JURNAL KESEHATAN MASYARAKAT (e-Journal)

Volume 5, Nomor 5, Oktober 2017 (ISSN: 2356-3346)

http://ejournal3.undip.ac.id/index.php/jkm

FAKTOR-FAKTOR YANG MEMPENGARUHI STRES KERJA DAN

PENGENDALIAN STRES KERJA PADA TENAGA KERJA DI BAGIAN
CARGO PT. ANGKASA PURA LOGISTIK BANDAR UDARA
INTERNASIONAL AHMAD YANI SEMARANG

Putri Utami, Ida Wahyuni, Ekawati

Bagian Keselamatan dan Kesehatan Kerja, Fakultas Kesehatan Masyarakat
Universitas Diponegoro
*PutriUtami, puputriutamii@gmail.com

ABSTRACT
Work stress is a feeling of pressure or distress experienced by employees in the
face of job. In carrying out activities in each group, humans can encounter a
stress. The same condition also occurs to a workers in cargo section in doing his
task. This research used mix method approach (quantitative – qualitative). The
subject of the research is the workers in cargo section PT Angkasa Pura logistik
Semarang. The data were collected by spreading the questionnaire of work
stress symptoms on 47 respondent, 54,1% experienced severe labor stress,
45,9% experienced mild stress and 0% did not experience work stress. Based on
eight job stress factors studied, the intrinsic factors of the job (job demands and
work environment) and external job demands all the elements related to work
stress a workers in cargo section PT Angkasa Pura logistik Semarang
(subjectively).How to control work stress on the workers in the cargo section that
does not experience work stress in controlling the saturation is by joking with co-
workers play mobile phones and always try to stay focused. If there is a problem
at work or with colleagues, they discuss with the Leader and colleagues to find
the best solution. To relieve fatigue during work is by drinking body movements
and cool the body in the customer service.

Keywords : Job Stress, Control Stress, Workers in the cargo section

PENDAHULUAN manual menjadi teknologi tinggi,

Bekerja merupakan sesuatu ekonomi sosial dipengaruhi
yang dibutuhkan oleh manusia. perubahan ekonomi dunia. Keadaan
Seseorang bekerja karena ada tersebut memaksa jutaan manusia
sesuatu yang ingin dicapai dan harus berbenturan secara tiba-tiba
orang berharap aktivitas kerja yang dengan perubahan-perubahan di
dilakukan akan membawa suatu masa depan yang sebetulnya
keadaan yang lebih memuaskan dari mereka belum siap untuk
sebelumnya. Telah terjadi trend menghadapinya. Kondisi tersebut
yang mempengaruhi peradaban ternyata banyak menimbulkan
kehidupan manusia seperti terjadinya stres pada masyarakat. 1
terjadinya perubahan dari Perusahaan yang
masyarakat agraris menuju baik adalah perusahaan yang
masyarakat industri. menjaga keselamatan dan
Selanjutnyaperubahan dari kesehatan karyawan dengan
masyarakat industri menuju membuat peraturan tentang
masyarakat informasi, teknologi keselamatan dan kesehatan kerja

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yang dilaksanakan oleh seluruh
karyawan dan pimpinan perusahaan.
Perlindungan tenaga kerja dari
bahaya dan penyakit akibat kerja
atau akibat dari lingkungan kerja
sangat dibutuhkan agar karyawan
merasa aman dan nyaman dalam
meyelesaikan pekerjaannya. Tenaga
kerja yang sehat akan bekerja
produktif, sehingga diharapkan
produktivitas kerja karyawan
meningkat yang dapat mendukung
keberhasilan bisnis perusahaan
dalam membangun dan mebesarkan
usahanya.2
Saat ini sektor industri dan
teknologi mengalami kemajuan yang
pesat. Kemajuan ini ditandai dengan
banyaknya penggunaan mesin untuk
pengolahan bahan maupun barang
secara cepat. Begitu juga untuk
transportasi baik melalui darat, laut,
maupun udara tidak terlepas dari
penggunaan mesin yang seringkali
menimbulkan dampak negative
terhadap lingkungan. 3
Manusia selalu berusaha
memenuhi kebutuhan hidupnya.
Mudah untuk dipahami bahwa
banyak kebutuhan manusia yang
harus didapatkan di luar tempat
tinggalnya, sebagai contoh
pendidikan, pekerjaan, dan rekreasi
sehingga mengakibatkan
meningkatnya kebutuhan akan
transportasi yang cepat dan efesien
dalam penggunaan waktu, dalam hal
ini modal transportasi udara dengan
menggunakan pesawat terbang
sebagai alat transportasi yang cepat
dan efisien, terdapat dampak negatif
terhadap lingkungan yang tidak
dapat dihindarkan yaitu paparan
kebisingan yang diakibatkan
operasional mesin pesawat
beroperasi mencapai 100dB. 4
Kondisi kerja yang aman dan
sehat, yaitu kondisi di mana bahaya-
bahaya dapat ditangani secara
benar, pekerja dapat diharapkan
312
untuk bekerja normal, fisik maupun
mental, sehinga perusahaan akan
lebih mudah melaksanakan berbagai
rencana peningkatan produktivitas
kerja. Sebaliknya pada tingkat
pengelola kualitas lingkungan kerja
yang rendah atau asal-asalan,
peluang tercapainya target dalam
perencanaan produktivitas kerja
secara otomatis juga akan menjadi
lebih kecil. Lebih jauh lagi,
rendahnya kuantitas lingkungan
kerja tersebut secara fisik dan
mental akan menimbulkan tekanan-
tekanan nonproduktif pada pekerja
sehingga banyak menimbulkan
muncul kejadian yang mengganggu
aktivitas pekerja berupa kecelakaan
dan penyakit akibat kerja yang
dampaknya akan merugikan pekerja
secara individual, kelompok, dan
bahkan hingga tingkat perusahaan.5
Salah satu kondisi yang bisa
menjadi stressor di lingkungan kerja
yaitu physical environmental
problem yang meliputi antara lain
kebisingan dan suhu di tempat
kerja.5 Ada beberapa faktor intrinsik
dalam pekerjaan dimana sangat
potensial menjadi penyebab
terjadinya stres dan dapat
mengakibatkan keadaan yang
bukruk pada mental. Faktor tersebut
meliputi keadaan fisik lingkungan
kerja yang tidak nyaman (bising,
berdebu, bau, suhu panas, dan
lembab), stasiun kerja yang tidak
ergonomis, kerja shift, jam kerja
yang panjang, perjalanan dari
tempat kerja yang semakin macet,
pekerjaan yang berisiko tinggi dan
berbahya, pemakaian teknologi
baru, pembebanan berlebih,
adaptasi pada jenis pekerjaan baru.6
Kebisingan adalah semua
suara yang tidak dikehendaki yang
bersumber dari alat-alat kerja yang
pada tingkat tertentu dapat
menimbulkan gangguan
pendnegaran. Kebiisngan
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merupakan salah satu faktor di
lingkungan kerja yang dapat
mengakibatkan penyakit akibat kerja
jika terpapar melebihi nilai ambang
batas (NAB).7 Kebisingan
merupakan suatu bunyi yang tidak
dikehendaki karena tidak sesuai
dengan konteks ruang dan waktu
sehingga dapat menimbulkan
gangguan terhadap kenyamanan
dan kesehatan manusia. Pada
Peraturan Menteri Tenaga Kerja dan
Transgigrasi No.1 tahun 1981
Tentang Kewajiban Melapor
Penyakit Akibat Kerja, penyakit
akibat kerja (PAK) adalah setiap
penyakit yang disebabkan oleh
pekerjaan atau lingkungan kerja.14
Iklim kerja adalah hasil
perpaduan antara suhu,
kelembaban, kecepatan gerakan
udara dan panas radiasi akibat dari
tingkat pengeluaran panas dari
tubuh pada tenaga kerja sebagai
akibat dari pekerjaannya. jika
pekerja terpapar dalam jumlah waktu
yang cukup lama makan pekerja
tersebut dapat mengalami penyakit
akibat kerja yaitu menurunnya daya
tahan tubuh dan berhubungan
terhadap timbulnya gangguan
kesehatan sehingga berhubungan
terhadap produktifitas dan efisiensi
kerja.8
Secara sederhana ‘stres’
sebenarnya merupakan suatu
bentuk tanggapan seseorang baik
secara fisik maupun mental,
terhadap suatu perubahan di
lingkungannya yang dirasakan
mengganggu dan mengakibatkan
dirinya terancam. Seorang ahli
menyebut tanggapan tersebut
dengan istilah “fight or flight
response”. Jadi sebenarnya ‘stres’
adalah sesuatu yang amat alamiah.
Jadi sebenarnya ada dua faktor
utama yang berkaitan langsung
dengan ‘stres’ yaitu perubahan
dalam lingkungan dan diri manusia
313
sendiri.9 Sedangkan stres kerja
merupakan kondisi yang muncul dari
interaksi antara manusia dan
pekerjaannya serta
dikarakteristikkan oleh perubahan
manusia yang memaksa mereka
untuk menyimpang dari fungsi
normal mereka.10 Pada umumnya
stres kerja lebih banyak merugikan
diri karyawan maupun perusahaan.
Pada diri karyawan, konsekuensi
tersebut dapat berupa menurunnya
gairah kerja, kecemasan yang tinggi,
frustasi dan sebagainya.7
Konsekuensi pada karyawan ini
tidak hanya berhubungan dengan
aktivitas kerja saja, tetapi dapat
meluas ke aktivitas lain di luar
pekerjaan. Seperti tidak dapat tidur
dan tenang, selera makan
berkurang, kurang mampu
berkonsentrasi, dan sebagainya.11
Penelitian Suksmono pada
Pada PT. NBI Semarang
membuktikan bahwa ada pengaruh
signifikan antara kebisingan dan
iklim kerja terhadap stres kerja.15
Beberapa penelitian sebelumnya
membuktikan bahwa terdapat
hubungan antara lingkungan kerja
terhadap stres kerja. Dan pada
penelitain tahun 2013 dan 2016 juga
membuktikan bahwa ada hubungan
antara kebisingan dengan stres kerja
yang melibatkan produktivitas
menurun.12,13
Bandara merupakan
kawasan di daratan dan/atau
perairan dengan batas-batas
tertentu yang digunakan sebagai
tempat pesawat udara mendarat dan
lepas landas, naik turun penumpang,
bongkar muat barang, dan tempat
perpindahan intra dan antarmoda
trasportasi, yang dilengkapi dengan
fasilitas penunjang lainnya. Karena
pertumbuhan ekonomi dan
pendapatan pada masyarakat,
transportasi udara menjadi semakin
banyak yang menggunakan. Seiring
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dengan banyak yang menggunakan,
maka semakin sibuk juga bandar
udara tersebut.
PT. Angkasa Pura I Bandar
Undara Internasional Ahmad Yani
Semarang merupakan Perusahaan
Badan Usaha Milih Negara (BUMN)
yang memberikan pelayanan lalu
lintas udara dan bisnis Bandar udara
di Indonesia. PT. Angkasa Pura I
bekerja sama dengan PT. Angkasa
Pura Logistik yaitu salah satu
perusahan pihak ketiga dibidang
penerbangan, perusahaan ini
bergerak dalam bidang usaha jasa
guna membantupelayanan terhadap
penumpang seperti bagasi, cargo,
bongkar muat barang, dan paket
pos. PT. Angkasa Pura Logistik
memiliki section inti dalampekerja
yaitu pada bagian cargo. Bagian
cargomerupakan kawasan
oprasional yang memiliki ruang
lingkup terdekat dengan Apron dan
Runway dengan jumlah 45-50
penerbangan berangkat dan total
mencapai 90-100 penerbangan
pulang pergi.
Hasil dari studi pendahuluan
dilakukan pengukuran awal dan
wawancara dengan perwakilan
manajemen bagian cargo
didapatkan bahwa belum
tersedianya APD berupa earplug
untuk pekerja sedangkan hasil dari
pengukuran awal di dua titik di area
cargo yaitu sebesar 96,1 dB dan
102,4 dB. Dari hasil pengukuran
awal tersebut tedapat salah satu
pendukung stres yaitu seperti yang
dijelaskan dalam Peraturan Menteri
Tenaga Kerja dan Transmigrasi
No.13 tahun 2011 Tentang Nilai
Ambang Batas Faktor Fisik dan
Faktor kimia di Tempat Kerja
menyebutkan bahwa pekerjaan pada
wilayah dengan paparan kebisingan
85 dB maksimal wajib menggunakan
APD berupa earmuff atau earplug
untuk meredam kebisingan. Pada
314
saat melakukan observasi di bagian
cargo memiliki potensi pekerja
mengalami stres kerja dikrenakan
bagian tersebut berhadapan
langsung dengan Apron juga tidak
memiliki kipas angina dan memiliki
atap yang rendah. Kondisi pada
bagian cargo sangat panas dan
bising sehingga dapat
mengakibatkan stres kerja. Hal ini
menginidikasikan terdapat pekerjaan
mengalami stressor yang kuat dalam
lingkungan pekerjaan yang
menyebabkan pekerja mengalami
stres.
Selain itu terdapat faktor
pendukung lainnya bagi pekerja
untuk menalami stres kerja yaitu
tingkat kebisingan pada lingkungan
kerja mencapai 90-105 dB dalam
sehari bekerja selama 8jam,
sedangkan paparan kebisingan yang
diperbolehkan dalam sehari selama
8jam bekerja ialah sekitar 85dB.4
Karena aktiftas dan intensitas yang
mengharuskan mereka untuk
terkena paparan bising dari suara
mesin pesawat dan suhu panas
yang ekstrim setiap harinya. Maka,
jika hal ini terjadi terus-menerus dan
tidak ada pengendalian,
dikhawatirkan dapat menyebabkan
stres kerja yang berdampak pada
produktivitas menurun.
METODE
Jenis penelitian ini dilakukan dengan
menggunakan penelitian mix
methods, yaitu dengan metode
kuantitatif dan kualitatif. 28 Kedua
pendekatan ini akan saling
melengkapi, dengan tujuan utama
untuk mengungkap factor stress
kerja dengan mendeskripsikan
kenyataan secara benar, dibentuk
oleh kata – kata berdasarkan teknik
pengumpulan dan analisis data yang
relevan serta diperoleh dari situasi
alamiah.
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Tujuan dari penelitian ini adalah Tabel2. Distribusi Frekuensi Umur

untuk mendeskripsikan faktor – Pada Pekerja Bagian Cargo PT.
faktor yang mempengaruhi stress Angkasa Pura Logistik Ahmad Yani
kerja dan pengendalian stress kerja. Semarang Tahun 2017
Populasi dalam penelitian ini adalah Status Gizi n (%)
mendeskripsikan faktor – faktor yang Dewasa Awal (< 30
mempengaruhi stress kerja dan 21 56,8
Tahun)
pengendalian stress kerja yang Dewasa Awal (< 30
berjumlah 40 orang. Sampel dalam 16 43,2
Tahun)
penelitian ini menggunakan total Total 37 100,0
sampling. Data dikumpulkan Umur pada pekerja bagian Cargo
menggunakan angket untuk PT. Angkasa Pura Logistik yang
mengetahui jumlah pekerja yang kurang dari 30 tahun sejumlah 21
tidak mengalami stress kerja dan pekerja dengan presentase 56,9%
mengalami stress kerja. Selanjutnya atau lebih banyak jika dibandingkan
dilakukan penelitian kualitatif berupa dengan yang berusia lebih dari 30
wawancara mendalam dengan tahun.
jumlah sampel yang tidak dapat Tabel 3. Distribusi Frekuensi Masa
ditentukan sampai menghasilkan Kerja Pada Pekerja Bagian Cargo
jawaban yang diinginkan peneliti PT. Angkasa Pura Logistik Ahmad
(sampel jenuh) Umur, Masa Kerja, Yani Semarang Tahun 2017
Status perkawinan, TuntutanTugas, MotivasiKerja n (%)
Tuntutan dari Luar Pekerjaan, Peran Masa Kerja Lama (> 2,5 20 54,1
Individu dalam Organisasi, Tahun)
Hubungan dalam Pekerjaan Analisis Masa KerjaBaru (< 2,5 17 45,9
data yang digunakan yaitu berupa Tahun)
analisis univariat dan uji validitas Total 37 100,0
dalam penelitian kualitatif dilakukan Sebanyak 20 pekerja (54,1%)
dengan teknik triangulasi.. merupakan pekerja terminal kargo
yang bekerja dalam masa kerja lama
yaitu lebih dari 2,5 tahun hal ini
HASIL dapat disimpulkan berdasarkan table
A. AnalisisUnivariat 3.
Tabel1. Distribusi Frekuensi Stres
Kerja Pada Pekerja Bagian Cargo PEMBAHASAN
PT. Angkasa Pura Logistik Ahmad 1. Umur
Yani Semarang Tahun 2017 Semakin tua umur pegawai
Stres n (%) maka kecenderungan untuk
Stres Berat 20 54,1 mempersepsikan stressor kerja
Stres Ringan 17 45,9 semakin besar sehingga
Total 37 100,0 terdapat kemungkinan karyawan
Tabel 1.menyatakan bahwa paling yang lebih muda kurang dapat
tinggi responden memiliki tingkatan mengatasi stress kerja secara
stress berat sebanyak 20 orang efektif dibandingkan yang
dengan perbandingan lebih dari berusia lebih tua
setengah jumlah pekerja. 2. TuntutanTugas
Berdasarkan penelitian yang
telah dilakukan, didapatkan
bahwa mengeluhkan tugas

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beban kerjanya yang paling stress kerja pada pekerja

beratyaitu pada shift pagi hari. Terminal kargo yang mengalami
3. Pengembangan Karir stress kerja. Hal ini dapat dilihat
Pekerja yang mengalami stres dari sebagian besar informan
kerja umumnya pekerja yang yang mengalami stress kerja
sudah bekerja lebih dari 3 tahun merupakan karir yang tidak
akan tetapi belum pernah dapat naik Selain itu pada
mendapatkan kenaikan gaji informan juga mengatakan tidak
sekalipun didukung oleh pimpinan untuk
4. Tuntutan dari Luar Pekerjaan naik jabatan
Gaji yang tidak sesuai dengan 6. Tuntutan dari luar pekerjaan
UMR membuat para pekerja merupakan faktor yang bukan
mencari pekerjaan tambahan, menyebabkan stress kerja bagi
5. Pengendalian Stres Kerja para pekerja Terminal kargo.
Mengendalikan beban kerja Hal ini dikarenakan menurut
dengan cara istirahat yang informan jika terjadi konflik
cukup, menggerakkan badan keluarga maka saat sedang
jika lelah, berolahraga dan bekerja dengan sendirinya akan
minum vitamin. lupa dikarenakan pekerjaan
yang sangat banyak.
KESIMPULAN
1. Sebagian pekerja bagian Cargo DAFTAR PUSTAKA
PT. Angkasa Pura Logistik 1. Tarwaka. Ergonomi Industri
(45,9%) alami stress ringan, Dasar-Dasar Pengetahuan
(54,1%) mengalami stress berat Ergonomi dan Aplikasi di Tempat
dan (0%) tidak mengalami Kerja. Surakarta. Harapan Press;
stress kerja. 2011.
2. Sebagian besar umur pekerja 2. Hanafiah, M Jusuf dan Amri
bagian Cargo PT. Angkasa Amir. Etika Kedokteran dan
Pura Logistik 56,6% lebih Hukum Kesehatan Edisi 4.
banyak usia dewasa awal Jakarta: Penerbit Buku
3. Sebanyak 54,1% pekerja Kedokteran EGC; 2009.
terminal cargo yang bekerja 3. Wardana W. Dampak
dalam masa kerjs lama Pencemaran Lingkungan.
daripada masa kerja baru Yogyakarta: Penerbit Andi;
sebanyak 45,9% 1999.
4. Peran individu dalam organisasi 4. Chaeran M. Kajian Kebisingan
bukan merupakan faktor yang Akibat Aktifitas di Bandara (studi
menyebabkan stress kerja pada kasus Bandara Ahmad Yani
pekerja di bagian kargo. Selain Semarang). Universitas
itu dari segi hubungan dengan Diponegoro; 2008.
pimpinan perusahaan, keadaan 5. S benyamin Sihar Tigor.
lingkungan organisasi, Kebisingan di Tempat Kerja.
kesanggupan menyelesaikan Malang: UPT Penerbitan UMM;
tugas, informasi and hal-hal 2008.
yang dengan pekerjaan sudah 6. Cartwright, S., Cooper, Cooper,
cukup baik menurut para C.L., and Murphy, L.R.
informan. Diagnosing a Healthy
5. Pengembangan karir OrganisationA Protective
merupakan factor penyebab Approach to Stress in the

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Volume 5, Nomor 5, Oktober 2017 (ISSN: 2356-3346)
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Workplace. Wasington:
American Psychological
Assosiation; 1995.
7. Kemenakertrans RI. Peraturan
Menteri Tenaga Kerjadan
Transmigrasi No
Per.01/MEN/X/2011 tahun 2011
Tentang Nilai Ambang Batas
Faktor Fisika dan Faktor Kimia di
Tempat Kerja. 2011; 1-6.
8. Tulus Winarsunu. Psikologi
Keselamatan Kerja. Malang:
UPT Penerbitan UMM; 2008.
9. Anora P. Psikologis Kerja.
Jakarta: PT. Rineka Cipta; 2006.
10. Pada Karyawan Pelayanan
Teknik (YANTEK) PT. PLN
(Pesero) Rayon Madiun Kota.
Fakultas Kesehatan Masyarakat,
UniversitasDiponegoro; 2015.
11. Waluyo M. Psikologi Teknik
Industri. Surabaya: GrahaIlmu;
2013.
12. E R. Analisis Potensi Stres Kerja
pada Karyawan di Bagian
Pendaftaran Rumah Sakit Ken
Saras Semarang. Skripsi.
Fakultas Kesehatan Masyarakat
Universitas Diponegoro. 2013.
13. Ferlia DA. Analisis Tingkat Stres
Kerja Pada Guru Tuna Grahita
Di Sekolah Dasar Luar Biasa
(SDLB) Negeri Purwosari Kudus.
Skripsi. Fakultas Kesehatan
Masyarakat Universitas
Diponegoro. 2016.
14. Kemenakertarans RI. Peraturan
Menteri Tenaga Kerjadan
Transmigrasi Nomor
Per.01/MEN/1981 Tentang
Kewajiban Melapor Penyakit
Akibat Kerja. 1981.
15. Schmitz N, Kruse J TW.
"Psychometric Properties of the
General Health Questionnaire
(GHQ-12) in Germany Primary
Care."ActaPsychtiar Scand.
1999

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Ilmu Kesehatan Masyarakat.
Ilmu Kesehatan 2020; 2020;
Masyarakat. 9 (1): 48-52
9 (1): 48-52

Jurnal Ilmu Kesehatan Masyarakat

(The Public Health Science Journal)

Journal Homepage: http://journals.stikim.ac.id/index.php/jikm

Pengaruh Stres Kerja dan Perilaku Kepemimpinan terhadap

Kepuasan Kerja Perawat

Abdul Aziz
Program Studi S1 Kesehatan Masyarakat, Sekolah Tinggi Ilmu Kesehatan Indonesia Maju
Jl. Harapan No.50 Lenteng Agung, Jakarta Selatan, Telp 021-78894045
Email: Az.mandiri@yahoo.com

Abstrak
Penelitian ini dilatar belakangi oleh adanya fenomena yang sering terjadi dalam era globalisasi dan mengakibatkan
adanya perubahan dengan tuntutan tertentu pada tenaga kerja. Penelitian ini secara khusus menguji tiga variabel
elemen-elemen kepuasan kerja yang terdiri stress kerja, perilaku kepemimpinan dan kepuasan kerja. Tujuan dari
penelitian ini untuk mengetahui pengaruh stres kerja, dan perilaku kepemimpinan terhadap kepuasan kerja. Data
dikumpulkan melalui metode survei terhadap 58 orang perawat yang diperoleh dengan menggunakan teknik
proporsional sampling. Hasil penelitian menggunakan analisis regresi linier berganda menunjukkan bahwa terdapat
hubungan negatif antara stress kerja dengan kepuasan kerja perawat (Pv=0,009; B=-335) dan terdapat hubungan yang
positif antara perilaku kepemimpinan dengan kepuasan kerja perawat (Pv=0,024; B=0,381).
Kata Kunci : Kepuasan kerja, perawat, stress kerja, perilaku kepemimpinan

Abstract
This research is motivated by the phenomena that often occur in the era of globalization and cause changes with certain
demands on the workforce. This study specifically examines three variables of elements of job satisfaction consisting of work
stress, leadership behavior and job satisfaction. The purpose of this study was to determine the effect of work stress and
leadership behavior on job satisfaction. Data were collected through a survey method of 58 nurses obtained using proportional
sampling techniques. The results of the study using multiple linear regression analysis showed that there was a negative
relationship between job stress and nurse job satisfaction (Pv = 0.009; B = -335) and there was a positive relationship
between leadership behavior and nurse job satisfaction (Pv = 0.024; B = 0.381) .
Keywords: Job satisfaction, nurses, work stress, leadership behavior

https://doi.org/10.33221/jikm.v9i01.484
48
Received : 27 Januari 2020 / Revised : 11 Februari 2020 / Accepted : 19 Februari 2020
Copyright @ 2020, Jurnal Ilmu Kesehatan Masyarakat, p-ISSN: 2252-4134, e-ISSN 2354-8185,
 Aziz A / Jurnal Ilmu Kesehatan Masyarakat. 2020; 9 (1): 48-52
Pendahuluan
Setiap karyawan yang bekerja pada
suatu organisasi atau perusahaan tentunya
sangat menginginkan tingkat kepuasan
kerja yang maksimal, namun pada
kenyataannya keinginan karyawan tersebut
belum dapat dirasakan oleh semua
karyawan, hal ini yang dirasakan pada
perawat Rumah Sakit X Jakarta, hal ini
bisa saja perawat yang pindah kerja
ketempat lain karena adanya stres kerja
yang dialami perawat sehingga berdampak
pada menurunkan kepuasan kerja. Hal ini
sesuai dengan pandangan Kreitner &
Kinicki,1 yang menyatakan bahwa stres
memiliki konsekuensi terhadap
psikologis/sikap, perilaku, kognitif, dan
kesehatan fisik seseorang. Sejumlah
penelitian besar memberikan data
pendukung efek-efek negatif dari stres
yang dirasakan pada banyak aspek
kehidupan. Stres di tempat kerja secara
negatif berpengaruh dengan kepuasan
kerja, komitmen organisasional, emosi
positif, kinerja, dan turnover/berhenti
kerja. Pimpinan perawat, belum dapat
sepenuhnya memberikan konstribusi
positif terhadap kepuasan kerja perawat
sehingga berdampak pada produktivitas
kerja yang menjadi tidak maksimal.
Semestinya pimpinan perawat berperan
aktif menciptakan kepuasan kerja yang
maksimal sehingga berdampak pada
peningkatan produktivitas perawat rawat
inap pandangan ini sesuai yang dikemukan
Jason A. Colquitt,2 bahwa perilaku
kepemimpinan berpengaruh langsung
terhadap kepuasan kerja. Artinya jika
pimpinan perawat mengerahkan
kemampuannya dan mengajak bawahannya
untuk mencapai tujuan organisasinya maka
berpengaruh terhadap pada peningkatan
kepuasan kerja pegawai. Sesuai hasil
penelitian Ramdhani, dkk menunjukkan
bahwa kepemimpinan kepala ruang di
Rumah Sakit Jasa berpengaruh positif
terhadap kepuasan kerja perawat.3
penelitian menyatakan bahwa terdapat
hubungan yang bermakna antara
49
kepemimpinan kepala ruang terhadap
kepuasan kerja perawat sebesar 19%.
Kecelakaan kerja seperti tertusuk
jarum suntik, hal ini bisa terjadi
disebabkan oleh adanya stres kerja,
kelelahan, kecemasan, dan hilangnya
konsentrasi kerja yang berdampak
menurunkan kepuasan kerja. Hal ini
sependapat dengan yang dikemukakan
Robbins,4 bahwa salah satu dampak stress
secara psikologis dapat menurunkan
kepuasan kerja karyawan dan dapat
menyebabkan ketidakpuasan yang
berkaitan dengan pekerjaan dan dampak
dari stress terhadap kepuasan. Penelitian
yang relevan seperti penelitian yang
dilakukan peneliti terdahulu seperti
penelitian Hsien membuktikan bahwa,
stres memilki pengaruh yang negatif dan
signifikan dengan kepuasan kerja (Pvalue
=-0,52).5 Hasil penelitian Runtu
menyatakan bahwa stress kerja mempunyai
pengaruh negatif terhadap kepuasan kerja
pada perawat rawat inap Rumah Sakit X
Jakarta Timur.6
Kepuasan kerja pegawai Rumah
Sakit merupakan hal penting dalam
implementasi terhadap tujuan pelayanan
kesehatan di Rumah Sakit. Menurut
Schemerhorn kepuasan kerja adalah
tingkatan sejauh mana seseorang merasa
positif terhadap suatu pekerjaan, yaitu
sebuah sikap yang mereflesikan perasaan
seseorang terhadap pekerjaan, rekan kerja
dan lingkungan kerja.7 Terdapat lima
komponen dari kepuasan kerja tersebut
adalah : (a) Pekerjaan itu sendiri (The work
itself) yaitu : tanggung jawab, minat dan
pertumbuhan. (b) Kualitas supervisi
(Quality of supervision) yaitu : bantuan
teknis dan dukungan social. (c) Hubungan
dengan reken sekerja (Relationship with
coworkers) yaitu : keharmonisan social dan
respek. (d) Kesempatan promosi
(Promotion Opportunities) yaitu:
kesempatan untuk kemajuan lebih lanjut.
(e) Upah (Pay) yaitu: kecukupan dan
keadilan.
Mencermati permasalahan dan
kenyataan yang ada, bahwa pihak
 Aziz A / Jurnal Ilmu Kesehatan Masyarakat. 2020; 9 (1): 48-52
manajemen perlu mengakomodir dan
menindak lanjuti keadaan yang dihadapi
perawat agar mereka merasa nyaman untuk
bekerja. Berdasarkan permasalahan hal
tersebut diatas maka tujuan yang ingin
dicapai dalam penelitian ini adalah untuk
memperoleh gambaran yang nyata serta
menganalisa, tentang pengaruh stres kerja
dan perilaku kepemimpinan terhadap
kepuasan kerja.
Metode Penelitian
Penelitian ini menggunakan teknik
analisis statistik regresi linier berganda.
Variabel yang dimaksud dalam penelitian
ini adalah stres kerja (X1), perilaku
kepemimpinan diberi simbol (X2), dan
kepuasan kerja diberi simbul (Y). Populasi
target dalam penelitian ini adalah seluruh
perawat yang bekerja pada ruang
perawatan rawat inap yang sudah
berkeluarga di lingkungan Rumah Sakit X
Jakarta. Adapun anggota populasi
berjumlah 138 orang perawat rawat inap.
Penelitian ini menggunakan model regresi
linier maka penetapan sampel harus
memenuhi asumsi model tersebut yaitu
menggunakan probability sampling yaitu
teknik pengambilan sampel untuk
memberikan peluang yang sama pada
setiap anggota populasi untuk dipilih
menjadi anggota sampel. Dari hasil
perhitungan sampel didapat jumlah sampel
sebanyak 58 orang perawat Rumah Sakit X
Jakarta. Jenis data dalam penelitian ini
adalah data primer. Sumber data yang
digunakan dalam penelitian ini adalah
tanggapan responden yang diperoleh
Hasil
Tabel 1. Hasil Analisi Regresi Linier
Unstandardized Coefficients
Model R2
B Std. Error
(Constant) .540 113.838
X1-Stres kerja -.261
X2-Perilaku .392
kepemimpinan
Dependent Variable: Y= Kepuasan kerja
50
melalui kuesioner tentang stress kerja,
perilaku kepemimpinan dan kepuasan kerja
perawat yang yang bekerja di perawatan
rawat inap Rumah Sakit X Jakarta.
Metode pengumpulan data dalam
penelitian ini menggunakan kuesioner
yaitu pengumpulan data dengan
memberikan daftar pertanyaan dalam
kuesioner yang kemudian dibagikan
kepada responden Perawat yang bekerja di
perawatan rawat inap Rumah Sakit X
Jakarta. Pengujian validitas instrumen
digunakan korelasi Pearson’s Product
Moment Kriteria valid atau tidaknya butir
instrumen dilakukan dengan cara
membandingkan rhitung dengan rtabel jika
rhitung > rtabel maka butir dinyatakan valid,
dan sebaliknya, jika rhitung < rtabel maka
butir dinyatakan gugur dengan taraf
signifikansi pada alpha = 0,01 dengan dk =
n-1.
Analisis regresi linier berganda
dilakukan untuk menguji hubungan antar
variabel stres kerja dan perilaku
kepemimpinan dengan kepuasan kerja
perawat. Analisis ini dimulai dengan
menseleksi kandidat variabel yang masuk
model dengan melakukan analisis bivariat.
Variabel yang memiliki Pv≤0,025 akan
menjadi kandidat model multivariat. Pada
analisis ini, semua variabel independen
(stres kerja dan perilaku kepemimpinan)
masuk menjadi kandidat. Setelah itu
variabel yang masuk ke dalam kandidat
model multivariat dianalisis secara
bersamaan. Variabel yang valid dalam
model multivariat adalah variabel yang
mempunyai Pv<0,05.
Standardized
Coefficients t Sig
Beta
23.195 4.908 .000
.157 -335 -2.569 .009
.126 .381 2.922 .024
 Aziz A / Jurnal Ilmu Kesehatan Masyarakat. 2020; 9 (1): 48-52
Berdasarkan hasil perhitungan
regresi pada tabel di atas di dapatkan suatu
persamaan garis regresi sebagai berikut : Ŷ
= -0,335 X1 + 0,381 X2 + e. Dari
persamaan regresi linear berganda tersebut
diatas menunjukkan bahwa nilai koefisien
regresi stres kerja sebesar -0,335 bernilai
negatif itu berarti bahwa dengan adanya
peningkat stres kerja maka kepuasan kerja
akan menurun. Nilai koefisien regresi
perilaku kepemimpinan sebesar 0,381
menunjukkan parameter positif sebesar
yang berarti bahwa dengan adanya
peningkatan perilaku kepemimpinan maka
kepuasan kerja akan meningkat.
Sesuai hasil penelitian pada tebl 1
diperoleh nilai t hitung untuk variabel stres
kerja terhadap kepuasan kerja sebesar -
2,569, dengan nilai signifikansi 0,009 <
0,05 pada degree of freedom tabel
diperoleh t tabel sebesar 2 dengan data
tersebut diperoleh nilai thit<ttab (-2,569< -2)
dapat diartikan bahwa terdapat pengaruh
negatif stres kerja terhadap kepuasan kerja
perawat. Berdasarkan pada langkah-
langkah pengujian di atas, maka dapat
disimpulkan bahwa Ha diterima, artinya
bahwa hipotesis yang menyatakan dugaan
adanya pengaruh negatif antara stres kerja
terhadap kepuasan kerja perawat dapat
diterima. Sesuai hasil output program
komputer diperoleh nilai t hitung untuk
variabel perilaku kepemimpinan terhadap
kepuasan kerja sebesar 2,922 dengan nilai
signifikansi 0,024 < 0,05 pada degree of
freedom diperoleh t tab sebesar dengan
data tersebut diperoleh nilai t hit > t tab
(2,922>2) dapat diartikan bahwa terdapat
pengaruh positif antara perilaku
kepemimpinan terhadap kepuasan kerja
perawat. dapat disimpulkan bahwa
pengujian tersebut mampu menerima
hipotesis ke dua, sehingga dugaan adanya
pengaruh perilaku kepemimpinan terhadap
kepuasan kerja perawat terbukti atau dapat
diterima. Berdasarkan pada tabel 1 di atas
diketahui angka R2 sebesar 0,540. Dari
nilai ini dapat disimpulkan bahwa variabel
stress kerja dan perilaku kepemimpinan
menjelaskan keragaman dari dependent
51
variabel kepuasan kerja yaitu sebesar
54,0%. Sedangkan sisanya sebesar 46
(100%- 54,0%) dijelaskan oleh variabel
lain yang tidak dimasukkan dalam model
persamaan.
Pembahasan
Berdasarkan hasil pengujian
hipotesis menunjukkan bahwa stres kerja
berpengaruh langsung negatif terhadap
kepuasan kerja. Dengan demikian telah
teruji melalui penelitian ini bahwa stres
kerja berpengaruh langsung negarif
terhadap kepuasan kerja perawat. Hal ini
menunjukkan bahwa stres kerja karyawan
merupakan kondisi ketegangan yang
mempengaruhi emosi berpikir. Apabila
stress menjadi terlalu besar, dimana akan
mengganggu pelaksanaan pekerjaan
sehingga hal itu akan berdampak pada
menurunnya kepuasan kerja perawat
perawatan rawat inap. Hal ini sejalan
dengan yang dikemukakan Robbins bahwa
salah satu dampak stres secara psikologis
dapat menurunkan kepuasan kerja
karyawan dan dapat menyebabkan
ketidakpuasan yang berkaitan dengan
pekerjaan dan dampak dari stress terhadap
kepuasan.6 Hal ini juga sejalan dengan
yang dikemukakan Kreitner & Kinicki
yang menyatakan bahwa stres memiliki
konsekuensi terhadap psikologis/sikap,
perilaku, kognitif, dan kesehatan fisik.1
Sejumlah penelitian besar memberikan
data pendukung efek-efek negatif dari stres
yang dirasakan pada banyak aspek dari
kehidupan kita. Stres di tempat kerja secara
negatif berpengaruh dengan kepuasan
kerja, komitmen organisasional, emosi
positif, kinerja, dan turnover/berhenti
kerja. Selain itu penelitian ini juga sejalan
dengan hasil penelitian yang dilakukan
Sugeng Purwanto dan Sri Mulyani yang
menyimpulkan bahwa stres kerja
mempunyai pengaruh negatif terhadap
kepuasan kerja.8 Adanya konflik kerja
antara pimpinan maupun dengan rekan
kerja juga akan mempengaruhi tingkat
stres kerja karyawan. Karyawan dengan
beban kerja yang berakibat bertambahnya
 Aziz A / Jurnal Ilmu Kesehatan Masyarakat. 2020; 9 (1): 48-52
jam kerja atau lembur juga akan
mempengaruhi stress kerja karyawan yang
berdampak pada menurunnya kepuasan
kerja karyawan.
Berdasarkan hasil pengujian
hipotesis menunjukkan bahwa perilaku
kepemimpinan berpengaruh langsung dan
positif terhadap kepuasan kerja. Dengan
demikian telah teruji melalui penelitian ini
bahwa perilaku kepemimpinan
berpengaruh langsung dan positif terhadap
kepuasan perawat. Hal ini berarti jika
usaha yang dilakukan pimpinan perawat
akan berpengaruh terhadap meningkatnya
kepuasan kerja. Penjelasan tersebut dapat
diartikan bahwa perilaku kepemimpinan
yang baik akan menciptakan suasana kerja
yang kondusif dimana setiap perawat akan
merasa nyaman dengan kepemimpinan
atasannya, sehingga akan meningkatkan
kepuasan kerja secara optimal. Colquitt
yang mengartikan kepemimpinan adalah
penggunaan kekuasaan dan pengaruh
untuk mengarahkan aktifitas pengikut
terhadap pencapaian tujuan.2 Hal ini
sejalan dengan teori yang dikemukakan
Stephen P. Robbins,4 bahwa kinerja dan
kepuasan karyawan dipengaruhi secara
positif bila pemimpin mengimbangi hal-hal
yang kurang dalam diri karyawan atau
dalam situasi kerja. Hasil temuan peneliti
juga sejalan dengan hasil penelitian
Ramdhani, dkk yang menunjukkan bahwa
kepemimpinan kepala ruang di Rumah
Sakit Jasa berpengaruh positif terhadap
kepuasan kerja perawat.3
Kesimpulan
Berdasarkan hasil penelitian dapat
disimpulkan bahwa terdapat pengaruh
langsung negatif stres kerja terhadap
kepuasan kerja yang berarti bahwa
peningkatan stres kerja dapat berakibat
kepada penurunan kepuasan kerja perawat.
Selain itu terdapat pengaruh langsung
positif perilaku kepemimpinan terhadap
kepuasan kerja yang berarti bahwa
peningkatan pada perilaku kepemimpinan
berpengaruh kepada peningkatan
kepuasan kerja perawat.
52
Daftar Pustaka
1. Kreitner R & Kinicki A.
Organizational Behavior, 7th edition.
New York McGraw-Hill Irwin; 2007.
2. Colquitt & Jason A. Organization
Behavior, Improving Performance and
Commitment in the Workplace. New
York: McGraw Hil Irwin; 2009.
3. Ramdhani, Marchaban dan Sumarni.
Pengaruh Gaya Kepemimpinan Kepala
Ruang Terhadap Kepuasan Kerja
Perawat (Studi Kasus di Rumah Sakit
Jasa Kartini Tasikmalaya). Jurnal
Manajemen dan Pelayanan Farmasi. 1
(4): 216-220; 2011.
4. Robbins SP. Prilaku Kepemimpinan
edisi kesepuluh terjemahan Benyamin
Molan. Jakarta: Gramedia; 2006.
5. Hsien, Wen Ching Sheng. Research
Article Effects of Job Rotation and
Role Stress Among Nurses on Job
Satisfaction and Organizational
Commitment. Taiwan: BioMed
Central Ltd; 2009.
6. Runtu. Iklim Organisasi, Stres kerja
dan kepuasan Kerja Perawat, Jakarta
Fak. Psikologi Univ. Gunadharma;
2002.
7. Schermerhorn. Organizational
Behavior 12th Edition. Inchoboken:
John Wiley & Sons Inc.; 2012.
8. Purwanto S dan Mulyani S. Pengaruh
Stres Kerja dan Afektivitas Negatif
terhadap Pemberdayaan Psikologis,
Kepuasan Kerja, dan Kinerja.
Universitas Wijaya Kusuma Surabaya;
2009.
Kploanyi et al. BMC Public Health (2020) 20:1045
https://doi.org/10.1186/s12889-020-08744-z

RESEARCH ARTICLE Open Access

The effect of occupational stress on

depression and insomnia: a cross-sectional
study among employees in a Ghanaian
telecommunication company
Emma Edinam Kploanyi1, Duah Dwomoh2 and Mawuli Dzodzomenyo1*

Abstract
Background: Depression and insomnia are major psychiatric conditions predicted by occupational stress. However,
the influence of occupational stress on these two conditions is under-explored in telecommunication companies,
especially in Africa. This research was conducted to assess occupational stress in a Ghanaian telecommunication
company and its effect on depression and insomnia.
Methods: An analytical cross-sectional study was conducted among employees at a telecommunication company
in Accra. Structured self-administered questionnaires were used in collecting data from 235 respondents using
simple random sampling. The Chi-square test of independence and Wilcoxon Rank-Sum test were employed to
assess the significance of associations with subsequent sensitivity analysis using Multiple logistic, Poisson and Probit
regression models. Occupational stress was matched on four variables: age of the workers, marital status,
responsibility for dependents and work experience, to improve on the estimation of its impact on symptomatic
depression and insomnia using the coarsened exact matching procedure.
Results: More males (52.8%) than females participated in this study. The age range for study participants was 20–
49 years with a mean of 30.8 ± 6.9 years. The prevalence of excessive occupational stress reported by the employees
was 32.8% (95% CI = 26.7–38.8). More than half of respondents (51%) reported depressive symptoms in the past
week and only a few (6%) reported being diagnosed with insomnia in the past year. Age, responsibility for
dependents and work experience were the only background characteristics that were significantly associated with
excessive occupational stress. After controlling for background characteristics, the estimated risk of reporting
symptoms of depression among employees who reported excessive stress from work was only 5% higher [ARR;
95% CI = 1.05 (0.94–1.17)] whereas it was 2.58 times the risk of reporting insomnia [ARR; 95% CI = 2.58(0.83–8.00)]
compared to those who did not report excessive stress from their jobs. The relative risk reduced to 2.46[ARR; 95%
CI = 2.46(0.77–7.87)] and 1.03[ARR; 95% CI = 1.03(0.91–1.17)] for insomnia and depression respectively after
employing Poisson regression with CEM.
(Continued on next page)

* Correspondence: mdzodzo@hotmail.com
1
Department of Biological, Environmental and Occupational Health Sciences,
School of Public Health, University of Ghana, Accra, Ghana
Full list of author information is available at the end of the article

© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
changes were made. The images or other third party material in this article are included in the article's Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the
data made available in this article, unless otherwise stated in a credit line to the data.
Kploanyi et al. BMC Public Health (2020) 20:1045
(Continued from previous page)
Conclusion: The study found a higher risk of insomnia among employees who reported excessive occupational
stress compared to those who did not. However, this study did not find a statistically significant relationship
between depression and occupational stress.
Keywords: Psychiatric conditions, Psychosocial stressors, Workload, Workplace, Job stress
Background
There are variations in how individuals express vulner-
ability to stress based on modifications in neural mecha-
nisms fashioned to properly tune and terminate stress
responses [1]. Coping strategies adopted toward stress
are also just as much different due to individual charac-
teristics. These characteristics including age, gross
monthly salary, work experience, educational qualifica-
tion, marital status, and gender have been reported as
contributing to differences in the level of occupational
stress [2–4].
Occupational strain resulting from exposure to
stressors at the workplace can affect an employee’s
mental and physical health. Depression, the leading
cause of disability and the main indication of psychi-
atric conditions, as well as insomnia, are major psy-
chological disorders reported to be significantly
associated with occupational stress [5–7]. High levels
of occupational stress do not only predict insomnia
but also its recurrence [8]. Fatigue after work and
high levels of work rumination could mediate this re-
lationship between occupational stress and insomnia
[9]. Moreover, occupational stress has been implicated
in the early onset of insomnia, which is before 30
years of age [10]. In a recent longitudinal study [11],
it was found that sleeping problems mediate the rela-
tionship between stress and metabolic syndrome; in-
somnia caused by occupational stress showed a highly
significant association with the latter.
Workload is known to be a major stressor in the fast-
growing and contemporary service industry globally and
the telecommunication companies (telcos) are no excep-
tions [12]. Moreover, a number of suicides informed by
occupational stress in some telcos [13] indicate its influ-
ence on the psychological wellbeing of employees. Des-
pite this, there is very little information on the extent of
stress workload exerts on the workforce in telcos and
also its psychosocial consequences on their workers in
Africa. This study, therefore, aims to assess occupational
stress in a Ghanaian telco and quantify its possible effect
on two psychiatric conditions, depression and insomnia
among the workers. The findings are intended to serve
as evidence for employers to assess psychosocial hazards
at their workplaces and effectively manage them so as to
protect workforce health with the ultimate goal of im-
proving productivity.
Page 2 of 10
Methods
Selection and description of participants
Ethical approval (GHS-ERC Number: 046/01/18) was
obtained from the Ghana Health Service Ethical Review
Committee of the Research and Development Division,
Accra, before conducting this analytical cross-sectional
study. The study population comprised of employees,
both permanent and contract staff, working at the Head
Office of a Ghanaian telco in Accra. Study participants
were selected by simple random sampling proportionate
to the size of their departments. By this, all employees in
this organization had equal opportunities to be part of
the study and the diversity in their job descriptions were
also catered for.
Data collection tool and technique
Data were collected on the variables of interest using a
structured self-administered questionnaire constructed
in English and adapted from the National Institute for
Occupational Safety and Health (NIOSH) Generic Job
Stress Questionnaire (GJSQ) [14]. This tool has shown
high validity and reliability: (0.65–0.90) [15] and (0.68–
0.95) [16, 17]. The questionnaire was divided into three
sections; the first section gathered data on respondents’
sociodemographic and job characteristics. Occupational
stress was measured using a composite scale under four
domains of workplace psychosocial stressors in section
two: quantitative workload (4 items; 5-point Likert
scale), responsibility for others (4 items; 5-point Likert
scale), role conflict (4 items;7-point Likert scale) and role
ambiguity (5 items; 7-point Likert scale). In section
three, the Center for Epidemiologic Studies Depression
Scale (CES-D) as employed in the GJSQ was used to
measure depression (reported symptoms of depression
for the past 1 week) using a composite scale (14 items;
4-point Likert scale) whereas insomnia (reported clinical
diagnosis of insomnia in the past 1 year) was measured
using a single item with a binary response (1 = Yes, 0 =
No). Also, two items in this section obtained respondent
information on two lifestyle patterns: smoking and alco-
hol intake. Scoring keys provided by NIOSH GJSQ were
used to convert responses into quantitative measure-
ments for analysis. The maximum period of time esti-
mated for filling out a questionnaire was 10 min. Data
collection was carried out for 5 weeks concurrently with
data entry and cleaning.
Kploanyi et al. BMC Public Health (2020) 20:1045
Statistical analysis
Respondents’ data from completed questionnaires were
entered manually into an excel form (Excel version
2016). A coding frame containing the scores correspond-
ing to the responses on the questionnaires served as a
guide for data entry to aid ‘translate’ the survey data into
a workable dataset.
Descriptive (mean, median) and inferential statistics
(hypothesis testing) were obtained from data gathered
using the STATA version 15 software. The various
ranges of scores for composite variables were as follows:
workload and responsibility for others (0–16); role ambi-
guity (0–30); role conflict (0–24); overall occupational
stress (0–86); depression (0–42) and work productivity
(0–60). Higher scores implied higher reported occupa-
tional stress and depression respectively. Total scores for
each composite variable were converted into percentages
before categorizing them. Overall occupational stress
and the stress from the four psychosocial stressors were
first categorized into a five-level ordinal scale: normal
(0–33); mild (33.1–43); moderate (43.1–60); severe
(60.1–79) and very severe (≥ 80) according to the De-
pression, Anxiety and Stress Scale (DASS) [18]. Overall
occupational stress was re-categorized into two levels:
low stress and excessive stress using the median as a
cut-off. Depression was also re-categorized into two
levels: no depression (normal:0–15) and depressed (mild:
15.1–33; moderate:33.1–52; major:52.1–70; and severe
depression:≥ 70.1) based on initial categorization
adopted from a previous paper [19]. The Skewness/Kur-
tosis test for normality was conducted to assess the dis-
tributions of each composite variable before
categorization. The Chi-square test of independence and
Kruskal Wallis test were employed to assess the signifi-
cance of associations with subsequent sensitivity analysis
using Multiple logistic, Poisson and Probit regression
models. To estimate sample average treatment effect
(occupational stress) on the treated (respondents who
reported excessive occupational stress), this study
employed Coarsened Exact Matching (CEM) to improve
on the estimation of the causal effect of occupational
stress on depression and insomnia by reducing the im-
balance in covariates between treated and control (re-
spondents who did not report excessive occupational
stress) groups. The advantages of using CEM instead of
other matching procedures have been well documented
[20–22]. The L1 statistic that measures overall covariate
imbalance between workers with excessive stress and
those with low stress before and after matching were es-
timated. The results from the Chi-square test of inde-
pendence showed an only statistically significant
relationship between occupational stress and age of the
workers, responsibility for dependents as well as work
experience hence the CEM procedure was restricted to
Page 3 of 10
these three variables and marital status which had a p-
value close to the cut-off for statistical significance.
However, to improve the precision of our impact esti-
mate and to adjust for the remaining imbalance with
other covariates, a Poisson regression model with a ro-
bust standard error was used to adjust for these other
covariates.
Results
A total of 235 respondents provided complete data in
their self-administered questionnaires (96% response
rate) and their demographic characteristics are presented
in Table 1. The mean age for the sample was 30.84 ± 6.9
years with 53.6% of respondents within the age range of
20–29 years. More males (52.8%) than females partici-
pated in this study just as there were more singles
(61.3%) than married. Respondents who reported having
at least one dependent at home (40.9%) were fewer than
those who had no dependents. For job characteristics,
more respondents (59.6%) were permanent employees
and 51.9% worked overtime (more than 40 h per week)
for an average of 5.24 ± 7.1 h per week. Employees who
had worked for a maximum of 5 years were 86.8%.
All four psychosocial stressors: workload (97.9%), re-
sponsibility for others (50.6%), role ambiguity (34.5%)
and role conflict (17.0%) were reported by respondents.
The prevalence of excessive occupational stress at this
telco was 32.8% (95% CI = 26.7–38.8). The distribution
of excessive occupational stress by background charac-
teristics among respondents is displayed in Table 1.
Most employees who reported excessive stress from
their jobs were in the 20–29 years category (64.9%) and
more males (58.4%) than females also reported the same.
Occupational stress was higher among singles (70.1%),
respondents without dependents (70.1%), and respon-
dents on permanent employment (52.0%). Fifty percent
of respondents who reported excessive occupational
stress had worked for at least 1 year in their current role.
The Chi-square test of independence revealed that occu-
pational stress was only significantly associated with age,
responsibility for dependents at home and work
experience.
More than three-quarters (84%; 95%CI = 78.51–88.03)
of the respondents reported depression in the past week.
Only 6% (95% CI = 3.24–9.37) of respondents reported
being diagnosed with insomnia in the past 1 year. Table 2
shows that employment status, age, marital status and
responsibility for dependents were the background char-
acteristics significantly associated with depression
whereas only marital status and responsibility for depen-
dents were significantly associated with insomnia. Occu-
pational stress was also significantly associated with
insomnia but not depression. After controlling for the
effect of other variables, sex predicted the highest risk of
Kploanyi et al. BMC Public Health (2020) 20:1045 Page 4 of 10

Table 1 Distribution of occupational stress by background characteristics

Characteristics Occupational stress levels n (%) χ2 value, p Total n (%)
Low Stress (158) Excessive Stress (77)
Age groups 7.26, 0.027
20–29 years 76 (48.10) 50 (64.94) 126 (53.62)
30–39 years 53 (33.54) 21 (27.27) 74 (31.49)
40–49 years 29 (18.35) 6 (7.79) 35 (14.89)
Mean age ± SD 30.84 ± 6.9
Sex 1.48, 0.224
Males 79 (50.00) 45 (58.44) 124 (52.77)
Females 79 (50.00) 32 (41.56) 111 (47.23)
Marital status 3.78, 0.052
Married 68 (43.04) 23 (29.87) 144 (61.28)
Single 90 (56.96) 54 (70.13) 91 (38.72)
Dependents 5.72, 0.017
No 85 (53.8) 54 (70.13) 139 (59.15)
Yes 73 (46.2) 23 (29.87) 96 (40.85)
Employment 2.77, 0.096
Permanent 100 (63.29) 40 (51.95) 140 (59.57)
Contract 58 (36.71) 37 (48.05) 95 (40.43)
Job ranking 3.42, 0.064
Other 129 (81.65) 70 (90.91) 199 (84.68)
Superior 29 (18.35) 7 (9.09) 36 (15.32)
Hours per week 0.68, 0.408
Regular (40 h per week) 73 (46.2) 40 (51.95) 113 (48.09)
Overtime 85 (53.8) 37 (48.05) 122 (51.91)
Mean hours overtime±SD 5.24 ± 7.1
a
Work experience: median (LQ, UQ) 2 (0.75,4.5) 1 (0.67,2) 0.0013 1.17 (0.75,4)
SD Standard Deviation; a The duration of service (years) in the current role; LQ Lower Quartile, UQ Upper Quartile; p values in bold are statistically significant

depression. Table 3 displays the effect of CEM on the
relative risk (RR) predicted by each variable. There was a
20% [ARR; 95% CI = 1.20 (1.06–1.36)] increased risk of
reporting depression among females compared to males
after conducting Poisson regression with CEM. How-
ever, of all variables, occupational stress was the least
predictor of depression. The estimated risk of reporting
depression among employees who reported being ex-
posed to excessive stress from work was 5% [ARR; 95%
CI = 1.05 (0.94–1.17)] after adjusting for other back-
ground characteristics. Moreover, this risk reduced to
3% [ARR; 95% CI = 1.03(0.91–1.17)] after Poisson regres-
sion with CEM. All background characteristics in excep-
tion of occupational stress and job ranking predicted
higher RR for depression after conducting this proced-
ure. Generally, the odds ratios (ORs) were far higher
than the RRs.
The RRs from ordinary Poisson regression analysis
were lower compared to ORs for insomnia predicted by
most of the variables. Nonetheless, the two measures of
association were similar for job ranking, type of employ-
ment, work experience, smoking status and responsibil-
ity for dependents. After conducting Poisson regression
with CEM analysis, similar to what was observed for de-
pression, the RR predicted by occupational stress and
employment type reduced whereas it increased for all
other variables. Controlling for background characteris-
tics, employees who reported excessive occupational
stress had 2.58 times the risk of reporting insomnia
[ARR; 95% CI = 2.58 (0.83–8.00)] compared to those
who reported low stress from their jobs and this risk re-
duced to 2.46 [ARR; 95% CI = 2.46 (0.77–7.87)] after
employing Poisson regression with CEM. Alcohol intake
posed the highest risk of reporting insomnia compared
to other background characteristics whereas employ-
ment posed the least risk (Table 4).
Discussion
The results of the study have revealed that almost a
third (32.8%) of employees at this telco were excessively
Kploanyi et al. BMC Public Health (2020) 20:1045 Page 5 of 10

Table 2 Bivariate analysis of factors associated with depression and insomnia using the Chi-square test of independence
Characteristics Depression n(%) χ2, p Insomnia n (%) χ2, p
No (38) Yes (197) No (221) Yes (13)
Overall occupational stress 0.86, 0.355 5.11, 0.024
Low 28 (73.68) 130 (65.99) 152 (68.78) 5 (38.46)
Excessive 10 (26.32) 67 (34.01) 69 (31.22) 8 (61.54)
Age groups 9.71, 0.008 0.064*
20–29 years 13 (34.21) 113 (57.36) 29 (25,36)* 26 (25,27)*
30–39 years 20 (52.63) 54 (27.41)
40–49 years 5 (13.16) 30 (15.23)
Sex 3.08, 0.079 0.23, 0.634
Males 25 (65.79) 99 (50.25) 117 (52.94) 6 (46.15)
Females 13 (34.21) 98 (49.75) 104 (47.06) 7 (53.85)
Marital status 11.4, 0.001 8.60, 0.003
Married 24 (63.16) 67 (34.01) 90 (40.72) 0
Single 14 (36.84) 130 (65.99) 131 (59.28) 13 (100)
Dependents 3.90, 0.048 6.18, 0.013
No 17 (44.74) 122 (61.93) 127 (57.47) 12 (92.31)
Yes 21 (55.26) 75 (38.07) 94 (42.53) 1 (7.69)
Employment 7.06, 0.008 0.03, 0.872
Permanent 30 (78.95) 110 (55.84) 131 (59.28) 8 (61.54)
Contract 8 (21.05) 87 (44.16) 90 (40.72) 5 (38.46)
Job ranking 0.01, 0.930 0.63, 0.429
Other 32 (84.21) 167 (84.77) 186 (84.16) 12 (92.31)
Superior 6 (15.79) 30 (15.23) 35 (15.84) 1 (7.69)
Hours per week 0.65, 0.420 1.61, 0.204
Regular 16 (42.11) 97 (49.24) 108 (48.87) 4 (30.77)
Overtime 22 (57.89) 100 (50.76) 113 (51.13) 9 (69.23)
Work experience: median (LQ, UQ) 2 (1,4) 1.2 (0.67,3.5) 0.120 1.3 (0.75,4.0) 1 (0.67,1.25) 0.100
Alcohol intake 1.79, 0.181 2.50, 0.114
No 34 (91.89) 164 (83.25) 189 (85.52) 9 (69.23)
Yes 3 (8.11) 33 (16.75) 32 (14.48) 4 (30.77)
Smoking status 2.80, 0.094 0.07, 0.789
No 37 (100) 183 (92.89) 208 (94.12) 12 (92.31)
Yes 0 14 (7.11) 13 (5.88) 1 (7.69)
* The Kruskal Wallis test was conducted to assess if insomnia significantly differed between age groups; p values in bold are statistically significant

stressed from work and more than three-quarters re-
ported depression in the past week, whereas only a few
reported being diagnosed with insomnia in the past year.
Age, having dependents at home and work experience
were the only respondent characteristics that were sig-
nificantly associated with exposure to occupational
stress. This study also found that occupational stress
was only a predictor for reported insomnia but not de-
pression among respondents. There was a higher risk of
insomnia among those exposed to excessive stress from
work compared to those who reported lower exposure.
In Africa, a similar prevalence (28.2%) has been recorded
among university staff in Ethiopia [23], and higher
among Tanzanians (46.5%) [24]. In Asia, prevalence
rates varied from 65.8% among Indian call centre
workers [25] to 21.7% among university staff in Malaysia
[26]. Physicians (51.4%) and nurses (51.2%) who worked
in the Intensive Care Unit and anaesthesiology unit at
hospitals in Poland [27] were also reported to have
work-related stress. However, there is insufficient evi-
dence of the prevalence of occupational stress among
telco employees in Africa.
Kploanyi et al. BMC Public Health (2020) 20:1045 Page 6 of 10

Table 3 Estimating the impact of occupational stress on depression: Modified Poisson regression with CEM
Variables Depression
Poisson Sensitivity Analysis
regression
Ordinary Poisson regression analysis Logistic regression analysis Probit regression analysis
with CEM
RR [95% CI] RR [95% CI] OR [95% CI] β [95% CI]
Occupational stress
Low Ref Ref Ref Ref
Excessive 1.03 [0.91–1.17] 1.05 [0.94–1.17] 1.43 [0.61–3.39] 0.23[− 0.25–0.71]
Age groups
a
18–29 years Ref Ref Ref
30–49 years 0.95 [0.81–1.12] 0.83 [0.27–2.52] − 0.07[− 0.69–0.55]
Sex
Males Ref Ref Ref Ref
Females 1.20 [1.06–1.36] 1.11 [0.99–1.24] 2.11 [0.96–4.67] 0.42 [0.02–0.86]
Marital status
a
Married Ref Ref Ref
Single 1.28 [1.03–1.59]* 4.04 [1.22–13.33]* 0.78 [0.10–1.46]*
Dependents
a
No Ref Ref Ref
Yes 1.10 [0.91–1.34] 1.61 [0.53–4.92] 0.27[−0.36–0.91]
Employment
Permanent Ref Ref Ref Ref
Contract 1.14 [1.01–1.29] 1.11 [0.99–1.26] 2.43 [0.88–6.65] 0.50[− 0.04–1.05]
Job ranking
Other Ref Ref Ref Ref
Superior 1.08 [0.94–1.23] 1.13 [0.95–1.34] 1.99 [0.68–5.82] 0.39[− 0.21–0.99]
Hours per week
Regular Ref Ref Ref Ref
Overtime 1.06 [0.94–1.21] 0.96 [0.86–1.07] 0.74 [0.34–1.60] −0.12[− 0.54–0.31]
a
Work experience 1.02 [1.00–1.04] 1.13 [0.96–1.33] 0.07[−0.02–0.16]
Alcohol intake
No Ref Ref Ref Ref
Yes 1.13 [0.97–1.33] 1.11 [0.98–1.25] 2.23 [0.59–8.37] 0.7[−0.24–1.17]
P-value notation: ***p < 0.001; **p < 0.01, *p < 0.05
a
: these variables were excluded from the model due to CEM

In the current study, workload was the most reported
of the four psychosocial stressors assessed whereas role
conflict was the least source of stress. This finding is
consistent with the observations of other researchers
[12, 28] who also reported workload as a major stressor
in telcos and the hotel industry respectively. Occupa-
tional stress was significantly associated with age, having
dependents at home and work experience of the em-
ployee. Younger employees may have spent a shorter
length of time in their roles and may yet be acquiring
the needed skills for effective delivery at work as com-
pared to their older counterparts and therefore may be
more stressed [29]. Similar reasoning is drawn from
Sharma and Devi’s [2] finding that a longer duration
spent in a job role was inversely related to the job stress
reported. Also, employees with dependents may have
more stringent allocations for time due to their extra re-
sponsibilities at home. Consequently, they may function
more effectively under stress compared to those without
dependents [30].
Among the respondents of this study, excessive occu-
pational stress was not found to be significantly associ-
ated with depression. Tsai, Chi, and Wang [30] reported
a similar finding from a longitudinal study conducted on
a sample of the older working population in Taiwan.
They indicated that their study population comprised of
Kploanyi et al. BMC Public Health (2020) 20:1045 Page 7 of 10

Table 4 Estimating the impact of occupational stress on Insomnia: Modified Poisson regression with CEM
Variables Insomnia
Poisson Sensitivity Analysis
regression with
Ordinary Poisson regression analysis Logistic regression analysis Probit regression analysis
CEM
RR [95% CI] RR [95% CI] OR [95% CI] β [95% CI]
Occupational stress
Low Ref Ref Ref Ref
Excessive 2.46 [0.77–7.87] 2.58 [0.83–8.00] 3.00 [0.88–10.28] 0.52[− 0.10–1.14]
Age groups
a
18–29 years Ref Ref Ref
30–49 years 0.61 [0.06–5.90] 0.57 [0.08–3.84] −0.28[−1.18–0.61]
Sex
Males Ref Ref Ref Ref
Females 2.05 [0.64–6.62]** 1.58 [0.53–4.76] 1.72 [0.47–6.30] 0.31[−0.35–0.96]
Dependents
a
No Ref Ref Ref
Yes 0.25 [0.02–3.45] 0.22 [0.02–2.21] −0.77[−1.81–0.28]
Employment
Permanent Ref Ref Ref Ref
Contract 0.70 [0.19–2.49]* 0.36 [0.11–1.18] 0.30 [0.08–1.16] −0.59[−1.27–0.10]
Job ranking
Other Ref Ref Ref Ref
Superior 0.53 [0.08–3.44] 0.57 [0.07–4.66] 0.52 [0.05–5.15] −0.39[−1.55–0.77]
Hours per week
Regular Ref Ref Ref Ref
Overtime 2.29 [0.70–7.52] 2.07 [0.65–6.62] 2.32 [0.62–8.73] 0.43[−0.23–1.09]
Work experience a
0.72 [0.51–1.02] 0.69 [0.39–1.24] −0.17[− 0.47–0.13]
Alcohol intake
No Ref Ref Ref Ref
Yes 3.15 [0.78–12.73] 1.77 [0.41–7.74] 1.95 [0.44–8.69] 0.38[−0.37–1.13
Smoking status
No Ref Ref Ref Ref
Yes 0.27 [0.03–2.91] 0.54 [0.04–6.63] 0.49 [0.05–5.41] −0.27[−1.40–0.86]
P-value notation: ***p < 0.001; **p < 0.01, *p < 0.05
a
: these variables were excluded from the model due to CEM

employees nearing retirement (≥50 years) who were
more likely to be experiencing diminishing job stress as
earlier posited [31]. However, they attributed the highest
impact on depression to perceived-health stress which
was not assessed by this study. Other findings based on
cross-sectional [32, 33] and longitudinal data [34] re-
ported, contrary to this study, a strong positive associ-
ation between work-related stress and depression.
Yoshizawa et al. [32] specifically indicated social support,
job control, and quantitative workload as psychosocial
stressors significantly influencing depression among
some psychiatric nurses in Japan. Oenning et al. [33]
and Romswinkel et al. [34] assessed job stress in general
and among community-dwelling workers as opposed to
employees from a specific industry which is the case for
this current study. In a lower-middle-income country
like Egypt, a positive correlation between work stress
and depression was also reported [35]. Similar to this
study, these researchers assessed both depression and
occupational stress using self-reports except for Oenning
et al. [33] who used a diagnostic tool to measure depres-
sive disorder. The robust risk estimation from this study
may account for the lack of association between occupa-
tional stress and depression. However, the effect of re-
sidual confounding on this association from risk factors
like income level, educational level, life events,
Kploanyi et al. BMC Public Health (2020) 20:1045
personality traits, earlier psychiatric morbidity and fam-
ily history [36] which were not measured and controlled
for in this study cannot be overlooked. Moreover, other
stress parameters not measured in the current study
such as effort, reward, overcommitment and support
were found to influence the level of depression among
workers exposed to high levels of occupational stress
whereas the workload (demand) was less important than
the other variables [37].
Occupational stress has been reported to facilitate the
development of sleep problems [7]. Elger and Sekera
[38] indicated that stressful events predicted insomnia,
the most prevalent sleep disorder [39]. Also, a recent
systematic review involving fifteen (15) countries found
a direct relationship between occupational exposure to
violence as a stress factor and sleep problems [40]. The
current study identified occupational stress as an im-
portant risk factor of insomnia. Almost all employees re-
ported quantitative workload as a stressor. The
aftermath of this exposure to stress could have been
after-work fatigue which influences the experience of in-
somnia. Also, high levels of work rumination may ad-
vance worry [9]. The daily psychological strain as a
consequence of worrying about workload could have
contributed to this occupational stress-related insomnia
observed in this study. This is informative to employers
especially in telcos of the possible effect of workload
strain on workers’ psychological health. It has been
proven that reducing weekly work hours of employees
by a quarter could significantly reduce workload and in-
crease the time they spend on recovery activities on
weekdays [41], improve sleep quality [42] and conse-
quently reduce occupational stress [43]. Our study indi-
cated a higher risk of insomnia among those who
worked overtime compared to those who worked regular
hours. Hence, employers in Ghanaian telcos could curb
occupational stress and its increased risk of insomnia by
putting measures in place to ensure employees spend
minimal time working beyond regular hours.
Implications for future research
There is a paucity in literature regarding the impact of
occupational stress on depression and insomnia in tel-
cos, especially in Africa. To this end, this study provides
preliminary findings that can form the basis for further
work, probably longitudinal studies, to document a clear
linkage between occupation-related stress and depres-
sion as well as insomnia. This will help report on their
peculiar experiences of strain and the two psychiatric
conditions. Generally, the odds ratios were far higher
than the risk ratios estimated from the Poisson regres-
sion with CEM in this study, suggesting an overesti-
mation of the strength of prediction by the variables if
only odds ratios were used. This analytical method could
Page 8 of 10
be adopted in cross-sectional studies to increase the
weight of evidence produced on the predictive power of
variables and make them comparable to estimates from
longitudinal studies.
Study limitations
The findings from this study were mainly based on self-
reported measures which are highly subjective. Also, the
study categorized stress by dividing the population into
two parts using the median as cut-off which is a limita-
tion. Moreover, the evidence from this study as is the
case for other cross-sectional studies needs supplemen-
tation from longitudinal studies. The use of findings
from this observational study to estimate relative risk
should be interpreted with caution as it may be associ-
ated with reverse causality bias although a rigorous stat-
istical procedure was used.
Conclusion
About a third of employees at the telco studied reported
excessive occupational stress whereas depression was re-
ported by over three-quarters of them. Only a few re-
ported being diagnosed with insomnia in the past year.
Occupational stress increases the risk of insomnia. How-
ever, this study did not find a statistically significant re-
lationship between depression and occupational stress.
Findings from this study are informative to employers in
the Ghanaian telecommunication sector to conduct rou-
tine assessments of the mental health of their employees
and explore psychosocial hazards reported by them. This
will contribute to effective interventions, including en-
suring employees spend minimal time working beyond
regular hours, to protect their health holistically.
Abbreviations
CEM: Coarsened Exact Matching; CES-D: Center for Epidemiologic Studies
Depression Scale; DASS: Depression Anxiety Stress Scales; GJSQ: Generic Job
Stress Questionnaire; LMICs: Low-Middle Income Countries; NIOSH: National
Institute for Occupational Safety and Health; Telcos: Telecommunication
Companies; OR: Odds Ratio; RR: Relative Risk; ARR: Adjusted Relative Risk
Acknowledgments
We are grateful to Cynthia and Loretta for assisting with the data collection
for this study.
Authors’ contributions
EEK developed the research concept and design, collected data, conducted
data analysis, and interpretation as well as preparation of the manuscript. DD
contributed to the study design, data analysis, interpretation of results and
reviewed manuscript. MD contributed to the development of the research
concept and design, interpretation of results and reviewed manuscript. All
authors read and approved the final draft for submission.
Funding
None.
Availability of data and materials
The datasets used and analyzed during this study are available from the
corresponding author on reasonable request.
Kploanyi et al. BMC Public Health (2020) 20:1045
Ethics approval and consent to participate
This study was approved by the Ghana Health Service Ethical Review
Committee of the Research and Development Division, Accra (046/01/18). All
respondents provided written informed consent. No experimental
interventions were performed.
Consent for publication
Not applicable.
Competing interests
The authors declare that they have no competing interests.
Author details
1
Department of Biological, Environmental and Occupational Health Sciences,
School of Public Health, University of Ghana, Accra, Ghana. 2Department of
Biostatistics, School of Public Health, University of Ghana, Accra, Ghana.
Received: 20 September 2019 Accepted: 21 April 2020
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