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Preplanned Studies: Associations of Occupational Stress and Coping Styles with Well-Being Among Couriers — Three Cities, Zhejiang Province, China, 2021

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  • Summary

    What is already known about this topic?

    Prior research has primarily concentrated on occupational health concerns, including injuries and heatstroke, among couriers. Nevertheless, there has been a scarcity of emphasis on mental health aspects, with existing studies predominantly addressing the risk factors associated with occupational stress.

    What is added by this report?

    The present study demonstrated a significant association between occupational stress and well-being among couriers, with positive coping strategies acting as a mediating factor. Furthermore, the results indicate that implementing a positive coping style may mitigate the impact of occupational stress on well-being.

    What are the implications for public health practice?

    Future public policy initiatives should focus on promoting the well-being of couriers by fostering improvements in the workplace environment, reevaluating the organization of work, and delivering support to couriers in managing occupational stress.

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  • [1] Nazari H, Jariani M, Beiranvand S, Saki M, Aghajeri N, Ebrahimzadeh F. The prevalence of job stress and its relationship with burnout syndrome among the academic members of Lorestan University of Medical Sciences. J Caring Sci 2016;5(1):75 − 84. http://dx.doi.org/10.15171/jcs.2016.008CrossRef
    [2] Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clin Med Res 2016;14(1):7 − 14. http://dx.doi.org/10.3121/cmr.2016.1303CrossRef
    [3] Li L, Ai H, Gao L, Zhou H, Liu XY, Zhang Z, et al. Moderating effects of coping on work stress and job performance for nurses in tertiary hospitals: a cross-sectional survey in China. BMC Health Serv Res 2017;17(1):401. http://dx.doi.org/10.1186/s12913-017-2348-3CrossRef
    [4] Suleman Q, Hussain I, Shehzad S, Syed MA, Raja SA. Relationship between perceived occupational stress and psychological well-being among secondary school heads in Khyber Pakhtunkhwa, Pakistan. PLoS One 2018;13(12):e0208143. http://dx.doi.org/10.1371/journal.pone.0208143CrossRef
    [5] Wang J, Zhang QY, Chen HQ, Sun DY, Wang C, Liu XM, et al. Development of the core occupational stress scale for occupational populations in China. Chin J Prev Med 2020;54(11):1184 − 9. http://dx.doi.org/10.3760/cma.j.cn112150-20200319-00383 (In Chinese). CrossRef
    [6] Ryu GW, Yang YS, Choi M. Mediating role of coping style on the relationship between job stress and subjective well-being among Korean police officers. BMC Public Health 2020;20(1):470. http://dx.doi.org/10.1186/s12889-020-08546-3CrossRef
    [7] Jang MH, Gu SY, Jeong YM. Role of coping styles in the relationship between nurses’ work stress and well-being across career. J Nurs Scholarsh 2019;51(6):699 − 707. http://dx.doi.org/10.1111/jnu.12523CrossRef
    [8] Serafin LI, Fukowska M, Zyskowska D, Olechowska J, Czarkowska-Pączek B. Impact of stress and coping strategies on insomnia among Polish novice nurses who are employed in their field while continuing their education: a cross-sectional study. BMJ Open 2021;11(12):e049787. http://dx.doi.org/10.1136/bmjopen-2021-049787CrossRef
    [9] Ding YQ, Yang YJ, Yang XX, Zhang TH, Qiu XH, He X, et al. The mediating role of coping style in the relationship between psychological capital and burnout among Chinese nurses. PLoS One 2015;10(4):e0122128. http://dx.doi.org/10.1371/journal.pone.0122128CrossRef
  • FIGURE 1.  Standardized path analysis illustrating the relationships among occupational stress, coping styles, and well-being among couriers in three cities in Zhejiang Province, China, 2021.

    Note: The three cities included in the study were Ningbo, Jiaxing, and Taizhou. The fit indices for the structural model were as follows: χ2=37.576; df=11; χ2/df=3.416; P<0.001; CFI=0.981, GFI=0.991, AGFI=0.976; NFI=0.986; RMSEA=0.046. A model is considered to have a good fit if it meets the following criteria: RMSEA<0.08, CFI>0.90, and NFI>0.90. Based on these results, the structural model demonstrated a good fit with the data in this study.

    Abbreviation: CFI=comparative fit index; GFI=goodness-of-fit index; AGFI=adjusted goodness-of-fit index; NFI=normed fit index; RMSEA=root-mean-square error of approximation.

    * P<0.05.

    ** P<0.001.

    TABLE 1.  Prevalence of occupational stress, coping styles, and poor well-being among couriers in three cities in Zhejiang Province, China, 2021.

    CharacteristicTotal, n (%)Occupational stressPositive coping styleNegative coping stylePoor well-being
    n (%)χ2Pn (%)χ2Pn (%)χ2Pn (%)χ2P
    Total1,161 (100)614 (52.9)842 (72.5)228 (19.6)505 (43.5)
    Gender6.1860.0236.5000.0114.5330.0332.0240.155
    Male835 (71.9)459 (55.0)623 (74.6)151 (18.1)374 (44.8)
    Female326 (28.1)155 (47.5)219 (67.2)77 (23.6)131 (40.2)
    Age (years)24.305<0.0016.1130.1915.0750.2803.0970.542
    18–25206 (17.7)103 (50.0)151 (73.3)40 (19.4)89 (43.2)
    26–30297 (25.6)179 (60.3)206 (69.4)61 (20.5)133 (44.8)
    31–40428 (36.9)240 (56.1)306 (71.5)91 (21.3)194 (45.3)
    41–50191 (16.5)77 (40.3)146 (76.4)33 (17.3)75 (39.3)
    >5039 (3.4)15 (38.5)33 (84.6)3 (7.7)14 (35.9)
    Education level42.431<0.00113.4660.00916.6380.00210.9320.027
    ≤Middle school265 (22.8)95 (35.8)198 (74.7)45 (17.0)105 (39.6)
    High school506 (43.6)282 (55.7)377 (74.5)89 (17.6)244 (48.2)
    College241 (20.8)145 (60.2)168 (69.7)53 (22.0)104 (43.2)
    University129 (11.1)79 (61.2)91 (70.5)31 (24.0)46 (35.7)
    ≥Graduate school20 (1.7)13 (65.0)8 (40.0)10 (50.0)6 (30.0)
    Marital status4.9760.29015.8530.00311.9760.0182.3850.665
    Unmarried301 (25.9)151 (50.2)215 (71.4)60 (19.9)126 (41.9)
    Married676 (58.2)370 (54.7)495 (73.2)135 (20.0)292 (43.2)
    Separated104 (9.0)47 (45.2)85 (81.7)11 (10.6)50 (48.1)
    Widowed61 (5.3)35 (57.4)39 (63.9)14 (23.0)30 (49.2)
    Divorced and others19 (1.6)11 (57.9)8 (42.1)8 (42.1)7 (36.8)
    Monthly income (CNY)25.912<0.00111.5820.04110.1050.0726.6150.251
    <3,00056 (4.8)18 (32.1)39 (69.6)11 (19.6)25 (44.6)
    3,000–4,999363 (31.3)183 (50.4)246 (67.8)87 (24.0)146 (40.2)
    5,000–6,999398 (34.3)200 (50.3)286 (71.9)80 (20.1)185 (46.5)
    7,000–9,000214 (18.4)135 (63.1)169 (79.0)32 (15.0)101 (47.2)
    9,000–10,99986 (7.4)56 (65.1)66 (76.7)12 (14.0)31 (36.0)
    ≥11,00044 (3.8)22 (50.0)36 (81.8)6 (13.6)17 (38.6)
    Working age (years)19.551<0.00113.0180.00511.5730.0097.0470.070
    1–5564 (48.6)286 (50.7)395 (70.0)115 (20.4)250 (44.3)
    6–10227 (19.6)141 (62.1)163 (71.8)47 (20.7)103 (45.4)
    11–15172 (14.8)102 (59.3)120 (69.8)43 (25.0)82 (47.7)
    >15198 (17.1)85 (42.9)164 (82.8)23 (11.6)70 (35.4)
    Smoking13.903<0.0018.0490.0178.8760.0125.2540.072
    No488 (42.0)234 (48.0)371 (76.0)85 (17.4)197 (40.4)
    Yes551 (47.5)323 (58.6)378 (68.6)127 (23.0)259 (47.0)
    Quit smoking122 (10.5)57 (46.7)93 (76.2)16 (13.1)49 (40.2)
    Alcohol drinking8.6390.00318.994<0.00120.425<0.0010.7650.382
    No414 (35.7)195 (47.1)332 (80.2)52 (12.6)173 (41.8)
    Yes747 (64.3)419 (56.1)510 (68.3)176 (23.6)332 (44.4)
    Physical exercise0.4920.4831.3770.2411.1220.2900.7620.092
    Lack of exercise622 (53.6)323 (51.9)460 (74.0)115 (18.5)268 (43.1)
    Often exercise539 (46.4)291 (54.0)382 (70.9)113 (21.0)237 (44.0)
    Working hour (per week)0.2330.6290.0110.9180.0530.81723.416<0.001
    ≤40122 (10.5)62 (50.8)88 (72.1)23 (18.9)28 (23.0)
    >401,039 (89.5)552 (53.1)754 (72.6)205 (19.7)477 (45.9)
    Shiftwork status0.0530.87121.112<0.00124.442<0.0010.1680.682
    No758 (65.3)399 (52.6)583 (76.9)117 (15.4)333 (43.9)
    Yes403 (34.7)215 (53.3)259 (64.3)111 (27.5)172 (42.7)
    Note: The three cities were Ningbo, Jiaxing, and Taizhou.
    Abbreviation: CNY=Chinese Yuan.
    Download: CSV

    TABLE 2.  Correlation analysis of occupational stress, coping styles, and well-being among couriers in three cities in Zhejiang Province, China, 2021.

    VariablesOccupational stressPositive coping styleNegative coping styleWell-being
    Occupational stress1.000
    Positive coping style−0.163**1.000
    Negative coping style0.092**−0.449**1.000
    Well-being−0.142**0.059*0.0111.000
    Note: The three cities were Ningbo, Jiaxing, and Taizhou.
    * P<0.05.
    ** P<0.01.
    Download: CSV

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Associations of Occupational Stress and Coping Styles with Well-Being Among Couriers — Three Cities, Zhejiang Province, China, 2021

View author affiliations

Summary

What is already known about this topic?

Prior research has primarily concentrated on occupational health concerns, including injuries and heatstroke, among couriers. Nevertheless, there has been a scarcity of emphasis on mental health aspects, with existing studies predominantly addressing the risk factors associated with occupational stress.

What is added by this report?

The present study demonstrated a significant association between occupational stress and well-being among couriers, with positive coping strategies acting as a mediating factor. Furthermore, the results indicate that implementing a positive coping style may mitigate the impact of occupational stress on well-being.

What are the implications for public health practice?

Future public policy initiatives should focus on promoting the well-being of couriers by fostering improvements in the workplace environment, reevaluating the organization of work, and delivering support to couriers in managing occupational stress.

  • 1. Institute of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China
  • 2. Department of Public Health, Hangzhou Normal University, Hangzhou City, Zhejiang Province, China
  • 3. National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
  • Corresponding author:

    Hua Zou, hzou@cdc.zj.cn

    Online Date: May 19 2023
    Issue Date: May 19 2023
    doi: 10.46234/ccdcw2023.085
  • In recent years, the rapid development of the express industry in China has led to an increase in occupational stress among couriers, potentially contributing to poor well-being (1). A positive attitude in the workplace significantly impacts reducing occupational stress, and coping styles are crucial factors in well-being (2-3). This study aimed to investigate the association between occupational stress, coping styles, and well-being and explore the intermediary effect of coping styles on the relationship between occupational stress and well-being among couriers. The research used a cluster random sampling method to select 1,200 couriers from mainstream express companies in three cities (Ningbo, Jiaxing, and Taizhou) within Zhejiang Province, China. The Core Occupational Stress Scale (COSS) was employed to assess occupational stress, the World Health Organization’s five-item Well-Being Index (WHO-5) scale to measure well-being, and the Trait Coping Style Questionnaire (TCSQ) to evaluate coping styles. Poor well-being was found to be relatively common among couriers in the three cities within Zhejiang Province, accounting for 43.5% in this study. Couriers’ well-being was correlated with occupational stress (rs=−0.142, P<0.01) and positive coping styles (rs=0.059, P<0.05), with occupational stress exhibiting a direct effect on well-being and an indirect effect through positive coping styles. The findings of this study emphasize the need for a coordinated, multi-level effort to control the prevalence of occupational stress among couriers and actively guide them in managing stressors to promote their mental health.

    This cross-sectional study was conducted from September to November 2021 and included 1,200 employees aged 18 years or older, with at least one year of work experience from 20 leading express companies in Ningbo, Jiaxing, and Taizhou cities in Zhejiang Province. An anonymous, self-administered questionnaire was employed for data collection, and all investigators underwent uniform training prior to conducting the survey. The study received approval from the Medical Ethics Committee of the National Institute of Occupational Health and Poison Control, and informed consent was provided by all participants. A total of 1,161 valid questionnaires were collected, yielding a response rate of 96.8%.

    The WHO-5 scale was employed to assess subjective well-being (4), with a total score below 13 indicating poor well-being. Occupational stress was evaluated using the COSS (5), which consists of four subscales: social support, organization and return, demand and pay, and autonomy. A total score exceeding 50 denotes occupational stress. The TCSQ, comprising 20 items, is divided into positive coping and negative coping aspects, each containing 10 items. The scores for both coping styles are determined by summing up their respective items. Data analysis was conducted using SPSS (version 25.0, IBM Corporation, Armonk, NY, USA) and AMOS (version 24.0, IBM Corporation, Armonk, NY, USA). The relationship between occupational stress, coping styles, and well-being was examined via Spearman’s rank correlation analysis. To further investigate the associations among occupational stress, coping styles, and well-being, structural equation modeling (SEM) was implemented. Two-tailed P values <0.05 were deemed statistically significant.

    The study sample included 1,161 couriers, primarily aged between 31 and 40 years and with 1–5 years of work experience (Table 1). The prevalence of occupational stress among these couriers was found to be 52.9%. A majority (72.5%) of the couriers exhibited a predominantly positive coping style, whereas 19.6% displayed a negative coping style. Poor well-being was reported by 43.5% of the participants.

    CharacteristicTotal, n (%)Occupational stressPositive coping styleNegative coping stylePoor well-being
    n (%)χ2Pn (%)χ2Pn (%)χ2Pn (%)χ2P
    Total1,161 (100)614 (52.9)842 (72.5)228 (19.6)505 (43.5)
    Gender6.1860.0236.5000.0114.5330.0332.0240.155
    Male835 (71.9)459 (55.0)623 (74.6)151 (18.1)374 (44.8)
    Female326 (28.1)155 (47.5)219 (67.2)77 (23.6)131 (40.2)
    Age (years)24.305<0.0016.1130.1915.0750.2803.0970.542
    18–25206 (17.7)103 (50.0)151 (73.3)40 (19.4)89 (43.2)
    26–30297 (25.6)179 (60.3)206 (69.4)61 (20.5)133 (44.8)
    31–40428 (36.9)240 (56.1)306 (71.5)91 (21.3)194 (45.3)
    41–50191 (16.5)77 (40.3)146 (76.4)33 (17.3)75 (39.3)
    >5039 (3.4)15 (38.5)33 (84.6)3 (7.7)14 (35.9)
    Education level42.431<0.00113.4660.00916.6380.00210.9320.027
    ≤Middle school265 (22.8)95 (35.8)198 (74.7)45 (17.0)105 (39.6)
    High school506 (43.6)282 (55.7)377 (74.5)89 (17.6)244 (48.2)
    College241 (20.8)145 (60.2)168 (69.7)53 (22.0)104 (43.2)
    University129 (11.1)79 (61.2)91 (70.5)31 (24.0)46 (35.7)
    ≥Graduate school20 (1.7)13 (65.0)8 (40.0)10 (50.0)6 (30.0)
    Marital status4.9760.29015.8530.00311.9760.0182.3850.665
    Unmarried301 (25.9)151 (50.2)215 (71.4)60 (19.9)126 (41.9)
    Married676 (58.2)370 (54.7)495 (73.2)135 (20.0)292 (43.2)
    Separated104 (9.0)47 (45.2)85 (81.7)11 (10.6)50 (48.1)
    Widowed61 (5.3)35 (57.4)39 (63.9)14 (23.0)30 (49.2)
    Divorced and others19 (1.6)11 (57.9)8 (42.1)8 (42.1)7 (36.8)
    Monthly income (CNY)25.912<0.00111.5820.04110.1050.0726.6150.251
    <3,00056 (4.8)18 (32.1)39 (69.6)11 (19.6)25 (44.6)
    3,000–4,999363 (31.3)183 (50.4)246 (67.8)87 (24.0)146 (40.2)
    5,000–6,999398 (34.3)200 (50.3)286 (71.9)80 (20.1)185 (46.5)
    7,000–9,000214 (18.4)135 (63.1)169 (79.0)32 (15.0)101 (47.2)
    9,000–10,99986 (7.4)56 (65.1)66 (76.7)12 (14.0)31 (36.0)
    ≥11,00044 (3.8)22 (50.0)36 (81.8)6 (13.6)17 (38.6)
    Working age (years)19.551<0.00113.0180.00511.5730.0097.0470.070
    1–5564 (48.6)286 (50.7)395 (70.0)115 (20.4)250 (44.3)
    6–10227 (19.6)141 (62.1)163 (71.8)47 (20.7)103 (45.4)
    11–15172 (14.8)102 (59.3)120 (69.8)43 (25.0)82 (47.7)
    >15198 (17.1)85 (42.9)164 (82.8)23 (11.6)70 (35.4)
    Smoking13.903<0.0018.0490.0178.8760.0125.2540.072
    No488 (42.0)234 (48.0)371 (76.0)85 (17.4)197 (40.4)
    Yes551 (47.5)323 (58.6)378 (68.6)127 (23.0)259 (47.0)
    Quit smoking122 (10.5)57 (46.7)93 (76.2)16 (13.1)49 (40.2)
    Alcohol drinking8.6390.00318.994<0.00120.425<0.0010.7650.382
    No414 (35.7)195 (47.1)332 (80.2)52 (12.6)173 (41.8)
    Yes747 (64.3)419 (56.1)510 (68.3)176 (23.6)332 (44.4)
    Physical exercise0.4920.4831.3770.2411.1220.2900.7620.092
    Lack of exercise622 (53.6)323 (51.9)460 (74.0)115 (18.5)268 (43.1)
    Often exercise539 (46.4)291 (54.0)382 (70.9)113 (21.0)237 (44.0)
    Working hour (per week)0.2330.6290.0110.9180.0530.81723.416<0.001
    ≤40122 (10.5)62 (50.8)88 (72.1)23 (18.9)28 (23.0)
    >401,039 (89.5)552 (53.1)754 (72.6)205 (19.7)477 (45.9)
    Shiftwork status0.0530.87121.112<0.00124.442<0.0010.1680.682
    No758 (65.3)399 (52.6)583 (76.9)117 (15.4)333 (43.9)
    Yes403 (34.7)215 (53.3)259 (64.3)111 (27.5)172 (42.7)
    Note: The three cities were Ningbo, Jiaxing, and Taizhou.
    Abbreviation: CNY=Chinese Yuan.

    Table 1.  Prevalence of occupational stress, coping styles, and poor well-being among couriers in three cities in Zhejiang Province, China, 2021.

    A significant difference in the prevalence of poor well-being was observed between couriers with different education levels (χ2=10.932, P=0.027). Additionally, a statistically significant difference was found in the prevalence of poor well-being among couriers with various working hours (χ2=23.416, P<0.001).

    Table 2 presents the results of the correlation analysis between occupational stress, coping styles, and well-being. Couriers’ well-being was found to be negatively correlated with occupational stress (rs=−0.142, P<0.01) and positively correlated with the positive coping style (rs=0.059, P<0.05). However, no significant correlation was observed between well-being and negative coping style (rs=0.011, P>0.05).

    VariablesOccupational stressPositive coping styleNegative coping styleWell-being
    Occupational stress1.000
    Positive coping style−0.163**1.000
    Negative coping style0.092**−0.449**1.000
    Well-being−0.142**0.059*0.0111.000
    Note: The three cities were Ningbo, Jiaxing, and Taizhou.
    * P<0.05.
    ** P<0.01.

    Table 2.  Correlation analysis of occupational stress, coping styles, and well-being among couriers in three cities in Zhejiang Province, China, 2021.

    The final output model illustrated research variables’ correlations and effect paths (Figure 1). It can be observed that occupational stress was negatively related to the positive coping style (β=−0.107, P<0.05), and the positive coping style was positively related to well-being (β=0.010, P<0.001).The 95% confidence interval (CI) of the estimation of the two-mediation path does not include 0, which means that the total effect of occupational stress on well-being was statistically significant, and occupational stress had significant indirect effects through the positive coping style on well-being (Supplementary Table S1). However, the negative coping style did not demonstrate direct or indirect effects on well-being (P>0.05).

    Figure 1. 

    Standardized path analysis illustrating the relationships among occupational stress, coping styles, and well-being among couriers in three cities in Zhejiang Province, China, 2021.

    Note: The three cities included in the study were Ningbo, Jiaxing, and Taizhou. The fit indices for the structural model were as follows: χ2=37.576; df=11; χ2/df=3.416; P<0.001; CFI=0.981, GFI=0.991, AGFI=0.976; NFI=0.986; RMSEA=0.046. A model is considered to have a good fit if it meets the following criteria: RMSEA<0.08, CFI>0.90, and NFI>0.90. Based on these results, the structural model demonstrated a good fit with the data in this study.

    Abbreviation: CFI=comparative fit index; GFI=goodness-of-fit index; AGFI=adjusted goodness-of-fit index; NFI=normed fit index; RMSEA=root-mean-square error of approximation.

    * P<0.05.

    ** P<0.001.

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