Academy of Romanian Scientists  
Journal of Knowledge Dynamics  
The Impact of Professional Stress on Managerial  
Performance Among Middle Managers  
Camelia Cristina DRAGOMIR-PÂNZARU1,3, Aurel Mihail ȚÎȚU2,3  
1Transilvania University of Brasov, Colina Universităţii Nr 1, 500068, Brasov, Romania;  
ORCID No. 0000-0002-7537-9217; camelia.dragomir@unitbv.ro (corresponding author)  
2 Lucian Blaga University of Sibiu, 10 Victoriei Street, 550024, Sibiu, Romania; ORCID No. 0000-  
0002-0054-6535; mihail.titu@ulbsibiu.ro  
3Academy of Romanian Scientists, 3 Ilfov Street, 050094 Bucharest, Romania  
Received: April 21, 2026  
Revised: May 17, 2026  
Accepted: May 25, 2026  
Published: June 30, 2026  
Abstract: The analysis of professional stress and understanding how it affects the activity and  
performance of managers is a strategic necessity for the sustainable development of  
organizations. Therefore, they are increasingly interested in identifying the causes of  
professional stress and developing strategies to prevent or reduce it. The purpose of this paper  
is to analyze professional stress and its implications on managerial performance among middle  
managers. The paper addresses the sources of professional stress, its effects on the activity of  
middle managers and the strategies adopted for stress management, considering the level of  
managerial experience. This study adopts a quantitative, cross-sectional, and exploratory  
approach. The results indicate a medium-to-high level of professional stress for the managers  
participating in the study. The findings suggest that, although a certain level of pressure can  
support managerial performance in the short term, maintaining high demands for long periods  
can affect the health, motivation and efficiency of managers' activities, with negative implications  
on individual results and organizational performance. The paper provides a useful perspective  
on how professional stress in the work of middle managers can be understood and managed  
effectively so that individual and organizational performance remains at an optimal level in an  
organizational context characterized by dynamism, competitive pressure and a high level of  
uncertainty.  
Keywords: professional stress; managerial performance; middle managers; stress  
management strategies; managerial experience.  
Introduction  
In the current organizational context, professional stress has become a constant in the  
lives of managers, with significant implications for the efficiency of their work and  
organizational performance. The rapid pace of changes in the organizational environment  
and the rapid evolution of digital technologies require a permanent effort to adapt,  
intensify the pace of work and increase responsibilities for managers in all fields (Lupsa-  
Tătaru et al., 2025). This professional category is subject to increased professional  
demands; managers being forced to make complex decisions and ensure the sustainability  
of the organization in a challenging economic environment characterized by a high level  
of uncertainty.  
Professional stress is presented in the academic literature as an individual's reaction to  
the imbalance between professional demands and personal adaptation resources.  
According to the World Health Organization (2024), this type of stress represents the  
response that people can have when faced with professional demands and pressures that  
do not correspond to their knowledge and skills and that test their ability to cope with  
them. The National Institute for Occupational Safety and Health (NIOSH, 2024) describes  
How to cite  
Dragomir-Pânzaru, C.C., & Țîțu, A. M. (2026). The Impact of Professional Stress on Managerial  
Performance Among Middle Managers. Journal of Knowledge Dynamics, Vol. 3, No.1, pp. 54-64.  
https://doi.org/10.56082/jkd.2026.1.54 ISSN ONLINE 3061-2640  
 
Academy of Romanian Scientists | 55  
Journal of Knowledge Dynamics  
Vol. 3 (2026) No.1, pp. 54-64  
occupational stress in a complementary way, as a set of harmful physical and emotional  
reactions that occur when job demands do not match the individual's capabilities,  
resources, or needs. This idea is also taken up in the study by Catapano et al (2023), which  
highlights the source of occupational stress in the imbalance between occupational  
pressures and individual resources and emphasizes how occupational stress affects the  
physical, emotional, and behavioral health of individuals, with negative effects on  
workplace performance.  
The specifics of managerial activity make professional stress reflect not only on individual  
results, but also on the way teams function and on organizational performance. Rapid  
organizational changes, pressure from operational and strategic demands, high workload  
and complex decision-making responsibilities can affect the ability of managers to  
effectively manage situations of occupational overload. This may have important  
implications not only for the efficiency and quality of their professional activities, but also  
for decision-making processes, employee coordination, the achievement of organizational  
objectives, and ultimately for the overall performance of the organization. Therefore,  
understanding how professional stress influences managerial performance and  
identifying effective strategies for its management are relevant aspects for the sustainable  
development of organizations.  
Although the literature has shown increasing interest in examining workplace stress and  
its effects on employee performance and organizational effectiveness, , the analysis of  
professional stress among managers, particularly those occupying middle-management  
positions, and its effects on managerial performance are insufficiently addressed.  
Therefore, our paper aims to examine, in an integrated manner, the sources of  
professional stress, its implications on managerial performance among middle managers  
and the strategies adopted for stress management, considering the level of managerial  
experience.  
To achieve the research goal, the following research objectives were established:  
O1: Identifying the main factors generating professional stress and analyzing its effects on  
managerial performance among middle managers.  
O2. Identifying the strategies used to manage professional stress.  
O3. Exploring the differences in the perception and management of professional stress  
depending on managerial experience.  
The results obtained provide a useful perspective on how professional stress in the  
activity of middle managers can be understood and managed effectively so that individual  
and organizational performance remains at an optimal level in a dynamic and highly  
competitive organizational context.  
The paper is further structured as follows. After this introduction, we review the literature  
and present the research methodology. The results are then presented and discussed. The  
final section is dedicated to the conclusions of the study, limitations and future research  
directions.  
Literature review  
The analysis of professional stress and understanding how it affects the activity and  
performance of managers is a strategic necessity for the sustainable development of the  
organization. The literature describes stress as a complex phenomenon, in which  
professional pressures and individual resources are in a constant imbalance. In the long  
term, this imbalance affects both the physical and emotional health of the individual, as  
well as their professional performance and, implicitly, that of the organization (Catapano  
et al., 2023; Chireh et al., 2025). In other words, the fewer organizational, personal and  
social resources individuals have at their disposal, the more vulnerable they will be to the  
cumulative effects of stressors.  
56 | Camelia Cristina Dragomir-Pânzaru, Aurel Mihail Țîțu  
The Impact of Professional Stress on Managerial Performance Among Middle Managers  
High workload, pressure to achieve objectives and insufficient resources are sources of  
professional stress for managers, frequently mentioned in the literature (Portoghese et  
al., 2020; Penconek et al., 2024), with a negative impact on job satisfaction and managerial  
performance. Also, low rewards for high-effort situations are associated with job  
dissatisfaction, high stress scores and intentions to leave the organization (Kokobun,  
2024). In contrast, adequate resources, organizational support and decision-making  
autonomy increase job satisfaction and reduce the effects of stress (Svanström et al., 2025;  
Christiansen et al., 2024).  
In the case of middle managers, research has identified a higher level of stress compared  
to leaders occupying higher hierarchical positions (Sherman et al., 2012; Pangert &  
Schüpbach, 2011). This situation is explained by the reduced sense of control over  
professional life (Sherman et al., 2012) and by the differences recorded in the distribution  
of stress factors and resources (Pangert and Schüpbach, 2011). In the opinion of  
researchers, the sources of stress become more pronounced at lower managerial levels,  
while the resources available to cope with them tend to be more limited (Bossmann et al.,  
2016). The position that middle managers have within the organization involves multiple  
responsibilities, intense work and high pressure generated by the need to simultaneously  
manage both the requests of senior managers and the responsibilities towards the  
coordinated team (Stilijanow, 2012). They are required to demonstrate a wide range of  
competencies, which involve effective management of resource, team coordination,  
communication skills, and leadership, within a highly competitive organizational context  
(Svanström et al., 2025). Team tensions, lack of role clarity and insufficient support from  
colleagues and superiors are significant stressors for middle managers, reported in the  
literature (Arakelian & Rudolfsson, 2021). Research by Hagerman et al. (2016) showed  
that managers who coordinate large teams face more problems in the case of insufficient  
resources, limited decision-making autonomy and lack of organizational support. Middle  
managers also have less freedom to effectively manage work-life balance compared to  
senior managers (Lundqvist et al., 2013), which can have a negative impact on the  
effectiveness of the activity and managerial performance. The results of the study  
conducted by Maharani and Dewi (2024) correlate occupational stress with work-life  
balance and job satisfaction. A poor work-life balance increases stress at work (Kumara &  
Fusana, 2018), affects personal well-being and has negative implications on work  
productivity and organizational performance (Shaffer et al., 2016). Added to these  
challenges is the limited experience of early-career managers in dealing with stressful  
situations, which may reduce their ability to identify and implement effective stress  
management mechanisms in critical circumstances (Foris et al., 2022). In this context, the  
high workload, the assumption of decision-making responsibilities and the pressure  
exerted by achieving performance objectives can trigger feelings of restlessness and  
anxiety, with potential effects on work-life balance and negative implications on  
managerial performance.  
Studies on occupational stress management strategies for middle managers highlight as  
priorities workload management, role clarification and better control over work activity  
(Johari, 2020), organizational support and development of personal resources (Putra &  
Sari, 2025). In the meta-analysis conducted by Dannheim et al. (2025) on occupational  
stress management interventions, the authors emphasize the important role of senior  
managers in promoting well-being at work and effective management of occupational  
stress. Along with personal resources, organizational aspects, such as access to resources,  
organizational culture, work organization mechanisms and favorable working conditions,  
influence employee well-being and can contribute to improving organizational  
performance by increasing individual productivity, reducing absenteeism and health care  
costs (Hassard et al., 2018; Lundqvist et al., 2024). At the same time, the literature  
highlights the role of social and family resources in better managing stress at work and  
maintaining professional performance. (Johari, 2020).  
Recent research reveals that the implications of professional stress on performance are  
not uniformly negative. In the study conducted by Conceoção & Palma-Moreira (2025),  
Academy of Romanian Scientists | 57  
Journal of Knowledge Dynamics  
Vol. 3 (2026) No.1, pp. 54-64  
the authors identified a positive association of stress generated by high workload with  
perceived performance and burnout. On the other hand, the results of the study suggest a  
positive relationship between stress associated with career and reward and performance  
at work. However, when exposure to stress is prolonged and of high intensity, productivity  
and professional performance are negatively affected.  
Methodology  
The aim of the study is to analyze professional stress among middle managers and its  
implications for managerial performance, taking into account the level of managerial  
experience.  
The study adopts a quantitative, cross-sectional and exploratory research design. The  
sample included 68 respondents, middle managers from several organizations in the  
Central Region, Romania. A non-probabilistic, purposive and convenience sampling  
method was used, with participants being selected based on the criterion of occupying a  
middle-level managerial position and their availability to participate in the study.  
The data were collected between March and April 2026 through a structured  
questionnaire, developed in accordance with the research objectives. The questionnaire  
was distributed electronically through a web platform. The data collected were processed  
using descriptive statistical methods, with frequencies and percentages being calculated  
to characterize the sample.  
The distribution of paticipants by fields of activity is presented in Table 1.  
Table 1. Distribution of respondents by fields of activity  
Field of Activity  
Industry  
Services  
Information Technology (IT)  
Medicine and Pharmacy  
Financial and Banking  
Total  
Frequency (n)  
16  
17  
14  
12  
9
Percentage (%)  
23,5  
25,4  
20,6  
17,3  
13,2  
100  
68  
Source: Author's own research  
Table 2 presents the distribution of respondents according to their experience in middle  
management position.  
Table 2. Distribution of respondents by middle management experience  
Middle Management  
Experience  
Frequency (n)  
Percentage (%)  
Less than 2 years  
2-5 years  
5-8 years  
More than 8 years  
Total  
8
11,8  
26,5  
38,2  
23,5  
100  
18  
26  
16  
68  
Source: Author's own research  
Results and discussion  
The results were analyzed according to the objectives pursued.  
The assessment of the level of stress perceived by the respondents indicates a significant  
degree of professional pressure. Specifically, 39.2% of the subjects experienced a high  
level of stress, 9.4% reporded a very high level, and 43.9% assessed their stress level as  
moderate. Only a small proportion of respondents (7,5%) perceived their stress level as  
low.  
58 | Camelia Cristina Dragomir-Pânzaru, Aurel Mihail Țîțu  
The Impact of Professional Stress on Managerial Performance Among Middle Managers  
With regard to the frequency of stress experienced in the workplace, most of the  
respondents reported experiencing stress frequently (45.8%) or constantly (26.5%).  
These results indicate that professional stress is a constant presence in the activity of the  
managers participating in the study and is generally perceived at moderate to high levels.  
These findings are in line with previous research, which suggests that professional stress  
among middle managers is a widespread problem and, for many of them, menifests itself  
at moderate to high levels (Bossmann et al., 2016; Svanström et al., 2025).  
To identify the factors contributing to professional stress, the respondents’ perceptions of  
the main sources of stress encountered in managerial work were examined. The  
distribution of responses is presented in Table 3.  
Table 3. Main sources of professional stress reported by respondents  
Source of professional stress  
Frequency  
(n)  
Percentage  
(%)  
Excessive Workload  
Limited resources  
Tight Deadlines  
Role ambiguity  
Relationships with Senior  
Management  
49  
72,1  
35  
33  
20  
18  
51,5  
48,5  
29,4  
26,5  
Team conflicts  
15  
22,1  
Source: own processing of survey data based on a questionnaire  
The data obtained highlight the high workload as the main source of professional stress  
indicated by the managers participating in the study (72.1% of respondents), followed  
by resource limitations (51.5%) and deadlines (48.5%). At the same time, role ambiguity  
(29.4%), relationships with superiors (26.5%) and team conflicts (22.1%) were  
mentioned to a lesser extent. The results suggest that the professional stress of the  
managers participating in the study is determined mainly by direct demands from the  
workplace and resource constraints, while relational factors and organizational clarity  
have a moderate contribution. The results are confirmed by the findings of other studies  
in the literature, which associate professional stress with the stress factors mentioned  
(Ojha, 2025; Saud & Rice, 2024).  
With regard to symptoms associated with professional stress, the results highlight  
chronic fatigue, irritability and difficulty concentrating as the most prevalent  
manifestations. The majority of respondents dexperiencing these symptoms either  
sometimes (41.2%) or often (34.5%). A very frequent occurrence of these symptoms was  
reported by 11.8% of respondents, while 9.3% indicated a low frequency. Only 3.2%  
declared that they had not experienced such manifestations. These findings are  
consistent with previous studies, which identify these manifestations as commom  
symptoms associated with profesional stress and burnout (Quick & Henderson, 2016).  
Regarding the impact of work-related stress on work-life balance, the results highlight  
significant negative implications. The majority of respondents perceived a moderate  
negative impact (41%), followed by those who considered work-related stress to have a  
high negative impact on work-life balance (32.6%). At the same time, 9.6% of  
respondents indicated a very high impact, while 14.7% indicated a low impact. These  
results suggest that the effects of work-related stress extend beyond the workplace for  
most of the managers surveyed, affecting not only their healt but also their ability to  
maintain an appropriate balance between work and personal life. This finding is  
confirmed by the results of recent studies in the literature, which associate high levels of  
professional stress with a reduced ability to maintain a healthy work–life balance  
(Thilagavathy & Geetha, 2021; Chireh et al., 2025).  
Academy of Romanian Scientists | 59  
Journal of Knowledge Dynamics  
Vol. 3 (2026) No.1, pp. 54-64  
To investigate the implications of professional stress on managerial performance,  
respondents were asked to assess their ability to make decisions under pressure and  
excessive workload. The results indicate that more than half of the respondents (58,3%)  
maintain a high level of decision-making capacity, while 31,9% assessed it as moderate.  
Only a small proportion of respondents (9,8%) reported a significant reduction in their  
decision-making capacity under conditions of professional pressure. These findings  
suggesting that effective mechanisms for adapting and managing situations of  
occupational overload have been identified.  
To analyze the impact of professional stress on individual performance, respondents  
were invited to indicate how frequently stress situations affects their productivity. The  
results show that 54.8% of the study participants considered that stress affects their  
productivity only occasionally, suggesting that its influence, although present, is not  
constant. At the same time, 29.6% of managers reported that professional stress  
frequently reduces their productivity, which is negatively reflected on individual  
performance. In contrast, only 11.3% of respondents indicated that professional stress  
rarely reduces productivity, while the responses “very frequently” and “never” were  
recorded by only a small proportion of participants (4,3%). The results suggest a  
constant and moderate influence of professional stress on the efficiency of managers’  
activity, without significantly affecting managerial performance. This finding is  
associated with the results highlighted in recent research (Conceoção & Palma-Moreira,  
2025).  
Regarding respondents’ perceptions of the effects of professional stress on managerial  
performance, the results indicate a predominantly negative assessment. Specifically, the  
majority of respondents (61.5%) considered that professional stress has a negative  
impact on managerial performance. In contrast, 22.7% of the subjects believed that  
professional stress may have a positive effect on the efficiency of the work, with favorable  
implications for managerial performance. At the same time, 15.8% of the study  
participants considered that professional stress does not have a significant impact on  
managerial performance. Therefore, the results suggest that, although professional  
stress may be perceived as a mobilizing factor by some managers, in the long term, it is  
associated with a decrease in the efficiency of professional activity and managerial  
performance. These findings are in line with previous studies, which suggest that, over  
the long term, occupational stress may adversely affect productivity, work efficiency, and  
managerial performance (Gunasekra & Perera, 2023; Conceoção & Palma-Moreira,  
2025).  
To identify the strategies used by research participants to reduce the effects of  
professional pressure on managerial performance, respondents were asked to indicate  
the methods they employ to manage professional stress. The distribution of responses is  
presented in Table 4.  
The results indicate that the managers surveyed employ a combination of organizational,  
social and individual strategies to manage professional stress. Thus, task planning and  
prioritization were the most frequently reported strategies (60.3%), followed by task  
delegation (52.9%), team support (48.5%) and communication with senior managers  
(38.2%). At the same time, family support (30.9%) and participation in sports activities  
(26.5%) were mentioned as strategies for managing professional stress. Only a small  
proportion of respondents reported that they did not use any specific strategies to  
manage stress.  
60 | Camelia Cristina Dragomir-Pânzaru, Aurel Mihail Țîțu  
The Impact of Professional Stress on Managerial Performance Among Middle Managers  
Table 4. Professional stress management strategies reported by respondents  
Professional Stress Management  
Strategies  
Frequency  
Percentage  
(%)  
(n)  
Task planning and prioritization  
Task delegation  
41  
36  
60,3  
52,9  
Team suport  
33  
48,5  
Communication with senior  
management  
26  
38,2  
Family suport  
Physical activity  
No specific stress management  
strategies  
21  
18  
7
30,9  
26,5  
10,3  
Source: own processing of survey data based on a questionnaire  
The results highlight middle managers’ preference for task organization mechanisms and  
organizational strategies for the effective management of professional stress and  
maintaining performance. The findings are in line with the results of other studies that  
emphasize the role of organizational context and support from the team and senior  
managers in reducing stress and supporting individual performance (Lundqvist et al.,  
2024; Putra & Sari, 2025). At the same time, the managers participating in the study  
mentioned that they use family and individual resources to reduce professional pressure  
and maintain an adequate level of involvement in professional activity, which confirms  
the results of studies in the literature (Dumas & Perry-Smith, 2018; Dannheim et al.,  
2023).  
Finally, the relationship between the respondents’ managerial experience and the main  
dimensions highlighted by the research results was investigated, namely: the main  
sources of professional stress, the perceived frequency of stress, the impact on work-life  
balance, the ability to make decisions under pressure, the impact of stress on managerial  
performance and the strategies used to manage stress.  
The results suggest moderate differences in the responses of the managers participating  
in the research according to managerial experience. Thus, managers at the early stages  
of their managerial careers reported higher levels of stress and perceived a more  
pronounced negative impact on managerial performance, with excessive workload being  
identified as the main source of professional stress. Support from the team members and  
senior managers represents the organizational strategy most frequently used by  
managers with limited managerial experiens to reduce the effects of professional stress.  
As managerial experience increases, the ability to make decisions under stress appears  
to improve, with managers placing greater emphasis on organizational mechanism such  
as more efficient planning of responsibilities and delegation of tasks. The impact of  
professional stress on work-life balance remains substantial regardless of the level of  
managerial experience, with negative implications for job satisfaction and work  
efficiency.  
The data underlying the findings presented above are summarized in Table 5, which  
illustrates the distribution of responses across the analyzed dimensions according to  
respondents' managerial experience.  
Academy of Romanian Scientists | 61  
Journal of Knowledge Dynamics  
Vol. 3 (2026) No.1, pp. 54-64  
Table 5. Distribution of the main dimensions of professional stress and stress management  
strategies by managerial experience  
Number of  
8
18  
26  
16  
respondents  
Middle Management Experience  
(years)  
< 2 ani  
2-5 ani  
5-8 ani  
>8 ani  
Excessive  
workload  
Tight  
deadlines  
Limited  
73,1%  
78,5%  
71,3%  
61,2%  
Main  
sources of  
professional  
stress  
61, 8%  
56, 4%  
61,4%  
63,8%  
48,6%  
60,3%  
54,3%  
67,2%  
62,2%  
59,1%  
53,6%  
50,8%  
52, 9%  
53,8%  
72,9%  
42,9%  
46,5%  
43,8%  
51, 6%  
81,7%  
resources  
High frequency of  
professional stress  
High impact on work–life  
balance  
High capacity for decision-  
making under pressure  
Perceived negative impact of  
stress on managerial  
performance  
62,%  
59,7%  
55,3%  
50, 4%  
66,2%  
43,1%  
69,7%  
Task  
Primary  
strategies  
used to  
manage  
professional  
stress  
planning and  
prioritization  
Task  
delegation  
Team support 52,6%  
49,8%  
34,5%  
46,2%  
51,8%  
58,7%  
49,6%  
69,6%  
42,9%  
Source: own processing of survey data based on a questionnaire  
The findings are consistent with the results of studies in the literature, which emphasize  
the adverse effects of professional stress on employee well-being and work performance  
(Thilagavathy, & Geetha, 2021; Maharani, & Tamara, 2024).  
Conclusions  
The accelerated pace of organizational change, competitive pressures, complex tasks and  
multiple responsibilities may increase the level of professional stress experienced by  
managers, negatively affecting their performance and, consequently, the performance at  
the organizational level. We aimed through this research to analyze the level of  
professional stress among middle managers operating in different fields of activity and to  
examine its implications on managerial performance, taking into account the level of  
managerial experience of the participants.  
The results suggest a moderate to high level of professional stress consistently  
experienced by the managers participating in the study. The main stress-generating  
factors identified were high workload, tight deadlines for completing tasks and resource  
limitations. Decision-making capacity remains high under pressure, particularly among  
respondents with more than five years of managerial experience. However, the impact of  
stress on productivity and managerial performance is perceived as predominantly  
negative, especially by managers with less than five years of experience, who appear to be  
the group most exposed to professional stress. For these respondents, stress is further  
amplified by role ambiguity and limited decision-making autonomy, correlated with the  
decision-making responsibilities assumed and the pressure to achieve performance  
objectives. The stress management strategies most frequently mentioned in the responses  
of the study participants primarily involve mechanisms aimed at improving work  
organization, such as effective planning, task prioritization, role clarity, and greater  
62 | Camelia Cristina Dragomir-Pânzaru, Aurel Mihail Țîțu  
The Impact of Professional Stress on Managerial Performance Among Middle Managers  
decision-making autonomy, as well as support from senior managers and team members.  
The results suggest that a certain level of professional pressure may have a mobilizing  
effect and contribute positively to managerial performance in the short term. However,  
the persistence and intensification of stress factors for long periods of time may negatively  
affect the health, motivation and efficiency of managers' activities, with negative  
consequences for both managerial and organizational performance.  
From a theoretical perspective, the paper contributes to the existing body of knowledge  
by enhancing the understanding of the implications of professional stress for middle  
managers’ performance. The study is of interest because it offers an integrated  
perspective on the main sources of professional stress, its effects on managerial  
performance and work efficiency among middle managers, as well as the strategies  
employed to manage stress across different levels of managerial experience.  
From a practical point of view, the findings can be used at the level of organizations to  
develop strategies for managing professional stress that are sustainable in the medium  
and long term. Institutionalizing stress management as an organizational practice and  
moving from an individual to strategic approach to stress management could contribute  
to improved managerial and organizational performance. Measures such a reducing  
excessive workloads, fostering  
a
supportive organizational culture, promoting  
transparent communication and providing structured support for novice managers may  
help mitigate the adverse effects of professional stress. For middle managers at the early  
stages of their managerial careers, managerial induction programs could be implemented  
to facilitate adaptation to managerial roles. Such programs should include roles and  
responsibility clarification, as well as regular feedback and support sessions involving  
both senior and middle management, with the aim of reducing role ambiguity and alleviate  
stress associated with performance expectations. In addition, middle managers should  
make greater use of personal and social resources to improve their well-being and reduce  
the adverse effects of work-related stress.  
The paper has certain methodological limitations. Given the relatively small sample size  
and the use of a non-probabilistic sampling method, the results cannot be generalized to  
the entire population of middle managers. However, they provide valuable exploratory  
insights into the phenomenon under investigation.  
Future studies may consider extending the analysis to a larger sample of managers from  
various fields of activity in order to explore differences in professional stress  
management strategies according to the specific characteristics of their work  
environments. Also, additional research could investigate how organizational culture  
contributes to reducing the effects of professional stress on managerial and organizational  
performance.  
AI Declaration: The authors used an artificial intelligence (AI) tool solely to verify the  
accuracy of translations of certain text passages during the preparation of the manuscript.  
All intellectual contributions, scientific content, analyses, interpretations, and conclusions  
were developed exclusively by the authors.  
References  
Arakelian, E., & Rudolfsson, G. (2021). Reaching a tipping point: Perioperative nurse managers’  
narratives about reasons for leaving their employment—A qualitative study. Journal  
of  
Nursing  
Management, 29(4),  
664-  
671. https://doi.org/10.1111/jonm.13202Digital Object Identifier (DOI)  
Bossmann, U., Ditzen, B., & Schweitzer, J. (2016). Organizational stress and dilemma  
management in mid-level industrial executives: An exploratory study. Mental Health  
& Prevention, 4(1), 9-18. https://doi.org/10.1016/j.mhp.2016.02.001  
Catapano, P., Cipolla, S., Sampogna, G., Perris, F., Luciano, M., Catapano, F., & Fiorillo, A. (2023).  
Academy of Romanian Scientists | 63  
Journal of Knowledge Dynamics  
Vol. 3 (2026) No.1, pp. 54-64  
Organizational and individual interventions for managing work-related stress in  
healthcare  
professionals:  
A
systematic  
review. Medicina, 59(10),  
1866.  
https://doi.org/10.3390/medicina59101866  
Chireh, B., Essien, S. K., Swerhun, K., D'Arcy, C., & Acharibasam, J. W. (2025). Workplace  
stressors and mental health outcomes among personal support workers: A  
systematic review. International journal of nursing studies, 168, 105093.  
https://doi.org/10.1016/j.ijnurstu.2025.105093  
Christiansen, F., Gynning, B. E., Lashari, A., Peláez Zuberbühler, J., Johansson, G., & Brulin, E.  
(2024). Associations between job demand-control-support and high burnout risk  
among physicians in Sweden: A cross-sectional study. Journal of Occupational  
Medicine and Toxicology, 19(1), 42. https://doi.org/10.1186/s12995-024-00441-6  
Conceoção, A., & Palma-Moreira, A. (2025). The Relationship Between Occupational Stress,  
Burnout, and Perceived Performance: The Moderating Role of Work Regime.  
Administrative Sciences, 15(10), 377. https://doi.org/10.3390/admsci15100377  
Dannheim, I., Ludwig-Walz, H., Kirsch, H., Bujard, M., Buyken, A. E., Richardson, K. M., & Kroke,  
A. (2025). Effectiveness of leader-targeted stress management interventions: A  
systematic review and meta-analysis. Scandinavian Journal of Work, Environment &  
Health, 51(4), 265. https://doi.org/10.5271/sjweh.4219  
Dannheim, I., Buyken, A. E. & Kroke, A. (2023). Work-related stressors and coping behaviors  
among leaders in small and medium-sized IT and technological services  
enterprises. BMC Public Health, 23(1), 700. https://doi.org/10.1186/s12889-023-  
15581-3  
Dumas, T. L. & Perry-Smith, J. E. (2018). The paradox of family structure and plans after work:  
Why single childless employees may be the least absorbed at work. Academy of  
management Journal, 61(4), 1231-1252. https://doi.org/10.5465/amj.2016.0086  
Foris, T., Tecău, A. S., Dragomir-Pânzaru, C. C., & Foris, D. (2022). The start-up manager in times  
of crisis: Challenges and solutions for increasing the resilience of companies and  
sustainable  
reconstruction. Sustainability, 14(15),  
9140.  
https://doi.org/10.3390/su14159140  
Gunasekra, K. A., & Perera, B. A. K. S. (2023). Defining occupational stress: A systematic  
literature review. FARU Journal, 10(1). https://doi.org/10.4038/faruj.v10i1.194  
Hassard, J., Teoh, K. R., Visockaite, G., Dewe, P., & Cox, T. (2018). The cost of work-related stress  
to society: A systematic review. Journal of occupational health psychology, 23(1).  
https://doi.org/10.1037/ocp0000069.  
Hagerman, H., Skytt, B., Wadensten, B., Högberg, H., & Engström, M. (2016). A longitudinal  
study of working life among first-line managers in the care of older adults. Applied  
Nursing Research, 32, 7-13. https://doi.org/10.1016/j.apnr.2016.03.003  
Johari, F. S. (2020). Work-related stress and coping strategies: Systematic. International  
journal of academic research in business and social sciences, 10(6), 1022-1035.  
http://dx.doi.org/10.6007/IJARBSS/v10-i6/7469  
Kokubun, K. (2024). Effort–reward imbalance and passion exploitation: A narrative review  
and  
a
new  
perspective.  
World,  
5(4),  
1235–1247.  
https://doi.org/10.3390/world5040063.  
Kumara, J., & Fusana, S.F. (2018). Work-life conflict and its impact on turnover intentions of  
employees: The mediation role of job satisfaction. International Journal of Scientific  
and  
Research  
Publications,  
8(4),  
7666. https://doi.org/10.29322/IJSRP.8.4.2018.p7666  
Lundqvist, D., Reineholm, C., Gustavsson, M., & Ekberg, K. (2013). Investigating work  
conditions and burnout at three hierarchical levels. Journal of occupational and  
environmental  
medicine, 55(10),  
1157-  
1163. https://doi.org/10.1097/JOM.0b013e31829b27df  
Lundqvist, D., Reineholm, C., Ståhl, C., & Hellgren, M. (2024). Occupational health and safety  
management: managers’ organizational conditions and effect on employee well-  
being. International Journal of Workplace Health Management, 17(2), 85-101.  
https://doi.org/10.1108/ijwhm-10-2023-0151  
Lupşa-Tătaru, F. R., Dragomir-Pânzaru, C. C., & Lupşa-Tătaru, D. A. (2025). Factors Influencing  
Digitalization Adoption in Romanian SMEs. In E. Busu (Ed.), Leading Change in  
Disruptive Times. Proceedings of the International Conference on Business Excellence,  
64 | Camelia Cristina Dragomir-Pânzaru, Aurel Mihail Țîțu  
The Impact of Professional Stress on Managerial Performance Among Middle Managers  
19(1),  
(pp.  
4075-7090). Bucharest  
University  
of  
Economic  
Studies.  
https://doi.org/10.2478/picbe-2025-0313,  
Maharani, A., & Dewi, T. (2024). The occupational stress and work-life balance on turnover  
intentions with job satisfaction as mediating. SA Journal of Human Resource  
Management, 22, 2369. https://doi.org/10.4102/sajhrm.v22i0.2369  
National Institute for Occupational Safety and Health (NIOSH). (2024). About Stress at Work.  
Centers  
for  
Disease  
Control  
and  
Prevention.  
https://www.cdc.gov/niosh/stress/about/index.html  
Ojha, G. (2025). Impact of Working Hours, Work Overload and Role Ambiguity on Perceived  
Workplace Stress among Employees in Nepalese Commercial Banks. MVIC Journal of  
Management  
https://doi.org/10.3126/mvicjmit.v1i1.77319.  
Pangert, B., Schüpbach, H. (2011). Arbeitsbedingungen und Gesundheit von  
Führungskräften auf mittlerer und unterer Hierarchieebene. In  
and  
Information  
Technology,  
1(1),  
42-62.  
&
B. Badura, A. Ducki, H. Schröder, J. Klose & K. Macco (Eds.) Fehlzeiten-Report 2011:  
Führung und Gesundheit: Zahlen, Daten, Analysen aus allen Branchen der Wirtschaft (pp.  
71-79). Springer Berlin Heidelberg.  
Penconek, T., Tate, K., Bernardes, A., Lee, S., Micaroni, S. P., Balsanelli, A. P., de Moura, A.A. &  
Cummings, G. G. (2021). Determinants of nurse manager job satisfaction: A  
systematic review. International Journal of Nursing Studies, 118, 103906.  
https://doi.org/10.1016/j.ijnurstu.2021.103906.  
Portoghese, I., Galletta, M., Leiter, M. P., Finco, G., d’Aloja, E., & Campagna, M. (2020). Job  
Demand-Control-Support Latent Profiles and Their Relationships with Interpersonal  
Stressors, Job Burnout, and Intrinsic Work Motivation. International Journal of  
Environmental  
Research  
and  
Public  
Health, 17(24),  
9430.  
https://doi.org/10.3390/ijerph17249430  
Putra, A. S. B., & Sari, V. I. P. (2025). Managing Stress in the Workplace: A Bibliometric Review  
of Coping Strategies and Resilience. Bulletin of Counseling and Psychotherapy, 7(1).  
6000. https://doi.org/10.51214/002025071286000  
Quick, J. C., & Henderson, D. F. (2016). Occupational stress: Preventing suffering, enhancing  
wellbeing. International journal of environmental research and public health, 13(5),  
459. https://doi.org/10.3390/ijerph13050459  
Shaffer, M.A., Sebastian Reiche, B., Dimitrova, M., Lazarova, M., Chen, S., Westman, M., & Wurtz,  
O. (2016). Work and family role adjustment of different types of global professionals:  
Scale development and validation. Journal of International Business Studies, 47, 113–  
139. https://doi.org/10.1057/jibs.2015.26  
Sherman, G. D., Lee, J. J., Cuddy, A. J. C., Renshon, J., Oveis, C., Gross, J. J., & Lerner, J. S. (2012).  
Leadership is associated with lower levels of stress. Proceedings of the National  
Academy of Sciences of the United States of America, 109 (44), 17903–17907.  
https://doi.org/10.1073/pnas.1207042109  
Saud, J., & Rice, J. (2024). Stress, Teamwork, and Wellbeing Policies: A Synergistic Approach to  
Reducing Burnout in Public Sector Organizations. Administrative Sciences, 14(12),  
319. https://doi.org/10.3390/admsci14120319,  
Stilijanow, U. (2012). Führung und Gesundheit. In A. Lohmann-Haislah (Ed.), Stressreport  
Deutschland,  
(pp.123-128).  
Springer  
International  
Publishing.  
https://www.springermedizin.de/gesundheitsfoerderung-in-virtueller-teamarbeit-  
durch-gesundheits/18653750  
Svanström, J., Skytt, B., Lindberg, M., & Lindberg, M. (2025). Expanded span of control,  
leadership and management performance, work-related stress, and job satisfaction  
among first-line managers: a repeated cross-sectional study. Work, 81(3), 2952-  
2963. https://doi.org/10.1177/10519815251326470  
Thilagavathy, S., & Geetha, S. N. (2021). Work-life balance: A systematic review. Vilakshan -  
XIMB Journal of Management, 20(2), 258–276. https://doi.org/10.1108/XJM-10-  
2020-0186  
World Health Organization. (2024). Occupational health: Stress at the workplace. Retrieved at  
May 20, 2026, from https://www.who.int