Stress and Healthcare Workers Productivity at Lexington Medical Center ABSTRACT The research proposal aim at assessing the effect of workplace stress on workers productivity at Lexington Medical Center. The objective of the research is to assess worker productivity, the stress level among health workers, and the extent to which their productivity and performance is related to stress levels. The research survey will be a cross section and it will involve 120 participants (about 20% of the total population) and it will be conducted through convenience sampling techniques and stratified sampling. The data will be collected using questionnaire and descriptive statistical regression analysis will be used for data analysis. Before the actual data collection, there will be pilot study to determine reliability of the research process. At this stage, the research will include expert opinion to enhance validity of the research. This abstract did not give a background and summary of your study, and your expected outcome Keywords:Employee productivity/ job performance, work place stress/occupational stress, doctors, nurses, medical attendant Lexington Medical Center. Table of Contents Why do you have a background and Statement of the Problem? The background can be covered in the statement and description of the problem. 1CHAPTER ONE 11.0INTRODUCTION 11.1 Background to the Research Problem 31.2 Statement of the Research Problem 31.3 Objectives of the Study 31.3.1General Objective 41.3.2 Specific Objectives 41.4. Research Questions Why do you have a General and a Specific Objectives and Research Question. Please read the textbook or my powertpoint and understand it. Also my dissertation.. 41.4.1 General Research Question 41.4.2 Specific Research Questions 41.5 Relevance of the Research 51.6 Organization of the Dissertation (Why disseration? Disseration is totally different from a Research Proposal 51.7. Limitations 6CHAPTER TWO 62.0 LITERATURE REVIEW 62.1 Overview 62.2 Conceptual Definitions 72.2.1 Work Place Stress 72.2.2 Employee Performance 82.3. Theoretical Literature Review 82.3.1 Employees Performance Management 82.3.2 Stress at Workplace 10Work Stress and Employees Performance 10Theories of Work Stress 10The Job Demands-Control Theory (JD-C) 11The Role Theory 11Empirical Literature Review 12Assessing Employee Performance 132.5.3 Relationship between work Stresses and Employee Performance 13Research Gap Identified 142.9 Statement of Hypotheses 15CHAPTER THREE 153.0 RESEARCH METHODOLOGY 153.1 Overview 153.2 Research Design 153.3 Study Population 153.4 Area of the Research 163.5.1 Sample Size 173.5.2 Sampling Procedure 183.6. Variables and Measurements 193.7 Methods and Instrument Used for Data Collection 193.8. Data Processing and Analysis 21CHAPTER FOUR 214.0 SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 214.1 Summary 22References CHAPTER ONE 1.0 INTRODUCTION (Omit the numbers. LOOK AT MY DISSERATION) 1.1 Background You do not need to put backgr.

1. Stress and Healthcare Workers Productivity at Lexington
Medical Center
ABSTRACT
The research proposal aim at assessing the effect of workplace
stress on workers productivity at Lexington Medical Center.
The objective of the research is to assess worker productivity,
the stress level among health workers, and the extent to which
their productivity and performance is related to stress levels.
The research survey will be a cross section and it will involve
120 participants (about 20% of the total population) and it will
be conducted through convenience sampling techniques and
stratified sampling. The data will be collected using
questionnaire and descriptive statistical regression analysis will
be used for data analysis. Before the actual data collection,
there will be pilot study to determine reliability of the
research process. At this stage, the research will include expert
opinion to enhance validity of the research.
This abstract did not give a background and summary of your
study, and your expected outcome
Keywords:Employee productivity/ job performance, work place
stress/occupational stress, doctors, nurses, medical attendant
Lexington Medical Center.
Table of Contents
Why do you have a background and Statement of the Problem?
The background can be covered in the statement and description
of the problem.
1CHAPTER ONE

2. 11.0INTRODUCTION
11.1 Background to the Research Problem
31.2 Statement of the Research Problem
31.3 Objectives of the Study
31.3.1General Objective
41.3.2 Specific Objectives
41.4. Research Questions
Why do you have a General and a Specific Objectives and
Research Question. Please read the textbook or my powertpoint
and understand it. Also my dissertation..
41.4.1 General Research Question
41.4.2 Specific Research Questions
41.5 Relevance of the Research
51.6 Organization of the Dissertation (Why disseration?
Disseration is totally different from a Research Proposal
51.7. Limitations
6CHAPTER TWO
62.0 LITERATURE REVIEW
62.1 Overview
62.2 Conceptual Definitions
72.2.1 Work Place Stress
72.2.2 Employee Performance
82.3. Theoretical Literature Review
82.3.1 Employees Performance Management
82.3.2 Stress at Workplace
10Work Stress and Employees Performance
10Theories of Work Stress
10The Job Demands-Control Theory (JD-C)
11The Role Theory
11Empirical Literature Review
12Assessing Employee Performance
132.5.3 Relationship between work Stresses and Employee
Performance
13Research Gap Identified
142.9 Statement of Hypotheses

3. 15CHAPTER THREE
153.0 RESEARCH METHODOLOGY
153.1 Overview
153.2 Research Design
153.3 Study Population
153.4 Area of the Research
163.5.1 Sample Size
173.5.2 Sampling Procedure
183.6. Variables and Measurements
193.7 Methods and Instrument Used for Data Collection
193.8. Data Processing and Analysis
21CHAPTER FOUR
214.0 SUMMARY, CONCLUSIONS AND
RECOMMENDATIONS
214.1 Summary
22References
CHAPTER ONE
1.0 INTRODUCTION (Omit the numbers. LOOK AT MY
DISSERATION)
1.1 Background You do not need to put background and this
section is too long. Most of what you stated here should be part
of the Review of Literature.
Stress is an emerging and growing problem in any health care
setting. Some organizations administration feel that stress has
no effect and it is simply and an exaggerated point while other
believe the work related stress is threatening to the wellbeing of
the health center and the general employees performance.
Around 3 billion people employed globally face the problem of
work related stress
. Scholarly work shows that the health sector is the most
stressing work setting. According to study by
(Ali & Jabir, 2014)
, health sector is a stressful work environment and the stress
come because of long working hours, the incompatible demands,

4. the ethical dilemmas, and frequent handling of difficult and
demanding patients.
Some of the stressors associated with the health workers and the
working environment include work overload, excessive
administrative work, shortage of staffs, uncertainty in
treatment, and lack of support from community, peers, and
superiors. In some health care setting, health workers operate on
a 24 hour schedule. Many workers operate for long hours; have
irregular working period, and over 30% of the health workers
work for more than 60 hours per week (Arbabisarjou &
Azizollah, 2013).
Health workers have different types of stress, they operate in
environment characterized by conflict between patients and
their families and the workplace is normally full of noise, liable
infections, and pollution. According to a study conducted in
Canada (AL-Swalhah, Irtima, Zouby, & Shaar, 2014), involving
over 2000 doctors, it was reported that medics who work under
stressful condition have difficult time dealing with patients and
the quality of care is equally poor. Actually, there is concern in
the US about the mental health of health practitioners such as
mental problem. The healthcare staffs are vulnerable to
emotional and physical morbidity which raise the concern.
According to (AL.Homayan, Shamsudin, Subramaniam, &
Rabiul, 2017), stress is not harmful in all encounters. On one
hand, stress is a motivating factor and on the other is can be
source of depression. The result of health stress is compromised
efficiency and the qualities of workers are equally vulnerable to
work errors. Other effects of stress include compromised team
work, increased patient complaints and absenteeism because of
burnout. The psychological effects of the work related stress
lead to bad habits such as smoking, over consumption of
alcohol, and over eating. In addition, these can lead to clinical
errors and carelessness in handling the patient wellbeing.

5. Studies (AL-Swalhah, Irtima, Zouby, & Shaar, 2014;
Arbabisarjou & Azizollah, 2013) shows the link between work
stress and clinical errors. In the US, it was reported that these
avoidable errors caused between “44,000 and 98,000 death to
patients.” A study by (Awardee, 2014), also shows that work
related stress cost between 200 and 300$ billion annually and
this is because of absenteeism, staff turnover, dropped
productivity, direct health, and injuries. Reports show that
stress among nurses, physician and health care worker is high.
The stress is worse in the third world. Such important
realization about stress in workplace shows that much stress has
negative effects on the organization and workers.
In the US, the health workers carry the responsibility of
providing health care to wide community. The demand for
health care has increase. Health workers working in this
organization are dissatisfied with the work because of the low
income, lack of promotion, unsafe working environment, heavy
workload, and burden of caring with lack of resources. The
health workers on duty are at risk of infection and build-up
chronic stress. Thus, there are concerns that the combination of
heavy workload, low salary, long working hours and exposure
to infection contribute to health workers stress and
underperformance (Dewe & Cooper, 2012). Therefore, this
research proposal seeks to make some contribution to growing
body of knowledge about workers performance and stress.1.2
Statement of the Research
Problem
Work related stress threatens the operation of organization and
workers performance. The stress in workers is serious problem
because of the cost implication and negative effects towards
organizations and employees performance. Studies shows that
work stress exist when health workers experience challenges in
coping with work demand. There is, however, a paucity of study

6. to prove whether work stress affect the performance of health
worker in Lexington Medical Center. It is in this light that this
research proposal aims at assessing the effects of stress on
worker performance and evaluation of the relationship between
work stress and performance at the Lexington Medical Center.
1.3 Objectives of the Study
1.3.1General Objective
The core objective of this research proposal is to study or
investigate the impact of workplace stress towards workers
performance at the Lexington Medical Center.
1.3.2 Specific Objectives
1. To assess the employees performance at the Lexington
Medical Center.
2. To evaluate the stress levels among health workers at the
Lexington Medical Center.
3. To assess the extent to which employees’ performance at the
Lexington Medical Center is related to their stress levels.
1.4. Research Questions
1.4.1 General Research Question
Are health workers performance at the Lexington Medical
Center affected by their work stress levels?
1.4.2 Specific Research Questions
1. How do medics at the facility perform?
2. How stressed are the health workers

7. at the Lexington Medical Center?
3. To what degree is performance o
f health workers at the Lexington Medical Center related to
their level of work stress?1.5 Relevance
of the Research
The research proposal
is relevant to the Hospital management, researchers, and policy
makers. For researcher and academicians, the study finding
contribute to the wide body of knowledge for understanding the
effect of stress at workplace and its relationship as related to
workers performance. The proposal
also a useful tool for future research related to “work stress and
employees performance.” For the Hospital management, the
proposal is expected to high some challenges and give some
recommendations on how to reduce stress and boost
performance. For the work related policy, the research facilitate
decision making for programme implementers and policy
makers. The health management at the facility is expected to
create working environment which harness the positive side of
health care workers.1.6 Organization of the Dissertation
The other part of this research proposal is organized as follows:
Chapter two cover definitions of research terms, the theories
governing work related stress and performance, the existing
research gap, the conceptual frame work and summary of
previous research. Chapter three present the proposed research
methodology which is adopted in this study. Chapter four
present the expected results and summary.
1.7. Limitations
This research paper has two limitations. The research focus on
specific hospital and other medical staffs such as therapists, and

8. administrators are not included.
The study is about one public hospital
and this means that the finding is limited to specific setting.
This suggests that the research finding of the research will be
limited to doctors, medical attendants, and nurses of Lexington
Medical Center. There could be cultural or regional specific
factors which make this study specific to geographical location
or hospital characteristics. A research with wider coverage
would be useful to mitigate the impact of stress in nurses and
doctors.
You can rephrase this whole section and be direct and specific.
CHAPTER TWO
2.0 LITERATURE REVIEW
2.1 Overview
This chapter presents the research literature review.
The intention of this literature review is to give direction on
what has been done in previous studies and what need to be
done in future. Therefore, the literature review give the wide
context of the research, precisely defining what is within the
proposal scope and justifies the decision. This chapter give
highlights the concepts of health workers stress and the
employees’ performance. Also, the chapter covers the empirical
studies, the theories, and the research gap.
2.2 Conceptual Definitions
2.2.1 Transactional Model of Stress
The transactional model of stress and the coping mechanism
address “the stress process as ongoing relationship between
environment” and individual where worker interpretations and
perceptions of environment play key role in psychological
stress. As stated by the transactional theory, work stressors are
different among people and they can be handled by appraisals

9. and coping (Haybatollahi, 2010). The research will involve
study on people strength and resources to cope with stressful
environments. Based on appraisals, people will choose
strategies for coping with stress. The model argue that stress
can be reduced by “helping the stressed health workers change
their perception towards stressors and giving them strategies to
cope and improve their confidence” (Dewe & Cooper, 2012).
The coping mechanism involve use of psychological support,
job reforming, and using workers welfare to offset negative
effects of stress among the health workers. The psychological
support will help workers transform perception on stressors in
(Hsieh, Huang, & Kuo-Jen, 2014). The transactional model of
stress is applied to check how stress is coped and eased and this
help people change how they perceive stress and cope with it.
With this realization, organisation program will be established
considering the various approaches of managing stress. .
2.2.1 Employee Performance
Employee performance is the personal variable or something
which a health worker does. It is how person does what is
supposed to be done. Therefore, employee performance is a mix
of ability, attitude, skills, and results and it involve quantity
and quality of work, the attendance at work, and helpful
nature.2.3. Theoretical
Literature Review2.3.1 Employees Performance Management
The performance management is continuous practice which aims
at improving the organizational performance by increase the
performance in health workers. It starts with decision to employ
workers. It also include performance criteria, action setting,
development activities, and monitoring and evaluation.
2.3.1.1 Objectives of Performance Management

10. According to (Dewe & Cooper, 2012), the objectives of
performance management are to make sure the health facilities
are optimally run to achieve effects preferred by the health
center. Performance management involves company
performance, staff performance and health outcome performance
measures. Since the health care performance management seeks
to support the systems in the organization, the focus of the
performance management should influence management of this
organization. 2.3.2 Stress at Workplace
In the US, the health workers use more than eight hours
working. This period does not include travel time to and from
the work. Health workers deal with not only work related stress
but even other types of stresses which come with personal
interaction. Employees experience stress when they deal with
circumstances which affect negatively their health. The stress in
health worker can be physiological and psychological stress
(Haybatollahi, 2010). The physiological stress is response of the
human body to stressful event at workplace. This might be
physiological response to sleep disorder or abdominal pain.
Psychological stress is emotional response which comes because
of stimulus in workplace.
It comprise of emotional response such as depression,
irritability, and frustration.Types of Stressors in Healthcare
Professionals
There are three types of stressor in health care center and these
are personal, interpersonal, and work related stressors. Personal
stressors are the incapacity to deal with work related tasks and
these stressors are as result of poor interaction among the
healthcare workers. The work environment stressors are caused
by high work load or working long hours, the death of patient,
shortage of workers, and damage because of work related errors.

11. In healthcare profession, stress among the workers is high
because of inadequate resources. Different studies show that
there are different causes of stress among the health care
workers. According to (Lutfi & Moh’d, 2015), work stress is
caused by work overload, increase responsibility, and poor
administration. From study
done on 333 doctors, it was found out that clinical workload
was number one cause of work stress. Another study by argue
that working hours, role overload, shift work, and physical
environment are challenging stressors in professionals.
Research in line with this argument show that dealing with
emotionally demanding patient, lack of time to plan for daily
work, responsibilities, and frequent interruptions are stressors
in hospital settings. Moreover, professional conflict and
emotional burden for shift work and workload are work
stressors in healthcare.Effects of Workplace Stress
Stress in health workers is inevitable and unwanted. Modest
level of stress may boost job attention, act like a motivator, and
has positive effect on job satisfaction. However, when stress is
excessive, it become demotivating, disturbing, and dangerous.
For employees at Lexington Medical Center to work well, they
require a stress free environment. Study
by, shows that stressed workers are less productive, unhealthful,
and poorly motivated at work. Likewise their organizations are
like to be less competitive. Worker at the Lexington Medical
Center who lack stress coping strategies are likely to end up
exhausted, having increase turnover intentions, and feeling
detached.
In health care setting, lack of mechanism to deal with stress in
the workplace can be shows through increase errors in medical
prescription, reduce team work, and more patient complaints
(Hsieh, Huang, & Kuo-Jen, 2014). Coping strategies in stressful
working environment reduce bad lifestyles practices such as
drinking alcohol, over eating, and chronic diseases such as heart

12. disease. Work Stress and Employees Performance
The theoretical literatures on works stress and worker
performance give more emphasis on reduce productivity because
of stress. However, not all stress level are fundamentally
negative for the workers concerned. Certain degree of stress can
develop workers performance. Some scholars believe there is an
obvious relationship between work stress and worker
productivity. For example, high level of stress leads to low
production and absenteeism (Mkumbo, 2014).
Theories of Work Stress
The Job Demands-Control Theory
(JD-C)
This theory state that work stress occurs when work demand is
high and job decision is low
. The theory shows that interaction between job control and
demand is important in defining performance outcome. Further,
the theory argue that when health work is under high work
related demand and he or she has low work control, then
psychological and biological problem occur and these cause low
job performance.
The Role Theory
This theory gives insight into process which distress emotional
state of worker and which in turn affect their behavior. One
basis point of the theory is that occupational roles of health
work may be stressful in spite of the occupation, this imply that
stress originates in various job duties and affect all workers
(Allen, 2010). Six roles which are stressful are “role ambiguity,
responsibility, role overload, role insufficiency, and physical

13. environment” (Dewe & Cooper, 2012). Empirical Literature
Review
Psychological support
Cognitive interventions are used to inform workers about the
effects of emotions and thoughts in managing stress and it
facilitate coping mechanism. The intervention change people
appraisal of stress in work place and ways of responding to
them. For instance, workers are advised to substitute negative
thinking with positive and rational ideas. Deep-breath,
relaxation, and mediation enable health workers reduce stress.
Meditation includes deep breathing exercises and relaxation
therapy. Relaxation involves controlled and conscious release of
muscle tension. Other intervention for stressful event includes
goal setting and time management. Health workers who operate
under tight schedule and do multiple task are normally stressed.
Time management give skills training in scheduling, goal
setting, delegating, conflict resolution, and prioritizing tasks.
According to (Mohite, Shinde, & Gulavani, 2014), Journaling
interventions are better ways of managing stress in workplace.
A Journaling intervention involves employees keeping diary or
journal of the stressful event in life. The journals help to cope
and monitor stress and identify source and causes of stress and
the probable reactions. Diary and journals are used to formulate
actions for managing stress. Another method of managing and
coping with stress is exercise programs which give muscle
relaxation. This focus on physical release of tension which
develops in stressful situations.
Social support is a way of coping with stress in workplace.
Social support from health workers such as colleagues and
supervisors is reported to be positively associated with stress
reduction. Research shows that people with strong social

14. support can cope with stress better and more effective.
Assessing Employee Performance
Muazza did a research in Indonesia on workers performance in
public sector organizations (Muazza, 2014). The aim of the
research was to measure performance of workers in terms of
financial input and working ability. The financial performance
was measured in terms of monetary benefits while the working
performance was checked based on workers achievement of
company objectives. The researcher found out that workers in
public health organization have moderate level of job
performance. This study is similar to research conducted by
(AL.Homayan, Shamsudin, Subramaniam, & Rabiul, 2017) to
determine occupational stress in relation to job performance.
The objective of (AL.Homayan, Shamsudin, Subramaniam, &
Rabiul, 2017) study was to check how job performance is
affected by job stress in hospital environment. The researcher
used survey design and data was collected through
questionnaires. The performance was defined in terms of quality
of work, timeliness and quantity of work done. The research
found out that half of participant had modest performance.2.5.3
Work Stresses and Employee Productivity
Lutfi & Moh’d (2015) researched on the relationship between
job related stress and workers performance in healthcare setting.
The data was gotten through use of questionnaire and it was
analyzed using multiple regression and descriptive statistics.
The analysis shows that there is “inverse relationship between
stress and performance”, this imply that when health care
workers are stressed, they have low performance. Another
research was conducted by (Rawal & Padeshi, 2014) to establish
the influence of job stress on workers productivity among the
nurses in Jordan. This research used structured questionnaire
and then researcher conducted descriptive statistics and

15. hierarchical regression to analyze the data. The finding shows
that nurses who are moderately stressed in their workplace
performed their duties less and have low productivity.
Moreover, research conducted by (Sahraian, 2013) focused on
work stress and workers productivity. The researchers used
structured questionnaire to collect data and they later did
correlation analyses to “check the relationship between stress
and performance.” The research finding shows that job stress do
not impact workers performance.Research Gap Identified
From the theoretical literature review, stress varies in different
organization and it seemingly higher in health care sector. The
effects of work stress have been shows in worker productivity
and job performance. In health care sector, worker productivity
have consequence to human life. The result from empirical
evidence is not consistent. In some research work, there is
positive relationship between stress and worker productivity
while in other pieces of research the relationship is negative.
These contradictions have resulted in research gap on work
stress and effects on workers performance.
2.9 Statement of Hypotheses
These are hypothesis based on the above discussions.
Ho: There is relationship between work stress and employees’
productivity.
H1: There is no relationship between work stress and health
worker productivity.CHAPTER THREE
3.0 RESEARCH
METHODOLOGY
3.1 Overview
This section of the study proposal highlights the methodology

16. which will be applied in the study. It defines the study design,
sampling design, the source of data, the analysis process which
will be used, and research design to be used.
3.2 Research Design
Study design is a way of answering research questions and
fulfilling objectives. In research work, there are various
research designs; this research will use “deductive approach and
use cross sectional survey research method.” The research use
quantitative data collection and analysis method
. This research design is appropriate because the survey plan is
highly related to deductive approach and it allows data to be
collected from respondents (Taylor, Sinha, & Goshal, 2006).
3.3 Study Population
The study will be based on workers in Lexington Medical
Center. The respondents include employees in the facility and it
will target the over 6500 health care professionals in the 5
community medical centers.
3.4 Area of the Research
Lexington Medical Center is located in South Carolina. It has
health care network which has five community medical centers
and the hospital has employed more than 6,500 health care
workers. The centre has the busiest Emergency department in
South Carolina; it handles more than 85,000 patients annually.
The hospital delivers more than 4,000 babies and it performs
nearly 23,000 surgeries. Administratively, the Hospital has
Chief medical officer, the human and administration
department. Chief nursing office, procurement office, Finance
unit, and healthy quality assurance department.
3.5. Sampling Design and Procedures

17. 3.5.1 Sample Size
The research proposed to have about 120 workers from
Lexington Medical Center with proportional representation to
each work cadre. The participants in the research in the
sampling will be doctors, medical assistants, and nurses.
S/N
Respondents Category
Number of workers
Sample Size
1
Doctors
42
21
2
Nurses
128
64
3
Medical assistants
45
35
Total
215
120
Data collection
The research will collect data for analysis. The data will be
collected using questionnaires. To get the needed data, “semi
structured questionnaire with open-ended and close-ended
questions”
will be used. The semi-structured questionnaires are used to
prepared question while open-ended questions give more
information which is not easily captured in the close-ended
format. The questionnaire is preferred because are literate and
can answer the questions adequately. Second, questionnaire is

18. useful because the information which is needed can be
described in written form. In order to encourage participation,
questionnaires keep the structure short and with multiple-choice
selections.
Researcher will inform respondents that the research is for
academic purpose and the respondents will be confidential. The
participants will have the questionnaire filled and collected
through drop and pick later approach. Before the data
collection, the researcher will do pilot study to determine
reliability of research instruments.
The research data should be reliable, In this case reliability is
the consistency of measurement and it is determined by testing-
retest method. Reliability of data give consistency of data
collected. This ensures data collected has internal consistency.
The reliability of will be enhanced through pilot study on a
different hospital using 25 respondents. The idea of using
another hospital is to prevent pre-emptying what the study is
about to the potential participants and to reduce bother to
participants in the actual study. The reliability of the study
should be measured using the Cronbach Alpha coefficient (α)
and it is recommended that the reliability should be above 0.70.
For higher validity of the research, there is need for opinions of
experts. The second opinion will help in making the necessary
modification and revision of the research. The validation of
research is important as it ensure that the study use relevant
information to answer the study questions.
3.5.2 Sampling Procedure
The research will involve the use of two sampling techniques:
the convenience sampling technique and the stratified random
sampling. The nature of the healthcare workers in the facility
makes it difficult to use probability sampling.3.5.2.1 Stratified

19. Random Sampling
According to (Taylor, Sinha, & Goshal, 2006), the use of this
means is based on the finite population which is divided into
homogeneous subgroups. The study will use “stratified random
sampling” where three hospital departments that are medical
attendants, doctors, and nurses are picked. Based on the
participants’ convenience or availability, all the doctors,
medical attendants, and nurses will be targeted for the research.
Based on this method, the focus will be on potential participants
who will be available during the visit and the respondents who
are willing to take part in the research until the sample size of
120 participants is reached.3.5.2.2 Convenience Sampling
Technique
This research method is based on using health workers who are
captive audience, people who the researcher will meet
accidentally or haphazardly. The convenience sampling will be
carried out where respondents from the three choose group are
available and show interest in the survey questionnaire. The
research will use people who are captive audience like resident
doctor, hospital secretary, and the human resource officer for
monitoring, distribution and administering the questionnaire.
3.6. Variables and Measurements
The research will have two variables; the independent variable
is the work place stress while the dependent variable is
employee performance
. The demographic variable which consists of the profession,
sex, and marital status will be measured using nominal scale.
The rest which include job experience and age group will be
measured by using ordinal scale. The work stress and employee
performance will be measure using give point Likert scale.
Employee performance respondents will indicate productivity,
quality of work, and objective achievements. The work stress

20. will be assessed based on three aspect role: role responsibility,
role overload, and physical environment.
3.7 Methods and Instrument Used for Data Collection
Study survey questionnaire will be used for data collection. The
primary data collected will be through “structured
questionnaire.” Questionnaire is a series of questions which
respondents have power to choose a number of answers. The
research will involve structured questionnaire with “Five point
Likert scale
” rating. The questionnaire will be designed, distributed and
administered to collect information from the workers. The
questionnaire will be used to measure employee performance
and work stress levels. It will collect the worker demographic
characteristics. The questionnaire design will be introduction,
main sections, and appreciation.
Rating in the questionnaire will be based on five-point rating
from “strong disagree” to “strong agree.”
3.8. Data Processing and Analysis
Data analysis is the systematic way for getting meaning from
the collected data. In this research, the data will be collected by
the researcher in the hospital, however, there is need for
analysis by use of “descriptive statistics and multiple regression
analysis.”
For consistency to be realized, the questionnaire will be
checked for completeness. The data should be cleaned and
inspected to check missing values, check accuracy before the
statistical analysis. The total score for work stress and
employee productivity will then be computed.
3.9 Data Analysis and Presentation
The research will involve checking the questionnaire for

21. consistency and completeness. The next step with be data clean-
up and this will involve tabulation, editing, checking anomalies
in the responses to further analysis. The result findings will be
reported in graphs and tables for further research analysis and
to ease comparison. This will in return generate quantitative
report by use of percentages, tabulations, and measure the
degree of central tendency. The research will also use
“multivariate regression approach to study the relationship
between stress and workers productivity, commitment and stress
management” (Dewe & Cooper, 2012).The regression approach
is useful in testing nature of influence of the dependent and
independent variables..
10. Ethical Issues
The researcher has moral duty to use the data from the
participants with secrecy. The researcher will assure the
respondents that their reply and response in the questionnaire
will be safe and out of public domain. The respondents answer
will be for research purpose only. CHAPTER FOUR4.0
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS4.1
Summary
The research will cover three specific objectives. First, the
research seeks to find out how workers at the Lexington
Medical Center perform; the results of the research indicate how
nurses, doctors, and medical attendants at the facility perform.
Second, the research will seek to determine the level of stress
among the workers in Lexington Medical Center. Third, the
researcher seeks to find out how stress levels among the
workers affect their productivity.
It is expected that work place stress affect negatively the
workers productivity. The high level of stress and it expected
impact to the workers means that stakeholders should provide

22. doctors, medical attendants, and nurses with programs for
managing the stress in order to maintain current productivity.
Some of the ways of coping with stress is by creating training
programs for the medical attendants, doctors, and nurses on how
to deal with stress from the hospital settings. Second, the
hospital management can organization cultural and social events
which bring together nurses, medical attendants, and doctors for
open dialogue to share experience, feelings, and
perspectives.References
AL.Homayan, M., Shamsudin, M., Subramaniam, C., & Rabiul,
I. (2017). Impacts of job performance level on nurses in public
sector hospitals. American Journal of Applied Science, 10(9),
1115-1123.
Ali, D., & Jabir, M. (2014). Impact of stress on job
performance. An empirical study of the employees of private
sector universities of Karachi, Pakistan:. Research Journal of
Management Sciences,, 3(7), 14-17.
Allen, M. &. (2010). Commitment in the workplace, Theory,
research and application. Thousand Oaks, CA: Sage.
AL-Swalhah, A., Irtima, H., Zouby, F., & Shaar, J. (2014). The
relationship between job stress and job performance among
workers in Alisraa hospital. Far East Journal of Psychology and
Business, 12(2), 22-32.
Arbabisarjou, M., & Azizollah, J. (2013). The relationship
between job stress and performance among the hospitals nurses.
World of Science Journal, 1(2), 181-188.
Awardee, U. J. (2014). Workplace stress among doctors in
government hospitals. An empirical study. International Journal
of Multidisciplinary Research,, 1(3), 1-13.

23. Dewe, P. O., & Cooper, C. (2012). Theories of psychological at
work. London:: Springer Publisher.
Haybatollahi, S. M. (2010). Work stress in the nursing
profession. An evaluation of organization causal attribution.
University of Helsinki: Department of Social Psychology.
Hsieh, H., Huang, L., & Kuo-Jen, S. (2014). Work stress and
job performance in the hi-tech industry: a closer view for
vocational education. World Transactions on Engineering and
Technology Education, 3(1), 147-150.
Lutfi, A., & Moh’d, S. (2015). The relationship between job
stress and nurses performance in the Jordanian hospitals. A case
study in King Abdullah the founder hospital. Asian Journal of
Business Management,, 5(2), 67-275.
Mkumbo, K. (2014). Prevalence of factors associated with work
stress in academia in Tanzania. International Journal of Higher
Education, 3(1), 1-11.
Mohite, N., Shinde, M., & Gulavani, A. (2014). Occupational
Stress among nurses working at selected tertiary care hospitals.
International Journal of Science and Research (IJSR),, 3(6),
999-1005.
Muazza, T. (2014). Stressors and impacts on nurses job
performance. A case study at one general public hospital, jambi
Indonesia:. Journal of Research in Humanities and Social
Science, 1(3), 1-7.
Rawal, C., & Padeshi, S. (2014). Job stress causes attrition
among nurses in public and private hospitals. Journal of
Nursing and Health Science, 3(3), 42-47.
Sahraian, A. (2013). Occupational stress among hospital nurses

24. comparison of internal, surgical and psychiatric wards. Original
article, 3(4), 213-221.
Taylor, B., Sinha, G., & Goshal, T. (2006). Research
methodology: A guide for researchers in management and social
science. London: PHI learning private limited.
�I explained this in one of my emails. Abstract is usually
written last because it is the summary of your whole research
�This should be described in the Methodology. The abstract
will only give an idea on what method to use and npoty
desctribe it.
�This is not APA format, PLEASE REFER TO YOUR
MANUAL OR MY DISSERATION) Take note of the
indentation and the numberings.
�Says who? How do you know this? This is a conclusive
statement that is obviously not yours. You need this cited.
�omit
�not APA format.
�Good citation

25. �Omit. We already know that this is a research.
�All these three can be combined into one general objective or
purpose of the study.
�Research questions are questions that will drive your research
�This does not seem to be a research question but intended to
describe work of medics. What about the work of staff, of
administrators, etc. These can be just described. You are not
going to do research and collect data to simply describe work.
You need to collect data that will show the correalation of work
performance to stress..
�
�Not directly relevant. You question should be like “How does
stress affect work performance.” With this question, it will
drive your research and you will design the methodology to use
to collect and analyze data.
�Again this is not a research question. It could be rephrased.
What is the impact of stress on the worker’s Performance?”
�Significance
�Omit. The end result of this is a full blown research not just a
proposal. You will be doing only the proposal to this research.

26. �research
�This is not a dissertation
�This is a good limitation. Earlier on I asked you about
administrators, but now here it is clear that the study is limited
only to medics.
�Be specific. Go straight to the point that the study is limited
to the Lwexington Medical Center. Do not go around the bush.
Be direct.
�Omit the numbering and follow my dissertation.
�omit
�
�What do you mean by this. There is no such thing as a
Theoretical Literature Review.
�Are you talking of a theory here? You need to look for a
theory on Performance management.There are a lot of
management theories that you can adopt. You need to select one
that is appropriate to your study.

27. �Says who?
�This must be cited or you need to get a citation to support this
and not just your own belief or thinking.
�Which study,who is the author
�Again which study
�Says who?
�Which study???
�Good theory
�This needs to be cited.
�You are making things difficult for yourself, You need oinly
one theory,
�What is this??? You are adding sections that are not needed.
�You are already giving solutions here when you have not yet
confirmed in your study the true presence of stress and how it is
related to productivity.This is what you are still going to find

28. out in your research. So why are you already concluding that
there is stress existing in Lexington? You need to show and
prove this bu conducting an actual research and getting the
findings yourself. AGAIN YOU ARE NOT SUPPOSED TO DO
THE ACTUAL RESEARCH BUT YOUR WILL PROPOSE HOW
IT SHOULD BE DONE.
�WHAT YOU ARE PRESENTING HERE ARE WORK AND
RSEULTS OF OTHER RESEARCHERS. You need to have your
own finding by proposoing the research process and method
your will propose..
�Omit. PLEASE SEE MY DISSERTATION
�You do not need overviews fro each section. Go direct to the
point. Look at other research in journals, do you see this
section?.
�You have a problem here. If you are using a quantitative
method, you need to use HYPOTHESIS which you intend to
statistically prove. RESEARCH QUESTIONS are used in
qualitativer research. Please read you textbook and my
powerpoints.
�This is good
�This is a qualitative method. Quantitative method do not use
open ended questions.

29. �This is very good and well identified and defined variables
�This already indicates that it is not an open ended question but
needs specific response
�What do you mean by this?
�Use ANOVA
�You did this section very well, perfect. I think you were
properly guided by the APA Manual. Maybe you should include
some sources from the internet and cite them appropriately.
3 hours ago
holly orme
RE: Discussion - Week 4 - Initial Post - Holly Orme
COLLAPSE
Top of Form
Nursing 6053; Leadership
Week 4 – Initial Post
Excellent leadership in nursing is likely to pull from different
theories according to the job at hand, the team’s needs and the
local state of affairs.
There is no simple answer to the complex question of what
makes exceptional leadership in nursing, despite the existence
of evidence showing that it can have a positive impact on both
patient experience and outcomes, and nurse satisfaction and
retention. There is some suggestion that the latter then

30. influences the former. However, establishing what makes good
nursing leadership is challenging.
A number of leadership theories describe how they can be
applied to nursing and how effective they are. What appears is
that different approaches are needed according to the goals of
the individual leader. One thing is clear: success hinges on good
relationships between leaders and their teams.
In the face of ambiguity and complexity, it seems that good
leadership is an anomaly and requires careful evaluation. Where
there are contradictory findings, it is important to delve deeper
to uncover what each different approach has in common.
Historically, leadership studies have been focused on the beliefs
and actions of leaders, leaving followers with a passive role and
at the of the mercy of those they follow. Recent studies have
explored the roles of both leaders and followers, and suggest
that it is the nature of the relationship between them, rather than
any specific behavior of their leaders, that creates effective
leadership.
Hersey and Blanchard (1969) observed that the leader’s actions
should be determined by the experience of the team
remembering that the behaviors of good leaders are
circumstantial rather than permanent. In this model, leaders
evaluate the needs of the followers and adjust their actions
accordingly.
Haslam et al (2011) suggest that leaders must be an essential
part of the team and that their primary role is to create a sense
of group uniqueness. The leader must convey what the team
dynamics are and why people would want to be part of it, and
motivate followers to identify with the group, by fostering a
true sense of loyalty.
Uhl-Bien et al (2014) go further, suggesting that the guidance of
a team is co-produced with followers and that it depends on
their actions toward the leader and the leader’s reaction towards
them, in an open network. The idea is that you cannot force
leadership and that it must be earned from followers. In this
model, there is a distinction between people in positions of

31. authority and leaders, and leadership has to be won rather than
assumed.
Avolio, who had worked with Bass on transformational
leadership, developed his thinking further into authentic
leadership, which emphasizes the leader’s ethics and behavioral
integrity (Avolio et al, 2004). This is reflected in Haslam’s
model, which requires the leader to lead by example, displaying
the team’s values and desired behaviors (Haslam et al, 2011).
What these theories have in common is a focus on collegiate
relationships that leaders form with, and promote between,
other members of the team.
The best and most relative example of exceptional leadership
that comes to mind is exemplified by my Walden professors.
The following key leadership skills are routinely exhibited by
all of my professors:
· Monitoring and calibrating the team’s workload
· Upholding the Walden Code of Conduct
· Creating a work environment in which all staff feel they can
contribute the maximum in a fulfilling way for them
· Creating relationships that build camaraderie
· Ensuring that the team delivers the best use of available
resources (Maxwell, 2017)
· Every week each of my professors provides direction, critical
updates and other additional tools provided via announcements,
feedback is frequently offered on previously completed
assignments and/or discussions, individual support is offered
through e-mail or the blackboard. Each of us embarked on this
course with virtually the same goal in mind, however, the
outcome is dependent partially on personal performance, but
also the leadership and expertise of those who educate us.
· Nurse leadership is in truth a pragmatic blend of theory and
evidence, adapted to the local circumstances, flexible enough to
respond to the reactions of the team, and agile enough to deal
with the unexpected.
References
Maxwell E (2017) Good leadership in nursing: what is the most

32. effective approach? Nursing Times [online]; 113: 8, 18-21.
Avolio BJ et al (2004) Unlocking the mask: a look at the
process by which authentic leaders impact follower attitudes
and behaviors. The Leadership Quarterly 15: 6, 801-823.
Haslam SA et al (2011) The New Psychology of Leadership –
Identity, Influence and Power. Hove: Psychology Press.
Hersey P, Blanchard K (1969) Life cycle theory of
leadership. Training & Development Journal 23(5) 26-34
Herzberg F et al (1959) The Motivation to Work. New York:
Wiley. Gerontological Nursing; 1: 3, 217-228.
Laureate Education (Producer). (2014). Leadership [Video
file]. Baltimore, MD: Author.
Marshall, E., & Broome, M. (2017). Transformational
leadership in nursing: From expert clinician to influential
leader (2nd ed.). New York, NY: Springer.
Uhl-Bien M et al (2014) Followership theory: a review and
research agenda. The Leadership Quarterly; 25: 1, 83-104.
West MA et al (2014) Collective leadership for cultures of high-
quality health care. Journal of Organizational Effectiveness:
People and Performance; 1: 3, 240-260.