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du Prel JB, Koscec Bjelajac A, Franić Z, Henftling L, Brborović H, Schernhammer E, McElvenny DM, Merisalu E, Pranjic N, Guseva Canu I, Godderis L. The Relationship Between Work-Related Stress and Depression: A Scoping Review. Public Health Rev 2024; 45:1606968. [PMID: 38751606 PMCID: PMC11094281 DOI: 10.3389/phrs.2024.1606968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge. Methods We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria. Results Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified. Conclusion The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.
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Affiliation(s)
- Jean-Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | | | - Zrinka Franić
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Lorena Henftling
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Hana Brborović
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Damien M. McElvenny
- Research Group, Institute of Occupational Medicine, Edinburgh, United Kingdom
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, United Kingdom
| | - Eda Merisalu
- Estonian University of Life Sciences, Tartu, Estonia
| | - Nurka Pranjic
- Department of Occupational Medicine, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Unisanté, University of Lausanne, Lausanne, Switzerland
| | - Lode Godderis
- Department of Primary Care and Public Health, University of Leuven, Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
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Iida M, Sakuraya A, Watanabe K, Imamura K, Sawada U, Akiyama H, Komase Y, Miyamoto Y, Kawakami N. The association between team job crafting and work engagement among nurses: a prospective cohort study. BMC Psychol 2024; 12:66. [PMID: 38336755 PMCID: PMC10854162 DOI: 10.1186/s40359-024-01538-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Team-level job crafting has been put forward as a method to promote nurses' mental health. However, a longitudinal association is unclear. Therefore, the objective of this study was to investigate the association between team job crafting at baseline and work engagement, work performance, psychological distress, and intention to leave at three-month and six-month follow-ups among Japanese hospital nurses. Also, whether an increase in the team job crafting during 3 or 6 months was associated with an increase in the work engagement during 3 or 6 months of individual nurses was examined. METHODS A multilevel prospective cohort study was conducted. Data were collected from nurses of five hospitals in Japan at baseline (T1) and follow-ups at 3-months (T2) and 6-months (T3). A total of 2,478 nurses were included. The team job crafting scale for nurses and its three subscales were measured for the independent variables. Ward-means were used as ward-level variables. The dependent variables were work engagement, work performance, psychological distress, and intention to leave. Hierarchical Linear Modeling (HLM) was used to examine the multilevel association. The study protocol was registered at the UMIN Clinical Trials Registry (ID = UMIN000047810) (May 22, 2022). RESULTS A total of 460 nurses completed the T1 survey (response rate = 18.6%), and data from 391 nurses nested in 30 wards were included in the analyses. The intraclass correlation coefficients (ICCs) at T1 were 0.02 for work engagement and 0.07 for team job crafting. The HLM revealed that ward-level team job crafting at T1 was not significantly associated with work engagement, work performance, psychological distress, and intention to leave at T2 or T3. The ward-level change (T3-T1) of "crafting for the task considering the team's growth" (subscale for team job crafting) was significantly and positively associated with the change (T3-T1) in work engagement. CONCLUSIONS Ward-level team job crafting at baseline did not predict nurses' work engagement, work performance, psychological distress, or intention to leave at a three-month or six-month follow-up. The impact of ward-level team job crafting may attenuate over several months.
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Affiliation(s)
- Mako Iida
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Asuka Sakuraya
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Kotaro Imamura
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Utako Sawada
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Hiroto Akiyama
- Accenture Japan Ltd, Sumitomo Fudosan Azabu Juban Bldg., 1-4-1 Mita, Minato-ku, Tokyo, 108-0073, Japan
| | - Yu Komase
- Fujitsu Japan Limited, 1-5-2, Higashishinbashi, Minato-Ku, Tokyo, 105-7123, Japan
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
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von Känel R, Princip M, Holzgang SA, Garefa C, Rossi A, Benz DC, Giannopoulos AA, Kaufmann PA, Buechel RR, Zuccarella-Hackl C, Pazhenkottil AP. Coronary microvascular function in male physicians with burnout and job stress: an observational study. BMC Med 2023; 21:477. [PMID: 38041159 PMCID: PMC10693019 DOI: 10.1186/s12916-023-03192-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND As a professional group, physicians are at increased risk of burnout and job stress, both of which are associated with an increased risk of coronary heart disease that is at least as high as that of other professionals. This study aimed to examine the association of burnout and job stress with coronary microvascular function, a predictor of major adverse cardiovascular events. METHODS Thirty male physicians with clinical burnout and 30 controls without burnout were included. Burnout was assessed with the Maslach Burnout Inventory and job stress with the effort-reward imbalance and overcommitment questionnaire. All participants underwent myocardial perfusion positron emission tomography to quantify endothelium-dependent (cold pressor test) and endothelium-independent (adenosine challenge) coronary microvascular function. Burnout and job stress were regressed on coronary flow reserve (primary outcome) and two additional measures of coronary microvascular function in the same model while adjusting for age and body mass index. RESULTS Burnout and job stress were significantly and independently associated with endothelium-dependent microvascular function. Burnout was positively associated with coronary flow reserve, myocardial blood flow response, and hyperemic myocardial blood flow (r partial = 0.28 to 0.35; p-value = 0.008 to 0.035). Effort-reward ratio (r partial = - 0.32 to - 0.38; p-value = 0.004 to 0.015) and overcommitment (r partial = - 0.30 to - 0.37; p-value = 0.005 to 0.022) showed inverse associations with these measures. CONCLUSIONS In male physicians, burnout and high job stress showed opposite associations with coronary microvascular endothelial function. Longitudinal studies are needed to show potential clinical implications and temporal relationships between work-related variables and coronary microvascular function. Future studies should include burnout and job stress for a more nuanced understanding of their potential role in cardiovascular health.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland.
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
| | - Sarah A Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
| | - Chrysoula Garefa
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexia Rossi
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dominik C Benz
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas A Giannopoulos
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Philipp A Kaufmann
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ronny R Buechel
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse 8, CH-8091, Zurich, Switzerland
- Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Yu J, Leka S. Where is the limit for overtime? Impacts of overtime on employees' mental health and potential solutions: A qualitative study in China. Front Psychol 2022; 13:976723. [PMID: 36600714 PMCID: PMC9806229 DOI: 10.3389/fpsyg.2022.976723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Although Labor Law of the People's Republic of China stipulates the overtime system, overtime is still widespread in the IT industry. Through qualitative interviews, we explored the impact of overtime on employees' mental health and life. The current study identified four main themes, namely overtime reasons, outcomes of overtime, influential factors and solutions to overtime challenges. Besides work-related reasons and cultural influence, it was found that employees may work overtime due to personal reasons, such as capability and personal qualities; the most frequent impacts reported were fatigue, depression, stress and interference with life; three predominant influential factors were timing of overtime, control and rewards; and overtime conditions could be improved in practical and emotional ways. The study's findings highlight the importance of the design of flexible working time arrangements for avoiding fatigue and improving employees' work-life balance, enhancement of schedule arrangement for avoiding daily work interruption and last-minute tasks, and optimization of rewarding systems for avoiding complaints and facilitating voluntary overtime. Results suggest that mental health and work-life balance can be promoted by organizational initiatives focusing on minimizing excessive job demands, increasing psychosocial resources, supporting boundary management, and enhancing perceived flexibility.
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Affiliation(s)
- Jiaoyang Yu
- School of Education, Taiyuan Normal University, Jinzhong, China,*Correspondence: Jiaoyang Yu,
| | - Stavroula Leka
- Business School, University College Cork, Cork, Ireland,School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Zhu D, Wang J, Zhao Y, Yang L, Gao J, Chang X, Li S, Zheng Y. The Status of Occupational Stress and Its Influence on the Health of Medical Staff in Lanzhou, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10808. [PMID: 36078517 PMCID: PMC9518311 DOI: 10.3390/ijerph191710808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to understand the status quo of occupational stress and its impact on the health of medical staff and provide a theoretical basis for relieving occupational stress and improving the health status of medical staff. The occupational stress and health status of medical staff in 14 hospitals in Lanzhou were studied using a general questionnaire, Effort-Reward Imbalance questionnaire, and Self-Rated Health Measurement Scale. A total of 2169 participants were included in the analysis, and 59.4% of the medical staff experienced occupational stress. The results of the occupational stress survey showed that the prevalence of occupational stress among medical staff aged 40-50, with a master's degree or above, senior professional title, working for 10-20 years, and working more than 48 h per week was higher than in the other groups. The health survey results showed that, compared with other groups, the scores of physical, mental, and social health were lower in medical staff with working years of 10-20 years and working hours of more than 48 h per week. The results show that working years and working hours per week affect not only the level of occupational stress but also physiological, psychological, and social health.
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Affiliation(s)
- Dongsheng Zhu
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Jinyu Wang
- School of Basic Medical Science, Lanzhou University, Lanzhou 730000, China
| | - Yurui Zhao
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Lu Yang
- School of Public Health, Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Jinxia Gao
- Lanzhou Municipal Center for Disease Control, Lanzhou 730030, China
| | - Xuhong Chang
- Department of Toxicology, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Sheng Li
- Department of Public Health, The First People’s Hospital of Lanzhou, Lanzhou 730050, China
| | - Yanni Zheng
- Department of Public Health, The First People’s Hospital of Lanzhou, Lanzhou 730050, China
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6
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Meta-analysis of effort–reward imbalance prevalence among physicians. Int Arch Occup Environ Health 2022; 95:559-571. [DOI: 10.1007/s00420-021-01784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/02/2021] [Indexed: 11/05/2022]
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7
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Tian M, Zhou X, Yin X, Jiang N, Wu Y, Zhang J, Lv C, Gong Y. Effort-Reward Imbalance in Emergency Department Physicians: Prevalence and Associated Factors. Front Public Health 2022; 10:793619. [PMID: 35198522 PMCID: PMC8858846 DOI: 10.3389/fpubh.2022.793619] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/03/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To examine the prevalence of effort-reward imbalance and explore its associated factors among emergency department physicians in China. Methods A cross-sectional survey was conducted in the Chinese emergency department in 2018. A total of 10,457 emergency department physicians completed a structured questionnaire containing demographic characteristics, work-related data, and effort-reward imbalance scale. All the data were analyzed using descriptive analysis and stepwise logistic regression. Results The prevalence of effort-reward imbalance was 78.39% among emergency department physicians in China. The results showed that the male emergency department physicians with a bachelor's degree, an intermediate title, long years of service, a high frequency of night shift, and who suffered workplace violence were at a higher risk of effort-reward imbalance. In contrast, physicians with higher monthly income and perceived adequate staff were associated with a lower risk of effort-reward imbalance. Conclusions The situation of effort-reward imbalance was serious among emergency department physicians in China. Administrators should pay more attention to key groups and take measures from the perspectives of effort and reward to improve the effort-reward imbalance in emergency department physicians.
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Affiliation(s)
- Mengge Tian
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yafei Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiali Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanzhu Lv
- Department of Emergency Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, China
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China
- Chuanzhu Lv
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Yanhong Gong
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Saade S, Parent-Lamarche A, Bazarbachi Z, Ezzeddine R, Ariss R. Depressive symptoms in helping professions: a systematic review of prevalence rates and work-related risk factors. Int Arch Occup Environ Health 2022; 95:67-116. [PMID: 34686912 PMCID: PMC8535108 DOI: 10.1007/s00420-021-01783-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study is twofold. Our first aim is to provide an overview of the prevalence rate of depression in a wide array of helping professions. Our second aim is to identify work organization conditions that seem to be associated with this depression risk. METHODS Four databases were searched (CINAHL, PsycInfo, PubMed, and Web of Science) yielding 87,626 records in total. We were interested in identifying depression prevalence rates and work-related variables that have been found to contribute to depression in helping professions. RESULTS In total, this systematic review included 17,437 workers in more than 29 countries. Depression prevalence rate varied between 2.5% and 91.30%. The two most frequently reported professions were nurses and doctors with 73.83% and 30.84% of studies including nurses and doctors in their sample. Work factors contributing to depression included: skill utilization, decision authority, psychological demands, physical demands, number of hours worked, work schedule (irregular or regular), work schedule (daytime or night time), social support from coworkers, social support from supervisor and the family, job insecurity, recognition, job promotion, and bullying. CONCLUSION The results of this study highlight alarmingly high rates of depression in helping professions and should serve as a reminder to pay close attention to the mental health of those workers. Investing in employees' mental health by preventing and reducing depression risk could prove to be a valuable investment from an employer's point of view, as it is likely to increase productivity and reduce absenteeism among a host of other positive outcomes.
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Affiliation(s)
- Sabine Saade
- Department of Psychology, American University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut, 1107 2020 Lebanon
| | - Annick Parent-Lamarche
- Département de Gestion des Ressources Humaines, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, QC G8Z 4M3 Canada
| | - Zeina Bazarbachi
- American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020 Lebanon
| | - Ruba Ezzeddine
- American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020 Lebanon
| | - Raya Ariss
- American University of Beirut, Riad El-Solh, P.O. Box 11-0236, Beirut, 1107 2020 Lebanon
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Fukuzaki T, Iwata N, Ooba S, Takeda S, Inoue M. The Effect of Nurses' Work-Life Balance on Work Engagement: The Adjustment Effect of Affective Commitment. Yonago Acta Med 2021; 64:269-281. [PMID: 34429703 DOI: 10.33160/yam.2021.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/17/2021] [Indexed: 11/05/2022]
Abstract
Background This study aimed to examine the effects of nurses' work-life balance (WLB), job demands and resources, and organizational attachment on their work engagement (WE). The second aim was to shed light on whether the relationships among WLB, job demands, resources, and WE are modulated by organizational attachment. Methods In total, 425 nurses working in a university hospital responded to the questionnaire. The primary statistical analysis method was hierarchical multiple regression with WE as the dependent variable. Results In the model in which all variables were applied, affective commitment (AC) (β = 0.41), family-to-work positive spillover (β = 0.25), and number of children (β = 0.13) were found to have a significant association with WE. Family-to-work negative spillover (FWNS) and AC had significant interaction effects. The result suggests that when AC was low, WE tended to decline further due to FWNS; however, when AC was high, WE did not change due to the effect of FWNS. Conclusion These results confirmed that to improve nurses' WE, hospital organizations should implement initiatives to facilitate WLB that considers nurses' household roles. Furthermore, high organizational attachment buffered the home's negative influence on work, thereby helping nurses work energetically.
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Affiliation(s)
- Toshiki Fukuzaki
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503 Japan
| | - Noboru Iwata
- Faculty of HealthCare, Kiryu University, Midori 379-2392 Japan
| | - Sawako Ooba
- Work-Life Balance Support Center, Tottori University Hospital, Yonago 683-8504 Japan
| | - Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503 Japan
| | - Masahiko Inoue
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Yonago 683-8503 Japan
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Maladaptive Schemata und berufliche Gratifikationskrisen bei ÄrztInnen und PsychotherapeutInnen. PSYCHOTHERAPEUT 2020. [DOI: 10.1007/s00278-020-00468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Hintergrund
Laut Studienlage leiden ÄrztInnen häufig an Arbeitsstress und Burn-out. Gründe dafür liegen v. a. in den Arbeitsbedingungen. Daneben spielen „intrinsische“ Faktoren eine Rolle. Frühe maladaptive Schemata (MS) können als Marker für intrinsische Belastungen dienen. Ein Schema umfasst dauerhafte, ungünstige Muster von Gefühlen, Gedanken und Erinnerungen, die das Verhalten in einer konkreten Situation steuern. Der Beitrag soll eine systematische Übersicht über die internationale Studienlage zu Gratifikationskrisen und MS bei ÄrztInnen/PsychotherapeutInnen (PT) geben.
Material und Methoden
Systematische Literaturrecherche von 2000 bis 2020 in PubMed, Psyndex und Google Scholar. Eine Registrierung erfolgte bei OSF-Registries (osf.io/jxhga/). Suchbegriffe waren: „schema“, „maladaptive schema“, kombiniert mit „physician“, „psychiatrist“, „psychotherapist“, „psychologist“, als weitere Suche verknüpft mit „effort reward (imbalance)“ bzw. „effort-reward (imbalance)“.
Ergebnisse
In der ersten Suche wurden 906 Publikationen, in der zweiten 1088 Veröffentlichungen gefunden. Durch Filtern von Duplikaten, Screening von Abstracts und Inhalten dezimierte sich die Zahl auf 2 Publikationen. Mithilfe vor- und rückwärts gerichteter Suche wurden 5 weitere Arbeiten und damit insgesamt 7 relevante Publikationen identifiziert.
Schlussfolgerung
Bislang gibt es wenige Untersuchungen, die sich mit MS im Zusammenhang mit beruflichem Stress und mentaler Gesundheit bei ÄrztInnen/PT beschäftigen. Insbesondere das vielschichtige Konzept der Schemata erscheint aussagekräftiger als eher eindimensionale Persönlichkeitszüge. Intrinsische Faktoren haben eine große Bedeutung, wenn es um die Entwicklung von Präventions- und Hilfsmaßnahmen für belastete ÄrztInnen/PT geht.
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Pereira-Lima K, Mata DA, Loureiro SR, Crippa JA, Bolsoni LM, Sen S. Association Between Physician Depressive Symptoms and Medical Errors: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e1916097. [PMID: 31774520 PMCID: PMC6902829 DOI: 10.1001/jamanetworkopen.2019.16097] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE Depression is highly prevalent among physicians and has been associated with increased risk of medical errors. However, questions regarding the magnitude and temporal direction of these associations remain open in recent literature. OBJECTIVE To provide summary relative risk (RR) estimates for the associations between physician depressive symptoms and medical errors. DATA SOURCES A systematic search of Embase, ERIC, PubMed, PsycINFO, Scopus, and Web of Science was performed from database inception to December 31, 2018. STUDY SELECTION Peer-reviewed empirical studies that reported on a valid measure of physician depressive symptoms associated with perceived or observed medical errors were included. No language restrictions were applied. DATA EXTRACTION AND SYNTHESIS Study characteristics and RR estimates were extracted from each article. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using subgroup meta-analysis and metaregression. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. MAIN OUTCOMES AND MEASURES Relative risk estimates for the associations between physician depressive symptoms and medical errors. RESULTS In total, 11 studies involving 21 517 physicians were included. Data were extracted from 7 longitudinal studies (64%; with 5595 individuals) and 4 cross-sectional studies (36%; with 15 922 individuals). The overall RR for medical errors among physicians with a positive screening for depression was 1.95 (95% CI, 1.63-2.33), with high heterogeneity across the studies (χ2 = 49.91; P < .001; I2 = 82%; τ2 = 0.06). Among the variables assessed, study design explained the most heterogeneity across studies, with lower RR estimates associated with medical errors in longitudinal studies (RR, 1.62; 95% CI, 1.43-1.84; χ2 = 5.77; P = .33; I2 = 13%; τ2 < 0.01) and higher RR estimates in cross-sectional studies (RR, 2.51; 95% CI, 2.20-2.83; χ2 = 5.44; P = .14; I2 = 45%; τ2 < 0.01). Similar to the results for the meta-analysis of physician depressive symptoms associated with subsequent medical errors, the meta-analysis of 4 longitudinal studies (involving 4462 individuals) found that medical errors associated with subsequent depressive symptoms had a pooled RR of 1.67 (95% CI, 1.48-1.87; χ2 = 1.85; P = .60; I2 = 0%; τ2 = 0), suggesting that the association between physician depressive symptoms and medical errors is bidirectional. CONCLUSIONS AND RELEVANCE Results of this study suggest that physicians with a positive screening for depressive symptoms are at higher risk for medical errors. Further research is needed to evaluate whether interventions to reduce physician depressive symptoms could play a role in mitigating medical errors and thus improving physician well-being and patient care.
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Affiliation(s)
- Karina Pereira-Lima
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Douglas A. Mata
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sonia R. Loureiro
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José A. Crippa
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lívia M. Bolsoni
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Srijan Sen
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
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Leutgeb R, Frankenhauser-Mannuß J, Scheuer M, Szecsenyi J, Goetz K. Job satisfaction and stressors for working in out-of-hours care - a pilot study with general practitioners in a rural area of Germany. BMC FAMILY PRACTICE 2018; 19:95. [PMID: 29933743 PMCID: PMC6015473 DOI: 10.1186/s12875-018-0777-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 05/25/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Challenging work environment, high workload, and increasing physician shortages characterize current rural general practice in Germany and in most European Countries. These factors extend into Out-Of-Hours Care (OOHC). However, little research about potential stressors for general practitioners (GPs) in OOHC settings is available. This pilot study aimed to evaluate workload, different elements of job satisfaction and stressors for GPs in OOHC and to analyze whether these aspects are associated with overall job satisfaction. METHODS Cross-sectional survey with a sample of 320 GPs who are working in OOHC was used to measure workload in OOHC, job satisfaction (using the Warr-Cook-Wall scale) and stressors with the effort-reward imbalance questionnaire. In order to assess associations between workload, job satisfaction and stressors at work we performed descriptive analyses as well as multivariable regression analyses. RESULTS The response rate was 40.9%. Over 80% agreed that OOHC was perceived as a stressor and 79% agreed that less OOHC improved job satisfaction. Only 42% of our sample were satisfied with their overall job satisfaction. The regression analysis showed that the modification of current OOHC organization was significantly associated with overall job satisfaction. CONCLUSIONS Our results suggest that OOHC in the current form is a relevant stressor in daily work of rural GPs in Germany and one of the reasons for a decreasing overall job satisfaction. Strategic changes such as the implementation of structural reforms e.g. reducing frequency of OOHC duties for each GP and improving continuing professional development options related to OOHC are needed to address current workload challenges experienced by GPs providing OOHC in Germany.
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Affiliation(s)
- R Leutgeb
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - J Frankenhauser-Mannuß
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - M Scheuer
- Headquarter of Control Centre, District Bergstraße, Gräffstrasse 5, 64646, Heppenheim, Germany
| | - J Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Katja Goetz
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius-Arcades, Western Tower, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.,Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Alle 160, 23538, Luebeck, Germany
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Nguyen Van H, Dinh Le M, Nguyen Van T, Nguyen Ngoc D, Tran Thi Ngoc A, Nguyen The P. A systematic review of effort-reward imbalance among health workers. Int J Health Plann Manage 2018; 33. [PMID: 29722057 DOI: 10.1002/hpm.2541] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 04/06/2018] [Accepted: 04/10/2018] [Indexed: 11/08/2022] Open
Abstract
The purpose of this article is to systematically collate effort-reward imbalance (ERI) rates among health workers internationally and to assess gender differences. The effort-reward (ER) ratio ranges quite widely from 0.47 up to 1.32 and the ERI rate from 3.5% to 80.7%. Many studies suggested that health workers contribute more than they are rewarded, especially in Japan, Vietnam, Greece, and Germany-with ERI rates of 57.1%, 32.3%, 80.7%, and 22.8% to 27.6%, respectively. Institutions can utilize systems such as the new appraisal and reward system, which is based on performance rather than the traditional system, seniority, which creates a more competitive working climate and generates insecurity. Additionally, an increased workload and short stay patients are realities for workers in a health care environment, while the structure of human resources for health care remains inadequate. Gender differences within the ER ratio can be explained by the continued impact of traditional gender roles on attitudes and motivations that place more pressure to succeed for men rather than for women. This systematic review provides some valued evidence for public health strategies to improve the ER balance among health workers in general as well as between genders in particular. An innovative approach for managing human resources for health care is necessary to motivate and value contributions made by health workers.
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Affiliation(s)
- Huy Nguyen Van
- Department of Health Management and Organization, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Mai Dinh Le
- Department of Hospital Quality Management, Vietnam National Cancer Hospital, Hanoi, Vietnam
| | - Thanh Nguyen Van
- Department of Vaccination, Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Dung Nguyen Ngoc
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Tran Thi Ngoc
- Center for Assessment and Quality Assurance in Education, Hanoi Medical University, Hanoi, Vietnam
| | - Phuong Nguyen The
- Research Department, Center for Community Health Research and Development, Hanoi, Vietnam
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Associations of psychosocial working conditions with health outcomes, quality of care and intentions to leave the profession: results from a cross-sectional study among physician assistants in Germany. Int Arch Occup Environ Health 2018; 91:643-654. [PMID: 29691658 DOI: 10.1007/s00420-018-1309-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/18/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Numerous epidemiological studies among health care staff have documented associations of adverse psychosocial working conditions with poorer health-related outcomes, a reduced quality of patient care and intentions to leave the profession. The evidence for physician assistants in Germany remains limited though. METHODS We surveyed a total of 994 physician assistants between September 2016 and April 2017. Psychosocial working conditions were measured by the established effort-reward imbalance (ERI) questionnaire and by a questionnaire specifically developed to capture psychosocial working conditions among physicians. Health outcomes (i.e., self-rated health, depression, anxiety), self-rated quality of care and the intention to leave the profession were assessed by established measures. We ran multivariable logistic regression analyses. RESULTS The prevalence of work stress in terms of ERI equalled 73.77%. Work stress according to the ERI model was associated with significantly poorer self-rated health [odds ratio (OR) 3.62], elevated symptoms of depression (OR 8.83) and anxiety (OR 4.95), poorer quality of care (OR for medical errors 4.04; OR for interference of work with patient care 3.88) and an increased intention to leave one's current profession (OR 3.74). The PA-specific questionnaire showed similar, albeit weaker, associations (all ORs > 1.22). CONCLUSIONS Our results are in line with previous findings among health care staff and provide specific and novel evidence for physician assistants. Interventions aiming at the improvement of working conditions seem needed given their potential adverse consequences in terms of employee health, quality of care, and personnel policy.
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Weiß EE, Süß S. Protective faith? The role of religiosity in the stressor-strain relationship in helping professions. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2017. [DOI: 10.1080/09585192.2017.1325387] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Eva-Ellen Weiß
- Chair of Business Administration, Organization Studies and Human Resource Management, Heinrich-Heine-University of Duesseldorf, Düsseldorf, Germany
| | - Stefan Süß
- Chair of Business Administration, Organization Studies and Human Resource Management, Heinrich-Heine-University of Duesseldorf, Düsseldorf, Germany
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Abstract
BACKGROUND Psychosocial factors have been shown to predict a poor disease course in patients with inflammatory bowel disease (IBD), but whether this applies to job stress is currently unknown. We assessed the prevalence of job stress and its correlates in a large cohort of patients with IBD. METHODS We included all adult, professionally active patients enrolled between 2006 and 2015 in the Swiss IBD Cohort. Job stress was measured through the self-report effort-reward imbalance ratio and overcommitment (OC) to work questionnaires. We used multiple linear regressions to assess association with sociodemographic, lifestyle, psychosocial, and disease-related factors. RESULTS Altogether 1656 patients completed the questionnaires (905 Crohn's disease and 751 ulcerative colitis/IBD unclassified). Only 91 (5.7%) of patients had an effort-reward imbalance ratio >1. Effort-reward imbalance and OC scores were higher in full-time versus part-time employees (coef = 0.050, P = 0.002; coef = 0.906, P < 0.001) and among those absent from the workplace in the previous 3 months (coef = 0.049, P = 0.010; coef = 1.062, P < 0.001). Higher OC scores were associated with sex (women vs. men: coef = 0.568, P = 0.014), being in a relationship (coef = 0.805, P = 0.001), higher level of occupation (director vs. trainee: coef = 1.447, P < 0.001), and extraintestinal manifestations (coef = 0.623, P = 0.005). Patients hospitalized in the previous 12 months had lower OC scores (coef = 0.560, P = 0.038). CONCLUSIONS The average level of job stress seems to be remarkably low in patients with IBD from Switzerland. The clinician should turn attention especially to women, full-time employees with a high level of education, and patients with extraintestinal manifestations to identify those with the most vulnerability to suffer from job stress.
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Lepnurm R, Dobson RT, Peña-Sánchez JN, Nesdole R. Modeling factors explaining physicians' satisfaction with competence. SAGE Open Med 2015; 3:2050312115613352. [PMID: 27092256 PMCID: PMC4821212 DOI: 10.1177/2050312115613352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 09/24/2015] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Attention to physician wellness has increased as medical practice gains in complexity. Physician satisfaction with practice is critical for quality of care and practice growth. The purpose of this study was to model physicians' self-reported Satisfaction with Competence as a function of their perceptions of the Quality of Health Services, Distress, Coping, Practice Management, Personal Satisfaction and Professional Equity. METHODS Comprehensive questionnaires were sent to a stratified sample of 5300 physicians across Canada. This cross-sectional study focused on physicians who examined and treated individual patients for a final study population of 2639 physicians. Response bias was negligible. The questionnaires contained measures of Satisfaction with Competence, Quality of Health Services, Distress, Coping, Personal Satisfaction, Practice Management and Professional Equity. Exploring relationships was done using Pearson correlations and one-way analysis of variance. Modeling was by hierarchical regressions. RESULTS The measures were reliable: Satisfaction with Competence (α = .86), Quality (α = .86), Access (α = .82), Distress (α = .82), Coping (α = .76), Personal Satisfaction (α = .78), Practice Management (α = .89) and the dimensions of Professional Equity (Fulfillment, α = .81; Financial, α = .93; and Recognition, α = .75) with comparative validity. Satisfaction with Competence was positively correlated with Quality (r = .32), Efficiency (r = .37) and Access (r = .32); negatively correlated with Distress (r = -.54); and positively correlated with Coping strategies (r = .43), Personal Satisfaction (r = .57), Practice Management (r = .17), Fulfillment (r = .53), Financial (r = .36) and Recognition (r = .54). Physicians' perceptions on Quality, Efficiency, Access, Distress, Coping, Personal Satisfaction, Practice Management, Fulfillment, Pay and Recognition explained 60.2% of the variation in Satisfaction with Competence, controlling for years in practice, self-reported health and duties of physicians. CONCLUSION Satisfaction with Competence could be affected by excessive accumulation of duties, concerns about quality, efficiency, access, excessive distress, inadequate coping abilities, personal satisfaction with life as a physician, challenges in managing practices and persistent inequities among physicians.
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Affiliation(s)
- Rein Lepnurm
- MERCURi Research Group, School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Roy Thomas Dobson
- MERCURi Research Group, School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
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du Prel JB, March S, Schröder H, Peter R. [Occupational gratification crisis and sickness absence in Germany: Cross-sectional results from the lidA-study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58:996-1004. [PMID: 26133162 DOI: 10.1007/s00103-015-2207-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Demographic change is leading to a shrinking and ageing workforce in industrialized nations. Therefore, sickness absence may become a relevant problem. Increasing absenteeism and retirement rates due to mental disorders raise the question of an association between work-related stress and sickness absence. Studies on this matter, particularly in older employees, are rare. OBJECTIVES We studied for the first time in Germany the relationship between effort-reward imbalance (ERI) and overall or long-term sickness absence. MATERIALS AND METHODS LidA ( "Living at Work") is a German cohort study on work, age, health, and work participation. A total of 6,339 employees born in 1959 and 1965 who were subject to social insurance contributions were interviewed nationwide using a representative sample concept. The response rate was 27.3 %. The sample showed high representativeness and no selectivity relating to 16 sociodemographic items. Sickness absence was defined as at least one long-term sickness absence with at least 43 days of absenteeism. Work-related stress was parameterized by ERI tertiles. Multiple logistic regression adjusting for age, sex, mental disorders, social status, and working time was performed. RESULTS High levels of work-related stress were significantly associated with overall and long-term sickness absence among older employees after adjusting for covariates. CONCLUSIONS Our unique findings on work-related stress and sickness absence in Germany are in agreement with the results of most international studies. Reducing work-related stress could help to preserve the workforce.
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Affiliation(s)
- Jean-Baptist du Prel
- Institut für Sicherheitstechnik, Bergische Universität Wuppertal, Gaußstraße 20, 42119, Wuppertal, Deutschland,
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Park SK, Rhee MK, Barak MM. Job stress and mental health among nonregular workers in Korea: What dimensions of job stress are associated with mental health? ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2014; 71:111-118. [PMID: 25513849 DOI: 10.1080/19338244.2014.997381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Although nonregular workers experience higher job stress, poorer mental health, and different job stress dimensions relative to regular workers, little is known about which job stress dimensions are associated with poor mental health among nonregular workers. This study investigated the association between job stress dimensions and mental health among Korean nonregular workers. Data were collected from 333 nonregular workers in Seoul and Gyeonggi Province, and logistic regression analysis was conducted. Results of the study indicated that high job insecurity and lack of rewards had stronger associations with poor mental health than other dimensions of job stress when controlling for sociodemographic and psychosocial variables. It is important for the government and organizations to improve job security and reward systems to reduce job stress among nonregular workers and ultimately alleviate their mental health issues.
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Affiliation(s)
- Soo Kyung Park
- a Department of Social Welfare , Daejin University , Pocheon-si , South Korea
| | - Min-Kyoung Rhee
- b School of Social Work, University of Southern California , Los Angeles , California , USA
| | - Michàlle Mor Barak
- b School of Social Work, University of Southern California , Los Angeles , California , USA
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Are effort-reward imbalance and social isolation mediating the association between education and depressiveness? Baseline findings from the lidA(§)-study. Int J Public Health 2014; 59:945-55. [PMID: 25323321 DOI: 10.1007/s00038-014-0613-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 09/25/2014] [Accepted: 09/29/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES To investigate multiple mediations of the association between education and depressive symptoms (BDI-V) by work-related stress (ERI) and social isolation, the regional variation of the first mediation and a potential moderating effect of regional unemployment rate. METHODS 6339 employees born in 1959 and 1965 were randomly recruited from 222 sample points in a German cohort study on work, age, health and work participation. A multilevel model of moderated lower-level mediation was used to investigate the confirmatory research question. Multiple mediations were tested corresponding to Baron and Kenny. These analyses were stratified for age and adjusted for sex, negative affectivity and overcommitment. RESULTS In the association between education and depressive symptoms, indirect effects of work-related stress and social isolation were significant in both age cohorts whereas a direct association was observable in the younger cohort, only. The significant regional variation in the association between work-related stress and depressive symptoms was not statistically explained by regional unemployment rate. CONCLUSIONS Our findings point out that work-related stress and social isolation play an intermediary role between education and depressive symptoms in middle-aged employees.
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Ding Y, Qu J, Yu X, Wang S. The mediating effects of burnout on the relationship between anxiety symptoms and occupational stress among community healthcare workers in China: a cross-sectional study. PLoS One 2014; 9:e107130. [PMID: 25211025 PMCID: PMC4161428 DOI: 10.1371/journal.pone.0107130] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/03/2014] [Indexed: 12/04/2022] Open
Abstract
Background Several occupational stress studies of healthcare workers have predicted a high prevalence of anxiety symptoms, which can affect their quality of life and the care that they provide. However, few studies have been conducted among community healthcare workers in China. We attempted to explore whether burnout mediates the association between occupational stress and anxiety symptoms. Methods A cross-sectional survey was completed in Liaoning Province, China from November to December 2012. A total of 1,752 healthcare workers from 52 Community Health Centers participated in this study, and all participants were given self-administered questionnaires. These questionnaires addressed the following aspects: the Zung Self-Rating Anxiety Scale, the Chinese version of the effort-reward imbalance scale and the Maslach Burnout Inventory–General Survey. Finally, the study included 1,243 effective respondents (effective response rate, 70.95%). Hierarchical linear regression analysis, performed with SPSS 17.0, was used to estimate the effect of burnout. Results The prevalence of anxiety symptoms among the community healthcare workers was 38.0%. After adjusting for demographic characteristics, the effort–reward ratio and overcommitment positively predicted anxiety symptoms. Meanwhile, the effort–reward ratio and overcommitment were positively related to the emotional exhaustion and cynicism subscales of burnout. In addition, the emotional exhaustion and cynicism subscales were positively related to anxiety symptoms. Thus, there is a link between burnout, occupational stress and anxiety symptoms. Conclusions Burnout mediates the effect of occupational stress on anxiety symptoms. To effectively reduce the impact of occupational stress on anxiety symptoms, burnout management should be considered.
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Affiliation(s)
- Yanwei Ding
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Jianwei Qu
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
| | - Xiaosong Yu
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
- * E-mail:
| | - Shuang Wang
- Department of General Practice, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China
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du Prel JB, Peter R. Work-family conflict as a mediator in the association between work stress and depressive symptoms: cross-sectional evidence from the German lidA-cohort study. Int Arch Occup Environ Health 2014; 88:359-68. [DOI: 10.1007/s00420-014-0967-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 07/17/2014] [Indexed: 11/30/2022]
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Hasselhorn HM, Peter R, Rauch A, Schröder H, Swart E, Bender S, du Prel JB, Ebener M, March S, Trappmann M, Steinwede J, Müller BH. Cohort profile: the lidA Cohort Study-a German Cohort Study on Work, Age, Health and Work Participation. Int J Epidemiol 2014; 43:1736-49. [PMID: 24618186 PMCID: PMC4276057 DOI: 10.1093/ije/dyu021] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx).
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Affiliation(s)
- Hans Martin Hasselhorn
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Richard Peter
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Angela Rauch
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Helmut Schröder
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Enno Swart
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Stefan Bender
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Jean-Baptist du Prel
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Melanie Ebener
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Stefanie March
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Mark Trappmann
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Jacob Steinwede
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bernd Hans Müller
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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24
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Li J, Weigl M, Glaser J, Petru R, Siegrist J, Angerer P. Changes in psychosocial work environment and depressive symptoms: a prospective study in junior physicians. Am J Ind Med 2013; 56:1414-22. [PMID: 24038041 DOI: 10.1002/ajim.22246] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2013] [Indexed: 11/12/2022]
Abstract
BACKGROUND We examined the impact of changes in the psychosocial work environment on depressive symptoms in a sample of junior physicians, a high risk group for stress and mental disorders. METHODS This is a three-wave prospective study in 417 junior physicians during their residency in German hospitals. The psychosocial work environment was measured by the Effort-Reward Imbalance (ERI) Questionnaire at Waves 1 and 2, and the depressive symptoms were assessed with the State-Trait Depression Scales at all three waves. Multivariate linear regression was applied for prospective associations between ERI across Waves 1 and 2, and baseline-adjusted depressive symptoms at Wave 3. RESULTS Compared with the ERI scores at Wave 1, at Wave 2, and mean scores between the two waves, the baseline-adjusted ERI change scores between the two waves showed slightly better statistical power, predicting depressive symptoms at Wave 3 (β = 0.78, 95% CI = 0.38-1.18 for increased ERI per SD, β = 0.64, 95% CI = 0.22-1.06 for increased effort per SD, β = -0.65, 95% CI = -1.06 to -0.24 for increased reward per SD, and β = 0.68, 95% CI = 0.27-1.09 for increased overcommitment per SD). CONCLUSIONS Negative changes in the psychosocial work environment, specifically increased ERI, are associated with depressive symptoms in German junior physicians. Reducing the non-reciprocity of working life, particularly improving reward at work, may have beneficial effects on prevention of mental health problems in the hospital workplace.
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Affiliation(s)
- Jian Li
- Institute of Occupational and Social Medicine; Center for Health and Society; Faculty of Medicine; University of Düsseldorf; Düsseldorf Germany
- Institute of Medical Sociology; Center for Health and Society; Faculty of Medicine; University of Düsseldorf; Düsseldorf Germany
| | - Matthias Weigl
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine; Ludwig-Maximilians-University; Munich Germany
| | - Jürgen Glaser
- Institute of Psychology; University of Innsbruck; Innsbruck Austria
| | - Raluca Petru
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine; Ludwig-Maximilians-University; Munich Germany
| | - Johannes Siegrist
- Institute of Medical Sociology; Center for Health and Society; Faculty of Medicine; University of Düsseldorf; Düsseldorf Germany
| | - Peter Angerer
- Institute of Occupational and Social Medicine; Center for Health and Society; Faculty of Medicine; University of Düsseldorf; Düsseldorf Germany
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25
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Kurioka S, Inoue A, Tsutsumi A. Optimum cut-off point of the Japanese short version of the effort-reward imbalance questionnaire. J Occup Health 2013; 55:340-8. [PMID: 23892637 DOI: 10.1539/joh.12-0235-oa] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The theoretical threshold (effort-reward ratio >1.0) may not be ideal for the Japanese short version of the effort-reward imbalance (ERI) questionnaire. We aimed to seek the optimum cut-off point. METHODS We administered the original and short versions of the ERI questionnaire with a psychological distress scale to randomly selected workers (n=1,489) in a web-based survey. We evaluated kappa statistics and conducted receiver operating characteristics curve analyses. Cut-off values of the short version effort-reward ratios at 0.1 intervals in the range of 1.0-1.9 were tested using the criterion of an effort-reward ratio >1.0 for the original version. RESULTS The short version questionnaire had acceptable reliabilities. When using the theoretical cut-off point, the prevalence of high-risk groups was 63.2% for the short version compared with 18.9% for the original version, and their agreement was slight. Kappa agreements and receiver operating characteristics curve analyses suggested that a short-version effort-reward ratio of around 1.3 and 1.4 was the most equivalent to the original criterion. Regression equation procedures supported the findings, and ERI defined by the cut-off values showed significant associations with an external criterion (psychological distress) with minimal estimation error. Because the highest but only moderate kappa agreements with the risk group defined by the original criterion were obtained when setting 1.4-1.6 as the cut-offs, we considered >1.4 as optimal. CONCLUSIONS This empirical investigation suggests the cut-off value of >1.4 for the Japanese short version of the ERI questionnaire screens out the ERI group with the most compatibility with the original version.
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Affiliation(s)
- Sumiko Kurioka
- Department of Health Policy and Management, Graduate School of Medical Science, University of Occupational and Environmental Health
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26
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Shen LL, Lao LM, Jiang SF, Yang H, Ren LM, Ying DGC, Zhu SZ. A survey of anxiety and depression symptoms among primary-care physicians in China. Int J Psychiatry Med 2013; 44:257-70. [PMID: 23586280 DOI: 10.2190/pm.44.3.f] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Anxiety and depression disorder are the most prevalent mental health problems. However, few studies are available pertaining to these problems among Chinese doctors, especially the assessment of the anxiety and depression symptoms among primary-care providers. The aim of this study was to assess the anxiety and depression symptoms among Chinese primary-care physicians and their associated factors. METHODS A cross-sectional study was conducted among 451 primary-care physicians in Shanghai China (effective response rate was 79.8%). There were 177 male physicians and 274 female physicians with average age of 37.8 (SD +/- 11.1) years. Questionnaire pertaining to depression disorder was indicated by the Zung Self-Rating Depression Scale (SDS) and anxiety disorder was indicated by the Zung Self-Rating Anxiety Scale (SAS). RESULTS The average SAS and SDS standard scores of the primary-care physicians were 41.1 +/- 11.5 and 46.5 +/- 11.8 respectively. Both of the scale scores were higher than those of Chinese national norms (P both < 0.001). SDS standard score > or = 53 and SAS standard score > or = 50 were regarded as screening-positive criteria. SAS and SDS screening positive rates of primary-care physicians were 18.0% and 31.7% respectively. In addition, married/cohabited and divorced/widowed physicians aged over 30 years with educational background of junior college had higher risks of anxiety and depression disorders. CONCLUSIONS Chinese primary-care physicians were at considerably high risk of anxiety and depression disorders, which was worthy of attention during healthcare system reform in China.
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Affiliation(s)
- Liang-Liang Shen
- Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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27
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Msaouel P, Keramaris NC, Apostolopoulos AP, Syrmos N, Kappos T, Tasoulis A, Tripodaki E, Kagiampaki E, Lekkas I, Siegrist J. The Effort‐reward Imbalance Questionnaire in Greek: Translation, Validation and Psychometric Properties in Health Professionals. J Occup Health 2012; 54:119-30. [DOI: 10.1539/joh.11-0197-oa] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Pavlos Msaouel
- Greek Junior Doctors and Health Scientists SocietyGreece
- Department of Internal MedicineJacobi Medical Center, Albert Einstein College of MedicineUSA
| | | | | | | | | | | | | | | | - Ioannis Lekkas
- Greek Junior Doctors and Health Scientists SocietyGreece
| | - Johannes Siegrist
- Department of Medical SociologyUniversity of Dűsseldorf, DűsseldorfGermany
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