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Block - Stress ManagementIntroduction

Stress stats: 75-90% of all patient visits to a primary health care facility are stress related Stats from the SA Heart Foundation: Costs of cardiovascular disease:

From a study done by the School of Economics at the University of Cape Town and the Chronic Diseases of Lifestyle Programme at the Medical Research Council (MRC):

  • Estimated cost of cardiovascular disease in South Africa: R6,135 – R10,035 billion. This does not include the cost of absenteeism, sick leave, rehabilitation and follow up of CVD.
  • Direct health care costs were ± 42% of the total costs. The indirect cost reflects the balance and includes the loss of productivity and earnings lost as a result of premature death.

Stress is the number one threat to health and wellbeing.

Long term stress increases the risk of conditions as diverse as colds and flu, heart disease, depression and insomnia. What is more, statistics show there has been a five-fold increase in stress-related illness in the last 40 years alone. One way to protect against the effects of stress is to build up the body’s internal reserves, enabling it to cope better with the demands life brings, by enhancing resilience to stress.

Some stress related ailments and illnesses as cause for employee absenteeism, presenteeism and sick leave:

  • Heart attacks
  • Heart disease
  • High blood pressure
  • Peptic ulcers
  • Migraine headaches
  • Diabetes mellitus (high blood sugar)
  • Muscle spasm in the neck
  • Certain types of asthma
  • Many forms of cancer
  • Alcohol abuse
  • Drug abuse
  • Depression
  • Anxiety
  • Insomnia
  • Frequent colds or other infections

Over the past 2 years, important advances regarding research on stress and its impact on health and wellness were made, including the following conclusions about the influence of lifestyle stress on your body and mind.

  • Results of a study published in the British Medical Journal show that work stress is associated with a doubling of the risk of death from heart disease. In promoting cardiovascular health, the traditional advice has always been for people to stop smoking, cut down drinking, eat less fat, and get moving through physical activity. These latest findings suggest that attention should also be paid to the prevention, mastering or management of work stress, according to the researchers.Adapted from BMJ 2002;325:857: Cardiovascular disease is the leading cause of death in modern society. Employees with high job strain, a combination of high demands at work and low job control, have high stress levels and more than twice the risk of death form heart disease compared with employees who have low job strain. The stress levels and risk for employees with effort-reward imbalance (low salary, lack of social approval, and few career opportunities relative to efforts required at work) were 2.5 times higher. High job strain also showed an increased total cholesterol at the 5year follow up, while effort-reward imbalance showed an increase in body weight.
  • A large Swedish study found that men who experience chronic high levels of stress are more likely to have cardiovascular disease and to die of a stroke, compared to their peers with lower stress levels.
  • Two studies presented at the 2004 American Society of Hypertension’s Annual Scientific Meeting, reported that screening for depression, anxiety and stress with suitable stress management interventions can improve cardiovascular disease outcomes and risk reduction.
  • Stress affects immune system health. It has long been known that stress affects our ability to fight infection. The July 2004 issue of Psychological Bulletin reported on a meta analysis (where studies from a multitude of research institutions are reviewed) and highlighted fascinating examples of how stress influences human immunity. Stress can enhance immunity in the short-term but weakens it in the long-term.
  • Stress can promote the ageing process. This pioneering finding in the field of stress research was published in the 29 November 2004 issue of the Proceedings of the National Academy of Sciences by doctors from the University of California in San Francisco. It can help explain why chronic stress may accelerate cell ageing.
  • Swedish researchers reported that work related stress doubles the risk of a heart attack. · Scientists from the USA and Germany, presented evidence that chronic stress in infancy or early childhood can impair the development of effective and optimal brain cell communication, a condition found in disorders such as autism, mental retardation, attention deficit disorder, depression and low academic performance.
  • According to research, stressed kids are more likely to suffer from adult onset depression and anxiety disorders than their peers with low stress levels.
  • British researchers reported that stress quadruples the risk of asthma attacks in children. Can something be done about this?

The problem has been identified: work stress is bad for your health. So is personal stress. Not only does it double your risk for getting heart disease, long term unrelenting stress can be the cause or exacerbating factor in almost any of our modern day chronic diseases or ailments: from infections, cancer, skin problems, premenstrual tension, severe menopause, back problems, to chronic fatigue, digestive system problems and lung disease.

Stress management is of the utmost importance to maintain health and wellbeing and restore a sense of serenity and peace while maintaining your creative, productive, high profile lifestyle.

Expected results when implementing health and wellness programs: Improved productivity and creativity, higher levels of company morale, reduced absenteeism and presenteeism, improved day-to-day quality of working life for the employer and employee.

Wellness Stress Solutions

Many people have excess stress that affects their health, happiness and other areas of their lives. While most of us could benefit from adding healthy habits to our lifestyle, it’s harder to begin a new habit than it seems, especially when you’re already overscheduled and overwhelmed by stress! The following steps can help you plan a wellness journey from your good intentions to the reality of maintaining a healthier, happier lifestyle with less stress.

Choose your wellness activities wisely

The first step in creating a healthy new habit that will become a long-term wellness habit and new behaviour in your lifestyle, is to choose an activity that fits well with who you are, how you live and what you enjoy or love doing. Otherwise, you may find that you’re working against personality and lifestyle factors that are too ingrained to change, and your new healthy habit never quite seem to flourish. When choosing a new practice, keep in mind factors like your strengths, your schedule and lifestyle, and the complexity of the new habit, as well as your current stress level and time available, and find an activity that fits these.

Whether you’re looking for health benefits, less stress, more work-life balance, or simply more enjoyment and fun in life, there are many reasons why choosing one regular stress management activity and practising it every day, is worth your time investment. However, there’s a difference between wanting to take on some stress relief habits and actually doing and maintaining these habits on a regular basis. Sometimes maintaining a new healthy habit is harder than it seems. Fortunately, there are a few tricks that can make it easier to maintain a new healthy habit.

  • Choose something simple: Unless you’re really ready for a challenge, don’t take on something meant to relieve stress, that will actually end up causing you more stress as you attempt to manage it! For example, if certain types of yoga seem too difficult to take on right now, look for easier beginner yoga classes, or choose something else, like Nia technique dance, walking, or pilates – all of these are available at the Centre for Health & Wellbeing in Pretoria and can also be brought right into the workplace by our team of trained experts. The only way you’ll maintain an exercise and relaxation program, is if you choose something you enjoy.
  • Select a habit that complements your lifestyle: If you’re not a morning person and find yourself struggling to make it on time to the office, don’t choose a morning stress management tool; you’ll find it too difficult to maintain. Likewise, if you’re exhausted in the evening, perhaps a meditation session might help energise you and enable you to do your selected exercise routine later on, or even the next morning. There are regular free meditation sessions held at the Centre to help you learn the healthy habit of becoming quiet and still, centered within your own Being. Instead of forcing something that doesn’t fit with your circumstances, look at your lifestyle and see where you have the most space for something new.
  • Work with your strengths: If you’re a very verbal person, perhaps journaling or a chat group support session might work for you. If you have a creative imagination, guided imagery meditation, mandala art drawing or pottery might be what you’re looking for. Join in the regular creativity workshops held at the Centre. If you’re trying to lose weight, an exercise and relaxation stress reliever combination like yoga, would be great, whereas it might not be so useful for someone with certain physical limitations. Looking at your strengths and weaknesses, and finding a stress reliever that fits them, is one of the most important steps in choosing a new stress management practice.

Once you’ve carefully looked at yourself and your needs, choosing the right new healthy habit will be much easier. And once you’ve chosen a stress management practice that fits well with your lifestyle and that you enjoy, you’re much more likely to stick with your new healthy habit.

Aims and objectives of stress management programs

  • The ultimate objective of stress management programs, is to increase self-awareness, self-responsibility and self-regulation of employee health and sense of wellbeing: a continuing, open-minded commitment to self-monitoring, so that people recognise and deal with stressors (stress triggers) proactively, thereby increasing their resilience to stress, improving their health and happiness and preventing stress associated ailments and illnesses.
  • To help people notice the link between their own perception and how they relate to the world around them
  • To make people aware of their own coping styles, perception, feelings, thoughts about their lifestyles
  • To provide a wide selection of different stress management tools & techniques
  • To create the awareness that stress (distress) can be managed
  • To create the awareness that some stress (eustress) is necessary and healthy
  • To increase awareness of the importance and value of practicing daily stress management & relaxation techniques

Additional services that should be available from a wellness and stress management service provider

  •  Stress and wellness talks: Talks can promote the awareness and education of employees and trigger and interest in self-responsibility for developing healthy habits. It also acts as introduction for longer practical workshops and courses. The talks provides a summary of a practical stress management and wellness program.
  • Stress and wellness workshops: 3-4 hours as part of teambuilding or group sessions over week-ends, during work hours, within companies or divided into two or three sessions specifically aimed at addressing specific stress triggers and health challenge risks identified within the company. These have to be accompanied by an initial stress and wellness assessment to show return on investment and personal growth and improved health and wellbeing in participants.
  • Stress and wellness courses: The courses stretch over 6-7 weeks, over one week-end or 2 days. The 6-7 week course could be 1 hour session per week addressing various stress triggers and health challenge risk solutions, as identified within the company, or 6-7 hours spread over the course of a week-end. These also have to be accompanied by an initial stress and wellness assessment to show return on investment and personal growth and improved health and wellbeing in participants.

There are also continued education CPD courses available for health professionals within a company, to run their own stress and wellness workshops in-house for employees

Outcomes of workshops and courses

After completing a workshop or course, participants should have a clear idea of:

  • The need for a wellness approach to health enhancing behaviour changes
  • The cornerstones, definitions, aspects, personal responsibility and key systems support of a wellness infused lifestyle
  • The difference between disease management and health / wellness promotion
  • A changed perspective in health promotion:
    • Practical stress solutions: tools, techniques, relaxercisesand personal experience
    • Ailments and illnesses as teachers and guides: an introduction to mind-body wellness withpractical examples
    • Basic nutrition: food and mood, phyto (plant) nutrients, system support eating, antioxidants, introduction: wellknown, well-researched herbal remedies, separating the wheat from the chaff.
    • Heart health
    • Endocrine / hormone system health
    • Immune system health
    • Nervous system health
    • Workplace enhancement
    • Work-life balance

Purpose / goal of a wellness intervention program (supporting business objectives):

  1. Reduce use of health benefits
  2. Reduce workers’ compensation claims
  3. Decrease medical station visits, absenteeism, presenteeism, accidents and sick leave
  4. Enhance employee loyalty and morale.
  5. Motivating pro-active health and well care through: i. Screening procedures and HRA’s ii. Health enhancing lifestyle changes and choices iii. Education and empowerment to encourage self responsibility and sustain motivation iv. Create a supportive work environment
  6. Raise the level of health and wellness awareness in Company
  7. Act as a model for other companies, even extending into other SA companies
  8. Attain a positive public and community relations image
  9. Highlight community responsibility

Revise goals frequently, adapt to arising needs. Build in ways to measure progress and success of program. Have an evaluation process in place.

Ways to wellness (some of the most popular wellness programs / interventions companies and individuals can use):

  • Stress solutions: Practical stress management tools and techniques, as well as stress courses
  • Life-skill development
  • Positive mental attitude
  • Complementary health care advice
  • High cholesterol, high stress, what now?
  • Heart, immune system (incl. HIV/Aids, TB), nervous system, hormone system health
  • Executive health
  • Health education and employee assistance: nutrition, HIV/Aids, family planning, hygiene, sexuality, responsibility
  • Sleep restoration
  • Workplace enhancement: Ergonomics, colour, chill rooms, private space, mini breaks
  • Work-life balance
  • Thriving during times of change
  • Difficult relationship as guides and teachers
  • Anger management

Work-life balance: Juggling all the balls

The three top stress complaints seen almost daily at the Healthy Living Space in Pretoria, as well as during workshops and seminars, are family, marital or relationship problems; fatigue and complaints about life feeling unsatisfactory and unbalanced, sort of ‘is this all there is?’. Mostly all of these are closely related. There just isn’t enough time and energy to get around to everything, or it’s simply a matter of not knowing what to do to ‘fix’ things. Short of having yourself cloned, something’s bound to draw the shortest end of the stick. Usually it’s personal or family life. Work is the easy winner.

Fortunately, radical lifestyle changes aren’t required. The answer is to stand back and try to see the bigger picture, and then to make one or two small, personally strategic changes.

Work-life balance workshops can be thoroughly enjoyable, interactive and experiential.

Workshop outline:

  • A short quiz to help identify specific work-life balance concerns. Employees are often amazed at the difference five or 10 minutes of taking their needs seriously can make to theri quality of life, sense of wellbeing and productivity.
  • Increase energy levels at work – easy practical tips for every day
  • Work-life separation time – silent time and quiet space.
  • Setting boundaries and saying ‘no’.
  • Dealing with techno-stress. Learn to counteract and balance the energy drain of machines, the electromagnetic radiation of computers & cellphones, artificial light, colour, basic ergonomics.
  • Mini breaks – 5 minutes here and there during a hectic day will make a world of difference
  • Relaxation exercises – for the workplace and the home. Self centering and relief from the monkey chatter in your own mind. Mindfulness and present moment awareness. Simple meditation exercises for everyone to use.
  • Creativity, exercise, hobbies – we need left and right brain interaction for integrative whole brain functioning. The Western mind-set emphasises predominantly left brain functioning. Easy, time saving techniques will be practised to encourage right brain activity
  • Time off & treating yourself – to rewind, rebalance and rejuvenate

Author: Dr Arien van der Merwe

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