Is the Global Occupational Stress Equally Addressed? A Systematic Literature Review on Effective Stress Interventions

This systematic review was conducted to provide an overview of effective interventions targeting stress at the workplace. The literature search was performed in the database ISI Web of Knowledge and Embase between January 2005 and July 2012. Study characteristics, types of interventions and outcome measures, work settings, the effectiveness of the interventions, and the quality of the studies were extracted, evaluated, and synthesized. A total of 114 studies reported 192 interventions and were identified for analyses. The overwhelming majority of these studies was conducted in high-income countries or regions. These interventions were categorized into seven types: training or learning interventions, social-support interventions, occupational interventions, organizational-structural interventions, physiological interventions, psychological interventions, and interventions combining physiological and psychological aspects. Results showed that training and learning interventions, social-support interventions and interventions combining physiological and psychological aspects were mainly conducted in both the public and the private sectors, while occupational interventions were specifically performed in the public sector. The effectiveness of stress interventions was especially investigated in health, education, and public-administration agencies in the public sector and in manufacturing enterprises in the private sector. Of the 114 studies, 36 studies rated as excellent or good quality reported 66 significantly or partly-significantly effective interventions. Training and learning interventions and social-support interventions were frequently used in both the public and the private sectors, while interventions combining physiological and psychological aspects were mainly applied in the public sector. Furthermore, specific stress interventions extracted from included studies were associated with work settings: Group meetings were most frequently applied in the administrative and health agencies, while fitness exercise was most commonly applied in financial and insurance companies. Our review revealed the great diversity in stress interventions at the workplace, which reflects the difficulties in conducting effective stress interventions there. Further studies that identify the factors that have the most impact on presenteeism are required. This review can serve as a guide for effective interventions targeting stress and the improvement of stress interventions at the workplace.