Return to work among employees with mental health problems: Development and validation of a self-efficacy questionnaire

Abstract

Because of the costs to both the organization and the individual, it is important that employees who are sick-listed with mental health problems are facilitated in their return to work (RTW). In order to provide adequate interventions, it is necessary to obtain a better understanding of the RTW process of people with mental health problems. Work-related self-efficacy (SE) might play a key role within this process. This paper describes the development and validation of the return-to-work self-efficacy’ scale (RTW-SE) for employees with mental health problems. Three Dutch samples of sick-listed employees were used to validate the 11-item instrument (N=2214). Based on the factor structure and reliability results, RTW-SE was conceptualized as a unitary construct. The associations with general SE, locus of control, coping, physical workload and mental health problems support the construct validity of this scale. Most importantly, RTW-SE proved to be a robust predictor of actual return to work within three months. The encouraging preliminary psychometric properties of the scale make it a potentially valuable tool in research and in clinical practice and occupational health care settings, both before and after employees have returned to work.     

The measurement of emotional reactions to work: Conceptual, methodological and research issues

This paper offers an overview of the literature on the measurement of emotional reactions to work. The paper opens with discussion of the meaning, definition and assessment of the terms 'work', 'emotion', and 'health/well-being' and then proposes that an understanding of the complex relationships among these variables should proceed through the use of ecological and interactional models. It is noted that, although there is still some controversy regarding the relationships between emotions, health and well-being, there is a growing recognition of the fact that emotions are closely related to the origins and exacerbation of disease and the promotion of health and well-being. Also, as an important context for human activity and development, the workplace can be both a direct and indirect source of negative emotions that are associated with severe stress, especially if certain workplace characteristics (e.g. quantitative and qualitative overload, poor control, low wages and poor social supports) are present. The paper summarizes some of the critical issues in the measurement of emotional reactions to work, including gender, age and culture, and lists some of the many instruments for this measurement. Lastly, the paper argues that the measurement of emotional reactions to work should proceed from a multimethod-multisource-multiemotion research strategy that samples different methods (questionnaires, behavioural observation, biological measures, etc.), emotions (anger, anxiety, happiness, etc), and sources (e.g. subject, professional, family).     

Satisfaction with HR practices and employee performance: A moderated mediation model of engagement and health

This study examines employee evaluations of HR practices (HRPs), which are a critical and yet underexplored antecedent of their effectiveness. Drawing on the Job Demands–Resources model, it proposes a moderated mediation model that studies the relationship between employee satisfaction with HRPs and in-role and extra-role performance as mediated by engagement. The results suggest satisfaction with HRPs influences both the performance dimensions considered, although its effects are greater for extra-role performance. Engagement intervenes significantly only in the relationship between this satisfaction and extra-role performance. Furthermore, the study acknowledges the burdens HRP-related resources may place on the workforce and examines the moderating effects of a personal resource such as health on the satisfaction with HRPs-engagement link, finding that it significantly strengthens it. It also finds that the indirect effect of satisfaction with HRPs on extra-role performance is stronger for healthier employees. These findings provide novel insights into the HR causal chain and help practitioners to better manage HRP design, communication, and audits.     

Personnel turnover in health care organizations: Test of a predictive model based on work assessments by employees

It is predicted that institutions in Dutch intramural health care will be increasingly confronted with problems in personnel supply. Instead of making great efforts to keep the inflow of new personnel on the desired level, control of turnover is an alternative solution. In this paper, an explanatory model is constructed, based on previous theories and research findings. It is hypothesized that the more employees have positive attitudes concerning their work and work situation, the greater their satisfaction and commitment and hence the less their intention to leave and the lower actual turnover. This model was tested using a large scale employee questionnaire. The instrument turned out to be reliable (internal consistencies above .70). The questionnaire was administered in eight institutions in four health care sectors (n = 1456). Results indicate that attitudes about work content and personnel management are relevant in predicting intention to leave. All in all, 8 work-related aspects predicted 21% of intention to leave. Aspects with the most predictive value were career guidance, work safety, responsibilities and job discretion. Furthermore, general satisfaction was shown to play an intermediary role in predicting intention to leave. It is concluded that improvements in work content and personnel management can reduce intention to leave and hence the demand for new personnel.     

Personnel turnover in health care organizations: Test of a predictive model based on work assessments by employees

Abstract

It is predicted that institutions in Dutch intramural health care will be increasingly confronted with problems in personnel supply. Instead of making great efforts to keep the inflow of new personnel on the desired level, control of turnover is an alternative solution. In this paper, an explanatory model is constructed, based on previous theories and research findings. It is hypothesized that the more employees have positive attitudes concerning their work and work situation, the greater their satisfaction and commitment and hence the less their intention to leave and the lower actual turnover. This model was tested using a large scale employee questionnaire. The instrument turned out to be reliable (internal consistencies above .70). The questionnaire was administered in eight institutions in four health care sectors (n = 1456). Results indicate that attitudes about work content and personnel management are relevant in predicting intention to leave. All in all, 8 work-related aspects predicted 21% of intention to leave. Aspects with the most predictive value were career guidance, work safety, responsibilities and job discretion. Furthermore, general satisfaction was shown to play an intermediary role in predicting intention to leave. It is concluded that improvements in work content and personnel management can reduce intention to leave and hence the demand for new personnel.     

Work and the good life: How work contributes to meaning in life

Many people expect their work to provide meaning to their lives, yet the specific organizational factors that can promote meaning in life are not clearly delineated. Drawing on the basic science of meaning in life, in this paper we propose that work entails a host of experiences that foster meaning in life. We begin by defining meaning in life, noting its placement within the broader well-being literature and dispelling common myths about its rarity in people’s lives. After highlighting the myriad benefits of meaning for individuals and organizations, we describe several established sources of meaning in life and their relevance to work. We then examine how work orientations and social demographic factors influence the propensity to seek meaning through work. We conclude with a discussion of future research directions that can better illuminate the predictors and functions of meaningfulness at work.     

Training perceptions,engagement, and performance: comparing work engagement and personal role engagement

The purpose of this study was to compare two engagement constructs (work engagement and personal role engagement) with regard to their relationship with training perceptions and work role performance behaviours. It was hypothesised that personal role engagement would show incremental validity above that of work engagement at predicting work role performance behaviours and be a stronger mediator of the relationships between training perceptions and such behaviours. Questionnaire data were gathered from 304 full-time working adults in the UK. As predicted, personal role engagement was found to explain additional variance above that of work engagement for task proficiency, task adaptability, and task proactivity behaviours. Moreover, personal role engagement was a stronger mediator of the relationship between training perceptions and task proficiency as well as between training perceptions and task adaptability. Both work engagement and personal role engagement mediated the relationship between training perceptions and task proactivity to a similar degree. The findings suggest that personal role engagement has better practical utility to the human resource development domain than work engagement and indicates that future research may benefit from adopting the personal role engagement construct.     

The relationships between work characteristics and mental health: examining normal, reversed and reciprocal relationships in a 4-wave study

This longitudinal study examined the causal relationships between job demands, job control and supervisor support on the one hand and mental health on the other. Whereas we assumed that work characteristics affect mental health, we also examined reversed causal relationships (mental health influences work characteristics). Further, the topic of the appropriate time lag for testing causal relationships was addressed. Our hypotheses were tested in a 4-wave study among a heterogeneous sample of 668 Dutch employees using structural equation modelling. The results provide evidence for reciprocal causal relationships between the work characteristics and mental health, although the effects of work characteristics on well-being were causally predominant. The best model fit was found for a 1-year time lag. Compared to earlier—predominantly cross-sectional—results, the present study presents a stronger case for the effects of work characteristics on the development of strain. The results also emphasize the need for a dynamic view of the relationship between work and health; the one-directional viewpoint in many work stress models does not seem to fully capture the relations between work characteristics and well-being.     

The relationships between work characteristics and mental health: examining normal,reversed and reciprocal relationships in a 4-wave study

This longitudinal study examined the causal relationships between job demands, job control and supervisor support on the one hand and mental health on the other. Whereas we assumed that work characteristics affect mental health, we also examined reversed causal relationships (mental health influences work characteristics). Further, the topic of the appropriate time lag for testing causal relationships was addressed. Our hypotheses were tested in a 4-wave study among a heterogeneous sample of 668 Dutch employees using structural equation modelling. The results provide evidence for reciprocal causal relationships between the work characteristics and mental health, although the effects of work characteristics on well-being were causally predominant. The best model fit was found for a 1-year time lag. Compared to earlier—predominantly cross-sectional—results, the present study presents a stronger case for the effects of work characteristics on the development of strain. The results also emphasize the need for a dynamic view of the relationship between work and health; the one-directional viewpoint in many work stress models does not seem to fully capture the relations between work characteristics and well-being.     

Demanding work schedules and mental health in nursing assistants working in nursing homes

Nursing home assistants have physically and emotionally challenging jobs, and they often work demanding schedules in order to provide 24-h care. While the physical effects of demanding work schedules have been studied, little is known about the impact on mental health. This study explored the relationship between demanding scheduling variables and mental health indicators of depression, anxiety and somatization. A cross-section of 473 US female nursing assistants working in nursing homes was surveyed. Work schedule characteristics included shiftwork, hours per day and week, days per week, number of weekends per month, number of double shifts per month, breaks, and number of jobs worked. Working two or more double-shifts per month was associated with increased risk for all mental health indicators, and working 6–7 days per week was associated with depression and somatization. There was a trend for increasing odds of adverse mental health with increased numbers of demanding work schedule factors. The odds of depression was increased four-fold when working 50+ h/week, more than two weekends/month and more than two double shifts/month. Providing work schedules that are less unhealthy may have implications for both worker retention and the quality of care delivered to nursing home residents.     

Relationship between job control,work pressure and strain: Studies in the USA and in The Netherlands

The purpose of this study was to test a model of job control, work pressure and strain in two samples in the USA and in The Netherlands. According to the proposed model, work pressure has a mediating role between job control and worker strain. The present model specifies three types of job control: task or instrumental control, conceptual or resource control, and decision organization control. Task and resource control are assumed to reduce the stressor of work pressure which, in turn, is related to high strain. Organization control is assumed to be positively related to work pressure. The model was tested in two samples : one US sample of 273office employees and one Dutch sample of 958 employees in a variety of jobs. The same measure of job control was used in both samples. Resultspartially confirm the proposed model. As predicted by the proposed model, high task control was related to low work pressure, whereas high organization control was related to high work pressure. The effects of task control and organization control on strain were mediated by work pressure for the measure of anxiety in the US sample and for the measure of stress in the Dutch sample. However, the mediating effect of work pressure was not found for job satisfaction in both samples, for the measure of mood disturbances in the US sample and for the measure of sick days in the Dutch sample. The proposed model is only partially confirmed by the results. These results confirm the importance of differentiating between different dimensions of job control.     

Demanding work schedules and mental health in nursing assistants working in nursing homes

Nursing home assistants have physically and emotionally challenging jobs, and they often work demanding schedules in order to provide 24-h care. While the physical effects of demanding work schedules have been studied, little is known about the impact on mental health. This study explored the relationship between demanding scheduling variables and mental health indicators of depression, anxiety and somatization. A cross-section of 473 US female nursing assistants working in nursing homes was surveyed. Work schedule characteristics included shiftwork, hours per day and week, days per week, number of weekends per month, number of double shifts per month, breaks, and number of jobs worked. Working two or more double-shifts per month was associated with increased risk for all mental health indicators, and working 6-7 days per week was associated with depression and somatization. There was a trend for increasing odds of adverse mental health with increased numbers of demanding work schedule factors. The odds of depression was increased four-fold when working 50+ h/week, more than two weekends/month and more than two double shifts/month. Providing work schedules that are less unhealthy may have implications for both worker retention and the quality of care delivered to nursing home residents.     

Relationship between job control, work pressure and strain: studies in the USA and in The Netherlands

The purpose of this study was to test a model of job control, work pressure and strain in two samples in the USA and in The Netherlands. According to the proposed model, work pressure has a mediating role between job control and worker strain. The present model specifies three types of job control: task or instrumental control, conceptual or resource control, and decision organization control. Task and resource control are assumed to reduce the stressor of work pressure which, in turn, is related to high strain. Organization control is assumed to be positively related to work pressure. The model was tested in two samples : one US sample of 273office employees and one Dutch sample of 958 employees in a variety of jobs. The same measure of job control was used in both samples. Resultspartially confirm the proposed model. As predicted by the proposed model, high task control was related to low work pressure, whereas high organization control was related to high work pressure. The effects of task control and organization control on strain were mediated by work pressure for the measure of anxiety in the US sample and for the measure of stress in the Dutch sample. However, the mediating effect of work pressure was not found for job satisfaction in both samples, for the measure of mood disturbances in the US sample and for the measure of sick days in the Dutch sample. The proposed model is only partially confirmed by the results. These results confirm the importance of differentiating between different dimensions of job control.     

Relationships between psychological,physical, and behavioural health and work performance: A review and meta-analysis

The relationships between health and job performance problems have received increased attention in business and scientific communities. This paper attempts to synthesize theoretical and empirical work in this arena. First, the theoretical links between health and work performance are presented. This is followed by a meta-analysis of the relations between psychological, physical, and behavioural health variables and work performance criteria. Meta-analytic results from 111 independent samples obtained from a search of the literature indicate that psychological health, in the form of psychological well-being, depression, general anxiety, and life satisfaction, is a moderate-to-strong correlate of work performance. Associations between physical health, particularly somatic complaints and hypertension, and performance were weak-to-moderate. Regarding health behaviour, alcohol consumption, and smoking were weakly and sleep problems moderately associated with performance problems. Effect sizes sometimes differed across performance dimensions and data sources. The results are consistent with the notion that ill-health is associated with substantial reductions in work performance. This implies that interventions to improve health may have an impact on performance. However, as most of the research in this area has been cross-sectional, more longitudinal research is needed to test theoretical and alternative causal explanations for the relations summarized in this review.     

The associations between work stress and mental health: A comparison of organizationally employed and self-employed workers

This study examined the associations between work stressors and mental health in organizationally employed and self-employed workers, and with the numbers of general practitioner (GP) services used by these two employment groups. The participants were selected from those already taking part in the PATH Through Life Project, in Australia. A total of 2275 men and women aged from 40 to 44 years participated in a community survey and were in the labour force at the time of the interview. Those who participated entered responses into a hand-held computer under the supervision of an interviewer. A total of 14.2% of the group identified themselves as self-employed. Respondents also provided details of their occupation and the extent to which they experienced work stressors. Some 72.6% of these participants gave consent for information on their use of GP services over a 12-month period to be obtained from national insurance records. We found that self-employed men and women reported more decision authority than the organizationally employed, while self-employed women also had more manageable job demands. Self-employment offered men no health benefit. However, women who were self-employed reported worse physical health than their organizationally employed counterparts. While work stress factors were most likely to be associated with the use of GP services by self-employed men, the use of those services by women was more strongly associated with their experiences of stress in organizational employment. Overall, self-employment was found to be associated with relatively few mental health benefits.     

Reciprocal relationships between psychosocial work characteristics and sleep problems: A two-wave study

Sleep problems are common and impair the health and productivity of employees. Work characteristics constitute one possible cause of sleep problems, and sleeping poorly might influence wellbeing and performance at work. This study examines the reciprocal associations between sleep problems and psychosocial work characteristics. The participants were 1744 full-time employed individuals (56% women; mean age 38 years in 2007) from the Young Finns study who responded to questionnaires on work characteristics (conceptualised by the demand–control model and effort–reward imbalance model) and sleep problems (Jenkins Sleep Scale) in 2007 and 2012. Cross-lagged structural equation models are used to examine the associations. The results show that low control and low rewards at baseline predicted sleep problems. Baseline sleep problems predicted higher effort, higher effort–reward imbalance, and lower reward. Sleep problems also predicted lower odds for belonging to the low (rather than high) job strain group and active jobs group. The association between work characteristics and sleep problems appears to be reciprocal, with a stressful work environment increasing sleep problems, and sleep problems influencing future work characteristics. The results emphasise the importance of interventions aimed at both enhancing sleep quality and reducing psychosocial risks at work.     

Inequity at work: Its measurement and association with worker health

Abstract

This paper considers the extent to which stress-induced illness can be regarded as a personal injury that could give rise to civil action for damages against employers in the UK. It outlines the results of a brief survey of personal injury solicitors, which indicates that claims are already being initiated by employees who allege they have suffered a stress-induced illness. The potential for claims within industrial tribunal cases that have already been decided is also examined. Consideration is given to the hurdles that litigants will have to surmount, such as proving that their condition was in fact caused by some feature of their working conditions, showing that it was foreseeable that they would suffer a stress-based injury, and demonstrating that their employer was in some way at fault. This leads to a questioning of what employers can do to protect themselves from such claims, or at least defend them successfully. The paper points out that success is likely to depend heavily upon the quality of expert medical opinion, and also upon policy conditions that may influence those adjudicating on such cases. It is concluded that the cost of losing claims may be significant, and that employees who ignore the warning signs do so at their peril.     

The role of sense of coherence in well-being at work: Analysis of main and moderator effects

The aim of this cross-sectional study was to investigate the role of the sense of coherence (SOC) as a main effect on well-being and also its possible moderating role in the relationship between work characteristics and well-being in a sample of Finnish technical designers (n = 989). MANOVA/MANCOVA analysis with hierarchical decomposition was used so that the demographic variables (age, occupation gender) were controlled throughout. The results offered strong support for a main effect model of SOC: the stronger the SOC, the lower the level of psychosomatic symptoms and emotional exhaustion. Also, some support for a moderating role of SOC on the relationships between perceived work characteristics and well-being was found. However, these relationships explained only a small proportion of the variance of well-being was found. However, these relationships explained only a small proportion of the variance of well-being indicators. These results showed that the strong SOC subjects seemed to be better protected from the adverse effects of certain work characteristics (e.g. pressure of time). Furthermore, good social relations at work emphasized well-being among subjects with a very weak SOC, whereas these relations matered less in determining well-being outcomes in subjects with a stronger SOC. Finally, some work characteristics seemed to have salutary effects on well-being when accompained by a strong SOC and, on the contrary, pathogenic effects when accompained by a weak SOC.     

The role of sense of coherence in well-being at work: Analysis of main and moderator effects

Abstract

The aim of this cross-sectional study was to investigate the role of the sense of coherence (SOC) as a main effect on well-being and also its possible moderating role in the relationship between work characteristics and well-being in a sample of Finnish technical designers (n = 989). MANOVA/MANCOVA analysis with hierarchical decomposition was used so that the demographic variables (age, occupation gender) were controlled throughout. The results offered strong support for a main effect model of SOC: the stronger the SOC, the lower the level of psychosomatic symptoms and emotional exhaustion. Also, some support for a moderating role of SOC on the relationships between perceived work characteristics and well-being was found. However, these relationships explained only a small proportion of the variance of well-being was found. However, these relationships explained only a small proportion of the variance of well-being indicators. These results showed that the strong SOC subjects seemed to be better protected from the adverse effects of certain work characteristics (e.g. pressure of time). Furthermore, good social relations at work emphasized well-being among subjects with a very weak SOC, whereas these relations matered less in determining well-being outcomes in subjects with a stronger SOC. Finally, some work characteristics seemed to have salutary effects on well-being when accompained by a strong SOC and, on the contrary, pathogenic effects when accompained by a weak SOC.     

Inequity at work: its measurement and association with worker health

The equity theory of Adams (1963, 1965) predicts that people pursue a balance between their investments in and the rewards gained from their work, such that their own investment/reward ratio is the same as that of similar others. Disturbance of this balance is expected to result in a range of negative outcomes, even if people are comparatively well off. The current study among a representative sample of 1297 Finnish workers examined two assumptions of this theory more closely, namely (1) whether the relationship between inequity and selected health-related outcome variables is U-shaped (is receiving too much as detrimental as receiving too little?), and (2) whether the reference to 'similar others' should be included in the measure tapping inequity. Multivariate analysis of variance only partly confirmed the hypothesis that the relationship between inequity and selected outcome variables is U-shaped. The reference to 'similar others' in the measurement of inequity seems to be superfluous.