Effort-reward imbalance and job strain index associated with health-related quality of life for civil servants in a national survey: the mediation effect of job support and over-commitment

OBJECTIVES

Work-related stress (WRS) is significantly associated with health-related quality of life (HRQoL), but the amounts of evidence on differences of effort-reward imbalance (ERI) and job strain index (JSI) remain sparse and have limited generalizability. Therefore, we aimed to assess the association between ERI and JSI with HRQoL and assess the mediation effect of social support (JS) and over-commitment (OC) on this association in Taiwan's civil servants.

MATERIAL AND METHODS

A cross-sectional national survey was given to registered civil servants in Taiwan - 20 046 civil servants from 647 institutions were enrolled using multistage stratified random cluster sampling. A web-questionnaire collected demographic information, job characteristics, and different indexes of ERI and job-control-demand-support (JCDS) models. Structural equation model (SEM) was used to examine the association between ERI and JSI with HRQoL, and the mediation effect of JS and OC on the associations.

RESULTS

In the ERI model, ERI and OC were consistently negatively associated with the mental component score (MCS) (r = -0.46 and r = -0.37) and physical component score (PCS) (r = -0.45 and r = -0.34), which were higher than job demand (r = -0.28 and r = -0.22) and JSI (r = -0.38 and r = -0.29). Using hierarchical multiple regression analyses, ERI was significantly correlated with MCS and PCS, which was consistently higher than JSI. The ERI and JSI were significantly correlated with MCS (β = -0.170 and β = -0.140) and PCS (β = -0.150 and β = -0.082) using SEM analysis, whereas ERI was considerably higher than in JSI. In addition, OC and JS mediated the association between The ERI and JSI with HRQoL.

CONCLUSIONS

We found the ERI index is significantly correlated with HRQoL superior to JSI, in particular among Taiwan civil servants. Further longitudinal studies are needed to determine the causality and spatiotemporal relation of these differences. Int J Occup Med Environ Health. 2022;35(4):425-36.

The Protective Role of Job Control/Autonomy on Mental Strain of Managers: A Cross-Sectional Study among Wittyfit's Users

BACKGROUND

Karasek's Job Demand-Control-Support model is the gold standard to assess the perception of work; however, this model has been poorly studied among managers. We aimed to explore the perception of work (job demand, control, and support) in managers, and to quantify their risk of job strain (high job demand and low job control) and isostrain (job strain with low job support).

METHODS

We conducted a cross-sectional study on workers from various French companies using the Wittyfit software. Job demand, control, and support were evaluated by self-reported questionnaires, as well as sociodemographic data.

RESULTS

We included 9257 workers: 8488 employees (median age of 45 years, median seniority of 10 years, 39.4% women) and 769 managers (463 were more than 45 years old, 343 with more than 10 years of service, 33.3% women). Managers had higher mean ± SD levels than employees in job control (79.2 ± 14.9 vs. 75.4 ± 16.9) and job support (25.2 ± 5.1 vs. 24.0 ± 6.1) (p < 0.001). Compared to employees, managers had a 37% decreased risk of job strain (OR = 0.63, 95% CI 0.52 to 0.77) and a 47% decreased risk of isostrain (OR = 0.53, 95% CI 0.40 to 0.69) (p < 0.001). Workers over age 45 (OR = 1.26, 95% CI 1.14 to 1.40, p < 0.001) and women (OR = 1.12, 95% CI 1.01 to 1. 25, p = 0.03) were at greater risk of job strain. Furthermore, workers over age 45 (OR = 1.51, 95% CI 1.32 to 1.73, p < 0.001), workers with over 10 years of service (OR = 1.35, 95% CI 1.16 to 1.56, p < 0.001), and women (OR = 1.15, 95% CI 1.00 to 1.31, p = 0.04) were at greater risk of isostrain.

CONCLUSIONS

Managers seem to have higher autonomy and greater social support and therefore are less at risk of job strain or isostrain than employees. Other factors such as age, seniority, and sex may influence this relationship.

TRIAL REGISTRATION

Clinicaltrials.gov: NCT02596737.

Factors associated with work-family enrichment among Chinese nurses assisting Wuhan's fight against the 2019 COVID-19 pandemic

AIMS AND OBJECTIVES

To examine the relationship between work-family enrichment and two contextual factors (job support and family support), together with two personal factors (family boundary flexibility and prosocial motivation) among Chinese nurses assisting Wuhan in its fight against the Coronavirus Disease 2019 (COVID-19) pandemic.

BACKGROUND

The COVID-19 pandemic was first reported in Wuhan, China, and has now spread worldwide, which has brought attention to the pivotal role of nurses in public health emergencies. Work-family enrichment is a bidirectional structure, including work-to-family enrichment and family-to-work enrichment, that can yield many mutually beneficial results in both work and family domains among clinical nurses. However, few studies have investigated work-family enrichment and its influential factors among front-line nurses during public health emergencies.

METHODS

A cross-sectional research design was adopted with a snowball sample of 258 Chinese nurses assisting Wuhan's anti-pandemic efforts. Data were collected from 21 March 2020 until 10 April 2020 through a battery of online questionnaires. Descriptive, univariate and hierarchical linear regression analyses and a Pearson correlation test were performed. A STROBE checklist was used to report findings.

RESULTS

The results showed that prosocial motivation, family support and job support predicted high work-to-family enrichment in those nurses, while prosocial motivation, family support and family boundary flexibility predicted high family-to-work enrichment.

CONCLUSIONS

The study confirmed the importance of paying attention to the work-family enrichment of front-line medical workers during the COVID-19 pandemic, so that they could concentrate on their anti-pandemic work and maintain their enthusiasm for disaster nursing.

RELEVANCE TO CLINICAL PRACTICE

The findings can help health administrators in affected countries around the world identify the influential factors of work-family enrichment among front-line nurses during infectious disease outbreaks, specifically in the areas of mobilising nurses' prosocial motivation and giving sufficient job support.

Job Demand-Control-Support Latent Profiles and Their Relationships with Interpersonal Stressors, Job Burnout, and Intrinsic Work Motivation

In the Job Demand-Control-Support (JDCS) model, the combination of job demands, job control, and social support was hypothesized to lead to eight different constellations of job types. According to the model, these constellations are linked to wellbeing/health and learning outcomes. In the last three decades, these constellations of job types have been investigated by adopting a variable-centered perspective. However, latent profile analyses (LPA) enable a person-centered approach and empirically capture constellations of job types. In the present study, we used LPA to empirically identify distinct profiles of JDCS among Italian healthcare workers. Furthermore, we investigated the role of social stressors (workplace relationships and coworkers’ incivility) as antecedents of these profiles and the association of these profiles with job burnout and work motivation. Results from LPA (n = 1671) revealed four profiles: Isolated Prisoner, Participatory Leader, Moderate Strain, and Low Strain. Negative relationships at work and coworkers’ incivility increased the chances of being included in both Isolated prisoner and Participatory Leader profiles. Finally, the Isolated Prisoner and Moderate Strain profiles showed the highest levels of emotional exhaustion and cynicism and the lower levels of intrinsic work motivation. This study extends previous JDCS research, highlighting that researchers should consider empirically identified profiles rather than theoretically defined subgroups. Implications for stress theory, future research, and practice are discussed.

The Interaction Effects of Burnout and Job Support on Peptic Ulcer Disease (PUD) among Firefighters and Policemen

Policemen and firefighters encounter numerous emergency events that frequently lead to high burnout and low job support, resulting in adverse health effects. A number of studies reported the correlation between job characteristics and the risk of peptic ulcer diseases (PUD) across various industries. However, there is very little research on evaluating the interaction effects of burnout and job support on the prevalence of PUD among firefighters and policemen. The objective of this study was to assess the interactional effects between burnout and job support on the prevalence of PUD among firefighters and policemen. This was a cross-sectional quantitative study. Registered, full-time police officers and firefighters in Taiwan were anonymously interviewed by a mail-delivered questionnaire. All female workers were excluded due to different job characteristics and a limited sample size. A total of 9328 firefighters and 42,798 policemen completed the questionnaire, with a response rate of 78.7%. Overall, prevalence rates of self-reported and self-reports of physician-diagnosed PUD were 8.3% and 6.5% for policemen and 7.1% and 5.5% for firefighters, respectively. There was a 22% reduced odds ratio of PUD as diagnosed by physicians for the group with low burnout and high job support, but an increased odds ratio of 53% for the group with high burnout and low job support, after adjusting for lifestyle and demographic variables. There must be an increase of job support and reduction of burnout through the modification of work structure and setting up of counseling services to reduce workplace stress and the prevalence of PUD among policemen and firefighters.

[Association between Job Stress and Number of Physical Symptoms among Female Nurses of Medical-university-affiliated Hospitals]

OBJECTIVES

To clarify the association between job stress and the number of physical symptoms among newly certified female nurses.

METHODS

In this cross-sectional self-administered survey, we investigated 313 female nurses working at three medical-university-affiliated hospitals in February 2016. We investigated working conditions including numbers of working and on-call hours, work-life balance, Job Content Questionnaire (JCQ) scores, and 16 physical symptoms perceived more often than once a week.

RESULTS

Among the 313 participants (mean age, 31.9), 57% were aged 21-29 years and 70% were single. Of the 16 physical symptoms investigated, fatigability was the most frequent complaint (66.1%), followed by lower back pain (44.7%). Univariate analysis showed that significant factors related to physical symptoms are job demands (p<0.001) and social support (p<0.001) in JCQ, binary index of supports (p<0.001), and total working hours per day (p =0.025). Multivariable-adjusted logistic regression analyses demonstrated that the likelihood of reporting a greater number (n≥3) of physical symptoms increased by 7% [95% confidence interval (CI), 2-13%] with a one-unit increase in job demand degree, and decreased by 16% (95% CI, 10-22%) in social support degree. When binary JCQ indexes were assessed, the high-support group [odds ratio (OR) 0.36; 95% CI, 0.23-0.59] was protectively associated with a greater number of physical symptoms while long working hours was significantly associated with a higher risk (OR 18%, 95% CI, 1-38%).

CONCLUSIONS

Reporting a greater number of physical symptoms may be a good indicator of job stress perceived by a nurse in a university hospital setting.

Work-related factors, job satisfaction and intent to leave the current job among United States nurses

AIMS AND OBJECTIVES

To examine the relationships of work-related factors (e.g., autonomy, work schedule, supervisory and peer support) to nurses' job satisfaction and intent to leave their current position.

BACKGROUND

Low job satisfaction and high turnover of nurses are major problems for health care. To improve nurse retention, work-related factors associated with job satisfaction and intent to leave should be investigated.

DESIGN

A cross-sectional secondary data analysis.

METHODS

Data were obtained in 2004 from Wave 3 of the Nurses' Worklife and Health Study. A random sample of 5000 actively licenced nurses in Illinois and North Carolina (two U.S. states) were sent the survey in wave 1, of which 1641 actively working bedside nurses participated in wave 3. We examined associations of various work-related factors with job satisfaction and intent to leave the current position.

RESULTS

Nurses who were dissatisfied with their job reported significantly higher psychological demands and lower autonomy than nurses who were satisfied. Nurses were significantly less satisfied with their jobs when they worked longer hours with inadequate breaks or sick days. Lack of support from peers and supervisors was also related to significantly lower odds of job satisfaction. For intention to leave, nurses who said they planned to leave their current job reported significantly lower autonomy and less support from their peers than nurses who intended to stay.

CONCLUSION

A variety of modifiable work-related factors were significantly related to job satisfaction and intention to leave the current job among nurses. Future research should focus on developing interventions that could mitigate these factors (e.g., by improving work schedules, increasing autonomy and/or nurse support). The impact of such interventions on job satisfaction and intention to leave the current position could then be evaluated.

RELEVANCE TO CLINICAL PRACTICE

To increase nurse retention, improved schedules, autonomy and supportive work environments should be promoted.