HLTH 4360 Week 8 Stress Record Analysis Example

Fourteen Days in a Pharmacy Technician's Stress Record: The Record Described as Data, Then Read for Recurrence, Clustering and Co-Occurrence Without a Single Causal Claim

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Walden University

HLTH 4360: Stress Management and Wellness

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Month Day, Year

Fourteen Days in a Pharmacy Technician's Stress Record: The Record Described as Data, Then Read for Recurrence, Clustering and Co-Occurrence Without a Single Causal Claim

Part 1: The Record as Data

Who Kept It and How

The record analyzed here belongs to Noor, a composite 41-year-old pharmacy technician at a retail pharmacy, built for this exercise. She kept a written record for 14 consecutive days, from Monday, September 7, to Sunday, September 20, 2026. Each evening between 8:00 and 10:00 p.m., she completed one entry on a printed form with five fields: the stressful events of the day, written as free text; the time of each event, to the nearest hour; a rating of how stressful the day felt overall, from 1, not at all, to 5, extremely; hours of sleep the night before; and whether she had eaten lunch away from the counter, yes or no.

Completeness and Gaps

Noor completed 13 of the 14 evening entries. The missing entry is Saturday, September 19, when she worked a double shift covering for a coworker and wrote nothing until the next day; she then wrote a brief note for that day from memory on Sunday, which is treated below as a recall entry rather than a same-day one. Event times were left blank for 6 of the 31 events she listed. Sleep hours were recorded every day. The lunch field was left blank on her four days off, as the form did not ask for it on nonworking days.

Summary of Entries

The events fall into four kinds by their wording: insurance rejections at the counter (11 mentions), conflict with a customer (7), short staffing (6) and events outside work, such as a late school pickup (7).

Table 1

Summary of Noor's Record, September 7 to 20, 2026

Figures are counts and means from the record; the Saturday double shift is counted as a workday with a recall entry.

Part 2: Reading the Record

Recurrence

The most frequent single event was an insurance claim rejected at the counter, which appeared on 8 of the 10 workdays. Kanner et al. (1981) distinguished such minor, repeated daily hassles from major life events and found, in a community sample assessed monthly for 10 months, that hassles predicted concurrent and later psychological symptoms better than life-event scores did. Noor's record contains no major life event in the two weeks; it is made almost entirely of hassles, which is the level the concept describes.

Clustering

Events clustered in time. Of the 25 events with a recorded time, 15 were between 4:00 and 7:00 p.m., the after-work pickup period at a retail pharmacy. Customer conflicts appeared almost only in that window, 6 of 7. The record does not show why: it might reflect the volume of customers, the staffing level at those hours or Noor's own fatigue late in a shift, and the record measured none of these directly.

Co-Occurrence

Some features appeared together. The four workdays with the highest stress ratings, all rated 4 or 5, were also the four days on which she listed short staffing, and on three of those four days she did not eat lunch away from the counter. Her nights before the highest-rated days averaged 5.6 hours of sleep, against 6.5 hours before the other workdays.

These are co-occurrences and the paper stops there. The record cannot say whether short staffing made the days more stressful, whether missed lunches did, whether short sleep did or whether some fourth factor, such as a busy week in the store, produced all of them together. With 10 workdays, even a striking overlap could arise by chance.

Comparing Noor With Herself

The record's strength is that it compares Noor with herself across days. Almeida (2005) describes how daily diary designs, such as the National Study of Daily Experiences in which adults reported stressors in telephone interviews on eight consecutive evenings, capture stressors close to when they occur and allow within-person comparisons that a single questionnaire cannot. Noor's workdays and days off differ by more than a point and a half in mean rating, and that within-person contrast is more trustworthy than any comparison between her and another person would be.

Reading the Days Off

The four days off are part of the record and are read on the same terms. They contained four events in total, all outside work, and their stress ratings ranged from 1 to 2. Sleep the night before averaged 7.6 hours. The contrast with workdays is sharp, but it is a contrast between two kinds of day that differ in many ways at once: hours awake, contact with customers, time at home and the absence of the counter. The record shows that the two kinds of day differ; it cannot show which of these differences accounts for the gap in ratings.

What a Second Record Would Need

If Noor or a researcher wanted the record to answer a narrower question, its design would have to change before the next two weeks began. A fixed list of event categories, in place of free text, would make counts comparable across days. Recording each event's time at the moment it happened, perhaps on a phone, would reduce the six blank times and the evening recall. A field for customer volume or staffing level, taken from the pharmacy's own schedule, would let the co-occurrence of short staffing and high ratings be examined with a measure Noor did not have to judge herself. None of these changes would turn a single-person record into evidence about cause, but each would make the patterns it shows easier to trust.

Limits of a Self-Kept Record

Three limits shape every reading above. First, recall: entries were written in the evening, hours after most events. Shiffman et al. (2008) note that retrospective self-reports are subject to recall bias and that momentary sampling, recording experiences as they happen, reduces it. An end-of-day entry is closer to a momentary record than a monthly questionnaire, but it is still a recall, and the Saturday entry is a recall of a recall.

Second, attention: the free-text field depended on what Noor noticed and chose to write. Events that felt routine may be missing.

Third, reactivity: keeping a record can change what is recorded. Korotitsch and Nelson-Gray (1999) describe how self-monitoring can alter the behavior or experience being monitored. Noor may have begun to notice insurance rejections more once she was writing them down, which would raise their count without any change in how often they happened.

What the Record Supports

The record supports a description of two weeks in one person's working life: frequent minor hassles, clustered in the late afternoon, with higher stress ratings on days that also had short staffing, missed lunches and shorter sleep. It does not support any statement about what caused those ratings, and it describes no one but Noor.

References

Almeida, D. M. (2005). Resilience and vulnerability to daily stressors assessed via diary methods. Current Directions in Psychological Science, 14(2), 64-68. https://doi.org/10.1111/j.0963-7214.2005.00336.x

Kanner, A. D., Coyne, J. C., Schaefer, C., & Lazarus, R. S. (1981). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. Journal of Behavioral Medicine, 4(1), 1-39. https://doi.org/10.1007/BF00844845

Korotitsch, W. J., & Nelson-Gray, R. O. (1999). An overview of self-monitoring research in assessment and treatment. Psychological Assessment, 11(4), 415-425. https://doi.org/10.1037/1040-3590.11.4.415

Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary assessment. Annual Review of Clinical Psychology, 4, 1-32. https://doi.org/10.1146/annurev.clinpsy.3.022806.091415