The impact of sense of coherence and high-demand/low-control job environment on self-reported health, burnout and psychophysiological stress indicators

Sense of Coherence (SOC) is a new concept belonging to a salutogenic paradigm, proposing to explain health as contrasted to disease, a pathogenic paradigm. The Job Demand-Control (JDC) model of job stress suggests that the combination of high job demands and low job control, defined as job strain, is strongly associated with adverse health consequences. The aim of this study was to evaluate the relationship between SOC and the JDC model in assessment of negative job effects within three pathogenically defined contexts: self-reported health, burnout and psychophysiological stress indicators, assessing the explanatory value of SOC for such variables. The study was conducted with 103 employees of social-welfare and social-insurance agencies in Sweden. A questionnaire related to job conditions, health and burnout was administered, and blood samples were collected and analysed for serum concentrations of cortisol, prolactin and immunoglobulin G. Multiple-regression models were calculated including variables from all three contexts. In the analyses, a distinction was made between emotional job strain and quantitative job strain. The SOC interacted with emotional job strain, but the interaction also increased the independent effect of emotional job strain. The independent effect of SOC disappeared in most models when interaction was included. It is concluded that studies of job strain-effects according to the JDC model should include the SOC as an interaction factor.     

The importance of context specificity in work stress research: A test of the Demand-Control-Support model in academics

Abstract

The Demand-Control (D-C) (Karasek, 1979) and the Demand-Control-Support (D-C-S) (Johnson & Hall, 1988; Johnson, Hall, & Theorell, 1989; Karasek & Theorell, 1990) models of work stress suggest that jobs with high demands and low control (and low support) are stressful. In line with the support in the literature for context-specificity in occupational stress research (Sparks & Cooper, 1999) and the limited and even contradictory support for interaction effects, the main aim of the present study was to examine how the D-C-S model applied in a well-defined occupational group. Using hierarchical regression analyses, and controlling for negative affect, the D-C-S model accounted for 26%, 6%, and 8% of the variance in job satisfaction, psychological distress and burnout, respectively, among 166 academics in a UK university. No two-way or three-way interactive effects were evident, but additive effects of job demands and control on psychological well-being and of job demands and support on both burnout and job satisfaction were shown, corroborating research showing that high job strain is linked to ill health and job dissatisfaction in this homogenous occupational sample. It is recommended that, in future, research includes more variables that are specific to a particular occupation.     

The Job Demand-Control (-Support) Model and psychological well-being: A review of 20 years of empirical research

The Job Demand-Control (JDC) model (Karasek, 1979) and the Job Demand-Control-Support (JDCS) model (Johnson, and Hall, 1988) have dominated research on occupational stress in the last 20 years. This detailed narrative review focuses on the JDC(S) model in relation to psychological well-being. It covers research from 63 samples, published in the period 1979-1997. In the review a distinction is drawn between two different hypotheses prevailing in research on the models. According to the strain hypothesis of the JDC model, employees working in a high-strain job (high demands-low control) experience the lowest well-being. The buffer hypothesis states that control can moderate the negative effects of high demands on well-being. Translating these hypotheses to the expanded JDCS model, the iso-strain hypothesis predicts the most negative outcomes among workers in an iso-strain job (high demands-low control-low social support/isolation), whereas the buffer hypothesis states that social support can moderate the negative impact of high strain on well-being. Although the literature gives considerable support for the strain and iso-strain hypotheses, support for the moderating influence of job control and social support is less consistent. The conceptualization of demands and control is a key factor in discriminating supportive from nonsupportive studies. Only aspects of job control that correspond to the specific demands of a given job moderate the impact of high demands on well-being. Furthermore, certain subpopulations appear to be more vulnerable to high (iso)strain, whereas others benefit more from high control. On the basis of the results of this review, suggestions for future research and theoretical development are formulated.     

Job characteristics as predictors of ill-health and sickness absenteeism in different occupational types--a multigroup structural equation modelling approach

The objective of the present study was to test for multigroup invariance in measurement models and structural models between job characteristics, psychosocial intervening variables, health outcomes and sickness absenteeism. Four types of occupation were represented in the study: blue-collar workers ( n = 241), white-collar workers ( n = 209), elderly-care workers ( n = 338) and child-care workers ( n = 336). A first-order, six-factor multigroup confirmatory factor analysis model (i.e. measurement model) composed of two perceived job characteristics ( job autonomy and skill discretion), appraised workload, job satisfaction, stress-related ill-health and sickness absenteeism provided a good model fit. Invariance tests showed that the six-factor model fits well for all occupations. A partially recursive mediated multigroup structural model showed both similarities and differences across occupations as regards the relationships between independent latent variables ( job autonomy, skill discretion), intervening latent variables (appraised workload, job satisfaction) and dependent latent variables (stressrelated ill-health, sickness absenteeism). By comparing a generic model with occupation-specific models across occupations, this study showed that occupation-specific models were more plausible. The results indicate that it is important to examine different occupational contexts in detail to better understand how certain psychosocial factors at work influence strain in different occupations. Since job characteristics can potentially be amended, the findings have important implications for the differentiation of prevention and intervention in different occupations.     

The importance of context specificity in work stress research: A test of the Demand-Control-Support model in academics

The Demand-Control (D-C) (Karasek, 1979) and the Demand-Control-Support (D-C-S) (Johnson & Hall, 1988; Johnson, Hall, & Theorell, 1989; Karasek & Theorell, 1990) models of work stress suggest that jobs with high demands and low control (and low support) are stressful. In line with the support in the literature for context-specificity in occupational stress research (Sparks & Cooper, 1999) and the limited and even contradictory support for interaction effects, the main aim of the present study was to examine how the D-C-S model applied in a well-defined occupational group. Using hierarchical regression analyses, and controlling for negative affect, the D-C-S model accounted for 26%, 6%, and 8% of the variance in job satisfaction, psychological distress and burnout, respectively, among 166 academics in a UK university. No two-way or three-way interactive effects were evident, but additive effects of job demands and control on psychological well-being and of job demands and support on both burnout and job satisfaction were shown, corroborating research showing that high job strain is linked to ill health and job dissatisfaction in this homogenous occupational sample. It is recommended that, in future, research includes more variables that are specific to a particular occupation.     

Helping people to sort it out: The role of social support in the Job Strain Model

This paper reports three studies of occupational stress investigating the role of social support as an intervening variable in the Job Strain Model (Karasek, 1979). A computer simulated mail-sorting work environment was used to assess the effect of demands, control and social support on measures of strain, satisfaction, and perceived and actual task performance. The first experiment ( N =60) tests the basic Job Strain Model by manipulating levels of task demand and control. The second experiment ( N =120) compares high and low levels of two types of social support (informational support and emotional support) to determine whether and how they interact with extreme conditions of the Job Strain Model (high strain and low strain). The final experiment ( N =90) investigates positive and negative forms of social support (praise and criticism) in relation to extreme job strain conditions. Results show that the job strain model is consistent with the stress and performance data, although stress showed no Demand 2 Control interaction. Social supports increased arousal, satisfaction and perceived performance, but did not affect stress or task performance. Moreover, contrary to buffer theories, social supports did not interact with the job strain variables. Congruence between preferred and experienced emotional support levels also predicted performance.     

Health habits,type A behaviour and job burnout

Abstract

This study examined the effects of health habits and type A behaviour on psychological health outcomes in the face of daily life stress. Measures of the experience of life stress, health habits, type A behaviour, job burnout and psychological distress were collected for 146 employees at the UCLA Medical Centre. Analyses of covariance revealed that health habits contributed significant main effects to psychological distress but not job burnout. Type A behaviour, but not life stress or health habits, directly affected both job burnout and psychological distress. The implications of the research for employee health programmes are discussed.     

The association between job skill discretion,decision authority and burnout

This paper reports on the relationship between dimensions of control (skill discretion and decision authority) and burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) among 164 human service workers. It examines the differential influence of job demands, control (skill discretion and decision authority) and social support (supervisor, co-workers, others) on each burnout dimension. Then it examines the moderating effects of higher skill discretion, higher decision authority, and higher social support on burnout. Low skill discretion was found to be associated with high emotional exhaustion and depersonalization and low personal accomplishment. The effects of decision authority were not statistically significant. High job demands were associated with high emotional exhaustion only. Social support (supervisor, co-worker, and others) was not associated with burnout when demographic variables and job characteristics were controlled for. Neither dimension of control moderated the impact of high job demands on burnout. Social support did not moderate the impact of high demands, low skill discretion, or low decision authority on any burnout dimension. The full model explained 44% of the variance in emotional exhaustion, 25% in depersonalization, and 42% in personal accomplishment. Despite its limitations, the study suggests that the Job Demand-Control model may provide a useful theoretical foundation for the study of burnout, but that the control dimensions need to be evaluated independently since they appear to be differentially related to the burnout dimensions.     

Job stress,burnout and substance use among urban transit operators: The potential mediating role of coping behaviour

Abstract

Urban transit operators, compared to other occupational groups, have higher rates of mortality and morbidity. A major risk factor is the highly stressful objective environment. This study used structural equation modelling to test a model hypothesizing that transit operators’ coping behaviours in responding to daily job hassles mediate the associations of work stress with burnout and substance use. The study sample consisted of 1231 transit operators who participated in the San Francisco MUNI Health and Safety Study. The results showed a direct and strong association between transit operators’ daily job stress and symptoms of occupational burnout even when a series of controls and coping behaviours were considered. In addition, use of “disengage-deny” and escapist strategies to cope with job stress was positively associated with burnout; the job stress–burnout association was partially mediated through such coping practices. Daily job stress was related to substance use only indirectly and mediated through burnout and use of “disengage-deny” and escapist coping strategies. “Disengage-deny” coping strategies might help reduce substance use whereas escapist coping strategies might increase such use. Overall, our findings suggest that coping behaviour may be an important correlate of transit operators’ ill health. Interventions enabling healthy coping behaviours may help reduce health risks for this occupational group.     

Back to basics: Re-examination of Demand-Control Theory of occupational stress

The Demand-Control model of occupational stress posits an interaction between job demands and job control predicting psychological strain, but previous research has found such an interaction only rarely or inconsistently. Such research, however, has often failed to measure either demands or strain faithfully to the model's constructs, or has simply failed to test for a statistical interaction. The present study corrected these shortcomings by going back to basics. Using a sample of 115 employees in a manufacturing company, it operationalized the variables more consistently with their original conceptualizations. However, when the hypothesized Demand-Control interaction was then tested, it still failed. Outcomes other than psychological strain (e.g. job dissatisfaction) were related negatively rather than positively to demands. This highlights the difference between psychological strain and dissatisfaction and casts doubt on models positing dissatisfaction as an intervening variable between stressors and strains.     

Subjective health and its relationship with working time variables and job stressors: Sequence or general factor model?

Abstract

This study compares two theoretical models that make different assumptions about the structure of subjective health constructs and about the effects of job stressors and working time variables on health. The first model, the sequence model, is based on sequential models of the development of ill-health and posits that chronic fatigue and sleep problems mediate the effects of job stressors and working time variables on depression and somatic complaints. The second model, the general strain factor model, posits that specific health constructs (e.g. fatigue, depression, and somatic complaints) are reflections of a common general strain factor (i.e. detrimental job conditions increase the individual's sensitization to strain). In this way the study expands traditional models of stress-related effects on health. The analyses were carried out in a sample of 365 individuals in Germany. Although both models fitted the data, the general strain factor model was found to be superior. Furthermore, the effects of job stressors and working time on the health constructs fatigue and sleep quality were mediated by the general strain factor. Also, a negative relationship emerged between working time duration and general strain. It is suggested that the general strain model could be useful in future health psychology research.     

Beyond demand–control: Emotional labour and symptoms of burnout in teachers

Abstract

Teaching is a profession that involves a high level of emotional labour. This includes such behaviours as surface acting (displaying an emotion that is not actually felt), deep acting (the activity undertaken to actually feel a required emotion), and suppression of emotion. In many professions, this emotional labour is thought to be related to high levels of burnout. The aim of our study was to show that emotional labour has a unique relationship with burnout that is separate from its relationship with the variables of the Demand Control Support (DCS) model. Emotional labour was studied, together with the variables of the Karasek Job Demand Control Support model, in a random sample of 365 mathematics teachers in the Netherlands. We used the Dutch Questionnaire on Emotional Labor (D-QEL) that measures: (1) surface acting, (2) deep acting, (3) suppression, and (4) emotional consonance. In line with other studies, job characteristics were found to be specifically related to emotional exhaustion. Surface acting was significantly related to depersonalization, and emotional consonance (the absence of emotional labour) was related to personal accomplishment. We conclude that whereas the DCS model has been valuable for understanding emotional exhaustion, emotional labour provides an additional perspective for understanding work stress.     

The Demands-Control-Support model,locus of control and job dissatisfaction: A longitudinal study

The Job-Demands-Control model (Karasek, 1979) has been widely studied in the job stress field, but the results obtained are frequently contradictory. Therefore, some investigations have expanded the model by including social support and personality characteristics such as locus of control. However, results obtained with these elaborated models have not been conclusive either. The present study sets out to integrate both types of expansions by simultaneously including social support at work and the employee's locus of control in a longitudinal multi-national study among 542 administrative personnel from Belgium, England, Spain, Italy and Israel. Hierarchical moderated multiple regression showed a significant 4-way interaction term (Demands 2 Control 2 Social support 2 Locus of control) on the change in job dissatisfaction. This effect is qualified by the interaction between job demands and control only for an internal locus of control with high social support. Contrary to the prediction of the JDC model, which posits that high control has a buffering effect on job dissatisfaction, the study result indicates a damaging effect of excess control (perceived job control and high internal locus of control), specifically in high social support situations.     

The Job Demand-Control (-Support) Model and psychological well-being: a review of 20 years of empirical research

The Job Demand-Control (JDC) model (Karasek, 1979) and the Job Demand-Control-Support (JDCS) model (Johnson, and Hall, 1988) have dominated research on occupational stress in the last 20 years. This detailed narrative review focuses on the JDC(S) model in relation to psychological well-being. It covers research from 63 samples, published in the period 1979-1997. In the review a distinction is drawn between two different hypotheses prevailing in research on the models. According to the strain hypothesis of the JDC model, employees working in a high-strain job (high demands-low control) experience the lowest well-being. The buffer hypothesis states that control can moderate the negative effects of high demands on well-being. Translating these hypotheses to the expanded JDCS model, the iso-strain hypothesis predicts the most negative outcomes among workers in an iso-strain job (high demands-low control-low social support/isolation), whereas the buffer hypothesis states that social support can moderate the negative impact of high strain on well-being. Although the literature gives considerable support for the strain and iso-strain hypotheses, support for the moderating influence of job control and social support is less consistent. The conceptualization of demands and control is a key factor in discriminating supportive from nonsupportive studies. Only aspects of job control that correspond to the specific demands of a given job moderate the impact of high demands on well-being. Furthermore, certain subpopulations appear to be more vulnerable to high (iso)strain, whereas others benefit more from high control. On the basis of the results of this review, suggestions for future research and theoretical development are formulated.     

Impact of shift work and department type upon strain and attitudinal measures of hospital nurses

The effects of shift work (fixed versus rotating), type of hospital department (intensive care unit versus non-ICU), and job scope on stress and attitudes have been reported previously. The goal of the present study was to examine the interactive, as well as individual, impact of these variables on measures of perceived work stress, strain, work satisfaction and withdrawal intentions. Respondents in the study were nurses in a large general hospital in Israel. None of the two- or three-way interactions received empirical support. However, significant multivariate main effects for each of the three independent measures were found. The negative influence of rotating work shift compared to fixed work shift was supported. Nurses who thought that their job was more enriching were more satisfied and perceived their workload as being lower. Department type affected only burnout level; nurses in non-ICUs were lower in burnout. Several theoretical and practical possible interpretations and possible implications are presented.     

The effects of new dimensions of psychological job demands and job control on active learning and occupational health

Abstract

Recent changes in job content may have led to changes in job demands and control, and earlier operationalizations of the demand concept may be too general (MT). The aim of this paper is to show how new dimensions of psychological job demands are related to two sets of outcome variables, employee health and active learning, and how these relationships are modified or interact with social support and types of job control. The study was carried out as a survey among employees of 13 electric companies in Norway, N=2435. Lisrel was used to assess the fit of the proposed models. Compared to the traditional demands control model, an extended version used in this study increased the explained variance on an average by 4% on various occupational health variables. It was found that various dimensions of demands were differentially related to the outcome variables. Skill discretion uniformly reduced the effect of the demands: for groups low in skill discretion there was a stronger relationship between demands and outcomes than for groups high in skill discretion. The interaction pattern for the remaining control and support variables was however more complicated and warrants further study. The practical implications are that employers should carefully consider the quality of work. Special attention should be given to the quantitative demands of the jobs, since there seems to be few moderators for the relationship between those demands and job stress and subjective health complaints.     

Burnout in Greek teachers: Main findings and validity of the Maslach Burnout Inventory

Abstract

The factorial structure of the Maslach Burnout Inventory (Maslach and Jackson 1986) was investigated in a sample of 220 Greek teachers and was found to be similar to that reported by Maslach and Jackson. A job satisfaction measure was employed for the investigation of the discriminant validity of the burnout measure. Correlations between job satisfaction and the three burnout dimensions were found to be low to moderate. It is suggested that the relationship and the degree of overlap between emotional exhaustion and job satisfaction require further examination. Greek teachers reported lower levels of burnout on the emotional exhaustion and depersonalization scales than teachers in other countries. Finally, younger teachers experienced more emotional exhaustion than older ones and primary education teachers experienced more personal accomplishment and less depersonalization than their counterparts in secondary education.     

Beyond demand-control: Emotional labour and symptoms of burnout in teachers

Teaching is a profession that involves a high level of emotional labour. This includes such behaviours as surface acting (displaying an emotion that is not actually felt), deep acting (the activity undertaken to actually feel a required emotion), and suppression of emotion. In many professions, this emotional labour is thought to be related to high levels of burnout. The aim of our study was to show that emotional labour has a unique relationship with burnout that is separate from its relationship with the variables of the Demand Control Support (DCS) model. Emotional labour was studied, together with the variables of the Karasek Job Demand Control Support model, in a random sample of 365 mathematics teachers in the Netherlands. We used the Dutch Questionnaire on Emotional Labor (D-QEL) that measures: (1) surface acting, (2) deep acting, (3) suppression, and (4) emotional consonance. In line with other studies, job characteristics were found to be specifically related to emotional exhaustion. Surface acting was significantly related to depersonalization, and emotional consonance (the absence of emotional labour) was related to personal accomplishment. We conclude that whereas the DCS model has been valuable for understanding emotional exhaustion, emotional labour provides an additional perspective for understanding work stress.     

A longitudinal test of Karasek's Job Strain model among office workers

Abstract

Karasek'sJob Strain model was tested in a sample of 122 office workers. Two rounds ofdata were collected and used to examine the reliability of the results and the relationships between job characteristics and worker strain over time. Moderated regression analyses based on standard scores of the independent variables were conducted to examine the interaction of job control and workload, and of skill utilization and workload, on various indicators of worker strain. The results indicated that there was neither multiplicative nor adhtive effect ofjob control/skill utilization and workload on worker strain. Some of the relationships between job characteristics and worker strain were not stable over time. The cross-lagged correlation analysis showed that workload at Time 1 had some effect on one ofthe worker strain indxators at Time 2, but not the reverse.     

Pre-employment antecedents of health resources,job factors and health risk behaviour in men and women

Abstract

The role of individual factors in youth as predictors of adult health resources, job factors and health risk behaviour was studied in men and women. The studied health risk behaviours were smoking, use of alcohol and sedentary behaviour. Sense of coherence (SOC) was the used measure of adult health resources. The pre-employment data had been collected from a sample of 1084 subjects representative of Finnish youth at the mean age of 12 years. For this follow-up study, 345 women and 361 men, working in Finland, responded to a questionnaire at the mean age of 36 years. In the analyses of structural relationships, individual factors in youth were related to adult variables for both sexes, although only two consistent relationships were found for women: outgoing, social activities in youth predicted adult smoking and use of alcohol. Of the job factors, low job demands were related to smoking and lack of support at work was related to sedentary behaviour in women. The strong relationships of SOC with perceptions of social support and influence at work for both sexes characterized its role in health-promoting experiences at work, and supported its importance as a general health resource.