The Explorer Islamabad: Journal of Social Sciences ISSN: 2411-0132(E), 2411-5487(P) Vol-1, Issue (10):353-359 www.theexplorerpak.org
STRESS, HEADACHE, HIGH BLOOD PRESSURE AND SELF-ESTEEM IN WORKING WOMEN Arfah Ayesha Shahid Lahore Grammar School, 55-Main Gulberg, Lahore
Corresponding Author: Arfah Ayesha Shahid Lahore Grammar School, 55-Main Gulberg, Lahore arfahayesha15@gmail.com Abstract: The present study was conducted to explore the relationship of stress with headache, high blood pressure and self-esteem in working women. It was hypothesized that stress is correlated positively with health related problems (experience of headache and blood pressure) and negatively with self-esteem of working women. For this purpose a sample comprising of 200 university teachers was obtained by using purposive sampling technique. Protocols used in the study included DASS by (Lovibond and Lovibond 1995) to assess levels of stress; self-structured measures to obtained information regarding headache experience and blood pressure and Rosenberg Self-Esteem Scale (Rosenberg 1965) to assess the selfesteem of working women. Descriptive statistics was used to calculate the preliminary profile of research participants while correlation analysis was used to explore correlation between variables and regression analysis was used to find the predictors of health related problems and self-esteem of working women. Results indicated significant relationship of stress with health related problems and self-esteem of working women. Similarly stress, monthly income, contractual job and dependents appeared as positive predictors of health related problems and negative predictors of self-esteem of working women.
INTRODUCTION Experiencing stress in the workplace is an element of everyday life. Stress in working people results in various issues and feelings such as worry, fear and depression (Margolis, et al. 1974). The consequences of stress in workers are; lethargy, absenteeism at work (Furnham 1997) lack of productivity, burnout (Dunham 1992), and the decrease in performance and production (Schafer 1996). Increased working hours, higher level of responsibilities all combined lead various health issues. The most common emerging psychological problem in working women is stress which can be due to work interfering family or family interfering work (Carlson, et al. 2000). Similarly there are various other health related problems; out of which headache is the most reported health problem. Headaches are internationally prevalent in a major portion of the world population, upsetting all age groups, affecting individuals in their performance and have been accepted as a main health problem by WHO (Berg and Stovner 2005; Stovner, et al. 2007). Headache has substantial impact on the health of the individual, thus limiting their physical activities and reducing their quality of life and performance at workplace. Headache reduces activities of the affected people by 77%, disturb their routine by 50% and 30%
of them must lie down during the headache attack (Edmeads, et al. 1993; King, et al. 2005). Biological, social and psychological factors are often considered as significant risks of hypertension (Mushtaq and Najam 2014). Psychological state of an individual immensely affects the physical condition of human body. Empirical evidence reports high incidence of stress among people causing hypertension. Stress has been considered an important factor in the etiology of hypertension. Stress is known to be significantly correlated with high blood pressure and is the cause of many cardiac problems. Natural reaction of the cardiovascular response to stress is the increase in heart rate (Mushtaq and Najam 2014). Literature establishes many emotional and physical health related issues associated with workplace environments (Maki, et al. 2008). Headache is the most recurrent health problem and is a great burden upon the affected, their families and to society (Leonardi, et al. 2005). Headache is considered a neurological problem and almost every person experiences it at some stage of life (Rasmussen, 1993). Only migraine treatment results in the annual expenditure of â‚Ź 27 billion and the prevalence of tension-type headache is greater than other types of headaches (Stovner, et al. 2007).
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Self-esteem is an indispensable element to the life process and has a myriad impact on normal and healthy self-development, and has a value for survival. It is believed that there are many benefits to having a positive view of the one’s own self. Those who have high self-esteem are assumed to be psychologically happy and healthy (Jan and Arshad 2008) whereas people with low self-esteem are believed to be psychologically distressed and perhaps even depressed. Self-esteem is the evaluative characteristic of the self-concept that corresponds to an overall view of the self as worthy or unworthy (Baumeister, et al. 2003). Most women in Pakistan step out of their comfort zone to share the economic burden of their families. The present research was conducted to explore the relationship of stress with headache, blood pressure problems and self-esteem of working women. Hypotheses 1. There will be negative correlation between stress and health problems in working women. 2. There will be significant positive relationship between stress and selfesteem in working women. 3. Stress is the positive predictor of health problems and negative predictor of selfesteem in working women. MATERIALS AND METHODS Cross-sectional research design was carried out in the current research and purposive sampling technique was used for data collection. Sample of the study was consisted of 200 married women working women. The sample of working women obtained from different departments of two universities of Lahore. Age range of the research participants was 25-45 years. About 62% of working women were Masters, 18% M.Phil and 30% were PhD. Their monthly income was between 40,000-160,000 rupees. Fourteen percent of working women had no child, 14% of working women had 1 child, 26% had 2 children, 24% of working women had 3 children, 14% of working women had 4 children, 6% of working women had 5 children and 2% of working women had 6 children. 40% of working women were living in nuclear family structure and 60% of working women had joint family structure. TOOLS FOR DATA COLLECTION Following instruments were used for data collection: 1. A demographic information form was prepared by the researcher, keeping in view the previous literature. This included; age,
2.
3.
4.
5.
monthly income, education, marital status, nature of job, residential area, number of children and family structure etc. Depression Anxiety and Stress Scale (DASS): The DASS is 42 item self-report inventory developed by (Lovibond and Lovibond 1995), which include three subscales designed to assess depression, anxiety and stress. It is a 4 point scale in which option included never, once, a few times and very frequent. The stress items are 1, 6, 8, 11, 12, 14, 18, 22, 27, 29, 32, 33, 35 and 39. Each item is scored from 1 to 4 (Likert) items includes upset by trivial things, overreact to situation, difficult to relax, upset easily, using nervous energy, impatience delayed, touchy, hard to wind down, irritable, hard to calm down, difficult tolerating interruptions, state of nervous tension, intolerant kept from getting on and agitated. The reliability scores of the scales in terms of Cronbach's alpha scores rate the Depression scale at 0.91, the Anxiety scale at 0.84 and the Stress scale at 0.90 in the normative sample as reported by authors. Headache Assessment: Data on headache experience was obtained by using a selfstructured questionnaire which contained questions on the existence of headache experience during the last 6 months on affirmative (yes/no) response style, if yes then it was categorized into 3 types i, e., mild headache experience, moderate headache experience and severe headache experience. People who are diagnosed patients of migraine or any other type of headache were excluded from the study. Blood pressure: data on blood pressure experience was obtained from by selfreported blood pressure questionnaire. They complaint frequent raise in their diastolic blood pressure from 80mm hg to 90mm hg but the participants were not using antihypertensive medicines. Rosenberg Self-Esteem Scale: The Rosenberg self-esteem scale (Rosenberg 1965) is ten item Likert scales with items answered on a four point scale - from strongly agree to strongly disagree. The Rosenberg Self-Esteem tool is one of the most widely-used selfesteem measures in social science studies.
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The tool has high test-retest reliability of .82-
.85.
Table. 1: Demographic characteristics of the research participants (N = 200) Variable Age in years 25-33 34-41 Experience in years 1-07 08-16 17-24 Marital status Single Married Divorced/widow with children
f
%
110 55 90 45 88 76 36
44 38 18
46 23 120 60 34 17
Variable Monthly income in thousands 35-47 48-65 Number of dependents 0-2 3-5 5-7 Nature of job Permanent job Contractual job Tenure track system
f
%
112 56 88 44 130 65 56 28 14 7 136 68 64 32
Note; f = frequencies, % percentages
Table. 2: Distribution of stress, health problems and self-esteem in working women (N =200) Variables M Mild stress 16.69 Moderate stress 20.51 Severe stress 28.73 Mild headaches 24.43 Moderate headache 37.42 Severe headaches 31.53 Mild blood pressure 34.60 Moderate blood pressure 29.31 Severe blood pressure 30.62 Mild self-esteem 15.16 Moderate self-esteem 20.81 Severe self-esteem 26.42 The table 2 shows that 74 (37%) of the working women are passing through mild stress, while 70 (35%) are experiencing moderate level of stress and 56(28%) are experiencing severe stress. Similarly, 80(40%) are experiencing mild headaches, while
SD Îą f % 6.32 .72 74 37 6.28 .84 70 35 7.80 .81 56 28 6.72 .70 80 40 8.70 .82 94 42 7.31 .80 26 13 8.67 .81 110 55 7.90 .79 56 28 7.92 .83 34 17 3.45 .85 58 29 6.20 .80 72 36 67.27 .82 70 35 94(42%) are passing through moderate headaches and 26(13%) severe headaches. About 110(55%) of working women are experiencing mild blood pressure, 56(28%) moderate blood pressure and 34(17%) from severe blood pressure.
Table. 3: Correlation of perceived stress with headache experience and self-esteem in working women (N =200) Variables Mild headaches Moderate headaches Severe headaches Mild blood pressure Moderate blood pressure Severe blood pressure Self-esteem
Perceived stress 0.52*** 0.56*** 0.64*** 0.53*** 0.67*** 0.65*** -0.71***
Variables Married Monthly expenditures Working hours Number of dependents Contractual job Tenure track job Joint family system
Perceived stress 0.41*** 0.56*** 0.62*** 0.40*** 0.52*** 0.56*** 0.42***
Note; ***p < .001
Results shown in the Table 3 indicate statistically significant correlation of perceived stress with mild
headaches (0.52***), moderate headaches (0.56***), severe headaches (0.64***), mild blood pressure
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(0.53***), moderate blood pressure (0.53***), severe blood pressure (0.65***). Stress has also significant negative correlation with self-esteem (-0.71***) in working women. Table shows that stress also has
statistically significant positive relationship with demographic variables like being married, more monthly expenditures, all types of headaches and blood pressure.
Table. 4: Stress predicting health problems and self-esteem of working women (N = 200)
Variable Constant Stress income Contractua l job dependent s
Overall headache β SB t -12.02 2.23 4.98*** 0.49 0.04 11.92*** 0.51 0.13 -12.32*** 0.42 0.02 12.10*** 0.45
0.03
11.47***
Overall blood pressure β SB t -11.31 2.18 5.39 0.43 0.02 11.24*** 0.54 0.14 -12.89*** 0.44 0.02 11.56*** 0.52
0.11
12.90***
Self-esteem β SB -12.81 2.10 -0.46 0.03 -0.55 0.04 -0.61 0.13
t 5.82 -12.54*** 13.18*** -14.17***
-0.63
14.93***
0.14
Note; R2= 64.59; b = beta values, ***p < .001, M = Arithmetic mean; SD = Standard deviation; a = Reliability coefficient
The prediction value of R2 = 64.59 in Table 4 shows that model is effectively fit, therefore stress, monthly income, contractual job and more number of dependents are contributing 64.59 % in the increasing of headaches and blood pressure of the research participants. Further, results also indicate that stress is a significant positive predictor of headache (t = 11.92***), blood pressure rise (11.24***) and negative predictor of self-esteem (t = -12.54***). Monthly income is a significant negative predictor of headache
(t = -12.32***) and blood pressure (-12.89***) and positive predictor of self-esteem (t = 13.18***). Contractual job emerged as a significant positive predictor of headache (t = 12.10***), blood pressure (t = 11.56***) and significant negative predictor of selfesteem (t = -14.17***). Similarly number of dependents significantly predicted headache (t = 11.47***), blood pressure rise (12.90***) and self-esteem (14.93***) which means that more number of dependents are a source of headache experience in working women.
Table 5: Correlation of demographic variables with stress and self-esteem of the working Variables Age Education Monthly income No of children Contractual job Joint family system
Stress .34*** -.45*** -.38*** .42*** .35*** .29***
Self-esteem .41*** .39*** .35*** .02 -23** .10
Headaches .22** .05 .33*** .36*** .52*** .37***
women (N = 200)
Blood pressure .52*** .07 -.52*** .21* .41*** .35***
Note; **p < .01; ***p<.001
Table 5 shows correlation of stress, self-esteem experience of headaches and blood pressure with demographic variables. The results given in Table 5 indicate statistically significant positive correlation of age with stress (.34***), self-esteem (.41***), headaches (r = .21**) and blood pressure (r = .52***). Education is significantly related with stress (-.45***), and selfesteem (.39***). Monthly income is significantly correlated with stress (-.38***), self-esteem (.35***), headaches (r = .33**) and blood pressure (r = -.52***). Number of children is significantly correlated with stress (.42***), headache (r = .36***) and blood pressure (r = .21*).Contractual job is significantly correlated
with stress (.35***), self-esteem (-.23***), headaches (r = .52***) and blood pressure (r = .41***). Joint family system with significantly correlated with stress (.29***), headache (r = .37***) and blood pressure (r = .35***). DISCUSSION This present study was conducted to explore relationship of stress with health related problems and self-esteem of working women. The study also predicted different health problems as a result of stress. It was hypothesized that stress is significantly correlated with and predict headache experience, rise in blood pressure and self-esteem at the work place in
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working women. Additionally, stress appeared as a significant positive predictor of health problems in working women. Results showed that there is significant positive relationship between stress and physical and psychological health of working women. Stress is an established risk factor of many health problems including headache, blood pressure elevation and sleep problems in working women (Jan and Ashraf 2008). The present findings are consistent with the findings of (Parveen 2009), who also find significant positive relationship of stress with health problems in working women. It is established that stress changes migraine in various ways and further it may work as onset of headache disorder. Further, headache itself is a great stressor affecting myriad spheres of an individualâ&#x20AC;&#x2122;s life and leads to the vicious cycle of headache disease. It has also biological basis because stress raises the activation level of hypothalamicpituitary-adrenocortical (HPA)-axis and sympathetic nervous system activity in response to stress (Sauro and Becker 2009; Nash and Thebarge 2006). Teaching is considered as one of the most stressful profession which affects both the teacher and the student (Forlin, et al. 1996). Teachers face hardships in dealing with students of diverse personalities and aptitudes, tension and in maintaining balanced relationship with colleagues and in the management of household affairs. Less achievement motivation among students, their attitude and disciplinary problems and ultimately very low grades in their final semesters creates a lot of stress which resulted in health related problems in working women. Low support from their colleagues, less salary, long working hours, work load, badworking conditions and always demanding attitude from family and friends contribute to create stress and affect the physical and psychological health of the working women. Many other sources of stress in teachers may be summarized as low motivation in students, discipline problems, the pressure of time and the work load, being evaluated by students, relationship with colleagues, conflict and indefiniteness of roles, bad working conditions and self-respect, studentsâ&#x20AC;&#x2122; discipline problems, the inadequate support of colleagues, family and friends. In addition many demographic variables play a significant role in tension headaches (Adams and Bromley 1998) and in the rising of blood pressure. Moreover, stress has significant positive relationship with monthly income and contractual job. Job on contract basis is a
continuous threat for the employees. The fear of removal from job keeps them in stressful condition which affects their body. The second hypothesis of the study that there will be a negative relationship between stress and selfesteem reveals that there is significant negative relationship between stress and self-esteem in working women. Working women enhance the financial resources of the family which has positive impact in their self-esteem. The findings from the existing study reveal that education is a significant predictor of self-esteem in working women. The present findings are consistent with those of (Wilburn and Smith 2005; Jan and Ashraf 2008; Azar and Vasudeva 2005) who have also found significant relationship between stress and self-esteem. Thus it is concluded that stress and self-esteem are significantly correlated. Maslow presented the hierarchy of needs and self-esteem comes after fulfilling basic needs of food, safety and love. Working women contribute in the family income and enjoy good level of self-esteem. The family depends upon their income and show compliance to them. Family income had significant association with womenâ&#x20AC;&#x2122;s self-esteem in family relations. Besides, university teachers are educated members of society and while living in majority of illiterate masses they earn more respect which enhances their self-esteem (Baumeister, et al. 2003). Thus the present research concluded that stress is a significant feature of working women which affect their physical and psychological health. University teachers experience stress, headache and frequent rise in their blood pressure. Similarly they enjoy high self-esteem due to their respect from society. The present research has its implications to give awareness. REFERENCES Adams, Bridget, and Barbara Bromley 1998 Psychology for Health Care: Key Terms and Concepts (5th ed). New York MacMillan Press. Azar, Irandokht Asadi Sadeghi, and Promila Vasudeva 2005 Self-efficacy and Self-esteem: A Comparative Study of Employed and Unemployed Married Women in Iran. German Journal of Psychiatry 9(3):11- 117. Berg, J., and L. J. Stovner 2005 Cost of Migraine and other
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