Effort-reward Imbalance Ratio Research Articles

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.

The prevalence of effort-reward imbalance and its associations with working conditions, psychosocial resources and burden among health care workers during the COVID-19 pandemic: Results of the egePan-Voice study.

The association between a measure of effort-reward imbalance (ERI) and profession as well as gender in a sample of health care workers (HCW) during the first wave of the COVID-19 pandemic in Germany using the egePan-Voice study. In addition, we examined, which factors are associated with an effort-reward imbalance ratio (ERI ratio) >1. In a large sample of HCW (N = 6174) we assessed occupational stress with the short version of the effort-reward imbalance (ERI) questionnaire, working conditions, COVID-19-related problems and psychosocial resources (ENRICHD Social Support Inventory, ESSI; Sense of Coherence Scale, SOC-3 and optimism, SOP2). The prevalence of a ERI ratio >1 among HCW was 50.9%. The prevalence's of an ERI ratio >1 were statistically significant different between gender as well as the occupational profession. The proportion of women (51.8%) with ERI ratio >1 was significantly higher than among men (47.8%). The highest ERI imbalance was found among nurses (62.8%), followed by medical technical assistants (MTA) (58.8%), while psychologists/psychotherapists revealed the lowest value (37.8%), followed by physicians (41.8%). In the total sample, most essential factors reported at this time for increased ERI ratio were: insufficient staff for the current work load, insufficient recovery, feeling insufficiently protected by measures taken by the hospital/the employer, high occupancy rate of the wards, insufficient trust in colleagues and being a nurse as compared with being a physician. The findings indicate a high proportion of HCW with effort-reward imbalance and substantial profession-related differences. Preventive interventions should be offered to vulnerable groups among the HCW to decrease the imbalance measured by work stress.

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

Berufliche Gratifikationskrisen, Verausgabungsneigung und Burnout bei ukrainischen Anästhesisten und Intensivmedizinern während der SARS-CoV-2-Pandemie

ZusammenfassungHintergrundPsychische Belastungen von Anästhesisten und Intensivmedizinern sind vielfältig und komplex. Overcommitment (OC) ist durch eine übersteigerte berufliche Verausgabungsneigung gekennzeichnet, die zu psychischen Beanspruchungsfolgen wie z. B. Burnout führen kann. Die Prävalenz von Burnout bei Intensivmedizinern ist international weit gestreut. Ziel der Studie war es, Verausgabungen und Gratifikationen bei ukrainischen Ärzten der Anästhesie und Intensivmedizin während der SARS-CoV-2-Pandemie zu ermitteln und zu analysieren, wie hoch das Burnout-Risiko in dieser Berufsgruppe ist und welche Assoziationen zwischen der intrinsischen Komponente und der extrinsischen Komponente des Modells der beruflichen Gratifikationskrise und dem Burnout bestehen.MethodikAn der Querschnittsstudie mit der konfirmatorischen Fragestellung im März 2021 nahmen 73 ukrainische intensivmedizinisch tätige Ärzte (47,9 %) und Ärztinnen (52,1 %) teil. Das mittlere Alter lag bei 39,8 ± 10,94 Jahren (Range: 23–78 Jahre). Neben soziodemografischen und berufsbezogenen Daten wurden die berufliche Gratifikation mittels Effort-reward-Imbalance-Fragebogen (ERI) einschließlich der OC-Fragen und das Maslach Burnout Inventory (MBI) erhoben. Die Teilnehmenden der Befragung wurden in Gruppen mit unterschiedlichem OC (< 16 Punkte) und (≥ 16 Punkte) eingestuft und verglichen.ErgebnisseIn die Gruppe mit OC < 16 Punkte konnten 75 % (55) Teilnehmende eingestuft werden, 18 boten ein erhöhtes OC. Zwischen diesen beiden Gruppen fand sich eine signifikante Differenz im Effort (13,9 ± 4,1 vs. 17,2 ± 3,6 Punkte; p = 0,003) und in der ERI-Ratio (0,58 ± 0,2 vs. 0,77 ± 0,2; p = 0,006). In der Gruppe mit OC ≥ 16 waren 50 % der Teilnehmenden mit einer hohen emotionalen Erschöpfung (vs. 12,7 % bei OC < 16; p = 0,002), aber auch 61,1 % mit einer hohen Leistungsfähigkeit (61,1 % vs. 32,7 %; p = 0,005). Insgesamt konnte eine Burnout-Prävalenz von 2,7 % in der Gesamtstichprobe festgestellt werden, wobei die beiden Probanden bei der Gruppe mit OC < 16 vertreten waren. Die höhere emotionale Erschöpfung war mit einer höheren Verausgabungsneigung und Verausgabung (Effort) sowie einer geringeren Belohnung (Reward) assoziiert.DiskussionDie Studienergebnisse zeigten hohe emotionale Erschöpfung bei Personen mit hohem Overcommitment. Drei Viertel der Befragten zeigten Burnout-Symptome. Aus diesem Grund sollten Gesundheitsförderungsmaßnahmen und Prävention angeboten werden, um den hohen Belastungen während der Pandemie entgegenzuwirken. Diese sollten Verhältnis- und Verhaltensprävention einschließen.

O desequilíbrio esforço-recompensa está associado à hipertensão arterial entre servidores públicos brasileiros? Resultados do ELSA-Brasil

Abstract Objectives: to evaluate the association between job stress, according to the effort-reward imbalance (ERI) model, and hypertension (HTN), as well as to investigate the effect modifier role of overcommitment (OC) and sex. Methods: cross-sectional analysis of data from active workers who participated in the second data collection wave (2012-2014) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Job stress was measured by the ERI scale - Brazilian version, comprising three dimensions: effort, reward, and OC. HTN was defined as systolic or diastolic blood pressure levels ≥ 140/90 mmHg or antihypertensive medication use. Associations were estimated by logistic regression, crude and adjusted for potential confounding factors. Multiplicative interactions were investigated. Results: a total of 9,465 civil servants participated in the study, 51.9% females. HTN prevalence was 34.9%. The adjusted model identified borderline associations between ERI (ratio &gt; 1) and higher OC with higher odds of HTN (OR = 1.11, 95%CI = 1.00; 1.24; and OR = 1.13; 95%CI = 1.01; 1.26, respectively). Interaction analysis indicated no differences in associations according to sex and OC. Conclusion: results show that ERI and OC are associated with higher odds of HTN after adjustment. Sex and OC were not effect modifiers.

Insomnia Partially Mediates the Relationship of Occupational Stress with Mental Health Among Shift Working Nurses and Midwives in Polish Hospitals.

Insufficient sleep increases sensitivity to chronic stress and may be a precursor to thedeterioration of mental health and the development of burnout. The aim of our study was to verify whether symptoms of insomnia mediate the relationship of occupational stress with mental health among nurses who work shifts. The analyses included 117 female nurses and midwives who work shifts. They filled in the 16-item Effort-Reward Imbalance Questionnaire (ERIQ) assessing occupational stress, the Insomnia Severity Index (ISI), the Patient Health Questionnaire (PHQ-9, the question about sleep was excluded from the analyses), the Generalized Anxiety Disorder Assessment (GAD-7), and the 16-item Oldenburg Burnout Inventory (OLBI) consisting of two scales - Disengagement and Exhaustion (OLBI-D and OLBI-E). Insomnia partially mediated the association of the effort-reward imbalance ratio with depression, anxiety and the exhaustion dimension of burnout. We found no association of insomnia symptoms with the depersonalization dimension of burnout, but the effort-reward imbalance ratio was associated with the depersonalization scale. The results showed that occupational stress has varying degrees of influence on mental health, partly depending on the severity of insomnia symptoms among nurses and midwives who work shifts.

The Relationship Between Effort-Reward Imbalance and Depressive Symptoms Among Chinese Firefighters: Moderating by Coping Styles.

This study aims to examine the association between effort-reward imbalance (ERI) and depressive symptoms among Chinese firefighters and the moderating role of positive and negative coping styles in the above association. A cross-sectional study including 1328 male firefighters was conducted in China. We adopted the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. Results showed that ERI was associated with depressive symptoms. Individuals with a higher ERI ratio and greater overcommitment were likely to have higher level of depressive symptoms. Furthermore, negative coping style strengthened the relationship between ERI ratio and overcommitment with depressive symptoms, whereas the positive coping style presented none significant moderation. These findings indicate that reforming the effort-reward system might be helpful for mental health promotion among Chinese firefighters.

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...

Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan.

BackgroundPsychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss.MethodsThis cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status.ResultsAmong medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with −2.81 (95% CI [−4.70 to −0.92]; p-value = 0.004) and −0.84 (95% CI [−1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04–2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models.ConclusionERI at work was associated with an increased risk of poor periodontal status.

Job stress and chronic and widespread musculoskeletal pain: a cross-sectional analysis from the Brazilian Longitudinal Study of Adult Health Musculoskeletal.

Musculoskeletal pain is a global health concern, and work-related psychosocial stress might be a potential contributing factor. This cross-sectional study investigates whether job stress is associated with chronic and widespread musculoskeletal pain in 2051 Brazilian active civil servants included in the Brazilian Longitudinal Study of Adult Health Musculoskeletal (ELSA-Brasil MSK). Job stress was assessed using the Effort-Reward Imbalance (ERI) questionnaire. Associations between ERI domains, categorized into tertiles, and chronic musculoskeletal pain (CMP) at any site and per number of affected sites (0, 1-2, ≥3-multisite pain) and body regions (0, 1-2, 3-generalized pain), were investigated using binary and multinomial logistic regression, adjusted for sociodemographic, occupational, and health covariates. The prevalence of CMP at any site, multisites, and generalized regions was 52.9%, 18.2%, and 9.5%, respectively. After adjustments, the lower the reward and the greater the overcommitment, the higher the odds of CMP at any site. The ERI domains were more strongly associated with multisite and generalized CMP than with CMP at any site. Multisite CMP was associated with lower reward and with greater effort, overcommitment, and effort-reward imbalance ratio. Chronic musculoskeletal pain according to body regions, especially generalized pain, was also associated with ERI domains effort (OR = 2.06; 95%CI = 1.33-3.21), overcommitment (OR = 3.44; 95%CI = 2.20-5.39), and effort-reward imbalance ratio (OR = 2.06; 95%CI = 1.30-3.27). Results reveal an association between job stress not only with CMP at any site but notably with the pain spread to other body sites or regions. Our findings suggest that lowering stress at work and discouraging overcommitment may help reduce the CMP burden, including reduction of CMP spread from one site or region of the body to another.

Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)-A Cross-Sectional Study among Medical Assistants.

Adverse psychosocial working conditions in the health care sector are widespread and have been associated with a reduced quality of patient care. Medical assistants (MA) assume that their unfavorable working conditions predominantly lead to a poorer quality of care in terms of slips and lapses, and poorer social interactions with patients. We examined those associations for the first time among MAs. A total of 944 MAs in Germany participated in a survey (September 2016–April 2017). Psychosocial working conditions were measured by the effort-reward imbalance (ERI) questionnaire and a questionnaire specifically designed for MAs. Slips and lapses (3 items, e.g., measurement or documentation errors) and the quality of interactions (3 items) with patients were measured by a questionnaire developed by the study team based on prior qualitative research. We ran Poisson regression to estimate multivariable prevalence ratios (PRs). The ERI ratio and MA-specific working conditions were significantly associated with frequent self-reported slips and lapses (PR = 2.53 and PR ≥ 1.22, respectively) or poor interactions with patients (PR = 3.62 and PR ≥ 1.38, respectively) due to work stress. Our study suggests that various types of adverse psychosocial working conditions are associated with perceptions of slips and lapses or poorer interaction with patients due to work stress among MAs.

The association of Shift Work and Effort–Reward Imbalance with Gastrointestinal Symptoms among Female Nurses

Background: Shift work impacts workers' health, mainly by disrupting the circadian rhythm, and gastrointestinal (GI) disturbances are among the health effects of shift work. Objectives: The objective of this study was to assess the association between shift work, work stress, and GI disturbance among nurses. Methods: In July 2018, a cross-sectional study was conducted in Dammam Medical Complex, Saudi Arabia. A total of 250 nurses were selected through convenience sampling from several departments. They completed a validated questionnaire, which included questions about their demographic data, GI symptoms, and effort–reward imbalance (ERI). Work stress was classified into two groups based on the ERI ratio. GI symptoms were categorized into three indices: total, upper, and lower GI. The sampling plan was designed to cover most of the shifts in the included departments throughout nonspecified dates. The daytime nurses' group was selected from the same hospital as a comparison group to the shift workers. Means and standard deviations were calculated for continuous variables and frequencies and percentages were calculated for categorical variables. The associations were assessed using the Chi-squares and analysis of variance. Results: Work stress among nurses, as measured by the ERI scale, was strongly associated with both upper and lower GI symptoms, with odds ratios of 5.7 (CI: 3.3–7.9) and 2.2 (CI: 1.8–4.3), respectively. The total GI symptom score of the shift workers was greater than that for the daytime workers, with means of 7.8 ± 6.9 and 5.4 ± 5.1, respectively (P = 0.005). Multivariable regression analysis showed that ERI was associated with both lower and upper GI symptoms after adjusting for shift work and years on the job. Conclusions: Shift work was associated with the high prevalence of GI symptoms. Stress (ERI) increased the risk for GI disturbance. Controlling work stress is necessary because it affects nurses' physical and social health, as well as their performances at work and the quality of care they provide.

Stress at work is associated with intima media thickness in older male employees, independent of other sources of stress perception

Chronic stress at work shows a moderate but robust longitudinal association with cardiovascular disease (CVD). Atherosclerosis is a pathophysiological process of most CVD, for which intima media thickness (IMT) of the carotid artery is used as an early marker. Its relationship with stress at work has remained largely unexplored, and the present study therefore aimed to elucidate the association between stress at work, assessed as effort-reward imbalance (ERI), and IMT. This cross-sectional study comprised of 501 male German employees aged 42 (19–64) years at enrollment into the Mannheim Industrial Cohort Study. Clinical assessments used fasting blood samples and IMT measurement. Self-report questionnaires assessed sources of perceived stress. Analyses adjusted for medical history, life style, and socio-economic status (SES) indicators as well as general perceived stress and worries to determine the specificity of ERI. Linear regression models estimated the association of ERI with IMT, stratifying for age groups and adjusting for potential confounders. ERI ratio increased until the age of 50 years and abated thereafter. In participants younger than 50 years IMT measurements were not associated with ERI ratios. However, despite lower mean ERI ratios in participants older than 50 years, this age group showed a significant relationship with IMT (standardized Beta = .36, p < .01), adjusting for multiple confounders including general perceived stress and worries. These analyses suggest that atherosclerosis in older employees is specifically related to stress at work. Longitudinal studies will help to elucidate the temporal relationship between stress exposure and downstream biological mechanisms. Lay summary Our study explored the association of job stress and the calcification of the carotid artery in German employees. We found out that this association is stronger in employees older than 50 years. In addition, it is independent of medical risk factors and stress caused by private issues.

The relationship between effort-reward imbalance and empathy among clinical nurses: A cross-sectional online survey.

To understand the factors that influence nurses empathy towards patients and to explore its influence on effort-reward imbalance involving empathy. Empathy is highly valued in nurse-patient relationships. However, currently, little evidence currently exists on the impact of work-related stress measured by effort-reward imbalance and empathy. An anonymous, cross-sectional online survey using a sample of convenient was conducted. Convenient online sampling was conducted with select nurses from seven cities in Shandong province, China. The nurses worked in clinical settings in 10 different hospitals. Two questionnaires, for example the Effort-Reward Imbalance Questionnaire and the Jefferson Scale of Physician Empathy, were used. Medians, percentages, related analysis and regression analysis were used to measure the relationship between Effort-Reward Imbalance and empathy levels among nurses in China. In addition, this study adhered to the EQUATOR checklist, STROBE (see Supplementary file 1). Among 1,077 participants, 26.5% stated experiencing an Effort-Reward Imbalance, with a mean empathy score among Chinese nurses, was 109.78±13.98. Multiple regression analysis revealed that females and head nurses had higher levels of empathy, and that those who had no experience learning about empathy-related courses and an Effort-Reward Imbalance ratio were negatively associated with empathy. Gender, department, position, experience learning about empathy-related courses and Effort-Reward Imbalance ratio were significant elements related to nurses' empathy levels. As we all know, empathy can affect the relationship between nurse and patient. If nurses are in an Effort-Reward Imbalance, they may have less empathy. It is advised to improve the reward level of nurses, so that the level of empathy towards patients is enhanced.

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.

The influence of working conditions on health satisfaction, physical and mental health: testing the effort-reward imbalance (ERI) model and its moderation with over-commitment using a representative sample of German employees (GSOEP)

BackgroundThe effort-reward imbalance (ERI) model is well-established in explaining work-related stress and health differences. A lack of reciprocity between efforts and rewards at the workplace is central to the theory. The third component (over-commitment) was defined to be a moderator of high-cost/low gain-working conditions increasing the risk of ill-health. Although the theory has been widely supported empirically, all underlying hypotheses have not been sufficiently tested. This article examines whether the strength of the effect of the effort-reward imbalance ratio on health indicators is bigger than the effects of efforts and rewards individually. Another research gap on the interaction with over-commitment is addressed and health measures are compared.MethodsThis study applied the effort-reward imbalance model on health satisfaction and the SF-12v2™ indicators physical health composite score (PCS) and mental health composite score (MCS) within a representative sample of German employees. After confirmatory factor analyses of the items of the components effort, reward and over-commitment were applied, multiple linear regression models and interaction effects were calculated for more than 7000 respondents within the German Socio-Economic Panel (GSOEP) study.ResultsAgainst the model’s hypothesis, effort and especially reward had a stronger effect on health satisfaction and mental health individually than the effort-reward imbalance ratio. Over-commitment exerted a negative influence on health indicators and its interaction with the effort-reward imbalance ratio intensified this effect significantly for mental health. Overall, the best model fit was reached for mental health, which is in line with the model’s stress theory foundation.ConclusionsAlthough the ERI model has been applied for more than 20 years, theoretical and methodological demands can no longer be neglected. This article contributes to the revision of the effort-reward imbalance (ERI) model and demonstrates possible starting points for prevention programs focusing on rewards.

Relationships between effort-reward imbalance and work engagement in police officers: taking a salutogenic perspective

Work engagement is an indicator of work-related well-being. Taking a salutogenic perspective, this study aims to examine work engagement within the effort-reward imbalance (ERI) model. To foster our understanding of work engagement, we analyzed relationships of the ERI model subscales effort, esteem reward, status reward and security reward as well as overcommitment with global work engagement and its subscales (vigor, dedication, absorption). Eight hundred eleven police officers participated in a cross-sectional health-monitoring survey in a German police department. Regression analyses were conducted. The ERI ratio was negatively related to measures of work engagement (β = −0.30 to −0.25). Whereas esteem (β = 0.23 to 0.19) and security reward (β = 0.20 to 0.16) positively predicted global work engagement as well as vigor, dedication and absorption, overcommitment showed a negative association with vigor (β = −0.14). The regression models explained up to 23% of the variance in work engagement or its subscales. An imbalance between effort and reward is associated with reduced work engagement in the sample of police officers. While effort is not accountable for reduced work engagement, esteem and security rewards are capable of promoting work engagement. Workplace interventions at the level of the supervisors and the department as well as public image campaigns may promote rewards in police work to foster work engagement.

Effort-reward imbalance at work and tooth loss: a cross-sectional study from the J-SHINE project.

Oral diseases produce enormous productivity loss. However, epidemiological evidence of work stress and tooth loss is scarce. The aim of this study was to examine the association of work stress, according to effort–reward imbalance (ERI), with tooth loss. We conducted a cross-sectional study using data obtained between 2010 and 2011 in Japan. This study included 1,195 employees aged 25–50 years old (response rate=32%). The dependent variable was self-reported tooth loss (having or not). The independent variable was a dichotomized ERI ratio (>1.4 and ≤1.4). Age, sex, sociodemographic variables, work-related factors, and health-related variables were adjusted. Psychological distress was used as a potential mediator. We also examined an additive interaction between support from supervisors and ERI. The median age was 37, and 48% were women. After adjusting for the covariates, ERI was still associated with tooth loss (prevalence ratio=1.20 [95% confidence interval=1.01, 1.42] from Poisson regression models with a robust error variance). Psychological distress partially explained the association, and support from supervisors significantly attenuated the association. In conclusion, high ERI ratio was still associated with an increased risk of tooth loss among working adults.

An Effort-Reward Imbalance Model to Study Engagement and Burnout: A Pilot Study

Introduction: Medical students are motivated to engage actively in their studies. Yet at least 50% of medical students suffer from academic burnout. Using a social environmental perspective, this pilot study tested six hypotheses to account for medical student engagement and burnout via an effort-reward imbalance (ERI) model.Methods: This study measured ERI, over-commitment, engagement, burnout, negative affect, demographic variables, and test results during 2017. Seventy-nine medical students at a college of medicine in Seoul, Republic of Korea completed the online questionnaires (response rate: 20.73%). We used hierarchical regression analyses to examine the effects of ERI ratio, over-commitment, and the interaction between ERI ratio and over-commitment on engagement and burnout after adjusting for demographic variables and negative affect.Results: The ERI ratio was negatively related to engagement (p &lt; 0.05), but over-commitment was positively related to engagement (p &lt; 0.05). For burnout, affiliation, age, and negative affect were significant predictors. The ERI ratio was positively associated with burnout (p &lt; 0.05). When we performed regression analyses on three sub-dimensions of engagement and burnout, the factors that affected each sub-dimension were different.Discussion: This pilot study revealed that the ERI ratio in school settings is a common factor for explaining the engagement and burnout of medical students. In addition, over-commitment significantly accounted for engagement, but it did not significantly account for burnout. These results for over-commitment may be explained by the unique characteristics of medical students.

Balancing Effort and Rewards at University: Implications for Physical Health, Mental Health, and Academic Outcomes.

The effort-reward imbalance model suggests that, when the efforts required within the workplace are disproportionately large in comparison to the rewards resulting from those efforts, there is an increased risk of stress-related health issues. The model posits that higher levels of "overcommitment," in addition to a high effort-reward imbalance ratio, magnifies this risk of ill-health. While work has been conducted to assess the validity of this model within the school setting, research in the higher education sector is limited. This study explored the validity of the effort-reward imbalance model for explaining burnout, poor health, and academic productivity among university students. This study utilized a cross-sectional survey of Australian university students (n = 395) from a range of universities. An imbalance of effort and reward was associated with poorer physical health, increased burnout, and reduced productivity. Effort-reward imbalance mediated a relationship between overcommitment and burnout; those high in overcommitment were more likely to experience an imbalance of effort and reward at university. The relationships between effort-reward imbalance, health, burnout, and academic productivity support the generalizability of this model to the university setting. In addition, the personal characteristic of overcommitment also appears to have an important relationship with burnout.