High Effort-reward Ratio Research Articles

Job Stress and Sleep Disturbances Among Career Firefighters in Northern California.

This study examined the association between job stress and sleep disturbance among career firefighters. A cross-sectional survey study was conducted with 154 career firefighters working in Northern California, US job stress was measured using the short form of the Effort-Reward Imbalance questionnaire and sleep was measured with the Patient-Reported Outcomes Measurement Information System Sleep Disturbance. Approximately 75% experienced sleep disturbance. For firefighters' job stress, high effort (odds ratio [OR] = 3.68; 95% confidence interval [CI]: 1.25-10.80), high effort-reward ratio (OR = 3.55; 95% CI: 1.23-10.23), and high overcommitment (OR = 9.09; 95% CI: 2.30-35.85) were significantly associated with increased likelihood of sleep disturbance, after adjustment for other factors. Job stress significantly affected firefighters' sleep health, suggesting the need to design effective health promotion interventions to reduce job stress and improve sleep quality for these public service workers.

Psychosocial Work Stress and Occupational Stressors in Emergency Medical Services

Emergency medical service (EMS) professionals often experience work stress, which escalated during COVID-19. High job demand in the EMS profession may lead to progressive decline in physical and mental health. We investigated the prevalence of psychosocial job stress in the three levels of EMS: basic, advanced, and paramedic, before and during the COVID-19 pandemic. EMS professionals (n = 36) were recruited from EMS agencies following the Institutional Review Board approval. Participants took surveys on demographics, personal characteristics, chronic diseases, and work schedules. Job stress indicators, namely the effort-reward ratio (ERR) and overcommitment (OC), were evaluated from survey questionnaires using the effort-reward imbalance model. Associations of job stress indicators with age, sex, body mass index, and working conditions were measured by logistic regression. Psychosocial work stress was prevalent with effort reward ratio > 1 in 83% of participants and overcommitment scores > 13 in 89% of participants. Age, body mass index, and work hours showed strong associations with ERR and OC scores. The investigation findings suggested that a psychosocial work environment is prevalent among EMS, as revealed by high ERR, OC, and their correlation with sleep apnea in rotating shift employees. Appropriate interventions may be helpful in reducing psychosocial work stress in EMS professionals.

Association of Occupational Stress With Tinnitus Among Career Firefighters in the United States.

This study explores the relationship between occupational stress and tinnitus among firefighters, a group often exposed to two tinnitus risk factors: high stress and noise. This cross-sectional study includes 240 firefighters in the United States. Data describing demographic characteristics, occupational stress, noise exposure, and tinnitus were collected by survey. Occupational stress was measured using the short version of the Effort-Reward Imbalance Questionnaire. Forty-three percent of participants reported experiencing tinnitus within the past month. For occupational stress, higher effort (odds ratio, 1.25; 95% confidence interval, 1.05 to 1.49) and higher effort-reward ratio (odds ratio, 12.28; 95% confidence interval, 3.08 to 48.86) were associated with increased odds of tinnitus, after adjustment for demographic characteristics and noise exposure. Occupational stress may increase the likelihood of tinnitus for firefighters, an already at-risk group of workers. Health providers should incorporate stress assessment into tinnitus management programs.

A cross-sectional study of the association between effort-reward imbalance and psychologic distress among Japanese dietitians.

ObjectivesThis study aims to clarify dietitians’ effort‐reward imbalance (ERI) and examine its association with psychologic distress.MethodsA cross‐sectional survey was conducted. A total of 3593 questionnaires were distributed to dietitians in about 110 organizations and 1890 responses were received (response rate 52.6%). Hence, a total of 1743 valid questionnaires were used in the analysis. Effort‐reward (ER) ratio was measured by a subscale of the ERI Questionnaire, and psychologic distress was measured by the Kessler Psychological Distress Scale (K6). The association between the ER ratio and psychologic distress was analyzed by multiple logistic regression analysis with covariates.ResultsThe mean ER ratio was 0.83 (SD = 0.53) and ERI (ER ratio >1) prevalence was 26.3%. The mean K6 score was 7.1 (5.3), and psychologic distress (K6 score ≥5) prevalence was 62.4%. The increased psychologic distress was associated with a higher ER ratio, less support from supervisors and coworkers, and lower age and household income. ERI was significantly associated with psychologic distress, even after being adjusted for covariates.ConclusionsDietitians experience high stress, as shown by their high ER ratio and K6 scores. Their ERI was greatly associated with psychologic distress.

Burnout and associated occupational stresses among Chinese nurses: A cross-sectional study in three hospitals.

There is literature scarcity relating to burnout and other work stresses in relation to Chinese nursing-workforce performance. To assess the relationship between self-esteem versus burnout; and effort-reward ratio versus favorability to the work environment, among Chinese nurses. We employed four validated questionnaires in the assessment burnout, self-esteem, effort-reward ratio, and favorability of nursing workplace; Maslach-Burnout Inventory (MBI), Rosenberg's self-esteem (RS), Effort-Reward imbalance (ERI) and Work-Environment Scale questionnaires (WES). Linear and ordinal regression models were utilized to assess the relationships between the variables. Analyses were conducted by using SPSS at a 95% level of significance. We assessed 487 (Mean age: 38.8±7.1 years) nurses from three hospitals. Higher self-esteem was associated with a lower level of emotional exhaustion (Unstandardized coefficient: -0.579, p-Value<0.001); and a lower level of depersonalization (Unstandardized coefficient: -0.212, p-Value = 0.001). The relationship between self-esteem and personal achievement did not reach statistical significance. A higher effort-reward ratio was associated with less likelihood that nurses would consider their work environment favorable (Logit estimate of -0.832, p-Value = 0.014). Lower self-esteem is associated with increased burnout. A higher effort-reward ratio is associated with an enhanced perception work environment as unfavorable. We recommend psychosocial intervention programs and amendments in nursing policies to improve effort-reward imbalance among Chinese nurses.

Psychological distress and associated factors among Japanese nursery school and kindergarten teachers: a cross-sectional study.

The understaffing of nursery schools and kindergartens and the increasing workload of childcare workers are becoming significant issues in Japan. In this study, a cross-sectional survey was conducted to investigate the stress experienced by childcare workers and its antecedents. We distributed 2,640 questionnaires to childcare workers in Miyagi prefecture, obtaining a response rate of 51.9% (n=1,370). Finally, 1,210 valid questionnaires were used in the analysis. As a stress indicator, psychological distress was measured with the Kessler Screening Scale for Psychological Distress (K6). The mean K6 score was 7.0 (SD=5.4), and the prevalence of psychological distress (K6 score ≥5) was 60.0%. Considering work-related factors, the mean scores were as follows: supervisor support 11.8 (2.6), coworker support 12.1 (2.0), work engagement 3.2 (1.2), and effort-reward ratio 0.93 (0.53). A multivariate logistic regression analysis with adjustment for possible confounders revealed that increased psychological distress was associated with higher effort-reward ratio, lower support from supervisors and coworkers, lower work engagement, and insufficient sleep. These results suggest that elevated psychological distress is strongly associated with effort-reward imbalance, while high work engagement in childcare workers helped to reduce their distress.

Validating the short measure of the Effort-Reward Imbalance Questionnaire in older workers in the context of New Zealand

The objective of this study was to validate a short version of the Effort-Reward-Imbalance (ERI) questionnaire in the context of New Zealand among older full-time and part-time employees. Data were collected from 1694 adults aged 48-83 years (mean 60 years, 53% female) who reported being in full- or part-time paid employment in the 2010 wave of the New Zealand Health, Work and Retirement study. Scale reliability was evaluated by item-total correlations and Cronbach's alpha. Factorial validity was assessed using multi-group confirmatory factor analyses assessing nested models of configural, metric, scalar and strict invariance across full- and part-time employment groups. Logistic regressions estimated associations of effort-reward ratio and over-commitment with poor physical/mental health, and depressive symptoms. Internal consistency of ERI scales was high across employment groups: effort 0.78-0.76; reward 0.81-0.77, and over-commitment 0.83-0.80. The three-factor model displayed acceptable fit in the overall sample (X2/df = 10.31; CFI = 0.95; TLI = 0.94; RMSEA = 0.075), and decrements in model fit indices provided evidence for strict invariance of the three-factor ERI model across full-time and part-time employment groups. High effort-reward ratio scores were consistently associated with poor mental health and depressive symptoms for both employment groups. High over-commitment was associated with poor mental health and depressive symptoms in both groups and also with poor physical health in the full-time employment group. The short ERI questionnaire appears to be a valid instrument to assess adverse psychosocial work characteristics in old full-time and part-time employees in New Zealand.

Effort-reward imbalance at work, over-commitment personality and diet quality in Central and Eastern European populations.

The aims of this study were to investigate the associations between work stress defined by the effort-reward imbalance (ERI) model and diet quality and to examine the potential role of over-commitment (OC) personality in ERI-diet relationships. A cross-sectional study was conducted in random population samples of 6340 men and 5792 women (age 45-69 years) from the Czech Republic, Russia and Poland. Dietary data were collected using FFQ. The healthy diet indicator (HDI) was constructed using eight nutrient/food intakes (HDI components) to reflect the adherence to WHO dietary guideline. The extent of imbalance between effort and reward was measured by the effort:reward (ER) ratio; the effort score was the numerator and the reward score was multiplied by a factor adjusting for unequal number of items in the denominator. Logistic regression and linear regression were used to assess the associations between exposures (ER ratio and OC) and outcomes (HDI components and HDI) after adjustment for confounders and mediators. The results showed that high ER ratio and high OC were significantly associated with unhealthy diet quality. For a 1-SD increase in the ER ratio, HDI was reduced by 0·030 and 0·033 sd in men and women, and for a 1-SD increase in OC, HDI was decreased by 0·036 and 0·032 sd in men and women, respectively. The modifying role of OC in ERI-diet relationships was non-significant. To improve diet quality at workplace, a multiple-level approach combining organisational intervention for work stress and individual intervention for vulnerable personality is recommended.

Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study

BackgroundTaiwan’s National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals.MethodsWe posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution.ResultsThe survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males.ConclusionsThere was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.

Working hours, occupational stress and depression among physicians

Physicians report high prevalence of depression, work long hours and are exposed to many occupational stresses (OSs). To investigate the cross-sectional association between working hours, OS and depression among physicians. A self-administered questionnaire was mailed to 1902 alumni of a medical school. The questionnaire evaluated working hours in the previous week, OS assessed by the effort-reward imbalance model, social support and depression evaluated by the Center for Epidemiologic Studies Depression scale. The associations between these occupational factors and depression were analyzed using multiple logistic regression. The questionnaire was returned by 795 alumni (response rate, 42%), and 706 respondents (534 men and 172 women) were suitable for analysis. The odds ratio (OR) of depression in the long working hours group (>70 h/week) was 1.8 (95% CI: 1.1-2.8) compared with the short working hours group (<54 h/week), adjusted for basic attributes. The adjusted ORs of depression in the upper effort-reward ratio (ERR) tertile versus the lower ERR tertile were 0.6 (0.2-1.8) in the short working hours group, 8.5 (3.0-24.0) in the middle working hours group and 9.9 (3.8-25.7) in the long working hours group. The adjusted ORs of depression stratified according to working hours and ERR tended to be higher in the groups with a higher ERR, but no association between working hours and depression was found. This study indicates that the management of OS is needed as a countermeasure against depression among physicians.

The impact of the 2008 financial crisis on psychological work stress among financial workers and lawyers

The aim of this study was to investigate the impact of the financial crisis on psychological work stress among financial workers and lawyers. The Chinese versions of Karasek's job content questionnaire (C-JCQ) and Siegrist's ERI questionnaire (C-ERI) were used to measure work stress, and the Copenhagen Burnout Inventory (C-CBI) questionnaire was used to measure personal and work-related burnout for 38 financial workers and 97 lawyers before and after the financial crisis in 2008. A paired t test was used to compare changes in work stress and burnout. A logistic regression was performed to determine the association between psychosocial work stress and burnout. After the financial crisis, financial workers reported significantly higher stress from fear of layoffs, increased experiences of undesirable changes and more fear of making mistakes during work. On the contrary, lawyers reported significantly higher scores of reward, fewer psychological demands and less exhaustion. In addition to high psychological demand and a high effort-reward ratio, high effort, over-commitment and stress of layoffs also contributed to personal and work-related burnout after the financial crisis. After the financial crisis, lawyers' personal burnout decreased with the increase of reward, and their work-related burnout decreased with the decrease in psychological demand. The financial crisis has an unequal psychological impact on financial workers and lawyers. Financial workers' psychosocial work stress and burnout were aggravated, while lawyers' psychosocial work stress and burnout were alleviated.