Cross-sectional study of cognitive stress appraisal and related factors among workers in metropolitan areas of Japan.

OBJECTIVE: Stress has major socioeconomic implications for all spheres of employment. It is a trigger for depression, and affects absenteeism, turnover, productivity, morale and suicide. Positive or negative cognitive stress appraisal can be a self-care strategy that affects workers' ability to cope with stress. This study examined cognitive stress appraisal among workers and identified related individual and environmental factors.

DESIGN: Cross-sectional study using self-administered postal questionnaires.

SETTING: Companies located in two metropolitan areas of Japan (Tokyo and Kanagawa prefectures).

PARTICIPANTS: 2311 employees of 48 companies in metropolitan areas in Japan. In total, 341 questionnaires were returned (response rate: 14.8%), 337 of which were suitable for analysis (effective response rate: 98.8%).

PRIMARY MEASURES: Cognitive stress appraisal was assessed using the Japanese version of the Perceived Stress Scale (PSS). Potential variables related to stress appraisal included demographic, individual and environmental factors. Multiple regression analysis was used to identify factors related to cognitive stress appraisal.

RESULTS: Participants' mean±SD age was 42.8±11.7 years, and two-thirds were male. The mean±SD PSS score was 25.8±6.2. The multiple regression analysis controlled for age, sex and depression showed that those with poorer economic status (β=0.171, p<0.001), lower electronic health (eHealth) literacy (β=-0.113, p=0.012), higher traditional organisational climate (β=0.131, p=0.004) and lower perceived social support (β=-0.205, p<0.001) experienced significantly higher levels of negatively perceived stress.

CONCLUSIONS: The results show individual and environmental factors related to cognitive stress appraisal among workers. An effective strategy to improve mental health among workers may involve an interprofessional approach by public health nurses and health practitioners that includes enhanced self-coping skills using individual workers' eHealth literacy, improvement of organisational climates in workplaces and community-based social support.