From source identification to preferential interventions: Determinants of a workplace mental health promotion program to control workplace stress among health care workers based on a qualitative study.

Workplace stress among healthcare workers was found to have both individual and environmental (mainly organizational) origins.

• Data were collected through semi-structured interviews and focus groups with healthcare workers (HCWs).
• Data analysis was conducted using a directed content analysis approach grounded in the PRECEDE-PROCEED model (PPM) and the Job Demands-Resources (JD-R) model.
• Both individual-level factors and broader organizational/environmental factors were identified as sources of occupational stress.

Ten subcategories were identified as effective factors in reducing employee stress, organized into three categories: predisposing, enabling, and reinforcing factors.

• The ten subcategories were identified in the second phase of the program development.
• The three categories align with the PRECEDE-PROCEED model framework.
• These factors represent actionable targets for a workplace mental health promotion program.

Five new subcategories were identified as additions to the PRECEDE-PROCEED model for investigating work stress.

• The five new subcategories identified were: Non-occupational factors, Cognitive factors, Supervisory function, Personality characteristics, and Personal context of the employee.
• These subcategories were not previously included in the standard PPM framework.
• Their identification suggests the PPM requires expansion to adequately capture the determinants of workplace stress.

Implementation of interventions requires formulation or revision of managerial and structural policies alongside employee empowerment to improve interpersonal skills and stress management.

• The final step of the program development revealed dual-level intervention needs: organizational policy change and individual skill building.
• Employee empowerment was specifically identified as a mechanism for improving interpersonal skills and managing workplace stress.
• This finding reflects the need for both top-down (managerial/structural) and bottom-up (individual) approaches.

A combined and multi-level approach is necessary for workplace mental health promotion programs targeting healthcare worker stress.

• The required levels identified include individual, social, organizational, and educational factors.
• The authors proposed a conceptual model intended to serve as a roadmap for researchers and employers.
• The model is positioned as applicable to controlling stress among HCWs and other employee populations.

Occupational stress among healthcare workers is increasing due to the development of healthcare services and increased occupational sensitivity.

• This trend was identified as the motivation for the study.
• A qualitative study design using semi-structured interviews and focus groups was chosen to investigate determinants of a workplace mental health promotion program.
• The study was framed around the need to identify sources and intervention points for stress management among HCWs.