Journal of Transcultural Nursing

http://tcn.sagepub.com/ Multiple Role Stress and Patterns of Coping of Egyptian Women in Clerical Jobs
Marianne Hattar-Pollara, Afaf Ibrahim Meleis and Hassanat Nagib J Transcult Nurs 2003 14: 125 DOI: 10.1177/1043659602250633 The online version of this article can be found at: http://tcn.sagepub.com/content/14/2/125

Published by:
http://www.sagepublications.com

On behalf of:

Transcultural Nursing Society

Additional services and information for Journal of Transcultural Nursing can be found at: Email Alerts: http://tcn.sagepub.com/cgi/alerts Subscriptions: http://tcn.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav Citations: http://tcn.sagepub.com/content/14/2/125.refs.html

>> Version of Record - Apr 1, 2003 What is This?

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

10.1177/1043659602250633 Hattar-Pollara TRANSCULTURAL NURSING / April 2003 JOURNAL OFet al. / EGYPTIAN WOMEN IN CLERICAL JOBS

ARTICLE

Multiple Role Stress and Patterns of Coping of Egyptian Women in Clerical Jobs
MARIANNE HATTAR-POLLARA, DNSc, RN
Azusa Pacific University

AFAF IBRAHIM MELEIS, PhD, DrPs (hon), FAAN

University of California, San Francisco

HASSANAT NAGIB, PhD, RN

University of Alexandria, Egypt

Egyptian women are increasingly becoming a significant work force; however, many of these women continue to occupy low-income jobs. In the study reported here, 190 women in Egypt employed in clerical jobs were asked about the satisfaction and stress they experience in their work and maternal roles. They were also asked about their coping approaches and the demands in their daily lives. The Womens Role Interview Protocol was used to collect data. The results were analyzed within the symbolism of the Arab/ Egyptian language using thematic and content analysis. A prevailing theme is the interconnectedness among all womens roles when describing their stress, satisfaction, and coping. Another major theme that transcends all roles is the perception of inequality and how it affects their daily lives. Emergent stressors were grouped under employment role stress, maternal role stress, marital role stress, and relational role stress. Women coped through learning to be self-reliant and by using cognitive and emotion-focused coping approaches. Womens stress was embedded in inequality in gender roles, and the women are empowered to cope through relying on endurance and outliving conflict.

Egyptian womens rate of participation in the labor force

has risen dramatically in the past two decades. Driven by economic pressure, the majority of Egyptian women, who are also wives and mothers, joined the labor force and are integrated into the market economy through employment in governmental agencies, in low-paying clerical jobs (Abed Ellatief, 1989; Zurayke & Saadeh, 1995). Although the economic pressure on the family urges Egyptian women to seek employment, cultural values continues to support the traditional roles of Egyptian women and, therefore, paid employment for women leads to negative sentiments and fear of neglect of womens primary roles (Fernea, 1994; Ghorayshi, 1996; Moghadam, 1995).1 Egyptian employed women have yet to receive recognition of their role expansion or social backing for their multiple roles. Cultural values continue to strongly enforce and prescribe assignments of responsibility for children and home to women, regardless of paid employment (Fernea, 1994; Mahmoud, 1989). Employed Egyptian women are expected to attend to their womanly duties and obligations and to continue to consider these responsibilities as their primary roles (Goodwin, 1994; Mohsen, 1994). Idealization of traditional gender roles compounds the employed womens daily efforts to handle both paid employment and family without structural assistance. By virtue of early socialization into prescribed traditional gender roles, Egyptian women tend to conform to their socially expected roles (Adam, 1982; Hijab, 1989) and take upon themselves the juggling of responsibilities for both paid work and family. The inevitable outcome of trying to accomplish twice as much with the same resources and without needed recognition or social support is multiple-role stress. Several research
125

Keywords: stress; coping; multiple roles; women; Egyptian

Authors Note: This report is part of an international study that was completed in five countries, including Egypt, Colombia, Brazil, Mexico, and the United States. This study was funded by Kellogg International Fellowship. Journal of Transcultural Nursing, Vol. 14 No. 2, April 2003 125-133 DOI: 10.1177/1043659602250633 2003 Sage Publications

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

126

JOURNAL OF TRANSCULTURAL NURSING / April 2003

studies have demonstrated the direct association between multiple-role stress and the negative physical and mental health consequences for women and their children (Barnett & Baruch, 1985; Barnett & Marshall, 1992; Barnett, Raudenbush, Brennan, Pleck, & Marshall, 1995; Baruch, Biener, & Barnett, 1987; Bullers, 1994; Parasuraman, Purohit, Godshalk, & Beutell, 1996; Piechowski, 1992). Brown, Rawlinson, and Hilles (1981), in their sociopsychiatric studies of married women with children who experienced disappointment in their multiple roles, found that these women had a higher risk for depression. Several studies have also noted the general rise in the workload of married women compared with that of married men. Married women with children were found to have 17% less time for rest and recreation than working married men (Kandel, Davies, & Raveis, 1985; Seymour, 1992). Stewart and Salt (1981) found a significant association between working womens multiple-role stress and physical illness and between stress and depression. They indicated that the stress at work preceded physical illness and stress in the home preceded depression. The effects of sex-role stereotype have based womens success on their ability to fulfill the typical female roles of childbearer and rearer, homemaker, and nurturer (Nykodym, Simonitti, Christen, & Kasper, 1987). As such, the stereotypical roles imposed on women in the work environment tend to create conflicts between their expectations of themselves and others expectations of them (Thorton & Leo, 1992; Yang, 1993; 1998). Little is known about the nature of stress that Egyptian employed women experience in managing the demands of their multiple roles and the coping pattern they use to offset stress. Without revealing and understanding the nature of these womens multiple role stress, within their own cultural context, and without delineating the structural forces governing their lives, efforts aimed at their empowerment and enhanced health outcomes will be only remedial. How these multiple roles affect women, and how women survive and cope with these stressors, are the questions examined in this article. METHOD
Participants

Participants ranged in age from 22 to 52, with a mean of 34.3 years (SD = 5.85). They had between one and five children (mean = 1.8, SD = 1.04). A total of 30% (n = 57) had a college degree, 21.5% (n = 41) had a technical high school diploma, 46% (n = 87) had a high school diploma, and 2.5% (n = 5) had a junior high school diploma. Of the participants, 93% (n = 177) were Moslem, and 7% (n = 13) were Christian. Participants rated the adequacy of their family income as not enough (24.2%), barely enough (30.8%), adequate (38.0%), and more than adequate (6.1%).
Instruments

Data were collected using The Womens Role Interview Protocol (WRIP). The WRIP is a semistructured interview guide designed to elicit participants descriptions of their multiple roles, the stress they experience, and their coping patterns. It has been used in several international studies of womens roles (Meleis & Bernal, 1994; Meleis, Douglas, Eribes, Shih, & Messias, 1996; Meleis, Kulig, Arruda-Neves, & Beckman, 1990; Meleis, Norbeck, & Laffrey, 1989; Meleis, Norbeck, Laffrey, Solomon, & Miller, 1989). The WRIP was developed and standardized in the English language. For this study, the standardized English language instrument was translated into Arabic by a team of four bilingual nurse researchers. A linguistics expert was also consulted regarding meaning and syntax of the translation. The translated instrument was pretested on three Egyptian clerical workers for readability and content validity. Several modifications were made by the Arabic-speaking researchers, as well as by several Arabic-speaking graduate students. The final product is a dynamic equivalence translation of the instrument that reflects the consensus among the Arabicspeaking Egyptian research team.
Data Collection

Participants were recruited from eight different government agencies and institutions in Alexandria, Egypt. Permission to conduct the study was obtained from all the appropriate department administrators. Potential participants who met the inclusion criteria of being married Egyptian women employed in clerical jobs in government agencies were invited to participate in the study by the research assistants. Four trained research assistants collected the data. Of the 199 women who were invited to participate, 190 agreed to do so and completed the interview.

The trained Egyptian research assistants conducted the interviews at an office or at the work areas of the participants. These sites were not ideal, but they were the only ones to which the participants would agree. The lack of privacy and the occasional interruptions may have constrained the participants openness and the candor of the interview data. During the process of data collection, frequent meetings were scheduled between the local research team coordinator (one of the coauthors) and the research assistants. The primary aim of these meetings was to supervise the data-collection procedure and to share experiences among the research assistants. The interview process was discussed to ensure consistency among the research assistants, clarify processes, and solve the issues that arise in the normal implementation of research methodology.
Data Analysis

The interview data were analyzed using a qualitative content-analysis approach to identify themes that describe

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

Hattar-Pollara et al. / EGYPTIAN WOMEN IN CLERICAL JOBS

127

the respondents perceived stresses and their patterns of coping in their multiple roles. This analysis was completed before the text was translated into English. Themes, categories, and concepts that emerged were then validated through constant comparison and cross-checking. Through dialogue between two of the coauthors, a thematic coding scheme was developed, and each interview was coded accordingly. The responses were analyzed for their content and context, and the identified themes were treated as the unit of analysis. RESULTS Participants descriptions of stress in their lives transcended the stress inherent in each of their multiple roles. Rather than confining their descriptions specifically to their work, spousal, and maternal roles, participants often connected the stress in their work and family roles and used each roles stress as a context for the other, indicating that it is the simultaneous demands of their multiple roles that contribute to their stress experience. For example, as one participant said, My job alone is manageable, but the responsibility toward my job, my children, and my husband leaves me feeling drained to a point I have no time to take care of myself. Within this overriding theme, four areas of role-related stress emerged from the data. These are employment-role stress, maternal-role stress, marital-role stress, and relational-role stress. Each emergent category is described below. EMPLOYMENT-ROLE STRESS/SATISFACTION The participants spoke of the physical and emotional drain they felt after a day of clerical work because they went home to deal with a second set of demands and responsibilities. The theme in their narrative responses singled out the coordination of their work role with the daily demands of their spouses, children, and household responsibilities as the source of their stress and overload. Clerical work deprived them from carrying out their primary functions of mother and spouse adequately. They described their guilt, anxiety, and dissatisfactions with their performance of other role functions. Mekassara, which means always feeling short in meeting ones goals, was a repeated concept used in relation to their responsibilities regardless whether related to their role functions as wives, mothers, or workers, or to their housekeeping responsibilities. Examples of their vivid descriptions of being mekassara are: I struggle daily to meet the needs of my family, but I feel that my job prevents me from carrying out my duties as a wife, a mother, and a homemaker; I feel always mekassara; My job does not allow me the time to carry out my duties as a wife; I am mekassara toward my husband; and The psychological pressure I experience at work makes me feel mekassara in my role as a wife and a mother. In spite of their constant sense of falling short of expectations, many of the women in this study perceived employment

as an opportunity to achieve a sense of selfhood, have a purpose in life other than mundane household work, and achieve a degree of freedom and independence. Therefore, despite the stress that the participants experienced in coordinating their family and work roles, the women valued their gainful employment and regarded their ability to go out in the world and earn an income as very important to their sense of security and the security of their families. For example: My job provides me with something different than household cleaning; My income provides me the freedom to buy things I need and to share in the financial decisions concerning the family; Working helps me fill my days with a purpose; and We cannot afford living with a single income; the cost of living has increased so much that without my income we cannot survive. Time for these women was a major source of stress as they experienced daily pressure to manage all the competing demands. Here are some of their comments: There is not enough time in the day to do everything that needs to be done; I try hard to use my time wisely, but time is always against me; there is just not enough time to be the wife, the mother, or the homemaker that I want to be; The demands of the family and the pressure from all sides makes me feel stressed and overwhelmed; The demands on me as a woman are much more than on my husband; I am expected to perform the womanly duties no matter how tired or sick I may be; and I would appreciate my husbands help with the care for children or the household duties, but I get no help. Participants were conscious of the gender inequity in the demands on their time. They described the injustice toward working women who are left with the burden of proving that gainful employment does not affect their household responsibilities. Participants described their sense of inequity: I feel that I have no rights; I am expected to perform the duties at home, regardless of my work responsibilities; As a working woman, I am supposed to care for my family first and be available to my husband and children; and I am told that my primary responsibilities are the home, and my work should not interfere with it. Work for the participants also had another consequence, an exaggerated worry over the safety and wellbeing of their children they experience while working: I fear and worry for my childrens safety. There are a lot of dangers out there in the society. The drugs, the car accidents, the bad people, and what I hear on the news make me feel anxious and worrisome about them when I am away from home. They also added that they worry about their second-shift responsibilities. As one participant described it, When I am at work, I worry about what needs to be done when I get home. Remunerated work, for the women in this study, appeared to be a privilege rather than a right. Whether to continue working for wages or relinquish the employment role was an active issue that the majority of the participants often encountered, especially during times of high stress in marital relations and when their spouses felt that their employment role

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

128

JOURNAL OF TRANSCULTURAL NURSING / April 2003

was taking them away from performing their domestic role functions. The participants spoke of their need to constantly defend continuation of their employment against spouses constant objections and opposition. Most of the participants indicated that their ability to work for a wage is contingent on both their ability to carry out their other family roles fully and on the extent of their husbands satisfaction with their performance as wives and mothers. If husbands evaluations are negative, the women often give up their employment due to spousal coercion, both formal and informal. Given that their traditional gender roles continue to be reinforced despite their gainful employment, the participants end up shouldering the demands of and stress in their various roles alone. It was clear to them that the issues and the stress associated with their employment are theirs, and theirs alone, to manage. That the women understood and abided by these rules was well described in their responses. For example, He believes that I am the one who should shoulder everything inside the house, so when my job interferes with ability to do my household duties, he tells me to stay at home and attend to my primary duties; I keep the problems of work to myself or vent with my friends about it; I cannot bring work problems at home for fear that my husband will pressure me again to quit my job; My husband is not content with the fact that I leave the house to work, but given our financial hardship, he feels forced to accept this fact; My second income is needed for the family; otherwise I would not be allowed to work; and He depends on me to do everything for him and the children, even on bringing him his glass of water, so he is not content with the fact that I can be tired after a day of work. Clearly, although they received neither support nor approval from their spouses for their work role, they sought to keep and protect the privilege of working for a wage. MATERNAL-ROLE STRESS/SATISFACTION Children brought immense happiness and satisfaction. Becoming or being a mother is a source of contentment and pride. Participants in this study described with conviction and clarity the intrinsic value of their role as mothers in preparing their children for a successful future through maintaining all aspects of their lives. Motivated to provide all they could for their children, they happily shouldered their maternal role responsibilities with love and much pride, despite the stress they experienced on a daily basis. Even their employment was perceived as a valuable resource for providing better living standards and to ensure a better future for their children. For example, My income allows me to give my children more of what they need and I try to save some of my income for the future of my children. In fact, their role as mothers seems to buffer the stress they experience in carrying out the responsibilities toward their children: My role as a mother makes me accept the responsibility of my other roles; When I give

care to my children I feel happy; and I am happy for being blessed with children. Schoolwork, health concerns, disciplinary issues, and problematic behavior in their children were sources of a great deal of stress for some participants. These responsibilities weighed heavily on the women on a daily basis. Time limitations and fatigue were perceived as contributing to their sense of burden. Making sure that their children achieved success in their schooling was of high priority to them. Indeed, educational success of children is the single most significant value they hold, and striving for such success is considered the most stressful aspect of their lives. They devote enormous amounts of energy and time to childrens homework, and preparation for milestone exams and the childrens success is often perceived to reflect the extent to which mothers are successful in their maternal role. At the same time, they worry and feel anxious about housecleaning and cooking. They felt that prioritizing is needed, but when each role demand has its own weight and significance to them or to others in the family, the sense of being mekassara tended to overwhelm them. MARITAL-ROLE STRESS The major areas of stress experienced by the participants in this study are the lack of spousal sharing of household responsibilities and the perception of inequity in their spousal relations. The women assumed and coordinated all the responsibilities for their children. Their domain was perceived as including schooling, cooking, feeding, caring, nurturing, and transporting, among other responsibilities, but necessarily by free choice: Inside the house, I am solely responsible for everything; I am expected to do everything inside the house because I am told that I am the manager of the household and I should shoulder all the work; and My husband just gives orders of how he wants me to care for the children, but since hes spoiled like all men, he does not help with the work. They did express their wishes and hopes for support and backing in the provision of childrens care and for equality in parental responsibilities, but they felt that they could not demand this sort of help. Instead, they resigned themselves to the constraints and limitations of their gender as women, accepting the confinement of their traditionally prescribed roles: The responsibility toward the children is not a concern for my husband; He forfeits his responsibility toward the children and leaves all the work for me to do; I want my husbands co-sharing of childrens responsibility, and I hate his negativity and refusal in lending help in their school work; and The views toward women is that they have to tolerate everything because they are women. The responses of these participants vividly portray their opposition to gender-based traditional role expectations. Yet, they seem to perform in their expected roles with a certain degree of resignation. This is likely due to the fact that they under-

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

Hattar-Pollara et al. / EGYPTIAN WOMEN IN CLERICAL JOBS

129

stand fully the potential repercussions if they rebel against patriarchal authority. Women who felt appreciated for what they do for their families perceived less stress than those who had to negotiate, anticipate, problem-solve, or avoid conflicts. Marital relations, as discussed by the participants, revealed patriarchal dominance in families. The women described their own issues in terms of perceived expectations of spouses, family, or society at large. They spoke of gender-based issues and consequent stress they experience in their multiple-role functions. The issues included the attitude of their spouses toward their employment, their natural or traditional roles, and their inability to fulfill their primary duties effectively, as well as spousal attitudes as to personal freedom and autonomy. They spoke of inequality in decision-making and the division of domestic labor, and of their sense of feeling controlled: I try to negotiate the household needs, but he is always the one who has the last word; He is only concerned with outside affairs; inside the house I am responsible for everything; I have no personal freedom; I have to have his permission to go visit my family; He is filled with jealousy to the point of hallucination; he imagines that I meet people when I go to work; I do not have any personal freedom; and It is true that marriage and motherhood gave a me chance to have more freedom than when I was living with my parents, but I am still constrained in movement and discussions. Participants expressed anxiety and, at times, despair in successfully managing their stress during times of marital conflicts. They thought that if they could develop and establish equality and reciprocal trust with their spouses, they would be more capable of managing the daily stress in their lives and of helping their spouses cope with the stress of daily living. Husbands domination, control, and abuse were perceived as powerful barriers to improving the conditions under which they assume their multiple roles: I wish that the intensity of my husbands domination would diminish; I wish for fairness and a change in the Eastern male way of thinking; My husband insults me and belittles me; and He easily loses his temper and takes his anger out on me. RELATIONAL ROLE STRESS/SATISFACTION Living with in-laws, limited income, and out-of-town employment of the spouse were expressed by participants as further sources of stress in managing their multiple roles. Due to limited income, survival needs have forced some participants to reside with in-laws but, as some participants indicated, interference by in-laws has limited their ability to establish their own identity as wives, mothers, and heads of domestic households: Living with the in-laws is not providing us the comfort we need; When our economical situation improves, everything else will also improve; My motherin-law controls my life; she keeps the money we make and

manages the household budget; and Living with the in-laws leaves no room for me to have a sense of myself or my identity. Living with in-laws seems, however, to provide tangible benefits for some participants. Saving rent money, child care, and cooking meals were identified by those women as minimizing the level of stress in their multiple roles. COPING WITH DAILY LIFE The participants in this study portrayed a copying style that is based more on self-reliance than on reliance on others. Relying on self to deal with multiple daily demands and during periods of increased stress emerged as an overriding theme. Two distinct approaches to coping with the stress in their multiple roles were identified. More than one third of the respondents used cognitive-focused coping; the rest used emotion-focused coping in the form of shielding of emotion, becoming nervous (assabiah), or disengaging and distancing of self. Among the recurrent themes that emerged from the participants responses is the tendency of these women to assume the problems in both their lives and the lives of their family members. Whether in their role as clerical workers or in their domestic roles, they appear to operate as essentially and ultimately responsible and accountable for providing for the comfort of their families. The notion of self-reliancetaking it upon themselves to problem-solve without expecting or enlisting the help of significant othersemerged as an overriding theme for their coping patterns. On a day-to-day basis, they coped with the stress of their multiple roles by effective use of time, prioritizing, and using whatever resources were available to them to avoid or prevent stressful situations: I use my time effectively; The moment I get home, I do not waste a minute on anything other than what needs to be done by way of cooking, cleaning, and childrens homework; Sometimes I feel obliged to postpone housecleaning to attend to family needs; I set aside time to discuss and deal with family issues before they become too difficult to handle; I use my sister to provide childcare; I trust her with raising my children; I leave the cooking for my mother in-law to do, since she is in control of the finances; and I do my grocery shopping during my lunch break. When stress exceeded the participants ability to manage their multiple role demands effectively, they coped by either taking a leave without pay from their employment or trying to negotiate ways to manage the stress with their spouses. About one third of the women saw taking a leave without pay as the only natural option available to them for managing the stress in their domestic role demands. The Egyptian Family Law provides women with the right to take an extended leave of absence for family affairs. This law demonstrates societal expectations that women are the one who are expected and supported by the law to maintain their family intact. Taking a

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

130

JOURNAL OF TRANSCULTURAL NURSING / April 2003

leave without pay was the womens way of coping with the stress associated with competing role demands. Participants described the primacy of their family responsibilities in the following comments: I take time off from work so I can do what is being asked of me as a wife; I obtain a marital leave of absence from work with my husbands approval, so that we can work out the stress and tension in our lives; I take time off from work to absorb the problems in my family; and My husband does not support my work; he pressures me to stay at home; I usually refuse, but when the stress and the demands are too much to handle, I consider taking time off to deal with the problems. Another approach the participants used to cope with personal and multiple role issues was negotiating issues with their spouses. Depending on the nature and intensity of the issues, and depending on their personal tendencies, the participants used cognitive-focused and/or emotion-focused approaches (Lazarus & Folkman, 1985). About one third of the respondents used a proactive, anticipatory, nonconfrontational approach to negotiation with their spouses. They described how they learned to think over the problem in their heads first, reflect on their choices and priorities, anticipate potential reactions, maintain rationality and objectivity, and approach the discussion with friendliness and calmness. They also emphasized the importance of active, attentive listening and remaining silent when the discussion became heated or tense. Some women indicated that they change their schedule to set apart uninterrupted time for their discussion. These participants indicated that they often achieve (with some compromise) the desired problem-resolution and succeed in releasing a great deal of tension in the marital relationship: I try to think systematically; then I start the discussion; I try to solve the problem while maintaining extreme calm, congeniality, and friendliness; I behave wisely; and I talk the problem over with my husband because I am certain that this will take care of the tension between us. Emotion-focused coping revealed several approaches to living with or handling stressful marital conflicts. Approximately another one third of the respondents used a process of covering up how they really felt as a strategy to cope with role overload and with the discord in their marital relationships. These participants described their hurt, anger, disappointments, frustration, and despair, but they learned how to keep their feelings to themselves to preserve their sense of dignity and to put an artificial limit on their husbands control over their lives. They described using strategies to help them endure stress and exercise patience, acceptance, and submission, knowing that there are no better alternatives: I remain silent and maintain patience; I end up carrying the burden of many problems; I endure his behavior because there is no other way; he will not change; I cannot do anything; I try to hide my true feelings so that he will not know that I am bothered by the problem; I got used to being distressed; that is why I ignore the problem and let it pass; I do not respond,

and I seclude myself in any place so as to minimize the intensity of the tension; It happens that when we are arguing I just prevent myself from talking with him, and later I resume talking; I remove myself and stay in my room, and I avoid talking to anyone; and I try to ignore it so as to avoid making my life unbearable. These women recognize that the potential of going against the patriarchal structure is an uphill battle and an added responsibility that could increase their sense of overload. Therefore, when faced with constricted alternatives, shielding feelings and emotional distancing and/ or disengaging became their coping style. This style underlines an oppressive family relationship and highlights the sense of powerlessness and marginalization that these respondents experience as women, wives, mothers, and wage workers. Becoming asabiah was identified by one quarter of the respondents as their instinctive tendency for handling stress in their multiple roles. As a construct, asabiah means a number of emotional states, including nervous, emotional, shorttempered, volatile, anxious, angry, having poor impulse control, and rage. These respondents spoke about the extreme level of frustration, most of which they attributed to inequities in their families and to lack of spousal participation in carrying their share of responsibilities. They described how they experience losing control of their emotion by shouting and crying, and at times ending up in a hysterical state of nervousness and a deep sense of emotional instability. They also indicated that they become easily irritated with everybody and everything, and responded to any minor infractions on the part of their children with physical punishment: Sometimes I get emotional; I cry and beat the children and avoid speaking with my husband; I cry and turn the apartment upside down and beat the children; I beat the children; I scream and end up in a state of nervousness; I get very upset with him during the discussion because he shows no willingness for mutual communication and understanding; At times I scream, and at times I tear away my clothing; and I beat the children; then I regret doing it. Becoming asabiah and demonstrating such an emotional response to stress is not a foreign concept for womens behavior in Egypt, and it is considered culturally acceptable among certain lower socioeconomic classes. However, of grave concern is the apparent level of stress and frustration that these respondents experience, as well as their tendency to exert their power on the powerless. Their abuse of their children as a response to stress is troubling to them, but they feel powerless in preventing it. It becomes an outlet of their anger about inequity. In the face of extreme stress, and when attempts to work out the problems with their spouses yielded more conflicts than solutions, a few of the women in this study resorted to enlisting the aid of members of their extended family. Some chose to speak privately with their mothers to seek advice and vent feelings. Others involved the members of their extended family openly to enlist their aid and support. Several took the

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

Hattar-Pollara et al. / EGYPTIAN WOMEN IN CLERICAL JOBS

131

children and left their home, seeking refuge in the home of their biological family. This last approach indicated reaching a level of stress and marital discord that the participants could no longer bear: I talk with my mother about my problems; this helps me ventilate my tension; I complain to my mother without him knowing, because he does not approve of discussing our domestic problems with anybody.; I involve my parents and ask them for their help. I take the children and go to my parentshouse; and I leave the house and go to my mothers. CONCLUSION AND DISCUSSION A total of 190 Egyptian married women, with children, in clerical jobs were interviewed about their stress in and coping with their multiple roles. The findings of this study detail the nature of the stress in their roles and their coping patterns. The findings profoundly demonstrate that much of their perceived stress, and the approaches used for coping, are imbedded and confined in their traditionally defined gender roles. Family life and employment shape the nature of womens experience, their stress experience, and how they tend to cope (Crouter, 1984; Hertz, 1986, 1994). When women are predominantly accountable for family responsibilities, the stress, in dealing with competing demands while trying to cope with inequities, is likely to have negative consequences on their lives and, consequently, on their health. Although the participants in this study were stressed because of competing demands and time constraints, their stress experience was heightened by the fact that their employment was perceived as being both peripheral to their other demands and dispensable if and when it interfered with domestic role functions. This pervasive societal and family perception of their work adds to their daily burden. Not only did they have to shoulder the task of constantly negotiating and trying to prove that their employment does not interfere with their family/home roles, but they constantly felt inadequate and/or unable to meet fully the demands of all of their roles, and they were dissatisfied with their own performance. They felt that they were short in fulfilling all of their role functions (mekassara). Studies have shown that the stress of combining parenthood and employment, in a male-centered society, exposes women to physical and psychological distress, including dissatisfaction, sadness, anger, malaise, and physical aches and pain (Cain, 1986; Davidson & Cooper, 1984, 1985, 1987; Gilbert & Rachlin, 1987; McBride, 1997; Mclaughlin, 2000; Parasaraman et al., 1996). These findings beg the question whether employment empowers Egyptian women or enhances their marginalization. In a study on womens paid employment in Iran, Ghorayshi (1996) points out that paid employment enhances Iranian womens position at the micro level, but their ability to negotiate is limited due to the prevailing traditional values and the reinforced gender-division of labor.

Studies have consistently shown that demands of the work-family role produce unique stress on working women in managing dual demands of employment and household responsibilities (Cooper, Arkkelin, & Tiebert, 1994; Davidson & Cooper, 1985; Leonardo, 2000; McBride, 1997; Ross, Mirowsky, & Huber, 1983; Yang, 1998). The participants responses reflect their awareness of the unjust division of labor, but the participants also resigned themselves to acceptance of cultural prescriptions of the demands in their roles, and the superimposed patriarchal structure of the family system. Similar findings were reported in a study of women in clerical jobs in the United States, where conditions of submission to dominant spouses or male partners, precedence of housewife and child-caring duties, and denial of personal desires and aspirations seemed to constrain womens health as they attempted to juggle their varied responsibilities and integrate domestic and occupational roles (Meleis & Stevens, 1992). Miller and Petro-Nustas (2002), in their ethnographic study of Jordanian women, indicate that women are caring more for their family than for themselves. The findings related to abusive spousal relations and the apparent downshift of abuse that the participants display toward their children reflect a serious health concern for both the women and their children. Domestic abuse and violence in Egypt is beginning to be addressed in the public media. Motivated by avoiding public shame and social disgrace, abused women tend to hide the abuse they endure. Abused Egyptian women tend to rationalize their husbands physical and verbal abuse and to attribute their spousesabusive behavior to their volatile male characteristic (Hattar-Pollara, Meleis, & Nagib, 2000). Thus, when women are socialized to accept abuse as an inevitable male characteristic, and when the legal system perpetuates the legitimacy of domestic abuse, it is no surprise that Egyptian women would not only endure it but would also find a rational explanation for it. The downshift of abuse toward the powerless seems to be a byproduct of the stress and abuse that the participants endure (Houston & Kelly, 1989; Santilli, 2000). Recent studies have demonstrated that women who face excessive frustration and stress are more irritable, explosive, and unpredictable (Houston & Kelly, 1989; Kandel et al., 1985; Ross et al., 1983; Porter et al., 2000; Santilli, 2000). The downshift victimization by the powerful toward the powerless poses an even greater and urgent health concern for both women and children. Gender and power seem to define the range of possible choices for coping by participants in this study. Shouldering all domestic responsibilities without the ability to access options for restructuring the nature of their role responsibilities or making independent decisions leaves women with no expectations for others help and with the need to rely only on themselves to manage their multiple role demands. In addition, Egyptian women are socialized to value, above all, their primary responsibility to protect, nurture, and maintain the

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

132

JOURNAL OF TRANSCULTURAL NURSING / April 2003

intactness of their families at all cost. This value, which is related to the primacy of mothering and familial responsibilities, make them vulnerable as workers (Ghorayshi, 1996). The respondents tendency to opt for a leave from employment to cope with the stress of their multiple roles restricts their chances for career advancement or job stability and may ultimately place them in a devalued employee position (Cooper et al., 1994; Gutek, Nakamura, & Nieva, 1981). Though both men and women may be caught up in a workfamily dilemma, a mans work is allowed to intrude into the family, whereas for women, family roles are allowed to intrude into work but not vice versa (Yang, 1998). Several studies have demonstrated that the intrusion of family affairs into womens employment does not only place more stress on women; it also accounts for some of the negative myth about working women to the effect that they are not serious workers (Brown & Gilligan, 1992; Gutek et al., 1981; Pleck, 1983, 1992). As such, their employment role remains at the margins of their traditional roles. Coping with domestic role-relation stress yielded patterns portraying cognitive process and negotiation for problem solving, and shielding of emotion and/or distancing of self from conflicts. The one third of the participants who opted for cognitive negotiation of stress in their marital relations seem to take it upon themselves not only to create the environment conducive to conflict resolution, but also to carefully plot the context that could make the negotiation successful. Macleod and Hagan (1992) surveyed working Egyptian women in lower-middle-class households to explore womens persistent effort toward change and the persistent presence of gender inequality. She found that her subjects used what she termed accommodating protest to resist the constraints of power. Similarly, the respondents in the present study employed accommodation to resist undue control. In their purposive and goal-directed accommodation, participants demonstrated their own brand of power. Their emotion-focused coping approaches in the forms of shielding of emotions, distancing, disengaging, and removing oneself from the home may be an indication either of the powerless position in which these women find themselves or that they have become empowered to effect positive change in their lives. As has been asserted by Lazarus and Folkman (1985), distancing is an emotion-focused coping process that creates a dissociation between thoughts and feelings that helps a person evade the emotional implications of a stressful event. This avoidance may be exercised for a long period of time or for a limited duration. It is very similar to the coping process of avoidance, which has consistently been associated with increased cardiovascular reactivity (Vitaliano, Russo, Paulsen, & Baily, 1995; Vitaliano, Russo, & Baily, 1993). Fontana and McLaughlin (1998) have, on the other hand, demonstrated that although distancing alone may be associated with increased blood pressure reactivity, implementation of certain emotion-focused processes (i.e., positive reap-

praisal) may result in lower levels of physiological variables for women who are confronted with anger-provoking situations. Those participants appear to use the shielding of emotion approach to prevent further spousal domination and to preserve their sense of dignity. Whether this coping style empowered or disempowered women is yet to be determined. In either case, it is likely that these respondents may experience physiological reactivity with long-term health consequences. NOTE
1. Throughout this manuscript employed and other variations of that term are used to refer to women who are paid wages for their work.

REFERENCES
Abed Ellatief, H. (1989). The effect of womens education and work on the economic activity of Egypt. Journal of the Social Sciences, 16(3), 119-136. Adam, M. (1982). Women between home and work. Cairo, Egypt: Dar Elmaaref. Barnett, R. C., & Baruch, G. K. (1985). Womens involvement in multiple roles and psychological distress. Journal of Personality and Social Psychology, 49, 135-145. Barnett, R. C., & Marshall, N. L. (1992). Worker and mother roles, spillover effects and psychological distress. Women and Health, 18, 9-32. Barnett, R. C., Raudenbush, S. W., Brennan, R. T., Pleck, J. H., & Marshall, N. L. (1995). Change in job and marital experiences and change in psychological distress: A longitudinal study of dual-earner couple. Journal of Personality and Social Psychology, 69(5), 839-850. Baruch, G. K., Biener, L., & Barnett, R. C. (1987). Women and gender in research on work and family stress. American Psychology, 42, 130-136. Brown, L. M., & Gilligan, C. (1992). Meeting at the Crossroads. New York: Ballentine. Brown, J. S., Rawlinson, M. E., & Hilles, N. C. (1981). Life satisfaction and chronic disease: Exploration of theoretical model. Medical Care, 19(11), 1136-1146. Bullers, S. (1994). Womens roles and health: The mediating effect of perceived control. Women and Health, 22, 11-30. Cain, C. (1986). Stress-related claims increasing: DeCarlo. Business Insurance, 20, 44. Cooper, S. E., Arkkelin, D. L., & Tiebert, M. J. (1994). Work-relationship values and gender role differences in relation to career-marriage aspirations. Journal of Counseling and Development, 73, 63-68. Crouter, A. C. (1984). Spillover from family to work: The neglected side of the work/family interface. Human Relations, 378(6), 425-442. Davidson, M. J., & Cooper, C. L. (1984, April). Occupational stress in female managers: A comparative study. Journal of Management Studies (UK), 21(2), 185-205. Davidson, M. J., & Cooper, C. L. (1985). Women managers: Work, stress and marriage. International Journal of Social Economics (UK), 12(2), 17-25. Davidson, M. J., & Cooper, C. L. (1987). The pressures on women managers. Management Decision (UK), 25(4), 57-63. Fernea, E. W. (1994). Women and the family in the Middle East: New voices of change. Austin: University of Texas Press. Fontana, A., & McLaughlin, M. (1998). Coping and appraisal of daily stressors predict heart rate and blood pressure levels in young women. Behavioral Medicine, 24(1), 5-16. Ghorayshi, P. (1996). Women, paid-work and the family: In the Islamic Republic of Iran. Journal of Comparative Family Studies, 27, 453-466. Gilbert, L., & Rachlin, V. (1987). Mental health and psychological functioning of dual-career families. Counseling Psychologist, 15, 7-49. Goodwin, J. (1994). The price of honor. New York: Penguin.

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013

Hattar-Pollara et al. / EGYPTIAN WOMEN IN CLERICAL JOBS

Gutek, B., Nakamura, C. U., & Nieva, V. G. (1981). The independence of work and family roles. Journal of Occupational Behavior, 2(1), 1-16. Hattar-Pollara, M., Meleis, A. I., & Nagib, H. (2000). A study of the spousal role of Egyptian women in clerical jobs. Health Care for Women International, 21(4), 305-317. Hertz, R. (1986). More equal than others: Women and men in dual career marriages. Berkeley: University of California Press. Hertz, R. (1994, August) Interviewing husbands and wives: Making sense of separate stories. Paper presented at the American Sociological Association, Los Angeles, CA. Hijab, N. (1989). Women power: The Arab debate on women at work. Cambridge: Cambridge University Press. Houston, B. K., & Kelly, K. E. (1989). Hostility in employed women: Relation to work and marital experiences, social support, stress, and anger expression. Personality and Social Psychology Bulletin, 15, 175-182. Kandel, D. B., Davies, M., & Raveis, V. H. (1985). The stressfulness of daily social roles for women: Marital, occupational and household roles. Journal of Health and Social Behavior, 26, 64-78. Lazarus, R. S., & Folkman, S. (1985). Stress appraisal and coping. New York: Springer. Leonardo, C. A. (2000). Gendered roles and stress. Dissertation Abstracts International: Section B: The Sciences & Engineering, 61(4-B), 2207. MacLeod, C., & Hagan, R. (1992). Individual differences in the selective processing of threatening information, and emotional responses to a stressful life event. Behaviour Research and Therapy, 30(2), 151-161. Mahmoud, A. S. (1989). Womens work outside the home: A comparison between dominating and non-dominating. Journal of the Social Sciences, 17(3), 161-181. McBride, M. C. (1997). Counseling the superwoman: Helping university women cope with multiple roles. Guidance and Counseling, 12, 19-23. Mclaughlin, K. (2000). Effects of childcare responsibility and self-efficacy on the wellness of working women with young children. Dissertation Abstracts International: Section B: The Science and Engineering, 60(11B), 5783. Meleis, A. I., & Bernal, P. (1994). Domestic workers in Colombia as spouses: Security and servitude. Holistic Nursing, 8(4), 33-43. Meleis, A. I., Douglas, M., Eribes, C., Shih, F., & Messias, D. (1996). Employed Mexican women as mothers and partners: Valued, empowered and overloaded. Journal of Advanced Nursing, 23, 82-90. Meleis, A. I., Kulig, J., Arruda-Neves, E., & Beckman, A. (1990). Maternal role of women in clerical jobs in Southern Brazil: Stress and satisfaction. Health Care for Women International, 11, 341-354. Meleis, A. I., Norbeck, J. S., Laffrey, S. C. (1989). Role integration and health among female clerical workers. Research in Nursing and Health, 12, 355-364. Meleis, A. I., Norbeck, J. S., Laffrey, S. C., Solomon, M., & Miller, L. (1989). Stress, satisfaction and coping: A study of women clerical workers. Health Care for Women International, 8, 319-334. Meleis, A. I., & Stevens, P. E. (1992). Women in clerical jobs: Spousal role satisfaction, stress, and coping. Women and Health, 18(1), 23-40. Miller, J. E., & Petro-Nusta, W. (2002). Context of care for Jordanian women. Journal of Transcultural Nursing, 13(3), 228-236. Moghadam, V. M. (1995). The political economy of female employment in the Arab region. In N. Khoury & V. Moghadam (Ed.), Gender and development in the Arab World (pp. 6-34). London: Zed Book Ltd. Mohsen, S. K. (1994). New images, old reflections: Working middle-class women in Egypt. In E. W. Fernea (Ed.), Women and the family in the Middle East (pp. 56-71). Austin: University of Texas Press. Nykodym, N., Simonitti, J. L., Christen, J. C., & Kasper, J. A. (1987). Stress and the working woman. Business, 37(1), 8-12.

133

Parasuraman, S., Purohit, Y. S., Godshalk, V. M., & Beutell, N. J. (1996). Work and family variables, entrepreneurial career success, and psychological well-being. Journal of Vocational Behavior, 48, 275-300. Piechowski, L. D. (1992). Mental health and womens multiple roles. Families in Society: The Journal of Contemporary Human Services, 73, 131-139. Pleck, J. (1983). Husbands paid work and family roles: Current research issues. In H. Lopata & J. Pleck (Eds.), Research in the interweave of social roles: Families and jobs (pp. 251-321). Greenwich, CT: JAI. Pleck, J. (1992). Work-family policies in the United States. In H. Kahne & Janet Z. Giele (Eds.) Womens work and womens lives: The continuing struggle worldwide (pp. 248-274). Boulder, CO: Westview. Porter, L. S., Marco, C. A., Schwartz, J. E., Neale, J. M., Shiffman, S., & Stone, A. A. (2000). Gender differences in coping: A comparison of trait and momentary assessments. Journal of Social & Clinical Psychology, 19(4), 480-498. Ross, C. E., Mirowsky, J., & Huber, J. (1983). Dividing work, sharing work, and in-between: Marriage patterns and depression. American Sociological Review, 89, 670-682. Santilli, M. B. (2000). Social support deterioration in the context of relationship hostility. Dissertation Abstracts International: Section B: The Sciences & Engineering, 61(1-B), 590. Seymour, J. (1992). No time to call my own: Womens time as a household resource. Womens Studies International Forum, 15, 187-196. Stewart, A. J., & Salt, P. (1981). Life stress, life-styles, depression and illness in adult women. Journal of Personality and Social Psychology, 40(6), 1063-1069. Thorton, B., & Leo, R. (1992). Gender typing, importance of multiple roles, and mental health consequences. Sex Roles, 27, 307-317. Vitaliano P. P., Russo J., & Bailey, S. L. (1993). Psychosocial factors associated with cardiovascular reactivity in older adults. Psychosomatic Medicine, 55(2), 164-177. Vitaliano, P. P., Russo, J., Paulsen, V. M., & Baily. S. L. (1995). Cardiovascular recovery from laboratory stress: Biopsychosocial concomitants in older adults. Journal of Psychosomatic Research, 39(3), 361-377. Yang, N. (1993). Work-family conflict and supervisor support. Eastern Academy of Management Best Paper Proceedings, 174-177. Yang, N. (1998). An international perspective on socioeconomic changes and their effects on life stress and career success of working women. Advanced Management Journal, 63(3), 15-19. Zurayke, H., & Saadeh, F. (1995). Women as mobilizers of human resources in Arab countries. In N. Khoury & V. Moghadam (Ed.), Gender and Development in the Arab World (pp. 35-48). London: Zed Book Ltd.

Marianne Hattar-Pollara, DNSc, RN, is a professor in the department of the School of Nursing at Azusa Pacific University. She received her DNSc in ethnic minority womens health from University of California at San Francisco. Her interests include womens health and psychiatric nursing. Afaf Ibrahim Meleis, PhD, DrPs (hon), FAAN, is a dean at The University of Pennsylvania, School of Nursing. She received her PhD in sociology from the University of California, Los Angeles. Her interests include womens health and immigrant nursing and community-based health care. Hassanat Nagib PhD, RN, is a faculty member at the University of Alexandria, Egypt. She received her PhD in ethical decision making from the University of Alexandria. Her interests include ethics, research, teaching, and community-based health care.

Downloaded from tcn.sagepub.com at Cairo University on February 3, 2013