Study design
An institutional-based cross-sectional study design was employed at Hawassa industrial park.
Study Area and period
The study was conducted at Hawassa industrial park, Hawassa city, southern Ethiopia. The Hawassa Industrial Park, which opened in July 2016, has been described as the Ethiopian government’s “flagship” industrial park. It is found in Hawassa city, located 275 km from Addis Ababa, and the capital of Ethiopia. The city has a latitude and longitude of 7°3′N 38°28′E and an elevation of 1,708 meters (5,604 ft) above sea level. The company encompasses an area of 1.3 million square meters, of which 300,000-meter square is a factory shed build-up area. Currently, 22 leading global apparel and textile companies from America, China, India, Sri Lanka as well as different local manufacturers are operating within the park(20). Currently, the company has overall 13,700 workers across 52 shades and around 80% of them are female. The study was conducted from August 1 to 30, 2021
Source Population
All employees work in Hawassa industrial park.
Study population
Employees who were available in their workplace during the study period
Eligibility criteria
Inclusion criteria
The study included employees who were currently working in the industry park.
Exclusion criteria
Those employees who were seriously ill, on annual leave or maternity leave during the data collection period were excluded from the study.
Sampling procedure and sampling technique
Sample size estimation
The sample size required for the study was calculated using a single population proportion formula by considering an estimated prevalence of work-related stress to be 45.2%, from the study conducted in Bahir Dar Textile Factory north-west Ethiopia, a 5% margin of error, a 95% confidence interval, and 10% non-response rate.
Where n is the sample size, P is expected prevalence (proportion) of work-related stress, d = margin of error and Z = standard score corresponds to 1.96.
Therefore the total sample size was determined by using the above formula
By considering 10% non-response rate the final sample size for the study was n = 419
Sampling procedure
First the total list of employees in the Hawassa industrial park was taken from the human resource office. Then a simple random sampling technique was employed through the computer generation random method by using Microsoft excel to select all 419 samples from the total list of employees. Finally the data was collected from the selected samples at their corresponding working place.
Study variable
Dependent variable
Work - related stress (Yes/No)
Independent variable
Socio demographic factors
Age, Gender, Religion, Marital status, Educational status, Types of employment, Income, Family size, Types of work, Position at work.
Organizational factors
Working conditions, Job security, Experience in the current organization, Working hours, Organizational support, Eemployee recognition, Overtime work.
Job content factors
Time pressure, Job control, Opportunity to learn, Interactions with machines, Workplace violence, Physical environment
Substance use
Alcohol use, Khat use, Tobacco use, Cannabis use, >1 substance use
Health related factors
Chronic medical illness and Acute illness
Operational definition:
Work related stress: A sum score below 60 of workplace stress scale was classified as having a work-related stress among participants(21).
Working condition: Poor working conditions was considered with the summed scores of participants’ on questions to assess working condition are less than 10(15,22).
Organizational support: Poor organizational support considered with the summed scores of participants’ on questions to assess organizational support was less than 7(22).
Temporary employee: employees those who had no permanent contract or recognition letter as permamanent employee from the organization.
Time pressure: High time pressure was defined as the summed scores of participants’ on questions to assess time pressure more than 10(15).
Data collection tool and Procedure
A 20-point standard questionnaire (WPSS) was used to measure work-related stress. The American Institute of Stress validated this tool, which is now used in a variety of occupations. It is a standard questionnaire with a 5-point Likert scale. The scores ranged from 1 (never) to 5 (very often). The inverse scores ranged between 5 (never) and 1 (very often). For all WPSS questions, the findings were summarized, and less than 60 scores were graded as work-related stress(23). The internal consistency, cronbach's alpha coefficient of WPSS in the current study was 0.83.
The Job Content Questionnaire (JCQ)(24), and the National Institute for Occupational Safety and Health (NIOSH) generic questionnaires(25), inquired about organizational factors (working conditions, overtime work, experience in the organization, working hours, organizational support, employee recognition, and job security), and job content factors (time pressure, job demand, job control, resources, opportunity to learn, interactions of people with machines, illness, and physical environment). A poor working condition is the summed scores of less than 10. Poor organizational support is the summed scores of less than 7. High time pressure is the summed scores of more than 10. The Poor physical environment is the summed score of below 9. These instruments were used in a previous study conducted among bahirdar textile factory and dukem shoe factory employees in Ethiopia and it was valid and reliable(14,15).
Screening Test for Alcohol, Smoking, and Substance (ASSIST Version 2.0) is made up of eight items that measure lifetime(Question 1 rated “yes” = 1/“no” = 0; interview stops if “no”) and recent (past 3 months; question 2: interview continues for each substance used in the past 3 months only) of substance. After reviewing different literatures four questions adopted from the tool to assess thr use of tobacco, alcohol, Khat and cannabis(26).
The data were collected through an interviewer-administered structured questionnaire, through a face-to-face interview. Four data collectors (Bsc nurse) were employed for one-month data collection periods and supervised by two supervisors (BSc psychiatry professional). The training was given for one day regarding the administration protocol of the data collection procedures for the data collectors by the main investigator.
Data processing, analysis and presentation
Before entering the data into the computer, it was checked for completeness and cleaned. The data was then coded, cleaned, and edited before being entered into EpiData version 4.6 and exported to SPSS version 26 for analysis. Frequency, tables, texts, and summary measures were used to present descriptive statistics. Using binary logistic regression, bivariate and multivariable analysis was performed to determine the relationship between each independent variable and the outcome variable. To control for all possible confounders, all variables with P0.25 in the bivariate analysis were included in the final model of multivariable analysis. At a P-value greater than 0.05, the Hosmer-Lemeshow statistic was used to assess the goodness of fit. The statistical associations were calculated using an odds ratio with a 95% confidence interval. Using multivariate analysis in binary logistic regression, the adjusted odds ratio and 95 percent CI were calculated to identify the associated factors with work-related stress. A P-value of < 0.05 was considered statistically significant in this study.