Control at work: a generalized resource factor for the prevention of musculoskeletal symptoms?

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.     

Editorial: Cognitive science,occupational stress and organizational health

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

How the psychosocial work environment of motor vehicle mechanics may influence coping with musculoskeletal symptoms

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Psychosocial safety climate as an antecedent of work characteristics and psychological strain: A multilevel model

Abstract

Psychosocial safety climate (PSC) refers to a specific organizational climate for the psychological health of workers. It is largely determined by management and at low levels is proposed as a latent pathogen for psychosocial risk factors and psychological strain. Using an extended Job Demands-Control-Support framework, we predicted the (24 month) cross-level effects of PSC on psychological strain via work conditions. We used a novel design whereby data from two unrelated samples of nurses working in remote areas were used across time (N=202, Time 1; N=163, Time 2), matched at the work unit level (N= 48). Using hierarchical linear modelling we found that unit PSC assessed by nurses predicted work conditions (workload, control, supervisor support) and psychological strain in different nurses in the same work unit 24 months later. There was evidence that the between-group relationship between unit PSC and psychological strain was mediated via Time 2 work conditions (workload, job control) as well as Time 1 emotional demands. The results support a multilevel work stress model with PSC as a plausible primary cause, or “cause of the causes”, of work-related strain. The study adds to the literature that identifies organizational contextual factors as origins of the work stress process.     

Work-related psychosocial,physical and individual factors associated with musculoskeletal symptoms in computer users

The aim of this study was to study associations between psychosocial, physical and individual factors, and musculoskeletal symptoms in the neck, shoulder and hand/wrist regions of computer users. Questionnaires were distributed to 5033 employees in 11 Danish companies; these employees all used computers for at least some of their work time. The response rate was 69% ( n = 3475). The analyses were based on employees working 32-41 h/week ( n = 2579). Symptomatic respondents reported symptoms for at least 8 days within the previous year. Multiple logistic regression analyses were used. Gender (female), age and duration of employment in the same job were associated with an increased prevalence of symptoms. High quantitative job demands and low possibilities for development at work were predictors of neck and hand/wrist symptoms. A high degree of repetitiveness and disturbing reflections on the computer screen were associated with symptoms in all three body regions. Repetitive movements were defined as the same finger, hand or arm movements performed many times per minute for at least 75% of their work time. Repetitiveness was the only factor that could partly explain associations between symptoms and duration of computer use, i.e. respondents who used the computer almost all the time at work reported more repetitive movements than those who used it less. Thus, long hours of computer use may be associated with musculoskeletal symptoms, due to physical factors such as repetitive movements, whereas psychosocial factors appeared to be associated with the symptoms independently of the duration of computer use.     

The New Zealand government approach to stress and fatigue

Abstract

Self-control involves inhibiting undesired behaviours and emotions, and it can be particularly relevant in the service sectors. Recent theoretical developments in cognitive and social psychology suggest that the demands on an individual of exercising self-control have an effect as a source of stress at work. In turn, burnout could be associated with being unable to meet those demands. It was expected that cognitive control deficits, as assessed by a questionnaire measure of self-reported failures in perception, memory, and action, would function as a vulnerability factor in the relationship between self-control demands and indicators of job strain. Data from 630 staff members of a German municipal administration revealed significant main effects of both self-control demands and cognitive control deficits on the burnout dimensions of emotional exhaustion and depersonalization. Both predictors were positively related to burnout. In addition, the results provided clear evidence of the vulnerability hypothesis of cognitive control deficits. By way of contrast, musculoskeletal complaints did not reflect similar main and interactive effects of self-control demands and cognitive control deficits. The requirements for self control in the service sector are expected to increase as the sector expands, and the practical implications for this are discussed.     

Psychosocial safety climate,psychosocial and physical factors in the aetiology of musculoskeletal disorder symptoms and workplace injury compensation claims

Causal agents for workers' compensation claims and physical injury have largely been identified as physical demands. We proposed an integrated theory of physical injury (i.e. musculoskeletal disorder symptoms [MSDs]) and workers' compensation claims, which combined psychosocial and physical mechanisms. A random, population-based sample of 1095 Australian workers completed a telephone interview on two occasions 12 months apart. As expected, the physical mechanism was confirmed; physical demands were related to MSDs, which in turn predicted workers' compensation claims. Further, a novel psychosocial mechanism was confirmed. Psychosocial safety climate (PSC; perceptions about the organisation's climate for psychological health) was a precursor to psychosocial risks (e.g. harassment, violence, bullying and work pressure). In turn, these psychosocial risks were related to emotional exhaustion, MSDs and then workers' compensation claims. Evidence was therefore provided for psychosocial-physical processes in explaining MSDs and workers' compensation for claims for physical injury. Occupational health and safety legislators and policy makers should be aware that, beyond physical demands, factors usually associated with risk for mental stress claims (e.g. harassment, bullying, and violence) may additionally manifest in physical health problems and workers' compensation injury claims. Focusing on modifying the PSC in an organisation, “the cause of the causes”, may be an effective injury prevention and intervention strategy.     

Coping resources,coping strategies and adjustment to organizational change: Direct or buffering effects?

Abstract

This study examined the effects of personal and social resources, coping strategies and appraised stress on employees' levels of anxiety and depression. In relation to the effects of resources and coping strategies, two different models were tested. The main effects model proposes that, irrespective of the level of stress, coping resources and coping strategies have direct effects on well-being. In contrast, the buffering model predicts that the buffering effects of coping resources ad strategies are only evident at high levels of stress. One hundred lawyers completed a structured self-administered questionnaire that measured their personal and social resources, use of problem-focused and emotion-focused coping strategies, and appraisals of the stressfulness of the situation. Results revealed generally strong support for the main effects model in the prediction of employee levels of anxiety and depression. Lower levels of anxiety were linked to judgements of lower levels of organizational change, greater self-confidence, greater internality of control beliefs and less use of emotion-focused coping strategies. Lower levels of depression in employees were also linked to judgements of lower levels of organizational change, greater use of resources and less appraised stress. There was only limited support for the buffering effects model. Due to the small size of the sample, the findings need to be explored further in other contexts.     

Musculoskeletal discomfort and work-related stress in New Zealand dentists

Abstract

There has been little research into the stressors, psychological distress and musculoskeletal symptoms experienced by dentists. The present study was carried out among a random sample of New Zealand dentists (N=413). The present study aimed to identify the severity of work psychosocial stressors, examine the occurrence of musculoskeletal discomfort and psychological disturbance, and determine relationships between these factors. The average age of the dentists was 43 years, with 74% being male. The annual prevalence of symptoms in both the lower back or neck was 63%, with 49% experiencing symptoms in the shoulders. Older dentists were no more likely to suffer musculoskeletal discomfort than younger dentists. The highest ranking dentistry-specific work-related stressor was ‘patients having a medical emergency’ with 78% scoring this stressor very highly. Dentists scored mental demands as the highest general work-related stressor. One-fifth of the dentists scored highly for psychological disturbance, which was very similar to the general population. Dentists with high scores for dentistry-specific work-related stressors were more likely to have evidence of psychological disturbance. The relationships between psychological disturbance and musculoskeletal discomfort needs to be taken into account when considering any multidisciplinary approach to prevention.     

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.     

Job demands,job control,and mental health in an 11-year follow-up study: Normal and reversed relationships

Abstract

Despite numerous studies of the demand-control model, there is a need for more longitudinal studies to test not only the normal, but also the reversed and reciprocal relationships between work characteristics and mental health. There is also a need for more studies of the multiplicative interaction between demands and control with respect to mental health, which is different from the simple additive effect of the two variables. This is a longitudinal study with an exceptionally long period of follow-up (11 years), with the focus on normal as well as reciprocal and reversed causality between work characteristics and mental health, as measured by reliable instruments close to the original definitions of Karasek. The study was based on a sample of 439 Norwegian employees of different occupations who had stayed in the same profession during the follow-up period. The results were in agreement with the hypothesis that low job control, and in particular low control in combination with high demands (“high strain jobs”), has a negative effect on mental health. There was a significant multiplicative interaction between demands and control, indicating a “buffering” effect of job control. Job demands alone were not significantly associated with mental health. The reversed relationship hypothesis was supported for job demands, but not for job control.     

Psychosocial work environment and mental health among travelling salespeople

Travelling salespeople have a rather unusual working environment, with long periods of absence from their firm and a low level of social contacts with colleagues. Furthermore, they are exposed to high demands in their work, which may conflict with a normal family life. In this paper a cross-sectional study of psychosocial work environment and mental health of Danish travelling salespeople is described. A sample of 1,306 travelling salespeople filled in a questionnaire (response rate 68%). The results indicate that poor mental health is associated with a number of demand indicators: number of working hours per week, number of customers per week, non-day work, and a high level of perceived job demands. On the other hand, the number of hours spent with customers per week is positively associated with mental health. The authors did not find the expected associations between poor mental health and several factors such as number of hours away from firm, nights away from home, and a low degree of perceived support from colleagues and superiors. It is concluded that the main stressors of travelling salespeople are long working hours, many customers, non-day work and high perceived psychological demands in general.     

Recovery experiences as moderators between psychosocial work characteristics and occupational well-being

Abstract

This study examined the direct and moderator roles of recovery experiences (psychological detachment from work, relaxation, mastery, and control) in the relationship between psychosocial work characteristics (i.e. time demands, job control, and justice of the supervisor) and occupational well-being (need for recovery, job exhaustion, and work engagement). The study was conducted among 527 Finnish employees from several occupational sectors who were employed in a variety of different jobs. Of the employees, 53% were women and the average age was 42.4 years. The moderated hierarchical regression analyses showed that psychological detachment and mastery were protective mechanisms against increased need for recovery in a situation of lack of job control. Also, relaxation protected against increased job exhaustion under high time demands. In addition, recovery experiences – psychological detachment and mastery in particular – had direct links to occupational well-being. Altogether, the study findings suggest that recovery experiences play a significant role in maintaining well-being at work.     

Relations between environmental problems,psychology and health among shift-workers in the Norwegian process industry

Abstract

A group of 89 male shift-workers, mean age 38 years, was examined for health complaints, subjective experience of their work environment, psychological defence strategies, and immunological factors. They worked in a process industry, controlling a complex chemical process partly by instruments and partly by direct checking of mechanical devices such as valves. Shifts were eight hours long and changed every second week.

The main problem areas identified were problems with the management, colleagues and superiors, feelings of being under-valued, time pressure, fear of making mistakes, and lack of influence and communication. The main health complaints were sleep disturbance and gastro-intestinal problems. Shift workers also complained about allergies, breathing difficulties, tension, anxiety and depression. There were no pathological levels of plasma immunoglobulins (Ig) or Ig complements. However, levels did correlate with experience of work-related problems and with measures of defence mechanisms. Up to 25% of the variance in die immunological indicators was explained by a combination of defence mechanism scores and those of perceived health and work problems. This suggests that immunoglobulins may be an indicator of work-related health risks (‘stress’), even if the level of explained variance is too low to use immunoglobulins alone as a ‘marker’. The same variables, and immunoglobulins, also related significantly to perceived health. This may be a particularly important indicator, and when combined with immunology and psychological variables, also as a risk factor for organic disease.     

Exploring work- and organization-based resources as moderators between work–family conflict,well-being,and job attitudes

Abstract

In modern Western life it is difficult to avoid work–family conflict. Therefore the resources that might reduce its negative outcomes on well-being and job attitudes come into focus. Our study contributes to the work–family conflict literature by exploring the indirect (moderator) and direct role of three work- and organization-related resources, i.e., job control, family supportive climate, organization-based self-esteem (OBSE), in the work-to-family conflict and well-being/job attitude relationship. Theoretically, the study tested the recently developed Job Demands–Resources (JD-R) model in the Scandinavian context. Data for the study were gathered from three differing Finnish organizations (health care district, ICT company, Cardboard mill; n=1252). In line with the predictions of the JD-R model, job demands (time- and strain-based work-to-family conflict) were more robustly associated with strain-based outcomes (physical symptoms), whereas job resources (job control, family supportive climate, OBSE) were more strongly linked to motivational-based outcomes (job satisfaction, organizational commitment). Both job control and family supportive climate moderated the relationships studied; high job control and family supportive climate buffered against the aversive effects of work-to-family conflict on well-being and job attitudes. These indirect effects also varied in relation to the independent, moderator, and dependent variables. However, OBSE did not operate as a buffering factor, although it showed significant direct effects. From a practical viewpoint, our findings suggest that job control and family supportive climate are resources that help employees to reduce the negative effects related to work–family conflict.     

The importance of knowing the affective meaning of job demands revisited

This paper starts with the assumption that when people are asked to describe the level of demands they face at work, it cannot be assumed that those demands are necessarily stressful, even if they are rated as strong or high demands. Thirty demand questions were designed for use with a sample of 2,253 public sector employees in Western Australia. As well as rating frequency of demand the respondents were asked to rate their level of dissatisfaction with the demand. For only 16 of the demands was there a correlation high enough to assume that the demand might be a stressor. Having demonstrated this, the rest of the paper compares different ways of combining the two scores to predict the level of psychological distress as measured by the General Health Questionnaire (GHQ12). The results support the claim in the title, that it is important to know the affective meaning of job demands.     

Work-related psychosocial, physical and individual factors associated with musculoskeletal symptoms in computer users

The aim of this study was to study associations between psychosocial, physical and individual factors, and musculoskeletal symptoms in the neck, shoulder and hand/wrist regions of computer users. Questionnaires were distributed to 5033 employees in 11 Danish companies; these employees all used computers for at least some of their work time. The response rate was 69% ( n = 3475). The analyses were based on employees working 32-41 h/week ( n = 2579). Symptomatic respondents reported symptoms for at least 8 days within the previous year. Multiple logistic regression analyses were used. Gender (female), age and duration of employment in the same job were associated with an increased prevalence of symptoms. High quantitative job demands and low possibilities for development at work were predictors of neck and hand/wrist symptoms. A high degree of repetitiveness and disturbing reflections on the computer screen were associated with symptoms in all three body regions. Repetitive movements were defined as the same finger, hand or arm movements performed many times per minute for at least 75% of their work time. Repetitiveness was the only factor that could partly explain associations between symptoms and duration of computer use, i.e. respondents who used the computer almost all the time at work reported more repetitive movements than those who used it less. Thus, long hours of computer use may be associated with musculoskeletal symptoms, due to physical factors such as repetitive movements, whereas psychosocial factors appeared to be associated with the symptoms independently of the duration of computer use.     

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.     

Job demands and work-related psychological responses among Malaysian technical workers: The moderating effects of self-efficacy

Abstract

Job design has long been found to affect the work-related psychological responses of employees, such as psychological strain, job satisfaction, and turnover intentions, but scholars have begun to question whether established theoretical relations regarding job design continue to hold given the enormous changes in the nature of work during the past two decades. It is also increasingly recognized that individual differences affect work behaviours in substantial ways, but few studies on work design have investigated these differences. We addressed these concerns with a two-wave longitudinal study among 245 technical workers at a telecommunications company in Malaysia, a country that has a collectivist culture and a high power distance between managers and subordinates. We examined the moderating effects of job control and self-efficacy on the relationships between job demands and employee responses. The results failed to support the job demands-control model, as job control variables did not moderate the impact of demands on employee work-related psychological responses. However, self-efficacy moderated their impact on psychological strain (although not on job satisfaction or turnover intentions). Our findings provide insight into the moderating effect of self-efficacy, and suggest that practitioners interested in reducing psychological strain should consider making efforts to increase self-efficacy among employees.     

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.