the two groups. Chapter Six discusses the results of the study, in terms of some of the significant implications of its findings, particularly in relation to social work course design and areas that warrant further investigation. Overall, the study concludes that a significant proportion of social work students are psychologically distressed by their course experience, particularly in terms of course design, role value conflict and the degree of idealisation of the social work role. A very strong association with burnout was found among social work practitioners when they experienced a similar level of psychological distress as that experienced by students. Finally, suggestions are made for ways in which social work course managers may constructively deal with these issues.

The social phenomenon of stress and workplace burnout has spanned over five decades. Despite a plethora of literature that exists, there still remain problematic issues that neither scientific investigation or government legislation have been able to resolve. The literature examined throughout this research is extensive and does reflect this 50-year period. It demonstrates that studies into this phenomenon have attempted to define stress, identify causal factors of workplace stress, workplace burnout and environmental congruence; and discusses strategies (focused on both the individual and organizational levels) that have been implemented to effect beneficial outcomes for individuals affected by any one of these. As this thesis continues, the more recent literature gives a greater recognition to violence in the workplace and legislative enactments as preventative measures to reduce the heavy burden of costs, both physical and financial, to organizations. This extensive literature review indicates no answer to the problem has been identified to date and that this phenomenon remains, giving a clear indication that further scientific investigation is required to find a solution to what was described as the most serious health issue of the 20th century. Based on the literature examined this health issue has now gone well beyond the 20th century, giving relevance to the research study described in this thesis. The investigation is validated as vital and should be used as a basis for further research. This study undertook a collaborative social process, action research, empowering participants to identify and change stressful factors identified within their practice indicative to rural remote community mental health teams. A critical social theory arose out of the problems within the context of the research setting, based on the ideal that the significant issues for this group of individuals within this organization could be solved through the action research process. The group ‘existed’ within the issues indicative to this rural remote area, however these issues were outside their control. Through the implementation of the action research process courses of actions were undertaken that provided enlightenment in self-knowledge with dialogue heightening collective empowerment to effect change within their practice. The action research process, being a holistic process, facilitated this change in practice, developed and refined theory as it proceeded in a cyclic fashion within this local setting. It concerned actual not abstract practices in the social world in which these participants practice. This methodology facilitated examining the significant stressors identified by the Community Mental Health Support Team (CMHST) that caused distress, allowing them to implement changes in their practice. The forum provided an avenue that could reduce stressors significantly and prevent ongoing occupational stress that contributes to workplace burnout. It offered an opportunity to work with a group of participants in a nonhierarchical and non-exploitative manner and enabled members of this group to identify their roles as effective practitioners, empowering them to effect the changes they deemed as essential criteria to reduce the stress they were experiencing indicative to their remoteness. Critical reviewing throughout the data collection attempted to understand and redefine these significant issues. It aimed to acknowledge the way things were relative to how things could be improved from organizational, personal and wider community perspectives. Simple principles and guidelines of action research were followed potentiating acceptance as a rigorous research approach from a positivist perspective whilst retaining the attributes that characterise action research. There are solutions to the dilemma of the employee overcoming the debilitating effects of stress leading to workplace burnout. This includes the cooperation of managers, policy makers, academic researchers and government officials working collaboratively to reduce the impact of occupational stress. Through this collaborative process, changes can be effected to ensure the health of the nation improves and that relevant recognition is given to the fact that there is a significant threat to a healthy workforce. Examining the nursing profession from a social perspective provides alternatives to medicalising workplace injuries and illnesses.
Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

The social phenomenon of stress and workplace burnout has spanned over five decades. Despite a plethora of literature that exists, there still remain problematic issues that neither scientific investigation or government legislation have been able to resolve. The literature examined throughout this research is extensive and does reflect this 50-year period. It demonstrates that studies into this phenomenon have attempted to define stress, identify causal factors of workplace stress, workplace burnout and environmental congruence; and discusses strategies (focused on both the individual and organizational levels) that have been implemented to effect beneficial outcomes for individuals affected by any one of these. As this thesis continues, the more recent literature gives a greater recognition to violence in the workplace and legislative enactments as preventative measures to reduce the heavy burden of costs, both physical and financial, to organizations. This extensive literature review indicates no answer to the problem has been identified to date and that this phenomenon remains, giving a clear indication that further scientific investigation is required to find a solution to what was described as the most serious health issue of the 20th century. Based on the literature examined this health issue has now gone well beyond the 20th century, giving relevance to the research study described in this thesis. The investigation is validated as vital and should be used as a basis for further research. This study undertook a collaborative social process, action research, empowering participants to identify and change stressful factors identified within their practice indicative to rural remote community mental health teams. A critical social theory arose out of the problems within the context of the research setting, based on the ideal that the significant issues for this group of individuals within this organization could be solved through the action research process. The group ‘existed’ within the issues indicative to this rural remote area, however these issues were outside their control. Through the implementation of the action research process courses of actions were undertaken that provided enlightenment in self-knowledge with dialogue heightening collective empowerment to effect change within their practice. The action research process, being a holistic process, facilitated this change in practice, developed and refined theory as it proceeded in a cyclic fashion within this local setting. It concerned actual not abstract practices in the social world in which these participants practice. This methodology facilitated examining the significant stressors identified by the Community Mental Health Support Team (CMHST) that caused distress, allowing them to implement changes in their practice. The forum provided an avenue that could reduce stressors significantly and prevent ongoing occupational stress that contributes to workplace burnout. It offered an opportunity to work with a group of participants in a nonhierarchical and non-exploitative manner and enabled members of this group to identify their roles as effective practitioners, empowering them to effect the changes they deemed as essential criteria to reduce the stress they were experiencing indicative to their remoteness. Critical reviewing throughout the data collection attempted to understand and redefine these significant issues. It aimed to acknowledge the way things were relative to how things could be improved from organizational, personal and wider community perspectives. Simple principles and guidelines of action research were followed potentiating acceptance as a rigorous research approach from a positivist perspective whilst retaining the attributes that characterise action research. There are solutions to the dilemma of the employee overcoming the debilitating effects of stress leading to workplace burnout. This includes the cooperation of managers, policy makers, academic researchers and government officials working collaboratively to reduce the impact of occupational stress. Through this collaborative process, changes can be effected to ensure the health of the nation improves and that relevant recognition is given to the fact that there is a significant threat to a healthy workforce. Examining the nursing profession from a social perspective provides alternatives to medicalising workplace injuries and illnesses.
Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008