The Japanese version of the Effort-Reward Imbalance Questionnaire: A study in dental technicians

To test the psychometric properties and criterion validity of the Japanese version of the EffortReward Imbalance (ERI) Questionnaire (Siegrist, 1996), a survey was conducted among 105 male dental technicians. The Japanese version of the questionnaire was developed through a backtranslation process. Internal consistency and factorial structure were tested and the criterion validity with respect to musculoskeletal symptoms was estimated with the help of a correlation matrix and logistic regression analysis. In psychometric terms, the factorial structure of the scales measuring the components of the theoretical concept was replicated satisfactorily, and internal consistencies of the scales measuring the extrinsic and intrinsic components of the model were appropriate. Significant associations between components of the ERI and musculoskeletal symptoms were found. Logistic regression analysis revealed a significantly elevated risk of musculoskeletal symptoms in participants scoring high on the scale measuring the model's intrinsic component, 'overcommitment'. This study indicates that, at least for the occupational group under study, the Japanese version of the ERI Questionnaire is a feasible and psychometrically well justified new measure for assessing psychosocial stress at work with relevance to health.     

Job Strain,Effort-Reward Imbalance and Mental Distress: A study of occupations in general medical practice

There is increasing evidence to support the predictive power of social epidemiological models such as Effort-Reward Imbalance (Siegrist, 1996) and the Job-Strain Model (Karasek, and Theorell, 1990) for explaining occupational stress, although it has been suggested that the models may have distinctive contributions towards explaining work stress in specific work settings. Alternatively, it has been suggested that the explanatory power of the different models might be enhanced if they were combined. The aim of this paper is to explore these questions by examining the power of the two different models both separately and in combination for explaining job satisfaction and mental distress in general medical practice. This analysis was based on data collected from a postal survey of the members of staff (N=1089, response rate = 70%) of 81 practices, which were randomly selected from all general practices in the National Health Service Executive South East region. The results show that while both models were predictors of mental distress and job satisfaction the models that combined different dimensions were the strongest predictors.     

Job Strain, Effort-Reward Imbalance and Mental Distress: a study of occupations in general medical practice

There is increasing evidence to support the predictive power of social epidemiological models such as Effort-Reward Imbalance (Siegrist, 1996) and the Job-Strain Model (Karasek, and Theorell, 1990) for explaining occupational stress, although it has been suggested that the models may have distinctive contributions towards explaining work stress in specific work settings. Alternatively, it has been suggested that the explanatory power of the different models might be enhanced if they were combined. The aim of this paper is to explore these questions by examining the power of the two different models both separately and in combination for explaining job satisfaction and mental distress in general medical practice. This analysis was based on data collected from a postal survey of the members of staff (N=1089, response rate = 70%) of 81 practices, which were randomly selected from all general practices in the National Health Service Executive South East region. The results show that while both models were predictors of mental distress and job satisfaction the models that combined different dimensions were the strongest predictors.     

The Effort-Reward Imbalance model of psychosocial stress at the workplace—a comparison of ERI exposure assessment using two estimation methods

It is not unusual for old data to be used in epidemiological studies. Recently developed instruments for measuring work-related stress did not exist when the data collection was carried out. Therefore, approximate questions are sometimes used. An apparent problem is the lack of validation of proxy questions. The aim of this study was to compare the original questions for measuring Effort-Reward Imbalance (ERI) with approximate questions. The study population corresponded with a subgroup in the WOLF-n (WOrk, Lipids, Fibrinogen-north) cohort study of cardiovascular risk in a working population in the north of Sweden: 655 men and 178 women. The agreement in exposure between the original and the approximate ERI single questions was relatively low throughout, whereas the correlation between the ERI subscales and the ERI ratios was reasonable. The latter agreement between the original and the approximate ERI ratio indicates that the approximate measures might have been useful in the past. Yet, whenever possible the implementation of the original questionnaire in study protocols is recommended since a complete measurement of ERI might help to further improve the internal consistency and the predictive validity of this exposure to effort-reward imbalance.     

A psychometric evaluation of a Dutch version of the Job Content Questionnaire and of a short direct questioning procedure

Using the demand-control-support perspective on job stress, a Dutch translation of an adapted version of the Job Content Questionnaire (AJCQ) was administered to a large population ( N = 3638) of Flemish workers in a variety of jobs, together with the General Health Questionnaire, and a negative affectivity scale. Overall, the AJCQ was shown to be a solid measurement instrument as indicated by several estimated reliability indices and validity of the subscales. A factor analysis largely reproduced the a priori structure of the AJCQ. A short 10-item direct questioning procedure was constructed to measure the 10 subscales of the AJCQ and the results of this procedure were compared with the AJCQ in a subsample ( N = 660). The correlations with six criterion variables showed that single questions were equally predictive than the much longer version of the AJCQ.     

Psychophysiological reactions during the first year of a foreign assignment: Results of a controlled longitudinal study

Abstract

Previous studies reveal that employees are exposed to several potential stressors during foreign assignments. This prospective multidisciplinary study followed managers (expatriate group) before and during their first year of an international work assignment. Concurrently, a matched reference group that did not relocate was observed. The secretion of the stress-sensitive hormone prolactin increased in the expatriate group during the first year abroad, compared to the reference group. Selfesteem, family relations, language skills, decreased internal locus of control and job promotion explained 32% of the variance in serum prolactin levels. Lower self-esteem and sense of coherence was related to increased serum prolactin. Increased working hours were associated with decreased work satisfaction. Job promotion was not related to work satisfaction. Mental well-being decreased in the expatriate group, compared to the reference group. Individual factors such as a strong sense of coherence and social provision attenuated decreases in mental well-being. A significant increase in cigarette and alcohol consumption was found in the expatriate group during the first year abroad. This study indicates that there are important psychosocial determinants influencing psychophysiological response patterns in expatriates. The present results put into question the generalizability of the ‘culture shock’ syndrome. The results have practical implications for guiding expatriates on time-limited assignments.     

Psychophysiological reactions during the first year of a foreign assignment: Results of a controlled longitudinal study

Previous studies reveal that employees are exposed to several potential stressors during foreign assignments. This prospective multidisciplinary study followed managers (expatriate group) before and during their first year of an international work assignment. Concurrently, a matched reference group that did not relocate was observed. The secretion of the stress-sensitive hormone prolactin increased in the expatriate group during the first year abroad, compared to the reference group. Selfesteem, family relations, language skills, decreased internal locus of control and job promotion explained 32% of the variance in serum prolactin levels. Lower self-esteem and sense of coherence was related to increased serum prolactin. Increased working hours were associated with decreased work satisfaction. Job promotion was not related to work satisfaction. Mental well-being decreased in the expatriate group, compared to the reference group. Individual factors such as a strong sense of coherence and social provision attenuated decreases in mental well-being. A significant increase in cigarette and alcohol consumption was found in the expatriate group during the first year abroad. This study indicates that there are important psychosocial determinants influencing psychophysiological response patterns in expatriates. The present results put into question the generalizability of the 'culture shock' syndrome. The results have practical implications for guiding expatriates on time-limited assignments.     

The social construction of the meaning of acute stressors: A qualitative study of the personal accounts of police officers using a stress counselling service

The police profession is one in which acute stressors are encountered more frequently than in other occupations. Using the personal accounts of 35 police officers attending an in-house stress counselling clinic, the aim of the present study was to provide a qualitative examination of how the institutional context of policing influenced the ways in which acute stressors signified to individual police officers experiencing felt distress. Using the framework of Rational Emotive Behaviour Therapy as an analytical tool, it is argued that beliefs contributing to the experience of felt distress are related to the way in which policing as both an identity and an activity is constructed through the police organizational culture. Not only do these constructions influence the ways in which officers perceive themselves and their environments, but they also operate at the collective level to 'normalize' some emotional responses and to 'pathologize' others which, it is argued, could impact upon the outcomes of interventions such as stress counselling.     

A psychometric evaluation of a Dutch version of the Job Content Questionnaire and of a short direct questioning procedure

Using the demand-control-support perspective on job stress, a Dutch translation of an adapted version of the Job Content Questionnaire (AJCQ) was administered to a large population ( N = 3638) of Flemish workers in a variety of jobs, together with the General Health Questionnaire, and a negative affectivity scale. Overall, the AJCQ was shown to be a solid measurement instrument as indicated by several estimated reliability indices and validity of the subscales. A factor analysis largely reproduced the a priori structure of the AJCQ. A short 10-item direct questioning procedure was constructed to measure the 10 subscales of the AJCQ and the results of this procedure were compared with the AJCQ in a subsample ( N = 660). The correlations with six criterion variables showed that single questions were equally predictive than the much longer version of the AJCQ.     

The social construction of the meaning of acute stressors: a qualitative study of the personal accounts of police officers using a stress counselling service

The police profession is one in which acute stressors are encountered more frequently than in other occupations. Using the personal accounts of 35 police officers attending an in-house stress counselling clinic, the aim of the present study was to provide a qualitative examination of how the institutional context of policing influenced the ways in which acute stressors signified to individual police officers experiencing felt distress. Using the framework of Rational Emotive Behaviour Therapy as an analytical tool, it is argued that beliefs contributing to the experience of felt distress are related to the way in which policing as both an identity and an activity is constructed through the police organizational culture. Not only do these constructions influence the ways in which officers perceive themselves and their environments, but they also operate at the collective level to 'normalize' some emotional responses and to 'pathologize' others which, it is argued, could impact upon the outcomes of interventions such as stress counselling.     

Sources of stress in the national health services: A comparison of seven occupational groups

This paper reports a comparative study of sources of occupational stress affecting the seven major occupational groups within the National Health Service. The groups are compared on seven dependent variables. These are the six sub-categories of stressors identified by Cooper and Marshall (1978) and measured by the Occupational Stress Indicator (OSI) (Cooper et al. 1988), and a total stress score that is derived by summing scores for each of the six sub-categories. Occupational groups differed significantly (p.05) in only two of the six sub-categories. In these cases occupational groups not normally associated with front-line care reported higher levels of stress than either doctors or nurses. The results show that high levels of occupational stress are experienced by all occupational groups within the NHS and the subsequent discussion argues for a more progressive research policy that gives adequate attention to 'lower status' groups, such as ancillary, works and maintenance, and administrative and clerical.     

The validity of the occupational stress indicator

During the last two decades two potent groups of predictors for work-related musculoskeletal problems have been identified: physical work load and poor psychosocial working conditions. However, little is known about their combined effects. In this study the buffering effect of control at work with respect to the negative effects of psychological demands and physical work load on musculoskeletal problems is examined. All study variables were sampled from 431 people working in geriatric nursing homes in Germany by means of questionnaires. Main effects and interactions were tested with multiple regression analysis. The results showed that control buffered the effects of high psychological demands, but not of high physical work load; the buffering effect of control was observed only when physical work load was low. The combined effects of demands and physical work load were over-additive. Thus, the power of different predictors for musculoskeletal symptoms depended on the level of other predictors. This suggests that the efficiency of certain strategies for the prevention of musculoskeletal problems is likely to depend on the level of risk factors, with different strategies being appropriate for different levels of risk.     

Employee reactions to behavioural control under conditions of stress: The moderating role of self-efficacy

Extensive research conducted in the occupational stress literature has failed to provide convincing support for the stress-buffering effects of work control on employee adjustment. Drawing on research conducted in the laboratory context, it was proposed that the stress-buffering effects of work control on employee adjustment would be more marked at high, rather than low, levels of self-efficacy. In a sample of 100 customer service representatives, a significant three-way interaction among role conflict, work control and self-efficacy (measured at Time 1) was observed on (low) depersonalization (measured at Time 2). Consistent with expectations, work control reduced the negative effects of work stress on this outcome measure only for employees who perceived high levels of self-efficacy at work. In addition, there was evidence to suggest that self-efficacy moderated the main effects of work control on job satisfaction and somatic health. These findings are discussed in terms of their theoretical contribution to the job strain model, and also in relation to workplace interventions designed to improve levels of employee adjustment.     

The four-dimensional symptom questionnaire (4DSQ): measuring distress and other mental health problems in a working population

In non-clinical (working) populations it is important to differentiate between general distress, on the one hand, and psychiatric symptoms—depression, anxiety and somatization—on the other hand. The Four-Dimensional Symptom Questionnaire (4DSQ) is a new instrument that measures these four symptom dimensions (Terluin, ). This study aimed to investigate the psychometric properties of the 4DSQ in a working population. A postal stress and health survey was sent to all employees of a Dutch telecom company, 51% of whom responded (N=3852). The mailing included the 4DSQ, a set of questionnaires concerning job stress (e.g. psychological demands), coping style (e.g. problem-focused coping, avoidant coping), and indicators of strain (e.g. emotional exhaustion, fatigue). Cronbach's α for the four sub-scales of the 4DSQ ranged from .79 to .90. Factor analysis showed four factors corresponding to the four scales of the 4DSQ: distress, depression, anxiety, and somatization. The validity of the 4DSQ was assessed using (partial) correlations with job stress, coping, and strain. As expected, the distress scale showed the strongest correlations with the indicators of strain, as well as with job stress and coping. In conclusion, the 4DSQ is a reliable and valid instrument that can be used in a working population to distinguish between stress-related symptoms and psychiatric illness.     

Interventions for musculoskeletal disorders in computer-intense office work: a framework for evaluation

Workplace interventions for work-related musculoskeletal disorders (WMSDs) are usually multifaceted. These interventions tend to deal with multiple work organizational and physical risk factors and have components occurring at different organizational levels. The organizations are often changing, with shifting initiatives and priorities. Evaluation of such interventions poses challenges in documentation of implementation, reduction in exposures, and assessment of improved health outcomes. We describe a means-outcomes framework for evaluating field interventions that includes strategies, activities, objectives and metrics for outcomes using quantitative and qualitative methods. We demonstrate application of the framework to our work with a large newspaper, which builds on existing laboratory, aetiological and best practice evidence to improve musculoskeletal health. The newspaper had adopted several organizational strategies aimed at improving financial performance, including restructuring into teams, a major set of moves/renovations and introduction of new software. Concomitant WMSD-related organizational strategies include an ergonomics policy, human resources activities, promotion of team work, changes in environment and equipment specifications and development of information systems. We have found the framework useful for focusing the purpose of data collection and ensuring coverage of important components. At the same time, it provides sufficient flexibility to respond to the changing process of implementation.     

Employee reactions to behavioural control under conditions of stress: the moderating role of self-efficacy

Extensive research conducted in the occupational stress literature has failed to provide convincing support for the stress-buffering effects of work control on employee adjustment. Drawing on research conducted in the laboratory context, it was proposed that the stress-buffering effects of work control on employee adjustment would be more marked at high, rather than low, levels of self-efficacy. In a sample of 100 customer service representatives, a significant three-way interaction among role conflict, work control and self-efficacy (measured at Time 1) was observed on (low) depersonalization (measured at Time 2). Consistent with expectations, work control reduced the negative effects of work stress on this outcome measure only for employees who perceived high levels of self-efficacy at work. In addition, there was evidence to suggest that self-efficacy moderated the main effects of work control on job satisfaction and somatic health. These findings are discussed in terms of their theoretical contribution to the job strain model, and also in relation to workplace interventions designed to improve levels of employee adjustment.     

Employees' perceptions of organizational restructuring: The role of social support

Organizational change and restructuring is often perceived as leading to increased occupational stress, impacting negatively on the psychological well-being of employees. This pragmatic study investigates the role of social support and dispositional affect as moderators of role stress post-restructuring for employees in a public utility company. A total of 176 employees, including 37 managers, 60 graded staff and 78 industrial staff completed a self-report questionnaire, approximately 1 year postrestructuring, retrospectively assessing role conflict, ambiguity, overload and positive and negative feedback pre- and post-restructuring. Results suggested that overall role stress increased for managers/ senior officers and graded staff, but not for industrial staff. Social support was linked with lower role stress, more positive feedback and less negative feedback at post-restructuring. For certain role stressors this impact was moderated by dispositional affect, but the effect was not consistent across occupational groups. Positive affect enhanced the effect of manager support in reducing role conflict for graded staff, and the effect of co-worker support in increasing positive feedback and reducing negative feedback for industrial staff. Findings suggest that managers should pay particular attention to support and feedback for employees during periods of chronic occupational stress following organizational restructuring.     

Musculoskeletal problems in bricklayers as a function of length of employment: The role of secondary selection by low-back pain

Abstract

Low-back problems that are caused by heavy physical work should increase with the length of employment. In a cross-sectional study 195 bricklayers were interviewed and subjected to a medical examination concerned with complaints and functional impairments of the musculoskeletal systems of different body regions (neck/shoulder, arms/hands, back, hip/legs/feet). Summary variables for complaints and impairments indicated an increase with increasing age. Contrary to expectation, in pairs of bricklayers of the same age, but different length of employment, a general decline of complaints and impairments with longer employment was observed. This finding suggested a healthy worker effect. In a follow-up the turnover rate among 190 of the 195 bricklayers of the original study was determined. Bricklayers who had quit the job had a higher incidence of low-back troubles before leaving than bricklayers who had stayed in the job; the relation between turnover and low-back problems was limited to bricklayers older than about 40 years.     

The stress of driving: A diary study

A study of daily behaviours and feelings while driving was carried out with a sample of drivers to ascertain driving stress levels and changes in these as a function of time of day and day of the week. The analysis of responses to a specially designed diary/checklist showed that drivers experience more stress in the evening than in the morning, and in mid-week than either at the beginning or end of the week. Daily driving stress varies with age and experience as well as with health condition and sleep quality. It is also related to driving conditions and depends upon people's overall perception of driving as a stressful activity.     

Musculoskeletal problems in bricklayers as a function of length of employment: The role of secondary selection by low-back pain

Low-back problems that are caused by heavy physical work should increase with the length of employment. In a cross-sectional study 195 bricklayers were interviewed and subjected to a medical examination concerned with complaints and functional impairments of the musculoskeletal systems of different body regions (neck/shoulder, arms/hands, back, hip/legs/feet). Summary variables for complaints and impairments indicated an increase with increasing age. Contrary to expectation, in pairs of bricklayers of the same age, but different length of employment, a general decline of complaints and impairments with longer employment was observed. This finding suggested a healthy worker effect. In a follow-up the turnover rate among 190 of the 195 bricklayers of the original study was determined. Bricklayers who had quit the job had a higher incidence of low-back troubles before leaving than bricklayers who had stayed in the job; the relation between turnover and low-back problems was limited to bricklayers older than about 40 years.