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Research Topic:
Impact of Stress on Healthcare Workers Productivity at
Lexington Medical Center. Coping Strategies for Stressful work
environments
APA format!!!
Complete a proposal for a research study
Upon completion of the course, you will prepare a research
proposal describing the research
study that you plan to complete. This proposal should reflect the
proposal outlines suggested in
the textbook. The proposal should developed according to the
following guideline::
FINAL RESEARCH PROPOSAL OUTLINE
Title Page
Table of Contents (1 page)
Abstract (1 paragraph)
Introduction (3 to 5 pages)
Statement of Purpose
Research Question / Hypothesis
Design of the Study
Significance of the Study
Review of Literature ( 4 to 6 pages)
Conceptual Framework / Theoretical Foundation (2 to 3 pages)
Methodology (3 - 5 pages)
Selection of Participants
Profiles of participants
Conduct of Study
Data Analysis
Expected Outcome / Summary (1 to 2 pages)
References (1 to 2 pages)
TOTAL NUMBER OF PAGES: minimum 16 pages
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
[BY1]
. Scholarly work shows that the health sector is the most
stressing work setting. According to study by
[BY2]
(Ali & Jabir, 2014)
[BY3]
, health sector is a stressful work environment and the stress
come because of long working hours, the incompatible demands,
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).
[BY4]
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.
[BY1]
Says who? How do you know this? This is a conclusive
statement that is obviously not yours. You need this cited.
[BY2]
omit
[BY3]
not APA format.
[BY4]
Good citation
1.2 Statement of the Research
[BY1]
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
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.
[BY1]
Omit. We already know that this is a research.
To assess the employees performance at the Lexington
Medical Center.
To evaluate the stress levels among health workers at the
Lexington Medical Center.
To assess the extent to which employees’ performance at the
Lexington Medical Center is related to their stress levels.
[BY1]
1.4. Research Questions
[BY2]
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
How do medics at the facility perform?
[BY3]
How stressed are the health workers
[BY4]
[BY5]
at the Lexington Medical Center?
To what degree is performance o
[BY6]
f health workers at the Lexington Medical Center related to
their level of work stress?
1.5 Relevance
[BY7]
of the Research
The research proposal
[BY8]
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
[BY9]
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
[BY10]
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
administrators are not included.
[BY11]
The study is about one public hospital
[BY12]
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.
[BY1]
All these three can be combined into one general objective or
purpose of the study.
[BY2]
Research questions are questions that will drive your research
[BY3]
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..
[BY4]
[BY5]
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.
[BY6]
Again this is not a research question. It could be rephrased.
What is the impact of stress on the worker’s Performance?”
[BY7]
Significance
[BY8]
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.
[BY9]
research
[BY10]
This is not a dissertation
[BY11]
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.
[BY12]
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.
0 LITERATURE REVIEW
[BY1]
2.1 Overview
This chapter presents the research literature review.
[BY2]
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.
[BY1]
Omit the numbering and follow my dissertation.
[BY2]
omit
. Theoretical
[BY1]
[BY2]
Literature Review
2.3.1 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
[BY3]
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.
[BY4]
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.
[BY5]
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
[BY6]
done on 333 doctors, it was found out that clinical workload
was number one cause of work stress. Another study by argue
[BY7]
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.
[BY8]
For employees at Lexington Medical Center to work well, they
require a stress free environment. Study
[BY9]
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
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
[BY10]
(JD-C)
This theory state that work stress occurs when work demand is
high and job decision is low
[BY11]
. 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
[BY12]
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
environment” (Dewe & Cooper, 2012).
Empirical Literature Review
[BY13]
Psychological support
[BY14]
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
support can cope with stress better and more effective.
Assessing Employee Performance
[BY15]
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
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
[BY16]
METHODOLOGY
3.1 Overview
[BY17]
This section of the study proposal highlights the methodology
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
[BY18]
. 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
3.5.1 Sample Size
The research proposed to have about 120 workers from
[BY19]
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”
[BY20]
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
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 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
[BY21]
. 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
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
[BY22]
” 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.
[BY23]
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.”
[BY24]
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
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 FOUR
4.0 SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
4.1 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
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
[BY25]
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.
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
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.
[BY1]
[BY2]
What do you mean by this. There is no such thing as a
Theoretical Literature Review.
[BY3]
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.
[BY4]
Says who?
[BY5]
This must be cited or you need to get a citation to support this
and not just your own belief or thinking.
[BY6]
Which study,who is the author
[BY7]
Again which study
[BY8]
Says who?
[BY9]
Which study???
[BY10]
Good theory
[BY11]
This needs to be cited.
[BY12]
You are making things difficult for yourself, You need oinly
one theory,
[BY13]
What is this??? You are adding sections that are not needed.
[BY14]
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
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.
[BY15]
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..
[BY16]
Omit. PLEASE SEE MY DISSERTATION
[BY17]
You do not need overviews fro each section. Go direct to the
point. Look at other research in journals, do you see this
section?.
[BY18]
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.
[BY19]
This is good
[BY20]
This is a qualitative method. Quantitative method do not use
open ended questions.
[BY21]
This is very good and well identified and defined variables
[BY22]
This already indicates that it is not an open ended question but
needs specific response
[BY23]
What do you mean by this?
[BY24]
Use ANOVA
[BY25]
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.

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Research Topic     Impact of Stress on Healthcare Workers P

  • 1. Research Topic: Impact of Stress on Healthcare Workers Productivity at Lexington Medical Center. Coping Strategies for Stressful work environments APA format!!! Complete a proposal for a research study Upon completion of the course, you will prepare a research proposal describing the research study that you plan to complete. This proposal should reflect the proposal outlines suggested in the textbook. The proposal should developed according to the following guideline:: FINAL RESEARCH PROPOSAL OUTLINE Title Page Table of Contents (1 page) Abstract (1 paragraph) Introduction (3 to 5 pages) Statement of Purpose Research Question / Hypothesis
  • 2. Design of the Study Significance of the Study Review of Literature ( 4 to 6 pages) Conceptual Framework / Theoretical Foundation (2 to 3 pages) Methodology (3 - 5 pages) Selection of Participants Profiles of participants Conduct of Study Data Analysis Expected Outcome / Summary (1 to 2 pages) References (1 to 2 pages) TOTAL NUMBER OF PAGES: minimum 16 pages 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
  • 3. 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 [BY1] . Scholarly work shows that the health sector is the most stressing work setting. According to study by [BY2] (Ali & Jabir, 2014) [BY3] , health sector is a stressful work environment and the stress come because of long working hours, the incompatible demands, 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). [BY4] 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.
  • 4. [BY1] Says who? How do you know this? This is a conclusive statement that is obviously not yours. You need this cited. [BY2] omit [BY3] not APA format. [BY4] Good citation 1.2 Statement of the Research [BY1] 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 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.
  • 5. [BY1] Omit. We already know that this is a research. To assess the employees performance at the Lexington Medical Center. To evaluate the stress levels among health workers at the Lexington Medical Center. To assess the extent to which employees’ performance at the Lexington Medical Center is related to their stress levels. [BY1] 1.4. Research Questions [BY2] 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 How do medics at the facility perform? [BY3]
  • 6. How stressed are the health workers [BY4] [BY5] at the Lexington Medical Center? To what degree is performance o [BY6] f health workers at the Lexington Medical Center related to their level of work stress? 1.5 Relevance [BY7] of the Research The research proposal [BY8] 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 [BY9] 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.
  • 7. 1.6 Organization of the Dissertation [BY10] 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 administrators are not included. [BY11] The study is about one public hospital [BY12] 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. [BY1] All these three can be combined into one general objective or purpose of the study.
  • 8. [BY2] Research questions are questions that will drive your research [BY3] 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.. [BY4] [BY5] 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. [BY6] Again this is not a research question. It could be rephrased. What is the impact of stress on the worker’s Performance?”
  • 9. [BY7] Significance [BY8] 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. [BY9] research [BY10] This is not a dissertation [BY11] 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. [BY12] 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. 0 LITERATURE REVIEW
  • 10. [BY1] 2.1 Overview This chapter presents the research literature review. [BY2] 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. [BY1] Omit the numbering and follow my dissertation. [BY2] omit . Theoretical [BY1] [BY2] Literature Review 2.3.1 Employees Performance Management
  • 11. 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 [BY3] 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. [BY4] It comprise of emotional response such as depression,
  • 12. 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. [BY5] 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 [BY6] done on 333 doctors, it was found out that clinical workload was number one cause of work stress. Another study by argue [BY7] 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
  • 13. 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. [BY8] For employees at Lexington Medical Center to work well, they require a stress free environment. Study [BY9] 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 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
  • 14. [BY10] (JD-C) This theory state that work stress occurs when work demand is high and job decision is low [BY11] . 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 [BY12] 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 environment” (Dewe & Cooper, 2012). Empirical Literature Review [BY13] Psychological support [BY14] Cognitive interventions are used to inform workers about the effects of emotions and thoughts in managing stress and it
  • 15. 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 support can cope with stress better and more effective. Assessing Employee Performance [BY15] Muazza did a research in Indonesia on workers performance in public sector organizations (Muazza, 2014). The aim of the
  • 16. 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 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
  • 17. 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 [BY16] METHODOLOGY
  • 18. 3.1 Overview [BY17] This section of the study proposal highlights the methodology 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 [BY18] . 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
  • 19. 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 3.5.1 Sample Size The research proposed to have about 120 workers from [BY19] 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
  • 21. 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” [BY20] 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 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
  • 22. 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 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
  • 23. 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 [BY21] . 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 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 [BY22] ” 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,
  • 24. main sections, and appreciation. [BY23] 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.” [BY24] 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 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
  • 25. 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 FOUR 4.0 SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 4.1 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 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.
  • 26. References [BY25] 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.
  • 27. 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:.
  • 28. 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 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. [BY1] [BY2] What do you mean by this. There is no such thing as a Theoretical Literature Review. [BY3] 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.
  • 29. [BY4] Says who? [BY5] This must be cited or you need to get a citation to support this and not just your own belief or thinking. [BY6] Which study,who is the author [BY7] Again which study [BY8] Says who? [BY9] Which study??? [BY10] Good theory
  • 30. [BY11] This needs to be cited. [BY12] You are making things difficult for yourself, You need oinly one theory, [BY13] What is this??? You are adding sections that are not needed. [BY14] 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 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. [BY15] 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..
  • 31. [BY16] Omit. PLEASE SEE MY DISSERTATION [BY17] You do not need overviews fro each section. Go direct to the point. Look at other research in journals, do you see this section?. [BY18] 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. [BY19] This is good [BY20] This is a qualitative method. Quantitative method do not use open ended questions. [BY21]
  • 32. This is very good and well identified and defined variables [BY22] This already indicates that it is not an open ended question but needs specific response [BY23] What do you mean by this? [BY24] Use ANOVA [BY25] 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.