Testing the Vitamin Model of job stress in Dutch health care workers

Three central hypotheses of Warr's Vitamin Model concerning the relationship between job characteristics and well-being and health outcomes were tested: (1) differential effects of job characteristics on the various well-being and health outcomes; (2) predominance of curvilinear associations; and (3) moderate influence of negative and positive affectivity on these relationships. The study participants were 162 employees from a health care organization (aged 19–54 years, 95% women) who completed questionnaires on job demands and job autonomy, as well as on the outcome variables depression, anxiety, job satisfaction, and health complaints. In addition, data on short-term sickness absence were collected. A higher level of job demands was significantly associated with a lower level of well-being and self-reported health. Job autonomy showed weaker relationships with the outcome variables. The effects of job demands were still large after controlling for negative and positive affectivity, while the effects of job autonomy in most cases became non-significant. The predicted curvilinear relationship between job characteristics and outcome variables did not have an additional value over a linear model in predicting the data. It is concluded that the present data from a homogeneous sample of mostly female nurses support Warr's Vitamin Model to a limited extent.     

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.     

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.     

Job stress, job strain, and psychological withdrawal among Dutch university staff: towards a dualprocess model for the effects of occupational stress

This study examined the antecedents of job strain (emotional exhaustion, health complaints) and withdrawal behaviour (e.g. lowered organizational commitment) among a cross-sectional sample of 131 academic staff members of the law department of a large Dutch university. Conservation of resources theory (Hobfoll, 1989) provided the theoretical background for this study. Strains and withdrawal behaviours were expected to be most prominent among those who reported having few resources and/or who reported high job demands. Structural equation modelling revealed that this was indeed the case. As predicted, differential patterns of effects emerged for job demands and job resources. Analysis of the effects of four job-specific stressors revealed that especially the structural aspects of a staff member's teaching task (e.g. the number of students in their classes) contributed strongly to perceived job demands. Theoretical and practical implications of the study are discussed.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

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.     

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.     

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.     

Cortisol on Sunday as indicator of recovery from work: Prediction by observer ratings of job demands and control

Several considerations guided the research reported in this paper. First, recovery is pivotal for preventing stressful experiences from inducing long-term consequences. Second, cortisol levels under relaxed conditions constitute a good baseline measure. Third, there are many calls to avoid common method problems. Therefore, the Job Demands–Control (JDS) model, one of the most prominent models in occupational stress, should be tested by a combination of observation, self-report, and physiological data in terms of predicting recovery-related variables. In a sample of 53 Swiss employees, we assessed the JDS variables, demands and control, by systematic observation, fatigue at the end of work as an indicator of short-term recovery by questionnaire, and delayed recovery by baseline levels of cortisol on a Sunday under relaxing conditions. In line with expectations, regression analyses showed an impact of job demands and control on Sunday cortisol levels, and this effect was fully mediated by after work fatigue. Contrary to expectations, there was no significant interaction between job demands and control. Demonstrating that job demands and control predict after-work fatigue as well as a delayed physiological marker of recovery, these findings suggest that high after-work fatigue may entail costs to the individual’s physiological systems.     

The impact of learning opportunities and decision authority on occupational health

In an investigation of 418 employees in the Norwegian Postal Service, employees with high learning opportunities and high decision authority were found to be better off on psychological functioning, health and organizational outcome variables than employees with low scores on these variables. Decision authority and learning opportunities had specific and independent impact on subjective health, psychological functioning, coping style and organizational outcome variables. There were, however, also interaction effects between demands, learning opportunities, and decision authority on subjective health. Learning opportunities and decision authority were operationalized with a questionnaire, supplemented with questions on the opportunities to learn skills beyond the present job situation. It is suggested that this is a particularly important dimension for coping with the present day rapid changes in working life, where the objective for many workers will be to broaden their repertoire and competence to increase their flexibility in the labour market.     

The impact of learning opportunities and decision authority on occupational health

In an investigation of 418 employees in the Norwegian Postal Service, employees with high learning opportunities and high decision authority were found to be better off on psychological functioning, health and organizational outcome variables than employees with low scores on these variables. Decision authority and learning opportunities had specific and independent impact on subjective health, psychological functioning, coping style and organizational outcome variables. There were, however, also interaction effects between demands, learning opportunities, and decision authority on subjective health. Learning opportunities and decision authority were operationalized with a questionnaire, supplemented with questions on the opportunities to learn skills beyond the present job situation. It is suggested that this is a particularly important dimension for coping with the present day rapid changes in working life, where the objective for many workers will be to broaden their repertoire and competence to increase their flexibility in the labour market.     

Testing Karasek's learning and strain hypotheses on young workers in their first job

This study tests the core hypotheses of Karasek's job demand-control model: high job demands (workload) in combination with low job control (autonomy) increase strains (job dissatisfaction; strain hypothesis), whereas high job demands in combination with high job control increase learning and development in the job (here: learning new skills in the first job; learning hypothesis). These hypotheses are tested in two ways: (a) the mere combination of both job characteristics is associated with the expected outcomes, and (b) a statistical interaction between both job characteristics in predicting the outcomes is expected. A large dataset (n=2,212) of young workers in their first job was used to test all hypotheses. As young workers are presumably still in the process of adjusting themselves to their work environment, we expected that the effects of work characteristics on work outcomes would be stronger for this group than for more experienced workers. The results confirm both the strain and the learning hypothesis. We found a combined effect of both job characteristics, as well as a statistical interaction between both variables. The lowest level of job satisfaction was found in the “high strain” job, whereas the highest increase in skills was found in the “active” job. The consequences of these findings for theory and practice are discussed.     

Relationships of work stress measures for employees with the same job

Most research on job stress is based on the assumption that correlations between perceived work environment and affective measures reflect a relationship between the objective work environment and affective measures. Correlations found among perceived stress measures were similar in magnitude to those found in other work stress studies that had greater variation in the subject sample and jobs. Also, no relationship was found between objective and perceived danger. Alternative explanations for perceived job stress relationships are discussed.     

A comparative analysis of occupational stress in managerial and shopfloor workers in the brewing industry: Mental health, job satisfaction and sickness

This study assessed the mental health, job satisfaction and sickness absence of comparative groups of 236 managers and 377 shopfloor workers in the brewing industry in Scotland and northern England. The results showed significant differences between the groups' scores on type A behaviour, locus of control, job satisfaction, and number of incidents of sickness absence. Multiple regression was used to elucidate similarities and differences between managers and shopfloor workers in the predictors of stress outcomes.     

The health of health care organizations

Abstract

This paper explores the nature and development of health care organizations in terms of a model of organizational healthiness. The model places particular emphasis on the psychosocial subsystems which describe the subjective organization. These represent the perceived internal functioning of the organization in terms of task completion, problem solving and staff development. The implications of such a model for the well-being of health care staff and for the evaluation of service delivery are discussed.     

The role of gender and job level in coping with occupational stress

The aim of the study was to investigate the relationship between coping and health problems in the context of gender and level in the organization. Questionnaire data were collected from 279 women and men (100 managers and 179 non-managers) at a sales department in a Swedish telecom company in which men and women worked at similar tasks. It was hypothesized that, if gender and level in the organization were controlled for, the use of problem-focused strategies would be associated with fewer health problems and the use of emotion-focused strategies with greater health problems. It was also predicted that men and women at a similar organizational level would not differ in their use of problem-focused coping strategies. The results showed, contrary to the hypothesis, that when level and gender were controlled for, no relation between problem-focused strategies and health was obtained. Instead the emotion-focused strategy of Seeking emotional support was associated with fewer health problems, whereas Focus on emotions and Alcohol/drug disengagement were associated with more symptoms. Coping was at least partly related to level. At a managerial level the men and the women used basically the same strategies whereas at a non-managerial level traditionally-conceived coping patterns were evident.     

The role of gender and job level in coping with occupational stress

The aim of the study was to investigate the relationship between coping and health problems in the context of gender and level in the organization. Questionnaire data were collected from 279 women and men (100 managers and 179 non-managers) at a sales department in a Swedish telecom company in which men and women worked at similar tasks. It was hypothesized that, if gender and level in the organization were controlled for, the use of problem-focused strategies would be associated with fewer health problems and the use of emotion-focused strategies with greater health problems. It was also predicted that men and women at a similar organizational level would not differ in their use of problem-focused coping strategies. The results showed, contrary to the hypothesis, that when level and gender were controlled for, no relation between problem-focused strategies and health was obtained. Instead the emotion-focused strategy of Seeking emotional support was associated with fewer health problems, whereas Focus on emotions and Alcohol/drug disengagement were associated with more symptoms. Coping was at least partly related to level. At a managerial level the men and the women used basically the same strategies whereas at a non-managerial level traditionally-conceived coping patterns were evident.     

Pre-employment antecedents of health resources, job factors and health risk behaviour in men and women

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.