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Perceived Occupational Stressors and the Health Software Professionals in Bengaluru, India

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Abstract

There is limited research on occupational stress and its relation to health from developing countries such as India. This study was done to evaluate work conditions of professionals in two highly productive sectors: the information technology (IT) sector, also known as software development, and Information Technology Enabled Services (ITES), also known as call centers. The study employed thirty-two in-depth interviews. The results indicate the presence of nine stress domains: job control, autonomy, time pressure, length of experience in industry, night shifts, income, appreciation of work, physical environment, work-environment and affective or emotional factors. Global drivers of demand, and local supply of a skilled workforce and the work force regulatory environment in India determine the work culture in Indian IT companies. Apart from affecting health of the professionals, these determinants influence workforce policies, priorities, goals and management practices.
The Qualitative Report 2015 Volume 20, Number 3, Article 9, 314-335
http://www.nova.edu/ssss/QR/QR20/3/babu9.pdf
Perceived Occupational Stressors and the Health Software
Professionals in Bengaluru, India
Giridhara R. Babu
Public Health Foundation of India IIPH-H Banglalore Campus, Bangalore, India
Sathyanarayana T. N.
Public Health Foundation of India IIPH-H Banglalore Campus, Bangalore, India
Asha Ketharam
National Institute of Occupational Health ICMR, Bangalore, India
Snehendu B. Kar and Roger Detels
University of California, Los Angeles, California, USA
There is limited research on occupational stress and its relation to health from
developing countries such as India. This study was done to evaluate work
conditions of professionals in two highly productive sectors: the information
technology (IT) sector, also known as software development, and Information
Technology Enabled Services (ITES), also known as call centers. The study
employed thirty-two in-depth interviews. The results indicate the presence of
nine stress domains: job control, autonomy, time pressure, length of
experience in industry, night shifts, income, appreciation of work, physical
environment, work-environment and affective or emotional factors. Global
drivers of demand, and local supply of a skilled workforce and the work force
regulatory environment in India determine the work culture in Indian IT
companies. Apart from affecting health of the professionals, these
determinants influence workforce policies, priorities, goals and management
practices. Keywords: Work Culture, Job Stress, Information Technology (IT),
Information Technology Enabled Services (ITES), Qualitative Research
Information Technology (IT) is a broad discipline, which uses computer technology in
managing and processing information, especially in large organizations. In particular, IT
deals with the use of computers and computer software to convert, store, protect, process,
transmit, and retrieve information (Rohith et al., 2005). Information technology enabled
services is a form of outsourced service, which has emerged due to involvement of IT in
various fields such as banking and finance, telecommunications, insurance, and others. Some
of the examples of ITES are medical transcription, back-office accounting, insurance claims,
credit card processing, and others.
Several factors at the workplace have been found to elicit negative somatic and
emotional reactions, including poor balance between occupational load and the competencies,
resources, and/or necessities of the worker (U.S. National Institute for Occupational Safety
and Health, 1999). These imbalances in individual traits and working environment determine
the presence and levels of occupational stressors among workers (Kirmeyer & Diamond,
1985; Koeske et al., 1993; Latack, 1986; Latack & Havlovic, 1992; Schuler, 1982). Hitherto,
several models and constructs have attempted to explain the interrelation between job stress
and ill health. These are the theory of allostatic load on illness by Caplan (Caplan, Cobb,
French, Van Harrison, & Pinneau, 1980), Hockey’s construct of "resources," or total burden
upon the human operator as an integrative model (1997), the “Effort-Distress Model” of
315 The Qualitative Report 2015
Folkow (1997), Job Content paradigms (JCQ; Hans et al., 1997; Karasek et al., 1998),
Demand-Control constructs (DCQ; Theorell et al., 1998), the Work Organization Matrix
(WOM) for imputing job title averages of job characteristics to study subjects (Alfredsson et
al., 1985; Hammar et al., 1998; Johnson et al., 1996; Johnson & Stewart, 1993) and the
effort-reward imbalance (ERI) model of work stress (Siegrist et al., 1990).
Based on the literature review, it is well documented that job-stress influences health
in several ways (Alfredsson et al., 1985; Babu et al., 2013; Caplan et. al., 1980; Folkow,
1997; Hales et al., 1994; Hammar et al., 1998; Hockey, 1997; Johnson et al., 1996; Johnson
& Stewart, 1993; Karasek et al., 1998; Siegrist et al., 1990; Theorell et al., 1998). These
studies and the relevant theoretical models were employed in occupations involving
workforce’s mostly in-developed countries. However, there is scarce evidence available from
such theoretical models originating from research in developing countries in any occupational
workforce. Moreover, there is hardly any evidence available from the contextual nature of job
stressors in the IT/ITES industries. It is important to understand locally applicable, culturally
relevant and contextually specific work related stressors in low and middle-income countries
(LMICs) such as India. Furthermore, there is a need to explore the relevant stressors at the
workplace in India and to consider the appropriateness of including them in interventions.
Thus, we conducted a qualitative study to explore the presence of contextual work stressors
and health-related factors in IT/ITES professionals.
Role of Researchers
The first author (GRB) was involved in the conception and design of this study,
supervision of the interviews, data extraction, data tabulation, data analysis, maintenance of
all the drafts, interpretation of data, drafting the article and revising it critically for important
intellectual content and final approval of the version to be published. The interviews were
conducted by the primary author of this article and a research assistant under the supervision
of primary author. The research assistant was paid from the research grant and had no
contribution towards working on this paper. The second author (STN) was involved in the
conceptualization and development of framework, reviewing the article and revising it
critically for important intellectual content and final approval of the version to be published.
The third author (AK) was involved in the conduct of FGDs, revising the manuscript
critically for important intellectual content and final approval of the version to be published.
The fourth author (SBK) was involved in revising the manuscript critically for important
intellectual content and final approval of the version to be published. Roger Detels (RD) was
consulted when there were divergent opinions, and also participated in revising the content
each time for critical and important intellectual content and final approval of the version to be
published. RD provided the overall supervision for the conduct of this qualitative research.
Methods
Study Site and Participants
From July 2010 to March 2011, a qualitative study was conducted among IT/ITES
professionals in Bengaluru, which included individual in-depth interviews and focus groups
discussions (FGD). The source population for the study was comprised of IT/ITES
professionals aged 20-59 years old working in “technical functions” in the IT/ITES sector.
Technical functions are characterized by involvement in human-computer interfaces within
the IT and ITES industries. The inclusion criteria for participants in the study were: aged
between 20-59 years, should have worked for at least 1 year in either IT or ITES industry and
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 316
should fit the designation of “Technical worker” according to the Revised Indian National
Classification of Occupations (Ministry of Communications and Information Technology,
2007-2008).
We conducted 32 in-depth interviews with IT/ITES workers, recruited with the
assistance of supervisors and Human Resources (HR) Managers in IT and ITES
organizations. Participants were recruited from workers holding different job titles, team
leaders, and administrative staff of informal groups. Recruitment of volunteers was done
through personal communication as well as with the help of HR managers.
Ethical Considerations
The study was reviewed and approved by the UCLA Institutional Review Board
(IRB, # G09-12-002-01, IRB#10-001348) and the ethics committee of The Public Health
Foundation of India. (TRC-IEC 40/10) At the outset, the interviewers emphasized the
confidentiality and importance of the responses. Potential participants were informed that the
study was designed to understand their work environment and how it affects them, and that
this information was not available anywhere else. We administered “informed consent”, and
specifically requested permission to record the interview. Informed consent was obtained
from all participants before conducting focus group discussions and in-depth interviews. All
the interviews were conducted at a convenient time for professionals in a private room
arranged by the investigators.
Data Collection
The objective of the qualitative interview was to explore information on socio-
demographic factors, individual experience as IT/ITES professionals, quality of work
environment, individual’s experience with stress, individual’s working and non-working
environments, awareness about health and hypertension and perceptions and knowledge on
"risks to health.” The interview guide listed the questions, which were to be used to ensure
that the same basic lines of inquiry were pursued with each person interviewed.
The FGDs comprised of people with minimum of five to a maximum of eight
members in each group. Two FGDs were conducted comprising of ITES sector while four
were of IT professionals. The interview guide for FGDs included a limited number of
questions, encouraging active discussion and contribution from the professionals. The
questions were neutral and open-ended in nature. The FGDs started with general questions,
which everyone responded followed by discussion on specific issues. The moderator
encouraged everyone to participate in the discussion by stimulating discussion between
participants and guiding the group from one discussion topic to another. The FGDs were
done in neutral venues.
The in-depth interviews started with greeting the participant and introducing the
research staff and research objectives. The interview guide explored information on socio-
demographic factors, individual experience as IT/ITES professional, quality of work
environment, individual’s experience with stress, individual’s working and non-working
environments, awareness about health and hypertension and perceptions, knowledge on "risks
to health.” The interview guide listed the questions or issues to be explored in the interview
and was used to ensure that the same basic lines of inquiry were pursued with each person
interviewed.
For both types of data collection, the interviews were semi-structured, open-ended
and were conducted using an interview guide. The interviews were conducted in a flexible
manner by allowing as much time as required by the participants to seek insights into each
317 The Qualitative Report 2015
domain of the interview guide covering all the questions in the protocol systematically. All
interviews were conducted in English. The whole conversation was audio-recorded. The
interviewers also took notes on the contents of the interview, focusing on key phrases and
main points made by the respondent. The interviews started with greeting the participant and
introducing the research staff and research objectives. The open-ended and anonymous nature
of the questions and the research setting enabled the participants to freely describe their
experiences without any pressure as the privacy and confidentiality were not only assured but
were acknowledged from the participants.
Data Analysis
The digital voice records were transcribed and transcriptions were checked for
mistakes to improve by the interviewer. The transcripts were read and re-read several times to
discover and label variables as categories. The analysis of the data transcripts done using
coding procedure and constant comparative approach adopted based on grounded theory. The
method has been chosen, as it is bottom up and inductive approach for analyzing qualitative
data. The process of coding began with application of series of codes to each transcript, later
the codes have been grouped into concepts of similar one for easy comparability.
We used the codes as short words or phrases that explained a descriptive sentence,
which had been obtained in an interview, or part of the field memo or notes. Further, from
these concepts, major themes have been generated through an iterative process and used for
description of the results. By coding the different expressions of the individual subjects, we
organized and sorted the data to develop the framework by integrating the different themes
that are patterned by way of sorting. For example, we had the preset code of how time might
be an important factor and thereby refined the code of time pressure through the notes
collected in the fieldwork. In addition time management emerged as the critical factor in the
routine functioning as part of the ongoing interviews. Once the interviews were completed,
we starts going through the transcripts, grouping the various contents with the help of the
“time”, “deadlines”, “pressures faced” as a series of codes and organized the data. The codes
were refined including the cutting and pasting of the various quotes and utilizing the
expressions according to the transcripts. Hence, we used the codes around deadlines and
pressures created by time, which eventually led to sorting out complexities of information
around several aspects and resulted in emergence of theme of “time pressure.”
The data collected were entered into an excel sheet and a set of codes were developed
to classify the words by categories by using specific software tools deDoose (Dedoose, 2011)
and ATLAS ti. (Muhr, 1998). After summarizing all the data, the shared information and
opinions of the respondents that emerged from various cross sections of the people were
summarized to make the conclusions. Following a series of revisions, the conceptual
framework for understanding the factors influencing stressors in IT/ITES professionals was
finalized. (See Figure 1)
Quality Control
In order to reduce researcher bias, the study did not capture identifiable information of
the participants such as name, email id, phone number or even name of company. The
participants were randomly invited and were self-selected and hence there is bias in selecting
the participants. Also, the lead researcher and research assistant administered the data
collection instruments. Open-ended questions were asked in keeping with the qualitative
framework. Specific attention was paid not to influence or provide any pointers as possible
answers to questions of researchers. The initial data collected were transcribed, given unique
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 318
codes and coded. The lead researcher and research assistant crosschecked the coded data. The
discrepancies in coding have been discussed by researcher and research assistant. Any major
issues were resolved by contacting the research supervisor (RD) through electronic
communication.
Figure 1. Conceptual Framework: Job stressors in IT/ITES sectors, health outcomes and
evidence feedback loop to address issues at different levels
The credibility and rigor were established by the details as follows. We captured
prolonged and varied field experiences of the IT professionals using a field journal, which
was designed for the purpose. The triangulation of the qualitative data was done as the
information regarding stressors and health perspectives was captured by several sources
including from most recent employees to experienced workers of several different positions.
Further, we followed the peer examination criteria to hasten credibility. Sharing the draft and
discussion by the researcher was done with independent and senior colleagues at UCLA, who
have rich experience with qualitative methods.
Results
The results have been organized as follows: Demographic profile of the participants
has been explained in the first section followed by themes. Under theme one, the role of
stressful domains, findings have been presented such as time pressure, length of experience in
industry, shift work, job control, income, autonomy, appreciation of work, physical factors
Biological/genetic constitution of
person, Behavioral pattern of person,
Beliefs of person
Companies: Interplaying factors of
productivity, accomplishments and losses
Work force policies, regulatory
environment, Company Priorities and
Company Perceptions
Demand-supply of skilled
workforce
Reduced costs and efficiency of
companies
Extraneous factors
Level of stressors and buffer
factors
Work environment of
IT /ITES Professionals
Priorities and goals of
companies
Global or macro level factors
influencing IT/ITES industries
Contexts
Stress domains
Time Pressure
Length of work experience
Shift work
Job control
Income related factors
Autonomy
Appreciation of work
Lifestyle factors
Emotional factors (Affect)
Family support
Physical and psychological illness
Hypertension
Musculoskeletal symptoms
Quality of Life
Psychological illness
Knowledge, awareness and attitudes
regarding health
Stressor and buffer loop
319 The Qualitative Report 2015
and affect. Under theme two, the roles of buffer domains, findings have been presented such
as work environment, family. Theme three displays findings related to lifestyle factors.
Theme four presents the results related knowledge and awareness about health. Finally,
theme five portrays the findings related to work culture and its determinants.
Demographic Information
A total of 32 subjects were interviewed. (Table 1) The majority of the sample (50%)
was 26-30 years of age, followed by 22% in 19-25 year age group. Around 60% of the
sample was single, half were females, around half had professional or higher education and
another 38% had a general degree. Employees from ITES comprised around 60% of the
sample and the remaining 40% were IT employees. Around half the people in the sample had
worked for at least two years in the settings (but less than seven years) while one fourth
respectively were junior or senior to them in number of years of experience.
Theme One: Role of Stressful Domains
As IT/ITES professionals, respondents had to spend most of their time either in the
office or attending work related calls or preparation at home in order to complete the stressful
work schedule. There were several stress domains that were described by the professionals.
Nine important domains emerged as common stressful factors across IT/ITES professionals.
The stress was perceived in a different manner based on the number of years spent in the
same type of work. Hence, experience in industry was an important factor. Professionals in
the ITES sector had to spend the maximum number of working hours in shiftwork. This was
stressful as night shifts disturbed diurnal rhythm and affected other activities. Other stressful
domains identified were poor job control, income related stress, autonomy, appreciation of
work, physical environment, work-environment and affect (emotional factors). The list of
stressful domains is presented in table 2.
Time pressure. The quantity of work IT/ITES professionals perform necessitates
lengthier stretches of time in focused work in front of computers. From the results of
qualitative studies, we found that there are several factors that are concerned with working
time of IT/ITES professionals. We term them as “Time Pressure” and they include: duration
of work on a daily basis, number of days worked per week, stress due to time taken to travel
to office, whether they continue to work at home beyond office hours and whether one takes
sufficient number of breaks during work. Nearly two thirds of the sample (64%) worked for
more than eight hours a day on average and a nearly equal proportion (66%) worked for more
than 40 hours per week. More than half (53%) worked on weekends.
During the interview, one of the responded mentioned that
“Somehow” is the key word in IT. Product timeline is fixed. Then everything
is based on “somehow” to get it done. If you ask for the moon, the managers
will just take it. If 31st July is the deadline given, we have to get it by 31st July.
In US, where I worked, the timelines were realistic. In India, it is not the same.
- (32 years, IT professional, male, single)
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 320
Table 1. Descriptive statistics of qualitative sample of IT/ITES professionals, Bengaluru,
2011-12
Age Group (in years)
Number
Percentage
19 to 25
7
21.88
26 to 30
16
50.00
31 to 35
6
18.75
36 to 55
3
9.38
Total
32
100.00
Marital Status
Married
13
40.63
Single
19
59.38
Total
32
100.00
Children
No
23
71.88
Yes
9
28.13
Total
32
100.00
Education
Pre-Degree
1
3.13
General Degree
12
37.50
Professional Degree
4
12.50
4) Post Graduate
11
34.38
Not mentioned
4
12.50
Total
32
100.00
Sector
BPO
19
59.38
IT
13
40.63
Grand Total
32
100.00
Total
Total Work Experience
1) 0.0 - 2.0 Years
7
21.88
2) 2.1 - 7.0 Years
17
53.13
3) 7.1 - 12.0 Years
7
21.88
4) 13.1 - 28.0 Years
1
3.13
Total
32
100.00
Smoking
No
6
18.75
No Idea
3
9.38
Yes
23
71.88
Total
32
100.00
The unreasonable work pressure is indicative of constant stress factor mounting on IT
professionals. The word ‘somehow’ can be construed to depict the plight of the professionals,
even beyond normal working hours. Based on the experiences and explanations of the study
participants, it reflects that work related issues constantly haunt them beyond the working
hours. This cumulative stress for an extended period of time may lead to health related
consequences. Few respondents also mentioned that some IT projects demands to work
several hours at home during weekends as well. These imply that there are very minimal
breaks from the work they do irrespective of place they work such as office or home.
Deadlines or any work come with lot of intensity and most of the times the professionals have
to complete the job quickly and therefore are under lot of pressure. This is also complicated
by stiff competition and as a result, Time is a big driving factor determining the work life of
the professionals in this sector.
321 The Qualitative Report 2015
Length of experience in industry. The duration of time spent in the working position
and capacity for work influences whether one is stressed or not. We found that title of
working designation, number of years in the current occupation and the total number of years
at work play an important role in the way IT/ITES professionals feel and respond to stress.
Life before 4 years it was excellent. It is not so good now. It (the work) is
indirectly affecting your social life also. Initially I used to socialize but now
we don’t get some time to do this…, I don’t know whether I would look like
an old lady if the same thing continues.
- (25 years, female IT professional, single)
The above expression clearly implies the fact that the individual’s social life has been
affected. The individual expressed loss of social life is a consequence of the work demands.
The central expression here is that while she can manage this for now, she cannot carry it for
long time. There is a clear anticipation that the length of service is going to make things
worse with respect to social life and ageing.
Shift work. Professionals mainly in ITES sector and to a much less extent in IT sector
will have to perform shift work as part of their routine work. Our interviews found that there
are several factors in shift work that influence one being stressed or not. They are whether
there is shift work required as part of the work or not, number of night shifts one has to do
and whether they get free days off as a result of shift work. In our study sample, nearly half
(50%) of the sample wanted that free day as compensatory off be given after the night shifts.
16% of the professionals didn’t like working in night shifts.
Because of the job, I am not able to do things what I want to do. My routine
life is totally different because of the night shift. I don’t find life so interesting
as it was when earlier.
- (23 years analyst in ITES Company, female, single)
The expressions imply a feeling of being enslaved by the job, frustration build up and
dissatisfaction in life. Night shifts change the circadian rhythm of the professionals and
results in fewer interactions with friends, family and miss on important aspects of social life.
Job control. Our study found that there are particular issues identified by
respondents, where job control had played an important role. Working from home is not
generally allowed in Indian companies and workers feel that lack of permission for this
causes a lot of other stressors such as traffic, not being able to balance between work and
family etc. Correspondingly, workers who could decide whether they can work from home
were found to be very happy and lack the stress caused due to several other factors.
Correspondingly, executing work under strict deadlines, enforcing scrupulous speed of work,
lack of clear instructions for accomplishing specific task/s and the repetitive nature of work
caused professional to think that they do not have the control on the job. Nearly 10% workers
inferred that they were being pushed against unrealistic expectations (11%) while an equal
proportion complained of the monotonous work (11%).
There was a new assignment, I was worried. Manager said, “It’s like
swimming. Take them, throw them into water. They will learn it eventually.
- (29 years old, IT professional, male)
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 322
Table 2. Description of themes of stress domains, qualitative study of IT/ITES professionals,
Bengaluru
Theme of stress
domains
Explanation
Length of
experience in
industry
The job title of professionals would reflect the amount of stress each person would have to
bear with.
Position and experience in the industry would determine the amount of time each one has to
contribute per day towards work.
Total number of years worked in current occupation determines how professionals perceive
stress and how they cope with it
Time pressure
The total number of hours worked per day would determine how much time is left for
individuals to spare for exercises, time to family and recreation activities.
The number of working days per week should ideally be five. More often than not, this
exceeds beyond 5 and takes time from weekends too.
Many professionals feel stressful to travel to office and travel back due to traffic congestion,
bad roads or poor vehicle
Answering calls while at home regarding work and/or working from Home even after
working at work-place determines amount of extra stress people will have to bear without
any time for relaxation
Taking breaks during workday are important for transient relief of work pressure, to be able
to discuss problems with friends/colleagues and rebound back.
Even when people take breaks, it will be stressful if professionals are under constant
pressure to return to work or complete some assignment. The duration of breaks will be an
important determinant of relaxation.
Night shifts
Working in night shifts has emerged as one of the key stressors for professionals working in
ITES sector. Very few IT professionals were working in night shifts.
For some workers, the schedule of night shifts was fixed extending for a fortnight to entire
month while few others had rotating night shifts. Both kinds of night shifts affect the stress
status of individuals.
Even when night shifts had to be done, the frequency of night shifts was the most important
determinant
It is very important to catch up with sleep and rest after night shifts. Hence number of free
days after working in night shifts is an important factor.
Job Control
Workers regarded that they lack the control of speed at which they work. Managers
determined speed without consul
ting workers. Unrealistic expectations was common
problem amongst workers
Permission to work from home was given only in few sites. Such permissions were not given
due to lack of trust on employees.
Pushing workers for strict deadlines for completing a given job or task was another problem
found in IT/ ITES sector.
A flexible job allows people to take time off from work when wanted. Strict control by
supervisors and managers puts pressure on workers.
Receiving clear instructions or information regarding work is an important aspect. However,
on assigning a new task many professionals are not even asked whether they are able to
perform the work
Income
When pay was decided based upon how much an individual works was found to be least
stressful while pay dependent on how much group works and hence was result of collective
effort caused stress to better performing individuals.
The emerged theme suggests least stress when salary can cover substantially more than basic
needs and those of my family. At the other end of spectrum was high stress due to inability
of salary to cover basic needs of self and family.
Availability of options upgrading job title and advancing the career emerged as an important
factor about genesis of stress.
Autonomy
Whenever people were in charge of deciding their own work schedule, they were least
stressful and felt happy about it. However, a constant theme that emerged was lack of such
autonomy being the cause of stress at work.
Job stress depended on the person/s evaluating one’s work. Good managers were able to
positively reinforce the workers while some managers induced as cascade of stress within
323 The Qualitative Report 2015
As part of their curriculum in graduate courses, the IT/ITES professionals can only be
trained in few disciplines and would have gained experience in only one or few domains.
However, the management on the other hand would push them to work in unfamiliar
domains. The expression implies a feeling of not knowing the demand of the new assignment,
feeling inferior about the competency required for the new task and there is a clear expression
of how it causes undue stress.
Income. Many of the interviewed professionals felt that income is a very important
factor in sticking onto the current job and it is this that has given them an edge over other
professions. Hence the lack of adequate salary operated as a worry for any given job. The
adequacy of pay, the extent to which professionals can afford luxuries and necessities and
presence of positive prospects were important factors affecting the stress status of
individuals.
We are here because Money; it is liked the mostly for economic security.
- (36 years, 11 years in IT, married and a daughter of 8 years)
The professionals hired by the software companies are paid well compared to most of
the other available jobs for the graduates. Hence, this quote explains that the preference for
IT sector might be because of the higher salaries in the sector. This also means the
professionals are ignoring negative consequences of the work involved in the IT sector.
Autonomy. Our results indicate that autonomy serves as an important factor in
determining the stress propensity of professionals. In particular, the freedom to decide on
schedules of work on their own, which was absent for most of the workers interviewed, is an
important factor for job-stress. In addition, the way individuals endure evaluations,
appraisals within their company and how they are supervised turn out to be important factors.
I can take my own decision and individuality by managing things. All other
things got transformed. If I am not able to do this, then I am not the capable
guy to do this and that is not the exact fact. Overall, continuously monitoring
and no proper system of mentoring of whatever you do is the main drawback.
- (36 years, 11 years in IT, male, married)
the system.
The feeling of being constantly monitored due to visits by managers, emails, video
monitoring and phone calls made workers stressful.
Appreciation of
work
Not being appreciated for good work done emerged as constant problem at workplace while
the presence of which showed positive atmosphere.
Giving the credit for work by supervisors/managers was regarded as a virtue and was
infrequent at worksite.
Physical
environment
Having special seating arrangements, ventilation and lighting was regarded as an important
factor for carrying out work.
Work-
environment
Functioning of systems of handling several issues at work place are important factors. Some
of them are system of identifying dilemmas at work and obtaining help from colleagues or
supervisors. Also, in the presence of an established system for resolution of conflicts at
workplace, people would easily resolve them. In the absence of this, there will be more
stress. Transparency of working procedures and absence of discrimination are other
important factors.
Affect or
Emotional
factors
Abuse of power or violations of norms of behavior at work, blaming for someone else’s
mistakes at workplace, bearing abusive communication at work place were important
determinants of emotional responses in IT/ITES professionals.
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 324
Too much supervision threatens one’s freedom to work and questions their autonomy
at work. The individuals feel the pressure of constant stressful situations when autonomy at
work is threatened.
Appreciation of work. Some small acts of gratitude shown by supervisors ensured
very good performance even when financial incentives were not given during the period of
recession. Hence, dearth of appreciation can be an important deterrent in such pressure filled
atmosphere. Additionally, some professionals articulated that some managers take away
credit for work that truly belongs to them. This was felt as a very tough adverse element in
enduring that job or with such supervisors in future.
The clients appreciate our work and again it depends on the relationship
between the clients and us besides, very difficult to get the management’s
appreciation.
- (24 years, 1 year in IT and single)
When good work is acknowledged, there is self-satisfaction and motivation to sustain
the work or to perform better. However, the quote denotes that appreciation of work is
provided only by the client and not from the management. This creates a void and the
workers feel that there is no recognition of their work, thereby leading to demotivation,
dissatisfaction and stress.
Physical factors. Many workers expressed that physical infrastructure provided to
them was very good and it was one of the positive reasons for going into IT sector. Some
people complained about air conditioning of the place in that the regulation is done centrally
and they cannot change the temperature that suits them. Overall, seating arrangements,
amount of workspace available, ventilation and amount of light at work place were important.
I feel like I am put in a cage. There was basically no exposure to the outside
world. As if I am put in a box, with no hole to breathe. I requested and got
released from the environment.
- (25 years, female, systems engineer in IT industry)
The working conditions are capsuled very well in the above statement. The
respondent expresses suffocation of being constrained in a small space. Restriction of
physical space has impact on the stress levels, mental status and work performance. As
clearly depicted in the quote above, suffocation results in moving away from the work place;
going away the current circumstances.
Affect. There are several emotional factors that have importance in determining how
IT/ITES professionals cope with stress. There are instances when mistreatments have
occurred or senior managers have resorted to using abusive communication at work. In these
instances, the cause of stress and coping mechanism are dependent on the way individual
responds. Other factors that fall in this domain are professionals getting unnecessary blame
for failures or impending failure, escalations involved in work and discrimination at work.
Discrimination at work is an important factor to study in India. In a setting that is
predominately occupied by upper castes, the reason for discrimination was found often on a
regional basis.
325 The Qualitative Report 2015
He (Human Resources (HR) officer) humiliated me in front of many of my
colleagues. He told me that the market is good and why don’t you quit if you
don’t like the job given to you.
-(25 years, female IT professional, female, single)
Criticism, rude language and unruly behavior from the senior staff create negativity
and causes stress in the IT/ITES professionals. Instead of communicating with younger
professionals in dignified manner, the HR professionals or seniors insult in the presence of
other colleagues. These acts of comparison, discrimination and humiliation will lead to stress.
Theme Two: Role of Buffer Domains
Work environment. Dilemmas at work can be caused due to several factors such as
lack of information, unrealistic expectations from senior managers. In such instances, the
system of dilemma resolution and providing help to solve the dilemmas play as an important
role towards relieving stress. Transparency of work is an additional factor influencing the
stress propensity of professionals. Further, comparing with others about work expectations
and how each person performed are as negative influences. A good work atmosphere has
better work environment and hence can be thought of a good buffer mechanism in relieving
the job stress. A good system will also ensure transparent and fair practices without undue
comparisons of individuals.
Setting targets themselves should be directly proportional to the ability of the
person and introspection of the person. Lack of knowledge from various parts
of the world; have to introspect what can I achieve and what is my target if
they can put that as a target and try look at it as an achieving note, they can
excel.
- (40 years, IT professional, male, married with two children)
Unrealistic expectations from the senior management professionals can frustrate the
junior cadre. Higher expectation from seniors often raises hopes for junior professionals but
also leaves them prone for greater frustration, in the event of failures. One cannot stretch
beyond their limitations and competence for too long.
Family. Apart from the work environment, the other most important buffer factor is
the support received from family members. The respondents felt that it was very difficult to
balance work and family life. Thus, IT/ITES professionals would feel less stressed if there
were good support from the family members and vice versa.
We are not their slaves because they are paying us. There was an instance
when I came out of my first assignment. They were forcing us to go to
different location. I requested them that my parents are staying with me and I
can’t go to Chennai. Initially they asked me to attend some interviews but later
the HR manager did not consider my request.
- (25 years, female IT professional, female, single)
Due to preoccupation with the work all the time, family life takes a beating.. The
employees face lot of challenges in fulfilling family duties. The above quote stresses that it is
difficult to take care of parents, which is expected as a normal task in most of the Indian
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 326
families. Here, the job poses hurdles in doing basic familial duties. Hence, the otherwise
buffering effect of the family is affected due to job stress.
Theme Three: Role of Lifestyle factors
Some people admitted that smoking helps them to relieve their stress. In the same
way, alcohol also seemed to act as a buffer factor. Both of these habits also were reported to
help people to group together and discuss their work related problems. However, habits such
as tobacco use puts people at higher risk for chronic diseases. Hence, the concentric group of
smokers might feel that they are getting relieved of stress while putting themselves at higher
risk for disease. In the current study, 72% of the professionals agreed that they were current
smokers while 6 % didn’t. On inquiring the proportion of smokers in IT/ITES industry, more
than one third of participants approximated it around to be 25-50%, while one fifth of people
thought it should be around 50-75%. Three individuals (9%) gave information voluntarily on
smoking proportion in women professionals and approximated around 25-50%.
I sneak out sometime for every 2-3 hours because I smoke and chat with
colleagues.
- (27 years old IT professional, male, single)
It is distressing to note that smoking is seen as a tool of having open discussion with
colleagues and provides relief for sometime and from their stressful work. Surprisingly, the
habit of smoking is seen as an attribute of getting to be friends with colleagues and seniors.
Irrespective of the reasons for initiation of smoking, the risk behavior once started will result
in higher stress levels in addition to causing poor health in the long run.
Theme Four: Knowledge and Awareness Regarding Health
Around 60% rated quality of life to be moderate (4-7 out of 10) and approximately
identical proportion (63%) regarded quality of health of IT/ITES professionals to be moderate
as well. (4-7 out of 10)
Whenever pulse rate goes up, it is high BP.
- (26 years, ITES professional, single, male)
Poorer understanding of blood pressure by IT/ITES professionals displays their
ignorance regarding health despite being highly educated.
No way that anyone can get BP. In this industry, the crowd is very young.
- (26 years, single, male, IT professional)
The IT/ITES professionals are unaware that young population can also be affected
with high blood pressure. Therefore, this statement displays the misconception about the
hypertension (high blood pressure).
Theme Five: Work Culture and its Determinants
Other major factors causing discomfort among employees were lack of transparency
and lack of adequate salaries. Around 4% of professionals complained that job stress itself is
one of the antipathies workers have to face. Other dislikes of professionals were the distance
327 The Qualitative Report 2015
and time to travel to office from home, prejudice demonstrated by managers, inefficiency of
other workers which affects team work and lack of interaction. The factors that professionals
don’t like are meetings, lack of creativity, no scope for developing personal relationships,
relying on outdated systems functioning, lack of adequate training required for performing
work, lack of support from supervisors, using sarcastic sentences in daily communication and
not providing free days after night shifts.
It is a very common saying, ‘to get something good, you have to loose
something.’ I am getting good experience and I am loosing my health,
spending with my family and friends. I need to compromise on such things but
health we need to take care of very much.
- (28 years old IT professional, female, single)
The expressions display the helplessness of the individuals, who think that in order to
gain experience, they are willing to concede on some the healthy behaviors. A the prime age
of their youth, the individulas feel threatened about their health. The IT/ITEs professionals
acknowledge the adverse effect on their health explicitly, as a consequence of working
conditions.
I want to be on top. I don’t care about others. I will suppress others progress
and I come on top. I saw such kind of people in my current team, which irks
me. I feel really bad and because I have not faced it personally. They shared
their experiences with me. Once that impression comes, it is very difficult to
change it. I tried to avoid them as far as possible.
- (25 years, female IT professional, single)
Competitiveness can contribute to improve productivity. This can be distressing when
it leads to distrust and suppression of other people. The above quote is expressed as a
summary of the negative work culture, often threatening the several individuals in the
IT/ITES sector. Exposed over longer periods, these stressors can lead to ill health.
11 12 hours we will be in office. No moving work only sitting and doing
work. Mostly obesity is the problem faced and back pain, glasses used for
headache, etc. Other than lunch we will not be moving away from the
computers. If we involve more to work, we may not be taking lunch in proper
times.
- (23-year-old IT professional, single, male)
The impact of posture problems and long working hours in this industry is expressed
in this statement. The long hours of sitting in any one posture is detrimental to the health of
the individuals. Thus it can be seen that the work life has had a great impact on their physical
and psychological health. Generally, young people should not suffer from any of the
symptoms mentioned in the quote. The very presence of these symptoms in younger
professionals is an alarming feature of ill health.
Priorities and goals of companies.
Sometimes, I have to manage my team members in their absence. Sometimes
the stress is from the management’s side, the deadlines and the projects to be
finished.
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 328
- (27 year ITES professional, married with 1 child)
Conflicts – manager gets pressurized and the same will be carried on to us that
kind of conflicts are witnessed.
- (23-year-old IT professional, single)
Dependency which builds up where your performance is not only Your’s but
its collective responsibility.
- (30 years IT professional)
The priorities and goals of the senior management not necessarily reflect the
competence and expertise of the workers. Hence, a lot of pressure is transferred from the
higher levels of hierarchy downwards. The above statement reflects that the IT professionals
have to display collective responsibility and be prepared for conflicting nature of the work.
This is a constant challenge to the faced by the workers, and is accepted as sort of a norm.
Workforce policies within companies.
Handling manager is more tougher than handling project. I solved most
difficult tasks but get 8% hike, whereas others who are pally with manager get
14% hike in salary.
- (23 years, male, IT sector)
The above expression describes how the interpersonal relationship with the manager
matters more than the work performance. This is very challenging for the individuals who
work harder but do not know how to handle managers. On the other hand, manipulative
people can work their way through even without particularly being industrious.
Apart from the above, there were several reasons that professionals informed that they
like in IT industry. These attributes included mostly about the quantum of money as they get
salary and incentives (17%), and next commonest was their interaction with People (10%).
The other likely reasons were liking the challenges in work (8%) and flexible type of work
(8%), ambience (6%), innovation at work (6%) while other listed high profile in society,
application of logic, prospect of having long term career, like people in team, like timings,
work culture, creativity at work, facilities, fun, independence, learning new things, like
everything, travel and sharing knowledge.
Discussion
Several theories (Alfredsson et al., 1985; Folkow, 1997; Hammar et al., 1998; Hans et
al., 1997; Hockey, 1997; Johnson et al., 1996; Johnson & Stewart, 1993; Karasek et al., 1998;
Siegrist et al., 1990; Theorell et al., 1998) have attempted to establish the causal link between
stress and ill health. The perception and adaptive changes in response to stressors are mostly
transient and contextually specific in nature. However, not much work has been done in
describing the contextual stressors and their role in developing countries such as India. Our
paper sheds light on this important aspect of exploring contextual specific stressors at the
individual and organizational levels including adaptive responses to these factors. Our results
indicate that there is constant interplay between stressors; buffers and positive attributes
associated with the working conditions in IT/ITES professionals.
Among the positive attributes, most of the IT/ITES professionals were satisfied and
expressed happiness with the infrastructure provided to them for work, salary they get, better
329 The Qualitative Report 2015
quality of life and recognition they get from society. Among the stressors, the study identified
contextual stressor domains at the individual level and some stressors at organization level.
Support from family was an important and constant buffer factor to alleviate stress while the
buffer role of lifestyle factors and emotional factors was varied among workers. These results
are in conformity with model of allostatic load by Caplan. (Caplan et al., 1980) The state of
equilibrium within an internal and external environment is referred to as “Homeostasis”
(McEwen, 2000). Bruce McEwen introduced the term Allostatic load in 2000, which refers to
the effect of chronic exposure to the neural and/or neuroendocrine stress response on chronic
diseases in general and for cardiovascular diseases in specific. (Caplan et al., 1980) In this
model, job stressors refer to working conditions that may lead to acute reactions, or strains in
the worker. These short-term strains, in turn, are presumed to have an impact on longer-term
indicators of mental and physical health. The model comprises three components namely,
individual factors, non-work factors, and buffer factors. This model guides us to measure
allostatic load at the macro level. The inclusion of these three categories covers an array of
personal and contextual factors that might be responsible for differences in the way
individuals exposed to the same job stressors perceive and \ or react to the situation. (Cooper
& Marshall, 1976; Greenberger et al., 2002)
There are specific global level stimuli affecting demand and supply of skilled
workforce in IT/ITES industries of India. The key factor among them is reduced costs and
better efficiency of the tasks. The global factors influence priorities and goals of the local
companies. However, the local companies will have to design their own work force policies
based on their priorities and perceptions of their own companies. The decisions made in the
process of setting priorities of companies have a great impact on working condition of
IT/ITES professionals. For example, in our study, it was found that companies who were
based out of United States had standard policies regarding fair practices and incorporated the
goals of welfare of their employees. This resulted in better productivity and better quality of
life among their workers.
Notwithstanding the positive attributes expressed, the results from this study indicated
presence of significant stressors based on the contextual information sought from the IT/ITES
professionals. First, at individual level, this qualitative study identified nine stress domains
namely job control, autonomy, time pressure, length of experience in industry, night shifts,
income, appreciation of work, physical environment, work-environment and affect or
emotional factors. The identification of these contextual stress domains has some important
features.
First, Job control is an important factor in determining stress perception and coping.
Job control is defined as “the extent to which employees control the scheduling, pacing,
order, and so forth of monitored job activities” (Carayon, 1993). Earlier studies examining
job control as a stressor support our results (Aiello & Kolb, 1995; Cohen, 1979; Hales et al.,
1994; Pearson, 1991; US Congress, 1987; Westin, 1992). As found in the study, the degree to
which workers can control the onset or timing of monitoring is an important factor in
alleviating the stress at work place (Stanton & Barnes-Farrell, 1996). According to literature
review, frequency of control exercised by managers, (Lund, 1992; Niehoff & Moorman,
1993) extent of control factors, the person who makes the decision of allowing flexibility to
workers (Critchfield & Vargas, 1991; Dickinson, 1997; McCurdy & Shapiro, 1992) and
characteristics of the individual who is the target in the “stress cascade” (Brewer & Ridgway,
1998; Komaki, 1978; Larson & Callahan, 1990; Wilton, 1971) are important determinants of
job control related stress. In a study done to examine applicability of the Job Demands-
Resources Model of burnout among rural development workers (N=194), job demands and
rewards were equally important in accounting for levels of psychological stress
(Duraisingam, 2005). A study on veterinary assistant surgeons by Triveni et al. (2006)
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 330
reported that the major sources of job stress were numerous meetings, work load, lack of
personal growth and monotonous nature of work. Their study also identified lack of facilities
and clear-cut policies, untimely supply of inputs and lack of conveyance to field visits as
sources of organizational stress. In a study done to assess job stress in railway engine pilots,
Sumit Prakash et al. (Saran et al., 2011) reported statistically significant correlates with
fatigue, ergonomics of work place, management pressure, high job demand, low control and
low support at work and biological functions. In an ethnographic study of the low-income
construction workers, Dhar describes emergence of two themes of work demand and stress
leisure experiences (Dhar, 2011). In an another study, on the prevalence of occupational
stress amongst nurses, “Time Pressure” was found to be the most stressful in everyday life
(Bhatia, 2010). Our results suggest that “Time pressure” is an inherent attribute of the work
environment of the IT/ITES industry in India.
Second, we found that workers differentially perceive and report stress factors. One of
the driving factors of this differential nature is the type of immediate supervisor/manager. If
the manager mistrusts the worker or if the workers thought so, the propensity of trigger points
was more and provoked feelings of unfair treatment, prejudice and causes stress. This
construct has been referred to as “attributed trust,” defined as the extent to which workers
believe that their supervisor trusts them to perform their work tasks without coercion
(Strickland, 1958). According to the experiences of professionals, there were several overt
and subtle methods of monitoring often construed as coercion assimilated in the regular
execution of tasks. These can act as trigger events and might reinforce generalized positive or
negative feelings about self and workplace (Kidwell, 1994). These personal experiences
modify the behaviour of workers over a period of time and thereby determine the priorities
for work related aspects and overall performance. Based on the results from our study, we
infer that perception of stressors by IT/ITES professionals is an important determinant of
their behaviors in their workplace or in other places. This might include whether or not they
choose to smoke, to follow relaxation techniques including exercises, and how professionals
treat each other at work place. The constructs involved in support from supervisors and
colleagues whilst monitoring have been discussed in literature.
Third, from the public health perspective, the level of knowledge and awareness
among IT/ITES professionals about health in general and hypertension in specific was very
poor. In a qualitative study, hypertension has been perceived as a common and serious
problem in the community of migrant workers and the theme of city life as major
predisposing factor for developing hypertension (Kusuma, 2009).
Fourth and most importantly, at the organization level, workplace culture emerged as
a very important source of perceived stress. Earlier evidence points to the importance of
organizational culture in determining the health of professionals (Peterson & Wilson, 2002;
Thompson et al., 1996). Peterson and Wilson states in their paper that “Simply stated, culture
matters(2002, p. 85). They further state, “it matters because the consequences of ignoring an
organization’s culture can lead to undesirable outcomes for both the company and the
workers” (p. 85). Perception of work culture can mediate stress factors and ill health in
several ways. IT/ITES professionals will have to confront the potential stressors routinely and
this occurs repetitively over a period of time. The extent to which poor job control and
unrealistic work expectations are widespread in the organization determines the level of
negative emotional reactions such as frustration and aversive interpersonal relationships such
as hostility or defensiveness (Peterson & Wilson, 2002).
There is ample evidence to suggest that work culture is determined by assumptions
and beliefs, which subsequently prescribe the way supervisors, managers, communicate and
interact with IT/ITES professionals (DiMaggio, 1997; Griffiths et al., 1994; Schein, 2009).
Peterson et al in their model, describe that health of both organization and employees are very
331 The Qualitative Report 2015
important (2002). The model describes organizational health as the well being of the
corporate whole, which can be measured in terms such as productivity, performance, quality,
competitiveness, and profit. In comparison, employee health involves traditional measures
such as physical and mental sickness, absenteeism, and fatigue of the workers (Peterson &
Wilson, 2002). The study also identified the work culture as an important source of perceived
stress. This study also found perceived positive attributes such as higher income, better
physical environment and recognition from society.
The earlier evidence with reference to job stressors has pointed to several matrices
exploring composite measures of job-stress (Alfredsson et al., 1985; Babu et al., 2013;
Caplan et. al., 1980; Folkow, 1997; Hales et al., 1994; Hammar et al., 1998; Hockey, 1997;
Johnson et al., 1996; Johnson and Stewart, 1993; Karasek et al., 1998; Siegrist et al., 1990;
Theorell et al., 1998). The most well known models for measuring job stress are
Occupational Stress Index (OSI; Belkic, 1995; Belkic, 2000) and Job content Questionnaire
(JCQ; Karasek R, 1990; Karasek et al., 1998). Both these matrixes aim at objectively
assessing the job stressors. The OSI is a step ahead of the JCQ in having specific
questionnaires for different occupations such as drivers, nurses and doctors (Belkic & Nedic,
2007; Emdad et al., 1998). However, both these questionnaires could capture the specific
experiences of workers in IT/ITES settings in India. Hence, ours is the first attempt in
exploring the contextual stressors in IT/ITES workforce in India. Further, our qualitative
study explores knowledge of health and other socio-demographic characteristics, as they are
important ingredients in understanding buffer mechanism for combatting job stressors and
their effect on health.
Generalizability of the Findings
Globally, there is an increased effort to shift jobs including the IT/ITES industry to
low cost areas in developing countries such as India, which have a huge pool of lower paid,
technically competent and English speaking workers. Our study finds that most of the time,
workers perceived that their Indian companies overemphasize their skillset and talent pool to
the global clients in order to successfully bid and win IT/ITES projects. This results in
creating unnecessary and heightened atmosphere of work pressure with unrealistic demands,
often exploiting the professionals. As a result, we identified nine contextual stressor domains
in these industries and based on the composition of the IT/ITES workforce, we infer that the
results will be applicable for such worksite settings in India and as well for similar settings in
low and middle-income countries. The work conditions and stress domains in low and
middle-income countries are comparable especially in IT and ITES sector. These finding
shall significantly play critical role in devising quality interventions to improve work
atmosphere, which shall indirectly have positive implications on health of employee in IT and
ITES sector. We are cautious that the work-culture and other contextual buffer mechanisms
might vary in countries other than India and therefore the applicability to their settings might
differ. Nevertheless, these findings have to be re-tested in other industries other than IT and
ITES sector in order to understand the specific stress domains and to devise cost effective
interventions.
Conclusion
In conclusion, this study identified a number of stressors perceived by workers in the
IT/ITES industries in India. Many of these perceived stressors can be reduced by improved
management policies and work environment. These changes may have a positive impact on
productivity and quality of work. Further evaluations of positive and negative impacts of
Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu B. Kar, and Roger Detels 332
occupational conditions through qualitative studies can help in understanding the
comprehensive profile of workforces.
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335 The Qualitative Report 2015
Author Note
Giridhar R Babu. MBBS, MPH, PhD. Associate Professor. Correspondence regarding
this article can be addressed directly to Giridhar R. Babu at Email: giridhar@iiphh.org;
Address: Public Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises,
beside leprosy hospital, 1st cross, Magadi road. Bangalore-560023.
Sathyanarayana T. N.MBBS, MPH, PhD Scholar. Correspondence regarding this
article can also be addressed directly to Email: drsathya1@gmail.com; Address: Public
Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises, beside leprosy
hospital, 1st cross, Magadi road. Bangalore-560023.
Asha Ketharam, Scientist ‘C’, ICMR Complex, Kannamangala PO, Poojanahalli
Road, Devanahalli Taluk, Bengaluru-562110, Karnataka, INDIA.
Snehendu. B. Kar, Dr.P.H, MPH, M.Sc., Fulbright-Nehru Distinguished Chair,
Professor Emeritus of Public Health & Asian American Studies, Fielding School of Public
Health, University of California at Los Angeles, California- 90095.
Roger Detels, MD MS, Professor of Epidemiology and Infectious Diseases,
Correspondence regarding this article can also be addressed directly to Roger Detels at
Address: UCLA Schools of Public Health and Medicine, UCLA Pub Hlth-Epid, BOX
951772, 71-267 CHS, Los Angeles, CA 90095-1772; Email: detels@ucla.edu
Copyright 2015: Giridhara R. Babu, Sathyanarayana T. N., Asha Ketharam, Snehendu
B. Kar, Roger Detels, and Nova Southeastern University.
Article Citation
Babu, G. R., Sathyanarayana, T. N., Ketharam, A., Kar, S. B., & Detels, R. (2015). Perceived
occupational stressors and the health of software professionals in Bengaluru, India.
The Qualitative Report, 20(3), 314-335. Retrieved from
http://www.nova.edu/ssss/QR/QR20/3/babu9.pdf
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Chapter
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