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.     

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 stress, satisfaction and mental health of factory workers in Bangladesh

The present study examined the relationship between job stress, job satisfaction and mental health, and attempted to assess the effects of job stress on different parameters of satisfaction and mental health in the context of two groups of Bangladeshi factory workers. There were 26 subjects in a 'high stress' group and 33 in a 'low stress' group. Individual data were collected by using the Stress and Arousal Checklist, the Job Satisfaction Scale, the General Health Questionnaire, absenteeism by sick leave, a self-esteem at work scale and heart rate monitor. Chi-square and t-tests were applied in the analyses of these data by group. The results, quite expectedly, showed that a greater number of high stress subjects were dissatisfied and had poorer mental health than low stress subjects. The results also showed that low stress subjects were significantly more satisfied and possessed better mental health than the high stress subjects. It would appear that the experience of stress plays an important role in determining the quality of working life of Bangladeshi factory workers having similar consequences in terms of health and well-being to those observed in developed countries. The dynamics of absenteeism in Bangladesh are discussed.     

Is there support for curvilinear relationships between psychosocial work characteristics and mental well-being? Cross-sectional and long-term data from the Whitehall II study

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.     

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.     

On the psychological and motivational processes linking job characteristics to employee functioning: Insights from self-determination theory

The aim of this study was to provide insight into the differential relationships between job characteristics (job demands and resources) and employee functioning by examining the psychological and motivational processes involved. Drawing on self-determination theory, we tested a model in which job demands are positively related to negative manifestations of employee functioning (psychological distress and psychosomatic complaints) through psychological need frustration and low-quality work motivation (controlled motivation), whereas job resources are positively related to positive manifestations of employee functioning (work engagement and job performance) through need satisfaction and high-quality work motivation (autonomous motivation). Data were collected from 699 Canadian nurses. Structural equation modelling (SEM) results support the proposed model: psychological needs and work motivation partially mediated the relationship between job characteristics and employee functioning. Specifically, job demands negatively predicted employee functioning (high distress and psychosomatic complaints, low engagement and performance) through need frustration and controlled motivation. In contrast, while positively predicting need satisfaction and negatively predicting need frustration, job resources fostered optimal work motivation (more autonomous and less controlled motivation) and employee functioning. The implications for self-determination theory (SDT) and research on occupational health and stress are discussed.     

The importance of context specificity in work stress research: A test of the Demand-Control-Support model in academics

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.     

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.     

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.     

Personality and organizational health: the role of conscientiousness

Organizational health research identifies processes through which the work environment and individual differences combine to influence both individual and organizational outcomes. This study investigated the contribution of conscientiousness to organizational health. Research in the areas of occupational stress, work performance, and organizational climate was used to develop a framework for integrating different elements of organizational health. Within this framework, the work environment was assessed by perceptions of workload and role clarity ; individual well-being was assessed by psychological distress and job satisfaction ; and behaviour important for organizational success was assessed by contextual performance. Conscientiousness was investigated within the framework using self-reports from a sample of 104 Australian employees. Conscientiousness directly influenced contextual performance but did not influence well-being or perceptions of the work environment. Conscientiousness also reduced the impact of role clarity on both psychological distress and job satisfaction. The role of conscientiousness in a comprehensive model of organizational health is discussed.     

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.     

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.     

Self-reported distress, job dissatisfaction and the Type A behaviour pattern in a sample of full-time employed Australians

The Type A behaviour pattern (TABP), which relates to risk of coronary heart disease (CHD), has also been shown to relate to self-reported feelings of both psychological and physical distress, at least during those times when the TABP is activated by salient environmental circumstances. The importance of the occupational setting for those with the TABP has led to the speculation that such distress may arise, in part, from job dissatisfaction which comes about when the Type A individual is unable to exert sufficient control over the environment. Associations between the TABP and measures of job dissatisfaction have not, however, been widely reported. The present study examined associations between the TABP, job (dis)satisfaction and self-reported experiences of both psychological and physical distress in a sample of employed individuals, and found tentative evidence that the relationship between the TABP and distress was mediated in a modest way by self-perceived job (dis)satisfaction. The implications of this for the areas of work stress and occupational health are discussed.     

Stress demands on school administrators in Singapore

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.     

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.     

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.     

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.     

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.