Work stress among the representatives of specialists in Khartoum state hospitals

 

Prepared by the researcher 

Dr. Ahmed Abdel Moneim Mohamed Ahmed[1] Assistant Professor – Faculty of Arts – Department of Psychology – University of Khartoum – Sudan

Democratic Arab Center

Journal of Afro-Asian Studies : Fourteenth Issue – August 2022

A Periodical International Journal published by the “Democratic Arab Center” Germany – Berlin

https://democraticac.de/wp-content/uploads/2022/08/Journal-of-Afro-Asian-Studies-Fourteenth-Issue-%E2%80%93-August-2022.pdf

Abstract 

The study aimed to know the work stress of the deputy specialists in Khartoum state hospitals. The researcher used the descriptive analytical method. The study sample consisted of (96) male and female doctors who were selected by a simple random method. The work stress scale was used by Al-Dosari design 2017, and the data were processed by the spss program, where it was used One-sample t-test, independent two-sample t-test and one-way anova test, The results showed that the work stresss of the deputies of specialists at Ibrahim Malik Hospital are high. married couples. There are No differences in work stresss among the deputies of specialists at Ibrahim Malik Hospital due to age, and the study also included a number of recommendations.

Introduction:

Man lives his life while working and the importance of work comes in that he acquires the lion’s share of human time, which is the way in which he achieves his goals and different needs and since psychology specializes in all aspects of the life of the individual, including work and study of human behavior in the framework of work where most individuals in the field of work feel satisfied as a result of their sense of achievement their goals and limited goals and sometimes leads work to put the individual in very high stress so it is necessary to pay attention to this stress In order to control it and control the confiscation and treatment of its effects.

We find that Islam urged action, as God has left man on earth and provided him with the requirements of the relationship, first and foremost the ability to work mentally and manually: (Say do, God will see your work and his Messenger and believers and you will return to the world of the unseen and testify and tell you what you were doing) Surat al-Tawba verse “105”.

The topic of work is one of the most important topics that has received the focus of attention of many researchers because of the importance of the topic and its negative and positive repercussions on both the individual, the institution and society (Tshat, 2003)

Due to the importance of work stresss, this topic has become one of the main areas of interest for many administrative and organizational workers, but we note that writings in this area are still mostly at the level of theoretical analysis and applied studies have seen only a limited share of attention (Blindness, 2005)

The researcher believes in the importance of the subject of work stresss and its implications for several aspects of behavior and psychology, especially in the field of medicine, where work is particularly important because it affects the life of the individual. For the health of society, studying the labour stresss affecting the performance of health workers is a humanitarian task to provide better health services. The characteristics of this impose certain circumstances on workers that are a source of stress.

Research problem:

The practice of medicine and other professions concerned with human health and life is associated with exposure to stresss resulting from a number of factors, including the suffering of patients and their families and the feeling of inability to control a range of things as a result of dealing with a degree of stress in relation to medical diseases and accidents and, on the other hand, the hospital environment and exposure to diseases and physical harm by patient escorts and psychological harm by not being able to provide adequate assistance to the patient because of the lack of appropriate equipment, therefore. The research problem revolves around the following:

1. What is the general characteristic of the stresss of working for deputy specialists?
2. Are there statistically significant differences in the work stresss of deputy specialists due to type?
3. Is there a statistical significance in the work stresss of deputy specialists due to age?
4. Are there statistically significant differences in the work stresss of deputy specialists due to the social situation?

Research objectives :

1. Knowing the general characteristic of the stresss of working with the deputy specialists.
2. Clarifying the statistically significant differences between work stresss depending on the type.
3. Looking for statistically significant differences between labour stresss and social status.
4. 4. Looking for statistically significant differences between work stresss due to age.

The importance of research:

First: its theoretical importance :

1. Hospitals play a central role in serving the community and providing health care to the citizen, as hospitals are made up of medical staff, especially doctors, they are the main pillars of hospitals and the main focus of the process of treating diseases, so it was necessary to take care of this segment and study it.

The study helps hospital officials identify possible sources of work stresss.

Second: Applied importance:

1. Give officials recommendations and suggestions and by knowing the results of the study to face the stresss of work to create functional satisfaction towards their work, which reflects on their performance positively and reduced the effects of negative work stresss on the patient and doctor.
2. Benefit from it by the Medical Council and ministries of health to work on the level of stress of work through the work of programs to study and develop solutions to deal with the stresss of work.

Research hypotheses:

1. The stresss of working with deputy specialists at Ibrahim Malik Al-Taa’a hospital are characterized by.
2. There are statistically significant differences in the work stresss of deputy specialists due to age.
3. There are statistically significant differences from the stresss of working among deputy specialists due to type.
4. There are statistically significant differences from the stresss of working among deputy specialists due to the social situation.

Search limits:

1. Objective boundaries

The study is limited to researching the stresss of working among deputy specialists from the sample point of view.

1. Human boundaries:

The study is limited to deputy specialists at Ibrahim Malik Teaching Hospital.

C.Spatial boundaries:

The study was conducted at Ibrahim Malik Teaching Hospital.

1. Temporal boundaries:

The study was conducted during the academic year (2019-2020)

Concepts of search terms:

1. Stress in language:

The stress of annexation means tightness and intensity, and the stress of his time and his crowd, and their stress, they have been crowded and crowded (Abadi 2005)

1. Concept of work:

An individual’s effort to obtain a benefit or benefit threatened him or the set of tasks to be carried out, accomplished, active, or seeking benefit. (Abdul Rahman 2005).

1. Work stress terms:

They are related to the nature of the work, tasks and activities of their workers and are therefore also called functional or professional stresss, which are often used as the same. (Saleh 2009)

1. Deputy specialists:

They are doctors who have passed the first part of their clinical doctoral examination and are serving a training period with the aim of specializing in a particular field of human medicine.

Theoretical framework and previous studies:

We live in an environment of diverse excitement and abuse regardless of their causes, whether physical or psychological, and these effects have affected the individual, and this effect was not limited to the home or public places, but also to the working environment, and these stress made the individual live in a state of anxiety, tension and emotion, which affected his or her duties and functional duties. In relation to his relationship with the employees of the foundation as well as on his health and body, the stress of work are an issue that has haunted man since he was on earth, he was found to work, and this work was and continues to be a source of misery, believing his saying: (We created man in the liver) of the country(4). This work and the accompanying misery have resulted in man facing many risks and challenges in his life that brought him stress (Blindness, 2005)

Due to the importance of work stress, this topic has become one of the key areas of interest for many administrative and organizational intellectuals who differed in their definitions of this concept from person to person depending on their specialization and field of work (Blind 2005).

The medical sector is one of the most stressed sectors for its employees, especially the medical sector, because of the different nature of working conditions in the medical profession, which imposes difficult and difficult conditions on doctors of both sexes and many of the difficulties that expose them to their lives. (Nabil 2020)

Definition of work stress:

A complex mood that the individual feels, affects his or her actions and hinders his or her way of thinking. (Mohammed 2011), as defined by the extent to which the individual responds to the effects and firm forces causing stress while neglecting the impact of interaction and other factors such as the subjective characteristics of the individual with the characteristics and conditions of the working environment, on which the amount of stress felt by the individual is determined. (Saleh 2009, )

Blind people define it as a lack of harmonization or disproportion between an individual’s skills and abilities and his or her work requirements. (Seven 2013). Al-Dosari also knew the stress of work from the issues that have beset man since his presence on earth and this work has been and continues to be a source of trouble, and this has resulted in the accompanying misery, risks, challenges or so-called stress. (Al-Dosari 2005).

Hamadat defines them as reactions or imbalances caused by institutional sources and unusual working conditions and their interaction with the leadership personality among workers or their work, which affects the psychological and physical condition of workers to varying degrees and leads to a change in the pattern of their behavior and deviation from the expected performance (Hamadat 2006). It is a set of environmental factors that adversely affect an individual’s performance at work, including the ambiguity of the role, the conflict of role and environmental working conditions, the workload of personal relationships at work, these elements cause physiological stress to the individual (ali 2002). It is also part of the physical and psychological working environment and is one of the sources that cause accidents and work diseases, including physical and psychological, whose effects are negatively reflected on the individual and the institution. (Abdul Karim 2012), the stress of work is an adaptive response to external situations or circumstances that result in physical, psychological or behavioral deviation of members of the institution. (Live 2009)

Kaplan and others defined work stress as any characteristics found in the work environment that created a threat to the individual. According to cooperand marshal, functional stress means a range of negative factors such as role ambiguity, role struggle, poor working conditions and overwork related to a particular work performance (Blind 2005).

The researcher believes through the definitions mentioned in the concept of work stress that this topic has received attention from researchers in the fields of management, psychology and others and the result of this differed definitions and did not reach a specific and comprehensive definition of this concept so that each researcher knew from the point of view of his specialization. The researcher believes that the stress of work are the interaction of many overlapping and interrelated elements that relate either to the personality of the individual or his ability or the working environment and the type of duties that affect the individual and on the basis of his awareness of it either negatively makes him frustrated and desperate or positive push him to persevere.

Types of work stress:

 Work stress are divided according to a number of things:

 A/ Working stress according to their implications:It is divided into two types:

1/ Positive stress: These are positive and beneficial stress that have positive repercussions where the individual feels the ability to produce and accomplish quickly and decisively and has positive psychological effects in generating a sense of happiness and pleasure and this is reflected in the entire production of the work as the tasks carried out with superiority are defined by a time frame for their implementation. The unspecified are, even if they are completed without setting a time frame, their achievement is poor and unacceptable (Nowshan, 2003).

2/ Negative stress: Stress with negative repercussions on human health and psychology are therefore reflected in their performance and production at work, such as those that are actually paid for by frustration or dissatisfaction with work as well as negative perception of labour issues (increase 2006). Elements of work stress: By defining the concept of work stress as a subjective experience, an individual’s psychological or organic imbalance stems from factors in the external environment, institution or individual himself by identifying the three elements of work stress:

1.Sexy element It is a different factor associated with the external and internal environment of the institution as well as factors associated with human resources that generate a feeling of stress.

2. Response element: These are the psychological, physiological and behavioral reactions shown by the human resource while exposed to a range of stimuli.
3. Interaction elements: It is the interaction between the stimuli and the responses that the stress faced by the individual stems from the complex interaction between factors associated with the external environment of the institution as well as those associated with the human resource (Sieslavy, 1991).

Stages of work stress:

Through the work of psychiatrist Hanseili, who identified the human psychological and physical reactions to stress from three distinct stages: (1976Seliey, ).

1) Phase 1 (alarm or alert): The body prepares itself to meet the threat or challenge that binds it to the secretion of endocrine hormones, which result in rapid heart rate, increased breathing rate and increased blood sugar.

2) Phase II (resistance):After the first shock, the individual moves to the stage of resistance, in which the body tries to repair to damage or harm that stems from the first shock and the individual feels at this stage tired, anxious and stressed and tries to resist the causes of stress if he can succeed and overcome the problem, the symptoms of stress disappear.

3) Phase III (exhaust):This stage appears when the individual cannot overcome the causes of stress and continues to suffer from them for a long time, the body’s ability to adapt becomes exhausted and stressful and weakens the means of defense and resistance and the individual is exposed to diseases stress, high blood stress, ulcers and heart attacks, this stage is considered acute and dangerous and poses a threat to both the individual and the institution, the mind and the human body have limits to work and resistance and the more frequency of warning the more resistance the more the individual becomes more exhausted in his work and life and the greater the susceptibility of physical diseases and diseases Psychological.

 Sources of work stresss: 

The divisions that classify the different sources have multiplied the touches of work stresss and the sources can be identified and divided into three main categories:

Environmental factors. 

Structured work-related factors

3- Personal factors associated with the individual himself

Environmental factors: (Robbins and judge 2007)

Environmental factors have an impact on the level of stress that affects workers within the organization, including:

1/ Lack of continued economic situation: Any volatility that can occur on the economic side and recession, high inflation rates in a country, negatively affect the population in terms of prices and the high supply or availability of consumer goods, and therefore will affect the income level of working individuals and their anxiety and tension (Almond, 2003).

2/ The progress, development and acceleration of technology: computers and modern technologies introduced into the work have led to an individual feeling threatened and stressd if he is not proficient in its use (cook and hanaker 2001)

3/ Social changes: new and old societies have emerged in new and old societies that differ with recognized values, customs and traditions, resulting in problems in society that lead to the individual feeling stress.

2) Regulatory factors:

Regulatory factors are one of the most important sources of work stress. Therefore, most researchers in cases of organizational behavior focused their studies on this source, where the level of work stresss varied from organization to organization according to reasons including: the size of the institution, its organizational climate prevailing over individuals within the institution, these characteristics are mentioned as follows:

1. The nature of the work and its requirements

Work stresss usually vary depending on the nature of the work and its requirements, and the causes of stresss for each job also vary in terms of the diversity of tasks and responsibilities, independence of work and the size of the powers assigned to the individual, all of which contribute to creating psychological and physical stress among the individual in the institution. (Nelson Quick, 2002)

The role of the individual in the institution: 

The functional role is one of the main causes of stress on the individual in the institution because it usually takes one of the following forms:

A/Job Uncertainty: The individual’s lack of detailed information about the expected role of not controlling his or her work, i.e., feeling stressd (Maher 2003)

B/ Role conflict: The conflict of role usually arises when many contradictory actions are asked of him, when expectations of the role conflict with certain individual values and principles or when he is forced to do work that he believes is outside his or her work (Maher, 2003).

C/ Role burden: There is a disettered relationship between levels of work stress and the size of the responsibilities assigned to the individual, which means that the greater the responsibilities at work, the greater the stresss, and studies have shown that these individuals suffer from severe stress that has been reflected in their physical health (stomach ulcers, high blood stress, blood sugar) (cook and Hanaken, 2001)

3) The nature of relationships between individuals within the work environment:

The performance of the work requires the interaction of individuals with each other and the personal relationships between the employees of the institution play an important role in satisfying their psychological and social needs, but stresss arise if these relationships are bad between individuals within the institution may lead them to justice and a sense of functional retirement (Maher 2003)

4) Organizational structure:

The organizational structure is one of the main sources of stress when classified as highly centralized in decision-making and weak communication channels within the organization, as well as poor opportunities for growth and promotion, all of which result in psychological stress within the institution (Lozi, 2003).

3) Organizational leadership style:

The main behaviour and way in which it deals with its subordinates in the management of work has a very important impact on the quality of their performance as a result, as a result of which workers under authoritarian leadership suffer from stress and anxiety and thus lead to stress at work. (Robbins 2005)

4) Working environment conditions:

It means the conditions of the environment surrounding the individual in the working environment in terms of ways of designing the workplace and its location, furniture, available equipment, ventilation and humidity. Working environment conditions are particularly important for the individual if they are not properly available and lead to psychological and physical stresss. (Maher, 2003)

5) Wages and bonuses:

Wages and rewards are the primary objective of the work of individuals in the organization and are the main and basic determinant of the individual’s standard of living and the main indicator of career status.

One of the most important sources of work stress lies in wages and the incentive system because it is linked to the justice and equality process, which relates to the rate of equivalent of these wages and privileges in relation to the effort made by the employees of the institution and the rate of fairness compared to the colleagues in the work in addition to the rate of adequacy of this wage with the general requirements of decent living due to the economic crises that the world has now seen. (Hanafi, Abu Quraf al-Balal, 2001)

6) Personal factors:

There are other main factors of stress that come from the individual himself, personal sources of work stresss in two parts:

1/ Stresss arising from factors and circumstances related to an individual’s private life and these are considered external factors such as personal events to which the individual is exposed, family problems and financial crises, which generates tensions and psychological emotions that come from his or her sense of stress in the working environment. (Maher 2003)

2/ Stresss arising from within the individual (internal factors) and determine the application of the personality and way of thinking of the individual such as excessive ambitions and the pursuit of a goal that is difficult to achieve or unhappiness and pessimism expects negative results and on the effect of which the individual feels sad and depressed.

One of the most important personal traits that affect an individual’s interaction with work stress factors is:

1. Personality style: Studies indicate that the nature of the personality pattern of the individual has a role in influencing his perception of stresss and determining the nature of the response to them and there are two types of personality, namely the first type called (style A) the individual who belongs to this pattern is characterized by the tendency to work alone and can accomplish many tasks in a short time and is usually taken as stubborn, impatient and aggressive and always has a love of control and in contrast to this personality comes the style of personality (b) where the individual who is characterized by This pattern belongs to the fact that it prefers teamwork and is patient and calm. Studies have shown that individuals belonging to type A are less adapted to stress than personality (b). They are therefore more influential with stress-induced diseases such as heart disease and blood stress. (Pigment 1981)

2.Perception: The stress process occurs in situations where the individual realizes that his or her ability to meet a particular requirement is a major burden on him, and there is no awareness of the situation that is stressful for the age of advantage and the psychological and behavioral situation at that moment (Robbin and Judge 2007).

1. Experience: The experiences gained by the individual are factors affecting a response to work stresss and the advantage determines the degree of difficulty or ease of stressors for the individual and has an influential low-stress role resulting in the working environment as the individual feels able to face repeatedly the source of stresss and training in response to dealing with situations and therefore the individual is adapting to the situations of distress and get rid of the feeling of stress when confronting psychological situations (Hanafi, 2001).
2. Level of self-confidence: The more compatibility between an individual’s abilities and the requirements of work, the greater the individual’s self-confidence, the more he or she does not feel stressed and stressed in that an individual who lacks a sense of self-confidence and responds negatively to distress situations that require some kind of challenge and is more vulnerable to work stresss.

 Dimensions of work stresss:

The stresss of work do not affect the individual alone because he does not live in an isolated environment around him, but affects him as one of the components of the system with which he interacts, so the individual’s sense of work stresss has multiple dimensions determined by the nature of the individual, among these dimensions (Hassan, 2012)

1. The social dimension (social relations): is every contact of the human being and he carries out his daily activity such as the relationship of neighborliness, tem and job sales and purchase relationships and cultural, artistic, sports and other relations and the multiplicity and breadth of human activity that includes all aspects of political, economic and cultural activities.
2. Family dimension (family relationships): these are the social relationships that are established between members of the same family (father, mother, children) in a way that balances the family.
3. The value dimension (value system): the set of rules, standards, customs and traditions adopted by the individual and accepted by society and contributes to the acquisition of all organizations by individuals and transformed after those values in accordance with the rules of Islamic law.

The importance of studying work stresss:

The importance of studying the stresss of work lies in the following points: (Naif, 2009)

1/ Protect the decision-maker from making wrong decisions resulting from the impact of the neurological reactions to the embarrassing situations they face.

2/ Provide the right environment in the working environment in such a way that the decision-maker can make his decisions and exercise his powers and administrative skills better.

3/ Protecting the executors from the randomness of the decision and the improvisation of politics and duplication resulting from the narrowness and shortcomings of the circle of vision in front of the decision-maker.

4/ Pushing the motivation of individuals as well as decision makers in the institution by raising and improving their ability to cope with the difficult stresss and situations they face, which reflects positively on increased production and improved productivity.

5/ Develop rapid testing skills and effectively deal with internal and external work stresss facing individuals and decision makers in the organization and thus develop the skills of planning, organization, confrontation and control under the rule of an atmosphere of stress on decision makers and working individuals.

6/ Create a spirit of cooperation and the sovereignty of team spirit between presidents and subordinates and increase understanding and positive and constructive participation. This contributes to raising the morale of employees and their sense of active participation in making the present and future of the institution.

7/ Control of the administrative behaviors of administrators at all administrative levels (high- middle-executive) is achieved in a way that confirms objective plans and eliminates the risks posed by any stress on decision makers.

8/ Increase the productivity of the working individual and thus maximize the investment returns resulting from training and increase the experience and skills of individuals during their careers.

9/ Reduce health treatment expenses resulting from administrative stresss on individuals.

10/ Reducing the costs of the institution resulting from making the wrong decisions as well as the costs of reforming the consequences of these decisions, which are mainly due to the fact that the decision maker is under influential administrative stress.

Attention to the subject of work stress can also be returned to two factors:

1/ The diseases caused by these stresss:

Evidence associated with studying work stresss suggests that these stresss can lead the individual to feel dissatisfied with his or her work. They are then trapped in physical, psychological and mental disorders. This has many adverse effects on the safety of the individual and the institution that is prepared for high blood sugar, rapid heartbeat, high blood stress and arterial diseases or lead to suicide as well as from these disorders appear in the form of many behavioral reactions including the heart, aggressiveness, indifference, depression, fatigue and nervous tension these responses may lead the individual to commit accidents and irregularities and slipping into problems of alcohol and drug addiction along with family and social problems. (Happy, 2009)

Costs from work stresss:

There are many financial problems arising from these stresss, whether at the national or regulatory level, at the national level, there are many studies that have shown significant economic losses resulting from the exposure of workers and employees to stresss, but at the organizational level the theory that stress is the main factor in many regulatory problems, particularly the problem of low performance, turnover, absenteeism and job leakage (blindness 2005) has increased.

In the United States, studies show that between 80% and 90% of industry accidents were due to work stresss. The value of $20 billion per year was the result of the absence of workers from work. The damage caused by the stress costs the United States economy about $1,55 million annually. The resulting loss of productivity is estimated at about $1 billion per year. (Hamadat, 2008)

Symptoms of work stresss:

1. Nervous tension.
2. Constant anxiety.
3. Inability to relax.
4. Excessive use of alcohol, drugs and analgesics.
5. Inability to sleep (insomnia).
6. A negative trend towards cooperation with others.
7. Feeling unable to adapt.
8. Difficulties in the nervous system.
9. High blood stress.
10. Grief and gloom.
11. Difficulties of concentration at work and emotional imbalance.
12. Tendency to be infected and to fall into industrial events.
13. Feeling afraid, difficulties speaking, expressing and conflict.
14. Alkalin and stomach pain.
15. Anorexia and sweating profusely. (Wafaa 2010)

Theories explaining the stresss of work:

As follows:

1/ Physiological theories:

Physiological studies focus on the fact that stresss are unspecified physical responses to stimuli and elements in the surrounding environment, and that the effect of these compressors on the body is done without an objective assessment of the individual for these compressors, i.e. there is a direct effect of stresss on the body so that some organs of the body deal with stimuli and compressors, the most important of which is the peripheral device, and the peripheral system receives signals about the stimuli and compressors surrounding it, and then affects two other organs in the human body, the first organ is the device glands The second organ is the voluntary nervous system.

2/ Social theories:

These theories assume that man is a social creature by nature, and that the presence of compressors in the social environment around him may cause him to feel stress, which leads to social incompatibility or a feeling of alienation, lack of adjustment and a sense of injustice, and one social theory depends on the fact that the individual seeks to form a structure of strong and persistent social constraints, and that the disturbance in the structure of social relations leads to the tension of the individual and his feeling of stress.

3/ Psychological and behavioral theories:

This theory assumes that feelings of tension and stress in responses appear and remain to be triggered in the situation surrounding the individual, when the individual realizes that there is a stuck or binding between the feeling of stress and the elements that provoke them, the appearance of these elements of stress leads to a high probability of the individual feeling stresss. It has been established that it is the individual’s assessment of the amount of risk from a particular element that determines the magnitude of the stresss, and the evaluation process indicates that the emotional experience of stresss and the attempt to adapt to them are primarily subject to the processes of perception and expectation that the individual experiences in stressful situations. Scientific progress has been able to divide people into two types of personality in relation to stress and stress. (Askar, 2000).

Effects of work stresss:

Labour stresss have positive and negative effects:

A/ Positive effects:

Many, but not all, organizations view labour stresss as an evil that must be combated because of their negative effects on both the individual and the institution. But the truth is otherwise, as the stresss of action have aroused desirable positive effects, along with the undesirable negative effects of the following:

1/ Stimulates work.

 2/ Focus on the results of the work.

3/ The individual’s concentration at work increases.

4/ The individual looks at his or her process with distinction

5/ focus on the results of the work.

6/ Sleep comfortably.

7/ Based on the expression of emotions and feelings.

8/ A sense of benefit. 9/ Feeling biased.

10/ Provide the individual with vitality, activity and confidence.

11/ Looking to the future with optimism.

12/The ability to return to normal psychological state when faced with an unpleasant experience. (Blind, 2005)

B/ Negative effects:

The sense of increased work stresss has some adverse effects on the individual and the institution, the most important of which are:

The effects of stresss on the individual:

Work-related stress can lead to dissatisfaction with work, and in fact dissatisfaction with work depends on the simplest and most obvious result in the psychological effects of stress and the effect is shown in other psychological areas such as accident tendency, alcoholism, drug use and analgesics, emotional explosion, overeating, smoking, aggressive behavior and nervous laughter. (Al-Attiyah, 2003).

Physiological effects:

Increased blood glucose, increased heart rate, increased blood stress, dry mouth, sweat, high body temperature, chest and back pain and increased blood sugar. (Giloud, 2008).

Studies have indicated a significant relationship between severe work stresss, high blood stress and cholesterol levels that can lead to heart disease, infectious ulcers and arthritis, and a direct relationship between work stresss and cancer. (The Big One, 2004).

3/ Psychological and objective effects:

The most important of these symptoms include anxiety, aggression, indifference, boredom, depression, fatigue, frustration, loss of mood and nerves, lack of self-esteem and loneliness. (Nadim, 2004).

2/ The effects of stress on the institution:

It can be accomplished as follows:

1. Increase financial costs (cost of late work – absence – suspension of work additional workers – failure and repair of machinery – cost of loss of resources).
2. Low level of production and low quality.
3. The difficulty of focusing on work and industrial accidents.
4. Resentment of the working atmosphere.
5. Job dissatisfaction.
6. Absence and delay from work.
7. High rate of complaints and complaints.
8. Inaccuracy in decision-making.
9. Poor relationship between individuals.
10. Miscommunication due to the ambiguity of the role and its distortion of information.
11. Career leakage.

Feeling of failure. (Blind, 2005).

Ways to address work stress:

1- The strategy of dealing with stress at the individual level.

Man can avoid and address stresses in many ways, the most important of which are:

1/ Exercise: Studies have shown that those who exercise such as walking, jogging, tourism, and cycling are less likely to be stressed and stressed than others.

2/ Humor: Research has published that laughter helps avoid and realize the stress people face. It also indicates that some famous comic actors come from families that have been facing growing concerns.

3/ Cognitive Reconstruction: This is to encourage the individual to forget the belief that his intermittent failure should not have meant to him that he is a failed or bad human being.

4/ Network of Relationships: Encouraging the individual to join different groups and strengthen friendship and relations between him and his co-workers. Others are out of work to help provide social support. (Nadim, 2004).

5/ Meditation: This method seeks to achieve a state of calm and physical comfort and provides the opportunity for the individual to stop his daily activities and to exercise a high degree of attention and awareness on his feelings and conscience and this leads to the preparation of the mind and training him to withstand the pressure of work.

6/ Relaxation: Sitting comfortably and quietly leads to the same results of meditation and relaxation the mind does not dictate the relaxation of the body.

7/ Focus: The individual’s focus on a meaningful and important activity for a certain period helps to relieve the psychological stress of work, depends in principle on the same ways of contemplating relaxation, and the individual’s goal is to think about the sources of pressure and lead him to make a difference and accomplish that helps to feel valued, respected and self-fulfilling. (Blind, 2005).

8/ Increased self-awareness: Your self-awareness plays an important role in withdrawing and retreating from the increasing burden on you and seeking help.

9/ Cognitive compatibility: Enables an individual to learn how to adapt his mind to deal with the elements of stress, especially those that he cannot control or get rid of and requires to be a interlocutor with yourself and ask questions, such as what is the worst thing that can happen if things do not go on their normal course? (Hilal, 2000).

Strategies for dealing with stress at the enterprise level:

Various organizations provide many incentives that overcome stress and pressure to work in the aspect of what is provided under the title of humanitarian incentives, their various areas there are also direct financial barriers, and in order to manage stress at the enterprise level can be used the following methods:

1/ The right choice and accommodation:

Choosing to work and choosing employers for you is the right start, when you see yourself wanting the job and seeking it and being willing to make an effort to reach it, you will develop yourself and your abilities through it and this means compatibility with the job on your part, what you see as just a station or source of income and that means making weak stress at first but quickly growing to be a problem for you.

2/ Training:

Training for individuals plays directly into how to deal with the different stress and frequencies that an individual can face at work, as well as the skills of dealing with others and human relationships. (Hilal, 2000).

3/ Reorganization of the organizational structure:

Reorganize it in several ways to address stress problems such as adding a new regulatory level, reducing supervision or integrating functions, as well as employing organizational relationships between management and departments. (Blind, 2005).

4/ The connection is open:

Open communication channels are provided during the organizational structure that allow an individual to receive information and resend its reflections, and he or she will feel that he or she is more accepted by the administration and that he or she can express what is going on and feel that the administration is concerned with him properly. Increases trust and mutual respect, leading to productive and productive behaviors.

5/ Periodic follow-up and evaluation:

Analyzing the work to follow up and evaluate performance and the surrounding environment means determining the exact work requirements for compatibility and communication with the employee’s capabilities with the work assigned to him.

6/ Team building:

Business needs community interaction with each other, so designing community building must include incentives to achieve cooperation rather than competition, and by building team spirit and providing an auxiliary climate, the facility can prevent the occurrence and emergence of elements of stress and tension. (Hilal, 2000).

7/ Social support:

Through positive social relationships between individuals, the individual feels that his boss and colleagues are helping him and helping him feel acceptable and that the individual seems to feel isolated and alienated.

8/ Assistance programs:

Includes practical, training and mentoring programmes to help individuals and convince them that the work stress they are exposed to must be addressed.

9/ Guidance:

The aim of guiding employees is to improve the mental health and safety of the employee so that the individual feels comfortable with himself, towards others and is able to meet the requirements of life.

Previous studies

A/ Arab Studies:

(1) Saada Makhlouf Study (2006):

The study aimed to find out the impact of work stress and the extent to which it affects the behavior of doctors working in health centers and to identify behavioral disorders that are more related to the work of the doctor and which cause him psychological stress behavior, in addition to knowing the importance of the problem of pressure in relation to the success of the worker in his work in terms of increasing his salary, where this study was completed over a year, and the sample of the study consisted of (10) doctors and used the researcher observation and holmes test. The clinical interview showed the results of the study that there are (10) sources of work stress for doctors working in health studiers, namely the lack of technical possibilities, job dissatisfaction and strained relationships with the working environment.

(2) Mohammed Salim Study (2013):

The study aimed to examine the level of psychological stress among health workers, and reached the sample (372) employees of the public hospital institution in Algeria and divided into (70) doctors and (270) nurses and (32) anaesthesia agents and the use of a measure of psychological pressure. The study found that health workers suffer from a high level of psychological stress, and that there are no differences in the level of psychological stress depending on professional experience and sex.

(3) Hanan Qurari Study (2014):

I aimed to examine the levels of work stress and its relationship to the motivation of achievement in the general health doctors reached the sample (20) doctors and doctors of the Public Health Foundation, selected according to the results of the application of the measure of occupational stress Berri and the measure of motivation of achievement prepared by the researcher, the results showed the high level of professional stress in public health doctors, and found a correlation a function inverse between professional stress and motivation of achievement and the presence of differences between sex in the stress of work for males.

(4) Mohammed Assem Study (2015):

The study aimed to examine the psychological stress at work and its relationship to the psychological flexibility of the staff at Kamal Adoun Hospital in North Azza governorate on a sample of (225) hospital staff divided into (60) doctors, 86 nurses, 47 administrative and (32) technicians. The researcher used the measure of stress and the measure of psychological flexibility, one of the most important things indicated by the results is the existence of a functioning correlation between psychological stress and psychological flexibility and the absence of statistically significant differences in psychological pressure due to the variable nature of work (doctor- nurse- administrative – technical).

(5) Happy Salmoni Study (2017):

I aimed to reveal the sources of work stress and its implications for doctors and the doctor’s name for the benefit of the emergency department in the hospital institution, Mohammed Boutda “Riyadh” in a sample of doctors (15) doctors and (53) health workers. (32 nurses) assisting nurses (17) medical secretary (3) head of a clinic (10)) and divided into (33) males and (35) females between the ages of 21 and 40 years and verification of assignments the work pressure form is designed for doctors and semi-doctors. The results indicated that the sample members were under pressure from members of the single and collective institution, which were reflected in their professional and personal lives.

B/ Foreign Studies:

(1) Linda Study (2006):

I aimed to examine the level of mental health of doctors and nurses working in a hospital in the city of Kinsot- Jamaica, the sample of the study (212) doctors and nurses used the measure of mental health, and the most important of the results of the study showed a functioning relationship between the appearance of symptoms of psychological problems and both stress at work and years of experience and the presence of differences between sex and male orientation.

(2) Saranani Study (2015):

The study aimed to find out the impact of stress and role struggle on the performance of public sector workers, which included (115) public sector workers and the state of Sulawesi in the south-east of Indonesia, this study showed that there is no statistical impact and indication of the conflict of role on the performance of workers in that stress negatively affect its performance.

Research methodology and procedures:The research approach is defined as the method used by the researcher to study a particular phenomenon through which diverse ideas are organized in a way that can treat the problem of research. (Sarhan, 2019).Looking at the nature of the subject of the study, through which the researcher seeks to detect the stress of working in the deputies of specialists, she used the descriptive analytical approach with the aim of describing the phenomenon under study and collecting information about it, which studies the phenomenon and describes it accurately and expresses it as a quantitative and qualitative expression. (Bojash, 2001).Research community:It is all individuals, persons or objects with the same observable characteristics, and the purpose of defining society is to determine the extent to which it includes individuals. (Abdul Baki, Ruqaya, D.T.) The original study community consists of deputy specialists working at Ibrahim Malik Hospital divided into sections such as children 56 women and obstetrics 75 surgeries 70 esoteric 55, i.e. number (256) deputy specialists.Search sample:So the sample is a partial group of a community that has common characteristics. (Abdul Baki, 2010).

Table(1) showing sample characterization by gender

gender	Frequency	Percentage
males	39	40.6%
females	57	59.4%
total	96	100%

Table(2) showing sample characterization by age

Age	Frequency	Percentage
25-30 years	67	69.8%
31-35 years	14	14.6%
36-40 years	7	7.3%
41 years	8	%8.3
total	96	100%

Table(3) showing sample characterization by age

Social status	Frequency	Percentage
Single	72	75%
married	24	25%
total	96	100%

Data collection tool:

Measure of work stress:

It consists of twenty-four items and relied on the Scart scale and the answer alternatives related to: strongly approved, OK, I don’t know, disapproved, and strongly disapproved.Virtual honesty of the scale:The researcher presented the scale in its original form to a number of arbitrators by adding clauses related to dealing with escorts, safety in the working environment and the displacement of tools and equipment, represented by questions from (25-34).How to correct the scale: Weights are given to answers between always and sometimes and weights do not occur for positive questions. Always (3) and sometimes (2) and does not happen (1). Any questions that indicate the presence of work pressure and weights have always been given to negative questions (1) and sometimes (2) and do not occur (3) and the scale in its last form consists of 33 words.

Statistical methods:

After printing and distributing the scale, the researcher collected information from the table and used the SPSS package, the following statistical methods were used:

1. T test one sample. 2. T test for two independent samples.

View and discuss the results of the field study:

1/ Discuss The first hypothesis: “The general feature of the work stress of the deputy specialists at Ibrahim Malik Teaching Hospital is the rise.

” The following table shows this:Table (4) shows a single sample test to see if the general feature of the work stress of the deputy specialists at Ibrahim Malik Teaching Hospital

Sample size	Mean	spoken medium	S D	T value	df	P. value	Conclusion
96	73.98	66	12.441	6.284	95	0.000	The work stress are high at the level of indication 0.01

 From the table above, which shows a test to see if the working stress of the deputy specialists at Ibrahim Malik Teaching Hospital are high. It should be noted that the computational medium (73.98), the value of T (6.284) and the probability value (0.00), which indicates that the general characteristic of the work stress of the deputy specialists at Ibrahim Malik Teaching Hospital is high and at the level of indication 0.01The conclusion is that most doctors suffer from high occupational pressure. The working environment and the proportion of work have led to stress that may have affected their psychological and intuitive condition and performance. In addition to the workload and great responsibility. The doctor’s career is stressful.Referring to the sources of work stress, many of them are influenced by the doctor, such as the ambiguity of the role, which stems from the nature of the profession and the inability of the individual to control medical procedures in addition to the size of the visitor’s responsibilities, which drives them to feel nervous.

In addition to the environment surrounding them, which lacks the equipment your doctor needs to manage his or her work. Relations between him and his fellow medical personnel and their superiors were strained. In addition to the large number of work and lack of adequate support, fear of failure are all reasons why your doctor is under high pressure. The economic situation is unstable. The high inflation rates in the country combined and others were the reason why this group was subjected to professional stress.The results of this study (Mohammed Salim, 2013), Hanan Furai (2014) and Saida Salman (2017) agreed. All of its results have led to a high level of professional pressure among doctors.According to the researcher, through the studies mentioned and the return of the theoretical framework, the reason behind the high pressure of work among deputy specialists. The professional burdens and the need to be in hospitals for long periods and to be exposed to diseases. The physical conditions of hospitals are deteriorating, they are frequently exposed to difficult and painful situations, and patients and escorts are behaving, intervening and violating treatment decisions. Through painful and unsupposed negative experiences,

 these doctors have been subjected to high pressure, possibly affecting their professional performance and making the medical errors that we often hear. In addition, this group is an intern who does not receive adequate monitoring and follow-up and inexperience. From the definitions and sources of labour stress mentioned in the theoretical framework, this group is one of the most vulnerable to this type of pressure.

2/Discussing the result of the second hypothesis:

The hypothesis states: “There are statistically significant differences in the work stress of the deputies specialists due to Gender.

Table (5) shows the T-test for two independent eyes to see if there are differences in the work stress of the Deputy Specialists in Ibrahim Malik Teaching Hospital by Gender.

My comparison group	Sample size	Mean	S D	df	T value	P. value	Conclusion
males	39	73.78	12.503	94	2.273	0.010	There are statistically significant differences in favor of females at the significance level of 0.05
females	57	75.58	12.500

 From the table above, which shows a test of two independent samples to see what differences were in the working stress of the deputy specialists at Ibrahim Malik Teaching Hospital by type. It is noted that the calculated value (2.273) and the probability value (0.010) indicate that there are statistically significant differences in the work stress of the deputy specialists at Ibrahim Malik Teaching Hospital by type and in favor of females at the level of indication 0.01Referring to Gibson’s model and colleagues to study the stress of work and the effects of his work, the individual is aware of these stress at the level of pressure he feels. The model refers to the role of individual differences (cognitive and emotional) and (biological and demographic) on an individual’s perception of stressful circumstances, including sex, which has a role in the individual’s perception of stress. This study has already shown that there are differences in pressure due to type. For females, the level of pressure increases in females.

We find that this study differed with the study of Mohammed Salim, which found that there are no differences in the level of psychological stress by gender. This difference may be due to the fact that it applied the measure of psychological stress.I agreed with Hanan Furai’s study (2014) that there are gender differences but in the interest of males. Also a study (item 2015), confirmed differences in male interest.

 The high stress among males from previous studies can be due to the fact that males and their society’s perception of them are subject to material stress to provide for life and support their families. It may be the cause of a level of pressure.The results of the current study, which indicates the benefit of females, can be deferred because of the different sample size and the proportion of female males. In addition, the cultural framework of the sample puts pressure on women of another kind. The show objects to the presence of women late. Patients look at them and tend to males. Women are subjected to the stress of his life outside of work, represented by her role as a wife and mother of her children.

3/Discussing the result of the third hypothesis:

The hypothesis states: “There are statistically significant differences in the work stress of deputies to the specialist that are due to the marital status.” The following table shows that

Table (6) shows the T-test for two independent eyes to see if there are differences in the work stress of the Deputy Specialists in Ibrahim Malik Teaching Hospital according to marital status.

My comparison group	Sample size	Mean	S D	df	T value	P. value	Conclusion
Single	72	76.36	11.638	94	2.351	0.020	There are statistically significant differences in favor of married couples at the significance level of 0.05
married	24	72.35	12.807

From the table above, which shows a test of two independent samples to see what differences were in the working stress of the deputy specialists at Ibrahim Malik Teaching Hospital according to the gender social situation. It is noted that the calculated value (2.351) and the probability value (0.020) indicate that there are statistically significant differences in the working stress of the deputy specialists at Ibrahim Malik Teaching Hospital by social situation, for the benefit of married couples and at the level of indication 0.001.The models of the study of labour stress have also shown that individual differences play a role in an individual’s perception of the stress to which they are exposed.The results of this study indicate that the group of married doctors, both women and men, are at higher risk of working stress than others.

Previous studies have not indicated this aspect. The researcher attributes the reason that married men have the financial burden of taking care of the family, they are aware of the stress of working as a threat to losing his job and thus providing security for his family and social status. Women’s stress stem from their traditional role as wives and caregivers and the risk of disease reduction. For males, too, it is the economic aspect, and as the labour analysis model has shown, the economic aspect has a role to play in the reactions to pressure, i.e. married couples are more vulnerable to work-related stress.

4/Discussing the result of the fourth hypothesis:

The hypothesis states: “There are statistically significant differences in the work stress of the deputies specialists due to age.” The following table illustrates this:

The following table(7) shows the one-way analysis of variance test to find out the differences in work stress among the Deputy Specialists in Ibrahim Malik Teaching Hospital by age.

Conclusion	Sig.	F	Mean Square	df	Sum of Squares	Oneway
There are no statistically significant differences at the 0.05 . significance level	0.785	0.289	11.681	1	11.681	Between Groups
			156.301	94	14692.278	Within Groups
				95	14703.958	Total

From the table above, which shows the analysis of the unilateral variation to see if there are differences in the working stress of the deputy specialists at Ibrahim Malik Teaching Hospital by age. It should be noted that the value of P (0.289) and the probability value (0.785) indicate that there are no differences in the working stress of the deputy specialists at Ibrahim Malik Teaching Hospital by age and at the level of indication 0.05.Referring to the theoretical framework, specifically the models and environment of work stress, Hassoun and his colleagues in their model mentioned the role of age from an individual’s perception of work stress.

 The model of pressure size and its results include individual differences, work experience, its impact on an individual’s sense of pressure, as well as a study of Za, which found a relationship between sample problems and years of experience. From what has been mentioned, models and studies have differed with the fact that there are no differences by age. The lack of difference can be attributed to the fact that the older frame does not have experience despite their insatiability and may be away from the field of work and contribute to the simple sample. The stress on the sample as a whole were the primary source of pressure and had nothing to do with medical work.

The results of studies that years of experience affect an individual’s perception of pressure. which were mentioned in the theoretical framework ensuring personal qualities. Experience is a factor influencing the response to pressure and has a role to play in reducing pressure due to repeated response and response training and pressure situations.In the end, the medical profession and for the doctor alike are a source of many stress because it is a profession that requires the burden of study, the doctor is always in case he learns everything new in addition to the burdens of his profession, which requires high mental and psychological strength.Findings and recommendations:

Results:

1. The general feature of the stress of working for deputy specialists at Ibrahim Malik Hospital is high.
2. There are statistically significant differences in the stress of working with deputy specialists at Ibrahim Malik Hospital by type in favor of females.
3. There are statistically significant differences in the stress of working for deputy specialists at Ibrahim Malik Hospital depending on the social situation in favour of married couples.
4. There are no differences in the stress of working for deputy specialists at Ibrahim Malik Hospital by age.

Recommendations:

1. Further studies on the sources of work stress of doctors and the effects of these stress on their professional performance.
2. A more comprehensive study of the symptoms of work stress experienced by doctors.
3. Design a preventive program for medical school students to prevent them from being exposed to these stress in the future.
4. The Ministry of Health and the Medical Council should conduct an orderly study of the working stress of this group. In order to explain them, control their sources, prevent them from occurring and require specialists to review and provide continuous guidance to them, medical errors will not occur.
5. The authority of doctors is allocated from physical harm by escorts and improving the working environment.
6. Limiting the movement and number of escorts inside the hospital.
7. Improve the relationship between doctors, colleagues and subordinates to create a favorable climate.
8. Continuous evaluation and identification of sources of pressure causing pressure for avoidance.
9. Conduct training courses that enable doctors to cope with and deal with work stress.

Proposed research:

1. Sources of work stress for general practitioners and specialists.
2. The arranged effects of work stress on the professional performance of doctors.
3. The effectiveness of a mentoring program to reduce the stress of working in doctors.

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