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Thielmann B, Pohl R, Böckelmann I. Overcommitment, Work-Related Behavior, and Cognitive and Emotional Irritation in Veterinarians: A Comparison of Different Veterinary Working Fields. Healthcare (Basel) 2024; 12:1514. [PMID: 39120217 PMCID: PMC11312069 DOI: 10.3390/healthcare12151514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/10/2024] Open
Abstract
Mental health is a serious problem among veterinarians. The aim of this study was to analyze work-related behaviors and experience (AVEM), overcommitment (OC), and cognitive and emotional irritation (IS) in different veterinary working fields. The survey included 724 German veterinarians (average age 41.0 ± 9.72 years). Validated questionnaires were used to assess overcommitment, work-related behavior and experience patterns (health-promoting pattern G or S; health-hazardous risk pattern A or B), and irritation in several working fields. A correlation analysis and a multivariate test were performed. Increased OC was observed in 35.8% of veterinarians (mixed animals vs. inspectors, p = 0.042; small vs. mixed animals, p = 0.001). A total of 66% of veterinarians exhibited AVEM risk pattern A or B. There was no significant association of AVEM risk patterns and veterinary specialty. Only the AVEM dimension "tendency toward resignation in the face of failure" differed among working fields (p = 0.04). Regardless of direct animal contact, German veterinarians showed increased psychological stress. Inadequate compensation and prolonged stress are significant factors that can lead to burnout or depression. These risks should be considered in the context of occupational healthcare.
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Affiliation(s)
- Beatrice Thielmann
- Institute of Occupational Medicine, Otto von Guericke University Magdeburg, Medical Faculty, Leipziger Str. 44, 39120 Magdeburg, Germany; (R.P.); (I.B.)
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Hubner FCL, Telles RW, Giatti L, Machado LAC, Griep RH, Viana MC, Barreto SM, Camelo LV. Job stress and chronic low back pain: incidence, number of episodes, and severity in a 4-year follow-up of the ELSA-Brasil Musculoskeletal cohort. Pain 2024:00006396-990000000-00610. [PMID: 38787636 DOI: 10.1097/j.pain.0000000000003276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/02/2024] [Indexed: 05/26/2024]
Abstract
ABSTRACT We investigated the association between job stress, as assessed by the effort-reward imbalance model, and the incidence of chronic low back pain (CLBP) over a 4-year period. A total of 1733 participants from the ELSA-Brasil Musculoskeletal cohort, who were free from LBP at baseline (2012-2014), were included. Episodes of LBP in the past 30 days, intensity, and the presence of disability were investigated in annual telephone follow-ups (2015-2018). Chronic LBP was defined as episodes of LBP lasting >3 months with at least moderate intensity. We analyzed the incidence of at least one episode of CLBP (yes/no), the number of CLBP episodes (0, 1, ≥2), and CLBP severity/disability (absent, nondisabling, severe/disabling). The association between these outcomes and tertiles of the effort-to-reward ratio, as well as each dimension of the effort-reward imbalance model, was investigated using multinomial logistic and Poisson regression models adjusting for sociodemographic and occupational variables. The cumulative incidence of CLBP over 4 years was 24.8%. High effort-reward imbalance increased the chances of experiencing multiple CLBP episodes and severe/disabling CLBP by 67% (95% confidence interval [CI]: 1.12-2.47) and 70% (95% CI: 1.14-2.53), respectively. High overcommitment increased the incidence of CLBP by 23% (95% CI: 1.01-1.50) and the chances of multiple CLBP episodes and severe/disabling CLBP by 67% (95% CI: 1.11-2.50) and 57% (95% CI: 1.05-2.34), respectively. These results indicate that exposure to job stress is associated with a higher incidence, a greater number of episodes, and increased severity of CLBP over a 4-year period. If this association is causal, measures aimed at reducing exposure to job stress are likely to alleviate the burden of CLBP.
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Affiliation(s)
- Fernanda Corsino Lima Hubner
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosa Weiss Telles
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luana Giatti
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luciana A C Machado
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Science Integrity Alliance, Sunrise, FL, United States
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Collective Health, Universidade Federal do Espirito Santo, Vitória, Brazil
| | - Sandhi Maria Barreto
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lidyane V Camelo
- Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade de Medicina and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Vilser M, Gentele S, Mausz I. Putting PhD students front and center: an empirical analysis using the Effort-Reward Imbalance Model. Front Psychol 2024; 14:1298242. [PMID: 38333427 PMCID: PMC10851940 DOI: 10.3389/fpsyg.2023.1298242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/06/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction A doctorate is associated with numerous challenges for many PhD students, including financial insecurities, little support from supervisors, and time pressure. The present study explores well-being of PhD students via the Effort-Reward Imbalance (ERI) model as well as the potential protective factor resilience. Method A web-based questionnaire survey was conducted among 1,275 PhD students from Germany. Data was collected at two measurement points over a six-week follow-up period. Results As hypothesized, overcommitment was found to mediate the relationship between ERI and perceived stress while no mediation effect was found for work engagement. Resilience strengthened the relationship between ERI and overcommitment, especially for an increasing unfavorable ERI, and counterintuitively did not act as a protective factor. Discussion Theoretical and practical implications are discussed, providing a deeper understanding on the ERI model and the negative coping pattern overcommitment in the context of PhD students.
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Affiliation(s)
- Melanie Vilser
- Center for Leadership and People Management, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Selina Gentele
- Center for Leadership and People Management, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Irmgard Mausz
- Center for Leadership and People Management, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Business Psychology and HR, International School of Management, Munich, Germany
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Stress and psychological wellbeing in british police force officers and staff. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03903-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AbstractInformed by the Demand Resources and Individual Effects model (DRIVE; Mark & Smith, 2008), we assessed how work and individual characteristics were associated with perceived job stress, and psychological wellbeing outcomes (e.g., anxiety, depression, positive mood) in a cross-sectional study with two British police forces (N = 852 officers and staff). Work characteristics predicted psychological wellbeing outcomes both directly and indirectly through the perception of job stress. Work resources and individual characteristics moderated the relationships between work demands, perception of job stress and psychological wellbeing outcomes. The associations between perception of work demands, job stress and psychological wellbeing outcomes were improved in police officers and staff who reported moderate-high physical activity behavior. This study added new knowledge to the domain as it was the first to test the DRIVE model in its entirety in an occupational setting. It also provided new insight into the multi-dimensional factors associated with psychological wellbeing in policing. Practically, the findings implied a reduction of work demands, or interventions that target appraisals and/or physical activity might improve psychological wellbeing in police workers.
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Magnavita N, Chiorri C, Karimi L, Karanika-Murray M. The Impact of Quality of Work Organization on Distress and Absenteeism among Healthcare Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13458. [PMID: 36294034 PMCID: PMC9603159 DOI: 10.3390/ijerph192013458] [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: 09/12/2022] [Revised: 10/03/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
The quality of work organization may be responsible not only for reduced productivity but also for an increased risk of mental and physical disorders. This study was aimed at testing this hypothesis. Workers of a local health unit in Italy were asked to fill out the Work Organization Assessment Questionnaire (WOAQ) during their periodic medical examinations in the second half of 2018. On the same occasion, they also completed the Demand/Control/Support (DCS) measure of job strain, the Effort/Reward Imbalance (ERI) questionnaire, and the General Health Questionnaire (GHQ12) to assess psychological health. A total of 345 workers (85.8%) completed the survey. Linear regression analysis showed that the quality of work organization was inversely proportional to psychological health problems (p < 0.001). Occupational stress, measured both by job strain and ERI, was a moderating factor in this relationship. The relationship between the WOAQ and psychological health, moderated by job strain or ERI, remained highly significant even after adjustment for sex, age, social support, and overcommitment. Regression models explained over 40% of the shared variance of the association between quality of work organization and psychological health. The quality of work organization significantly predicted the risk of sickness absence for musculoskeletal disorders (OR = 0.984, CI95% 0.972-0.996) and for other health problems (OR = 0.977, CI95% 0.967-0.988). A continuous improvement of work organization must consider not only the clients' or production needs but also the well-being of workers.
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Affiliation(s)
- Nicola Magnavita
- Postgraduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Department of Woman, Child & Public Health Sciences, Fondazione A. Gemelli IRCCS, 00168 Rome, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genova, 16126 Genova, Italy
| | - Leila Karimi
- School of Applied Health, Psychology Department, RMIT University, Melbourne, VIC 3000, Australia
- School of Medicine and Healthcare Management, Caucasus University, Tbilisi 0141, Georgia
| | - Maria Karanika-Murray
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham NG1 4FQ, UK
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Job stress and chronic and widespread musculoskeletal pain: a cross-sectional analysis from the Brazilian Longitudinal Study of Adult Health Musculoskeletal. Pain 2022; 163:2044-2051. [PMID: 35121698 DOI: 10.1097/j.pain.0000000000002602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/17/2021] [Indexed: 01/05/2023]
Abstract
ABSTRACT Musculoskeletal pain is a global health concern, and work-related psychosocial stress might be a potential contributing factor. This cross-sectional study investigates whether job stress is associated with chronic and widespread musculoskeletal pain in 2051 Brazilian active civil servants included in the Brazilian Longitudinal Study of Adult Health Musculoskeletal (ELSA-Brasil MSK). Job stress was assessed using the Effort-Reward Imbalance (ERI) questionnaire. Associations between ERI domains, categorized into tertiles, and chronic musculoskeletal pain (CMP) at any site and per number of affected sites (0, 1-2, ≥3-multisite pain) and body regions (0, 1-2, 3-generalized pain), were investigated using binary and multinomial logistic regression, adjusted for sociodemographic, occupational, and health covariates. The prevalence of CMP at any site, multisites, and generalized regions was 52.9%, 18.2%, and 9.5%, respectively. After adjustments, the lower the reward and the greater the overcommitment, the higher the odds of CMP at any site. The ERI domains were more strongly associated with multisite and generalized CMP than with CMP at any site. Multisite CMP was associated with lower reward and with greater effort, overcommitment, and effort-reward imbalance ratio. Chronic musculoskeletal pain according to body regions, especially generalized pain, was also associated with ERI domains effort (OR = 2.06; 95%CI = 1.33-3.21), overcommitment (OR = 3.44; 95%CI = 2.20-5.39), and effort-reward imbalance ratio (OR = 2.06; 95%CI = 1.30-3.27). Results reveal an association between job stress not only with CMP at any site but notably with the pain spread to other body sites or regions. Our findings suggest that lowering stress at work and discouraging overcommitment may help reduce the CMP burden, including reduction of CMP spread from one site or region of the body to another.
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Li Y, Zhang F, Feng D. Does Type A personality have a positive or negative impact on the delayed retirement intention of older workers? Australas J Ageing 2022; 41:e406-e413. [PMID: 35899874 DOI: 10.1111/ajag.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/25/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine whether the effects of Type A personality were positive or negative on the intention to delay retirement when taking into account both its direct and indirect effects mediated by occupational stressors and psychological distress. METHODS A cross-sectional survey on the intention to delay retirement, psychological distress, occupational stressors, and Type A personality among 1752 older Chinese workers was conducted, and a structural equation approach was employed to examine these effects. RESULTS The delayed retirement intention of Chinese workers was low (i.e., individuals were unwilling to delay retirement), and the expected retirement age was significantly lower than the official retirement age (i.e., the age when individuals become eligible for government pensions). Type A personality was directly associated with significantly higher intentions to delay retirement, but its indirect effects mediated by occupational stressors and psychological distress were insignificant. CONCLUSIONS The total effects of Type A personality on the intention to delay retirement were positive. Personalized intervention strategies based on Type A personality may be beneficial in motivating the work potential of older workers.
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Affiliation(s)
- Yuqin Li
- School of Philosophy and Social Development, Shandong University, Jinan, China.,Shandong Institute of New Urbanization, Shandong Management University, Jinan, China
| | - Feng Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Thoracic Surgery, Shandong Provincial Hospital, Jinan, China
| | - Danjun Feng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Araújo TM, de Sousa CC, Siegrist J. Stressful work in primary health care and mental health: The role of gender inequities in Brazil. Am J Ind Med 2022; 65:604-612. [PMID: 35524468 DOI: 10.1002/ajim.23360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aims to analyze the association between occupational stressors, evaluated by the Effort-Reward Imbalance Model (ERI), and the occurrence of common mental disorders (CMD) among healthcare workers (HCW), additionally considering mediation by over-commitment from work (OW) and mediation of gender effects by work stressors. METHODS Cross-sectional study, including a random sample of 3343 HCWs, from six municipalities of Bahia, Brazil. The ERI scale measured the occupational stressors (main exposure), and the Self-Reporting Questionnaire (SRQ-20) was used to screen for CMD. Data analysis used Structural Equation Modeling techniques to understand the relationships between gender, occupational stressors, and the occurrence of CMD. RESULTS ERI and OW were associated with CMD. OW mediated the negative effect of ERI on the mental health of HCW. Female workers had higher levels of ERI, OW, and CMD prevalence; the total gender effect on CMD prevalence was mediated by ERI and OW. CONCLUSIONS The findings highlight the association of work psychosocial stressors and CMD among HCW, including partial mediation by OW. Gender inequalities persisted among HCW, with women most exposed to occupational stressors and CMD. ERI and OW partially mediated the effect of gender on CMD.
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Affiliation(s)
- Tânia M. Araújo
- State University of Feira de Santana Feira de Santana Brazil
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Qiu D, Li Y, Li R, He J, Ouyang F, Luo D, Xiao S. Long working hours, work-related stressors and sleep disturbances among Chinese government employees: A large population-based follow-up study. Sleep Med 2022; 96:79-86. [DOI: 10.1016/j.sleep.2022.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 10/18/2022]
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Hultén AM, Bjerkeli P, Holmgren K. Work-related stress and future sick leave in a working population seeking care at primary health care centres: a prospective longitudinal study using the WSQ. BMC Public Health 2022; 22:851. [PMID: 35484592 PMCID: PMC9047382 DOI: 10.1186/s12889-022-13269-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Studying the relationship between work-related stress and sick leave is valuable in identifying and assessing employees at risk of sick leave, but also in developing interventions and taking actions for workers’ health. The overall aim of this study was to analyse the association between work-related stress, measured with the work stress questionnaire (WSQ), and registered sick leave in a working population seeking care at primary health care centres in Sweden. Methods A prospective longitudinal study was performed with 232 employed patients aged 18–64 years seeking care for mental and/or physical health complaints at seven primary health care centres. Bivariate logistic regression analysis adjusted for educational level, occupational class and marital status was performed using questionnaire data on work-related stress and sociodemographic factors collected between May 2015 until January 2016 together with registered sick leave data from a national database. Results High stress due to indistinct organization and conflicts was reported by 21% (n = 49), while 45% (n = 105) reported high stress due to individual demands and commitment. Thirty-six percent were on sick leave for 15 days or more during 12 months after baseline. The odds of being on registered sick leave during this period was approximately twice as high for patients perceiving high stress due to indistinct organization and conflicts (OR 2.25, 95% CI 1.18;4.26), high stress due to individual demands and commitment (OR 2.21, 95% CI 1.28;3.82), low influence at work (OR 2.07, 95% CI 1.20;3.57), or high interference between work and leisure time (OR 2.19, 95% CI 1.27;3.80). Perceiving high stress due to both indistinct organization and conflicts as well as individual demands and commitment quadrupled the odds of sick leave, OR 4.15 (95% CI 1.84; 9.38). Conclusions Work-related stress and sick leave were prevalent among the patients. Perceiving one or more of the work-related stressors and stress increased the odds of registered sick leave between two to four times. Hence, to capture the dynamic interaction between the individual and the work environment, a wide spectrum of factors must be considered. In addition, primary health care could be a suitable arena for preventing sick leave due to work-related stress. Trial registration ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13269-8.
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Affiliation(s)
- Anna-Maria Hultén
- Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Pernilla Bjerkeli
- Department for Public Health Research, University of Skövde, Box 408, 541 28, Skövde, Sweden
| | - Kristina Holmgren
- Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Peng X, Pu Y, Jiang X, Zheng Q, Gu J, Zhou H, Deng D. Analysis of Factors That Influenced the Mental Health Status of Public Health Workers During the COVID-19 Epidemic Based on Bayesian Networks: A Cross-Sectional Study. Front Psychol 2021; 12:755347. [PMID: 34955975 PMCID: PMC8702525 DOI: 10.3389/fpsyg.2021.755347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Public health workers are essential to responding to the coronavirus disease 2019 (COVID-19) epidemic, but research on anxiety and stress among public health workers during the epidemic is limited. This study aimed to evaluate related factors affecting mental health among public health workers during the epidemic. Methods: Between February 19 and 25, 2020, an online, cross-sectional study was conducted among public health workers in a city in China. Mental health status was assessed using the Chinese versions of the Generalized Anxiety Disorder-7 (GAD-7) scale and Patient Health Questionnaire-9 (PHQ-9), both with a cutoff score of 5. Work-related variables, workloads and sacrifices, and personal perceptions were also assessed. Results: The prevalence of anxiety and depression were 49.2% and 45.7%, respectively, among public health workers. Three risk factors and one protective factor, namely, overcommitment (OR = 1.10∼1.20, p < 0.001), perceived troubles at work (OR = 1.14∼1.18, p < 0.001), perceived tension (OR = 1.11, p < 0.001) and the capability to persist for more than 1 month at the current work intensity (OR = 0.41∼0.42, p < 0.001) were found to be independently associated with anxiety and depression in the multivariable logistic regression analyses after propensity score matching. But the Bayesian networks analysis found that the last three factors directly affect anxiety and depression. Conclusion: Psychological responses to COVID-19 were dramatic among public health workers during the severe phase of the outbreak. To minimize the impact of the epidemic, working conditions should be improved, and easily accessible psychological support services should be implemented.
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Affiliation(s)
- Xin Peng
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yangyang Pu
- Zigong First People’s Hospital, Zigong, China
| | - Xiaoyong Jiang
- Health Education Institute, Zigong Center for Disease Control and Prevention, Zigong, China
| | - Qingmei Zheng
- Chronic Disease Institute, Zigong Center for Disease Control and Prevention, Zigong, China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huan Zhou
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Dan Deng
- Department of Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China
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Ruile S, Meisinger C, Burkhardt K, Heier M, Thilo C, Kirchberger I. Effort-Reward Imbalance at Work and Overcommitment in Patients with Acute Myocardial Infarction (AMI): Associations with Return to Work 6 Months After AMI. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:532-542. [PMID: 33196948 PMCID: PMC8298327 DOI: 10.1007/s10926-020-09942-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 06/11/2023]
Abstract
Purpose Stress-related factors influence the adaptation to life after acute myocardial infarction (AMI), including return to work. The goal of this study was to investigate the effect of work-related stress, (expressed by the effort-reward imbalance (ERI) model) on return to work after AMI. Methods A longitudinal study with AMI patients was conducted in order to assess associations between the independent variables effort, reward, ERI and overcommitment and the outcome return to work after AMI. Return to work was inquired at 6 months follow-up. Logistic regression models were applied in the analysis. The fully-adjusted model included demographic, clinical, social, stress-related and health-related quality of life (HRQOL) covariables. Results Of the 346 enrolled patients aged 31 to 82 years, 239 (69.1%) were included in the regression analysis. In the unadjusted model ERI presented an odds ratio (OR) of 1.72 (95% confidence interval (CI) 0.86-3.42). Associations for effort and overcommitment were 0.98 (95% CI 0.83-1.15) and 1.09 (95% CI 0.99-1.18). However, reward showed a significantly inverse association with return to work with an OR of 0.90 (95% CI 0.83-0.99). In the fully adjusted model the OR of ERI decreased to 1.20 (95% CI 0.49-2.96). Effort, reward and overcommitment also showed attenuated ORs without significant results in all models. Diabetes mellitus, current smoking, low physical and low mental HRQOL presented significantly negative relations with return to work. Conclusions Work-related stress appears less important than HRQOL and resilience in terms of return to work after AMI.
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Affiliation(s)
- Sarah Ruile
- Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology-IBE, Ludwig-Maximilians-Universität München, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Christine Meisinger
- Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany
- MONICA/KORA Myocardial Infarction Registry, University Hospital of Augsburg, Augsburg, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Katrin Burkhardt
- Department of Laboratory Medicine and Microbiology, University Hospital of Augsburg, Augsburg, Germany
| | - Margit Heier
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
| | - Christian Thilo
- Department of Internal Medicine I - Cardiology, University Hospital of Augsburg, Augsburg, Germany
| | - Inge Kirchberger
- Chair of Epidemiology, UNIKA-T Augsburg, Ludwig-Maximilians-Universität München, Neusässer Str. 47, 86156, Augsburg, Germany.
- MONICA/KORA Myocardial Infarction Registry, University Hospital of Augsburg, Augsburg, Germany.
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
- Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares (CIBERcv), Madrid, Spain.
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Almén N. A Cognitive Behavioral Model Proposing That Clinical Burnout May Maintain Itself. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073446. [PMID: 33810358 PMCID: PMC8037062 DOI: 10.3390/ijerph18073446] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/16/2021] [Accepted: 03/24/2021] [Indexed: 12/21/2022]
Abstract
Burnout is common in many countries and is associated with several other problems such as depression, anxiety, insomnia, and memory deficits, and prospectively it predicts long-term sick-leave, cardiovascular disease, and death. Clinical burnout or its residual symptoms often last several years and a common assumption is that recovery takes a long time by nature, despite full time sick-leave and the absence of work stress. The literature suggests models that hypothetically explain the development, but not maintenance, of the syndrome. Based on cognitive and behavioral principles, stress research, and stress theories, this paper describes a theoretical model explaining how clinical burnout can develop and be maintained. While the development of clinical burnout is mainly explained by prolonged stress reactions and disturbed recovery processes due to work related stressors, maintenance of the syndrome is particularly explained by prolonged stress reactions and disturbed recovery processes due to the new context of experiencing burnout and being on sick-leave. Worry about acquired memory deficits, passivity and excessive sleep, shame, fear of stress reactions, and the perception of not being safe are examples of responses that can contribute to the maintenance. The model has important implications for research and how to intervene in clinical burnout. For example, it can offer support to professional care providers and patients in terms of focusing on, identifying, and changing current contextual factors and behaviors that maintain the individual’s clinical burnout symptoms and by that facilitate burnout recovery. Regarding research, the model provides a highly important reason for researchers to study contextual factors and behaviors that contribute to the maintenance of clinical burnout, which has been neglected in research.
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Affiliation(s)
- Niclas Almén
- Department of Psychology and Social Work, Mid Sweden University, 831 25 Östersund, Sweden
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Li N, Zhang L, Li X, Lu Q. The influence of operating room nurses' job stress on burnout and organizational commitment: The moderating effect of over-commitment. J Adv Nurs 2020; 77:1772-1782. [PMID: 33305491 DOI: 10.1111/jan.14725] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/03/2020] [Accepted: 11/24/2020] [Indexed: 12/21/2022]
Abstract
AIMS To determine job stress among Chinese operating room nurses, test the mediating effect of burnout and verify the moderating effect of over-commitment between job stress and mental health. DESIGN A descriptive, cross-sectional study. METHODS A multistage sampling method was adopted. First, a random sampling method was used to select 30 tertiary hospitals in Beijing, after which 509 operating room nurses were selected by convenience sampling from March-June 2017. Self-administered questionnaires were used to evaluate job stress, burnout, and organizational commitment among participants. Multiple-group path analysis was used to test the mediating effect and the moderating effect. RESULTS Of all nurses, 70.3% were in a state of job stress, which had negative effects on organizational commitment mediated by emotional exhaustion and depersonalization. The result of multiple-group path analysis showed that the path coefficients are different between the low and high groups of over-commitment. When facing job stress, operating room nurses with low over-commitment were more likely to have emotional exhaustion (β = 0.750 vs. 0.602), while those with high over-commitment were more likely to have low organizational commitment (β = -0.641 vs. -0.594). CONCLUSION The job stress of operating room nurses in China was high. Burnout played a mediating role between job stress and organizational commitment. Over-commitment played a moderating role in the relationship among job stress, burnout, and organizational commitment. IMPACT This study analysed the relationship among operating room nurses' job stress, burnout, and organizational commitment. The findings provided confirmatory support on the mediated effect of burnout between job stress and organizational commitment and the moderation effect of over-commitment. Different measures are needed to reduce job stress, as for easing burnout and improving organizational commitment among different groups of nurses.
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Affiliation(s)
- Na Li
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lichuan Zhang
- School of Nursing, Peking University, Beijing, China
| | - XueJing Li
- Division of Operating Center, Peking University people's Hospital, Beijing, China
| | - Qian Lu
- School of Nursing, Peking University, Beijing, China
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15
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Li J, Wege N, Loerbroks A, Riedel N. Does cognitive function predict changes in perception of stressful working conditions? INDUSTRIAL HEALTH 2020; 58:72-77. [PMID: 31155520 PMCID: PMC6997721 DOI: 10.2486/indhealth.2019-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
Cognitive health is a key resource for individuals to nurture their employability. We studied the longitudinal association of cognitive function with changes in stressful working conditions, testing a possible reversed causation. We used a sample of employees (N=1,355) participating in two surveys (2006 and 2011) within a German national representative study (GSOEP). Cognitive function was captured by perceptual speed (Symbol Digit Test) and word fluency (Animal Naming Test). Stressful working conditions were measured by the validated short version of the effort-reward imbalance questionnaire. Multivariate linear regression models assessed the impact of perceptual speed and verbal fluency in 2006 on changes in participants' perceptions of effort, reward, effort-reward ratio, and over-commitment between 2006 and 2011, adjusting for socio-demography, behaviours, physical and mental health at baseline. Neither perceptual speed nor verbal fluency was significantly related to changes in perceived working conditions. Our findings did not support the notion of reversed causation.
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Affiliation(s)
- Jian Li
- Institute of Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, USA
| | - Natalia Wege
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Center for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
| | - Natalie Riedel
- Department of Social Epidemiology, Institute of Public Health and Nursing Research, University of Bremen, Germany
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16
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Kunz C. The influence of working conditions on health satisfaction, physical and mental health: testing the effort-reward imbalance (ERI) model and its moderation with over-commitment using a representative sample of German employees (GSOEP). BMC Public Health 2019; 19:1009. [PMID: 31357973 PMCID: PMC6664758 DOI: 10.1186/s12889-019-7187-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/17/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The effort-reward imbalance (ERI) model is well-established in explaining work-related stress and health differences. A lack of reciprocity between efforts and rewards at the workplace is central to the theory. The third component (over-commitment) was defined to be a moderator of high-cost/low gain-working conditions increasing the risk of ill-health. Although the theory has been widely supported empirically, all underlying hypotheses have not been sufficiently tested. This article examines whether the strength of the effect of the effort-reward imbalance ratio on health indicators is bigger than the effects of efforts and rewards individually. Another research gap on the interaction with over-commitment is addressed and health measures are compared. METHODS This study applied the effort-reward imbalance model on health satisfaction and the SF-12v2™ indicators physical health composite score (PCS) and mental health composite score (MCS) within a representative sample of German employees. After confirmatory factor analyses of the items of the components effort, reward and over-commitment were applied, multiple linear regression models and interaction effects were calculated for more than 7000 respondents within the German Socio-Economic Panel (GSOEP) study. RESULTS Against the model's hypothesis, effort and especially reward had a stronger effect on health satisfaction and mental health individually than the effort-reward imbalance ratio. Over-commitment exerted a negative influence on health indicators and its interaction with the effort-reward imbalance ratio intensified this effect significantly for mental health. Overall, the best model fit was reached for mental health, which is in line with the model's stress theory foundation. CONCLUSIONS Although the ERI model has been applied for more than 20 years, theoretical and methodological demands can no longer be neglected. This article contributes to the revision of the effort-reward imbalance (ERI) model and demonstrates possible starting points for prevention programs focusing on rewards.
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Affiliation(s)
- Carolin Kunz
- Faculty of Sociology, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
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17
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Runeson-Broberg R, du Prel JB, Westerholm P, Nordin M, Knutsson A, Alfredsson L, Fahlén G, Peter R. Age-related associations between work over-commitment and zest for work among Swedish employees from a cross-sectional and longitudinal perspective. Work 2017; 57:269-279. [PMID: 28582947 DOI: 10.3233/wor-172555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In aging societies, zest for work may be pivotal when deciding to stay occupationally active longer. Psychosocial work stress is a prevalent public health problem and may have an impact on zest for work. Work over-commitment (WOC) is a personal coping strategy for work stress with excessive striving and a health risk. However, the long-term effect of WOC on zest for work is poorly understood. OBJECTIVE To investigate the age-related associations of work over-commitment with zest for work. METHODS During 1996-1998 and 2000-2003, predominantly industrial workers (n = 2940) participated in the WOLF-Norrland study and responded to a questionnaire referring to socio-demographics, WOC, zest for work, effort-reward imbalance proxies, and mental health. Age-adjusted multiple logistic regressions were performed with original and imputed datasets. RESULTS Cross-sectionally, work overcommitted middle-aged employees had an increased prevalence of poor zest for work compared to their contemporaries without WOC (OR: 3.74 [95%-CI 2.19; 6.40]). However, in a longitudinal analysis associations between onset of 'poor zest for work' and the WOC subscales 'need for approval' (OR: 3.29 [95%-CI 1.04; 10.37]) and 'inability to withdraw from work' (OR: 5.14 [95%-CI 1.32; 20.03]) were observed. CONCLUSION The longitudinal findings among older employees could be relevant regarding the expected need to remain occupationally active longer.
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Affiliation(s)
- Roma Runeson-Broberg
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Jean-Baptist du Prel
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany.,Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Peter Westerholm
- Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Maria Nordin
- Psychology, Umeå University, Umeå, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden
| | - Göran Fahlén
- National Agency for Special Needs Education and Schools, Härnösand, Sweden
| | - Richard Peter
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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