Journal of Neuropsychology & Stress Management
The Impact of Job Stress on Performance of Employees: A Study of Social Security Hospital of District Okara & Sahiwal
  • Shahid Hafeez

    Shahid Hafeez, Doctor of Pharmacy, Hospital Pharmacist, Social Security Hospital Multan, Islamabad, Pakistan, Email: drshahidhafeez@yahoo.com

Received: 13-06-2018

Accepted: 20-06-2018

Published: 25-06-2018

Citation: Shahid Hafeez (2018) The Impact of Job Stress on Performance of Employees: A Study of Social Security Hospital of District Okara & Sahiwal, jou Neur & Stre Mang 3: 4-12

Copyrights: © 2018 Shahid Hafeez


The aim of this research study is to determine the impact of job stress on performance of employees working in Social Security hospital of district Okara and Sahiwal in 2017. The factors of job stress studied were: workload, role ambiguity and role conflict. A sample of 204 employees was chosen by using purposive, non-probability sampling technique. A self-administered questionnaire was distributed and 200 responses were fit to analysis. The data was analyzed using SPSS 21 software. The results were obtained by descriptive statistics, correlation; multiple regression and ANOVA tests. The findings showed that there is statistically significant positive effect of workload and role conflict on performance of employees while insignificant relationship shown by role ambiguity. The findings revealed that the hospital employees are facing the positive aspect of stress termed as good stress or Eustress. The present study is considered to be policy oriented as it would give an approach to various public hospitals that how to keep up a required level of stress in the organization that is responsible for the inefficiency of the employees. This study also provides valuable literatures to other research related to employee performance.


Key words: Job stress; Employee performance; Workload; Role conflict; Role ambiguity.


This research explores the relationship between job stress and employee performance. This article describes the concepts, links and factors related with job stress and performance of employees.


Research Objectives

The general objective of the study is to determine the effects of job stress on employee s’ performance at Social Security Hospitals as a case study.  These are specific objectives of the research study


  • To study overall nature of job stress.

  • To examine the effects of Workload on performance of employees.

  • To examine the effects of Role Conflict on performance of employees.

  • To examine the effects of Role Ambiguity on performance of employees.

  • To make recommendations to deal with those stressors



What is stress?

There are a lot of definitions of job stress. According to definition of World Health Organization, job stress is the response with work demands that are not harmonized to their comprehension and aptitude and which challenge their capability to deal with. In simple words, Stress is a built-in condition. Human beings are solid-wired to have a physical and psychosomatic “stress” response when facing an apparent threat. There are many definitions of stress.  Stress can be defined as undue, inappropriate or exaggerated reaction to a situation [1].


 The Concept of Stress

Hans Selye is known as fathers of stress research. In 1956 he was of the view that stress is not necessarily a bad thing – it is all about how you take it. It was believe of Selye that the biochemical effects of stress would be felt regardless of whether the situation was negative or positive. After this, further research has been conducted, and new ideas have moved on. Stress is now taken as a "bad thing", with a variety of harmful biochemical effects.

Job stress is a critical physical and psychological reaction that happens when the requisites of the job do not match the aptitude, sources or requirements of the employees.


Job stress is a global issue. According to [2] an individual acknowledged flawed in organization’s expectation as well as in his individual needs owing to stress. Now job stress is emerging an international concern which is affecting all the countries, races, classes of workers and cultures.


Stress in the Health Care Professions

There is significant evidence that the stress has negative impact on health care personnel. Stress can results into increased depression, reduced job satisfaction and agitated personal relationships[3].


Another study by McNeely, 1987 revealed that there are variety of stressors in the place of work of healthcare employees that have been proved to increase the risk of distress and poor performance such as work overload, and organizational issues and conflicts.


Performance of employees

Performance of employee is the capability of the worker to work efficiently so that organizational objectives should be achieved (kovach, 1987). The analysis of a study conducted by showed a U-shaped relationship between occupational stress and performance and in this case employees manage stress by exhibiting stress management techniques in organizations. Analysis of another study by [4] showed that there is present an inverse link between job stress and performance signifying that there is high occupational stress in the house officers, which resulted in reduced job performance.


Employee performance is a foremost concern for any organization. All owners want their employees to have excellent performance so that their organizations become better and competitive in market. Job stress has been consistently taken as one of the causative factors of variance to the performance at job. The hospitals have been considered as odd working environment with diverse workloads. In hospitals, expectations of patients have lifted up the level of working demands and apparent stress among employees of hospitals. Thus, in healthcare professionals, stress management is a complex challenge for doctors, nurses and other paramedical staff. The present study investigates impact of job stress on performance of employees of hospitals.



This research study was mainly based on [5] and [6] framework. Employee performance is an important decisive factor for organizational productivity and success. Many research studies have been conducted to determine the relationship and consequence of job stress on performance of employees. Theoretically, the exploration may engross determining linear and non-linear relationship linking stress and Employee performance. This study conceptualizes that hospital employees are experiences a certain level of stress while performing their duties at hospital settings. A variety of causes of job stress need to be recognized within various hospital departments. The level of professed stress will be based on self-reporting. In this study theoretical framework shows that independent variables are role conflict, role ambiguity and work load and dependent variable is employee performance


Description of the conceptual model

This proposed conceptual model exemplifies four variables which are Employee performance as dependent variable while role conflict, workload, role ambiguity as independent variables. This conceptual model is adapted from [5].




Figure 1:- The relationship between various variables is given in the figure


Source: The Impact of Job Stress on Job Performance: A Case Study on Academic Staff at Dhofar University by Moaz Nagib Gharib, Syed Ahsan Jamil, Moinuddin Ahmad and Suhail Ghouse in 2016.


Employee Performance and Workload

Workload is the one of the main significant causal factor of work related stress. The heavy assignments, unapproachable deadlines and extended duty timings coalesce in the concept of workload. Karatepe conducted a research study to investigate effects of work family conflict and work overload on job embededness  and job performance and showed that emotional exhaustion acts as a mediator of the effect of work overload, work-family conflict on performance of employees those results in reduced service delivery.


Employee Performance and Role conflict

Role conflict Role conflict arises when the communications and indications comprising a role are clear but paradoxical or mutually exclusive. There are four types of role conflicts may commonly occur.


A study conducted with aim to determine effect of Role Conflict on Employee Performance at the Department of Public Works Southeast Sulawesi by [7] revealed that Role conflict had no significant positive effect on employee performance with a correlation coefficient of 0.089. This showed that the role conflict is not able to impact the development of performance of employees.


Employee Performance and Role Ambiguity

In many past research studies role ambiguity was study of interest related to performance of workers. According to [8] Abramis role ambiguity resulted in the reduction of work performance Moaz  conducted a study ‘The impact of job stress on job performance at Dhofar University’. Findings of this study showed that performance of university employees is not significantly correlated with role ambiguity.




Hypothesis 1 H1

Workload has significant impact on employee performance.

Hypothesis 2 H2

Role Conflict has significant impact on employee performance.

Hypothesis 3 H3

Role Ambiguity has significant impact on employee performance.

Research Methodology

This study is described as a descriptive & analytical which explores the fundamental correlation of dependent variable i.e. Employee performance and independent variables by hypothesis testing.


In this study the sampling frame was selected for the hospital staff including physicians, nurses, technicians, pharmacists, Lady Health visitors and dispensers as well as administration & management of hospital & attached dispensaries. In this study sample size is taken 200. In this study purposive, non-probability sampling technique is used. This sampling technique is used in many research studies for example Occupational Stress in Health Care workers: The Case of the Goaso Government Hospital by TankoIddi Abdulai in 2011, [9],  Kamisan.


Survey Instrument

The research instrument utilized in this research study was questionnaire. The questionnaire is divided into five sections containing 29 questions. Section A comprises demographic information of employees such as age, gender, marital status, designation, qualification and scales. Section B, C& D comprised of statements related to three stressors which were work overload, role conflict and role ambiguity. The section E consists of statements regarding performance of employees. The independent variables role conflict and role ambiguity were measured by using a 14 item scale made by Rizzo . The independent variable Workload was assessed by using questionnaire that has been used in a study by Al-Hareth. The dependent variable performance was assessed by statements used in research thesis by Kamisan.


The Likert-5 type scale was employed to measure the responses of the respondents toward the statements enquired in the questionnaire. This five item scale was used in B, C, and D & E sections. This scale ranges from 1 to 5 as 1= strongly disagree, 2= disagree, 3= uncertain 4= agree and 5 = strongly agree.


Data Analysis

Statistical Package for Sciences Software (SPSS) version 21.0 was used to analyze the collected data. The interpretation of the data was collected and tested to inspect the correlation among the dependent & independent variables used.



Validity of the Questionnaire can be calculated using the Kaiser MeyerOlkin (KMO) measure of sample adequacy. The obtained value of 0.666signifies that sample is generable to the population and is acceptable. 



Cronbach's Alpha


No of Items

Workload (IV)



Role Conflict (IV)



Role Ambiguity (IV)



Employees Performance (DV)













Scale Wise Reliability Analysis




Validity of the Questionnaire can be calculated using the Kaiser MeyerOlkin (KMO) measure of sample adequacy. The obtained value of 0.666signifies that sample is generable to the population and is acceptable.



KMO and Bartlett's Test

Kaiser-Meyer-Olkin Measure of Sampling Adequacy.


Bartlett's Test of Sphericity


Approx. Chi-Square

















Descriptive Statistics







Std. Deviation

Work. Load






Role. Conflict






Role. Ambiguity






E .Performance






Valid N (listwise)







Descriptive Statistics


In present study Mean of job stressors by employees of PESSI hospital staff was low, because mean of role conflict, role ambiguity and workload were less than 3. The findings showed that role conflict got first rank with mean 2.46 that means staff face low level of conflict as they perform contradictory tasks and do activities which coincide with their values.Role ambiguity obtained the 2nd rank with mean score 2.43.This shows defined and clear tasks performed by hospital employees. The mean value of workload dimension was 2.13. This indicates employees face low levels of stress related to shortage of time, amount of work , long working hours ,work extra time in order to accomplish tasks was most effecting factor in workload.










Pearson Correlation



Sig. (2-tailed)











Pearson Correlation




Sig. (2-tailed)









Pearson Correlation





Sig. (2-tailed)











Pearson Correlation





Sig. (2-tailed)










**. Correlation is significant at the 0.01 level (2-tailed).


Correlation of Employee Performance Vs Variables




R Square

Adjusted R Square

Std. Error of the Estimate







a. Predictors: (Constant), RA, WL, RC


Regression Analysis Model Summary




Sum of Squares


Mean Square























a. Dependent Variable: EP

b. Predictors: (Constant), RA, WL, RC




Multiple Regression model is significant with F value of 29.425(p < 0.05). R square is coefficient of determination that shows 31.1 % variation in employee performance as explained by stress.





Unstandardized Coefficients

Standardized Coefficients



95.0% Confidence Interval for B


Std. Error


Lower Bound

Upper Bound


































a. Dependent Variable: EP


















The findings of this study contravenes the results of many previous studies that have shown that job stress has negative relationship with performance of employees for example a study conducted by [10] concluded that there exists a significant negative relationship between work stress and job performance of employees, it means stress at work lowers the performance of employees. In another study with same result was done by Beehr.


The present study found significant effect of Workload on performance of employees. This result indicated that hospital employees are able to settle in or be active to complete assigned work.  There is 0.311value of beta at significance value 0.000(which is less than 0.05), indicates that workload is positively related to employee performance. This result supports the findings of [11] ,Moaz , Shadab, Sattar, & Anum . The findings of present study also verify the results of study conducted by Oyoo M. O . which concluded that workload had positive significant influence on performance of employees in NGOs working in Kenya [12] to [16].


The present study found insignificant result of relationship between role ambiguity and performance of employees. This result indicated that role ambiguity’s levels were low, that’s mean hospital staff do not face ambiguity related to their duties and professional services. This is due to fact that they are clear about job description, they know their responsibilities and their authorities .The results indicated that the beta coefficient values obtained are positive but not significant. There is unidirectional relationship but not significant.  We can say that there is no significant effect of role ambiguity on performance of employees. This result supports the findings of Moaz .






Role conflict


Role Ambiguity




As values of VIF are less than 5, so there is no problem of multi-co linearity







Workload has significant impact on  performance of employees




Role Conflict has significant impact on performance of employees




Role Ambiguity has significant impact on  performance of employees

Failed to accept


Summary of Hypothesis Testing


The intention of this study was to investigate whether job stress factors such as workload, role ambiguity, role conflict would affect the performance of the employees working in PESSI hospital district Okara & Sahiwal. The results supported that the job stress factors such as workload and role conflict are significantly related with employees’ job performance.  From Regression model, it is clear that the job stressors have a moderate positive impact on employees’ performance. When employees are uncomplaining the pressure and they are capable to bear the workload subsequently their performance will be up to the mark. In present study most of the employees are there, who put up with the strain and work in critical circumstances and perform healthy. It shows positive impact of workload on performance of the employees at job. To sum up, the result of present study has provided empirical support to literature by signifying the relationship between job stressors: workload, role ambiguity, role conflict and performance of employees. Since Stress at work is inevitable and cannot be eliminated completely in any organization. However the management of an organization by lowering workload, cutting back role conflict and redesigning jobs, can minimize it.


Recommendations and Suggestions


  • The empirical findings of this study have revealed that job stress is a factual challenge for hospital employees. The working environment should be monitored continuously for stress related factors .Organizations should make sure that there is a trustworthy distribution of reasonable workload to employees. To find out the ‘reasonable workload’ the management should make certain that : - assignments are owed to employees with the intention that their work load do not exceed from reasonably expected work.  Working hours of employees should also be monitored. When employees work on a regular basis in excess to their allocated working hours, extra resources should provide to them as well as changes should made  in responsibility & technology. The duty timings should be proper and flexible so that employees can do their best.

  • The management has to markedly define roles and responsibilities of employees to reduce role uncertainty and make sure efficient & friendly communication to reduce the job stress so that job performance of employees should increase.

  • The Management of hospital should invest in the stress management strategy to lessen the effects of stress on employees’ performance as a result of which performance of employees as well as organization will more boost.


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