Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
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On Sep 2018




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On Sep 2018




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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
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Professor and Head
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Saraswati Dental College
Lucknow
On Sep 2018




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MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
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Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




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Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
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An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help ones reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journalsNo manuscriptsNo authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2007 | Month : August | Volume : 1 | Issue : 4 | Page : 224 - 234

Job Stress, Job Satisfaction and Mental Health

MARZABADI E A, TARKHORANI H

Es. Azad Marzabadi and Hamid Tarkhorani are affiliated with Behavioral Science Research Center, Baqiyatallah University of medical sciences , Tehran, Iran.

Correspondence Address :
Azad Marzabadi, Baqiyatallah University of Medical Sciences and Health Services. Tehran, Iran. E-mails: esfandearazad@yahoo.com (Es Azad Marzabadi), tarkhorani@gmail.com (H Tarkhorani).

Abstract

Introduction: Stress has been proven to be a big contributor to medical ailments and a lot of people suffer from stress throughout the world. There are different factors that lead to stress, and among them stress from work has been learnt as a major contributor to illnesses. There have been a lot of studies conducted that have shown that a lot of people are suffering from stress at work due to various reasons, and these studies have helped us a lot to understand the situation much better.
Methods: Our study revolves around finding the relationship between job stress, job satisfaction and mental health. There were about 164 individuals in our study who were employees of a governmental organisation in Iran. All the individuals were interviewed, and the questionnaires that were used included the General Health Questionnaire (GHQ), Occupational Stress Inventory (OSI), and Job Descriptive Index (JDI).
Results: The statistics were collected from 164 individuals who were employees of a governmental organisation in Iran. In the study, it was found that a large number of participants were ranked in the low-stress range, which was about 93.9%.
Discussion: There have been a lot of studies conducted to understand the relationship between job stress and job satisfaction. A lot of the researches have shown that the people are suffering from increased amount of stress in their work environment and hence that caused them to suffer from medical illnesses. On the other hand, a good number of participants in our study showed very low stress in their work environment that helped us to learn the different factors that can provide an ideal environment for people at their jobs.

Keywords

Stress, satisfaction, job, work, environment, performance, diseases

Mental health
Though many elements of mental health may be identifiable, the term is not easy to define. The meaning of being mentally healthy is subject to many interpretations rooted in value judgements, which may vary across cultures. Mental health should not be seen as the absence of illness, but more to do with a form of subjective well-being, when individuals feel that they are coping fairly in control of their lives and are able to face challenges and take on responsibility. Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity specific to the individual’s culture.

Stress
Stress is defined as a non-specific response of the body to any demand made upon it, which results in symptoms such as rise in the blood pressure, release of hormones, quickness of breath, tightening of muscles, perspiration and increased cardiac activity. Stress is not necessarily negative. Some stress keeps us motivated and alert, while too little stress can create problems. However, too much stress can trigger problems with mental and physical health, particularly over a prolonged period of time.

Job stress
Job stress can be defined as the harmful physical and emotional response that occurs when the requirements of the job do not match the capabilities, resources, or needs of the worker. Job stress can lead to poor health and even injury. Long-term exposure to job stress has been linked to an increased risk of musculoskeletal disorders, depression and job burnout and may contribute to a range of debilitating diseases, ranging from cardiovascular disease to cancer. Stressful working conditions may also interfere with an employee’s ability to work safely, contributing to work injuries and illnesses. In the workplace of the 1990s, the most highly ranked and frequently reported organisational stressors are potential job loss, technological advances, and ineffective top management. At the work unit level, work overload, poor supervision, and inadequate training are the top-ranking stressors.

Job satisfaction
Job satisfaction has been defined as a pleasurable emotional state resulting from the appraisal of one’s job, an affective reaction to one’s job, and an attitude towards one’s job. Weiss (2002) has argued that job satisfaction is an attitude but points out that researchers should clearly distinguish the objects of cognitive evaluation, which are affect (emotion), beliefs and behaviours. This definition suggests that we form attitudes towards our jobs by taking into account our feelings, our beliefs and our behaviours.

There are a lot of studies that have been conducted from time to time to understand the relationship between job stress, job satisfaction and its effect on mental health. Job performance is greatly linked with job stress and job satisfaction. It is seen that the individuals who are satisfied at their job positions perform really well, whereas the individuals who are really stressed perform really bad and are always on the look out to switch jobs, as job stress can result in medical ailments.

Instability of employment, rapid change of demands and intensification of work pressure are widely prevalent consequences of economic globalisation and technological change (1). Even in established sectors of industrial production, administration and services of advanced societies, experiences of downsizing, mergers and outsourcing are increasingly shared by employees (2). Surveys of working conditions in Europe indicate that stressful experience recently increased in the European workforce although variations between countries and sectors are observed (3). Chronic stressful experience at work can adversely affect physical and mental health. This has been documented in a

Material and Methods

This is a descriptive study to find relation between job stress and its relations to mental health.

Our statistics embraces 164 individuals who were employees of a governmental organisation in Iran.

We did conventional sampling. After sampling the questionnaire of the study was given to the individuals to complete.

In this study we used three questionnaires:

1. General Health Questionnaire
The General Health Questionnaire (GHQ) is a self-reporting psychiatric screening instrument with a variety of forms that range from 12 to 60. The GHQ is developed from a pool of 140 items that are believed to cover all aspects of adjustments. These concepts include depression and unhappiness, anxiety and psychological disturbance, social impairment and hypochondriasis (15).

The GHQ-28 is a scaled version using Likert scoring methods.

Factor analysis showed that the factors measured are somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. Other forms of the GHQ do not use Likert scale.

Scoring: Respondents rate themselves on a four-point severity scale, according to how they have recently experienced each GHQ item: “better than usual”, “same as usual”, “worse than usual” or “much worse than usual”. Normally each item is scored either ‘0’ or ‘1’ depending on which severity the choice is selected. A total score is computed by adding the scores of each individual item (15).

The GHQ-28 is a scaled version. Likert scoring method is used to assign values of 0, 1, 2 and 3 for item severity (15).

The cut-off scores are 11/12, 3/4 and 4/5 for the GHQ-60, the GHQ-30 and the GHQ-28, respectively (15).

Reliability: (1) Split-half coefficient: r = 0.95 (GHQ-60), 0.92 (GHQ-30), 0.90 (GHQ-20) and 0.83 (GHQ-12) (15). (2) Test–retest coefficient: r = 0.85 (GHQ-30) (Folstein), 0.90, 0.75 and 0.51 (GHQ-60) (15).

Validity: Current validity: In comparison with patients’ overall clinical assessment, r = 0.70–0.83 (15). In comparison with clinical ratings for two large group of general medical patients, r = 0.67–0.76 (GHQ-28) (16).

2. Occupational Stress Inventory
The Occupational Stress Inventory (OSI) is designed to measure the occupational adjustment on three different dimensions. These three different dimensions are Occupational Roles Questionnaire (ORQ), Personal Strain Questionnaire (PSQ) and Personal Resources Questionnaire (PRQ).

The OSI was developed by Osipow in 1998 and is not intended for clinical utilisation but rather for research purposes. The OSI-R was based upon a previous version of the instrument that was developed by Osipow and Spokane in 1987 to measure occupational adjustment on three different dimensions. The OSI-R’s three dimensions are defined as the ORQ, the PSQ and the PRQ. Each dimension has its own scales, which assess specific characteristics that subsequently contribute to the total overall score. The three dimensions can be used together, like in this study or individually based on the research questions. The three dimensions are further divided into the following scales:
(a) ORQ – role overload, role insufficiency, role ambiguity, role boundary, responsibility, and physical environment
(b) PSQ – vocational strain, psychological strain, interpersonal strain, and physical strain
(c) PRQ – recreation, self-care, social support and rational/cognitive coping

Each scale is comprised of 10 items, with the total number of items for all scales being 140. The ORQ consists of 60 items and the PSQ and PRQ have 40 items each. Reading the instructions and responding to the test items takes approximately 30 minutes to complete and requires approximately a fifth-grade reading level. Osipow articulates that care should be used if the OSI-R is administered

Results

The relationship between job stress, job satisfaction and mental health was studied in a governmental organisation. In this study, there were 8% individuals below the age of 30 years, about 19.5% individuals in the age range 31–35 years, 42% individuals between the ages of 36 and 40 years, and 26% individuals were above the age of 42 years. The individuals who were the part of this study had different years of experience at their job. There were about 10% of individuals with an experience level below 5 years, 20% had 5–10 years’ experience, 17% had 11–15 years’ experience and 46% had about 16–20 years of experience. This study comprised of 85% males and 15% females.

In (Table/Fig 1), the different kinds of stress were listed and the individuals were being questioned in the different stress categories. The stress categories were related to roles at work, the physical environment, responsibilities, family, work, and work and family. The different stress levels that were taken ranged from no stress to low stress, intermediate stress and high stress. The results were then categorised in average and standard deviation, in order to simplify the results. Among the roles at work, the role conflict was the one with the highest results of about 35.54. The next highest stress level among the roles was role ambiguity, which got an average of about 31.81. Role overload and role insufficiency both got an average of about 29.25 and 28.96. The stress caused by physical environment got an average of about 37.93. The stress among individuals due to responsibility was averaged at 20.97. The stress related to the family got an average of about 23.97. In the end, the stresses caused by work and work and family were ranked at an average of 94.87 and 118.81, respectively. The standard deviation was seen to be highest in the category of work and family at 15.57, and the least deviation was reported with family stress at 4.37.

In (Table/Fig 2), we studied the satisfaction aspects of the individuals by breaking down the satisfaction level into three different standards, which were low satisfaction, intermediate satisfaction and high satisfaction, and analysed it from the perspective of work, chief, cohorts, preferment, salary and premium, and job. The satisfaction from preferment ranked the highest at about 20.1% and the satisfaction from work and salary and premium both were ranked at 13.4%. The lowest level of high satisfaction was seen from cohorts, which was at 1.2%. The satisfaction from cohorts in the intermediate satisfaction category was seen at the highest level with 88.4%. The satisfaction from work and chief in the intermediate satisfaction category were ranked at the second and third place with 86% and 84.8%, respectively. The lowest level of satisfaction was from preferment in the intermediate category with 16.6%.



In (Table/Fig 3), the individuals were studied with reference of mental health, anxiety, social dysfunction and depression. Categorically, there were 22% of the individuals who were tending to have problems of mental health; 2.4% of the individuals were suffering from anxiety, 2.4% suffering from social dysfunction and 1.2% were suffering from depression.
In (Table/Fig 4) and (Table/Fig 5), we are discussing the relation between total satisfaction and mental health, their relation was significant and negative (p = 0.301) as in (Table/Fig 4).

Covariant between job and family stress and job stress was p = 0.87 and this covariant was significant in 99%. A

Discussion

Work is an essential part of our lives. There are people who find real satisfaction in their work but there are people who get really stressed out because of their work situation. There are different factors that play a role with an individual suffering from stress in their job situation. Personal, interpersonal and organisational factors have been reported to relate to stress and burnout. For instance, burnout seems to be less prevalent among older people and among married people. Perfectionism, in contrast, increases vulnerability. Stress induced by emotion-laden patient contacts is often considered a cause of burnout. In the well-known model of Karasek, social support is emphasised as being a moderator between high work load, low work control and stress. In the work of Ramirez and colleagues, workload and a lack of adequate resources emerged as important stressors for medical specialists. There have been a lot of studies conducted from time and time again to understand the different factors that are related in causing stress at work and the factors that are the reason for a person’s job satisfaction. It was through the various studies, it was learnt that job stress can lead to medical illnesses and it has been learnt that such a high level of stress among individuals through work can cause serious ailments such as cardiovascular diseases. Our study was based on studying the relation between job stress, job satisfaction and mental health in a governmental organisation in Iran. The studies that were conducted mostly showed that the individuals were having a great deal of stress in their job situation and a very few studies showed that the individuals were experiencing job satisfaction in their work environment. The study that we conducted matched the study conducted at a hospital where the participants were nurses. Each of the nurses was interviewed for about 2½ hours, and the major question that was asked to them was their experience of job satisfaction as a clinical nurse and their answer was that they were really satisfied with it. Most of the nurses stated that there were four major things that were the basis of their satisfaction, which included the sense of belonging to their profession, the self-respect that they were earning by helping others, perception of life, learning and pride. This study matched ours because there was a high satisfaction level among the participants who were being evaluated under various stress level categories. The majority of our participants were between the ages of 36 and 40 years, which made about a good 42% of the total number of participants. The second highest majority was above the age of 42 years and that made about 26% of the total individuals. In this study, there were about a total of 85% males and 15% females. The results in broader terms were really amazing where about 93.9% of individuals were noted in the low stress range, 3% in the intermediate stress range and 0% reported in the high stress range. In the low stress category, there was an increased percentage of people who were having problem balancing their work life and family life, which was about 85.4%, and about 75.6% were suffering from low stress due to role overload. With regards to the satisfaction, the highest rank was taken up by satisfaction from cohorts, which was at 88.4%, 86% from work and 84.8% from chief.

This study has really helped us to understand the different factors that are responsible for the individuals to feel satisfied in their work environment and the factors that were the cause of their stress so that steps can be taken to improve the work environment and eliminate the factors that would reduce the stress so that people can live a healthy life and are able to balance it in almost every aspect.

Conclusion

There is a very close relationship between stress and medical illnesses. There are a lot of individuals in a lot of studies who have shown to suffer from increased amounts of stress just because they are not paid well, because of bad work environment, because of less growth opportunities, etc., and all these factors just lead to the development of high stress and can ultimately make a person to suffer. Our study showed that there were a lot of individuals who were suffering from low stress and that has really helped us to understand the different factors that were related to job satisfaction and mental health, as well as job stress and its relation to mental health. The statistics that are gathered are really going to help us learn the different aspects of the study and promote better working environment, growth opportunities, as well as a lot of other factors that make people get the best out of their potential.

Conflict of interest, None Declared

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Tables and Figures
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JCDR is now Monthly and more widely Indexed .