Effort-Reward Imbalance Questionnaire Research Articles

Correlation of stress and work load in dental students during clinical academic years

Context: Stress produces physical and mental effects that can affect student academic performance, social interactions and overall quality of life. Identification and treatment of stressed individuals are necessary during clinical training. Aims: The purpose of this study was to assess and correlate the perceived stress levels and work load observed in dental students. Subjects and Methods: Students were assessed using the Perceived Stress Scale and Effort-Reward Imbalance questionnaires to evaluate the level of general stress and academic-related work load/satisfaction, respectively. Data was collected before, during and after examinations in students from the third to fifth year of the BDS programme. Results: The perceived stress was correlated primarily with student's effort and commitment, and increased with academic progression. Changes in blood pressure or body temperature did not correlate with stress in a consistent manner. Perceived stress was significantly higher during examination periods while the effort-reward index was higher in students before or after examinations. Few students were classified as being stressed or dissatisfied significantly more than what was considered normal for their peers. Conclusions: Stress experienced by dentistry students may be greatly influenced by their effort and commitment. The level of stress experienced may not be severe enough to produce a physical response that may affect overall health; however, some students may experience periods of stress or dissatisfaction that are significantly higher than the norm and may be at risk of burnout. The stress scores and effort-reward indexes had a tendency to increase with academic progression and with demanding academic periods.

The effect of work-related psychosocial stressors on musculoskeletal disorder symptoms in hospital attendants.

Psychosocial stress at work is an important issue among hospital attendants. This study aimed to examine psychosocial stressors in the work environment and assess their impacts on WMSD symptoms among hospital attendants in Shiraz, southern Iran. This cross-sectional study was conducted on 198 hospital attendants from Shiraz. The study data were collected using a basic demographic questionnaire, Nordic Musculoskeletal Questionnaire (NMQ), the Persian version of Effort-Reward Imbalance Questionnaire (F-ERIQ), and an individual risk assessment (Evaluación del Riesgo Individual [ERIN]). The data were entered into SPSS version 16 and analyzed using Mann-Whitney U, Chi-square, and Spearman's correlation tests. The prevalence of WMSD symptoms was 29.8% in the lower back, 25.3% in knees, and 20.7% in ankles/feet. Posture analysis by the ERIN technique demonstrated that 95.5% of the postures were high risk for WMSDs. F-ERIQ identified that 83.4% of the hospital attendants belonged to the "1 < ER-ratio" category. Besides, the "effort" subscale of the F-ERIQ was significantly associated with reporting of MSD symptoms in the neck, shoulders, wrists/hands, and lower back. In addition, a significant correlation was observed between effort (r = 0.367, p = 0.028), esteem (r = -0.273, p = 0.041), security (r = -0.253, p = 0.045), and over-commitment (r = 0.301, p = 0.019) and the total score of the ERIN technique. Intervention programs and coping strategies for reduction of work-related stress and, subsequently, prevention of WMSD symptoms are recommended among hospital attendants.

Occupational Stress and Burnout Among Health Care Workers Caring for People Living With HIV in Eswatini.

We used the Effort-Reward Imbalance Questionnaire and Copenhagen Burnout Inventory in our cross-sectional study to examine associations between occupational stress and burnout among 368 health care workers (HCW) who cared for people living with HIV (PLWH) in Eswatini. Chi-square and logistic regression analyses were conducted. HCW caring for PLWH reported high efforts, imbalanced effort-reward ratios, overcommitment, and low rewards. Health care managers, physicians, and nurses reported higher work efforts, effort-reward ratios, overcommitment, and personal, work-related, and client-related burnout than laboratory staff or peer counselors. HCW with high work efforts, effort-reward ratios, and overcommitment had significantly higher risks of having personal (odds ratio [OR] = 4.60), work-related (OR = 3.96), and client-related burnout (OR = 2.20). HCW with low rewards had a significant risk of having personal (OR = 3.13) and work-related (OR = 2.08) burnout. Our results suggested the need for policies to reduce work stress for HCW caring for PLWH.

Changes in work stress among doctors in Norway from 2010 to 2019: a study based on repeated surveys

Abstract Background Changes in the organization of health care can influence the doctors` working conditions, which may in turn impact on doctors` perception of work stress. Since high levels of work stress can affect both the doctors’ own health and the quality of patient care, it is of importance for public health. We studied changes in work stress among Norwegian doctors from 2010 to 2018-19, and the associations of high work stress with job positions, self-rated health and sickness absence in 2018-19. Methods The study populations consisted of representative samples of 1,500 to 2,200 doctors working as hospital doctors, general practitioners (GPs), private practice specialists and doctors in academia. Data were drawn from nationwide repeated postal surveys in 2010, 2016 and 2018-19 in Norway. Response rates were between 67%-73%. The main outcome measure was perception of work stress as measured by the validated short form of the Effort-Reward Imbalance Questionnaire (ERI). Linear mixed models, proportions with 95% confidence intervals and logistic regression model were used in the analyses. Results From 2010 to 2018-19, the scores on the effort items (time pressure, responsibility, demands) increased significantly and the scores on the reward items (recognition, job stability, promotion prospects, prestige) decreased significantly for GPs, but remained stable for doctors in other positions. The proportion of doctors with high levels of work stress increased significantly for GPs. In 2018-19, high levels of work stress were associated with being a GP as compared with other job positions, younger age groups, average or poor health vs. very good or good health, but not with sickness absence or gender. Conclusions During a nine-year-period, work stress increased significantly for GPs, but remained stable for other job positions. This may be partly due to several health care reforms. Less work stress may improve both the doctors` own health and the quality of health care. Key messages From 2010 to 2018-19 in Norway, the proportion of GPs with high levels of work stress increased, while it remained stable for doctors in other job positions. This study supports previous findings on the association between high levels of work stress and health.

Cost, Gain, and Health: Theoretical Clarification and Psychometric Validation of a Work Stress Model With Data From Two National Studies.

The aim of this study was to test nonsymmetric effects of cost/gain imbalance at work on depression, based on the effort-reward imbalance (ERI) model. Study participants were derived from two large national studies from Germany and Sweden. Associations between the ERI scales, including the effort-reward (E-R) ratio in 2016 and depression (in 2016 for German sample, and in 2018 for Swedish sample) were examined by multivariable logistic regression. In both samples, high cost/low gain, but not low cost/high gain, is associated with depression, with a 3- to 5-fold elevated risk in the highest decile of the E-R ratio. The short version of the ERI questionnaire is a psychometrically useful tool for epidemiological research. The finding demonstrating nonsymmetric effects of cost/gain imbalance contributes to a theoretical clarification of this stress-theoretical model.

Stress among university students: factorial structure and measurement invariance of the Italian version of the Effort-Reward Imbalance student questionnaire

BackgroundIn the last decade academic stress and its mental health implications amongst university students has become a global topic. The use of valid and theoretically-grounded measures of academic stress in university settings is crucial. The aim of this study was to examine the factorial structure, reliability and measurement invariance of the short student version of the effort-reward imbalance questionnaire (ERI-SQ).MethodsA total of 6448 Italian university students participated in an online cross-sectional survey. The factorial structure was investigated using exploratory factor analysis and confirmatory factor analysis. Finally, the measurement invariance of the ERI-SQ was investigated.ResultsResults from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the ERI-SQ. A modified version of 12 items showed the best fit to the data confirming the 3-factor model. Moreover, multigroup analyses showed metric invariance across gender and university course (health vs other courses).ConclusionsIn sum, our results suggest that the ERI-SQ is a valid, reliable and robust instrument for the measurement of stress among Italian university students.

Resilience is strongly associated with health-related quality of life but does not buffer work-related stress in employed persons 1year after acute myocardial infarction.

Resilience may facilitate the adaptation after experiencing a severe disease such as acute myocardial infarction (AMI) and attenuate the negative effects of stress on health-related quality of life (HRQOL). However, it is unclear so far whether resilience moderates a negative association between work-related stress and HRQOL in employed patients after AMI. Patients with confirmed AMI and regular paid employment admitted to a hospital in the study region of the MONICA/KORA Myocardial Infarction Registry, Germany (04/2014-06/2017) were included and completed questionnaires during their hospital stay and 6 and 12months after discharge. The Resilience Questionnaire (RS-11) and the Effort-Reward Imbalance (ERI) Questionnaire were used to assess trait resilience and ERI, respectively. HRQOL was measured by the Short Form 36 Health Survey (SF-36) mental and physical component summary scales. Generalized estimating equations (GEE) adjusted for relevant potential confounding variables (demographic, social, stress-related, and clinical) were used to determine the association between resilience and HRQOL in the study course. From the 346 patients enrolled in the study, 270 patients (78.0%) had completed all surveys. High baseline trait resilience was significantly and independently associated with high physical HRQOL (ß = 0.15, p < 0.0001) and high mental HRQOL (ß = 0.37, p < 0.0001) 1year post AMI. No significant interaction effects between trait resilience and ERI were found in the physical HRQOL GEE model (ß = 0.05, p = 0.7241) and in the mental HRQOL model (ß = 0.05, p = 0.3478). The results demonstrated that trait resilience is independently and strongly related with post-AMI HRQOL but does not moderate the association between ERI and HRQOL.

Effort-Reward Imbalance Is Associated With Alcohol-Related Problems. WIRUS-Screening Study.

There is ample evidence of associations between a perceived stressful working environment and several health-related outcomes. To better understand potential mechanisms behind these observations some studies have focused on the relationship between effort-reward imbalance at work and alcohol consumption. So far, the findings have been inconsistent. One reason for this inconsistency might come from the focus on alcohol consumption per se, while disregarding other aspects such as adverse consequences related to the consumption of alcohol. The aim of the present study was to explore associations between perceived effort and reward, effort-reward imbalance and overcommitment, and alcohol-related problems. Using data from the alcohol screening component in the Norwegian WIRUS-project (N = 5,080), we ascertained the perceived effort, reward, effort-reward imbalance (ERI) and overcommitment using the effort-reward imbalance questionnaire. Alcohol-related problems was determined using a cut-off ≥8 on the Alcohol Use Disorder Identification Test (AUDIT). Associations were estimated using crude and adjusted logistic regression models. Covariates were age, gender and education. We found associations between different aspects of ERI and overcommitment, and alcohol-related problems. Specifically, the main analysis indicated that there was an increased odds for alcohol-related problems among those who reported high levels of ERI in conjunction with high overcommitment [adjusted OR: 1.40 (CI 95% 1.10–1.78)] compared to those with low levels of ERI and low overcommitment. Our findings suggest that ERI and overcommitment is associated with increased likelihood of alcohol-related problems. These findings indicate that individual and work-related factors should be taken into account collectively when aiming to determine the impact of psychosocial work environment on alcohol-related problems. Due to the cross-sectional nature of the present study, we are not able to determine the direction of the associations, and future studies should aim to investigate this.

Psychometric Properties of the Effort-Reward Imbalance Questionnaire for Teachers (Teacher ERIQ).

The effort-reward imbalance (ERI) model is a theoretical model of a psychosocial work environment with adverse effects on health and well-being that focuses on a mismatch between high efforts spent and low rewards received at work. This study aimed to develop and psychometrically test an effort-reward imbalance questionnaire for teachers (Teacher ERIQ) based on the ERI model. The structure validity, reliability, and criterion validity of the new questionnaire’s scores were evaluated in a sample of 475 Chinese teachers. The results of exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) showed that a structure of four factors of effort (workload, emotional demands, student-related issues, and social responsibility) and two factors of reward (emotional reward and material reward) in accordance with the ERI model had significant factor loadings and acceptable model fit. The Cronbach’s Alpha coefficients of all dimensions’ scores showed that the questionnaire scores had good reliability. Criterion validity was indicated by significant correlation coefficients of scores of most dimensions along with teachers’ self-reported job burnout and non-reciprocal social relations, as well as the ANOVA results showing that the differences of the scores of the two criterion scales in different ERI ratio levels were significant. The results also showed that teacher’s ERI level varied with demographic variables such as age, gender and school type. The Teacher ERIQ is a valid and reliable new measurement for assessing teachers’ psychosocial work characteristics. It can be an important tool to provide new explanations of stress-related health risks among teachers and to guide the development of preventive measurements.

Impact of effort reward imbalance at work on suicidal ideation in ten European countries: The role of depressive symptoms

BackgroundEvidence of the association between effort reward imbalance (ERI) and suicidal ideation is sparse. This study examined the influence of ERI at work on suicidal ideation and the mediating effect of depressive symptoms. MethodsThere were 4963 workers aged 50+ without suicidal ideation at baseline in the Survey of Health, Aging and Retirement in Europe, these workers were followed-up for 8-years to detect incident suicidal ideation. ERI was measured by a short ERI questionnaire. Suicidal ideation was evaluated by one item derived from the 12-item Europe-depression scale, and depressive symptoms were assessed by the remaining 11 items in the scale. Cox models were employed to explore the relationship adjusting for potential confounders. Mediation analysis was used to test the mediating effect of depressive symptoms. ResultsA significantly higher incidence of suicidal ideation was related with high effort (HR = 1.51) and low reward (HR = 1.42), respectively. A high effort–low reward imbalance was associated with even higher risk of suicidal ideation (HR = 1.96) as compared to low effort-high reward combination. The association was varied by gender, region, education and household income. Depressive symptoms mediated a modest proportion (natural indirect effect 14.4%) of the total association between ERI and suicidal ideation. LimitationSuicidal ideation definition based on self-administered questionnaires which could lead to false negatives. And some unmeasured confounders might have biased the results. ConclusionsEfforts in promoting balanced effort–reward at work may reduce suicidal ideation among working population aged 50+. Avoiding depressive symptoms may further enhance such efforts.

Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: a case–control study

IntroductionStroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. MethodsWe conducted a case–control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group. Participants were asked a subjective question about their perception of stress in the previous months and completed the standardised Effort-Reward Imbalance (ERI) questionnaire. Logistic regression models were used for data analysis. ResultsThe study included data on 50 cases and 50 controls. There were no significant differences in demographic variables and economic, social, and employment status between cases and controls. Fifty percent of the cases reported moderate to severe stress, compared to 30% of controls (OR: 2.33; 95% CI: 1.02-5.30; P=.041). ERI questionnaire results found that greater effort at work (OR: 1.48; 95% CI: 1.19-1.83) and greater commitment is associated with stroke (OR: 1.34; 95% CI: 1.17-1.54), while higher reward constitutes a protective factor against the disease (OR: 0.71; 95% CI: 0.61-0.82). ConclusionsThere is a strong association between self-perceived psychological stress and TIA. The imbalance between effort and reward at work is also clearly related to TIA.

Associations of work stress and humor with health status in hospital nurses-A cross-sectional study.

To analyse the relationship among hospital nurses' socio-demographic data, work stress, humor and health conditions, and to determine the predictors of nurses' health status. Humor can decrease the feelings of helplessness, fear and anxiety, and that may result in the development of positive emotions, which might have a good impact on health. This research applied cross-sectional designs and used structured questionnaires which included socio-demographic data, an Effort-Reward Imbalance questionnaire (ERI), humor and 12-item Chinese health questionnaires (CHQ). A total of 236 nurses in a regional hospital in Taiwan were recruited. SPSS was used for the data analysis in the study. The STROBE was chosen as a checklist for this study. The results showed that the significant predictors of the participants' health were "whether experienced significant life events during the past 3months," "the degree of work stress" and the level of "humor." It is recommended that administrators pay attention to the cultivation of nursing staff's humor, such as providing nurses with musical CDs or humorous books and providing stress management training courses to nurses. It is necessary for hospital managers to determine and deal with the causes of work stress to avoid the development of health problems in the nursing personnel. Furthermore, in order to develop stress-releasing strategies, it is necessary to provide nurses with stress management and resilience enhancement courses. Cultivating a humor competency of nurses is also recommended to alleviate the work stress.

Does cognitive function predict changes in perception of stressful working conditions?

Cognitive health is a key resource for individuals to nurture their employability. We studied the longitudinal association of cognitive function with changes in stressful working conditions, testing a possible reversed causation. We used a sample of employees (N=1,355) participating in two surveys (2006 and 2011) within a German national representative study (GSOEP). Cognitive function was captured by perceptual speed (Symbol Digit Test) and word fluency (Animal Naming Test). Stressful working conditions were measured by the validated short version of the effort-reward imbalance questionnaire. Multivariate linear regression models assessed the impact of perceptual speed and verbal fluency in 2006 on changes in participants’ perceptions of effort, reward, effort-reward ratio, and over-commitment between 2006 and 2011, adjusting for socio-demography, behaviours, physical and mental health at baseline. Neither perceptual speed nor verbal fluency was significantly related to changes in perceived working conditions. Our findings did not support the notion of reversed causation.

Effects of job conditions, occupational stress, and emotional intelligence on chronic fatigue among Chinese nurses: a cross-sectional study.

Purpose: Nurses are undertaking considerable emotional and physical work, which may lead to unrecoverable fatigue. This study aimed to evaluate the level of chronic fatigue and explore its associated factors among Chinese nurses in the hope of providing scientific evidence for fatigue-reduction strategies.Methods: This cross-sectional study was carried out in Liaoning Province, China in 2018. The study recruited 700 nurses and collected 566 effective respondents. Chronic fatigue, demographic factors, job conditions, and emotional intelligence were assessed through questionnaires. Chronic fatigue was assessed with the Fatigue Scale 11, occupational stress with the Effort–Reward Imbalance Questionnaire, and emotional intelligence with the Wong and Law Emotional Intelligence Scale. Hierarchical multiple regression was used to explore factors related to chronic fatigue and to test the moderating effect of emotional intelligence on the association between occupational stress and chronic fatigue. Simple slope analysis was conducted to visualize the interaction.Results: The mean score of chronic fatigue among the Chinese nurses was 17.14±6.16. Being married, having long weekly work time, working night shifts, and discontent with the nurse–patient relationship were positively associated with chronic fatigue. Effort:reward ratio, overcommitment, and emotional intelligence were important factors related to chronic fatigue. Emotional intelligence played a moderating role in the relationship between the effort:reward ratio and chronic fatigue. When emotional intelligence was higher, the effect of the effort:reward ratio on chronic fatigue became weaker.Conclusion: Most nurses surveyed in China might have relatively high levels of chronic fatigue. Our results highlight the importance of interventions on these factors for the reduction of fatigue among nurses in China. Providing more opportunities and support and developing emotional intelligence are crucial strategies to reduce chronic fatigue among nurses in China.

Job crafting and well-being in the elderly care sector: the effect of over-commitment

PurposeThe purpose of this paper is to analyze the moderation effect of over-commitment in the job crafting–well-being relationship, in the elderly care sector in Spain.Design/methodology/approachA cross-sectional design was implemented and a final sample of 353 participants were assessed using the Job Crafting Questionnaire, an adaptation of the Over-commitment Scale from the Effort-Reward Imbalance Questionnaire, and the General Health Questionnaire (GHQ-12).FindingsA positive interaction between relational and task crafting and over-commitment is observed in the prediction of well-being levels. Specifically, the effect of over-commitment in the task crafting–well-being relationship proved to be statistically significant when opposed to low, medium and high levels of over-commitment. Additionally, the effect of over-commitment in the relational crafting–well-being relationship proved to be statistically significant only when opposed to medium and high levels of over-commitment. Finally, a direct and simple effect was observed between cognitive crafting and well-being, not moderated by over-commitment.Research limitations/implicationsImplementation of non-behavioral measurements, and a non-longitudinal design are suggested. The development of behavioral measures for job crafting is encouraged, along with the implementation of longitudinal designs sensitive to changes in over-commitment. Possible over-commitment results are biased by an economically contracted environment.Practical implicationsJob crafting training, over-commitment early detection and further research on job crafting strategies’ preferences are suggested.Originality/valueThe moderating role of over-commitment in the job crafting–well-being relationship in the elderly care sector represents one of these attempts to better understand evidences of how work-related efforts modify a worker’s psychological functioning and adaptation, which is the reason why, specially in contexts of uncertainty, its study becomes relevant.

Relationship between occupational stress, psychological capital and depressive symptoms among female workers in five electronic manufacturing enterprises

Objective: To explore the relationship between occupational stress, psychological capital and depressive symptoms among electronic manufacturing female workers in the Pearl River Delta region. Methods: Using cluster sampling method, 845 female workers from 5 electronic manufacturing enterprises in the Pearl River Delta region were selected as research subjects from June to August 2017. The Effort Reward Imbalance questionnaire (ERI) , Psychological Capital questionnaire-24 (PCQ-24) and Patient Health questionnaire-9 (PHQ-9) were applied to measure the level of occupational stress, psychological capital and depressive symptoms in female workers. Results: Effort (r=0.197, P<0.01) and over commitment (r=-0.260, P<0.01) were positively correlated with the score of depressive symptoms, and the rewards was negatively correlated with depressive symptoms (r=-0.211, P<0.01) . The reward and over-commitment for depressive symptoms were accounted for 8.2%. Psychological capital was negatively correlated with depressive symptoms, and plays a partly mediating role in the relationship between occupational stress and depressive symptoms of female workers. The psychological capital for depressive symptoms was accounted for 8.7%. Conclusion: Occupational stress can affects the depressive symptoms of electronic manufacturing female workers, or indirectly affect depressive symptoms through psychological capital, reduce occupational stress and improve psychological capital as a way to relieve the depressive symptoms of female workers.

Predicting presenteeism via effort-reward imbalance and dispositional optimism: Is it the interaction that matters? Results from The Saxony Longitudinal Study.

The importance of experienced work stress and individual traits as well as their interplay is analyzed with regard to dysfunctional coping behavior in case of sickness. The aim of this study was to examine the predictive capability of effort-reward imbalance (ERI) including overcommitment, meaning the intrinsic propensity in terms of excessive work-related expenditure (OC), in consideration of dispositional optimism/pessimism on presenteeism. A total of 353 men and women aged 38 from the 25th panel wave of The Saxony Longitudinal Study in 2011 were included in the analysis. Effort-reward imbalance (ERI) including overcommitment was assessed with the Effort-Reward Imbalance Questionnaire. Dispositional optimism and pessimism were quantified using the German version of the Life-Orientation-Test (LOT-R). Presenteeism was measured by single item two years later. Multiple regression analysis showed that the amount of the effort-reward imbalance experienced in 2011 had no statistically significant predictive potential with regard to presenteeism in 2013. After splitting the sample according to a validated effort-reward imbalance threshold, remarkable prediction of presenteeism for participants experiencing an ERI was accomplished by the moderating effect of dispositional pessimism on overcommitment (ß= 0.32; p < 0.001). Although ERI did not have the expected predictive capability relating to the entire sample, the detailed analysis of the moderating effect of pessimism on overcommitment and the resulting amount of explained variance for those participants experiencing an ERI is a noteworthy finding.

Associations between overcommitment, effort-reward imbalance and mental health: findings from a longitudinal study.

The effort-reward imbalance (ERI) model includes extrinsic and intrinsic aspects of work stress. The single components, ERI and overcommitment (OC), are known to be associated with mental health. The aim of this study was to test whether OC is a mediator of the association between ERI and mental health. Longitudinal analyses were conducted using data from the Third German Sociomedical Panel of Employees on German employees aged 40-54years. The short version of the ERI questionnaire was used to measure ERI and OC at baseline (2013). Outcomes were mental health problems and self-rated mental health (5-Item Mental Health Inventory) in 2015. Multivariate regressions were conducted controlling for sociodemographics, health-related behaviour, job-related aspects, and mental health at baseline. A total of 912 men and 1148 women were included in the final analysis. Baseline OC was positively associated with follow-up mental health problems and negatively with self-rated follow-up mental health. While there was no direct effect of ERI on mental health, ERI affected mental health problems (b = 0.14; 95% CI 0.03to0.25) and self-rated mental health (b = - 1.15; 95% CI - 1.79 to - 0.57) indirectly through OC. OC was associated with reduced mental health. There was no association between ERI and mental health that was independent of OC. OC could therefore be interpreted as a mediator between ERI and mental health. Future studies are needed to test the causality of this association.

The association of potential stressors with hair steroids in parents with small children: The Ulm SPATZ health study

Previous studies have reported weak associations between questionnaire-based stress measurements and hair steroids. A stronger relationship may exist in highly stressed subpopulations or with stress brought up by novel or unpredictable situations. In the Ulm SPATZ Health Study, conducted in Ulm, Germany, baseline recruitment 04/2012 to 05/2013, we analyzed data of families enrolled shortly after childbirth. Mothers completed standardized questionnaires assessing sociodemographic, health- and family-life-related factors, and the Screening Scale of the Trier Inventory of Chronic Stress (TICS) at 6 months (T2) and 12 months postpartum (T3). Their current partners completed SSCS-TICS and an Effort-Reward Imbalance (ERI) Questionnaire obtained at 6 weeks postpartum (T1). Partners (n = 375 at T1) and mothers (n = 654 at T2 or T3) provided a 2 to 3-cm hair segment for hair analysis. Adjusted linear and cubic spline regressions were used to analyze (non-)linear relationships between potential stressors and hair cortisol (hairF) and hair cortisone (hairE) concentrations as well as the respective change scores between 12 months and 6 months. Lacking social recognition and high paternal work overload were significantly associated with paternal hairF in cubic spline models (test for overall association, chi2 = 8.24, p = 0.041, chi2 = 8.41, p = 0.038) but not in linear models. However, the association between ERI and hairF (chi2 = 7.54, p = 0.059) was marginally significant. Maternal education was related to maternal hairF and hairE at T2. No association was observed between maternal postpartum employment and hair steroids at T2 or T3. Conversely, we could show a relationship between some change scores of stress and hairE in mothers. Considering non-linearity and family-related stressors, there are few associations between questionnaire-based stress measurements and hairF or hairE. Novelty of stressors was not shown to be a relevant factor.

Examining Effort-Reward Imbalance and Depressive Symptoms Among Turkish University Workers.

The body of research pertaining to work-related stress and health among Turkish workers is sparse. It was the aim of this study to test the feasibility of two work stress scales of the Turkish short version of the Effort-Reward Imbalance (ERI-SV) questionnaire among staff and faculty in an academic university setting. We also assessed and examined if work stress was associated with depressive symptoms, using Center for Epidemiological Studies-Depression (CES-D) scale. The two ERI-SV scales and the CES-D scale were distributed to 170 study subjects employed at a southern university in Turkey, in which 67% ( n = 114/170) responded. We examined Cronbach's alpha coefficients for the internal consistency of the two main work stress scales of the ERI-SV, and scale structural validity was assessed using exploratory factor analysis. Logistic regression was performed to test the hypothesis of associations of work stress with depressive symptoms. Cronbach's alpha coefficients were .75 and .76 for the scales "Effort" and "Reward," respectively. Two separate factors were extracted according to the theoretical assumption of the ERI model. Associations between ERI and depressive symptoms were significant (odds ratio [OR] = 3.80 for Effort-Reward [E-R] ratio with an increase per SD, and 7.39 for the high work stress group as defined by an E-R ratio > 1.0). This study provides evidence of the feasibility of the short version of the Turkish ERI questionnaire by pointing to a strong association of stressful work with depressive symptoms in this group of academic workers. Further psychometric properties of the ERI questionnaire are required before its wider application in research and practice.