Effort-reward Balance Research Articles

Motivating supervisors during disability accommodation: a comprehensive examination on job demand and resources theories

PurposeThis study develops and tests a comprehensive model that examines whether dimensions of supervisors’ job demands and resources influence their work motivation through their job strain levels while managing disability accommodation (DA).Design/methodology/approachThe proposed model leverages the assumptions of established job demand and resources theories, including demand-ability fit, job demand-control, job demand-control-support, and effort-reward balance models. Then, we tested with the quantitative data from 335 British, Canadian, American, Australian, Dutch, and German supervisors with recent DA experience.FindingsThis study found support for the proposed model. Job control and social support directly affected work motivation, while job strain did not mediate the relationship between job control and social support and work motivation. The results suggest that employers looking to improve the likelihood of DA success should focus on providing adequate job control, social support, and rewards to supervisors responsible for accommodating employees with disabilities.Practical implicationsThis research enhances our understanding of how additional DA responsibilities impact supervisors and aids in the development of effective DA management policies and interventions, providing robust support for practitioners.Originality/valueThis study contributes to extending the DA literature by testing the applicability of different theoretical models to explain the effect of the additional DA responsibility on supervisors’ job demand, strain, and motivation levels and identify the resources to mitigate them.

Job satisfaction and work stress among physicians in Norway and Germany-A cross-sectional study.

Physicians' health and wellbeing are important albeit often neglected quality indicators of health care systems. The aims of the study were to compare job satisfaction and work stress among doctors in Germany and Norway, and to identify predictors for job satisfaction. All active physicians in Schleswig-Holstein, Germany (N = 13,304) and a nationwide sample of Norwegian physicians (N = 2,316) were surveyed in a cross-sectional design in 2021. Response rates of German and Norwegian physicians were n = 4,385 (33%) and n = 1,639 (70.8%), respectively. In addition to age, sex, and work-hours, the main outcome measures were the validated Job Satisfaction Scale (JSS) and the short form of the Effort-Reward Imbalance Questionnaire (ERI). There were significant differences between Norwegian and German physicians in job satisfaction but with small effect sizes. All effort scores of German physicians were significantly higher and four of seven reward scores significantly lower than for their Norwegian colleagues. The proportion of German physicians in the state of a gratification crisis was significantly higher (67%) than in their Norwegian colleagues (53%). In both countries, physicians with a gratification crisis scored significantly lower on all items of job satisfaction. There were only minor gender differences in job satisfaction and effort-reward balance. Age, effort, and reward accounted for 46% of the explained variance of job satisfaction. Lower job satisfaction and reward in some areas and higher perceived effort of physicians in Germany than in Norway are still in favor of Norwegian working conditions, but the differences seem to diminish. The high proportions of gratification crises in both countries warrants appropriate measures for prevention and health promotion.

Anxious hotel employees in China: Engaged or exhausted? Multiple effects of workplace anxiety

This study aims to investigate the multiple effects of hotel employees' workplace anxiety under COVID-19. By using time-lag data with 223 matched responses, we showed that workplace anxiety has a positive direct impact on workaholic behavior, emotional exhaustion, and work withdrawal behavior and that effort-reward balance (imbalance) would ameliorate (deteriorate) the negative effect of workaholic behavior on emotional exhaustion, implying that understanding of the adverse but reversible effects of workplace anxiety could help strengthen the hotel industry's development. This study may be the first attempt to examine the moderation of ERI in the link between workaholic behavior and emotional exhaustion, as well as how to mitigate such negative consequences, thereby contributing to the existing hospitality literature. Moreover, we argue that exploring more new ways to deal with workplace anxiety among hotel employees while maintaining employee performance is worthwhile for future research, especially given the industry's current competitive conditions.

Understanding socio-labor inclusion among young adults with autism spectrum and mental disorders: preliminary findings

IntroductionPrevious studies suggest that adults with mental disorders (MD) or Autism Spectrum Disorder (ASD) are more likely to be unemployed than those without MD. However, it is unclear whether working adults with MD or ASD perceive the same effort-reward balance as their counterparts without MD or ASD.ObjectivesTo analyze labor conditions and to identify factors associated with effort-reward imbalance among young adults with ASD, MD and those from the general population (GP).MethodsA qualitative and quantitative study design is being conducted to analyze the rates of employment among young adults with ASD, and to identify factors associated with employment rates (Fondecyt ID11201028.). As part of this study, we conducted a quantitative analysis in young adults 16 to 30 years of age in two regions of Chile between August and October, 2022. Young adults with MD and ASD were compared with adults of similar age recruited from the GP. We applied a questionnaire to collect data on participant’s sociodemographic information, autonomy level and employment status. We applied the short Spanish version of the effort–reward imbalance (ERI) and overcommitment (OC) questionnaire, which has been widely used in Latin American countries.Chi-square test was used and the Kruskal Wallis H Test was applied to compare among groups. The statistical significance was set at P<0.05.ResultsOverall, 422 participants were included in the analysis (mean age 22±3.2, 64.2% women, 65.2% students, and 4.4% unemployed). Of the total respondents, 22% of young adults from GP, 17.8% with MD, and 4.8% with ASD were working at the moment of the survey. Regarding autonomy level, a higher proportion of participants with ASD needed support (36.4%), compared with 9.7% and 0.8% of young adults with MD and GP, respectively. Of the population who reported working (n=125), about 56.0% have a permanent job, and 44% a seasonal or occasional job. The median value for the effort–reward ratio was 0.96 (range 0.4–1.8), with no significant differences between the groups. Of those participants working, 44.3% showed an ERI ratio higher than 1, which was higher in participants with ASD (60%). ERI-esteem was significantly different (P=0.01) among ASD (7.0; range 5-8), MD (6.0; range 2-8) and PG (6.0; range 2-8). In the OC questionnaire, young adults with ASD were more likely to think about work (P=0.01) and having trouble sleeping at night due to work issues (P=0.03) than GP and MD groups.ConclusionsThe ASD group showed higher overcommitment and a considerable proportion of subjects at risk of effort-reward imbalance at work, were more likely to think about work at home, and had trouble sleeping thinking about work. Our preliminary results highlight the importance of considering the working conditions of young adults diagnosed with ASD and the need to provide them with enough support to promote labor inclusion.Disclosure of InterestNone Declared

Does Occupational Stress Play a Role in Forming Restrictionist Immigration Opinions?

ABSTRACT This study extends the labor market competition perspective of immigration attitudes by examining the influence of occupational stress and employer-sponsored stress management programs on native-born, full-time workers’ opinions toward immigration levels. Binary logit and ordered logit models, with data from the 2018 General Social Survey, test the predictions of three occupational stress theories: job demands-control-support, effort-reward balance, and distributive justice. The results indicate that native-born, non-Hispanic white workers and native-born, Latino workers who are unable to develop their occupational skills on the job have greater odds of favoring reduced immigration. Job insecurity, lack of promotion opportunities, and poor intercolleague respect also negatively affect native-born, non-Hispanic white workers’ immigration opinions, while having to expend greater physical effort and having less time to complete the work negatively affect native-born, Latino workers’ immigration opinions. At the same time, native-born, non-Hispanic white workers who participate in stress management training have significantly greater odds of supporting increased immigration levels and significantly lower odds of desiring lower immigration levels. As immigration to the United States remains strong, understanding the social processes of native-born employee perceptions and the solutions to problematic intergroup relations may benefit individuals, businesses, and the economy.

Association between work stress and health behaviours in Korean and Japanese ageing studies: a cross-sectional study

ObjectivesLimited research has focused on the association between work stress and health behaviours in Asian countries. We aimed to explore the effect of work stress on two health behaviours among...

Stress Management in Pre- and Postoperative Care Amongst Practitioners and Patients in Cardiac Catheterization Laboratory: A Study Protocol.

BackgroundAs the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization.MethodsThe clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis.DiscussionThis study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines.

Mental health problems and their related factors among seafarers: a scoping review

BackgroundSeafarers are often reported to be engaged in a dangerous physical and psychosocial work environment. However, mental health status among seafarers has not been focused on compared with physical health issues. Systematic, comprehensive reviews of mental health problems and their relevant factors are lacking. This review aimed to clarify beneficial approaches to the mental health problems faced among seafarers using a scoping review to systematically map the evidence regarding mental health issues and their related factors.MethodsStudies were searched on MEDLINE/PubMed, Science Direct, Academic search complete using EBSCOhost databases, SCOPUS, EMBASE, and Web of science on 20, August 2020. This scoping review was conducted based on the framework of Arksey and O’Malley and Preferred Reporting items for Scoping Reviews flow diagram. The inclusion criteria were studies which determined the relationship between factors relevant to working conditions or working environment, and mental health in seafarers, and etc. Data were narratively summarized and reported.ResultsTwenty-four were included in this review while two major findings were clarified. Firstly, the prevalence of stress, depressive symptoms, and burnout have been mentioned for decades. Secondly, factors related to mental health and psychological issues can be categorized as individual and work environmental factors. The individual factors include experience, age, health status (high BMI, poor sleep, and diabetics), and resilience. The work environmental factors consist of two parts. Job demands comprise pressure from contractors/customers/time, working hours, ship department, job title, voyage episodes, period of seafaring, noise, and vibration. The job resources included instrumental support, team cohesion, shipboard caring and effort-reward imbalance.ConclusionsA beneficial approach to mental health problems faced among seafarers is necessary to understand comprehensively at individual and organization levels. Promoting health behaviors, training resilience, and managing obesity and chronic diseases comprise individual level strategies. Providing seafarers with adequate instrumental support, and practical support to communicate with customers, managing their distinct work-rest hours and adequate effort-reward balance comprise organization level methods.

Application of Psychological Contract Theory in Mental Health and Professional Development of University Teachers.

Mental health is an important element of human public health. To investigate the respective causes of and the relationship between effort-reward imbalance and psychological anxiety of university teachers, the author, after making a targeted survey of more than 2000 questionnaires and conducting statistics and analysis of the survey data, discovers that the effort-reward imbalance has a significant effect on the anxiety of university teachers and meanwhile, effort-reward imbalance will indirectly affect the anxiety of university teachers through the breach of psychological contracts and thus directly affect the mental health of university teachers. To solve this problem, the author takes advantage of the psychological contract theory and designs a mental health improvement system for university teachers, that is, to pay more attention to the feeling of effort-reward balance of young university teachers, to give more care and help to teachers who have imbalance feelings, to take the maintenance of psychological contracts as an important starting point of the ideological work of young teachers in universities, and so on. Through the implementation of relevant systems, colleges and universities have effectively strengthened their ability to fulfill contracts, established convenient and unobstructed communication channels, prevented breach of psychological contracts of teachers, and prevented teachers from working at high exhaustion at the cost of their physical and mental health, which can finally improve the job satisfaction and professional development of university teachers and enable them to be devoted to higher education in better health.

Predicting of job burnout of female nurses based on effort – reward imbalance and characteristics of positive psychology

Introduction: The present study aimed to predict job burnout based on effort-reward imbalance and characteristics of positive psychology among female nurses of Shahid Rahnemoon Hospital of Yazd. Materials and Methods: The research method was descriptive; correlation type. 132 female nurses working in the different parts of Shahid Rahnemoon Hospital in Yazd were selected by random sampling. Three questionnaires (Muslesh & Jackson`s job burnout, Seligman`s positive psychological characteristics scale, and effort-reward imbalance of Seigersit) were completed by nurses. Results: The findings of the one-sample t-test showed that the job burnout level of nurses in the components of emotional exhaustion and depersonalization was moderate, but personal accomplishment is severe and statistically significant. Also, the score of effort-reward imbalance in female nurses is 1.09, which is higher than the cutting point and showed the imbalance of effort-reward in nurses. The situation of the meaning life component and the engagement life component (in the characteristics of positive psychology) among nurses was higher than the average and statistically significant, but the situation of the pleasant life was lower than the average and insignificant. The findings also showed that a positive and significant correlation between effort-reward imbalance with job burnout(r=0.458, p<0.01), as well as a negative and significant correlation between the positive psychological characteristics with job burnout (r=-0.65, p<0.01). In addition, the results of multiple regression analysis showed that 40% of variances of job burnout were predicted by the meaning of life, the effort-reward imbalance, and the engagement life. Conclusion: According to the results of this study, job burnout of nurses is moderate. Serious action should be taken by health policymakers and managers to increase the effort-reward balance improve the characteristics of positive psychology and reduce the burnout of nurses.

Motivating Supervisors During Disability Accommodation

This study examined the relationship between increased job demands and strain on supervisors during disability accommodation (DA). We proposed and tested a comprehensive model of supervisors’ DA, applying/integrating existing theories on job demand and resources (i.e., demand-ability fit, job demand-control, job control-control-support, effort-reward balance, and job demand-resource models) to explain how and why supervisors’ increased job demand during DA can be negatively associated with their work motivation. Specifically, we examined whether the level of supervisors’ job strain can mediate the relationships between multiple dimensions of demand and resources of supervisors (job demand, job control, social support, and rewards) and their work motivation. We also suggest that DA complexity can be associated with increased job demand, which in turn increases strain on supervisors and reduces work motivation. Based on a sample of 335 British, Canadian, American, Australian, Dutch, and German supervisors with recent DA experience, we found support for the demand-ability fit, effort-reward balance, and job demand-resource models. Job strain did not mediate the relationship between job control and social support and work motivation; instead, job control and social support directly affected work motivation. Our findings contribute to the understanding of how increased job demand during DA influences supervisors’ strain and motivation, how DA regulates supervisors’ job demand and strain, and why sufficient job control, social support, and reward is important to support supervisors to accommodate employees with disabilities.

Work-related factors on mental health among migrant factory workers in china: Application of the Demand-Control and Effort-Reward Imbalance Model.

Mental health problems are prevalent among migrant workers in China. The present study examined the prevalence of mental health problems (depression, anxiety and suicidal ideation) among migrant workers in China, and identified the work-related factors associated with their mental health problems based on the Demand-Control and Effort-Reward Imbalance Model. A total of 807 migrant workers were recruited from three factories in Shenzhen using stratified randomized sampling. The prevalence of moderate-to-severe anxiety, mild-to-severe depression and suicidal ideation in the past year was 17.8%, 60.3% and 4.8% respectively. Results from stepwise regression analyses reported that role conflict and effort were risk factors, whereas utilization of job skills and reward were protective factors for anxiety and depression. Social support was also associated with lower level of depression. Effort was the only factor associated with suicidal ideation in the stepwise analysis. Interventions to improve their mental health are warranted and they should work to reduce their role conflict, improve effort-reward balance, promote utilization of skills and increase social support.

Effort-reward balance and work motivation in rats: Effects of context and order of experience

Being motivated means exerting effort toward a goal. The ‘law of least work’ emphasizes a preference for exerting relatively less effort. The law crosses boundaries among species and between physical and mental work. Organisms should be highly sensitive to shifts in effort-reward balance (ERB) in order to make optimal choices. We used a free operant-foraging task to investigate changes in ERB on choice between options requiring more or less effort. Results showed a consistent preference for the option with less effort and insensitivity to shifts in ERB. A second aim explored the influence of order of experience on effort choice. Choice for the more effortful option significantly increased after experiencing an equal effort-reward relationship during the initial free operant-foraging session. This relative increase in choice for the effortful option persisted even after effort-reward imbalance. The findings highlight the importance of contextual factors such as order of experience when examining the impact of shifting effort-reward associations. Instead of ignoring or reducing order effects, the sequence of experience (e.g. for shifts in ERB) could be manipulated to enhance or reduce value of outcomes or effort itself.

Belastungsfaktoren, Overcommitment und Burnout-Risiko bei Bankangestellten unterschiedlichen Alters

Strain factors, overcommitment und burnout risk among bank employees in relation to age Objective: Trends in the working world, financial crises and growing competitive pressure are influencing factors leading to an increase in psychological strain among bank employees. The aim of the study was to analyse the correlations between job-related strain factors and perception of the latter as well as the risk of burnout among bank employees, with overcommitment (OC) as a control variable. Method: In this study, 90 employees (mean age 43.2 ± 9.4 years) working in a regional bank completed questionnaires assessing strain factors, individual stress perception, OC and burnout risk. Results: The main job-related strain factors identified among bank employees were ‘increased data maintenance’, ‘increased PC knowledge requirements’, ‘poor communication structures’, ‘hierarchical pressure to perform’ and ‘pressure to fulfil targets’. One fifth of the overall collective showed an effort-reward imbalance. The subjective perception of older bank employees indicated more pressure to perform concurrent with a lower level of appreciation. Approximately one tenth of the subjects had a critical tendency towards OC, with age not really a significant factor here. The burnout risk among both age groups was comparatively small (2%). There was evidence of weak correlations between some stress factors and burnout risk. The correlations had some influence on OC, whereas age did not. Conclusions: A framework of stress-reducing and coping strategies must be established in order to safeguard the long-term mental health of bank employees. The early detection and prevention of burnout risk, the promotion of an effort-reward balance and the setting of achievable goals are only some of the key factors. It is also advisable to optimise collaboration between occupational health physicians, management and bank employees in order to deal with the problem and improve mental health. Keywords: bank-specific strain factors – effort-reward-imbalance – overcommitment – burnout risk

A longitudinal assessment of occupational stress in Emergency Department Nursing Staff

To examine perceptions of occupational stress in Emergency Department (ED) nurses and measure the impact of interventions to address them. Cross-sectional studies internationally have established that Emergency Department (ED) nursing staff experience high levels of occupational stress. Few however have examined changes in perceptions of stress over time or the impact of interventions to address them. A structured questionnaire completed by volunteer nursing staff in one United Kingdom ED assessing perceptions of occupational stress and job satisfaction. Questionnaire rounds were administered in 2014 (T1), 2015 (T2) and 2017 (T3) at 18-month intervals. Statistical analyses were conducted using multivariate regression, t-tests and Mann-Whitney U tests. Statistically significant improvements in effort-reward balance, relational justice and job satisfaction were seen between T2 and T3 for nurses completing questionnaires at all three time points, but not for other stressors. This study suggests that organisational interventions, supported by robust research data and consistent departmental leadership can positively influence perceptions of organisational stress in ED nurses. Our approach is generic, internationally applicable and can be adopted in all EDs. These occupational stressors are common to all EDs. Nurse managers should know their distribution amongst their staff. Such data can inform interventions to achieve maximal benefits for staff wellbeing and may be of value when targeting resources in times of financial pressure.

Effect of Burnout on Post-traumatic Stress Disorder Symptoms Among Firefighters in Korea: Data From the Firefighter Research on Enhancement of Safety & Health (FRESH).

ObjectivesIt is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea.MethodsA total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling.ResultsJob demands (β=0.411, p<0.001) and effort-reward balance (β=-0.290, p<0.001) were significantly related to burnout. Burnout (β=0.237, p<0.001) and violence (β=0.123, p=0.014) were significantly related to PTSD risk. Trauma (β=0.131, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (β=0.085, p=0.081).ConclusionsOur results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants’ PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.

Does previous job mobility behaviour have an effect on current turnover intentions of rural nurses? A cross-sectional survey in western China

BackgroundNursing shortages are a serious problem in rural China. Little evidence has been found to determine the factors influencing turnover of rural nurses in China. Meanwhile, the effect of nurses' previous job mobility behaviours (ie, nurses who previously moved between different institutions) on their current turnover intentions is rarely identified. This study aimed to identify these factors and determine other factors related to the turnover of rural nurses in China. MethodsA cross-sectional survey was done in seven western provinces of China in 2013. 1163 rural nurses participated in the survey and 1158 were enrolled in this study after data cleaning. Turnover intention was set as a dependent variable; variables related to previous job mobility behaviour including whether they had a previous job mobility behaviour (ie, yes or no), the way of last job mobility behaviour (ie, moving from a same-level medical institution, from a low-level to a high-level medical institution, from a high-level to a low-level medical institution, or from a non-medical institution), and the time of last job mobility behaviour (ie, ≤3 years ago, 4–6 years ago, or ≥7 years ago) were set as the independent variables; and all other variables were set as confounders. We used a descriptive analysis, Pearson's χ2 test, one-way ANOVA, and binary logistic regression analysis for our data analyses. FindingsApproximately 326 (28·2%) of 1158 rural nurses disclosed turnover intentions. 525 (47·1%) had previous job mobility behaviours. The previous job mobility behaviours of rural nurses had a significant effect on their current turnover intentions (odds ratio [OR] 1·85, 95% CI 1·34–2·56); further analyses indicated that the specific way (moving from a same-level medical institution, OR 2·72, 1·59–4·66; moving from a high-level to a low-level medical institution, 1·82, 1·02–3·27; moving from a non-medical institution, 2·37, 1·09–5·17) and time (moving 4–6 years ago, 2·57, 1·59–4·17; moving ≥7 years ago, 2·01, 1·25–3·24) of last job mobility behaviour were significantly associated with nurses' turnover intentions. Other risk factors for turnover intention in rural nurses included a high-level professional title (eg, the title of chief [associate] nurse; OR 4·40, 1·43–13·54), low-level job satisfaction with effort–reward balance (0·77, 0·62–0·96), and social support from superiors (0·67, 0·55–0·83). InterpretationPrevious job mobility behaviours of rural nurses significantly increased their odds of current turnover intentions, especially for those rural nurses who moved between two same-level medical institutions within 4–6 years for the last time of job mobility behaviour. Hospital managers should pay more attention to these rural nurses to reduce their turnover. Reasonable job mobility channels related to career development for rural nurses should also be established. FundingChina Medical Board: Situational Analysis and Policy Evaluation of Development and Retention of Human Resources for Health in Rural Western China (10-029).

Effect of occupational stress on recurrent spontaneous abortion in women of childbearing age

Objective: To investigate the influence of occupational stress on recurrent spontaneous abortion (RSA) in women of childbearing age. Methods: From January to December, 2017, 75 working women of childbearing age (25-35 years) who were admitted to a provisional hospital in Lanzhou, China and diagnosed with RSA were assigned into patient group. At a 1∶4 ratio, 300 age-matched working women who had normal first pregnancy were randomly selected as controls. A case-control study was conducted by a self-made questionnaire and the effort-reward imbalance scale. The impact of occupational stress on RSA in women of childbearing age was analyzed by evaluation of occupational harmful factors, regularity, effort-reward ratio, and sleep quality. Results: There were significant differences in the distribution of sleep, daily exercise, night shift, extrinsic-effort/low-reward score, and effort/low-reward score between the patient group and the control group (χ(2)=7.867, P<0.05; χ(2)=7.377, P<0.05; χ(2)=3.714, P<0.05; χ(2)=6.651, P<0.05; χ(2)=8.556, P<0.05) . With controlled factors such as general conditions and living habits, logistic regression analysis showed that poor sleep quality and high-effort/low-reward were risk factors for RSA (odds ratio[OR]=1.462, 95% confidence interval[CI]: 1.032~2.073; OR=3.253, 95%CI: 1.169~9.053) . A regular work was a protective factor against RSA (OR=0.644, 95%CI: 0.438-0.946) . Conclusion: In occupational stress, irregular working hours, lack of sleep, and high-effort/low-reward are risk factors for RSA. Working women of childbearing age should ensure adequate sleep, pay attention to effort-reward balance, and make a regular work schedule.

Social Connectedness and Perceived Listening Effort in Adult Cochlear Implant Users: A Grounded Theory to Establish Content Validity for a New Patient-Reported Outcome Measure.

Individuals with hearing loss often report a need for increased effort when listening, particularly in challenging acoustic environments. Despite audiologists' recognition of the impact of listening effort on individuals' quality of life, there are currently no standardized clinical measures of listening effort, including patient-reported outcome measures (PROMs). To generate items and content for a new PROM, this qualitative study explored the perceptions, understanding, and experiences of listening effort in adults with severe-profound sensorineural hearing loss before and after cochlear implantation. Three focus groups (1 to 3) were conducted. Purposive sampling was used to recruit 17 participants from a cochlear implant (CI) center in the United Kingdom. The participants included adults (n = 15, mean age = 64.1 years, range 42 to 84 years) with acquired severe-profound sensorineural hearing loss who satisfied the UK's national candidacy criteria for cochlear implantation and their normal-hearing significant others (n = 2). Participants were CI candidates who used hearing aids (HAs) and were awaiting CI surgery or CI recipients who used a unilateral CI or a CI and contralateral HA (CI + HA). Data from a pilot focus group conducted with 2 CI recipients were included in the analysis. The data, verbatim transcripts of the focus group proceedings, were analyzed qualitatively using constructivist grounded theory (GT) methodology. A GT of listening effort in cochlear implantation was developed from participants' accounts. The participants provided rich, nuanced descriptions of the complex and multidimensional nature of their listening effort. Interpreting and integrating these descriptions through GT methodology, listening effort was described as the mental energy required to attend to and process the auditory signal, as well as the effort required to adapt to, and compensate for, a hearing loss. Analyses also suggested that listening effort for most participants was motivated by a need to maintain a sense of social connectedness (i.e., the subjective awareness of being in touch with one's social world). Before implantation, low social connectedness in the presence of high listening effort encouraged self-alienating behaviors and resulted in social isolation with adverse effects for participant's well-being and quality of life. A CI moderated but did not remove the requirement for listening effort. Listening effort, in combination with the improved auditory signal supplied by the CI, enabled most participants to listen and communicate more effectively. These participants reported a restored sense of social connectedness and an acceptance of the continued need for listening effort. Social connectedness, effort-reward balance, and listening effort as a multidimensional phenomenon were the core constructs identified as important to participants' experiences and understanding of listening effort. The study's findings suggest: (1) perceived listening effort is related to social and psychological factors and (2) these factors may influence how individuals with hearing loss report on the actual cognitive processing demands of listening. These findings provide evidence in support of the Framework for Understanding Effortful Listening a heuristic that describes listening effort as a function of both motivation and demands on cognitive capacity. This GT will inform item development and establish the content validity for a new PROM for measuring listening effort.

Efforts, rewards and professional autonomy determine residents\u2019 experienced well-being

The well-being of residents, our future medical specialists, is not only beneficial to the individual physician but also conditional for delivering high-quality patient care. Therefore, the authors further explored how residents experience their own well-being in relation to their professional and personal life. The authors conducted a qualitative study based on a phenomenological approach. From June to October 2013, 13 in-depth interviews were conducted with residents in various training programs using a semi-structured interview guide to explore participants’ experience of their well-being in relation to their professional life. The data were collected and analyzed through an iterative process using the thematic network approach. Effort–reward balance and perceived autonomy were dominant overarching experiences in influencing residents’ well-being. Experiencing sufficient autonomy was important in residents’ roles as caregivers, as learners and in their personal lives. The experienced effort–reward balance could both positively and negatively influence well-being. We found two categories of ways that influence residents’ experience of well-being; (1) professional lives: delivering patient care, participating in teamwork, learning at the workplace and dealing with the organization and (2) personal lives: dealing with personal characteristics and balancing work–life. In residents’ well-being experiences, the effort–reward balance and perceived autonomy are crucial. Additionally, ways that influence residents’ well-being are identified in both their professional and personal lives. These dominant experiences and ways that influence well-being could be key factors for interventions and residency training adaptations for enhancing residents’ well-being.