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'''Stress''' affects the way we work and our ability to work efficiently and effectively. The employees are very crucial resources when managing projects and it is important to ensure their wellbeing so they can perform their part in the project. Therefore stressed employees can affect the outcome of a project, by e.g. worsening their performance and delaying the project or in worst case losing the employee completely. Based on this, stress management is important to consider when working with projects. An example of dealing with stressed employees is the current pandemic happening. It required change in where and how to work. Change in the communication between coworkers and managers. These aspects have to be considered when working in projects. Companies have handled this crisis differently with both positive and negative outcomes. Changes are a common stressor and has to be considered when working with stress management. Therefore managers have had to manage stress to ensure their employees' performance. Changes causes stress whether it is working conditions or restructuring of the organizations. As a project manager, a project will always have issues and errors happening. The project rarely runs smoothly and adjustments have to occur. Therefore in a position as a project manager, stress needs to be managed to handle the changes and the employees. Another aspect of stress managing is managing the project manager as well. To work with stress management it is possible to use tools such as time management and open communication workshops to manage stress not only for the project manager but also their employees while keeping them happy. Managing stress eliminates uncertainty and keeps the project steady.

   
==What is stress - Basic information about stress==

Most people have probably experienced a situation where they felt they were not in control. Examples of stressed situations could be too much work, too many appointments, economic issues or your dog ate something bad and has to go to the vet. Stress is the body’s survival reaction to unexpected happenings.  When a stressful event occurs, for example a university student having to deliver in an assignment the next day, stress hormones are released which triggers the fight or flight system, making the student able to respond to the stressful situation. 
A common way of looking at stress is the following statement: ‘’Stress is the feeling of being overwhelmed or unable to cope with mental or emotional pressure.’’<ref name="Mentalhealth"/>  from the UK mental health foundation. You can call stress a survival instinct. Stress is often related to mental health. It can have both positive and negative effects depending on the situation the person is in. It can help people through fearful situations, and the stress hormones will usually disappear after the stressful situation is over. It can also work against people and deteriorate them physically and mentally if the person is unable to cope with the stress over a longer duration of time. 

If you are experiencing overwhelming amount of stress you should seek help with a medical professional who in turn can help you find local resources to help you. 


===Stress identifiers===

Sometimes stress is not easy to identify since it is not always clear instances that causes stress. Sometimes stress feels like standing in a shower and slowly turning up the heat, not realizing how warm the shower is. Stress also affects the individual differently and people have different thresholds, but there are certain identifiers to look for when experiencing stress<ref name="WellMind"/>. 

<ol>
<li>Psychological signs</li>
<li>Emotional signs</li>
<li>Physical signs</li>
<li>Behavioral signs</li>
</ol>

Psychological signs could be concentration or anxiety issues while emotional signs could be feeling more irritated or frustrated than normal.  Physical signs could be bodily changes like blood pressure or illness while behavioral signs could be poor self-care or the need to rely on substance abuse.

===Different types of stress===

As mentioned earlier stress can have different effects on a person, both positive and negative. Below is described 4 different types of stress<ref name="WellMind"/>.
<ol>
<li>Acute stress – short term stress with either a positive or negative effect depending on the situation.</li>
<li>Chronic stress – long term stress which can start affecting the mental and physical health.</li>
<li>Episodic acute stress – A type of acute stress where the stressful situations keep happening causing distress.</li>
<li>Eustress – A positive type of stress where the person is energized by the situation for example when racing.</li>
</ol>

==What causes stress==

When stressful situations occur the causes of the stress are called stressors<ref name="helpguide"/>. Stressors can be external and internal. External stressors could for example work, school, financial or relationship issues whereas internal stressors could be negative thoughts and unrealistic expectations. 
As stated earlier, people have different thresholds. These thresholds might be dependent on the persons background and physical properties. What one person finds easy to work around might be hard work for another. Therefore it is important to respect how people react differently to stress. 

[[File:Change causes stress.PNG|right|thumbnail|alt=change causes stress|Figure 1. A figure visualising the effect of stress on the individual<ref name="changestress"/>]]



One common stressor is that change causes stress as it takes people out of their comfort zone. Especially organizational change can bring the employees out of balance, disrupting their working patterns. According to a paper by Barbara Wisse and Ed Sleebos<ref name="changestress"/>  organizational change would cause an increasing level of self-reported stress among staff members and medication to combat stress also increased. When change occurs, the employees will experience uncertainty in their work methods, some might even find it a threat to their everyday life. This increases their stress levels if not managed properly. Therefore, when creating changes within a company, it is nessecary to manage it properly, not only the individually, but there needs to be a proper change management plan executed to ensure the employees feel a safe transition. Another type of stress is occupational stress, as things such as job satisfaction or work pressure can affect the individual. According to a journal about stress in information system professionals, people experienced stress and burnouts depending on factors such as age and gender, but also deadlines, coworkers, performance and job security<ref name="informationstress"/>.

==How stress affects project management==

[[File:Sources and symptoms of stress.PNG|right|thumbnail|alt=sources and symptoms of stress|Figure 2. A visualisation of sources and symptoms of stress<ref name="occupationalstress"/>]]

According to a paper by Alan Patching and Rick Best, Regardless of the cause of stress, it can decrease the workplace performance<ref name="stressdetection"/>. Imagine a situation where an employee is dealing with the effects of stress, and this results in them being unable to communicate properly with their teammates. The employee’s performance starts deteriorating and they could be unable to keep up with their deadlines. All these negative aspects will bring down the productivity of the individual, but this is not the only issue. Considering the amount of teamwork and cooperation employees conduct not only internally but also externally with customers or suppliers, the reduced performance of an individual can affect the people around them. This means, that with the stress of an individual, the whole team can be affected. See Figure 2 for examples of sources and symptoms of stress. A specific term comes to mind, when looking at the aftereffects of stress. Burnouts is a psychological syndrome response to chronic emotional and interpersonal job stressors<ref name="burnout"/>. Employees who are burned out can experience physical health issues such as headaches, sleep disturbances and chronic fatigue. This in turn will result in lower productivity and effectiveness. The employee will possibly work less for the organization and their work quality will go down. 
With this in mind, a project manager has to focus on time, money and resources management which are important when running projects. Even with project time buffers, a project risks delays. Now the question is, what about including the reduced performance in risk management, then you as a project manager would be prepared in case their employees' performance reclines.
Now imagine the stress of the employee being severe over a longer duration of time and it has resulted in physical duress that led to an employee going on sick leave. If an employee goes on sick leave because of stress, it can take a long time to rebuild their strength. They can be gone for months, years or even quit their job<ref name="lægebog"/>. Therefore an important resource is temporarily unavailable or lost and it might be necessary to hire new replacements to the lost resources. Hiring new people requires on boarding and training, while their performance in the beginning is low until they become adjusted to the new work environment. When you are working with a time limited project, there might not be time to onboard new employees, which means as a project manager you might have to accept the quality of work might go down or use extra resources on hiring expensive consultants. If no compensation is made, the customers might become unsatisfied with the project.

==Project management and stress==

It is common knowledge that managing projects is no easy task. There are many aspects of project management touching subjects within purpose, people, complexity and uncertainty. According to Margareta Gällstedt<ref name="margareta"/> projects involve tight deadlines and imply high pressure on the participants involved. The projects also rely heavily on the individual’s performance. These tight deadlines and high pressure can cause stress in a good way. As described earlier, stress can have a positive effect, and give people a boost when working. It is not difficult to imagine, that if the stress of the employees in the project is not managed properly, the project can be affected in a negative way. It can also be mentioned that projects can be both complex and carry much risk. Therefore it is important that a project manager can counter delays and issues with immediate action to handle the necessary changes. You can not as a project manager see the future and be prepared for all possible project issues, and it is possible that the project manager or their employees have a risk of being stressed in a negative way, especially if the pressure is high. It is possible though, to not only manage your project, but use some stress management tools to prevent stress and therefore ensuring the employees can continue working effectively which in turn will help keeping the project on track.  
During this wiki article, managing your employees stress is a common theme, but it is also necessary to manage the project manager's stress. Being a project manager means you have to make many decisions which affects a different amount of people depending on the size and complexity of the project. Therefore you need to, as a project manager, be in fighting condition before, during and after the project has been concluded. You might think that you are strong and managing your own stress seems unnecessary and a waste of time, especially if you have a high tolerance of pressure, but if you want people to follow you, you need to set a good example. By using some of the following stress management tools, it is possible to create a good routine and prepare for known and unknown stressors for you and your employees.

==Stress management tools==

After going through the reasoning as to what stress can do to the individual and the aftereffects, it is necessary to look at possible tools to prevent or manage the stress of you and your employees. The tools represented in this wikiarticle are relatively simple tools including time management, communication, individual management and risk management. 

===Time Management===

[[File:Time management.PNG|right|thumbnail|alt=A simple management schedule|Figure 3. A simple management schedule<ref name="timestress"/> ]]
The first tool is time management. According to a book about time and stress management<ref name="timestress"/>, time management and stress are closely related. To ensure being able to keep track of the overall project plan, it is important to manage the necessary tasks on a daily basis. Unexpected events happen, and as a project manager you will have to counter whatever happens so the project still runs smoothly. 
The first step in time management  is planning your day in advance. At the end of each day structure how your next day will look like. Answering emails takes time and is sometimes a chore. Therefore set a specific hour or two a day where you will answer and look through emails. Update your calendar so your coworkers know when to book you for a meeting. Also do remember, it is okay to say no to a coworker, if you have other important deadlines to reach. 

The next step is routine meetings. Meetings can take up your whole day, especially in an open office where people drop in time to time. Organize meetings on a daily or weekly basis depending on the need. Also make sure that whatever you have to discuss is planned in advance for an effective meeting.

The third step is meeting the deadlines. It is easy to say yes to assignments, but being able to complete them all is another topic. In project management deadlines are quite important, as the plan might get postponed, which will cost money and resources. Make sure you and your employees are able to meet the deadlines necessary to complete the project in time. 

The fourth step is prioritizing your work and failure to do so is a waste. Together with planning the previous day a you should prioritize the assignments you have to do. Most important first and less important last.  As seen in Figure 3 this is a simple time management form from the  time and stress management book<ref name="timestress"/>. You list your priorities and when you have to do them. People are different, but visualizing your plan might help you.

By following these four steps it is possible to keep track of your assignments, and it should help you reduce stress as it gives some control over a possible chaotic day.

'''The pros'''
* Less unwanted interruption
* More control of yourself and your time
* The feeling of success when the plan goes as expected
'''The cons'''
* It takes time to plan
* Restrictions when choosing what tasks to complete
'''Limitations'''
* If you have a very diverse project, with many changes happening, it might be difficult to plan ahead.

===Individual Management===
[[File:Individual management.PNG|right|thumbnail|alt=Individual stress management methods|Figure 4. A figure based showing the individual reaction to stress<ref name="causes"/>]]
As an individual it is possible to make changes to lessen your stress. Based on Figure 4 it is possible to change two overall aspects. Either your situation or your self. If your situation is causing you stress, for example at work or in your home, you should try to remove yourself from the situation or change it, so it stops working as a stressor. There are certain cases where the individual might not find it possible to remove themselves from the situation, for example being in a project with a uncooperative coworker. As a project manager it is your job to ensure your team is able to work together.

The other aspect is changing oneself. As a project manager you can mostly have workshops to help educate your employees how to cope with stressors through workshops and open communication<ref name="causes"/>. Changes one can make to themselves is gaining healthy habits such as eating and sleeping regularly or exercising and taking their necessary vacations.

'''The pros''' 
* Less stressors or it gives you insigts in what stressors affect you.
* Open communication channels is not only good for stress management but can encourage ideas to improve work from your employees.
* Being healthy improves your ability and possibly your motivation to work.
'''The cons'''
* Knowing a stressor does not mean you can do anything about this stressor.
* Depending on your knowledge, it might be necessary to invest in materials and resources for the stress management workshops.
'''Limitations'''
* Sometimes people want to just work and your employees might not know or be interested in working with their mental health. This means it will be difficult to setup these workshops and open communication channels.

===Risk management - The six stages===
[[File:6 stages picture.PNG|right|thumbnail|Figure 5. A visualization of the six stages<ref name="causes"/>.]]
When managing stress, there can be many factors, which means it is impossible to counter all stressors that can happen during your project work. Therefore it is crucial to look into several factors to be able to navigate where the highest severity can happen. A method called ‘’A risk assessment strategy – six stages’’<ref name="causes"/>  is described below and can be seen in Figure 5.

<ol>
<li>First you need to assess the risk of stress. What is the risk of stress happening. What types of stressors are happening. This helps you assess the situation.</li>
<li>Secondly you have to assess what the risk of illness can occur. How will the stressors affect the individuals and how severe is the stress that can happen for your employees.</li>
<li>Thirdly you have to assess the extent of exposure. Which employees are affected by the different stressors and how many are affected. </li>
<li>Fourth you need to understand how the stressors work on the individuals.</li>
<li>Fifth you need to identify current stressor management systems in your business or create new ones to support the employees that needs help.</li>
<li>Sixth you have to start managing based on the severity and portion of people affected by the stressors. The stressors with the most negative outcome on your project needs to be prioritized.</li>
</ol>

The Figure ''six stages'' represents the different steps a project manager should conduct through risk assessment of stress. 

'''The pros''' 
* This tool makes it possible to prepare ahead of the stressors with the highest risks in the project.
* It encourages communication and understanding your employees needs

'''The cons'''
* It can be time consuming gathering data
* Depending on your knowledge, it might be necessary to invest in materials and resources to understand different stressors.

'''Limitations'''
* Knowing the worst stressors is a subjective decision based on the current knowledge you have.
* You know what you know, and you know there are things you do not know which might be difficult to take into consideration.

==Conclusion==

Stress can affect people differently. What is known is that stress can have negative physical and mental effects on the individual. Because of how projects work, there is plenty of pressure on the individuals and their performance which in turn can affect the projects outcome. Therefore stress can have a negative outcome on projects, if not managed properly. Having to work with stress management is up to the project manager. Especially since people are affected differently by the levels of stress, the project manager needs through communication, available resources and their decision making, to choose whether they think it is worth the effort. Based on the negative effects on not only people but their ability to work, stress management should be taken into consideration when starting up or working on a project. There are several tools listed in this article, but based on the projects need, the project manager can choose to focus on one or several.



==Annotated Bibliography==
<references>
===References===
<ref name="Mentalhealth">UK Mental health foundation (2021). An article about the definition of stress.[https://www.mentalhealth.org.uk/a-to-z/s/stress External link]</ref>

<ref name="WellMind">Scott, Elisabeth (2020). An article defining stress.[https://www.verywellmind.com/stress-and-health-3145086 External link]</ref>

<ref name="helpguide">Segal, Jeanne; Smith, Melinda; Segal, Robert; Robinson, Lawrence (2021). A helpguide to handle everyday stress.[https://www.helpguide.org/articles/stress/stress-symptoms-signs-and-causes.htm External link]</ref>

<ref name="changestress">Wisse, Barbara; Sleebos, Ed. When Change Causes Stress: Effects of Selfconstrual and Change Consequences. Journal of Business and Psychology, Vol 31, no. 2, 2016, p. 249-264, Springer New York LLC. [https://findit.dtu.dk/en/catalog/564b651336b20a153b0bf059 External link]</ref>

<ref name="informationstress">Sethi, Vikram; King, Ruth C.; Quick, James Campbell. What causes stress in information system professionals?. Communications of the Acm, Vol 47, no. 3, 2004, p. 99-102, ASSOC COMPUTING MACHINERY. [https://findit.dtu.dk/en/catalog/54406dfeacc4e2154daf916e External link]</ref>

<ref name="stressdetection">Patching, Alan; Best, Rick. An investigation into psychological stress detection and management in organisations operating in project and construction management. Selected papers from the 27th Ipma, Vol 119, 2014, p. 682-691, ELSEVIER SCIENCE BV. [https://findit.dtu.dk/en/catalog/58fc919e5010df51ba280f70 External link]</ref>

<ref name="occupationalstress">Bridger, Robert S.; Day, Andrea J.; Morton, Kate. Occupational stress and employee turnover. Ergonomics, Vol 52, no. 11, 2013, p. 1629-1639, TAYLOR & FRANCIS LTD. [https://findit.dtu.dk/en/catalog/544f377ae44c7a8667403313 External link]</ref>

<ref name="burnout">Bridger, Maslach, C.; Leiter, M. P.. Burnout. Encyclopedia of Mental Health: Second Edition, 2016, p. 222-227, Elsevier Inc. [https://findit.dtu.dk/en/catalog/5cfa166dd9001d013d0b0876 External link]</ref>

<ref name="lægebog"> Nelholt, Lisa; Sachs, Camilla. (2019). Danish health platform ''Sundhed.dk'' guide for doctors handling stress affected patients.[https://www.sundhed.dk/sundhedsfaglig/laegehaandbogen/sundhedsoplysning/sundhedsoplysning/diverse/stress/ External link]</ref>

<ref name="margareta">Gällstedt, Margareta.Working conditions in projects: Perceptions of stress and motivation among project team memebers and project managers. International Journal of Project Management, Vol 21, no. 6, 2003, p.449-455, Elsevier BV. [https://findit.dtu.dk/en/catalog/543e8d92acc4e2154d1eea4d External link]</ref>

<ref name="timestress">Benson, Greg; Fagel, Michael J.; Garwood, Eric L.; Thibodeau, Charles T.. Time and stress management. Professional Protection Officer: Practical Security Strategies and Emerging Trends,2019, p.41-48, Elsevier. [https://findit.dtu.dk/en/catalog/5f9ff9aad9001d46223ef408 External link]</ref>

<ref name="causes">Michie, S. Causes and management of stress at work. Occupational and Environmental Medicine, Vol 59, no. 1 ,2002, p.67-72, B M J PUBLISHING GROUP. [https://findit.dtu.dk/en/catalog/543e414cacc4e2154d063d7c External link]</ref>