Responsiveness of measures in the effort-reward imbalance questionnaire to organizational changes: a validation study

Predictors of Effort-Reward Imbalance Among Employees Providing Three Types of Long-Term Care Services in Japan: Implications for Employee Well-Being

The purpose of this study was to identify predictive factors of effort-reward imbalance (ERI) among employees in multiple long-term care settings in Japan. This cross-sectional study by convenience sampling included 944 participants providing three types of long-term care: home-based (n = 201), community-based (n = 128), and institutional (n = 615). Multiple logistic regression analysis was used to identify factors associated with self-reported ERI. Low job satisfaction, being a care manager, holding a position of department head, working long hours, and having family-related stress were the common factors associated with ERI in employees across all three types of long-term care setting. Long-term care providers should consider the needs of care recipients and their family, as well as the needs of care employees, maximizing rewards so that turnover can be reduced and the diversity of individual work-family needs can be accommodated across multiple forms of long-term care settings.

Presenteeism, Overcommitment, Workplace Bullying, and Job Satisfaction: A Moderated Mediation Relationship

Presenteeism is a hazardous behaviour that may have personal and organizational consequences. The main objective of this research was to investigate the relationship between presenteeism and job satisfaction and evaluate the role of overcommitment as a mediator and the role of work-related and personal bullying as moderators in these relationships. Results from 377 subjects showed that presenteeism and overcommitment are positively related to job satisfaction, with overcommitment being a mediator in the relationships. These relationships are moderated by work-related bullying but not by personal bullying. The findings are discussed, and implications, future research pathways, and limitations are noted.

The long-term impact of a change in Effort-Reward imbalance on mental health-results from the prospective MAN-GO study

Background

Little is yet known on the long-term effects of stress management interventions (SMIs) in the workplace. The aim this study was to prospectively examine the effect of an improvement of psychosocial working conditions measured by the Effort-Reward (E-R) Imbalance model within 2 years following an SMI, and mental health 7 years later.

Methods

The study sample consisted of 97 male industrial workers from southern Germany. Data were collected pre- and post-intervention in 2006 (T1) and 2008 (T2), respectively, as well as in 2015 (T3). Change scores were computed by subtracting T1 from T3 values. The associations between E-R ratio at T1, T2 and the change score, respectively, with depression and anxiety 7 years later were estimated by means of linear regression analysis. Analyses were adjusted for baseline levels of the exposure and outcome variables, socio-demographic-, health- and work-related covariates.

Results

Within-person comparisons revealed a significant reduction (i.e. improvement) in E-R ratio post-intervention (-0.103, SD 0.24, P = 0.000). This improvement in the E-R ratio was significantly associated with lower anxiety (β = 0.358, P = 0.001) and depression (β = 0.246, P = 0.031) scores in the fully adjusted models. The association between change scores and mental health were slightly stronger than associations with absolute values at T1 and T2.

Conclusions

An improvement in E-R ratio following an SMI, was significantly associated with lower anxiety and depression 7 years later. These results strongly support the importance of improving psychosocial working conditions in order to protect the mental health of employees in the long-run.

Job Insecurity and Innovative Work Behaviour: A Psychological Contract Perspective

Innovation is considered to be of crucial importance for organisational survival and growth, and in this respect employees play a leading role, as they are the ones who develop innovative ideas. At the same time, the struggle for organisational survival and growth gives rise to perceptions of job insecurity. To date, few studies have explored how employees' innovative work behaviour (IWB) is influenced by the perceived threat of job loss (i.e. job insecurity). As both job insecurity and IWB are increasingly salient in light of organisational change and competition, the present study examines the relationship between job insecurity and IWB, as well as the role of psychological contract breach in explaining this relationship. We hypothesized a negative relation between job insecurity and innovative work behaviour, with psychological contract breach as a mediator in this relationship. Participants were 190 employees from an industrial organisation that had faced restructuring and downsizing for several years. Contrary to our predictions, no direct association was found between job insecurity and the two sub-dimensions of innovative work behaviour (i.e., idea generation and idea implementation). Indirect relationships, however, were found between job insecurity and the two types of IWB through psychological contract breach. Surprisingly, psychological contract breach was positively related to idea generation and idea implementation. These findings shed new light on the relationship between job insecurity and IWB.

Perceived Job Stress and Presence of Hypertension Among Administrative Officers in Sri Lanka

A cross-sectional survey was carried out among 275 and 760 randomly selected senior officers (SOs) and managerial assistants (MAs) aged between 30 and 60 years. Sum of scores of efforts, rewards, and overcommitment and effort-reward ratio assessed job stress. Blood pressure was measured and classified using JNC-7 guidelines. The response rates of SOs and MAs were 98.9% and 97.2%, respectively. The prevalence of job stress based on high effort-rewards imbalance among SOs and MAs was 74.6% and 80.5%, respectively. The prevalence of overcommitment among SOs and MAs was 35.3% and 29%, respectively. Statistically significant differences (P = .05) were observed between the prevalence of effort-reward imbalance and overcommitment among SOs and MAs. Multivariate analysis indicated effort-reward imbalance (odds ratio [OR] = 2.8; 95% confidence interval [CI] = 1.1-7.4), high efforts (OR = 2.5; 95% CI = 1.2-5.3), and overcommitment (OR = 2.5; 95% CI = 1.1-5.6) were significantly associated with hypertension among SOs. Similarly, effort-reward imbalance and high efforts increased the risk of hypertension by 2-fold (OR = 2.2; 95% CI = 1.1-4.2) and 3-fold (OR = 3.02; 95% CI = 1.9-4.8), respectively, among the MAs. A significant number of administrators are afflicted by job stress, and job stress was significantly associated with hypertension.

Impaired mental well-being and psychosocial risk: a cross-sectional study in female nursing home direct staff

OBJECTIVES

The present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model.

METHODS

A transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses.

RESULTS

36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort-reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35).

CONCLUSIONS

Several changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work.

Contribution of the psychosocial work environment to psychological distress among health care professionals before and during a major organizational change

The aim of this study was to investigate the relationships between 4 dimensions of the psychosocial work environment (psychological demands, decision latitude, social support, and effort-reward) among health care professionals as well as their psychological distress during a reorganization process. A correlational descriptive design was used for this quantitative study. A total of 159 health care professionals completed the questionnaire at T1, and 141 at T2. First, before the work reorganization, effort-reward imbalance was the sole variable of the psychological work environment that significantly predicted psychological distress. Second, the high overall level of psychological distress increased during the process of organizational change (from T1 to T2). Finally, effort-reward imbalance, high psychological demands, and low decision latitude were all significant predictors of psychological distress at T2, during the organizational change. In conclusion, to reduce the expected negative outcomes of restructuring on health care practitioners, managers could increase the number of opportunities for rewards, carefully explain the demands, and clarify the tasks to be performed by each of the employees to reduce their psychological burden and increase their perceptions of autonomy.

Factors associated with the intention to leave among newly graduated nurses in advanced-treatment hospitals in Japan

AIM

The early resignation of newly graduated nurses (NGNs) will become a concern in Japan as the need for nurses increases. The aim of this study was to conduct an investigation using the Effort-Reward Imbalance (ERI) questionnaire to examine the effect of stressful experiences in the work environment and over-commitment on NGNs' intention to leave and to identify the factors that were associated with their intention to leave, clarifying the appropriate times at which to conduct interventions to prevent NGNs from leaving advanced-treatment hospitals.

METHODS

Anonymous self-administered questionnaires were distributed to all the NGNs (n = 1364) in 14 advanced-treatment university hospitals. Questionnaires with no missing data were returned by 737 NGNs (54%). For the development of the questionnaire, we designed a framework that consisted of the factors that occur during three stages of the NGNs' transition into the workplace. The questions addressed items for individual attributes, employment and organizational characteristics, the Role Model Scale, the ERI questionnaire, two scale items for health status, and the intention to leave. In order to determine the factors that related to the dependent variables, hierarchical multiple linear regression analyses were carried out.

RESULTS

We revealed that effort, subjective health status, role models, and effort were important factors that related to the NGNs' intention to leave, as well as their age and city size. Over-commitment and reward were not significant factors. We also found that three subscales of the Job Readiness Scale independently related to the NGNs' intention to leave.

CONCLUSION

These findings can help employers, supervisors, and senior staff of advanced-treatment university hospitals in Japan to improve their work environment in order to benefit NGNs and aid in their retention.

Measures of stress in epidemiological research

A comprehensive assessment of psychosocial stress often poses significant challenges due to diversity in conceptualization of stress. Consequently, a number of instruments that measure psychosocial stress, its stressors, and its impact at the individual, organizational, and societal levels have been developed. This article aims to provide a brief review of such instruments, focusing on established questionnaire and interview measures in line with the environmentalist and psychological conceptualizations of stress. This includes measures of major life events; work, marital, and social stress; the individual's coping abilities; and psychological and somatic outcomes of stress. We provide a general description of selected instruments and discuss their administration, scoring, and psychometric properties. Appropriate application of these instruments in epidemiological and clinical research, as well as in inpatient care, can aid the detection of psychosocial stress, support thorough assessment and management of the individual's illness, and ensure accurate identification of individuals who would benefit from specific behavioral (psychotherapeutic) interventions.

Effort-reward imbalance for learning is associated with fatigue in school children

We examined relationships among fatigue, sleep quality, and effort-reward imbalance for learning in school children. We developed an effort-reward for learning scale in school students and examined its reliability and validity. Self-administered surveys, including the effort reward for leaning scale and fatigue scale, were completed by 1,023 elementary school students (grades 4-6) and 1,361 junior high school students (grades 7-9) at the end of 2006. Effort-reward imbalance for learning was associated with a high incidence of fatigue and sleep problems in elementary and junior high school students of both genders. A good relationship with family was associated with a low fatigue score in junior high school boys, and a good relationship with friends was associated with a low fatigue score in junior high school girls by multiple regression analysis. Fatigue score was associated with effort-reward imbalance and fatigue and quality of sleep in schoolchildren. Fatigue may lead to a decline in school performance, negative health outcomes, or refusal to attend school. These results suggest that it is desirable to consider social support, quality of sleep, and effort-reward imbalance when managing fatigue in school children.

Development and validity of the Japanese version of the organizational justice scale

Organizational justice has recently attracted attention as a predictor of employee mental and physical health. However, the lack of a Japanese translation of the original English-language organizational justice scale (OJS) has precluded its application in Japan. The present study aimed to develop Japanese version of the measure of organizational justice. We translated the original questionnaire, which is comprised of 20 items, from English to Japanese. The OJS is made up of four distinct dimensions: procedural, distributive, interpersonal and information justice. A total of 229 employees responded to the Japanese version of the OJS (OJS-J), the effort-reward imbalance (ERI) model and the Kessler Psychological Distress Scale (K10). To assess construct validity, we recorded job satisfaction using the visual analog scale (VAS). Our exploratory factor analysis supported the four-factor structure model of OJS-J. Correlation coefficients between the OJS-J and ERI, K10 and VAS were statistically significant, indicating a reasonable degree of construct validity. Obtained internal consistency was markedly high (Cronbach's alpha was 0.96), and test-retest reliability as analyzed with an intraclass correlation coefficient was 0.91. These results suggest that the OJS-J is a reliable and valid measure that may be suitable for use as a predictor of employee health in the Japanese work place.

Differences in medical error risk among nurses working two- and three-shift systems at teaching hospitals: a six-month prospective study

Shift work, including night work, has been regarded as a risk factor for medical safety. However, few studies have investigated the difference in medical error risk between two- and three-shift systems. A total of 1,506 registered nurses working shifts at teaching hospitals participated in this study to evaluate the difference in medical error risk between two- and three-shift systems. After adjustment for potential confounding factors using a log Poisson generalized estimating equation model, the results showed significantly higher frequencies of perceived adverse events over 6 months in the three-shift than in the two-shift system, with estimated mean numbers of adverse events of 1.05 and 0.74, respectively. Shorter intervals after night shifts and greater frequency of night shifts in three-shift systems, which reduce the recovery time from night shift work, may be linked to increased medical errors by nurses.

The relationship between temperament, job stress and overcommitment: a cross-sectional study using the TEMPS-A and a scale of ERI

This cross-sectional study examined the relationship between temperament, job stress, and overcommitment using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A) and a scale of the effort-reward imbalance (ERI) model. In July 2004, self-administered questionnaires were distributed to all employees in a Japanese IT service company through the company postal system. Total response rate was 63% (N=874), with 730 completed questionnaires. Information collected included individual attributes, employment and organizational characteristics. The TEMPS-A and the Japanese version of the ERI questionnaire were self-administered. The completed data of 637 personal computer technical support staff (87%) were used in a hierarchical regression analysis. Our results showed that depressive and anxious temperaments attenuate the influence of working hours and influence effort and rewards independently. While actual working hours had more impact on perceived high effort, our findings regarding rewards suggest that understanding anxious and depressive temperaments has a significant role in stress self-management. Temperaments explained 36% of the variance of overcommitment, and the variance was more than that of mean working hours. Our research has provided meaningful insights into occupational health, which could assist employees in self-management of job stress and contribute to better adaptation at the workplace.

A short generic measure of work stress in the era of globalization: effort-reward imbalance

OBJECTIVE

We evaluate psychometric properties of a short version of the original effort-reward imbalance (ERI) questionnaire. This measure is of interest in the context of assessing stressful work conditions in the era of economic globalization.

METHODS

In a representative sample of 10,698 employed men and women participating in the longitudinal Socio-Economic Panel (SOEP) in Germany, a short version of the ERI questionnaire was included in the 2006 panel wave. Structural equation modeling and logistic regression analysis were applied.

RESULTS

In addition to satisfactory internal consistency of scales, a model representing the theoretical structure of the scales provided the best data fit in a competitive test (RMSEA = 0.059, CAIC = 4124.19). Scoring high on the ERI scales was associated with elevated risks of poor self-rated health.

CONCLUSIONS

This short version of the ERI questionnaire reveals satisfactory psychometric properties, and can be recommended for further use in research and practice.

Reciprocal relations between effort-reward imbalance at work and adverse health: a three-wave panel survey

Siegrist's [1996. Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology, 1, 27-41.] Effort-Reward Imbalance (ERI) Model assumes that ERI at one point in time influences health at a later point in time. Empirical cross-sectional and longitudinal findings have supported the influence of ERI on adverse health. However, the ERI model does not explicitly take into account that the relation between ERI and adverse health may be also explained by reversed causal relations, or even reciprocal (bi-directional) relations in which ERI and health mutually influence each other. The present 3-wave panel study among 211 Japanese male blue-collar workers in one construction machinery company examined reciprocal relations between ERI and adverse health (i.e., psychological distress and physical complaints) with a 1-year time-lag per wave. Hypotheses were tested using structural equation modeling (Amos 7.0J). Results showed cross-lagged and causally dominant effects of ERI on both psychological distress and physical complaints after 1 year for both Time 1-Time 2 and Time 2-Time 3. In addition, cross-lagged effects of psychological distress on ERI were found after 1 year for both Time 1-Time 2 and Time 2-Time 3. These findings suggest that (perceived) ERI and employee health influence each other reciprocally rather than uni-directionally, and underline the importance of studying reversed causal effects in the relation between ERI and employee health.

Effort-reward imbalance and depression in Japanese medical residents

The effort-reward imbalance is an important psychosocial factor which is related to poor health among employees. However, there are few studies that have evaluated effort-reward imbalance among medical residents. The present study was done to determine the association between psychosocial factors at work as defined by the effort-reward imbalance model and depression among Japanese medical residents. We distributed a questionnaire to 227 medical residents at 16 teaching hospitals in Japan at the end of August 2005. We asked participants to answer questions which included demographic information, depressive symptoms, effort-reward imbalance, over-commitment and social support. Depression was evaluated using the Japanese version of the Center for Epidemiologic Studies-Depression (CES-D) scale. The effort-reward imbalance and over-commitment were assessed by the Effort-Reward Imbalance (ERI) questionnaire which Siegrist developed. Social support was determined on a visual analog scale. Logistic regression analysis was performed to determine the associations between effort-reward imbalance and depressive symptoms. Depressive symptoms were found in 35 (29.2%) 1st-year residents and 21 (27.6%) 2nd-year residents. The effort-reward ratio >1 (OR, 8.83; 95% CI, 2.87-27.12) and low social support score (OR, 2.77, 95% CI, 1.36-5.64) were associated with depressive symptoms among medical residents. Effort-reward imbalance was independently related to depression among Japanese medical residents. The present study suggests that balancing between effort and reward at work is important for medical residents' mental health.

Psychosocial factors and health: community and workplace study

The effects of psychosocial factors on health have drawn growing attention. An important prerequisite for epidemiologic studies is that instruments to measure psychosocial factors be reliable and valid based on psychometric properties. The introduction of occupational stress models has made breakthroughs in conceptualizing real-life complex phenomena in the workplace. This article describes some trials that explore the associations between psychosocial factors and health in the community and workplace. Scales for measuring social support and psychosocial job characteristics were developed, and their validation was pursued. Findings suggest that adverse social relationships and job characteristics measured by these instruments are associated with ill health. To strengthen the validities of the measurements and to provide strong causal evidence between psychosocial factors and health, more prospective studies and interventional approaches are needed.

A prospective study of cumulative job stress in relation to mental health

Background

This study tests associations between psychosocial stress at work measured by the effort-reward imbalance model in a dynamic perspective, and multiple indicators of poor mental health, in a prospective design.

Methods

1986 male and female employees from four Belgian enterprises were followed-up over one year within the framework of the Somstress study. Based on two consecutive measurements, an index of cumulative job stress was constructed and its associations with five indicators of mental health were studied, excluding caseness at entry (for depression, anxiety, somatisation, chronic fatigue and psychotropic drug consumption respectively). Taking into account the longitudinal design, four categories of job stress are defined: 1) employees free from stress at both measures, 2) job stress present at first measure but not at the second one, 3) recent onset of job stress as evidenced by second measure 4) workers exposed to stress at both measures. Multivariate logistic regression with appropriate adjustments was applied.

Results

In bivariate analysis, a clear graded association of cumulative job stress with all five mental health indicators is observed, both in men and women. In multivariate logistic regression analysis, recent onset of stress is strongly associated with poor mental health among men (odds ratios ranging from 1.8 to 4.6), while cumulative stress shows strongest effects on mental health in women (odds ratios ranging from 1.4 to 7.1).

Conclusion

Cumulative experience and recent onset of job stress in terms of high effort spent and low reward received is associated with elevated risk of all five indicators of poor mental health at follow-up in a large cohort of employees.

The measurement of effort-reward imbalance at work: European comparisons

Using comparative data from five countries, this study investigates the psychometric properties of the effort-reward imbalance (ERI) at work model. In this model, chronic work-related stress is identified as non-reciprocity or imbalance between high efforts spent and low rewards received. Health-adverse effects of this imbalance were documented in several prospective and cross-sectional investigations. The internal consistency, discriminant validity and factorial structure of 'effort', 'reward', and 'overcommitment' scales are evaluated, using confirmatory factor analysis. Moreover, content (or external) validity is explored with respect to a measure of self-reported health. Data for the analysis is derived from epidemiologic studies conducted in five European countries: the Somstress Study (Belgium; n = 3796), the GAZEL-Cohort Study (France; n = 10,174), the WOLF-Norrland Study (Sweden; n = 960), the Whitehall II Study (UK; n = 3697) and the Public Transport Employees Study (Germany; n = 316). Internal consistency of the scales was satisfactory in all samples, and the factorial structure of the scales was consistently confirmed (all goodness of fit measures were > 0.92). Moreover, in 12 of 14 analyses, significantly elevated odds ratios of poor health were observed in employees scoring high on the ERI scales. In conclusion, a psychometrically well-justified measure of work-related stress (ERI) grounded in sociological theory is available for comparative socioepidemiologic investigations. In the light of the importance of work for adult health such investigations are crucial in advanced societies within and beyond Europe.

Fragebogen zur Messung beruflicher Gratifikationskrisen

Zusammenfassung: Das zur Erklärung gesundheitlicher Risiken infolge chronischer psychomentaler und sozioemotionaler Arbeitsbelastungen entwickelte Modell beruflicher Gratifikationskrisen ist in verschiedenen, z.T. internationalen epidemiologischen und experimentellen Untersuchungen anhand eines standardisierten Messverfahrens erfolgreich überprüft worden. Erstmals werden hier Ergebnisse der psychometrischen Testung des Messverfahrens an einer für die erwerbstätige Bevölkerung Deutschlands repräsentativen Stichprobe vorgestellt (N = 666 Männer und Frauen; durchschnittliches Alter: 40.1±11.2). Die das Modell messenden Skalen werden bezüglich interner Konsistenz, Item-Skalen- und Interskalen-Korrelationen sowie kriterienbezogener Validität charakterisiert. Ferner wird die faktorielle Validität des Messmodells durch konfirmatorische Testung von vier alternativen Strukturmodellen überprüft, wobei der Modell-Fit der theoriekonform spezifizierten derjenigen der weniger spezifizierten überlegen ist. Zusammenfassend zeigen sich für die deutschsprachige Fassung der zur Modellmessung eingesetzten Skalen befriedigende psychometrische Kennwerte, die den weiteren Einsatz des Verfahrens rechtfertigen.