Effort-reward imbalance and work-home interference: a two-wave study among European male nurses

ABSTRACT

This one-year follow-up study among 1,421 male nurses from seven European countries tested the validity of the Effort-Reward Imbalance (ERI) model in predicting prospective vital exhaustion and work-home interference. We hypothesised that effort and lack of reward would have both main and interactive effects on future outcomes. Results of structural equation modelling (SEM) showed that effort was positively related to exhaustion and work-home interference, both simultaneously and over time. Lack of reward predicted increased exhaustion at follow-up, but effort-reward imbalance did not influence the outcomes. Additionally, Time 1 exhaustion predicted increased work-home interference and exhaustion at follow-up. These results do not support the ERI model, which postulates a primacy of effort-reward imbalance over main effects. Instead, the findings are in line with dual path models of job stress and work-home interference. Multi-group SEM showed partial cross-cultural metric invariance for the ERI measure of effort, but the ERI measure of rewards showed no metric measurement invariance, indicating its meaning is qualitatively different across cultures. Nevertheless, the main conclusions were markedly similar for each national sub-sample. We discuss the theoretical and practical implications of our study.     

Trajectories of effort-reward imbalance in Swedish workers: Differences in demographic and work-related factors and associations with health

ABSTRACT

The aim of the study was to identify trajectories of effort-reward imbalance (ERI), to examine these with respect to demographic (age, gender, socio-economic position) and work-related (employment contract, work hours, shift work, sector) factors, and to investigate associations with different health indicators (self-rated health, depressive symptoms, migraine, sickness absence). The study used four waves of data (N?=?6702), collected biennially within the Swedish Longitudinal Occupational Survey of Health (SLOSH). Using latent class growth modelling, we identified four trajectories: a stable low imbalance trajectory, which comprised 90% of all participants, and three change trajectories including a decreasing trajectory (4% of the participants), an inverted U-shaped trajectory and an increasing imbalance trajectory, both in 3% of the participants. Results indicate that a sizeable proportion of Swedish employees’ experience imbalance between efforts and rewards at work. The most favourable trajectory comprised relatively more men and was characterised by better work-related characteristics than the less favourable ERI trajectories. All change trajectories were dominated by women and employees in the public sector. Health developments followed ERI trajectories, such that less favourable trajectories associated with impaired health and more favourable trajectories associated with better health. Sickness absence increased among all ERI trajectories, most so for the decreasing and increasing ERI trajectory.     

Adverse psychosocial working conditions and subjective health in freelance media workers

In recent years there has been a steady growth of non-standard work contracts in advanced societies. These contracts are characterized by increased flexibility of work arrangements and increased job instability, which holds particularly true for the media industry. This pilot study analyses associations of work stress with subjective health in a group of German freelancers (N = 290) working in the media industry. The measurement of work stress is based on the effort-reward imbalance model. Results of logistic regression analyses indicate significant effects of high effort in combination with low reward (money, esteem, promotion prospects, job security) on subjective health in men and women, with the effects being higher in men. Moreover, among men a critical pattern of coping with work stress enhanced the reported effect. In conclusion, the preliminary evidence from this study indicates an elevated risk of poor subjective health among freelance workers who are exposed to adverse psychosocial work conditions.     

Perceived physical work capacity, stress, sleep disturbance and occupational accidents among firefighters working during a strike

Fire-fighting and rescue work are arranged in such a way that various kinds of accidents and catastrophes can be handled. In an understaffed situation, such as a strike, this goal may not be met. The objective of this study was to investigate factors associated with perceived physical work capacity, stress, sleep disturbance, and occupational accidents among firefighters who remained at work during an extended strike. A cross-sectional questionnaire study was carried out among 543 firefighters (83% of the target group) in 71 fire brigades in Finland. After the strike had lasted for 9 to 11 weeks, most of the firefighters perceived their physical work capacity to be rather good or very good. Stress increased along with a decreasing number of personnel in a crew (OR= 2.3, CI= 1.0-5.3, for less than 75% of a normal crew vs. normal crew) and with decreasing number of personnel in a shift (OR= 2.4, CI= 1.1-5.4, for less than 25% of normal shift vs. normal shift). Sleep disturbance was reported to occur as soon as the total working time exceeded 50 h/week. Working more than 70 h/week increased the risk of occupational accidents almost 4-fold compared with working no more than 50 h/week. These results suggest that exceptional situations, such as a strike, are a challenge to human capacity. With time, increased stress and sleep disturbance may lead to serious consequences.     

Perceived physical work capacity,stress, sleep disturbance and occupational accidents among firefighters working during a strike

Fire-fighting and rescue work are arranged in such a way that various kinds of accidents and catastrophes can be handled. In an understaffed situation, such as a strike, this goal may not be met. The objective of this study was to investigate factors associated with perceived physical work capacity, stress, sleep disturbance, and occupational accidents among firefighters who remained at work during an extended strike. A cross-sectional questionnaire study was carried out among 543 firefighters (83% of the target group) in 71 fire brigades in Finland. After the strike had lasted for 9 to 11 weeks, most of the firefighters perceived their physical work capacity to be rather good or very good. Stress increased along with a decreasing number of personnel in a crew (OR= 2.3, CI= 1.0-5.3, for less than 75% of a normal crew vs. normal crew) and with decreasing number of personnel in a shift (OR= 2.4, CI= 1.1-5.4, for less than 25% of normal shift vs. normal shift). Sleep disturbance was reported to occur as soon as the total working time exceeded 50 h/week. Working more than 70 h/week increased the risk of occupational accidents almost 4-fold compared with working no more than 50 h/week. These results suggest that exceptional situations, such as a strike, are a challenge to human capacity. With time, increased stress and sleep disturbance may lead to serious consequences.     

Job stressors and coping characteristics in work-related disease: Issues of validity

There is now broad evidence that stressful work conditions and critical person characteristics contribute to the development of coronary dysfunction and disease via sustained autonomic nervous system activation. To improve the prediction of coronary risk and disease we combined information on psychosocial work stressors and work-related coping characteristics ('need for control') in several studies. The theoretical model termed 'effort-reward imbalance' assumes that high extrinsic (e.g. work pressure, cumulative workload) and intrinsic (e.g. 'need for control') effort spent at work in combination with low reward obtained (e.g. status control, esteem, monetary gratification) trigger sustained neuro-hormonal activation. In this paper the results of a 6 year prospective study conducted in 416 male blue-collar workers underline the validity of this model. The main findings indicate that components of effort-reward imbalance are strongly related to new coronary events and to elevated levels of established coronary risk factors (e.g. hypertension, atherogenic lipids) as well as to reduced cardiovascular responsiveness. It is concluded that the results clearly demonstrate the validity of effort-reward imbalance as an important predictor of coronary risk and disease, and indicate the need for structural and behavioural intervention in the workplace to prevent coronary heart dseases.     

Is there an optimum number of night shifts? Relationship between sleep, health and well-being

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health: i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

Using pharmacological aids to improve waking function and sleep while working at night

Non-refreshing or insufficient sleep, and impaired alertness on the job, are two nearly universal consequences of night work. The effects of drugs upon the sleep and alertness of night workers has only recently been studied and much work remains to be done. To date, it is clear that sleep during the day can be improved with sedative-hypnotic compounds, particularly the benzodiazepines. Despite improvement in sleep, alertness at night is improved only mildly, if at all, with short-acting sleeping agents and can be further impaired with long-acting drugs. The limited research examining alertness and performance during night shift hours after administration of CNS stimulants suggests significant benefits. The judicious use of CNS stimulants in this way needs further exploration. Precise pharmacological manipulation of the endogenous sleep/wake rhythm is primarily theoretical at this time but should be pursued.     

Power imbalance and value creation in joint ventures

Joint ventures (JVs) often do not create expected value due to power imbalance between partners. Despite the fact that JV partners are embedded in relational constraints, prior research has largely relied on economic reasoning by focusing on equity ownership difference between JV partners as the main source of power imbalance. We extend prior research to also consider important relational factors represented by repeated ties between partners and network openness, as well as institutional status difference and network status difference as two additional dimensions of power imbalance. Our findings indicate that ownership power imbalance by itself does not have a significant effect on value creation. However, value creation is facilitated when there is ownership power imbalance between partners with more repeated ties. In contrast, value creation may be hindered when JV partners with unequal ownership are embedded in more open interfirm alliance networks. Furthermore, value creation is facilitated if JV partners that have unequal ownership also have network status power imbalance in the same direction.     

Individual differences in working hours,work perceptions and accident rates in veterinary surgeries

This study addresses an under-researched outcome of occupational stress, namely the frequency of accidents at work and car accidents. A large, random sample of 778 vets and their auxiliary personnel was assessed in relation to socio-demographic variables, work perception and accident involvement. The study, involving veterinary practices in Germany, revealed that work-related injuries/accidents experienced during the previous 12-month period were significantly related to individual differences in job-related stress and job satisfaction. The average yearly number of car accidents was predicted by age, working climate and job satisfaction. Furthermore, driving accidents going to or from work during the previous year were calculated against distance travelled. Vets working in excess of 48 h/week displayed significantly more driving accidents when visiting clients. Results indicate heterogeneous correlations both between and within the two categories of car and work accidents, suggesting that these are different phenomena, each with its own associated personal and work factors. Results also suggest that work perceptions may act as intermediary influences on accident rates.     

Individual differences in working hours, work perceptions and accident rates in veterinary surgeries

This study addresses an under-researched outcome of occupational stress, namely the frequency of accidents at work and car accidents. A large, random sample of 778 vets and their auxiliary personnel was assessed in relation to socio-demographic variables, work perception and accident involvement. The study, involving veterinary practices in Germany, revealed that work-related injuries/accidents experienced during the previous 12-month period were significantly related to individual differences in job-related stress and job satisfaction. The average yearly number of car accidents was predicted by age, working climate and job satisfaction. Furthermore, driving accidents going to or from work during the previous year were calculated against distance travelled. Vets working in excess of 48 h/week displayed significantly more driving accidents when visiting clients. Results indicate heterogeneous correlations both between and within the two categories of car and work accidents, suggesting that these are different phenomena, each with its own associated personal and work factors. Results also suggest that work perceptions may act as intermediary influences on accident rates.     

Sleep hygiene practices and sleep duration in rotating-shift shiftworkers

Abstract

Alcohol, caffeine and tobacco intake, exercise, activities on going to bed, and sleep-enhancing measures were assessed in 72 rotating-shift shiftworkers to determine whether these variables differ following day shifts and night-shifts, and which are related to sleep duration. Only alcohol intake and exercise prior to sleep, and feeling drowsy when retiring, differed following the night-shift. Workers generally followed recommendations concerning alcohol intake, sleeping immediately on retiring, and exercising, but acted contrary to recommendations concerning caffeine and nicotine intake. The only behaviour clearly associated with poor sleep was smoking, which reduced sleep duration.     

Sleep hygiene practices and sleep duration in rotating-shift shiftworkers

Alcohol, caffeine and tobacco intake, exercise, activities on going to bed, and sleep-enhancing measures were assessed in 72 rotating-shift shiftworkers to determine whether these variables differ following day shifts and night-shifts, and which are related to sleep duration. Only alcohol intake and exercise prior to sleep, and feeling drowsy when retiring, differed following the night-shift. Workers generally followed recommendations concerning alcohol intake, sleeping immediately on retiring, and exercising, but acted contrary to recommendations concerning caffeine and nicotine intake. The only behaviour clearly associated with poor sleep was smoking, which reduced sleep duration.     

Patterns of working and living conditions: a holistic, multivariate approach to occupational health studies

The objective of the study was to develop a multivariate approach to occupational health studies that is: capable of identifying groups with similar working conditions; relevant for studies of associations between working and living conditions and health; and an appropriate basis for preventive actions. Data at the individual level were obtained through measurements, observations, interviews and questionnaires, and at the organizational level, through interviews with managers. Cluster analyses were applied with the purpose of identifying groups of individuals with small, within-group differences. Eighty work sites and a sample of employees at each site were strategically selected. The study group comprised 203 men and women, and was characterized by large variation. The final analysis produced eight clusters of individuals, denoted according to their best-defining characteristic, i.e. 'decent', 'boundary-less', 'locked', 'exposed', 'heavy and monotonous', 'changed', 'mobile' and 'restrained'. The clusters differed with regard to 'what' characterized working conditions, 'where' on the labour market they were found, and 'who' clustered in these groups. The holistic approach revealed conditions that were important for health and had higher explanatory power in relation to ill-health than applying socio-economic groupings or the demand-control-support model. It showed how psychosocial, ergonomic-physical and occupational hygiene factors combine and interact to create settings with different risks of ill-health. The chosen strategy is recommended for future occupational health studies and is particularly suitable as guidance for preventive actions relevant to specific clusters of working and living conditions.     

Sleep and napping in young shiftworkers: A 5-year follow-up

Abstract

The present study examined sleep characteristics in young workers who entered rapidly rotating shiftwork for the first time and stayed on shifts for 5 years. Data were collected when the subjects had shiftwork experience of approximately 1.5, 3.5 and 5.5 years and a mean age of 22, 24 and 26 years. Data are presented showing significant differences in the main sleep durations between situations within the shift cycle and a small reduction in overall sleep over the observed period, primarily due to a sleep reduction on afternoon shift days. Data on sleep quality did not show any change over this early period of shiftwork exposure. In addition, napping strategies did not change, with the exception of a small increase in those taking naps on night-shift days between 1.5 years and 3.5 years of shiftwork exposure. At all the observed phases there were more young shiftworkers taking a nap on the morning shift days than on the night-shift days. The data suggested that reduced sleeps on morning and night-shift days were not compensated by taking a nap, but rather with an increase in main sleep duration on afternoon shift days and days off. A weak tendency for individuals to be relatively long or short sleepers irrespective of sleep conditions could be seen.     

A community study of dual-role stress and coping in working mothers

This paper describes a pilot study in a community in North London of dual-role stress and coping in three groups of working mothers with dependent children at home. One group was married and enjoying comparatively high income; another was 'single' and also with comparatively high income; the third group was 'single' with comparatively low income. There were 15 women in each group. The study was by interview and questionnaire. Evidence of dual-role stress was found in the study, and the results are consistent with conclusions drawn from the literature. However, many women appeared to obtain important benefits from going to work, and there was considerable evidence of good coping, especially in terms of drawing on the informal support of other women. Both the quality of the job and quality of domestic support were important for the working mother's stress management. The relative poverty of organized child-care in Britain was reflected in the child-care problem reported by most of these women and the 'single' women in particular. Low income 'single' women reported greatest levels of stress and strain, financial and child-care stress, and work stress.     

Stress at sea: A review of working conditions in the offshore oil and fishing industries

Abstract

This paper reviews the literature available on the psychosocial aspects of the offshore oil and fishing industries. Both work sectors present unique problems for their employees and these are discussed with reference to risk and safety, accidents and injuries, occupational stressors, marriage and family life, noise, alcohol and drug abuse and personality. The paper concludes that although both occupations are intrinsically different, some psychosocial similarities can be observed.     

Risk factors for neck and back pain in a working population in Sweden

The relationship between lifestyle, ergonomie and psychosocial workplace factors and musculo-skeletal pain was examined in this cross-sectional study. A total of 22180 employees undergoing screening examinations at their occupational health-care service filled in a series of questionnaires concerning their health, lifestyle and working situation. Of these 31% reported having had neck pain and 18% had seen a health professional for such pain during the previous year. Similarly, 39% reported having had back pain and 16% had seen a professional during the year. Odds ratios were calculated to estimate the relative risk of the various exposure factors. Although not eating regularly and smoking increased the risk for both neck and back pain somewhat, not exercising and consuming alcohol did not increase the risk for these musculoskeletal pains. Lifting, monotonous work tasks, vibration and uncomfortable work postures were the most important ergonomie factors (odds ratios from 1.01 to 2.95). Sitting, however, did not increase the risk for either neck or back pain. A 'poor' psychosocial work environment, as compared to a 'good' one, increased the risk for both neck and back pain (odds ratios from 1.62 to 3.01). Work content and social support were of particular relevance. Finally, a combination of a 'poor' psychosocial work environment and exposure to one of the ergonomic variables produced the highest risk factors (odds ratios from 2.42 to 3.61). Although the conclusions that may be drawn are limited by the cross-sectional nature of this study, the results seem to underscore the complex aetiology of musculoskeletal pain and especially the importance of psychosocial variables. Prevention programmes should therefore be broad-based and include psychosocial as well as ergonomic measures.     

Sustained work, fatigue, sleep loss and performance: A review of the issues

The physiological and psychological stressors associated with sustained work, fatigue, and sleep loss affect worker performance. This review describes findings relating to sustained work stresses commonly found in our advancing technological world. Researchers report decrements in sustained performance as a function of fatigue, especially during and following one or more nights of complete sleep loss, or longer periods of reduced or fragmented sleep. Sleep loss appears to result in reduced reaction time, decreased vigilance, perceptual and cognitive distortions, and changes in affect. Sleep loss and workload interact with circadian rhythms in producing their effects. These interactions are a major source of stress in work situations requiring sustained work in continuous operations and have implications for theoretical models of sustained perceptual and cognitive functioning.     

The distinction between work pace and working hours in the measurement of quantitative demands at work

During recent years many researchers have criticized the widely used scales on psychological job demands. For instance, they comment that in most cases different types of demand seem to be mixed in one measure. In this paper we analyse the scale on quantitative job demands in the recently developed Copenhagen Psychosocial Questionnaire (COPSOQ), with special emphasis on Differential Item Functioning (DIF). DIF refers to basic differences between groups of respondents, which may affect how they respond to questionnaire items. The data material for our study comprised a representative sample of Danish employees. The respondents were categorized into 32 specific jobs according to the International Standard Classification of Occupations (ISCO 1968). We analysed DIF with respect to the respondents' jobs with logistic regression analyses. These analyses showed that the items used in the original demand scale functioned very differently for different jobs in the population. The conclusion is that scales on quantitative demands are very sensitive to the choice of specific items. If many items on fast work pace and tempo are included in a scale, a number of blue-collar jobs will be identified as high-demand jobs. If, on the other hand, many questions on long working hours and overtime are included, the use of the scale will result in an entirely different picture. This issue has so far received little attention in occupational health psychology. The results have wide theoretical and methodological implications for research on quantitative job demands.