Effort-reward Imbalance Model Research Articles

O46 PSYCHOSOCIAL STRESSORS AT WORK ARE ASSOCIATED WITH INCREASED BLOOD PRESSURE VARIABILITY

Background and Objectives: Elevated blood pressure variability (BPV) is associated with an increased risk of cardiovascular morbidity and mortality, independently of blood pressure values. Psychosocial stressors at work are modifiable risk factors from the work environment, shown to increase the risk of hypertension and cardiovascular diseases. The present study aims to determine whether psychosocial stressors at work have a detrimental effect on BPV. Methods: The present study relied on a prospective cohort of 3 645 white-collar workers in Quebec City evaluated at three visits: at recruitment, 3 years, and 5 years. At each visit, participants wore an ambulatory blood pressure monitor during working hours and answered a questionnaire on psychosocial work stressors, as measured using validated instruments according to the demand-control (DC) and effort-reward imbalance (ERI) models. Working hours BPV was calculated using average real variability. Results: A total of 7 078 observations (n = 4 246 in women and n = 2 832 in men) were available. Using the DC model, systolic and diastolic BPV were higher in active (high psychological demands, high job control) when compared to non-exposed participants (low demands, high control). Using the ERI model, systolic and diastolic BPV were higher among participants exposed to an imbalance between efforts at work and rewards when compared to unexposed participants. These associations were robust to adjustment for socio-demographics, lifestyle-related risk factors and clinical risk factors. Conclusions: Participants exposed to psychosocial stressors at work showed higher BPV than non-exposed participants. Since these risk factors are amenable to appropriate preventive intervention in workplaces, they should be considered for the primordial prevention of hypertension and cardiovascular diseases. Adjusted for age, education, body mass index, alcohol intake, smoking status, sedentary behaviors, family history of CVD and medication for hypertension (as well as for sex in analyses conducted in the total sample).

Unveiling social relationships: exploring the importance of relationships as a moderator of the link between effort-reward imbalance and leader-member exchange among healthcare professionals

ObjectiveHealthcare professionals are at increased risk of experiencing occupational stress and its detrimental stress-sequalae. Relevant theories that contribute to the subjective experience of occupational stress have been identified, such as the model of effort-reward imbalance (ERI) and the concept of leader-member exchange (LMX). The aim of this study was to examine how the perceived importance of social relationships at work moderates the relationship between LMX and imbalance ERI.MethodsA survey was conducted among N = 1,137 healthcare professionals from diverse occupational categories in a tertiary hospital in Germany. ERI was gauged using the German version of the Effort-Reward Imbalance Questionnaire (ERI-S 10). The quality of leader-employee dyadic relationships was assessed using the German version of the Leader-Member Exchange (LMX-7). The importance of social relationships was assessed on the basis of a previously validated polarity profile.ResultsMore than 75% of healthcare professionals reported high levels of ERI, with those involved in direct patient care particularly affected. On average, leaders rated relationship quality higher than their respective followers. Subjectively higher LMX was associated with lower ERI. This association was moderated by the perceived importance of social relationships at work. Higher subjective ratings of their importance led to a stronger association.ConclusionThe study highlights the particular challenges faced in the healthcare sector. The results emphasize that the perceived importance of social relationships at work can play a key role in healthcare professionals’ job stress and underline the need for stress prevention programs that engage both leaders and followers.

Correlation analysis of occupational stress and metabolic syndrome among employees of a power grid enterprise in China.

Being in a state of high occupational stress may disrupt the metabolic balance of the body, thus increasing the risk of metabolic diseases. However, the evidence about the relationship between occupational stress and metabolic syndrome was limited. To explore the association between occupational stress and metabolic syndrome (MetS) in employees of a power grid enterprise. A total of 1091 employees were recruited from a power grid enterprise in China. Excluding those who failed to complete the questionnaire and those who had incomplete health check-ups, 945 subjects were included in the study. Assessment of occupational stress was used by job demand-control (JDC) and effort-reward imbalance (ERI) questionnaires, respectively. The information on body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were collected. The levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and fasting blood glucose (FBG) in the fasting venous blood samples were measured. Logistic regression analysis and multiple linear regression methods were used to analyze the correlation between JDC and ERI models of occupational stress, metabolic syndrome, and its components, respectively. The prevalence of MetS was 8.4% and 9.9% in JDC and ERI model high occupational stress employees, respectively. ERI model occupational stress and smoking are significantly associated with the risk of MetS. ERI ratio was significantly associated with lower HDL-C levels. Gender, age, marital status, smoking, high-temperature and high-altitude work were significantly associated with metabolic component levels. Our study revealed a high detection rate of occupational stress in both JDC and ERI models among employees of a power grid enterprise. ERI model occupational stress, demanding more attention, was associated with the risk of MetS as well as its components such as HDL-C.

Associations between effort-reward imbalance and risk of burnout among Swedish physicians.

The high prevalence of burnout among Swedish physicians may have several possible effects on individuals and society. However, further investigations of work-related factors associated with the risk of burnout among Swedish physicians are needed. We aimed to study the associations between psychosocial work factors, based on the effort-reward imbalance (ERI) model, and the risk of burnout among Swedish physicians. A representative sample of 7200 Swedish physicians was invited in 2021. Data were gathered through questionnaires, with a response rate of 41%. Logistic regression models were used to study the associations between exposure to ERI and the risk of burnout. Approximately 62% of Swedish physicians were exposed to a high ERI. Exposure to a high ERI was associated with 11 times increased risk (95% confidence interval 6.5-20.0) of burnout in adjusted models. Large variations in the prevalence of ERI and risk of burnout across sociodemographic and occupational factors were identified, particularly across different clinical specialties. A majority of Swedish physicians were exposed to high levels of work-related stress, strongly associated with an increased risk of burnout. This population-based cross-sectional study underlines the need to further study variations of work-related stress across clinical specialties and to monitor occupational health among physicians longitudinally.

Longitudinal associations of effort-reward imbalance and overcommitment with burnout symptoms among Italian university students

BackgroundBurnout symptoms are highly prevalent among university students. The effort-reward imbalance (ERI) model is predictive for workers’ mental health. This study aims to investigate the associations of ERI and overcommitment with burnout symptoms among students. MethodsAn Italian version of the Oldenburg Burnout Inventory-Student (OLBI-S) and the Effort-Reward Imbalance-Student Questionnaire (ERI-SQ) were administered to assess burnout symptoms (range: 16–64), effort (range: 2–8), reward (range: 5–20) and overcommitment (range: 5–20) among 545 students twice with six months of follow-up. ERI (range: 0.25–4) was estimated multiplying the effort/reward ratio by a correction factor to account the difference in items investigating effort and reward. A between-within linear regression model was used to investigate whether ERI and overcommitment were associated with burnout symptoms (between individuals) and whether individual changes in ERI and overcommitment during the follow-up were associated with changes in burnout symptoms (within individuals). ResultsHigher levels of ERI (β: 10.13, 95 % CI: 9.21–11.05) and overcommitment (β: 1.09, 95 % CI: 0.95–1.23) were associated with higher levels of burnout symptoms. An increase in ERI (β: 4.93, 95 % CI: 3.02–6.84) and overcommitment (β: 0.92, 95 % CI: 0.59–1.26) within individuals was associated with an increase in burnout symptoms. DiscussionThis study supports the validity of the ERI model in the university setting. ERI and overcommitment may be determinants of burnout symptoms among university students. Interventions at individual and environmental level may aim to decrease ERI and overcommitment to tackle the burden of burnout among students. Future research may investigate the drivers of students’ ERI and overcommitment among students.

Job Stress Evaluation of Private Banking Employees in Indonesia through the Job Demand-Control Support Model and the Effort-Reward Imbalance Model

Job Stress Evaluation of Private Banking Employees in Indonesia through the Job Demand-Control Support Model and the Effort-Reward Imbalance Model

Effort-reward imbalance and common mental disorders among public sector employees of Iran: a cross-sectional analysis

BackgroundThe effort-reward imbalance (ERI) model is a widely used theoretical model to measure stress in the workplace. The objective of this study was to investigate the relationship between ERI and three common mental disorders: major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD).MethodsIn this cross-sectional analysis, the study sample consisted of 4453 baseline participants of the Employees’ Health Cohort Study of Iran (EHCSIR). Trained psychologists utilized the Persian version of the Composite International Diagnostic Interview (CIDI-2.1) during the baseline assessment to identify common mental disorders. Additionally, the validated Persian version of the 23-item ERI questionnaire was employed to assess effort, reward, overcommitment, and effort-reward ratio. To examine the association of ERI components with three common mental disorders (MDD, GAD, and OCD) over the past twelve months, multiple logistic regression analyses were conducted.ResultsThe prevalence of effort-reward imbalance in the study sample was 47.1%. Higher ERI score was significantly associated with MDD (OR: 3.43, 95% CI: 2.30–5.13), GAD (OR: 2.42, 95% CI: 1.27–4.63), and OCD (OR: 2.23, 95% CI:1.19–4.19). The study participants who reported higher scores on work overcommitment had a higher likelihood of having MDD (OR: 1.16, 95% CI:1.10–1.23), GAD (OR: 1.07, 95% CI: 1.01–1.14), and OCD (OR: 1.19, 95% CI: 1.09–1.29).ConclusionsAccording to the study’s findings, work-related stress, as determined by the ERI model, is a significant factor in the development of common mental disorders among employees in the public sector.

Job stress and chronic low back pain: incidence, number of episodes, and severity in a 4-year follow-up of the ELSA-Brasil Musculoskeletal cohort.

We investigated the association between job stress, as assessed by the effort-reward imbalance model, and the incidence of chronic low back pain (CLBP) over a 4-year period. A total of 1733 participants from the ELSA-Brasil Musculoskeletal cohort, who were free from LBP at baseline (2012-2014), were included. Episodes of LBP in the past 30 days, intensity, and the presence of disability were investigated in annual telephone follow-ups (2015-2018). Chronic LBP was defined as episodes of LBP lasting >3 months with at least moderate intensity. We analyzed the incidence of at least one episode of CLBP (yes/no), the number of CLBP episodes (0, 1, ≥2), and CLBP severity/disability (absent, nondisabling, severe/disabling). The association between these outcomes and tertiles of the effort-to-reward ratio, as well as each dimension of the effort-reward imbalance model, was investigated using multinomial logistic and Poisson regression models adjusting for sociodemographic and occupational variables. The cumulative incidence of CLBP over 4 years was 24.8%. High effort-reward imbalance increased the chances of experiencing multiple CLBP episodes and severe/disabling CLBP by 67% (95% confidence interval [CI]: 1.12-2.47) and 70% (95% CI: 1.14-2.53), respectively. High overcommitment increased the incidence of CLBP by 23% (95% CI: 1.01-1.50) and the chances of multiple CLBP episodes and severe/disabling CLBP by 67% (95% CI: 1.11-2.50) and 57% (95% CI: 1.05-2.34), respectively. These results indicate that exposure to job stress is associated with a higher incidence, a greater number of episodes, and increased severity of CLBP over a 4-year period. If this association is causal, measures aimed at reducing exposure to job stress are likely to alleviate the burden of CLBP.

The associations of psychosocial work exposures with suicidal ideation in the national French SUMER study

BackgroundThe literature remains scarce on the work-related risk factors for suicide and suicidal ideation. The objectives were to explore the associations of psychosocial work exposures with suicidal ideation in a nationally representative sample of the working population. MethodsThe study was based on the sample of 25,977 employees (14,682 men and 11,295 women) of the national French 2016–17 SUMER survey. The outcome was suicidal ideation assessed using the PHQ-9 instrument. Psychosocial work exposures included various factors from the job strain and effort-reward imbalance models, and other concepts. Statistical analyses were performed using weighted methods, including weighted logistic regression models. Other occupational exposures and covariates were considered. Gender differences were tested. ResultsThe prevalence of suicidal ideation was 3.5 % without any difference between genders. Psychosocial work exposures were found to be associated with suicidal ideation. The strongest association was observed between workplace bullying and suicidal ideation. Associations were also found between job strain model factors, job insecurity, low esteem, work-family conflict, ethical conflict, teleworking, and low meaning, and suicidal ideation. The associations were in general similar for men and women. LimitationsThe study had a cross-sectional design and no causal interpretation could be done. A reporting bias and a healthy worker effect may be suspected. ConclusionPsychosocial work exposures played a major role in suicidal ideation. More research may be needed to confirm our results, as suicidal ideation is an important warning signal for suicide prevention. More primary prevention towards the psychosocial work environment may be useful to reduce suicidal ideation at the workplace.

Review Article] Measurement Tools to Evaluate Psychosocial Factors in a Changing Work Environment: A Rapid Literature Review

This literature review examines the measurement instruments and questionnaires used to assess psychosocial factors in work environments. The focus is on their applicability across diverse professional settings. The review begins with identifying keywords and MeSH/EMTREE terms. Searches were then conducted across multiple databases and grey literature sources. The screening process identified 60 relevant articles. From these, 30 were selected to discuss the validity and reliability of various scales. The Copenhagen Psychosocial Questionnaire (COPSOQ) was found to be the most commonly used instrument, followed by the Job Content Questionnaire (JCQ), the Effort-Reward Imbalance (ERI) model, and the NIOSH General Job Stress Instrument. In Colombia, the evaluation of psychosocial risk factors in organizations is conducted using the _Batería de Instrumentos para la Evaluación de Factores de Riesgo Psicosocial_. This assessment provides a detailed evaluation of both intra-laboral and extra-laboral occupational psychosocial risk factors. Regarding reliability, all instruments identified and reviewed in this article had Cronbach's alpha values ranging from 0.7 to 0.9, indicating acceptable to excellent internal consistency, reliability, and validity for evaluating psychosocial risk factors in a representative work environment sample. Although each instrument is useful, adapting to evolving workplace dynamics is necessary for more comprehensive evaluations. The article emphasizes the impact of the COVID-19 pandemic on work arrangements, specifically remote and hybrid work, and highlights the need to evaluate psychosocial risk factors. The review provides insights into the changing landscape of work and the importance of addressing psychosocial factors to promote employee well-being and organizational effectiveness.

Work stress and changes in heart rate variability among employees after first acute coronary syndrome: a hospital-based longitudinal cohort study.

Work stress is considered as a risk factor for coronary heart disease, but its link with heart rate variability (HRV) among heart attack survivors is unknown yet. The aim of this study was to investigate associations between baseline work stress and the changes of HRV over one-year after onset of acute coronary syndrome (ACS). Hundred and twenty-two patients with regular paid work before their first ACS episode were recruited into this hospital-based longitudinal cohort study. During hospitalization (baseline), all patients underwent assessments of work stress by job strain (JS) and effort-reward imbalance (ERI) models, and were assigned into low or high groups; simultaneously, sociodemographic and clinical data, as well depression, anxiety, and job burnout, were collected. Patients were followed up 1, 6, and 12 months after discharge, with HRV measurements at baseline and each follow-up point. Generalized estimating equations were used to analyze the effects of baseline work stress on HRV over the following 1 year. After adjusting for baseline characteristics and clinical data, anxiety, depression, and burnout scores, high JS was not associated with any HRV measures during follow-up (all p > 0.10), whereas high ERI was significantly related to slower recovery of 5 frequency domain HRV measures (TP, HF, LF, VLF, and ULF) (all p < 0.001), and marginally associated with one time domain measure (SDNN) (p = 0.069). When mutually adjusting for both work stress models, results of ERI remained nearly unchanged. Work stress in terms of ERI predicted lower HRV during the one-year period after ACS, especially frequency domain measures.

Developing a conceptual framework for burnout intervention program in the workplace

This review proposes a comprehensive conceptual framework for developing and implementing burnout intervention programs in the workplace. In recent years, job burnout has become a new and vigorous research hotspot in the field of psychology and human resources management at home and abroad. Job burnout has a serious impact on personal health and performance but also harms the work efficiency, organizational effectiveness, and even social stability of employees. With the escalating concern over employee burnout and its consequent negative impacts on both individual health and organizational productivity, there is a pressing need for effective strategies to mitigate this issue. The framework draws on extensive literature review and theoretical model analysis, integrating key theories such as the Job Strain Model, Effort-Reward Imbalance Model, Conservation of Resources Theory, and the Job Demands-Resources Theory to explore the multifaceted nature of burnout. It identifies critical components of burnout, including symptoms such as emotional exhaustion, depersonalization, and reduced personal accomplishment, and contributing factors such as high job demands, inadequate job resources, and personal traits. Intervention strategies such as exercise have been identified as beneficial in addressing burnout. A systematic review of six studies highlights that aerobic exercise effectively lowers burnout and stress levels among employees. The framework also examines mediating factors such as personality traits and external factors, evaluating outcomes such as improved mental and physical health, enhanced job performance, and better workplace environment. Moreover, this review discusses the sustainability of interventions and emphasizes the importance of tailoring approaches to fit specific organizational contexts. The proposed framework provides a structured approach to understanding and addressing workplace burnout, highlighting the necessity for ongoing research and adaptation of intervention programs to meet evolving workplace dynamics.

Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress.

Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers. A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components. A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG. The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

Psychosocial risks of the work environment and metabolic syndrome (literature review)

Introduction. Along with physical, chemical, ergonomic, and biological factors, working psychosocial stress is one of the main risks for the development of metabolic syndrome (MS), system effects of which can cause severe lesions of cardiovascular, endocrine, and hepatobiliary systems.&#x0D; The purpose of the work was to summarize and analyze modern domestic and foreign experience of studying the relationship between categories and factors of psychosocial risks of the working environment and MS and its components in different occupational cohorts.&#x0D; The publications were searched through the RSCI, CyberLeninka, eLibrary, and PubMed databases containing Russian and foreign sources of scientific information for 2006–2023. &#x0D; The article briefly highlights the taxonomy of categories and factors of psychosocial hazards and risks in the workplace, as well as the most popular questionnaires for quantitative assessment of psychosocial stress, based on the requirement/control model (JDC) assessing workload in gradations of high, active, passive, low, and effort-reward imbalance (ERI) model. The close association of JDC and ERI with metabolic syndrome, obesity, blood lipid profile atherogenicity, and hyperglycemia in men and women of different occupational cohorts with high and low socioeconomic status was examined. &#x0D; Conclusion. The analysis of scientific publications has convincingly shown working psychosocial stress to have a causal relationship with MS that regardless of intervening factors (age, gender, socio-economic status, lifestyle, bad habits). At the same time, the statistical significance of stress-realizing effects in relation to MS components is determined by the used model for assessing psychosocial risks and is complementary to the cognitive assessment of perceived stress, which must be taken into account when planning and conducting research.

Putting PhD students front and center: an empirical analysis using the Effort-Reward Imbalance Model

IntroductionA doctorate is associated with numerous challenges for many PhD students, including financial insecurities, little support from supervisors, and time pressure. The present study explores well-being of PhD students via the Effort-Reward Imbalance (ERI) model as well as the potential protective factor resilience.MethodA web-based questionnaire survey was conducted among 1,275 PhD students from Germany. Data was collected at two measurement points over a six-week follow-up period.ResultsAs hypothesized, overcommitment was found to mediate the relationship between ERI and perceived stress while no mediation effect was found for work engagement. Resilience strengthened the relationship between ERI and overcommitment, especially for an increasing unfavorable ERI, and counterintuitively did not act as a protective factor.DiscussionTheoretical and practical implications are discussed, providing a deeper understanding on the ERI model and the negative coping pattern overcommitment in the context of PhD students.

Testing a chain mediation model of effort-reward imbalance, Confucian values, job satisfaction, and intention to quit among Chinese vocational education teachers.

This research delves into the significant impact of Confucian Values on the societal fabric of China, particularly in the realm of vocational education. In this setting, these principles are instrumental in guiding both educators and students. The study employs the Culture-Value Structure (CVS) model to dissect the intricate dynamics between Confucian Values, the Effort-Reward Imbalance (ERI), educators' job satisfaction, and their inclination toward leaving the profession. Teachers in vocational education, who are often regarded as moral guides, play a pivotal role in the ethical and social upbringing of students. Adopting Confucian values not only promotes academic success but also nurtures all-round development, equipping students for conscientious societal roles. In the backdrop of Confucian influence, these educators face substantial stressors in the workplace due to varied demands. The ERI model, proposed by Siegrist, serves as a tool to comprehend the stress experienced when there is a disproportion between efforts and rewards. This study delves into how ERI correlates with job satisfaction among vocational education teachers, with a focus on the modifying effect of Confucian values. Additionally, it examines the potential role of job satisfaction in mediating the relationship between ERI and the tendency to consider leaving the job. The research illuminates the complex interrelation of cultural values, occupational stress, job contentment, and career decision-making in the context of vocational education in China. The research involved a group of 332 Vocational education teachers from diverse Chinese institutions. Through thorough statistical analysis, the study validated the model's effectiveness, notably indicating a substantial direct impact of ERI on the Intention to Quit. The investigation pinpointed Factors I (Integrity), II (Confucian Ethos), and IV (Moderation) as key determinants of job satisfaction. Notably, an increase in job satisfaction was found to inversely relate to the likelihood of leaving the profession, implying it could lessen the propensity to resign. The research applied a Chain Mediation Model to elucidate the influence of ERI on the decision to quit, mediated by various factors. The findings highlight the complex interaction of elements influencing teachers' decisions to leave, showcasing the utility of sophisticated statistical methodologies in decoding complex social dynamics.

Perceived stress and psychological disorders in healthcare professionals: a multiple chain mediating model of effort-reward imbalance and resilience.

Healthcare professionals have shown more psychological disorders such as anxiety and depression due to the nature of work, which can cause job burnout, decrease the quality of medical services, and even endanger medical safety. The aim of the study is to explore the serial multiple mediating role of effort- reward imbalance and resilience between perceived stress and psychological disorders among healthcare professionals. A cross-sectional study was conducted in China from February to April 2023. A total of 2098 healthcare professionals at a tertiary general hospital was investigated by the following self-reported questionnaires: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), The Effort-Reward Imbalance (ERI), Healthcare professionals Resilience Scale (MSRS). Anxiety and depression are interrelated (r = 0.362, p < 0.01), and they were positively related to perceived stress (r = 0.640/0.607, p < 0.01) and ERI (r = 0.422/0.383, p < 0.01), and negatively related to resilience (r = -0.343/-0.320, p < 0.01). After controlling demographic factors, the variance in anxiety and depression was explained by perceived stress was 37.7 and 35.0%. Bootstrap analyses examining the pathway of perceived stress-ERI-resilience-anxiety revealed significant direct effects [B = 0.560, 95%CI (0.528, 0.591)], as well as indirect effects mediated independently by ERI [B = 0.045, 95%CI (0.029, 0.060)], resilience [B = 0.031, 95%CI (0.017, 0.047)], or a combination of both [B = 0.004, 95%CI (0.002, 0.007)]. Similarly, in the path of perceived stress-ERI-resilience-anxiety-depression, significant direct effects were found [B = -0.310, 95%CI(0.265, 0.351)], along with indirect effects mediated individually by ERI [B = 0.033, 95%CI(0.013, 0.052)], resilience [B = 0.014, 95%CI (0.001, 0.028)], and anxiety [B = 0.218, 95%CI (0.190, 0.246)], or by both or three together (B = 0.032). This study proved the hypothesis that ERI and resilience played a mediating role in perceived stress and psychological disorders, revealed the potential mechanism of anxiety in stress and depression, and proposed a solution for perceived stress to psychological distress, which can provide a basis for the intervention of healthcare professionals in the face of mental health crisis.

Associations of effort-reward imbalance at work and quality of life among workers after stroke: a one-year longitudinal study in Thailand

Stroke incidence is increasing among working-age population, but the role of psychosocial stress in the workplace in predicting quality of life (QoL) after stroke onset is understudied. This longitudinal study aimed to investigate the relationship between work stress, measured by the effort-reward imbalance (ERI) model, and QoL over one-year period among 103 Thai workers who had experienced a stroke. The study evaluated the effort (E)-reward (R) ratio and over-commitment, the extrinsic and intrinsic components of the ERI model, before discharge; QoL was repeatedly measured at baseline, six months, and 12 months after discharge, respectively, using the Short Form Version 2 (SF-12v2) indicators of physical and mental health composite scores. Generalized estimating equations were used to examine longitudinal relationships between work stress at baseline and QoL over one year by testing the hypotheses that E-R ratio and over-commitment would have direct effects on QoL, and potential moderating effects of over-commitment on E-R ratio and QoL. The results supported the ERI model partially, as over-commitment was significantly associated with poor mental health (coefficient − 8.50; 95% CI: -13.79, -3.20) after adjusting baseline sociodemographic, behavioral, and clinical characteristics, while the E-R ratio was not significantly associated with physical or mental health; the interaction between the E-R ratio and over-commitment was also not significant. These findings suggest that more attention should be paid to workers’ personal coping skills and ability to handle work-related problems and prioritize interventions that address over-commitment to promote long-term mental health among workers with stroke.

The stress of nursing: exploring communicatively restricted organizational stress (CROS), effort-reward imbalance, and organizational support among a sample of U.S. working nurses

BackgroundNurses experience a constellation of negative outcomes such as lost productivity, based on their high levels of organizational stress. Following recommendations for best practices in health communication can dramatically improve the organizational climate for nurses and can have a significant effect on patient outcomes. In this study, we evaluate the impact of Communicative Restricted Organizational Stress (CROS) and effort-reward imbalance (ERI).MethodsA mixed-methods approach was employed. A professional survey research vendor was contracted to obtain an appropriate national sample (N = 299) of working nurses in the United States of America. Participants completed an online closed-ended questionnaire for the quantitative portion of the study. Qualitative data were gathered from member-checking follow-up interviews.ResultsResults of the quantitative analysis indicated that nurses experience CROS, that these experiences are distressing, that CROS functions as an effort in the effort-reward-imbalance model, and that CROS and ERI contribute to negative outcomes such as insomnia, productivity lost, and poor general health. Specifically, a moderated moderation model accounted for 53% of the variance [F (7,290) = 47.363, p < .001] indicating that nurses with high levels of CROS distress and low levels of organizational support experienced the highest level of ERI in the presence of high nursing stress, t (296) = 3.05, p = .03, 95% CI [0.0038, 0.0178]. These findings were validated through member-checking qualitative interviews and specific overarching themes were explicated.ConclusionsCROS is an important variable in understanding the experience of nursing stress. Furthermore, CROS serves as an effort in the ERI Model and serves to exacerbate nursing stress. We recommend practical implications for the improvement of psychosocial stress in an occupational environment for nurses.

An integrated perspective of the demand–control and effort–reward imbalance models on burnout among sport coaches: The moderating role of over-commitment and coaching efficacy

The present study aimed to explore the relationship between stress and burnout through an integration of the demand–control (DC) and effort–reward imbalance (ERI) model in the context of sport coaching. This is the first study to integrate these two models to explain burnout experienced by sport coaches, providing a theoretical basis for understanding the development of burnout in this population. A sample of 398 Chinese sport coaches working in the school system participated in the study. Moderated mediation analyses were conducted to test the research model, and results indicated that the data fit the model well and supported all hypotheses. Specifically, the study verified the hypotheses related to the importance of contextual conditions in burnout development (i.e. burnout caused by job stress consistent with ERI) and personal characteristics that regulate these conditions (i.e. over-commitment as the enhancing moderator and coaching efficacy as the buffering moderator consistent with DC). The findings suggest that addressing the social system (i.e. ERI) in which burnout develops and individual responses (i.e. DC) is crucial to prevent burnout among sport coaches.