Work stressors and their controllability: Content analysis of employee perceptions of hindrances to the flow of work in the health care sector.

High levels of work stress are prevalent today, and the underlying working conditions need to be tackled urgently. In this study, our aim was to identify the range of factors that employees themselves perceive as hindrances to the flow of work, that is, hindrance stressors. We analysed the open-ended questionnaire responses of 4766 employees working in the health care sector using semi-automated content analysis. We then used more detailed conventional content analysis to compare the responses of the groups that reported high (n = 1388) and low (n = 833) levels of subjective stress. Finally, we interpreted and categorised the stressors raised by the respondents from the viewpoint of controllability, to shed light on where to target interventions. The main hindrance stressors reflected inadequate staffing, work overload, time pressure, and management-related issues, of which the responses revealed concrete examples. Interruptions and problems related to cooperation and instructions were also commonly mentioned. The respondents in the high stress group emphasised work overload and issues related to management and clients. Our results suggest that the major hindrances to daily work are beyond employees' control and require decisions and resources at the level of supervisors, managers, directors, and policymakers. Future studies on work stress should explore the controllability of common stressors in more detail and include the appraisal of controllability in explanatory models. Avoiding overemphasis of psychological coping and instead targeting harmful working conditions and the organisational actors who can influence these could make workplace stress management interventions more effective.