Testing global and specific indicators of rewards in the Effort-Reward Imbalance Model: Does it make any difference?

Understanding Reciprocity Among University Students in Low-Resource Settings: Validation and Measurement Using a Mixed-Methods Approach

Objectives

This study aimed to investigate reciprocity among university students in low-resource settings using a convergent mixed-methods approach in Jordan. The study operationalized the effort-reward imbalance (ERI) model which is a sociological framework used to predict occupational-related health outcomes. The basic theory of ERI model assumes that an imbalance of effort and reward predicts adverse health outcomes.

Methods

The research involved two studies, Study I (n = 833) to quantitatively measure ERI and Study II to collect qualitative data (n = 44) on the drivers of ERI among university students. In Study I, a modified Arabic version of the ERI questionnaire was used. The study measured ERI and investigated the reliability and validity of the Arabic version of the ERI model questionnaire. In Study II, data were collected from focus groups and personal interviews and thematic analysis was used.

Results

The results suggested that ERI was associated with poor academic performance (OR=2.31, 95% CI 1.60–3.32), absenteeism (OR=1.66, 95% CI 1.21–2.27), low exercise level (OR=2.02, 95% CI 1.49–2.74) and poor self-reported health (OR=1.12, 95% CI 1.08–1.30). Three major themes emerged, namely high academic load, financial pressures and negative influence on the students' performance, wellbeing and health to explain effort-reward imbalance.

Conclusions

Results suggest that ERI among university students is multi-faceted and is not bound only to academic-related demands and that the extrinsic factors such as the economic context of Jordan is among drivers of ERI.

Are there differences between officers and ratings on merchant vessels concerning effort-reward imbalance: a cross-sectional maritime field study

PURPOSE

Today, measures to economise in the operation of ships can cause either an effort-reward imbalance or health impairments. The goal of this study was to assess the risk of effort-reward imbalance including overcommitment among officers and ratings on merchant vessels during their assignments and to evaluate lifestyle factors of seafarers as well as the health-promoting conditions on board.

METHODS

A study sample of 308 male seafarers was examined during a total of 20 sea voyages on German container ships (participation rate 91.9%).

RESULTS

Only 11 seafarers were identified as having an increased health risk of an effort-reward imbalance (ER ratio > 1). Officers tended to have a higher risk of an elevated ratio than ratings (4.4% vs. 3.1%) and also showed a significantly higher risk of an ER ratio above the median (58.8% vs. 41.8%; p = 0.022). Compared to land-based populations, the average overcommitment score of seafarers was high (17.9)-particularly among officers (20.3 vs. 16.5; p = 0.031). This corresponded to an elevated risk of overcommitment among officers compared to ratings (OR 2.14; 95% CI 1.78-2.37). This elevated risk remained significant after adjustment for age (OR 2.11; 95% CI 1.76-2.35) and job-related stressors.

CONCLUSION

Although an elevated risk of effort-reward imbalance was only observed in few seafarers, this study revealed a high prevalence of overcommitment particularly among officers. In the course of time, overcommitment can lead to mental exhaustion. Therefore, shipboard health-promoting conditions need to be optimised.

Factors Associated with Psychological Distress in French Medical Students during the COVID-19 Health Crisis: A Cross-Sectional Study

BACKGROUND

The purpose of this study was to assess the prevalence of psychological distress in medical students during the COVID-19 health crisis and to identify factors associated with psychological distress.

METHODS

A cross-sectional observational study was presented to 1814 medical students (from first to sixth year) in a French university hospital center. Sociodemographic, occupational and medical information (psychological distress measured on the French GHQ12 scale) were collected via an online anonymous self-administered questionnaire. Variables associated with psychological distress were investigated using univariate analysis and multivariate analysis (modified Poisson regression).

RESULTS

In total, 832 medical students responded (46%) and 699 completed the questionnaire in full (39%); 625 (75%) showed signs of psychological distress and 109 (15%) reported suicidal ideation. Female gender, psychological trauma during the COVID-19 health crisis, change in alcohol consumption, and difficulties with online learning emerged as risk factors for psychological distress, whereas a paid activity, a feeling of mutual aid and cooperation within the studies framework, and recognition of work appeared to be protective factors.

CONCLUSIONS

Mental health care or suicide prevention should be provided to students at risk in the aftermath of the pandemic. Knowing the educational and medical factors associated with psychological distress enables areas for prevention to be identified.

Praise and recognition from supervisors buffers employee psychological strain: A two-sample investigation with tourism workers

BACKGROUND

Focusing on employees with psychological strain, this research draws on Fredrickson's 'undoing hypothesis' to examine praise and recognition from one's supervisor as an organizational resource.

OBJECTIVE

A model is tested in which psychological strain is a mediator in the positive relationship between role demands and employees' intentions to take sick leave and seek medical advice, and positions supervisor praise and recognition as a buffer of psychological strain on such intentions.

METHODS

The model was tested using two Australian samples in the tourism sector, consisting of motel workers (n = 104) and museum workers (n = 168).

RESULTS

For museum workers, but not motel workers, there was a positive indirect effect of each role demand on sick leave intentions through psychological strain that weakened as a function of supervisor praise and recognition. The proposed moderated mediated model was supported for both samples in regards to intentions to seek medical advice.

CONCLUSIONS

This research contributes new evidence regarding the antecedents of employees' intentions to take sick leave and seek medical advice for work stress-related problems. It also contributes to the limited evidence regarding supervisor praise and recognition as a protective factor for employees exhibiting the symptoms of psychological strain.

Prevalence of mental health problems and associated factors among front-line public health workers during the COVID-19 pandemic in China: an effort-reward imbalance model-informed study

BACKGROUND

Poor mental health status and associated risk factors of public health workers have been overlooked during the COVID-19 pandemic. This study used the effort-reward imbalance model to investigate the association between work-stress characteristics (effort, over-commitment, reward) and mental health problems (anxiety and depression) among front-line public health workers during the COVID-19 pandemic in China.

METHODS

A total of 4850 valid online questionnaires were collected through a self- constructed sociodemographic questionnaire, the adapted ERI questionnaire, the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder Scale (GAD-7). Hierarchical logistic regression analysis was conducted to investigate the association between ERI factors and mental health problems (i.e., depression and anxiety), with reward treated as a potential moderator in such associations.

RESULTS

The data showed that effort and over-commitment were positively associated with depression and anxiety, while reward was negatively associated with depression and anxiety. Development and job acceptance were the two dimensions of reward buffered the harmful effect of effort/over-commitment on depression and anxiety, whereas esteem was non-significant.

CONCLUSIONS

This study confirmed the harmful effects of effort and over-commitment on mental health among public health workers during the COVID-19 pandemic in China. Such effects could be alleviated through an appropriate reward system, especially the development and job acceptance dimensions of such a system. These findings highlight the importance of establishing an emergency reward system, comprising reasonable work-allocation mechanism, bonuses and honorary titles, a continuous education system and better career-development opportunities.

Roles of effort and reward in well-being for police officers in Singapore: The effort-reward imbalance model

RATIONALE

Despite the growing body of research on the effort-reward imbalance (ERI) model, evidence is scarce for the generalizability of the model across various national and occupational contexts. Also, studies that examine a wider variety of health and well-being outcomes of ERI are warranted, especially in vocations in which effort and stress is known to be high and reward is usually limited - such as policing.

OBJECTIVE

The current study examined the relationship between the ERI perception and four employee well-being outcomes (self-reported physical health, sickness absence, job satisfaction, and work-life effectiveness) among a sample of police officers in Singapore.

METHODS

Cross-sectional survey data collected from a large representative sample of uniformed police officers from Singapore were used (N = 8729). Missing data were handled with the multiple imputation method and logistic regression analyses were used to test hypotheses.

RESULTS

In line with the theory, employees characterized by high intrinsic effort and low reward (ERI > 1) reported significantly elevated odds ratios of poor physical health (OR = 1.25), job dissatisfaction (OR = 1.53), and work-life ineffectiveness (OR = 1.31). Contrary to expectations, an unusual relationship was observed such that police officers who were overcommitted exhibited lower odds ratios of the suboptimal outcomes. Interestingly, police officers in the low effort-low reward condition exhibited the worst outcomes, whereas officers in the high effort-high reward condition reported optimal outcomes. Findings were generally consistent across genders and age groups.

CONCLUSIONS

This research bolsters the core proposition of the ERI model and emphasizes the importance of social and occupational contexts in the study of ERI.

How does appreciation lead to higher job satisfaction?

Purpose

Building on the “Stress-as-Offense-to-Self” theory, this study investigates appreciation as a predictor of job satisfaction over time, mediated by subjective success and feelings of resentment towards one's organization.

Design/methodology/approach

Analyses are based on a three-wave study with two-month time intervals, with a sample of 193 employees from six Swiss organizations.

Findings

Double mediation by subjective success and feelings of resentment was confirmed; no mediation was found in a reversed mediation model. Results highlight the importance of appreciation for employees' feelings of success and job satisfaction, but also for affect related to the organization as a whole.

Practical implications

Organizations should recognize the role of appreciation in satisfaction, affective reactions toward the organization, and information about one's standing. Appreciation can be expressed in multiple ways; it not only increases job satisfaction but also helps employees to validate their judgments about their own performance.

Originality/value

Appreciation is a promising resource for employee well-being. The present study is one of few focusing on appreciation as a resource in its own right, rather than as part of broader constructs, such as social support. Our results not only confirm the importance of appreciation but also shed light on mechanisms through which it may exert its influence. They complement a multilevel analysis based on the same data showing an association of appreciation with different indicators of well-being on the interpersonal as well as the intrapersonal level.

Two Sides of Workplace Interactions: How Appreciation and Social Stressors Shape the Relationship Between Job Insecurity and Well-Being

Job insecurity has frequently been shown to have a dysfunctional impact on well-being. Based on the conservation of resources (COR) theory, the aim of this study was to investigate how the experience of appreciation at the workplace and the occurrence of social stressors shape the relationship between job insecurity and three indicators of well-being: (a) job satisfaction, (b) (emotional) irritation, and (c) engagement (dedication to the job). In an online study with 117 psychologists, we found that appreciation buffered the relationship between job insecurity and irritation. Social stressors further qualified the moderating effect of appreciation on job satisfaction and dedication, but not fully in the proposed direction. Theoretical implications about the role of more or less social contacts at work (reflected in the experience of appreciation as well as social stressors) when dealing with job insecurity will be discussed.

Development of a new measure for mental retirement; testing of a three-factor structure of mentale retirement in different subgroups

BACKGROUND

The aim of this study is to develop a new measure for the concept of mental retirement and test the construct validity of the measure. Employees who are 'mentally retired' are present at their work physically, but have already said their goodbyes mentally. Mental retirement has a three-factor structure: developmental proactivity, work engagement and perceived appreciation.

METHODS

We use data from employees (N = 867) of five different organizations in the Netherlands. Mental retirement was assessed with 11 items in an online survey. In addition, socio-demographic characteristics like age, level of education and occupation, were measured. Next to tests of internal consistency, a confirmatory factor analysis (CFA) is performed to test the three-factor structure of mental retirement in this population and in different subgroups (age, education, occupation).

RESULTS

The internal consistency varies from .80 to .94 for the developmental proactivity scale and the work engagement scale, respectively (appreciation was measured with one item). For the CFA, the three-factor model fits the data adequately. Multiple group analyses also shows equal factor loadings in all subgroups, but the mean levels of mental retirement differ across subgroups.

CONCLUSIONS

This study confirms the three-factor model of mental retirement in a general group of employees as well as across different subgroups. However, this study only tested the construct validity. Future research should study validity more extensively and be longitudinal in nature. In addition, the causal chain of antecedent variables to mental retirement and its outcomes should be considered. These studies could also focus on the effects of interventions aiming at preventing or decreasing the level of mental retirement in organizations.

Who gains the most from improving working conditions? Health-related absenteeism and presenteeism due to stress at work

Work stress-related productivity losses represent a substantial economic burden. In this study, we estimate the effects of social and task-related stressors and resources at work on health-related productivity losses caused by absenteeism and presenteeism. We also explore the interaction effects between job stressors, job resources and personal resources and estimate the costs of work stress. Work stress is defined as exposure to an unfavorable combination of high job stressors and low job resources. The study is based on a repeated survey assessing work productivity and workplace characteristics among Swiss employees. We use a representative cross-sectional data set and a longitudinal data set and apply both OLS and fixed effects models. We find that an increase in task-related and social job stressors increases health-related productivity losses, whereas an increase in social job resources and personal resources (measured by occupational self-efficacy) reduces these losses. Moreover, we find that job stressors have a stronger effect on health-related productivity losses for employees lacking personal and job resources, and that employees with high levels of job stressors and low personal resources will profit the most from an increase in job resources. Productivity losses due to absenteeism and presenteeism attributable to work stress are estimated at 195 Swiss francs per person and month. Our study has implications for interventions aiming to reduce health absenteeism and presenteeism.

Stress as Offense to Self: a Promising Approach Comes of Age

Stress is related to goals being thwarted. Arguably, protecting one’s self, both in terms of personal self-esteem and in terms of social self-esteem, is among the most prominent goals people pursue. Although this line of thought is hardly disputed, it does not play the prominent role in occupational health psychology that we think it deserves. Stress-as-Offense-to-Self theory focuses on threats and boosts to the self as important aspects of stressful, and resourceful, experiences at work. Within this framework we have developed the new concepts of illegitimate tasks and illegitimate stressors; we have investigated appreciation as a construct in its own right, rather than as part of larger constructs such as social support; and we propose that the threshold for noticing implications for the self in one’s surroundings typically is low, implying that even subtle negative cues are likely to be appraised as offending, as exemplified by the concept of subtly offending feedback. Updating the first publication of the SOS concept, the current paper presents its theoretical rationale as well as research conducted so far. Research has covered a variety of phenomena, but the emphasis has been (a) on illegitimate tasks, which now can be considered as an established stressor, and (b) on appreciation, showing its importance in general and as a core element of social support. Furthermore, we discuss implications for further research as well as practical implications of an approach that is organized around threats and boosts to the self, thus complementing approaches that are organized around specific conditions or behaviors.

Effect of a participative action intervention program on reducing mental retirement

BACKGROUND

The present study aimed to investigate the effects of a stepwise, bottom-up participatory program with a tailor-made intervention process addressing the level of mental retirement in a sample of Dutch employees. Mental retirement refers to feelings of being disconnected from your work and your organization. Prevention of mental retirement is important since sustainable employability is becoming more important in today's society due to the ageing of the working population and the changes in skills demands.

METHODS

This prospective cohort study with a one-year follow-up employs a sample of 683 employees of three organizations in The Netherlands, who filled out two questionnaires: at baseline and 1 year later. The dependent measure was mental retirement, which consists of three sub-concepts: developmental pro-activity, work engagement and perceived appreciation.

RESULTS

Multilevel analysis (N = 466) showed that employees who more actively participated in the intervention(s) had a small but statistically significant larger decrease in mental retirement at follow-up.

CONCLUSIONS

The stepwise, bottom-up participatory program with a tailor-made intervention process shows a tendency to decrease the level of mental retirement in Dutch employees. However, the implementation of interventions could be further improved since it turned out to be very challenging to keep up participants' commitment to the program. Future research should study the effectiveness of this program further with an improved study design (control group, multiple follow-ups, several data sources).

A systematic review of effort-reward imbalance among health workers

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.

Marginal socio-economic effects of an employer's efforts to improve the work environment

Background

Workplace health promotion (WHP) strongly requires the employer’s efforts to improve the psychosocial, ergonomic, and physical environments of the workplace. There are many studies discussing the socio-economic advantage of WHP intervention programmes and thus the internal and external factors motivating employers to implement and integrate such programmes. However, the socio-economic impacts of the employer’s multifactorial efforts to improve the work environment need to be adequately assessed.

Methods

Data were collected from Swedish company Sandvik Materials Technology (SMT) through a work environment survey in April 2014. Different regression equations were analysed to assess marginal effects of the employer’s efforts on overall labour effectiveness (OLE), informal work impairments (IWI), lost working hours (LWH), and labour productivity loss (LPL) in terms of money.

Results

The employer’s multifactorial efforts resulted in increasing OLE, decreasing IWI and illness-related LWH, and cost savings in terms of decreasing LPL.

Conclusion

Environmental factors at the workplace are the important determinant factor for OLE, and the latter is where socio-economic impacts of the employer’s efforts primarily manifest.

The Impact of Occupational Rewards on Risk Taking Among Managers

Abstract. Managers often have to deal with the financial and ethical risks that companies face. Evidence from risk management research suggests a negative relationship between people’s age and risk taking tendencies. Within such a framework, the present contribution examines how different perceived occupational rewards may mediate or interact with the relationship between age and risk taking of managers at the company level. Our results show that perceived rewards in terms of job security partially mediate the relationship between age and ethical risk taking, while perceived rewards related to job promotion moderate the effect of age on financial risk taking. We further discuss the role of different organizational strategies to preserve an organization’s health.

Effort-reward imbalance and self-rated health among Gambian healthcare professionals

Background

The effort-reward imbalance (ERI) model of work stress has been widely applied in investigating association between psychosocial factors at work and health. This study examined associations between perceived psychosocial work stress as measured by the ERI model and self-rated health (SRH) among nurses and environmental health officers (EHOs) working in secondary public healthcare facilities in the Gambia.

Method

A cross-sectional study on a random sample of 287 health care professionals (201 nurses and 86 EHOs). A 22-item ERI questionnaire was used to collect data on the psychosocial factors defined by the ERI model. SRH was assessed using a single item measure.

Results

The distribution of subjective health was not statistically different between nurses and EHOs. However, our study uncovered significant associations between perceived psychosocial work stress and subjective health. Specifically, we found that a perceived high effort-reward imbalance (ER-ratio > 1) is a significant risk factor for poor SRH, in both occupational groups. However, over-commitment was not significantly associated with poor SRH in the two groups. When efforts and rewards were considered as separate variables in the analysis, rewards were inversely associated with poor SRH in both groups.

Conclusion

Because of the high perceived Effort-Reward Imbalance among healthcare professionals at secondary public healthcare facilities, it is necessary to modify working conditions through improvement of psychosocial work environment, such as reasonable allocation of resources to increase pay, incentives or other forms of rewards from government. Interventions that could mitigate and prevent stress at work are worth considering in future healthcare policies.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-016-1347-0) contains supplementary material, which is available to authorized users.

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.

Changes in Leadership Behaviors Predict Changes in Job Satisfaction and Well-Being in Low-Skilled Workers

The purpose of this longitudinal study of 255 members of the low-skilled workforce was to enhance insight into the nature of the relations between specific supervisor behavior (social support, positive feedback, task-related communication) and employee well-being. Data were analyzed using latent change models focusing on interindividual change and change–change associations over time. Our results indicated that interindividual differences in the intraindividual change in perceived supervisor behavior were related to changes in indicators of well-being across a 6-month period. These results provide further evidence for longitudinal associations between leader behavior and employee outcomes as well as the necessity of designing specific interventions for low-level managers.

Appreciative Leadership and Employee Well-Being in Everyday Working Life

This study examines the relationship between appreciative behavior and employee well-being on a daily basis. The theoretical rationale of our approach is based in leadership concepts emphasizing the relational aspect of leadership, and, more generally, in a framework that emphasizes the central role of threats, or boosts, to self-esteem (i.e., the concept of “Stress-as-Offense-to-Self” [SOS]). Qualitative and quantitative data of 139 employees working in different occupations were assessed during five consecutive workdays. First, based on event-sampling of appreciative situations, the nature of appreciative situations from the perspective of the employees, as it manifests itself in daily episodes, was examined. Simple praise and gratitude were the most frequent types of appreciative behavior reported. Besides leaders, customers and co-workers were frequent sources of appreciation as well. Second, the intra-individual effects of daily experiences of appreciation on employee well-being at the end of work were analyzed. Multi-level random coefficient modeling showed that daily appreciation by all sources significantly predicted serenity (i.e., a low-arousal / high pleasure type of well-being) at the end of work. As serenity is likely to affect recovery, which, in turn, may affect health and performance, our findings show that for leaders, but not only for leaders, displaying elementary appreciative behavior is a simple but important tool for enhancing employee health and well-being.

Leadership Behavior as a Health-Promoting Resource for Workers in Low-Skilled Jobs and the Moderating Role of Power Distance Orientation

In this study, the authors analyze leadership behaviors as potential health-promoting resources for low-skilled workers in a highly culturally diverse work setting. The authors hypothesize that subordinates' and supervisors' individual power distance orientations will moderate the effect of subordinates' perceptions of leadership behavior and the subsequent effects on their well-being. Multilevel modeling is used to analyze a sample of data from 474 low-skilled employees (50% immigrants) and 35 direct supervisors from three German companies. Supporting the hypotheses, social support, task-related communication, and positive feedback, as expressions of esteem, are found to positively impact subordinates' well-being, but individual consideration shows no significant effects. Furthermore, results confirm that supervisors' power distance orientation moderates employees' perceptions about supervisors' positive feedback and the subsequent well-being effects. The moderating effect fails to hold for employees' power distance orientation. Results indicate that supervisors can most effectively promote the health of low-skilled workers by showing esteem through positive feedback, but if the supervisor has high individual power distance orientation, the effect is attenuated.

Musculoskeletal pain and effort-reward imbalance--a systematic review

Background

Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures psychosocial factors in the working world. The question is whether workers with an effort-reward imbalance report musculoskeletal pain more frequently than those with no effort-reward imbalance. A systematic review using a best evidence synthesis approach was conducted to answer this question.

Methods

A literature search was conducted for the period from 1996 to 2012, using three databases (Pubmed, Embase and PsycINFO). The research criteria related to psychosocial, work-related stress as per the ERI model and to musculoskeletal pain. A quality score was developed using various quality criteria to assess the standard of the studies. The level of evidence was graded as in (Am J Ind Med 39:180–193, 2001).

Results

After applying the inclusion criteria, a total of 19 studies were included in the review: 15 cross-sectional studies, three prospective studies and one case–control study. 74% of all studies exhibited good methodological quality, 53% collected data using the original ERI questionnaire, and in 42% of the studies, there was adequate control for physical working conditions. Furthermore, different cut-off points were used to classify exposed and non-exposed individuals. On the basis of 13 studies with a positive, statistically significant association, a moderate level of evidence was inferred for the association between effort-reward imbalance and musculoskeletal pain. The evidence for a role of over-commitment and for its interaction with effort-reward imbalance was rated as inconclusive - on the basis of eight and five studies, respectively.

Conclusions

On the basis of the available evidence, no reliable conclusion may be drawn about any association between the psychosocial factors ascertained using the ERI model and musculoskeletal pain. Before a reliable statement can be made on the association between ERI and musculoskeletal pain, additional longitudinal studies must be performed - with a standardised method for recording and classifying exposure, as well as control of physical confounders. Appropriate preventive measures can then be specified.

Preliminary study about occupational stress of physicians and nurses in pediatric and neonatal intensive care units: the balance between effort and reward

This study compared the balance between effort (E) and reward (R) among physicians and nurses working in pediatric (PED) and neonatal (NEO) Intensive Care Units. This descriptive cross-sectional study was carried out with 37 physicians and 20 nurses. The Effort-Reward Imbalance Questionnaire was used. Statistically significant differences were not found among physicians (p>0.05) or nurses from PED and NEO in relation to E and R (p>0.05). No statistically significant differences were found between physicians and nurses in PED in the several studied variables. Comparison between the professionals working in NEO revealed that physicians presented more over-commitment than nurses (p=0.01). The organizational setting of NEO proved to be more demanding for physicians, exacting a greater commitment to their work, while demands presented in both units seemed to be the same for nurses.

Beyond the Demand-Control Model

This study among 12,359 employees working in 148 organizations tested the interaction hypothesis of the Job Demands-Resources (JD-R) model. Accordingly, employees endorse most positive work attitudes (task enjoyment and organizational commitment) when job demands and job resources are both high. Results of moderated structural equation modeling analyses provided strong support for the hypothesis: 15 of the 16 hypothesized interactions were significant for task enjoyment and 13 of the 16 interactions were significant for organizational commitment. Job resources (skill utilization, learning opportunities, autonomy, colleague support, leader support, performance feedback, participation in decision making, and career opportunities) predicted task enjoyment and organizational commitment particularly under conditions of high job demands (workload and emotional demands). These findings clearly expand the Demand-Control model and support the JD-R model. Moreover, the results illustrate what managers can do to secure employee well-being.

Appreciation at Work in the Swiss Armed Forces

This study explores the impact of appreciation at work among military professionals. Based on the concept of “Stress-as-Offense-to-Self” ( Semmer, Jacobshagen, Meier, & Elfering, 2007 ), appreciation is a possible resource due to boosts to self-esteem. We measured appreciation at work with a scale differentiating several forms and sources of appreciation. Data were gathered by an online survey of 228 male career officers and career noncommissioned officers of the Swiss Armed Forces. Appreciation at work correlated positively with job satisfaction and negatively with feelings of resentment. Moreover, appreciation at work explained incremental variance over and above job control, social support, and interactional justice. These results underline its distinction from other resource variables. Legal employment conditions of the military professionals include working hours in accordance with ongoing requirements without upper limits established. Moderator analysis showed that appreciation buffered the effect of long working hours on job satisfaction. Furthermore, appreciation mediated the effect of illegitimate tasks on job satisfaction as well as on feelings of resentment. Overall, these findings imply that it is worth building an organisational culture based on appreciation at work. Implications for research and military training are discussed.

Application of item response theory to achieve cross-cultural comparability of occupational stress measurement

Our objective was to examine cross-cultural comparability of standard scales of the Effort-Reward Imbalance occupational stress scales by item response theory (IRT) analyses. Data were from 20,256 Japanese employees, 1464 Dutch nurses and nurses' aides, 2128 representative employees from post-communist countries, 963 Swedish representative employees, 421 Chinese female employees, 10,175 employees of the French national gas and electric company and 734 Spanish railroad employees, sanitary personnel and telephone operators. The IRT likelihood ratio model was used for differential item functioning (DIF) and differential test functioning (DTF) analyses. Despite the existence of DIF, most comparisons did not show discernible differences in the relations between Effort-Reward total score and level of the underlying trait across cultural groups. In the case that DTF was suspected, excluding an item with significant DIF improved the comparability. The full cross-cultural comparability of Effort-Reward Imbalance scores can be achieved with the help of IRT analysis.

Psychosoziale Merkmale der Arbeit, Überforderungserleben und Depressivität

Die vorliegende Studie untersuchte die im Job-Demand-Control-Support-Modell und Effort-Reward-Imbalance-Modell beschriebenen Tätigkeitsmerkmale in Bezug auf Depressivität in einer Stichprobe von 265 Erwerbstätigen. Anhand konfirmatorischer Faktorenanalysen wurden Gemeinsamkeiten und Unterschiede beider Modelle geprüft. Anschließend wurde die Bedeutung der nachweisbaren Tätigkeitsmerkmale für die Vorhersage von Depressivität getestet und untersucht, inwieweit die Effekte durch Überforderungserleben mediiert werden. Die Analysen zeigten, dass die Modelle sowohl gemeinsame (Arbeitsintensität bzw. berufliche Anforderungen) als auch distinkte Arbeitsmerkmale (Tätigkeitsspielraum, Arbeitsplatzsicherheit, beruflicher Status, soziale Anerkennung) erfassen. Hohe Arbeitsintensität, geringe Arbeitsplatzsicherheit und fehlende soziale Anerkennung standen in signifikantem Zusammenhang mit Depressivität. Anders als erwartet war der berufliche Status positiv mit Depressivität assoziiert, während für den Tätigkeitsspielraum keine signifikanten Effekte nachweisbar waren. Das Pfadmodell bestätigte sowohl direkte als auch durch Überforderungserleben vermittelte Zusammenhänge zwischen den Tätigkeitsmerkmalen und Depressivität (39 % Varianzaufklärung). Die Ergebnisse bieten eine Grundlage für die Identifizierung potenzieller Risikofaktoren für das Auftreten depressiver Symptome am Arbeitsplatz.

Does occupational gender segregation influence the association of effort-reward imbalance with myocardial infarction in the SHEEP study?

The objective of this study was to investigate whether occupational gender segregation moderates the association between job stress in terms of effort-reward imbalance and the risk of myocardial infarction. This analysis was conducted in 1,381 cases and 1,697 referents of the Swedish SHEEP case control study aged 45-70 years. Information on myocardial infarction and biological coronary risk factors (e.g. hypertension, blood lipids) was achieved from clinical screenings. Information on socio-demographic variables, effort-reward imbalance, behavioral coronary risk factors (e.g., smoking), and additional coronary risk factors (e.g., diabetes, family history of coronary heart disease) was derived from well-tested standardized questionnaires. After adjustment for confounders the strongest association between overcommitment (the intrinsic component of effort-reward imbalance) and risk of belonging to the myocardial infarction group was found among women in male-dominated jobs (odds ratio [OR] = 2.71, 95% CI = 1.13-6.52) as compared to the remaining group (OR = 1.52, 95% CI = 1.01-2.31). Moreover, a significant interaction between pronounced overcommitment and male domination in relation to myocardial infarction was observed among women (OR = 2.44, 95% CI = 1.05-5.67). In men, an association between the ratio of effort and reward (the extrinsic component of the model) and risk of myocardial infarction was found for the majority, that is the group not working in women-dominated jobs (OR = 1.39, 95% CI = 1.04-1.86). Despite methodological limitations, this study gives preliminary evidence of a moderating effect of occupational gender segregation on the association of effort-reward imbalance (i.e., the intrinsic model component overcommitment) with acute myocardial infarction risk among women, but not among men.

Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort-reward imbalance model

Nursing staff are exposed to stressful work load which in turn is associated with poor physical and psychological health, sickness absence and job exit. The effort-reward imbalance (ERI) model is a validated approach to measure chronic psychosocial work stress by identifying nonreciprocity between occupational efforts spent and rewards received, and has been found to predict poor health. The aim of this cross-sectional study (n = 367 nurses and nurses aides) was first to test the psychometric properties of the Danish questionnaire measuring ERI, and secondly to analyse whether psychosocial work stress is associated with six indicators of poor self-rated health. Results derived from confirmatory factor analysis indicate satisfying psychometric properties. Elevated risks of poor self-rated health (odds ratios varying from 1.92 to 4.76) are observed in nursing staff characterized by high effort in combination with low reward. Effects are enhanced in those respondents who additionally exhibit a high level of work-related overcommitment. In conclusion, despite methodological limitations, this study contributes to the validation of the ERI questionnaire in Danish language. Furthermore, by documenting associations with poor self-rated health, it supports efforts of theory-guided prevention of work stress in health care professions.

Reviewing the effort–reward imbalance model: drawing up the balance of 45 empirical studies

The present paper provides a review of 45 studies on the Effort-Reward Imbalance (ERI) Model published from 1986 to 2003 (inclusive). In 1986, the ERI Model was introduced by Siegrist et al. (Biological and Psychological Factors in Cardiovascular Disease, Springer, Berlin, 1986, pp. 104-126; Social Science & Medicine 22 (1986) 247). The central tenet of the ERI Model is that an imbalance between (high) efforts and (low) rewards leads to (sustained) strain reactions. Besides efforts and rewards, overcommitment (i.e., a personality characteristic) is a crucial aspect of the model. Essentially, the ERI Model contains three main assumptions, which could be labeled as (1) the extrinsic ERI hypothesis: high efforts in combination with low rewards increase the risk of poor health, (2) the intrinsic overcommitment hypothesis: a high level of overcommitment may increase the risk of poor health, and (3) the interaction hypothesis: employees reporting an extrinsic ERI and a high level of overcommitment have an even higher risk of poor health. The review showed that the extrinsic ERI hypothesis has gained considerable empirical support. Results for overcommitment remain inconsistent and the moderating effect of overcommitment on the relation between ERI and employee health has been scarcely examined. Based on these review results suggestions for future research are proposed.

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.