ENOP: Organizational issues in hospitals

Abstract

The major aim of this study was to examine how job stress in the offshore working environment may affect workers experience of strain. This study also analyses both the main and moderator effect of social support on the association between job stress and strain. The association between strain and absenteeism is also analysed. The analyses are based on a self-completion questionnaire survey among employees on offshore oil installations in the Norwegian part of the North Sea (n = 1137). The data collection was carried out in 1994. A similar study was conducted in 1990. Job stress was found to be associated with job dissatisfaction, as well as experience of strain. Social support from a supervisor had a main effect on strain. Some evidence of the moderating effects of social support were found. The employees who had been absent from work experienced most strain. It is concluded that job stress predicted job dissatisfaction and strain. In turn, strain and absenteeism were associated with each other. These results suggest that improving organizational and social factors should be the focal area in health promotion in the offshore oil industry.     

Determinants of perceived occupational stress among Chinese offshore oil workers

This is the first comprehensive study to explore the determinants of perceived sources of occupational stress among workers in the rapidly expanding Chinese offshore oil industry. In this study we surveyed 561 Chinese workers in a state-owned oil company using a questionnaire that measured occupational stress and Type A personality behaviour (TABP), social support and other socio-demographic data. Occupational stress was assessed by the Occupational Stress Scale, adapted from the questionnaire developed in previous studies (Cooper & Sutherland, 1987; Sutherland & Cooper, 1996). Using factor analyses, we identified nine sources of stress: 'interface between job and family/social life'; 'career and achievement'; 'safety'; 'management problems and relationship with workmates'; 'physical environment of workplace'; 'living environment'; 'managerial role'; 'ergonomics'; and 'organizational structure'. We performed hierarchical regression analyses on each source of stress with variables reflecting socio-demographic characteristics, TABP and social support. Better-educated workers perceived more stress from the interface between their job and family or social life and career achievement, but less stress from ergonomics. Type A workers perceived more stress from career achievement and the living environment. Social support was significantly associated with four sources of stress. Workers with different job titles perceived stress from different sources. Our findings imply that, in the stress management of offshore oil workers, different strategies and methods could be applied to different occupational groups, and to workers with different personalities and socio-demographic characteristics.     

The availability of personal and external coping resources: Thier impact on job stress and employee attitudes during organizational restructuring

This study examines the relationships among personal coping resources, social support, external coping resources, job stressors and job strains in a sample of 110 American Telephone and Telegraph employees undergoing a major organizational restructuring. The study expanded on a model suggested by Ashford (1988) by defining another category of coping resources that employees may draw upon to deal with the stressors and strains which occur during major organizational changes. External coping resources were defined as those which provided employees with a sense of 'vicarious control' in stressful situations. Results indicated that personal coping resources, social support and external coping resources had a direct effect upon job stressor and strain levels. No 'buffering' effect of these coplng resources was found. Hierarchical regression analyses indicated that external coping resources added to the prediction of job stressors and strains even when pertonal coping resources and social support were entered first into the prediction questions.     

Social support at work and its relationship to absenteeism

In this study, the impact of psychosocial work characteristics on illness and work absenteeism has been examined. The study group consisted of 133 civil servants (33 men and 100 women) with a mean age of 43 years (range 21-65 years). Psychosocial work characteristics, social support, quality of life, work absenteeism, psychosomatic and gastrointestinal symptoms were assessed by means of questionnaires. Five different work support or functions were identified by factor analysis: appraisal support, belonging support, instrumental support, emotional support and supportive atmosphere. The analysis showed that work absenteeism was associated with lower belonging support and a less supportive atmosphere. Furthermore, psychosomatic symptoms were associated with lack of support at work, measured as belonging support, instrumental support and supportive atmosphere. Gastrointestinal symptoms were associated with lack of belonging support and lack of social integration outside work. A bad general health status was associated with lack of insrumental support. The association between work absenteeism and social support at work was confirmed in multivariate analysis with control for confounding factors. In this analysis, high work strain and low social support were associated with a lower quality of life, which in turn was associated with increased absenteeism. Although there are well-known difficulties in drawing causal conclusions from cross-sectional studies, it seems reasonable to conclude that social support at work is an important factor to take into consideration when analysing illness and absenteeism from work.     

Psychosocial stress and job satisfaction in female office employees with and without neck-shoulder symptoms

The objective of this research performed in a Finnish occupational health care setting was to describe the annual prevalence of neck and shoulder symptoms in female office employees and to test whether or not these symptoms were associated with psychosocial stress, job satisfaction and health locus of control. The subjects consisted wholly of female office employees (n = 232) at one local bank and three insurance offices, chosen on a voluntary basis. The annual prevalence of disturbing neck-shoulder symptoms among female office employees was 43.3%. An association of these symptoms with psychosomatic symptoms, poor general job satisfaction and its two subdimensions, work content and perception of the healthiness of the working environment, was noticed. The subjects with neck-shoulder symptoms had a significantly higher score of feelings of external control (fatalism) than those without symptoms. The results lead to the conclusion that neck-shoulder symptoms are common amongst female office employees. These symptoms are associated with some psychosocial stress factors and job dissatisfaction. In future, it would be important to pay attention to these factors when trying to reduce the prevalence of neck-shoulder symptoms in office work.     

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.     

Social support at work and its relationship to absenteeism

Abstract

In this study, the impact of psychosocial work characteristics on illness and work absenteeism has been examined. The study group consisted of 133 civil servants (33 men and 100 women) with a mean age of 43 years (range 21-65 years). Psychosocial work characteristics, social support, quality of life, work absenteeism, psychosomatic and gastrointestinal symptoms were assessed by means of questionnaires. Five different work support or functions were identified by factor analysis: appraisal support, belonging support, instrumental support, emotional support and supportive atmosphere. The analysis showed that work absenteeism was associated with lower belonging support and a less supportive atmosphere. Furthermore, psychosomatic symptoms were associated with lack of support at work, measured as belonging support, instrumental support and supportive atmosphere. Gastrointestinal symptoms were associated with lack of belonging support and lack of social integration outside work. A bad general health status was associated with lack of insrumental support. The association between work absenteeism and social support at work was confirmed in multivariate analysis with control for confounding factors. In this analysis, high work strain and low social support were associated with a lower quality of life, which in turn was associated with increased absenteeism. Although there are well-known difficulties in drawing causal conclusions from cross-sectional studies, it seems reasonable to conclude that social support at work is an important factor to take into consideration when analysing illness and absenteeism from work.     

Moderating effects of social support in shiftworking and non-shiftworking nurses

The effects of social support on the job stress (role ambiguity)-strain (job dissatisfaction, intent-to-turnover, health problems) relationship were investigated in shiftworking (second and third shifts) and non-shiftworking (first shift) groups of nurses (N = 191). Previous research indicates that shiftworkers frequently report problems of social integration as a negative aspect of their jobs. Additionally, shiftworkers demonstrate a number of stress-related illnesses. Social support has been hypothesized to show its strongest stress-buffering (i.e. moderating) effects in high stress environments. In other words, persons with higher levels of social support are less likely to be negatively affected by high stress environments. It was hypothesized that individuals working on shiftwork would demonstrate stronger moderating effects of social support on the job stress-strain relationship than non-shiftworkers because of the stressful nature of shiftwork and the importance of social integration difficulties to shiftworkers. The dependent measures used in the analyses were global job satisfaction, intent-to-quit, and perceived health problems. Main and moderating effects of social support were found for several of the analyses. For shiftworkers, this buffering effect was significantly greater for supervisor social support on global job satisfaction and intent-to-quit. Implications of the findings are discussed.     

Job stress, satisfaction and mental health of factory workers in Bangladesh

The present study examined the relationship between job stress, job satisfaction and mental health, and attempted to assess the effects of job stress on different parameters of satisfaction and mental health in the context of two groups of Bangladeshi factory workers. There were 26 subjects in a 'high stress' group and 33 in a 'low stress' group. Individual data were collected by using the Stress and Arousal Checklist, the Job Satisfaction Scale, the General Health Questionnaire, absenteeism by sick leave, a self-esteem at work scale and heart rate monitor. Chi-square and t-tests were applied in the analyses of these data by group. The results, quite expectedly, showed that a greater number of high stress subjects were dissatisfied and had poorer mental health than low stress subjects. The results also showed that low stress subjects were significantly more satisfied and possessed better mental health than the high stress subjects. It would appear that the experience of stress plays an important role in determining the quality of working life of Bangladeshi factory workers having similar consequences in terms of health and well-being to those observed in developed countries. The dynamics of absenteeism in Bangladesh are discussed.     

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.     

Job stress and employee strain in Indian executives

Abstract

This paper reports a study which examined: the effects of job stress on strain, the pattern of stress and strain in three different work groups, and differences in the levels of job stress and strain due to occupational level The respondents consisted of ‘executives’ from a large steel manufacturing organization. Regression analyses indicated that job future ambiguity had a significant negative effect on job satisfaction in each group of executives. Further, role overload (in the case of production executives) and role ambiguity (in the case of data processing executives) had negative effects on job satisfaction. Role overload accounted for fatigue among the personnel as well as among production executives. The data indicated that the patterns of stress and strain were different in the three groups of employees. The examination of differences due to occupational level indicated that the employees of middle levels had more role ambiguity than those at the higher levels. No significant differences were observed on other dimensions. The implications of these findings are discussed.     

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 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 ×Control ×Social support ×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 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.     

The Danish psychosocial work environment and symptoms of stress: the main, mediating and moderating role of sense of coherence

The aim of this cross-sectional study was to explore the main, mediating and moderating role of sense of coherence (SOC) on stress symptoms and on the association between perceived psychosocial work environment and stress symptoms. The sample includes 2053 Danish employees from 52 workplaces. Hierarchical regression models were applied for each measure of stress. The results strongly supported the presence of a main effect for SOC. People with high levels of SOC experienced fewer stress symptoms. A mediating effect of SOC was also supported. Thus, SOC in part explained the association between work environment and stress symptoms. In addition, some support for a moderating effect of SOC was found, suggesting that people with higher SOC coped more efficiently with work environmental strain that people with lower SOC. Taken together the regression models explained 11-32% of the variance in stress symptoms. The results suggest that measures of individual factors such as SOC should be included in analyses of the effects of work environmental factors on stress and well-being.     

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 Danish psychosocial work environment and symptoms of stress: The main,mediating and moderating role of sense of coherence

The aim of this cross-sectional study was to explore the main, mediating and moderating role of sense of coherence (SOC) on stress symptoms and on the association between perceived psychosocial work environment and stress symptoms. The sample includes 2053 Danish employees from 52 workplaces. Hierarchical regression models were applied for each measure of stress. The results strongly supported the presence of a main effect for SOC. People with high levels of SOC experienced fewer stress symptoms. A mediating effect of SOC was also supported. Thus, SOC in part explained the association between work environment and stress symptoms. In addition, some support for a moderating effect of SOC was found, suggesting that people with higher SOC coped more efficiently with work environmental strain that people with lower SOC. Taken together the regression models explained 11–32% of the variance in stress symptoms. The results suggest that measures of individual factors such as SOC should be included in analyses of the effects of work environmental factors on stress and well-being.     

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.     

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.     

Changes in the association between job decision latitude and work engagement at different levels of work experience: A 10-year longitudinal study

ABSTRACT

This study set out to explore the effects of accumulating work experience on the association between job decision latitude and its interaction with job demands and work engagement. Our ten-year longitudinal study followed 333 junior physicians in postgraduate training at baseline. We used self-report measures in four assessment waves, and we conducted path analyses to investigate linear and curvilinear regression effects. Results show that high job decision latitude was associated with high work engagement at all levels of work experience, with strongest associations at baseline and after ten years. Only for novices did job decision latitude buffer the negative association between job demands and work engagement. At the stage of high work experience, low levels of job decision latitude were weakly associated with work engagement, whereas with higher levels of job decision latitude, the positive association seemed to strengthen. Our findings indicate that job decision latitude is a key job resource at all stages of work experience, with stronger effects among novices and experts. Organisations’ work design efforts should include job decision latitude to promote work engagement across employees’ different career stages, with consideration to job entrants and experts in order to tailor specific work design solutions.