Human Behaviour & Health - Essay Example

Human Behaviour & Health Introduction Human beings react to situations based on their usual behaviour and their frame of mind. This frame of mind often affects a person’s daily activities the outcomes of such, including work and social activities. In the workplace, a person’s behaviour and emotional health often affects work outcomes and general demeanour. In this psychological assessment, we discuss the case of Tanya, who has been off work for over four months now. Tanya’s original sick note was based on a lower back problem, subsequent notes reasoned anxiety, stress and fatigue. She was referred to a company physiotherapist who assessed that Tanya’s lower back pain problems were manageable and with gradual work re-introduction could be resolved. The HR now referred this matter for comment on the psychological/behavioural issues which has to be considered alongside the physical recommendations of the physiotherapist when planning a return to work programme. This report shall discuss the aspects of health psychology which has to be considered. It shall discuss how I can determine the scale of any of her problems, who will need to be involved in the return-to-work process, what form a return-to-work process can take, and how I will monitor the effectiveness of any return-to-work intervention. Discussion Aspects of health psychology to consider I believe that I will have to consider the mind-body connection, psychological adjustment, optimism, and social relationships in this case. The mind-body connection is crucial in her case because the connection is impacting on her condition following her initial lower back pain symptoms and subsequent feelings of anxiety, and stress. Gurgevich and Gurgevich emphasize that the mind-body connection implies that “every thought and idea in your mind has an effect on your body; and every sensation in your body has an effect on the mind” (2007, p. 11). I have to consider this aspect in health psychology in Tanya’s case because her anxiety and work stress seems to be affecting her recovery from her lower back pain. Her lower back pain symptoms are also affecting her mind and allowing her to think that she really is not ready to go back to work as yet. This mind-body connection is also very much related to her psychological adjustment. Kuhlberg (2000) discusses that psychological conditions, like stress or anxiety, can affect a person’s biological processes, resulting to poor health practices. People’s lives often change after they go through an illness or an injury and these changes often affect how people view themselves (Kuhlberg, 2000). Many of these patients often suffer anxiety or depression after going through an illness or an injury and these psychological states can also affect how these patients recover from illnesses, impacting on their health practices and social functioning (Kuhlberg, 2000). It is obvious that Tanya’s back pain has caused her to be stressed and anxious and it has also affected her health practices and social functioning, thereby impacting on her return to work. I need to consider her psychological adjustment because it is obvious that she is not adjusting well from her illness and not gaining any clear progress in her health recovery. I also need to consider her optimism. Optimism is related to positive attitudes and improved reports on physical health and recovery from illness (Dobson & Dozois, 2008). It is basically about positive thinking, positive emotions and building up the strength and attitude of a person in order to better deal with daily challenges. In this case, I believe that I have to address Tanya’s optimism because she appears to be negative and defeated in her general demeanour, especially in the thought of returning to work. There is a need to address her attitude and to possibly make it more positive – in order to help her recover faster from her affliction. On a more minimal scale, there is a need to address her social support (or lack thereof). Psychologists emphasize that there is a positive relationship between social support, mental health, and physical health (Kuhlberg, 2000). Social support is important for most people because it helps them cope better with emotional, physical, and psychological issues. In Tanya’s case, there is no mention of support from her friends or family, and her work environment is also considered an intolerable place for her; she mentions that the Head Chef is very rigid in the way he is running the kitchen – creating a very socially uncomfortable working environment for her. There is a need to address social support for Tanya because this will help determine how well she would recover from her illness and how well she would re-integrate into the workplace. The general understanding of stress implies that it is often triggered by “demand or threatening or harmful events, and that it is often associated with negative moods” (Gallagher, 2003, p. 442). In case a person is unable to handle the demands of threatening events, then strain or stress often manifests in a person in the form of negative, anxious, and depressed moods. Cannon was one of the first theorists who evaluated stress and its effects on a person. He emphasized that the body has to be in a state of equilibrium, and anything which disturbs such state often prompts the body to carry out processes which would help restore equilibrium (Gallagher, 2003). Stressful events often trigger negative reactions such as fear and anger in a person. The biological processes of the body then prompt the fight or flight response in order to gradually attain physiological balance. Until equilibrium is reached, a person often stays in such state of fear or anger – eventually affecting the person’s conduct of daily activities. In the workplace, stress often comes from a variety of sources. These sources may be intrinsic to the job or it may be related to the person’s role in the workplace, including his relationships at work, or the organization’s culture or climate (Stranks, 2005). Different people have different types of behaviour and with this they have different ways of dealing with stress. Some individuals are able to manage their home, work, and social lives with little difficulty; however, other people can be overwhelmed with the multiple tasks and roles they have to play in their daily lives (Karwowski, 2006). Because of the inability to cope and manage stress, individual characteristics which manifest include anxiety, neuroticism, decreased tolerance for ambiguity, and in some cases, fear and anger (Stranks, 2006). Beyond individual characteristics, a person is also likely to present symptoms of occupational ill health, including: increased diastolic blood pressure, increased cholesterol levels, smoking, depression, escapist drinking, and job dissatisfaction (Stranks, 2006). In the workplace, the stressed person is also likely to be frequently absent, to quit work, or to experience difficulties in labour relations. These problems may also manifest in terms of diseases like heart diseases, mental illnesses, and chronic workplace accidents (Stranks, 2006). In the case of Tanya, she appears to be extremely stressed with her condition. She is stressed by her lower back pain and she is stressed by her work environment. The trigger for her stress appears to be the lower back pain, which is exacerbated by her rigid work environment. This stressful work environment which was defined in terms of an autocratic leadership by the Head Chef is now affecting her return to work. Even as her GP and her physiotherapist cleared her to be physically well enough to gradually be reintegrated into the workplace, the thought of returning to work seems to be triggering a physical reaction on the part of Tanya – seen apparently as recurrent, persistent lower back pains and guarding behaviour. Psychologist Doka (2009) discusses how individuals often manifest stress physically, how their mental affectations translates to physical symptoms. “The range of physical reactions to stress includes insomnia, headaches, dizziness, fatigue, nausea, tingling sensations, and a variety of physical ills” (Doka, 2009, p. 82). In the case of Tanya, her lower back pains are exacerbated by her stressed feelings. She even admits that just the thought of getting back to work was making her back ache. This is a telling sign that points out to a crucial link between Tanya’s stressed feelings in the workplace and her lower back pains. In a discussion by the Canadian Centre for Occupational Health and Safety (2008), the centre discusses how stress is a common enough phenomenon, however, when excessive stress is felt by a person, his normal functions are compromised. This also applies in the workplace, as stress often manifests when there is a “conflict between job demands on the employee and the amount of control an employee has over meeting these demands” (Canadian Centre for Occupational Health and Safety, 2008). In essence, high work demands and low levels of control over the situation can create stress. In Tanya’s case, the physical demands of her work are high – she is required to carry, to clean, to restock shelves and pantries, and to generally be on her toes at most times during her working hours. There is almost no moment of relaxation for her and her colleagues. Since she is a subordinate employee, she has little control over her situation. She is obliged to follow orders and to be on her toes all the time. At work she is in a constant state of tension and physical labour. Based on the Canadian Centre’s evaluation, this can indeed create workplace stress. Her work has high demands and she has little control over her situation – typically fitting the parameters of a situation creating workplace stress. Fatigue and recovery at human work is very much related to the concepts of stress and strain according to Rohmert (1984, as cited by Stellman & International Labour Office, 1998). In most cases, the intensity, duration, and the composition of work often contributes to stress which then affects a person’s general demeanour. Stress and the normal conduct of activities mostly depends on the individual characteristics of a person. Factors affecting the impact of stress on a person are mostly related to motivation and concentration as well as disposition (Stellman & International Labour Office, 1998). Stress which affect human behaviour cause individually different types of strain on a person. “The strains can be indicated by the reaction of physiological or biochemical indicators (e.g. raising the heart rate) or it can be perceived” (Stellman & International Labour Office, 1998, p. 29). In Tanya’s case, her reactions to the stress or the strain are mostly manifest as a physical reaction – through her lower back pains, and psychologically through her anxiety and apprehension in going back to work. Another important matter which needs to be considered in Tanya’s case is her manager – the Head Chef and the latter’s management style which is affecting her ability to work and her return to work. The manager’s type of management “takes a rather dim view of people, seemingly operating on the assumption that, for the most part, people have to be continually told what to do to obtain the best possible output” (McConnell, 2007, p. 148). Based on the Head Chef’s and on Tanya’s account, it may be deduced that the Head Chef portrays the qualities of an authoritarian leader: he has a dim view of the employees under him, referring to them as “foot soldiers”; he does not allow moments of relaxation for employees (including playing music or chatting in the workplace); he always keeps the employees busy; he focuses highly on doing the task and nothing else; and he does not allow employees to engage with more personably with him (employees do not even know his name). According to Stellman and the International Labour Office (1998), the Head Chef may also be considered an abrasive personality – is focused on achievement, perfection, functions less on an emotional level, and is preoccupied with himself. Consequently, these personalities often “induce feelings of inadequacy among their subordinates” (Stellman & International Labour Office, 1998, p. 1989). This type of management is highly stressful for the subordinates and it also interferes with their interpersonal relationships. This is manifest in Tanya’s workplace. The Head Chef is highly abrasive as a manager. He triggers feelings of inadequacy among his subordinates, including Tanya, who, despite clearance from her GP and the physiotherapist, does not feel ready to get back to work. Her attitudes imply that her readiness to return to work is less about her lower back pains, but more about her fears and her apprehension in getting back to her daily work routine and in dealing with her autocratic boss. How can you determine the scale of any problem? I can determine the scale of her problems by assessing her medical records from her GP and from her physiotherapist. This would help determine her physical problems – the possible causes and the extent of her lower back pain complaint, and if such physical problems require surgery, physical therapy, or extended rest. This physical assessment would also assess whether or not she is already capable of going back to work. I can assess her psychological problems based on her interview. Based on her interview, I can determine the degree of her anxiety and stress – whether or not she needs therapeutic assistance for these problems and whether or not such psychological problems are likely to interfere with her work. In case her physical and psychological problems interfere with her work, then her problems require more professional assistance; if such problems however do not interfere with her work, then such problems may be considered mild and manageable. At this point, the basis for rating her condition would have to be on the extent to which her condition interferes with her work. A determination of how physically and psychologically well she is to go back to work will help determine the scale of this problem and will also help determine the problems which have to be addressed to ensure Tanya’s full recovery (DeLisa, Gans, & Walsh, 2005). Who will need to be involved in the return-to-work process? The return to work process has to involve the company physician, the manager, the co-workers, the physiotherapist, the company psychologist and Tanya. The company physician has to assess Tanya physically in order to determine that she is physically able to carry out her work. Company physicians are there to assess whether or not the employees are physically and mentally fit to return to work and whether or not their previous ailments hinder with their ability to carry out their duties and responsibilities (Gibson, 1985). As for the manager (Head Chef), his cooperation is also needed in order to create a less rigid and more conducive work environment for Tanya and for the workers in general. The co-workers also need to know that Tanya may not be able to work based on her 100% capacity during the initial weeks she would re-enter the workforce. Adjustments in schedule, amount, and difficulty of work have to be made in order to accommodate Tanya’s condition. These are important measures and adjustments to follow in the workplace because “employees returning to the same job without modification of the work environment are at risk for recurrence” (Keer & Grahame, 2003, p. 138). In order to avoid recurrence of her back pains (and possibly, her stress), the cooperation of her manager and her colleagues is needed. There is also a need to involve the physiotherapist in order to ensure that Tanya’s lower back pains would not be worsened or exacerbated; and eventually that these pains would be minimized or be totally diminished. The physiotherapist would also be responsible for teaching her proper techniques in lifting and carrying heavy objects and in managing pain symptoms (Strong, Unruh, Wright, & Baxter, 2002). The psychologist is needed in order to assess her psychological wellness – her anxiety, stress, and fatigue levels. The psychologist needs to determine if she is psychologically well enough to return to work. He also has to counsel her during the first months of her return to work in order to assess how well she is coping with her psychological issues, to help her cope with these issues, and to assess possible therapy and other recommendations for psychiatric help in case her situation would ever call for it (Drenth, Thierry, & Wolff, 1998). Finally, Tanya’s cooperation is needed in the return-to-work process. She needs to submit herself to the fact that other people would have to be involved in order to determine whether or not she is well enough to return to work; to ensure that her return to work would be gradual and conducive to her condition; and to ensure that she is getting adequate medical and psychological help for her condition. What form could a return-to-work intervention take? Based on a summary research conducted by Franche, et.al., (2004), a return-to-work intervention may involve three main elements: early contact with the worker by the workplace; a work accommodation offer; and contact between healthcare providers and the workplace in order to reduce work disability duration and costs. In Tanya’s case, her return to work intervention could include ergonomic worksite visits to be conducted by the physiotherapist or occupational therapist. These interventions would help ensure that she is carrying out her physical activities in the workplace while keeping in mind lifting and carrying techniques which would be ergonomically safe for her and for her colleagues (Maras & Karwowski, 2006). A return to work intervention, I believe, would also include educating supervisors and managers about the safety and ergonomic standards they can apply and enforce among the staff, and most especially for Tanya (Franche, et.al., 2004). The return to work intervention would therefore also entail an educational element for the Head Chef and the manager of the restaurant. They would have to be trained on the ergonomically safe techniques which have to be applied and implemented in the workplace. Aside from the ergonomic techniques, Franche, et.al., (2004) also discuss that labour-management cooperation is very much related to shorter work disability duration. They recommend that “increased attention be given to labour-management relations and consideration be given to workplace culture” (Franche, et.al., 2004, p. 6). Through these considerations, it is possible to improve Tanya’s relationship with her manager – the Head Chef as it seems to be a major setback in her return to work. How will you monitor the effectiveness of any return-to-work intervention? I would monitor the effectiveness of any return to work intervention by regularly consulting with Tanya – to check on her physical and psychological progress and adjustment in the workplace. I would assess how she carries out her kitchen activities – if these are in keeping with the principles of ergonomics. Decreased pain incidents involving her back would also indicate that the return to work intervention is effective. Getting along well with the Head Chef would also mean that labour and management relationship is improving, thereby creating an emotionally and psychologically healthy workplace. During interviews and psychotherapeutic sessions, she should be able to express that she understands the need for an efficient work environment through strict measures implemented by the Head Chef. And the manager should also be able to express how he understands the importance of implementing ergonomically-safe work practices in order to ensure the physical safety and health of the employees. The Head Chef should also be able to make some adjustments in his managerial technique – making it more participative, rather than autocratic, in order to ensure that the workplace is healthy is and accommodating to the needs of the management and of the employees. Conclusion Upon assessment and review of the facts of Tanya’s case, it is apparent that Tanya is physically and psychologically conflicted. In assessing her return to work, it is important to consider the mind-body connection, her optimism, her social relations, and her psychological adjustment. These are factors which affect her ability to accept her work reintegration. There is obviously a mind-body connection between her lower back pains and her emotions – as seen from her guarding and her worsened pain symptoms every time her return to work is discussed. Clearance from her GP and from the physiotherapist on the possibility of returning to work is clearly not agreeable to Tanya. She is holding on to her lower back pain as an excuse and as a safety zone – to avoid facing the fact that she has to go back to work. She is clearly stressed by her work environment and this stress is affecting her return to work. In considering her work environment, the stress she feels is an understandable deduction, considering that her manager is applying a very autocratic leadership style. This leadership style is triggering stress, tension, fatigue, and unhealthy work relations among the employees, most especially Tanya. In order to ease her into a favourable return to work intervention, the physician, the physiotherapist, the psychologist, the manager, and Tanya have to work together to make necessary adjustments in the workplace. These adjustments have to be geared towards making the workplace ergonomically safe and less stressful for the employees. These adjustments will help gradually reintegrate Tanya into the workforce, hopefully without the recurrence of symptoms. It would also help improve worker satisfaction and work output, and help to ensure the physical and psychological health of all employees. Works Cited Canadian Centre for Occupational Health & Safety (2008) Workplace Stress – General. Retrieved 04 July 2010 from http://www.ccohs.ca/oshanswers/psychosocial/stress.html DeLisa, J., Gans, B. & Walsh, N. 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