An assessment of stress coping for mental health promotion among Information Technology employees in Japan

Primary health care for mental health in workers should apply to actualities of workers’ stress coping and stress response. We conducted an assessment by cross-sectional study concerning stress coping, job stress, and stress response among IT employees in Japan. Subjects were 75 healthy new employees (males). We used the 54-item Maslach Burnout InventoryGeneral Survey (MBI-GS, domains: exhaustion, cynicism, professional effi cacy), the Job Content Questionnaire (JCQ, domains: demand, control, social support), the General Coping Questionnaire (GCQ, domains: emotion expression, emotional support seeking, cognitive reinterpretation, problem solving). All subjects attained high scores for job demand. High scores for the coping domains emotional expression was associated with high scores for the burnout domain cynicism (p=0.019). High scores for the coping domains cognitive reinterpretation associated with low scores for the burnout domain cynicism (p=0.002). The result suggested that high expressing emotion which is not usual their coping associated to low concern and passion for work. Furthermore, cognitive reinterpretation against stress factors associated to passion for work. Research Article An assessment of stress coping for mental health promotion among Information Technology employees in Japan Makie Nagai1*, Yuko Morikawa2, Yuko Hamazaki3 and Hideaki Nakagawa2 1Professor of Tsuruga Nursing University, Faculty of Nursing Science, Psychiatric and Mental Health Nursing, Japan 2Kanazawa Medical University, Japan 3Bukkyo Univercity, Japan Received: 02 April, 2019 Accepted: 19 April, 2019 Published: 20 April, 2019 *Corresponding author: Makie Nagai, Professor of Tsuruga Nursing University, Faculty of Nursing Science, Psychiatric and Mental Health Nursing, 7821 Kizaki, Tsuruga-city, Fukui, Japan, Tel: +81 770 20 5500; E-mail:


Introduction
According to a Japanese Ministry of Health report, 42.5% of companies which employed young workers in the last year lost these workers for personal reasons. Information technology companies in particular employ many young workers. These companies are especially interested in mental health promotion.
Job stress has been shown to be related to worker resignation in the IT industry in Japan [1]. Job stress has also been associated with decline in mental health in Japan [2,3].
Additionally, the main job stress of 20-29 years-old employees has reported job demand [4].
The Global Burden of Disease in 1990 [5], reported that psychiatric disease is major risk of DALY (disability-adjusted life years) as well as heart disease and cancer. Psychiatric disease is related to stress response that is need effective measures for mental health promotion.
Mental Health Promotion should apply to actualities of workers' stress circumstances. It is necessary to assess coping strategies and their effects on the stress responses of individual workers. The purpose of this study is to assessment by crosssectional study concerning stress coping, job stress, and stress response among IT employees in Japan.

Design and sample
A cross-sectional study was conducted concerning stress coping, job stress, and stress response (burnout). Subjects were new employees of information technology companies in Japan.
Surveys were conducted 10 months from the start of their employment. After one survey was excluded for incomplete data,

Measures
The questionnaire was structured using 3 scales, and the total number of items was 54.

Job Content Questionnaire Japanese Version (JCQ-J, [6])
This scale measures job stress [7]. JCQ-J is validated for all users in Japan. This scale measures 3 elements: demand (quantity and quality), control (decision latitude), and social support (supervisor support and coworker support).
Kawakami [6], demonstrated the equivalence of American and Japanese responses for this tool. Demand (12-48 point) is considered high above 31 points. Control (24-96 point) is considered high above 66 points. Higher scores in social support are considered advantageous.
Exhaustion (0.0-6.0 points) is considered high above 4.0 points. Cynicism is defi ned as an attitude marked by loss of job enthusiasm and is considered high above 2.6 points.
Professional effi cacy is considered low below 1.5 points. Criteria for defi ning burnout in Japan include high levels of exhaustion and either high levels of cynicism or low levels of professional effi cacy [10].

General coping questionnaire [11]
There are two types of stress coping scales: one which was developed based on general characteristics (i.e. coping situations. Problem solving is coping by actively solving the problem. These criteria were reported for Japanese college students [11]. This serves as an appropriate comparison group with the present study's participants.

Analytic strategy
Total scores of each element of JCQ-J were calculated to compare to previous study [12]. Kawakami administered the same questionnaire to 603 men (average age 27.9 years, SD=5.4) at Japanese IT companies.
This entailed JCQ-J and MBI-GS scores compared between the two groups divided by GCQ score median. These data were only applicable in males due to effect modifi cation of sex in stress coping [11]. In all analysis, the level of signifi cance was set at p≤0.05 (two sided). Statistical analyses were conducted using SPSS version 16.0 (SPSS Inc., Chicago, IL, USA).

Ethical standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. Ethical approval was obtained from Epidemiology Research Ethics of Kanazawa Medical University (No.68, 2010).

Results
Seventy-six questionnaires were collected (100%). One was excluded for missing data. Seventy-fi ve were subject to analysis.

Subject attributes
There were 75 male employees. The average age was 22.1 years (SD=0.46). Occupations included manufacturing, systems management, system engineer, development, etc.

New employees' occupational stress
Occupational stress mean and standard deviation (SD) are shown in table 1. New employees had a mean of 33.3 (SD=5.2) for work demand score, which is a subscale of occupational stress. It was higher than previous study [12]. The other scores (control, supervisor support and coworker support) were also higher than previous study.
No employee satisfi ed burnout criteria based on stress response.

Stress levels of employees by high and low coping groups
Next, we analyzed stress by stratifying into two groups at the median for each coping subscale score. Table 2 shows occupational stress and burnout scores stratifi ed by performance on the high empathy, cognitive reinterpretation, and problem solving coping subscales.
In those scoring low in coping: emotional expression (11 points or less), the median burnout: cynicism score was 1.2 (quartile 0.6 -2.2). The median score was 1.7 (quartile 0.9 - In the group performing highly in coping: cognitive reinterpretation (15 points or higher), cynicism median score was 0.9 (quartile 0.6 -1.3). For those with low scores in cognitive reinterpretation (14 or less), median was 1.8 (quartile 1.1 -2.6) (p=0.002). There were no signifi cant differences in other factors.
There was no signifi cant difference in occupational stress and burnout scores when stratifying high and low groups for coping: emotional support.

Difference job stress scores between present study subjects and previous study subjects
Regarding occupational stress, this result was somewhat higher than the previous study [12], on all subscales: degree of work demand, work control (technology and decisionmaking), supervisor support, and colleague support. It may be the differences of work environment between two generations. The present workers' average age (22.1 years, SD=0.5) was lower than the subjects' average age attributes Kawakami (males 27.9 years, SD=5.4; females 25.8 years, SD=3.4;1996). The present new employees receive psychological support from superiors and colleagues. Nevertheless, the psychological burden of work is high.
Takesaki et al. report that subjective symptoms such as depressive feelings increase over time based on a follow-up survey of employees 5 years after joining IT companies. Mental health promotion is important from an early stage.

Difference of burnout scores between two groups of their emotional expression
In groups that cope by expressing emotion, there was a tendency decline to interest in work. Takaya et al. report that high emotional expression associated to low stress response.
Additionally, it has been pointed out negatively that Japanese young people working in the IT industry have the tendency to avoid communication with others [13]. Nevertheless, this result showed that high expressing emotion which is not usual their coping associated to low concern and passion for work.
It seemed that high expressing emotion means shame and non-assertiveness communication for Japanese employees in their cognition. Assertiveness communication is a chance to gain mutual understanding, moreover it may connect to interest in work. Assertiveness training may be useful to increase interest in work for the newly-recruited employees.

Difference of burnout scores between two groups of their cognitive reinterpretation
In the group using cognitive reinterpretation against stress factors, there was a tendency to retain concern and passion for work. Suzuki [14], evaluated cognition against stress factors from the perspective of how much stress infl uences individuals, whether or not it is a threat, and whether it can be controlled. By sober evaluation of cognition, by thinking about controllable aspects, it is possible to remove oneself from a problem and to interpret that problem positively, in order to fi nd hope in stressful job demand. Incorporating such reconstructive cognitive reinterpretation into mental health promotion is considered to be important in career development.
The result suggested that some measures for mental health promotion in the IT industry. It is assertiveness training for appropriate expression of emotion and reconstructive cognitive reinterpretation based on cognitive behavioral therapy.
Recently, effect of brief training program based on cognitive behavioral therapy in workplace are showed [15,16]. We need to study to effect of intervention of assertiveness training and adapting cognitive restructuring for mental health promotion for new employees in the IT industry in Japan. The main weakness our study was the small size of participant. Although we suggested that some measures for mental health promotion based on assessment of coping strategies and their effects on the stress responses of individual workers [17][18][19].