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Framke E, Sørensen JK, Madsen IEH, Rugulies R. Emotional demands at work and risk of disability pension: a nationwide cohort study in Denmark. Occup Environ Med 2024; 81:262-265. [PMID: 38719454 PMCID: PMC11187389 DOI: 10.1136/oemed-2023-109378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/15/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Working in emotionally demanding jobs is associated with an increased risk of temporarily leaving the labour market due to long-term sickness absence. We tested whether employees working in emotionally demanding jobs are also at higher risk of permanently leaving the labour market due to disability pension compared with employees working in jobs that are not emotionally demanding. METHODS We conducted a 10-year cohort study in the workforce in Denmark (n=1 670 825), aged 30-59 years at baseline, by linking job exposure matrices with nationwide registries on social transfer payments and covariates. Using Cox regression, we analysed the risk of disability pension in relation to emotional demands in the full population and sex stratified. Multivariable adjusted models included sex, age, cohabitation, migration background, household disposable income and other work environmental factors (physical workload, influence, possibilities for development and role conflicts). RESULTS We identified 67 923 new cases of disability pension during 15 649 743 person-years of follow-up (mean follow-up: 9.4 years). We found an increasing risk of disability pension with higher levels of emotional demands, with HRs of 1.20, 1.23 and 1.73 for medium-low, medium-high and high emotional demands, respectively, compared with low emotional demands in the most adjusted model. There was an exposure-response association in women and a tendency towards an exposure-response association in men. DISCUSSION In this nationwide cohort study, we found an increased risk of permanent exit from the labour market due to disability pension in women and men working in emotionally demanding jobs.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
- The Danish Multiple Sclerosis Registry, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark
| | | | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Knutsen RH, Nielsen MB, Lunde LK, Skare Ø, Johannessen HA. Impact of psychosocial work factors on risk of medically certified sick leave due to common mental disorders: a nationwide prospective cohort study of Norwegian home care workers. BMC Public Health 2024; 24:773. [PMID: 38475747 DOI: 10.1186/s12889-024-18299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/06/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The Norwegian home care services experience a high level of sick leave, a large proportion of which is due to common mental disorders. A substantial number of such cases can be attributed to psychosocial factors at work, but more knowledge about occupation-specific risk factors is needed to develop targeted preventive measures to reduce sick leave levels. The aim of this study is to identify the most prominent psychosocial work factors influencing the risk of sick leave spells due to common mental disorders. METHODS Employees from a random sample of 130 Norwegian home care services (N = 1.819) completed a baseline survey on 15 psychosocial work factors. Participants were subsequently followed up for 26 months using registry data on sick leave. The outcome measure was the number of medically certified sick leave spells due to common mental disorders during follow-up in the Norwegian social insurance database. Incidence risk ratios (IRR) and 95% confidence intervals (CIs) were calculated using negative binomial regression with robust standard errors. RESULTS Emotional dissonance (IRR 1.30, 95% CI 1.05-1.60) and emotional demands (IRR 1.35, 95% CI 1.14-1.58) were associated with an excess risk of sick leave, while control over work pacing (IRR 0.78, 95% CI 0.62-0.98) was associated with a reduced risk. An estimated 30% (95% CI 8.73-48.82) of sick leave cases were attributable to emotional dissonance and 27% (95% CI 4.80-46.33) were attributable to emotional demands. Control over work pacing was estimated to have prevented 20% (95% CI 1.32-37.78) of the sick leave cases. CONCLUSIONS This study found that emotional dissonance and emotional demands were robust risk factors for sick leave due to common mental disorders, and that control of work pacing constituted a robust protective factor against sick leave.
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Affiliation(s)
- Rigmor Harang Knutsen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Morten Birkeland Nielsen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
| | - Lars-Kristian Lunde
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
| | - Øivind Skare
- Research Group for Occupational Medicine and Epidemiology, National Institute for Occupational Health, Oslo, Norway
| | - Håkon A Johannessen
- Research Group for Work Psychology and Physiology, National Institute for Occupational Health, Oslo, Norway
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Sterud T, Marti AR, Degerud E. Comprehensive evaluation of the impact of workplace exposures on physician-certified sick leave in the general working population. BMC Public Health 2024; 24:214. [PMID: 38233766 PMCID: PMC10795203 DOI: 10.1186/s12889-024-17662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Our objective was to quantify the prospective associations between work factors across chemical, physical, mechanical, and psychosocial domains and the onset of medically certified sick leave. METHODS Eligible respondents were interviewed in 2009, 2013, or 2016 and were registered in the national sick leave register with an employee relationship lasting more than 50 working days during the year of the survey interviews and the following year (n = 15,294 observations). To focus on the onset of high-level sick leave (HLSL; >16 days a year), we excluded individuals with HLSL during the survey year (baseline). We then used mixed-effect logistic regression models to assess prospective associations between self-reported work conditions and the occurrence of doctor-certified HLSL in the following year. RESULTS The average occurrence of HLSL was 13.1%. After adjusting for sex, age, level of education, chronic health problems, and smoking, we observed an exposure-response relationship between cumulative exposure to work factors within all domains and the occurrence of HLSL. When evaluating the impact of combined exposures, predicted odds ratios (OR) for employees exposed to 1, 2, and 3 or more work factors within all domains were 1.60 (95%CI 1.32 - 1.94), 2.56 (95%CI 1.73 - 3.74) and 4.09 (95%CI 2.28 - 7.25), compared to those not exposed. CONCLUSIONS The results support the notion that exposure to multiple work factors in various domains, including psychosocial, mechanical, chemical, and physical work conditions, is associated with an increased risk of high-level sick leave. Employers and occupational health professionals should consider the joint impact of these domains when designing interventions.
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Affiliation(s)
- Tom Sterud
- Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 8149 Dep, Oslo, N-0033, Norway.
| | - Andrea R Marti
- Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 8149 Dep, Oslo, N-0033, Norway
| | - Eirik Degerud
- Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 8149 Dep, Oslo, N-0033, Norway
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Zhang Y, Lei S, Chen L, Yang F. Influence of job demands on implicit absenteeism in Chinese nurses: mediating effects of work-family conflict and job embeddedness. Front Psychol 2023; 14:1265710. [PMID: 37936572 PMCID: PMC10627013 DOI: 10.3389/fpsyg.2023.1265710] [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: 07/23/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023] Open
Abstract
Purpose It has been widely noted that implicit absenteeism is common among nurses, with job demand influencing it. Theoretically, work-family conflict and job embeddedness may help link job demands to implicit absenteeism. However, the mediating effects of the two on the association between job demands and implicit absenteeism remain unclear. Thus, this study aims to explore the association between nurses' job demands and implicit absenteeism, and the chain mediating effect of work-family conflict and job embeddedness in this relationship. Patients and methods Data were collected from 1,420 nurses from five tertiary public hospitals in China. They were asked to respond to a questionnaire asking about job demands, implicit absenteeism, work-family conflict, and job embeddedness. The data were coded and analyzed using IBM SPSS version 21.0. Descriptive analysis, t-test, one-way ANOVA, hierarchical multiple regression analysis, and bootstrapping were used to analyze the extracted data. Results The mean score for implicit absenteeism was 17.75 ± 5.60. There was a significant correlation (p < 0.05) between nurses' job demands, work-family conflict, job embeddedness, and implicit absenteeism. Nurses' job demands directly influenced implicit absenteeism and indirectly influenced implicit absenteeism through the mediating effects of work-family conflict and job embeddedness. Furthermore, work-family conflict and job embeddedness have a chain effect on the association between job demands and implicit absenteeism. Conclusion The study found that nurses' job demands directly and positively influence implicit absenteeism, and indirectly influence implicit absenteeism through single and chain mediating effects of work-family conflict and job embeddedness.
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Affiliation(s)
- Yujie Zhang
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shanyan Lei
- Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Liying Chen
- Department of Nursing, Weifang People’s Hospital, Weifang, China
| | - Fang Yang
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
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Framke E, Alexanderson K, Sørensen JK, Pedersen J, Madsen IEH, Rugulies R, Farrants K. Emotional demands and all-cause and diagnosis-specific long-term sickness absence: a prospective cohort study in Sweden. Eur J Public Health 2023:7152427. [PMID: 37141461 DOI: 10.1093/eurpub/ckad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND High emotional demands at work require sustained emotional effort and are associated with adverse health outcomes. We tested whether individuals in occupations with high emotional demands, compared with low demands, had a higher future risk of all-cause long-term sickness absence (LTSA). We further explored whether the risk of LTSA associated with high emotional demands differed by LTSA diagnoses. METHODS We conducted a prospective, nationwide cohort study on the association between emotional demands and LTSA (>30 days) in the workforce in Sweden (n = 3 905 685) during a 7-year follow-up. Using Cox regression, we analyzed sex-stratified risks of all-cause and diagnosis-specific LTSA due to common mental disorders (CMD), musculoskeletal disorders (MSD) and all other diagnoses. Multivariable adjusted models included age, birth country, education, living area, family situation and physical work demands. RESULTS Working in emotionally demanding occupations was associated with a higher risk of all-cause LTSA in women [hazard ratio (HR) = 1.92, 95% confidence interval (CI): 1.88-1.96] and men (HR = 1.23, 95% CI: 1.21-1.25). In women, the higher risk was similar for LTSA due to CMD, MSD and all other diagnoses (HR of 1.82, 1.92 and 1.93, respectively). In men, risk of LTSA due to CMD was pronounced (HR = 2.01, 95% CI: 1.92-2.11), whereas risk of LTSA due to MSD and all other diagnoses was only slightly elevated (HR of 1.13, both outcomes). CONCLUSIONS Workers in occupations with high emotional demands had a higher risk of all-cause LTSA. In women, risk of all-cause and diagnosis-specific LTSA were similar. In men, the risk was more pronounced for LTSA due to CMD.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Neurology, The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Glostrup, Denmark
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Jacob Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Clausen T, Christensen KB, Sørensen JK, Bjorner JB, Madsen IEH, Borg V, Rugulies R. The Predictive Validity of the Danish Psychosocial Work Environment Questionnaire With Regard to Onset of Depressive Disorders and Long-Term Sickness Absence. Ann Work Expo Health 2022; 67:195-207. [PMID: 36242547 PMCID: PMC9923041 DOI: 10.1093/annweh/wxac069] [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: 01/12/2022] [Revised: 07/04/2022] [Accepted: 09/14/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate the predictive validity of 32 measures of the Danish Psychosocial Work Environment Questionnaire (DPQ) against two criteria variables: onset of depressive disorders and long-term sickness absence (LTSA). METHODS The DPQ was sent to 8958 employed individuals in 14 job groups of which 4340 responded (response rate: 48.4%). Depressive disorders were measured by self-report with a 6-month follow-up. LTSA was measured with a 1-year follow-up in a national register. We analyzed onset of depressive disorders at follow-up using logistic regression models, adjusted for age, sex, and job group, while excluding respondents with depressive disorders at baseline. We analyzed onset of LTSA with Cox regression models, adjusted for age, sex, and job group, while excluding respondents with previous LTSA. RESULTS The general pattern of the results followed our hypotheses as high job demands, poorly organized working conditions, poor relations to colleagues and superiors, and negative reactions to the work situation predicted onset of depressive disorders at follow-up and onset of LTSA during follow-up. Analyzing onset of depressive disorders and onset of LTSA, we found risk estimates that deviated from unity in most of the investigated associations. Overall, we found higher risk estimates when analyzing onset of depressive disorders compared with onset of LTSA. CONCLUSIONS The analyses provide support for the predictive validity of most DPQ-measures. Results suggest that the DPQ constitutes a useful tool for identifying risk factors for depression and LTSA in the psychosocial work environment.
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Affiliation(s)
- Thomas Clausen
- Author to whom correspondence should be addressed. National Research Centre for the Working Environment, Lersoe Parkalle 105, DK-2100, Copenhagen, Denmark. Tel: +45-39165368; fax: +45-39165201; e-mail:
| | | | | | - Jakob B Bjorner
- National Research Centre for the Working Environment, Copenhagen, Denmark,Department of Public Health, University of Copenhagen, Copenhagen, Denmark,Optum Patient Insights, Johnston, RI, USA
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Vilhelm Borg
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Andersen LL, Vinstrup J, Thorsen SV, Pedersen J, Sundstrup E, Rugulies R. Combined psychosocial work factors and risk of long-term sickness absence in the general working population: Prospective cohort with register follow-up among 69 371 workers. Scand J Work Environ Health 2022; 48:549-559. [PMID: 35647686 PMCID: PMC10539106 DOI: 10.5271/sjweh.4035] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the importance of combined psychosocial work factors for the risk of long-term sickness absence (LTSA). METHODS We followed 69 371 employees in the general working population (Work Environment and Health in Denmark study 2012-2018), without LTSA during the preceding year, for up to two years in the Danish Register for Evaluation of Marginalization. Using k-means cluster analyses and weighted Cox-regression controlling for age, gender, survey year, education, health-behaviors, and physical work demands, we determined the prospective association of 11 identified clusters - based on the combination of nine psychosocial work factors (recognition, quantitative demands, work pace, emotional demands, influence, justice, role clarity, role conflicts, and support from colleagues) - with the risk of LTSA. RESULTS During 124 045 person-years of follow-up, 6197 employees developed LTSA (weighted 8.5%). Using the cluster with the most favorable psychosocial scores as reference, clusters scoring poorly on several combined psychosocial factors had increased risk of LTSA. The cluster scoring poor on all nine psychosocial factors exhibited the highest risk [hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.45-1.94]. Scoring poorly on one or two psychosocial factors did not increase the risk of LTSA when combined with favorable scores on the other psychosocial factors. Interaction analyses showed that gender, but not age and education, modified the association between cluster and LTSA. CONCLUSION Scoring poorly on several combined psychosocial work factors plays an important role in the risk of LTSA. Scoring favorably on several psychosocial factors outweighed the potentially adverse effects of scoring poorly on one or two factors.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100 Copenhagen, Denmark.
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Shiga K, Izumi K, Minato K, Yoshimura M, Kitazawa M, Hanashiro S, Cortright K, Kurokawa S, Momota Y, Sado M, Maeno T, Takebayashi T, Mimura M, Kishimoto T. Association of work environment with stress and depression among Japanese workers. Work 2022; 72:1321-1335. [DOI: 10.3233/wor-210356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: There is a lack of studies that investigated the effect of a wide range of work environmental factors on stress and depression in Japan. OBJECTIVES: To examine the association of work environment factors with stress and depression among workers in Japan. METHODS: We conducted questionnaire surveys of workers that mainly engage in desk work in Japan. Stress was assessed through the Perceived Stress Scale (PSS), depression through the Patient Health Questionnaire-9 (PHQ-9), and work environment through physical and psychological workplace environment questionnaires. Workers were divided into low and high stress groups based on PSS score (median split), and divided into non-depressed and depressed groups based on their PHQ-9 score (< 5, and ≥5); these groups were then compared with their working environment. In addition, a multiple regression analysis was performed. RESULTS: Responses were obtained from 210 subjects. Multiple regression analysis showed that “Ability to work at one’s own pace” and “Ability to apply personal viewpoint to work,” etc., had effect on stress, while “Workplace harassment” and “Support from colleagues,” etc., had effect on depression. CONCLUSIONS: The results suggest that stress and depression in Japanese workers are related to factors such as job demands, control of work, workplace harassment, and psychological safety.
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Affiliation(s)
- Kiko Shiga
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Clinical Psychology, Faculty of Human Relations, Shigakukan University, Kagoshima, Japan
| | - Keisuke Izumi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- National Tokyo Medical Center, Tokyo, Japan
- Medical AI Center, Keio University, Tokyo, Japan
| | - Kazumichi Minato
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Momoko Kitazawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Sayaka Hanashiro
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kelley Cortright
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shunya Kurokawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Momota
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Center for Stress Research, Keio University, Tokyo, Japan
| | - Takashi Maeno
- Human System Design Laboratory, Graduate School of System Design and Management, Keio University, Kanagawa, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taishiro Kishimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Psychiatry Department, Donald and Barbara Zucker School of Medicine, New York, NY, USA
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
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Madsen IE, Sørensen JK, Bruun JE, Framke E, Burr H, Melchior M, Sivertsen B, Stansfeld S, Kivimäki M, Rugulies R. Emotional demands at work and risk of hospital-treated depressive disorder in up to 1.6 million Danish employees: a prospective nationwide register-based cohort study. Scand J Work Environ Health 2022; 48:302-311. [PMID: 35262742 PMCID: PMC9524161 DOI: 10.5271/sjweh.4020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Previous studies on effects of emotional demands on depression have relied on self-reported exposure data and lacked control for potential confounding by pre-employment risk factors for depression. This study used a register-based design to examine the risk of hospital-treated depressive disorder in relation to occupational levels of emotional demands at work, furthermore addressing the role of risk factors for depression before workforce entry. METHODS We analyzed data from two Danish register-based cohorts - Job Exposure Matrix Analyses of Psychosocial Factors and Healthy Ageing in Denmark (JEMPAD, N= 1 665 798) (17) and Danish Work Life Course Cohort (DaWCo, N=939 411), which link assessments of emotional demands by job exposure matrices to records of hospital-treated depressive disorder among employees aged 15-59 years at baseline (average follow up: 9.7 years in JEMPAD, 7.3 years in DaWCo). Potential confounders comprised sociodemographics, job control, work-related violence and physical demands at work. In DaWCo, we followed individuals from their entry into the workforce, and also included data on risk factors for depression before workforce entry (eg, parental income, education, and psychiatric diagnoses). RESULTS Employees in occupations with high emotional demands had an increased risk of hospital-treated depressive disorder with confounder-adjusted hazard ratios of 1.32 [95% confidence interval (CI) 1.24‒1.41] and 1.19 (95% CI 1.09‒1.30) in JEMPAD and DaWCO, respectively. This association remained after controlling for risk factors before workforce entry. CONCLUSIONS This study suggests that employees in occupations with high emotional demands are at increased risk of hospital-treated depressive disorder. This increased risk was neither attributable to reporting bias nor explained by the included risk factors for depression recorded before workforce entry.
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Affiliation(s)
- Ida Eh Madsen
- National Research Centre for the Working Environment, Lerso Parkalle 105, DK- 2100 Copenhagen, Denmark.
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10
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Framke E, Sørensen JK, Alexanderson K, Farrants K, Kivimäki M, Nyberg ST, Pedersen J, Madsen IEH, Rugulies R. Emotional demands at work and risk of long-term sickness absence in 1·5 million employees in Denmark: a prospective cohort study on effect modifiers. LANCET PUBLIC HEALTH 2021; 6:e752-e759. [PMID: 34563282 DOI: 10.1016/s2468-2667(21)00185-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/01/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND High emotional demands at work can affect employees' health and there is a need to understand whether such an association might be modified by other working conditions. We aimed to examine emotional demands at work as a risk factor for long-term sickness absence and analyse whether influence, possibilities for development, role conflicts, and physical demands at work might modify this risk. METHODS We did a nationwide, population-based, prospective cohort study in Denmark and included employed individuals who were residing in Denmark in 2000, aged 30-59 years, who had complete data on age, sex, and migration background, with information on emotional demands and possible effect modifiers from job exposure matrices, and covariates and outcome (sickness absence) from population registers. Individuals with long-term sickness absence (≥6 weeks of consecutive sickness absence) between Jan 1, 1998, and Dec 31, 2000, and self-employed individuals were excluded. We assessed long-term sickness absence during a 10-year period from Jan 1, 2001, to Dec 31, 2010. Using Cox regression, we estimated hazard ratios (HRs) and 95% CIs and tested interaction as departure from additivity, estimating relative excess risk due to interaction (RERI). Multivariable adjusted models included sex, age, cohabitation, migration background, and income. FINDINGS 1 521 352 employed individuals were included and contributed data between Jan 1, 2000, and Dec 31, 2010. During 11 919 021 person-years (mean follow-up 7·8 years), we identified 480 685 new cases of long-term sickness absence. High emotional demands were associated with increased risk of long-term sickness absence compared with low emotional demands, after adjusting for age, sex, cohabitation, migration background, income, and the four possible effect modifiers (adjusted HR 1·55 [95% CI 1·53-1·56]). The association between high emotional demands and risk of long-term sickness absence was stronger in a synergistic way when individuals were also exposed to low possibilities for development (RERI 0·35 [95% CI 0·22-0·47]; 28·9 additional cases per 1000 person-years) and high role conflicts (0·13 [0·11-0·15]; 22·0 additional cases per 1000 person-years). No synergy was observed for influence and physical demands at work. INTERPRETATION People in occupations with high emotional demands were at increased risk of long-term sickness absence. Our findings on synergistic interactions suggest that, in emotionally demanding occupations, increasing possibilities for development and reducing work-related role conflicts might reduce long-term sickness absence. Further interventional studies are needed to confirm or refute this hypothesis. FUNDING Danish Work Environment Research Fund, NordForsk.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | | | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristin Farrants
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK; Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Finnish Institute of Occupational Health, Helsinki, Finland
| | - Solja T Nyberg
- Department of Public Health, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jacob Pedersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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11
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Macassa G, McGrath C, Tomaselli G, Buttigieg SC. Corporate social responsibility and internal stakeholders' health and well-being in Europe: a systematic descriptive review. Health Promot Int 2021; 36:866-883. [PMID: 32856071 PMCID: PMC8384380 DOI: 10.1093/heapro/daaa071] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Corporate social responsibility (CSR) can contribute to the triple bottom line of economic, social and environmental performance in organizations. However, the relationship between CSR, employee health and well-being has not been frequently assessed despite an increased awareness that this relationship can contribute to sustainable workplaces. To identify studies addressing the relationship between CSR and employee health and well-being within the EuCIropean context, we conducted a systematic literature search using Web of Science and Medline. Of the 60 articles screened for inclusion, 16 were retained. The results suggest that the majority (n = 14) of the identified studies aimed to understand the impact of CSR strategies on employees' job satisfaction. None of the studies investigated the relationship between internal CSR and physical health. There was no clarity in the measurement of either internal CSR or the extent to which it affected employee outcomes. There is a need for consensus on measurement of internal CSR and of the health and well-being-related outcomes. Public health and occupational health researchers should be part of the discussion on the potential role of CSR in physical and psychological health outcomes beyond job satisfaction.
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Affiliation(s)
- Gloria Macassa
- Department of Occupational and Public Health Sciences, University of Gävle, Kungsbäcksvägen 47, Gävle 801 76, Sweden.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, Porto 4050-600, Portugal
| | - Cormac McGrath
- Department of Education, Stockholm University, Frescativägen, 11419, Stockholm 106 91, Sweden.,Department of LIME, Karolinska Institutet, Solnavägen 1, Solna 171 77, Sweden
| | - Gianpaolo Tomaselli
- Department of Health Services Management, Faculty of Health Sciences, University of Malta, Msida MS2080, Malta
| | - Sandra C Buttigieg
- Department of Health Services Management, Faculty of Health Sciences, University of Malta, Msida MS2080, Malta.,Health Services Management Centre, School of Social Policy, College of Social Sciences, University of Birmingham, Birmingham B15 2TT, UK
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12
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Leadership Quality and Risk of Long-term Sickness Absence Among 53,157 Employees of the Danish Workforce. J Occup Environ Med 2021; 62:557-565. [PMID: 32324702 PMCID: PMC7409772 DOI: 10.1097/jom.0000000000001879] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine whether low leadership quality predicts long-term sickness absence (LTSA) in Denmark. METHODS Using Cox models, we estimated the association between exposure to low leadership quality and onset of register based LTSA (more than or equal to 6 weeks) during 12-months follow-up among 53,157 employees without previous LTSA. RESULTS During 51,155 person-years, we identified 2270 cases of LTSA. Low leadership quality predicted LTSA with a dose-respone pattern after adjustment for confounders. The hazard ratio (HR) of LTSA in the lowest compared with the highest quartile of leadership quality was 1.61 (95% CI: 1.43 to 1.82). Further, change from high to low leadership quality over time predicted risk of LTSA (HR = 1.42, 95% CI: 1.02 to 1.97) compared with persistent high leadership quality. CONCLUSIONS Exposure to low leadership quality is a risk factor of LTSA in the Danish workforce.
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13
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Rugulies R, Sørensen JK, Madsen IEH, Nordentoft M, Sørensen K, Framke E. Can leadership quality buffer the association between emotionally demanding work and risk of long-term sickness absence? Eur J Public Health 2021; 31:739-741. [PMID: 34219170 PMCID: PMC8561255 DOI: 10.1093/eurpub/ckab090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We examined whether the association between emotionally demanding work and risk of register-based long-term sickness absence (LTSA, ≥6 weeks) was buffered by high leadership quality among 25 416 Danish employees during 52-week follow-up. Emotional demands were measured at the job group level, whereas leadership quality was measured by workers rating their closest manager. Emotionally demanding work was associated with a higher risk of LTSA, regardless if leadership quality was high or low, with neither multiplicative nor additive interaction. We conclude that we found no evidence for high leadership quality buffering the effect of emotionally demanding work on risk of LTSA.
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Affiliation(s)
- Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mads Nordentoft
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Kathrine Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
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14
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Faruque MO, Framke E, Sørensen JK, Madsen IEH, Rugulies R, Vonk JM, Boezen HM, Bültmann U. Psychosocial work factors and blood pressure among 63 800 employees from The Netherlands in the Lifelines Cohort Study. J Epidemiol Community Health 2021; 76:60-66. [PMID: 34215566 PMCID: PMC8666827 DOI: 10.1136/jech-2021-216678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/02/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Previous studies on the association between psychosocial work factors and blood pressure mainly focused on specific occupations or populations and had limited sample sizes. We, therefore, investigated the associations between psychosocial work factors and blood pressure in a large general working population in the Netherlands. METHODS We included 63 800 employees from the Netherlands, aged 18-65 years, with blood pressure measurements and a reliable job code at baseline. Psychosocial work factors (job strain, effort-reward imbalance (ERI) and emotional demands) in the current job were estimated with three recently developed psychosocial job exposure matrices. To examine the associations, regression analyses adjusted for covariates (age, sex, body mass index, education, monthly income, pack-years, smoking, alcohol consumption and antihypertensive medication (not included for hypertension)) were performed. RESULTS Higher job strain was associated with higher systolic blood pressure (SBP) (B (regression coefficients) (95% CI) 2.14 (1.23 to 3.06)) and diastolic blood pressure (DBP) (B (95% CI) 1.26 (0.65 to 1.86)) and with higher odds of hypertension (OR (95% CI) 1.43 (1.17 to 1.74)). Higher ERI was associated with higher DBP (B (95% CI) 4.37 (3.05 to 5.68)), but not with SBP or hypertension. Higher emotional demands were associated with lower SBP (B (95% CI) -0.90 (-1.14 to -0.66)) and lower odds of hypertension ((OR) (95% CI) 0.91 (0.87 to 0.96)). CONCLUSIONS In the general working population, employees in jobs with high job strain and ERI have higher blood pressure compared with employees with low job strain and ERI. Emotional demands at work are inversely associated with blood pressure.
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Affiliation(s)
- Md Omar Faruque
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Groningen, Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | | | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Judith M Vonk
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Groningen, Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - H Marike Boezen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Groningen, Netherlands .,Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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15
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Harkko J, Nordquist H, Pietiläinen O, Piha K, Mänty M, Lallukka T, Rahkonen O, Kouvonen A. Frequent short sickness absence, occupational health service utilisation and long-term sickness absence due to mental disorders among young employees. Int Arch Occup Environ Health 2021; 94:1549-1558. [PMID: 34095973 PMCID: PMC8384820 DOI: 10.1007/s00420-021-01728-5] [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: 04/30/2020] [Accepted: 04/01/2021] [Indexed: 11/16/2022]
Abstract
Objectives We examined whether frequent short-term sickness absence (FSTSA) and primary care use in occupational health service (OHS) were associated with medically-certified long-term sickness absence (LTSA) due to mental disorders among young employees. Methods We used record-linkage data covering the young employees (< 35 years) of the City of Helsinki, Finland (n = 8,282) from 2010 to 2014. The outcome was LTSA due to mental disorders. Cox regression models were fitted. Results FSTSAs were associated with subsequent LTSA. Also OHS use predicted LTSA due to mental disorders; however, this association was not found for those with prior FSTSA. Conclusions Both FSTSA and primary care use indicate subsequent LTSA independently, and together these indicators identify a larger proportion of individuals at risk of LTSA due to mental disorders.
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Affiliation(s)
- Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Hilla Nordquist
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,South Eastern Finland, University of Applied Sciences, Kotka, Finland
| | - Olli Pietiläinen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kustaa Piha
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Minna Mänty
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Unit of Strategy and Research, City of Vantaa, Vantaa, Finland
| | - Tea Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Administrative Data Research Centre, Northern Ireland, Centre for Public Health, Queen's University, Belfast, UK
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16
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Framke E, Svane-Petersen AC, Holm A, Burr H, Melchior M, Sivertsen B, Stansfeld S, Sørensen JK, Virtanen M, Rugulies R, Madsen IEH. Cumulated and most recent job control and risk of disability pension in the Danish Work Life Course Cohort (DaWCo). Eur J Public Health 2020; 30:1212-1218. [PMID: 32658982 PMCID: PMC7733044 DOI: 10.1093/eurpub/ckaa107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous studies have found low job control to be associated with a higher risk of disability pension (DP). Most studies have measured job control only at one time-point, and there is a lack of knowledge regarding the role of exposure duration. This study examines the prospective association between job control and DP measuring exposure both cumulated throughout work life and most recent. METHODS We included 712 519 individuals (about 4.5 million person-years) from The Danish Work Life Course Cohort which follows young employees in Denmark from their entry into the labour market. Job control was assessed with a job exposure matrix and DP with register data on public transfer payments. We adjusted for several potential life course confounders, including physical demands at work and parental socioeconomic position and psychiatric and somatic diagnoses. RESULTS Employees in occupations with low job control had a higher risk of DP. There were effects of both cumulated and most recent job control when mutually adjusted. Fully adjusted hazard ratios (HRs) were 1.14 [95% confidence intervals (CIs) 1.11-1.17] and 1.15 (95% CI 1.02-1.29) for cumulated and most recent job control, respectively. Without mutual adjustment, estimates were 1.15 (95% CI 1.13-1.18) and 1.55 (95% CI 1.39-1.72) for cumulated and most recent low job control, respectively. CONCLUSIONS Low job control predicts a higher risk of DP, even after adjustment for physical demands at work. The results indicate both gradual and short-term effects of low job control on DP risk.
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Affiliation(s)
- Elisabeth Framke
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Anders Holm
- Department of Sociology, University of Western Ontario, London, ON, Canada
| | - Hermann Burr
- Unit Mental Health and Cognitive Capacity, Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Maria Melchior
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Research Group in Social Epidemiology, F75012 Paris, France
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Stephen Stansfeld
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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17
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Duarte J, Berthelsen H, Owen M. Not All Emotional Demands Are the Same: Emotional Demands from Clients' or Co-Workers' Relations Have Different Associations with Well-Being in Service Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217738. [PMID: 33105900 PMCID: PMC7660165 DOI: 10.3390/ijerph17217738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 11/16/2022]
Abstract
There has been an increased interest in the study of emotional demands (ED) at work and its impact on workers’ well-being. However, ED have been conceptualized as a unitary concept, focused on interactions with clients, and excluding other potential sources of ED at work. Therefore, the aim of the current study is to explore the relation between ED from different relational sources (clients/patients/customers and colleagues, supervisors, and employees) and service workers’ exhaustion and engagement. Cross-sectional data from a sample of 2742 service workers were analysed using structural equation modelling. Results showed that ED from both sources (clients and colleagues) were associated with more emotional exhaustion, particularly if dealing with clients was not an integrated part of the role. Further, ED from clients’ relations were negatively associated with engagement for managers with staff responsibility, but positively for managers without staff responsibility. We also found moderating effects of psychosocial safety climate (PSC), whereby ED had the strongest effect on emotional exhaustion when PSC was low. This study suggests that different relational sources of ED at work have a different impact on employees’ well-being. Strategies that promote a reduction of extra-role ED, and the development of a PSC in the organization, could therefore offer possible solutions to promote employees’ psychological well-being and motivation.
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Affiliation(s)
- Joana Duarte
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, 21119 Malmö, Sweden
- Correspondence:
| | - Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA) & the Faculty of Odontology, Malmö University, 21119 Malmö, Sweden;
| | - Mikaela Owen
- Centre for Workplace Excellence, University of South Australia, Adelaide, SA 5001, Australia;
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