Effort-reward Imbalance Scale Research Articles

The mediating role of psychological capital on the association between occupational stress and depressive symptoms among Chinese physicians: a cross-sectional study

BackgroundAlthough occupational stress is an identified predictor of depressive symptoms, the mechanism behind the association is not well understood. The purpose of this study was to examine how psychological capital (PsyCap), a positive psychological state, mediates the association between occupational stress and depressive symptoms among Chinese physicians.MethodsA cross-sectional survey was conducted in Liaoning Province, China, during September–October 2010. Self-administered questionnaires including items on depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale, occupational stress assessed by the effort–reward imbalance scale and PsyCap estimated by a 24-item Psychological Capital Questionnaire, together with age, gender, marital status and education were distributed to 1300 physicians employed in large general hospitals. The final sample consisted of 998 participants. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between occupational stress and depressive symptoms.ResultsBoth the effort/reward ratio (ERR) and overcommitment were significantly associated with depressive symptoms among male and female physicians. There was a gender difference in the mediating role of PsyCap on the occupational stress–depressive symptoms association. For male physicians, PsyCap did not mediate the association between occupational stress and depressive symptoms. For female physicians, ERR and overcommitment were negatively associated with PsyCap, and PsyCap was negatively associated with depressive symptoms. As a result, PsyCap significantly mediated the associations of ERR and overcommitment with depressive symptoms. The proportion of PsyCap mediation was 19.07% for ERR, and 24.29% for overcommitment.ConclusionsPsyCap could be a positive resource for combating depressive symptoms in Chinese physicians. In addition to reducing occupational stress, PsyCap development should be included in depression prevention and treatment strategies, especially for female physicians.

Adverse Psychosocial Working Conditions and Poor Quality of Life among Financial Service Employees in Brazil

Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

The Effort‐reward Imbalance Questionnaire in Greek: Translation, Validation and Psychometric Properties in Health Professionals

The aim of the present study was to translate, adapt and validate the Effort-reward imbalance (ERI) questionnaire in a sample of Greek healthcare professionals. An internationally recommended methodology was followed to perform translation of the ERI instrument into the Greek language. The questionnaire was then randomly administered to 600 Greek physicians, nurses, physiotherapists and laboratory staff, and 456 questionnaires with no missing data on the ERI items were returned (76% response rate). Tool validation included assessment of internal consistency, factorial structure, discriminant validity and presence of floor or ceiling effects. Criterion validity was demonstrated by investigating the association of theoretically relevant ERI summary measurements with respondents' self-rated health. The Greek version of the ERI questionnaire showed good psychometric properties. Cronbach's alpha values were 0.79, 0.72 and 0.75 for the three ERI scales of effort, reward and overcommitment respectively. Exploratory factor analysis yielded a 5-factor solution that closely reflected the original theoretical ERI model. Significant associations were found between respondents' age, gender and specific occupation with ERI scores. ERI ratio and "overcommitment" scores in the highest tertiles were associated with elevated odds ratios (OR) of below-average self-rated health (OR=5.38, 95% confidence intervals 1.77 to 16.38, p=0.003, and OR=3.41, 95% confidence intervals 1.39 to 8.38, p=0.007, respectively). The translated and adapted Greek version is comparable with the original ERI instrument in terms of validity and factorial structure and is suitable for assessment of the psychosocial work environment of Greek healthcare professionals.

Effort-Reward Imbalance at Work and Psychological Distress

To examine whether the psychometric properties of the effort-reward imbalance (ERI) at work scales could be replicated with post-myocardial infarction (post-MI) patients and to measure the criterion validity through its association with psychological distress. A cross-sectional survey was conducted among 814 patients (739 men and 75 women) who had returned to work after their first MI and who were followed up by telephone at an average of 2.2 years after their baseline interview (1998-2000). The psychological demands scale of the Karasek Job Content Questionnaire was used to measure effort. Reward was measured with nine items from the original reward scale by Siegrist plus two proxy items. Exploratory and confirmatory factor analyses were used to test the theoretical structure of ERI. Using log-binomial regression models, we evaluated the association between ERI scales and psychological distress measured with the 14-item Psychiatric Symptom Index. ERI scales and subscales demonstrated adequate internal consistencies. Exploratory factor analysis using oblique (promax) rotation yielded a three-factor solution with items representative of extrinsic effort (Factor 1) and reward subscales (Factors 2 and 3). Confirmatory factor analysis demonstrated a good fit with the data. The internal consistencies and discriminant validities of the ERI scales were satisfactory. Furthermore, effort, reward, and ERI ratio were significantly associated with psychological distress (adjusted prevalence ratio [PR] = 1.71, 95% confidence interval [CI] = 1.26-2.31; PR = 1.63, 95% CI = 1.16-2.29; and PR = 1.70, 95% CI = 1.17-2.47, respectively). The psychometric properties of the ERI scales were generally reproduced among post-MI patients. The associations with psychological distress supported the criterion validity of the ERI scales in this population.

Bergen Burnout Inventory: reliability and validity among Finnish and Estonian managers

This study introduces a short measure for burnout (the Bergen Burnout Inventory, BBI) and examines its validity and reliability among managers in Finland and Estonia by means of confirmatory factor analysis. Burnout comprises three dimensions: (1) exhaustion at work (emotional component), (2) cynicism toward the meaning of work (cognitive component), and (3) the sense of inadequacy at work (behavioral component). A total of 742 young Finnish managers and 414 Estonian managers responded to burnout (BBI) and effort-reward imbalance (ERI) scales. The results showed that the three-factor solution for burnout, compared to the one- or two-factor solutions, fitted the data best and gave the best reliability indices. The three theoretically derived dimensions of burnout were closely related but separate constructs. The BBI also had high item scale reliabilities among the managers in both countries. Finally, the effort-reward imbalance (ERI) model and the three dimensions of burnout had similar associations among Finnish and Estonian managers providing evidence for the concurrent validity of the BBI. That is, high effort was related to high exhaustion and high cynicism. High reward was related to low exhaustion, but especially to low cynicism and low inadequacy. High overcommitment was related particularly to high exhaustion, but also to high cynicism and high inadequacy. The BBI can be used for the measurement of burnout in both research and occupational health contexts.

The influence of occupational stress factors on the nicotine dependence: a cross sectional study

ObjectiveThis study analyses the association between occupational stress factors and nicotine dependence. Our hypothesis is that occupational stress factors increase nicotine dependence.MethodsData were taken from the Cologne Smoking Study, a case-control study that examines which genetic/psychosocial factors lead to a higher risk for smokers to suffer from cardiac infarction, lung cancer and/or to become addicted to nicotine. Our sample consisted of N = 197 currently smoking and employed participants. Nicotine dependence was measured using the Fagerström Test for Nicotine Dependence (FTND). The extent of the stress factors experienced at work was assessed using the Effort-Reward Imbalance scale (ERI). Logistic regression was used for the statistical analysis.ResultsContrary to our hypothesis, the results show that occupational stress factors are actually associated with lower levels of nicotine dependence (N = 197; adjusted OR = 0.439; p = .059).ConclusionsOne possible explanation for the study's findings is that the participants have a heavy workload and can only smoke in their spare time. Another reason may be workplace smoking bans. Furthermore, the Fagerström Test for Nicotine Dependence is unable to examine nicotine dependence during working hours.

Adaptação transcultural para o português brasileiro da escala effort-reward imbalance: um estudo com trabalhadores de banco

To describe the transcultural adaptation of the effort-reward imbalance scale into Brazilian Portuguese and to examine the resulting construct's validity and reliability. Forward and backward translation was used. Internal consistency, test-retest reliability, and factor structure were tested in a sample of 100 individuals of both sexes working at a large government-owned Brazilian bank. The sample included different age groups and schooling levels. The adapted version was named escala de desequilíbrio esforço-recompensa. Cronbach's alpha for the three scale dimensions--effort, reward, and overcommitment--was 0.70, 0.95 and 0.86, respectively. Intraclass correlation coefficients for these dimensions were 0.82, 0.96, and 0.91, respectively. Factor analysis kept all the initial questionnaire items and was consistent with the theoretical construct of the model. The results indicate that the transcultural adaptation into Brazilian Portuguese of the effort-reward imbalance scale was successful and is adequate to assess this situation in work environments.

Effort-reward imbalance and depressive state in nurses

The mental health of nurses is an important issue. To examine relationships between effort-reward imbalance (ERI) and depression and anxiety in nurses of a Japanese general hospital. A self-report survey was conducted among 406 nurses. Work stress was measured using a Japanese version of the ERI scale. Depression and anxiety were assessed by an item of the QOL-26. Logistic regression analysis was used to determine the independent contribution of the effort-reward ratios or overcommitment to the depressive state. Both higher effort-money ratio and higher overcommitment significantly correlated with the depressive state (OR: 2.75; 95% CI: 1.34-5.66 and OR: 1.27; 95% CI: 1.15-1.41, respectively). These findings suggest that in addition to effort-money ratio, overcommitment at work is an especially important issue that may be able to be managed in health promotion services for nurses in general hospitals.

Workplace experience of radiographers: impact of structural and interpersonal interventions

Within the framework of organisational development, an assessment of the workplace experience of radiographers (RGs) was conducted. The aims of this study were to develop structural and interpersonal interventions and to prove their effectiveness and feasibility. A questionnaire consisting of work-related factors, e.g. time management and communication, and two validated instruments (Workplace Analysis Questionnaire, Effort-Reward Imbalance Scale) was distributed to all RGs (n = 33) at baseline (T1). Interventions were implemented and a follow-up survey (T2) was performed 18 months after the initial assessment. At T1, areas with highest dissatisfaction were communication and time management for ambulant patients (bad/very bad, 57% each). The interventions addressed adaptation of work plans, coaching in developing interpersonal and team leadership skills, and regular team meetings. The follow-up survey (T2) showed significantly improved communication and cooperation within the team and improved qualification opportunities, whereas no significant changes could be identified in time management and in the workplace-related scales 'effort' expended at work and 'reward' received in return for the effort. Motivating workplace experience is important for high-level service quality and for attracting well-qualified radiographers to work at a place and to stay in the team for a longer period.

The psychometric properties of demand-control and effort–reward imbalance scales among Brazilian nurses

To compare the psychometric adequacy of the demand-control-support (DCS) and the effort-reward imbalance (ERI) questionnaires in relation to their respective theoretical models among workers within the same psychosocial work environment. A self-report questionnaire was administered to 1,509 nursing personnel at two Brazilian hospitals. Analyses were based on internal consistency, corrected item-total correlation, and confirmatory factor analysis models for ordinal data (conducted with Mplus software) to test the fit of each model. Internal consistency was satisfactory (>0.70) for most scales of the DCS and ERI questionnaires, except for the job decision latitude scale (alpha = 0.50). With reference to corrected item-total correlations, adequate performance was observed for most items of both questionnaires. The item 'Do you have to do same thing over and over again' had a very low corrected item-total correlation (-0.09) and the removal of this item increased the internal consistency of the skill discretion subscale. Overall, fit indices (of factorial validity) for the DCS and the ERI questionnaires were adequate. However, a low correlation between subscales of the decision latitude scale (-0.164) was observed. For the psychological job demands and overcommitment scales, the best adjustment of the model was obtained when correlated errors between items were considered. Strengths and limitations were observed in both the DCS and the ERI scales. The questionnaires could be improved by the revision of some items.

Effort–reward imbalance and burnout among German nurses in medical compared with psychiatric hospital settings

The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort-reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort-Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.

A short generic measure of work stress in the era of globalization: effort–reward imbalance

We evaluate psychometric properties of a short version of the original effort-reward imbalance (ERI) questionnaire. This measure is of interest in the context of assessing stressful work conditions in the era of economic globalization. In a representative sample of 10,698 employed men and women participating in the longitudinal Socio-Economic Panel (SOEP) in Germany, a short version of the ERI questionnaire was included in the 2006 panel wave. Structural equation modeling and logistic regression analysis were applied. In addition to satisfactory internal consistency of scales, a model representing the theoretical structure of the scales provided the best data fit in a competitive test (RMSEA = 0.059, CAIC = 4124.19). Scoring high on the ERI scales was associated with elevated risks of poor self-rated health. This short version of the ERI questionnaire reveals satisfactory psychometric properties, and can be recommended for further use in research and practice.

Improving the measurement accuracy of the effort-reward imbalance scales

The effort-reward imbalance (ERI) scale items are answered in a two-step process, but the justification is questioned for the formulation of summary measure by combining information rated in two steps. To examine whether the basic prerequisites of the ERI scales are empirically satisfied and to seek ways to improve the rating procedure. A polytomous item response theory (IRT) model was applied to the responses of 20,256 workers who completed the ERI scales. To determine the most appropriate statistical justification, three alternative scoring algorithms were compared with regard to the test properties revealed by the IRT analyses and efficiencies of screening performance and criterion validity against depressive symptomatology. The rated raw-score units did not reflect the hypothesized order of lowest stress levels to highest stress levels. Exchanging or collapsing the lowest two categories of a Likert scaled item, where data of different quality are combined, solved this problem, thereby making the test content more appropriate. The modified rating improved the efficiencies of screening performance and the correlation of the stress summary measures against health criterion, i.e., depression. An avoidable measurement error exists in the current ERI scales. Modifying the rating procedure can improve the measurement accuracy.

Factorial invariance and stability of the effort-reward imbalance scales: A longitudinal analysis of two samples with different time lags

Key measures of Siegrist's (1996) Effort-Reward Imbalance (ERI) Model (i.e., efforts, rewards, and overcommitment) were psychometrically tested. To study change in organizational interventions, knowledge about the type of change underlying the instruments used is needed. Next to assessing baseline factorial validity and reliability, the factorial stability over time - known as alpha-beta-gamma change - of the ERI scales was examined. Psychometrics were tested among 383 and 267 healthcare workers from two Dutch panel surveys with different time lags. Baseline results favored a five-factor model (i.e., efforts, esteem rewards, financial/career-related aspects, job security, and overcommitment) over and above a three-factor solution (i.e., efforts, composite rewards, and overcommitment). Considering changes as a whole, particularly the factor loadings of the three ERI scales were not equal over time. Findings suggest in general that moderate changes in the ERI factor structure did not affect the interpretation of mean changes over time. Occupational health researchers utilizing the ERI scales can feel confident that self-reported changes are more likely to be due to factors other than structural change of the ERI scales over time, which has important implications for evaluating job stress and health interventions.

Le déséquilibre efforts-récompenses et les débordements entre vie au travail, vie privée chez les éleveurs laitiers : leurs effets sur l'épuisement professionnel

Résumé The aim of this study is to test the hypothesis according to which the imbalance between effort and reward, as well as to what degree the interference of professional life upon one’s private life, can affect the level of job burnout felt by a group of dairy farmers. The sample group was composed of dairy farmers (N = 104) from Eure who were sent a questionnaire by mail. Each questionnaire was designed to collect results which could be analysed with the help of the Siegrist scale (the effort-reward imbalance scale), the Swing scale and the MBI (General Survey). The data show that effort-reward imbalance does not in itself explain the burnout. On the other hand, negative professional/personal interaction strongly contributed to it. In addition, no difference was observed based on the sex of the worker. The limits and contributions of the study are presented in the discussion.

Le déséquilibre efforts-récompenses et les débordements entre vie au travail, vie privée chez les éleveurs laitiers : leurs effets sur l'épuisement professionnel

The aim of this study is to test the hypothesis according to which the imbalance between effort and reward, as well as to what degree the interference of professional life upon one's private life, can affect the level of job burnout felt by a group of dairy farmers. The sample group was composed of dairy farmers (N=104) from Eure who were sent a questionnaire by mail. Each questionnaire was designed to collect results which could be analysed with the help of the Siegrist scale (the effort-reward imbalance scale), the Swing scale and the MBI (General Survey). The data show that effort-reward imbalance does not in itself explain the burnout. On the other hand, negative professional/personal interaction strongly contributed to it. In addition, no difference was observed based on the sex of the worker. The limits and contributions of the study are presented in the discussion.

The Brazilian version of the effort-reward imbalance questionnaire to assess job stress

The effort-reward imbalance (ERI) model has been used to assess the health impact of job stress. We aimed at describing the cross-cultural adaptation of the ERI questionnaire into Portuguese and some psychometric properties, in particular internal consistency, test-retest reliability, and factorial structure. We developed a Brazilian version of the ERI using a back-translation method and tested its reliability. The test-retest reliability study was conducted with 111 health workers and University staff. The current analyses are based on 89 participants, after exclusion of those with missing data. Reproducibility (interclass correlation coefficients) for the "effort", "'reward", and "'overcommitment"' dimensions of the scale was estimated at 0.76, 0.86, and 0.78, respectively. Internal consistency (Cronbach's alpha) estimates for these same dimensions were 0.68, 0.78, and 0.78, respectively. The exploratory factorial structure was fairly consistent with the model's theoretical components. We conclude that the results of this study represent the first evidence in favor of the application of the Brazilian Portuguese version of the ERI scale in health research in populations with similar socioeconomic characteristics.

Psychometric properties of the Korean version of the effort–reward imbalance questionnaire: a study in a petrochemical company

To evaluate the criterion validity, factorial validity, and internal consistency of Korean version of effort-reward imbalance (ERI) for the scales of effort, reward, and overcommitment as well as to examine the effect of psychosocial factors on physical and mental illness among petroleum refinery workers in South Korea. The Korean version of ERI questionnaire was constructed using the translation and back-translation technique, and its psychometric properties were explored among 908 male workers in a large petroleum refinery in South Korea in 2002. Cronbach's alpha coefficient was used to test internal consistency. An exploratory factor analysis was conducted on all items of the instrument. Confirmatory factor analyses were conducted on each dimension of effort, reward and overcommitment. Physical and mental health was measured by self-rated health (SF-8). The lowest tertiles of the scores were defined as illness. Multiple logistic regression models were used to test the effect of job stress on the physical and mental health (criterion validity of ERI scales). The Cronbach's alpha coefficients for effort, reward, and overcommitment were 0.71, 0.86, and 0.75, respectively, indicating satisfactory internal consistency. Exploratory factor analysis found three latent factors, which closely corresponded to the theoretical structure of the ERI model. Acceptable construct validity was shown using confirmatory factor analysis. The highest tertile of effort-reward ratio was significantly associated with physical illness (OR 2.4, 95% CI 1.7-3.6) and mental illness (OR 2.9, 95% CI 2.0-4.2), compared to lower tertiles. Overcommitment was significantly associated with mental illness, but not with physical illness. These findings contribute to the validity and reliability of the Korean ERI questionnaire. Importantly, in the context of a rapid change in the labour market, the lack of reciprocity between efforts and rewards at work is strongly associated with self-rated physical and mental health.

Staff Nurse Empowerment and Effort-Reward Imbalance

The purpose of this study was to test an expanded model of Rosabeth Moss Kanter's Structural Theory of Organizational Behaviour (Kanter 1977; Laschinger, Finegan, Shamian and Wilk 2001) by examining the relationship between nurses' empowerment and their perceptions of effort-reward imbalance (Siegrist 1996). A sample of 112 staff nurses employed in teaching hospitals in Ontario participated in this study (58% return rate). A descriptive correlational survey design was used to collect data by eLiciting responses to five self-report instruments: the Conditions of Work Effectiveness II, the Job Activities Scale II, and the Organizational Relationships Scale II (Laschinger, Finegan, Shamian and Wilk 2001), the Effort-Reward Imbalance (ERI) scale (Siegrist and Peter 1999a) and a demographic questionnaire. Staff nurses were only moderately empowered, and 24.1% perceived their work to have more efforts than rewards, according to Siegrist's guidelines.

The measurement of effort–reward imbalance at work: European comparisons

Using comparative data from five countries, this study investigates the psychometric properties of the effort–reward imbalance (ERI) at work model. In this model, chronic work-related stress is identified as non-reciprocity or imbalance between high efforts spent and low rewards received. Health-adverse effects of this imbalance were documented in several prospective and cross-sectional investigations. The internal consistency, discriminant validity and factorial structure of ‘effort’, ‘reward’, and ‘overcommitment’ scales are evaluated, using confirmatory factor analysis. Moreover, content (or external) validity is explored with respect to a measure of self-reported health. Data for the analysis is derived from epidemiologic studies conducted in five European countries: the Somstress Study (Belgium; n=3796), the GAZEL-Cohort Study (France; n=10,174), the WOLF-Norrland Study (Sweden; n=960), the Whitehall II Study (UK; n=3697) and the Public Transport Employees Study (Germany; n=316). Internal consistency of the scales was satisfactory in all samples, and the factorial structure of the scales was consistently confirmed (all goodness of fit measures were >0.92). Moreover, in 12 of 14 analyses, significantly elevated odds ratios of poor health were observed in employees scoring high on the ERI scales. In conclusion, a psychometrically well-justified measure of work-related stress (ERI) grounded in sociological theory is available for comparative socioepidemiologic investigations. In the light of the importance of work for adult health such investigations are crucial in advanced societies within and beyond Europe.