Risk assessment for work-related stress : a development study with UK hospital-based doctors
This thesis describes the development and implementation of a risk assessment strategy to deal with the problem of work-related stress in hospital-based doctors in the United Kingdom. Risk assessment is the initial phase of the risk management approach to work stress, and is followed by the 'translation' phase, risk reduction and evaluation of interventions. Three case studies were carried out in two National Health Service (NHS) Trusts to explore how standardised implementation procedures and adequate data analysis can be developed to ensure the sound application of the principles of the framework. The case studies were commissioned and funded by the British Medical Association. The thesis begins by considering the definition of work-related stress and summarising the extent of the problem in terms of its economic and social cost. The new risk management approach is introduced as an alternative research framework that may address some of the shortcomings of contemporary stress research. The background to the case studies is described, and then the assessment methodology and strategy developed for the project are explained in detail. The subsequent chapters report the main results for each NHS Trust, and then illustrate how the assessment data can also be used for research-oriented purposes, such as the development and testing of models. The final chapter brings together the results and conclusions from the preceding sections and examines them in the light of the wider debates taking place within stress research. The strengths and weaknesses of the risk assessment methodology are discussed, and some possible ways forward are considered that may build on its strengths and address its weaknesses.