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.     

Work-related stress,coping resources,and heavy drinking in the restaurant business

Abstract

This study aimed to test whether curvilinearity would add explanatory power to the long-term relationships between job characteristics and mental well-being. The study was based on cross-sectional and longitudinal data from phases 3 and 5 of the Whitehall II sample (N=4154 for job satisfaction and 6000 for context-free mental well-being, mean follow-up 5.8 years). The curvilinear components of the job characteristics were introduced after controlling for the baseline outcome measure, demographic factors, and the linear measures of the job characteristics. The cross-sectional analyses showed only a curvilinear association with the expected U-shape between job demands and context-free mental well-being. The longitudinal analyses showed no curvilinear relationships between the job characteristics and context-free mental well-being. While small non-linear relationships were found between social support and decision latitude and job-related mental well-being, the shape of these relationships was the reverse of that expected. Post hoc analyses revealed that only the positive segment of the relationship between decision latitude and job satisfaction was significant, while both segments of the relationship between social support and job satisfaction were significant. The findings from this study, based on a large sample with high variety in working conditions, provide little support for the assumption of curvilinearity in the long-term relationship between psychosocial working conditions and mental well-being. This has practical implications, as if associations are linear this would indicate that it would be reasonable to take a population (rather than individually targeted) approach to stress management interventions.     

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.     

Stress demands on school administrators in Singapore

Abstract

This study investigated the use of the Occupational Stress Indicator (OSI) on school administrators in Singapore. The sample of 223 school administrators consisted of the top management group of principals and vice-principals and the middle management group of heads of department. The school administrators reported pressure at work, and consequently, higher levels of mental and physical ill health. They had high locus of control scores, indicating low internal control over their environment. However, they also reported greater use of coping strategies and higher job satisfaction. Psychometrically, the sub-scales of sources of pressure, job satisfaction, and mental and physical ill health were found to be reliable. The items of the scales of type A, locus of control and coping skills had to be re-factor analysed for the Singaporean sample. The new factors were found to have higher reliability. When the stress and job satisfaction levels of the principals/vice-principals and heads of department were compared, the heads of department reported significantly less job satisfaction and higher levels of mental and physical ill health. They perceived less internal control in their work situation.     

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.     

Job stressors,coping, and psychological distress among Japanese employees: Interplay between active and non-active coping

In this study the sole and the combined effects of active and non-active forms of coping on psychological distress across various kinds of job stressors were examined. Data on job stressors, coping and psychological distress were obtained from 4487 male employees of a research institute in the automobile industry in Japan (mean age=36.27 years, SD = 7.43). A hierarchical moderated multiple regression analysis was conducted to estimate and test the significance of the main effects and their interactions. The results show that although active coping was effective in decreasing psychological distress regardless of the type of job stressor, the effectiveness was weaker in situations that require effortful coping, such as role ambiguity and insufficient authority. Furthermore, the effectiveness of active coping was influenced by the other strategies, especially in effortful coping situations. While distancing or seeking social support improved the effectiveness, restraint coping reduced it. These results suggest that the type of non-active coping that individuals combine with active coping can be critical in determining health outcomes in more complex and effortful coping situations. Consideration of the coping combinations, not merely the situational context, is important in explaining how the work environment influences employees' psychological distress.     

Daily reports of distress: Not for women only

Abstract

A context-dependence paradigm was developed for research into effects of the menstrual cycle in women. This involved the investigation of situational effects on self-reported distress in both men and women. For 35 consecutive days, 25 women and 36 men working in two occupations that varied in degree of situational stress completed Body Awareness Questionnaires (modified menstrual distress questionnaires) and daily subjective stress ratings. After controlling for contraceptive use, age range, and percentage of body fat, the following variables were selected for a multiple regression analysis as predictors of distress: (a) job stress, (b) feminine values, (c) life stress, (d) subjective stress, (e) type of job, (f) sex, (g) job experience, and (h) history of menstrual distress. Women working in the high-stress job (military police) reported significantly more distress than all the other groups. Life stress was identified as the dominant predictor of distress. In a separate analysis of daily distress scores and menstrual cycle phases for all the women, there was no interaction between the type of job and the menstrual cycle phase on reports of distress. A similar analysis of the effects on sex and shift revealed shift effects in distress for men but not women. Sources of variability for both sexes (shift-work rotation and cycle phase) are discussed.     

Lifestyle habits,substance use and predictors of job burnout in professional working women

Abstract

This study explores differences in self-reported lifestyle habits, substance use (alcohol, drugs and smoking) and predictors of job burnout in a sample of 879 professional working women employed in dental health ofices in a cross-sectional design. Job burnout was measured using the Maslach Burnout Inventory (MBI) and self-reported substance use and lifestyle habits were assessed using the Stress Assessment Profile. Self-reported drinking, smolung and drug use were only modestly correlated with each other in this sample. Employed women with higher levels of drinking reported significantly lower quality overall lifestyle practices, eating/nunition habits, and more frequent use of avoidant coping strategies in the face of work and life hassles compared to non-drinkers. Women who smoked also reported significantly lower overall lifestyle practices and eating/nutrition habits. Those who reported using drugs for recreational purposes reported significantly greater hassles, poorer lifestyle habits, a less hardy outlook on life, and more frequent use of dysfunctional coping strategies. Although women who reported using drugs experienced significantly higher interpersonal burnout (depersonalization) compared to non-drug users, in general, self-reported substance use was not significantly related to job burnout. After controlling for age and psychological distress, perceived stress, type A behaviour, cognitive hardiness and lifestyle habits significantly contributed to predictions of job burnout in multiple regression analyses. Despite methodological limitations, the prevalence of substance use found in this study supports previous research findings. Professional working women who practise poor lifestyle and health habits appear to be at risk of experiencing job burnout.     

Job satisfaction and mental health of temporary agency workers in Europe: a systematic review and research agenda

ABSTRACT

The current systematic literature review aimed to analyse the associations between temporary agency work (TAW), job satisfaction, and mental health in Europe, as well as to outline a future research agenda. Twenty-eight scientific articles were identified by searching different data bases (i.e. PSYNDEX, PsycINFO, PubMed, and Web of Science) for the time span from January 2000 to December 2016. Our review reveals first that TAW is not consistently negatively related to job satisfaction. However, job insecurity and working conditions are important mediators in the relation of TAW and lowered job satisfaction. Second, TAW is not consistently related to all investigated types of mental health impairments. However, when focusing on specific outcomes and comparing temporary agency workers to permanent employees, we still find consistent evidence regarding higher levels of depression and fatigue among temporary agency workers. Inconsistent associations between TAW, job satisfaction and mental health can partly be attributed to unfavourable methodological aspects of the included primary studies. To address these aspects, future research should consider applying a standard measurement of TAW, including a minimum of meaningful confounding variables, improving the operationalisation of outcome variables and the study design.     

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.     

Work satisfaction,health, and stress: A study of Dutch nurses

Abstract

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Stress and job satisfaction in mammography radiographers

Abstract

Previous research suggests that substantial numbers of health professionals experience undue levels of occupational stress. Little is yet known, however, about a recently established specialized group, namely radiographers who work in the UK National Health Service Breast Screening Programme. All 134 radiographers in the first wave of the programme were sent a postal questionnaire to determine how stressed they felt at work, how satisfied they were with the job, and what were the principal causes of stress and dissatisfaction. A total of 103 were returned, a response rate of 77 %. The results showed that 30 % reported high levels of stress, which is more than in most other professions, and that only 17% described themselves as ‘very satisfied’ with their jobs. The most important predictors of stress were problems of communication (mainly knowing what to tell the client) and conflicts between home and work. The most important predictor of dissatisfaction was role ambiguity. Ways of reducing stress and increasing satisfaction must be found if radiographers are to remain healthy and are to continue to work for the programme.     

Beyond demand and control: The contribution of organizational risk factors in assessing the psychological well-being of health care employees

Abstract

The job demand–control(–support) model is frequently used as a theoretical framework in studies on determinants of psychological well-being. Consequently, these studies are confined to the impact of job characteristics on worker outcomes. In the present study the relation between work conditions and outcomes (job satisfaction, emotional exhaustion, psychological distress, and somatic complaints) is examined from a broader organizational perspective. This paper reports on an analysis that examines both the unique and the additional contribution of organizational characteristics to well-being indicators, beyond those attributed to job characteristics. A total of 706 care staff from three public residential institutions for people with mental or physical disabilities in the Netherlands took part in this research. To assess organizational risk factors a measurement instrument was developed, the organizational Risk Factors Questionnaire (ORFQ), based on the safety-critical factors of the Tripod accident causation model. Factor analyses and reliability testing resulted in a 52-item scale consisting of six reliable sub-scales: staffing resources, communication, social hindrance, training opportunities, job skills, and material resources. These organizational risk factors explained important parts of the variance in each of the outcome measures, beyond that accounted for by demographic variables and job demand–control–support (JDCS) measures. Communication and training opportunities were of central importance to carers’ job satisfaction. Social hindrance, job skills, and material resources explained a substantial amount of unique variance on the negative outcomes investigated.     

Specific relationships between psychosocial job conditions and job-related stress: A three-level analytic approach

This cross-sectional questionnaire study presents a multi-level analysis on 2565 workers in 188 departments in 36 organizations in the Netherlands. A three-level model is used in which individual workers are nested within departments, which in turn are nested within organizations. Research questions concern (1) the amount and distribution of variance in job-related stress explained for the three levels in the study (individuals, departments, organizations), and (2) the specificity of relationships between psychosocial job demands and job-related stress in the three-level model. Well-being showed slightly more raw variance to be explained at supra-individual levels than strain. The full regression model explained about 35% of the total variance in both work-related strain and well-being. Psychosocial job conditions did not exceed the expected amount of 10 to 15% contribution to this explained variance. These results do not differ from comparable studies that do not use multi-level analysis. The variance distribution in the full model, however, showed unexplained variance to be located at the individual level for both strain and well-being, and at the departmental level only for well-being. This last finding shows a direction for possible improvement of work stress models. Specificity of relationships was also shown: psychological job demands were more strongly related to strain, whereas job content variables (i.e. job variety, job control) were more strongly related to well-being. Results also suggested that social support was more strongly associated with well-being than with strain. Well-being appeared to have a more widely varying range of predictors than strain.     

Exploring the Michigan model: The relationship of personality, managerial support and organizational structure with health outcomes in entrants to the healthcare environment

Few studies have examined the role of managerial support in the adaptation of entrants to healthcare. The purpose of this study was to identify the job characteristic and role-related variables that mediate the effects of managerial support and personality on the mental and physical health and sickness absence in two independent groups of new recruits to a healthcare organization. Entrants to a healthcare environment (student nurses) were surveyed 25 weeks after entry. Latent variables represented neuroticism, demand, control, role clarity and affective outcome variables in a simplified version of the Michigan model of work stress (House, 1981). This study used a two-stage approach to structural equation modelling, exploring hypothesized structural models on an initial data set (N=195) prior to confirmation on an independent replication data set (N=239) using multi-sample methods. Finally the confirmed model of choice was evaluated using the combined data (N=434). Emotional distress reported at 6 months was found to be associated with dispositional characteristics of the entrant and indirectly, via job satisfaction, with managerial support from academic and clinical sources. Managerial support from academic and clinical sources had an indirect influence on job satisfaction, but by differing mechanisms involving role clarity and control. The demands perceived by the entrants arose from neuroticism and were independent of any other variable. Emotional distress had its deleterious association with sickness absence via somatic health. This study details a series of mechanisms that will subsequently be tested longitudinally.     

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

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

Health habits,type A behaviour and job burnout

Abstract

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

A longitudinal study of newcomer role adjustment in US organizations

Abstract

This paper examines the socialization and adjustment experiences of newcomers to organizations from a role stress perspective. A longitudinal field study is reported which tested a three-stage socialization model using physiological and psychological distress symptoms, general satisfaction, and intention to leave the organization as indicators of newcomer adjustment. Data were collected from newcomers (the focal role) (N = 91) at three times during me study and also from their supervisors (the role senders) (N = 41). While the data confirmed the general utility of the model, it also suggested some revisions by way of new and altered pathways between some of the variables.     

Work and mental disorders in a German national representative sample

Abstract

Most previous studies concerning the associations between work and mental ill-health have used dimensional self-report questionnaires for mental health problems (e.g., depressive symptoms). This study contributes to occupational health research by providing standardized clinical diagnoses based on DSM-IV criteria. A total of 2329 employees (age 18–65 years) took part in a structured, computer-assisted clinical interview (DIA-X/M-CIDI). Further, they specified whether their job was characterized by physical workload, overtime, or stress, and evaluated whether they feel impaired by each job characteristic. Results show that substance abuse/dependence (including nicotine dependence) was the highest prevalent mental disorder in German employees (12 month prevalence: 14.4%; only alcohol and illicit substance abuse/dependence: 4.9%) followed by anxiety (12.0%) somatoform (9.7%), and affective (9.3%) disorders. Sequential logistic regression analyses showed significant associations between the presence of stress at work and affective and somatoform disorders. Furthermore, feeling impaired by stress at work was strongly associated with anxiety, affective, somatoform disorders, and substance abuse/dependence. Beside work, personal characteristics, primarily gender, were associated with mental disorders in employees. However, except for affective disorders, gender did not modify the association between job characteristics and mental disorders. Taken together, results corroborate the necessity of considering mental disorders at work. Further studies to define the relation between work and mental disorders in employees are strongly recommended and should include objective analyses of job characteristics.     

Satisfactions and stresses in the sorting of mail

Abstract

The effects of two types of letter-sorting technology on job stress and satisfaction were compared. Manual sorting, which uses the traditional method of assigning letters to classified pigeon-holes, was judged to provide elements of discretion, autonomy, and social interaction which are largely absent in coding-desk work, in which a keyboard is used to enter postcodes. Between and within-subject methodology was used in the analysis of data from those engaged in sorting (n = 160). In addition, these groups were compared with supervisors (n = 36) and engineers (n = 26) also working in the sorting area.

The key findings were: (a) higher levels of satisfaction were found amongst manual sorters and those spending 50–75% of their time in code-sorting; (b) stress is closely related to satisfaction in the code-sort group but not in the manual group; (c) in manual groups and in supervisors stress was manifested in fatigue, but in the code-sort group stress took the form of anxiety. The results are discussed in terms of the impact of the type of work on fatigue, as well as on job stress and satisfaction.