Conceptualizing Occupational Stress: A Scoping Review of the Development and Application of Theories, Models and Frameworks (TMFs)

Background and Purpose:

Human service professionals experience high-levels of occupational stress, which adversely affects individuals, organizations, and service users. To date, previous attempts to address occupational stress have primarily targeted workers’ internal responses (e.g. cognitive training), even though research suggests organizational-level conditions also influence stress within the workplace. This practice-research gap may partly explain evidence indicating that, despite their popularity, stress-reduction programs based solely on individual-level theories (e.g. Demand-Control) have been largely ineffective. The purpose of this review is to identify and synthesize individual and organizational-level theories, models, and frameworks (TMFs) of worker stress. Our findings are intended to advance a cross-level theory of occupational stress and intervention development.

Methods:

This study followed the five-stage scoping review process as outlined by Levac et al. (2010). To identify TMF-originating literature, we conducted a bibliographic search and applied four inclusion/exclusion criteria: (1) published in peer-reviewed journals, (2) in English, (3) from the social sciences, and (4) focused on developing or refining a TMF. TMF features extracted included: (1) TMF type (theory, model, framework), (2) mechanisms of change (e.g., physiological, psychological) (3) level(s) (i.e., individual, organizational, multi-level), (4) variable definitions, (5) variable relationships, (6) the role of stress (e.g., cause, mediator, outcome), (7) discipline origins (e.g., sociology, economics), (8) article characteristics (e.g., conceptual, empirical), and (9) data collection methods and measures. Frequency analyses summarized the TMF characteristics, and qualitative thematic analyses identified convergence and/or divergence among construct definitions and measurement (e.g., control, rewards).

Results:

Initial searches yielded 23,147 articles describing relevant TMFs; after title screening and deduplication, 209 articles remained for subsequent full-text review. Analysis of fully-reviewed article data identified 33 unique TMFs, which were advanced by a variety of disciplines (e.g., business, medicine, sociology, psychology, social work). Conceptual models were found to be the most common TMF-type (n=20), followed by theories (n=11), and few frameworks (n=2). TMFs fell into five levels of change mechanisms, ranging from multi-level meta-models to individual internal processes. Conceptualizations of stress primarily included interpersonal processes, but dependent variables were primarily individual-level (n=11). A similar number of TMFs fell into the most micro level (n=9), involving solely individual internal mechanisms. No TMFs specified transactional relationships between organizational-level stressors and employee-level responses. Moreover, only five of TMFs described stress as involving both physiological and psychological processes. In six cases, articles both described and tested their proposed TMFs; however, each of these studies measured stress differently.

Conclusions and Implications:

Clearly specified TMFs that explain how organizational conditions and individual factors interact to affect stress are essential for developing effective stress-reduction interventions. The results of this scoping review highlight significant variation in TMFs, limited explanations for the role of organizational factors, and minimal acknowledgement of relationships between individual and organizational variables. Future conceptual and empirical is needed that investigates these cross-level effects to support their operationalization and application to effective stress-management approaches.