Effort-Reward Imbalance and Quality of Life Among Female Nurses at a General Hospital in Japan

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An effort-reward imbalance (ERI) model is a measurement of psychosocial work stress. The ERI model with both the effort-reward ratios and the concept of overcommitment (OC) indicates that work stress is related to high effort with low reward. Effort is evaluated by measuring work demands. Reward includes money, esteem, status, and control over promotion prospects, and job security. Overcommitment is a set of attitudes, behaviors, and emotions that reflect excessive work effort13,14,18). This model has been used to study psychosocial work stress in various occupational groups. It has been suggested that the ERI model has a predictive power for poor physical or mental health2-3,6-8,10,12,14-16,18-21). Concerning overcommitment, according to Siegrist and Tsutumi et al., overcommitment causes emotional exhaustion and exacerbates the negative effects of the effort-reward imbalance14,18). Weyers et al. found that nurses who report higher ERI with high overcommitment scores were twice as likely to suffer from poor psychological health compared to those who report higher ERI with low overcommitment scores21). Aust et al. and Ire et al. found that overcommitment was significantly reduced in an intervention group through stress management programs or counseling1,4).