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Braunheim L, Dragano N, Khachatryan K, Beutel ME, Brähler E. The effects of effort-reward imbalance on the job, overcommitment, and income on life satisfaction in Germany from a longitudinal perspective. Soc Sci Med 2024; 341:116523. [PMID: 38169180 DOI: 10.1016/j.socscimed.2023.116523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/09/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The effort-reward imbalance at work model offers a theoretical and analytical framework to estimate the subjective perception of work-related stress. High demands and low rewards in return can harm mental and physical health, well-being, and life satisfaction. According to the theory, overcommitment partially explains why employees endure such straining jobs. In Germany, cultural and economic aspects of labor differ between East and West. Incomes are lower in the East, while work centrality there is higher. In this article, the effects of effort-reward imbalance, overcommitment, and income on life satisfaction as well as their interactions with region were analyzed to gain a clearer picture of regional disparities regarding life satisfaction and the generality of this work stress model in Germany. METHODS Data from 3848 participants from 2006 to 2011 of the German Socio-Economic Panel were analyzed. Within-between models were estimated, including fixed and random effects of the continuous form of effort-reward imbalance to predict subjective life satisfaction. Time-variant covariates - e.g., overcommitment or income - as well as time-constant variables - e.g., region, sex, education - were integrated. Differences in regional labor markets between East and West Germany were considered. RESULTS Easterners exhibited higher imbalances and overcommitment than Westerners, indicating worse working conditions. Higher imbalances and overcommitment were associated with lower life satisfaction within and between participants, whereas for income only random effects were supported. While region did not moderate the effect of work stress, East Germans' life satisfaction benefitted more from a higher income. CONCLUSION The importance of internal work structures in terms of recognition, adequate pay, advancement opportunities, or time pressure were underlined. As compared to the West, Easterners' life satisfaction benefitted more from higher income but not more from a lower imbalance or lower overcommitment. The interplay between materialistic and nonmaterialistic rewards at work should be focused on in the future.
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Affiliation(s)
- Lisa Braunheim
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, University of Düsseldorf, Germany
| | - Kristine Khachatryan
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany; Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
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AbuAlSamen MM, El-Elimat T. Understanding Reciprocity Among University Students in Low-Resource Settings: Validation and Measurement Using a Mixed-Methods Approach. Front Public Health 2022; 10:922892. [PMID: 35719638 PMCID: PMC9204171 DOI: 10.3389/fpubh.2022.922892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to investigate reciprocity among university students in low-resource settings using a convergent mixed-methods approach in Jordan. The study operationalized the effort-reward imbalance (ERI) model which is a sociological framework used to predict occupational-related health outcomes. The basic theory of ERI model assumes that an imbalance of effort and reward predicts adverse health outcomes. Methods The research involved two studies, Study I (n = 833) to quantitatively measure ERI and Study II to collect qualitative data (n = 44) on the drivers of ERI among university students. In Study I, a modified Arabic version of the ERI questionnaire was used. The study measured ERI and investigated the reliability and validity of the Arabic version of the ERI model questionnaire. In Study II, data were collected from focus groups and personal interviews and thematic analysis was used. Results The results suggested that ERI was associated with poor academic performance (OR=2.31, 95% CI 1.60–3.32), absenteeism (OR=1.66, 95% CI 1.21–2.27), low exercise level (OR=2.02, 95% CI 1.49–2.74) and poor self-reported health (OR=1.12, 95% CI 1.08–1.30). Three major themes emerged, namely high academic load, financial pressures and negative influence on the students' performance, wellbeing and health to explain effort-reward imbalance. Conclusions Results suggest that ERI among university students is multi-faceted and is not bound only to academic-related demands and that the extrinsic factors such as the economic context of Jordan is among drivers of ERI.
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Koch P, Kersten JF, Stranzinger J, Nienhaus A. The effect of effort-reward imbalance on the health of childcare workers in Hamburg: a longitudinal study. J Occup Med Toxicol 2017; 12:16. [PMID: 28670329 PMCID: PMC5485678 DOI: 10.1186/s12995-017-0163-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/20/2017] [Indexed: 01/01/2023] Open
Abstract
Background The prevalence of effort-reward imbalance (ERI) among qualified childcare workers in Germany is currently estimated at around 65%. High rates of burnout and musculoskeletal symptoms (MS) have also been reported for this group. Previous longitudinal studies show inconsistent results with regard to the association between ERI and MS. As yet, no longitudinal studies have been conducted to investigate the association between ERI and burnout or MS in childcare workers. This study aims to investigate the extent to which a relationship between ERI and MS or burnout can be observed in childcare workers in Germany on a longitudinal basis. Methods In 2014 childcare workers (N = 199, response rate: 57%) of a provider of facilities for children and youth in Hamburg were asked about stress and health effects in the workplace. Follow-up was completed one year later (N = 106, follow-up rate: 53%) For the baseline assessment, ERI was determined as the primary influencing factor. Data on MS was recorded using the Nordic questionnaire, and burnout using the personal burnout scale of the Copenhagen Burnout Inventory (CBI). The statistical analysis was carried out using multivariate linear and logistic regression. Results At baseline ERI was present in 65% of the sample population. The mean burnout score at the time of follow-up was 53.7 (SD: 20.7); the prevalence of MS was between 19% and 62%. ERI was identified as a statistically significant factor for MS, after adjusting especially for physical stress (lower back: OR 4.2; 95% CI: 1.14 to 15.50, neck: OR 4.3; 95% CI: 1.25 to 15.0, total MS: OR 4.0; 95% CI: 1.20 to 13.49). With regard to burnout, a relative increase of 10% in the ERI ratio score increased the burnout score by 1.1 points (p = 0.034). Conclusions ERI was revealed to be a major factor in relation to MS and burnout in childcare workers. Based on this observation worksite interventions on the individual and organizational level should be introduced in order to prevent ERI. Electronic supplementary material The online version of this article (doi:10.1186/s12995-017-0163-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peter Koch
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Jan Felix Kersten
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Johanna Stranzinger
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Albert Nienhaus
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,Health Protection Division (FBG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33, 22089 Hamburg, Germany
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Koch P, Stranzinger J, Nienhaus A, Kozak A. Musculoskeletal Symptoms and Risk of Burnout in Child Care Workers - A Cross-Sectional Study. PLoS One 2015; 10:e0140980. [PMID: 26488770 PMCID: PMC4619302 DOI: 10.1371/journal.pone.0140980] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/02/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives German child care workers' job satisfaction is influenced by the consequences of unfavourable underlying conditions. Child care workers tend to suffer from psychosocial stress, as they feel that their work is undervalued. The objective of the present study is to investigate how the psychosocial factors of the effort-reward imbalance (ERI) model influence musculoskeletal symptoms (MS) and the risk of burnout. To our knowledge this is the first study investigating the association between the factors of the ERI model and MS in child care workers. Methods and Findings Data from 199 child care workers were examined in a cross-sectional study. Psychosocial factors were recorded with the ERI questionnaire. MS was recorded with the Nordic Questionnaire and risk of burnout with the Personal Burnout scale of the Copenhagen Burnout Inventory. Multivariate analysis was performed using linear and logistic regression models. The response rate was 57%. In most of the sample (65%), an effort-reward imbalance was observed. 56% of the child care workers were at risk of burnout and 58% reported MS. Factors associated with risk of burnout were subjective noise exposure (OR: 4.4, 95%CI: 1.55–12.29) and overcommitment (OR: 3.4; 95%CI: 1.46–7.75). There were statistically significant associations between MS and overcommitment (low back pain—OR: 2.2, 95%CI: 1.04–4.51), low control (overall MS OR: 3.8; 95%CI: 1.68–3.37) and risk of burnout (overall MS OR: 2.3, 95%CI: 1.01–5.28). For ERI no statistically significant associations were found with reference to risk of burnout or MS. Conclusion Overcommitment in child care workers is related to MS and risk of burnout. There is also evidence that low control is associated with MS and subjective noise exposure with risk of burnout. Effort-reward imbalance is not related to either outcome. This occupational health risk assessment identifies changeable working factors in different types of facilities.
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Affiliation(s)
- Peter Koch
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
- * E-mail:
| | - Johanna Stranzinger
- Health Protection Division (FBG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33, 22089 Hamburg, Germany
| | - Albert Nienhaus
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
- Health Protection Division (FBG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33, 22089 Hamburg, Germany
| | - Agnessa Kozak
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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Koch P, Schablon A, Latza U, Nienhaus A. Musculoskeletal pain and effort-reward imbalance--a systematic review. BMC Public Health 2014; 14:37. [PMID: 24428955 PMCID: PMC3898401 DOI: 10.1186/1471-2458-14-37] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 01/10/2014] [Indexed: 11/22/2022] Open
Abstract
Background Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures psychosocial factors in the working world. The question is whether workers with an effort-reward imbalance report musculoskeletal pain more frequently than those with no effort-reward imbalance. A systematic review using a best evidence synthesis approach was conducted to answer this question. Methods A literature search was conducted for the period from 1996 to 2012, using three databases (Pubmed, Embase and PsycINFO). The research criteria related to psychosocial, work-related stress as per the ERI model and to musculoskeletal pain. A quality score was developed using various quality criteria to assess the standard of the studies. The level of evidence was graded as in (Am J Ind Med 39:180–193, 2001). Results After applying the inclusion criteria, a total of 19 studies were included in the review: 15 cross-sectional studies, three prospective studies and one case–control study. 74% of all studies exhibited good methodological quality, 53% collected data using the original ERI questionnaire, and in 42% of the studies, there was adequate control for physical working conditions. Furthermore, different cut-off points were used to classify exposed and non-exposed individuals. On the basis of 13 studies with a positive, statistically significant association, a moderate level of evidence was inferred for the association between effort-reward imbalance and musculoskeletal pain. The evidence for a role of over-commitment and for its interaction with effort-reward imbalance was rated as inconclusive - on the basis of eight and five studies, respectively. Conclusions On the basis of the available evidence, no reliable conclusion may be drawn about any association between the psychosocial factors ascertained using the ERI model and musculoskeletal pain. Before a reliable statement can be made on the association between ERI and musculoskeletal pain, additional longitudinal studies must be performed - with a standardised method for recording and classifying exposure, as well as control of physical confounders. Appropriate preventive measures can then be specified.
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Affiliation(s)
- Peter Koch
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg 20246, Germany.
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Almadi T, Cathers I, Chow CM. An Arabic version of the effort-reward imbalance questionnaire: translation and validation study. Psychol Rep 2014; 113:1287-302. [PMID: 24340817 DOI: 10.2466/08.14.pr0.113x10z7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An Arabic version of the Effort-Reward Imbalance Questionnaire was developed and validated through a translation process with cross-cultural considerations. The translated questionnaire was evaluated for reliability and validity. A Principal Components Analysis was conducted following assessment of the suitability of data for factor analysis. Components with high eigenvalues were extracted, followed by Varimax rotation. Three components with eigenvalues greater than 1.0 (50% of variance) were indicated. The analysis showed Cronbach's alpha coefficients of .82 for the Effort scale, .88 for the Reward scale, and .74 for the Overcommitment scale. The test-retest reliability was high with intra-correlation coefficients of > or = .86. The Arabic version of the Effort-Reward Imbalance Questionnaire showed adequate reliability and validity and is a suitable instrument to assess work stress in Arabic-speaking people.
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Affiliation(s)
- Tawfiq Almadi
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW, Australia.
| | - Ian Cathers
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW, Australia
| | - Chin Moi Chow
- Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, NSW, Australia
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Psychosoziale Arbeitsbelastungen und depressive Symptome bei Führungskräften. PSYCHOTHERAPEUT 2010. [DOI: 10.1007/s00278-010-0794-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lang J, Bliese PD, Adler AB, Hölzl R. The Role of Effort–Reward Imbalance for Reservists on a Military Deployment. MILITARY PSYCHOLOGY 2010. [DOI: 10.1080/08995605.2010.521730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jessica Lang
- a U.S. Army Medical Research Unit–Europe , Heidelberg , Germany
| | - Paul D. Bliese
- a U.S. Army Medical Research Unit–Europe , Heidelberg , Germany
| | - Amy B. Adler
- a U.S. Army Medical Research Unit–Europe , Heidelberg , Germany
| | - Rupert Hölzl
- b Otto-Selz Institute of Applied Psychology, University of Mannheim , Germany
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Factorial invariance and stability of the effort-reward imbalance scales: A longitudinal analysis of two samples with different time lags. Int J Behav Med 2008; 15:62-72. [DOI: 10.1007/bf03003075] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weyers S, Peter R, Boggild H, Jeppesen HJ, Siegrist J. Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort-reward imbalance model. Scand J Caring Sci 2006; 20:26-34. [PMID: 16489957 DOI: 10.1111/j.1471-6712.2006.00376.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nursing staff are exposed to stressful work load which in turn is associated with poor physical and psychological health, sickness absence and job exit. The effort-reward imbalance (ERI) model is a validated approach to measure chronic psychosocial work stress by identifying nonreciprocity between occupational efforts spent and rewards received, and has been found to predict poor health. The aim of this cross-sectional study (n = 367 nurses and nurses aides) was first to test the psychometric properties of the Danish questionnaire measuring ERI, and secondly to analyse whether psychosocial work stress is associated with six indicators of poor self-rated health. Results derived from confirmatory factor analysis indicate satisfying psychometric properties. Elevated risks of poor self-rated health (odds ratios varying from 1.92 to 4.76) are observed in nursing staff characterized by high effort in combination with low reward. Effects are enhanced in those respondents who additionally exhibit a high level of work-related overcommitment. In conclusion, despite methodological limitations, this study contributes to the validation of the ERI questionnaire in Danish language. Furthermore, by documenting associations with poor self-rated health, it supports efforts of theory-guided prevention of work stress in health care professions.
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Affiliation(s)
- Simone Weyers
- Department of Medical Sociology, University of Duesseldorf, PO Box 10 10 7, D-40001 Duesseldorf, Germany.
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Abstract
As social inequalities in health continue to be a key public health problem, scientific advances in explaining these inequalities are needed. It is unlikely that there will be a single explanation of social inequalities in health. This introductory paper sets out one explanatory framework, exposure to adverse psychosocial environments during midlife, and particularly at work. We argue that exposure to an adverse psychosocial environment, in terms of job tasks, defined by high demands and low control and/or by effort-reward imbalance, elicits sustained stress reactions with negative long-term consequences for health. These exposures may be implicated in the association of socioeconomic status with health in two ways. First, these exposures are likely to be experienced more frequently among lower socioeconomic groups. Second, the size of the effects on health produced by adverse working conditions may be higher in lower status groups, due to their increased vulnerability. In this special issue, these arguments are illustrated by a collection of original contributions from collaborative research across Europe. The papers, in our view, advance the case for the robust associations between measures of adverse psychosocial environment and ill health, as they are based on comparative studies across several European countries and as they combine different types of study designs. This collaboration was enabled and supported by a European Science Foundation scientific programme on 'Social Variations in Health Expectancy in Europe'.
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Affiliation(s)
- Johannes Siegrist
- Department of Medical Sociology, Heinrich Heine Universitat, University of Duesseldorf, Universitaetstrasse 1, P.O. Box 10 10 07, D-40001, 40225 Duesseldorf, Germany.
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Rödel A, Siegrist J, Hessel A, Brähler E. Fragebogen zur Messung beruflicher Gratifikationskrisen. ACTA ACUST UNITED AC 2004. [DOI: 10.1024/0170-1789.25.4.227] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Das zur Erklärung gesundheitlicher Risiken infolge chronischer psychomentaler und sozioemotionaler Arbeitsbelastungen entwickelte Modell beruflicher Gratifikationskrisen ist in verschiedenen, z.T. internationalen epidemiologischen und experimentellen Untersuchungen anhand eines standardisierten Messverfahrens erfolgreich überprüft worden. Erstmals werden hier Ergebnisse der psychometrischen Testung des Messverfahrens an einer für die erwerbstätige Bevölkerung Deutschlands repräsentativen Stichprobe vorgestellt (N = 666 Männer und Frauen; durchschnittliches Alter: 40.1±11.2). Die das Modell messenden Skalen werden bezüglich interner Konsistenz, Item-Skalen- und Interskalen-Korrelationen sowie kriterienbezogener Validität charakterisiert. Ferner wird die faktorielle Validität des Messmodells durch konfirmatorische Testung von vier alternativen Strukturmodellen überprüft, wobei der Modell-Fit der theoriekonform spezifizierten derjenigen der weniger spezifizierten überlegen ist. Zusammenfassend zeigen sich für die deutschsprachige Fassung der zur Modellmessung eingesetzten Skalen befriedigende psychometrische Kennwerte, die den weiteren Einsatz des Verfahrens rechtfertigen.
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Affiliation(s)
- Andreas Rödel
- Institut für Medizinische Soziologie, Heinrich-Heine-Universität Düsseldorf
| | - Johannes Siegrist
- Institut für Medizinische Soziologie, Heinrich-Heine-Universität Düsseldorf
| | - Aike Hessel
- Klinik und Poliklinik für Psychotherapie und Psychosomatische Medizin, Universität Leipzig
| | - Elmar Brähler
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig
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