Karasek's Job Content Questionnaire Research Articles

Health care restructuring, work environment, and health of nurses

In the last 15 years, the health care system has undergone significant restructuring. The study's objective was to examine the psychosocial work environment and the health of nurses after major restructuring in comparison with two reference populations. This cross-sectional study involved 2,006 nurses from 16 health centers. A questionnaire measured current work characteristics: psychological demands, decision latitude, and social support at work from Karasek's Job Content Questionnaire, organizational changes, and health effects. Prevalence ratios and binomial regression were used to examine the associations between current work characteristics, changes and psychological distress (PSI). There was a considerable increase in the prevalence of PSI and of adverse psychosocial work factors in comparison to the prevalence reported by a comparable group of nurses in 1994. These adverse factors were also more prevalent among nurses than among Québec working women and they were independently associated with psychological distress. Workplace interventions should be based on elements identified by many nurses as being problematic.

Job strain in relation to ambulatory blood pressure, heart rate, and heart rate variability among female nurses

This study examined the effects of exposure to job strain on independent predictors of cardiovascular disease (ambulatory blood pressure, heart rate, and heart rate variability). The participants comprised a homogeneous group of 159 healthy female nurses [mean age 35.9 (SD 8.5) years]. The choice of this population minimized variance attributable to gender, socioeconomic status, and work characteristics. Job demands, decision latitude, and social support were measured with the Karasek job content questionnaire, which was administered twice with an average interval of 12.2 months. The nurses' scores for job demands and decision latitude on both occasions were used to define their job-strain category. Ambulatory blood pressure, heart rate, and heart rate variability were assessed on a workday and a day of leisure. No effect on the ambulatory levels of blood pressure, heart rate, or heart rate variability was found for job strain by itself or in interaction with social support. In addition, job strain was not associated with differences in short-term or long-term physiological recovery during sleep after a workday or a day of leisure. High job demand was associated with higher systolic blood pressure at work and with higher diastolic blood pressure at work, but the latter association was found only when decision latitude was concurrently high, rather than low. High job strain among young female nurses is not associated with an unfavorable ambulatory cardiovascular profile. The robust effect of job strain on male health appears to be less apparent for women.

Job Stress and Breast Cancer Risk: The Nurses' Health Study

Workers tend to perceive certain features of their jobs as harmful to health and are alert to associations between job stress and health outcomes, but few observational studies have evaluated the role of job stress in carcinogenesis. The authors prospectively assessed the association between job strain, measured by Karasek and Theorell's job content questionnaire in four categories (low strain, active, passive, and high strain), and breast cancer risk among participants in the Nurses' Health Study. A total of 37,562 US female registered nurses were followed for up to 8 years (1992-2000), and 1,030 cases of invasive breast cancer were ascertained during that period. All participants were still in the workforce at baseline and completed the job content questionnaire. Adjusted for age, reproductive history, and other breast cancer risk factors, the multivariate relative risks of breast cancer, in comparison with women who worked in low-strain jobs, were 0.83 (95% confidence interval (CI): 0.69, 0.99) for women in active jobs, 0.87 (95% CI: 0.73, 1.04) for women in high-strain jobs, and 0.90 (95% CI: 0.76, 1.06) for women in passive jobs. Findings from this study indicate that job stress is not related to any increase in breast cancer risk.

Urinary catecholamines and salivary cortisol on workdays and days off in relation to job strain among female health care providers

This study examined the effects of psychosocial job strain on the excretion of neuroendocrine stress hormones (adrenaline, noradrenaline, and cortisol) on workdays and days off. Japanese female health care providers (N=16) filled out Karasek's job content questionnaire and had their neuroendocrine excretions (ie, urinary catecholamines and salivary cortisol) measured on a day off and on two workdays (one day shift and one night shift). After control for age and job experience as covariates, a repeated-measures analysis of variance was carried out. Noradrenaline excretion was significantly greater over time in the high-strain group than in the low-strain group, and that of the high-demand group was significantly greater over time than that of the low-demand group. Adrenaline excretion did not significantly differ between the groups. The group with high supervisory support had significantly higher adrenaline excretion than the group with low supervisory support. The concentration of salivary cortisol on a dayshift was significantly lower, but marginally, in the high-strain group than in the low-strain group. Psychosocial job strain is associated with greater noradrenaline excretion over time. This finding suggests unwinding sympathetic nervous activity. The low cortisol levels of the high-strain group may indicate circadian rhythm disturbance induced by job strain. Supervisory relationships may have a particular influence for the studied occupation because the participants had more administrative contact with supervisors than support at the worksite; therefore, supervisory support may increase adrenaline excretion.

Social support and individual styles of coping in the Japanese workplace: an occupational stress model by structural equation analysis

AbstractThe aim of the present study was to ascertain the role of social support and individual styles of coping on employee well‐being. The subjects were intermediate managers working for a zipper and sash manufacturing company in Japan. Measurements were made of the following: depression using the Self‐rating Depression Scale (SDS), job demand, job control, social support using Karasek's Job Content Questionnaire, and of three coping styles: emotion‐oriented coping, task‐oriented coping and avoidance‐oriented coping using the Coping Inventory for Stressful Situations (CISS). Data was analysed by structural equation modeling. Each coping style had a direct effect on depression. Emotion‐oriented coping had a negative effect. On the other hand, task‐oriented coping and avoidance‐oriented coping had a positive effect. Moreover, there was an indirect effect that coping styles precede and determine the perception of social support as well as job demand and control. Social support showed a direct positive effect on depression. However, the overall impact on employee well‐being was greater for individual coping styles as compared to social support from either supervisors or co‐workers. The present study showed the effectiveness of coping strategies in the workplace. Copyright © 2003 John Wiley & Sons, Ltd.

The psychometric properties of Karasek's demand and control scales within a single sector: data from a large teaching hospital.

This paper reviews the psychometric properties of the core components from Karasek's job content questionnaire, the decision latitude and psychological job demands scales. A self-reported survey was administered in 1995 (time 1), 1996 (time 2), and 1997 (time 3) to employees of a large teaching hospital. Analyses for this paper are based on data from the 484 employees who responded at times 1 and 2. Both scales demonstrated acceptable internal consistency as assessed by item-total correlations and Cronbach's alpha. In confirmatory factor analysis, the two-factor decision latitude model adequately fit the data. However, our findings suggest that a two-factor model may provide an improved fit over the original one-factor demands model, suggesting that this scale may be two distinct subscales. Lastly, the scales demonstrated acceptable discriminant validity. Apart from some guarded uncertainty over what the demands scale may be measuring, overall, the two scales appeared to perform reasonably well in this sample of health care workers.

Testing Karasek's Demands-Control Model in restructured healthcare settings: effects of job strain on staff nurses' quality of work life.

Job strain among staff nurses has become an increasingly important concern in relationship to employee performance and commitment to the organization in current restructured healthcare settings. The purpose of this study was to test Karasek's Demands-Control Model of job strain by examining the extent to which the degree of job strain in nursing work environments affects staff nurses' perceptions of structural and psychological empowerment, work satisfaction, and organizational commitment. A predictive, nonexperimental design was used to test these relationships in a random sample of 404 Canadian staff nurses. Karasek's Job Content Questionnaire, the Conditions of Work Effectiveness Questionnaire-II, Spreitzer's Psychological Empowerment Questionnaire, Meyer and Allen's Organizational Commitment Questionnaire, and the Global Satisfaction Scale were used to measure the major study variables. Nurses with higher level of job strain were found to be significantly more empowered, more committed to the organization, and more satisfied with their work. Support for Karasek's Demands/Control theory was established in this study.

A prospective study of job strain and risk of breast cancer.

There is conflicting evidence on whether stress is a risk factor for breast cancer. The present study examined prospectively the relationship between stress at work and risk of breast cancer. Participants comprised 26 936 postmenopausal women in the Nurses' Health Study ages 46-72 who were in paid employment, and who had no previous history of cancer. Multivariate-adjusted regression analysis was used to examine the relationship between job strain (measured by the Karasek Job Content Questionnaire in 1992) and risk of incident invasive and in situ breast cancer. From 1992 through 1994, 219 women were diagnosed with breast cancer. No evidence was found for a relationship between job stress and risk of breast cancer. Compared with women in low strain jobs, the multivariate-adjusted relative risks of breast cancer were RR = 0.78 (95% CI : 0.52-1.16) for high-strain jobs; RR = 0.76 (95% CI : 0.49-1.17) for active jobs; and RR = 0.94 (95% CI : 0.67-1.34) for passive jobs. Although job strain was related to less breast cancer screening among women in highly demanding jobs, it was not associated with tumour size. Job stress was not related to an increase in the incidence of breast cancer in the present cohort of nurses.

Perceived Psychological Stress and Upper Extremity Cumulative Trauma Disorders

This report presents data exploring the relationship between perceived psychological stress and several variables implicated in the etiology of upper extremity cumulative trauma disorders (UECTDs). The sample was 354 workers from three different manufacturing companies. The primary job exposure for the subjects was that they were engaged in jobs that involved repetitious movements of the upper extremities, primarily of the hands and arms. Data collection included a detailed health history, a comprehensive physical examination of the upper extremities, limited electrodiagnostic testing, Cohen's Perceived Stress Scale, Karasek's Job Content Questionnaire, demographic information, and a measurement of repetition. Descriptive analyses, analysis of variance, correlational analyses, and multiple linear regression were used to examine the data. Perceived stress, as measured in this study, was only weakly associated with repetition, job dissatisfaction, and subjective complaints related to UECTDs. In addition, factors generally accepted as related to UECTDs (e.g., repetition, female gender, hormonal influences, and existing medical conditions) were not robust predictors of perceived stress. The major limitation is related to the measurement of perceived psychological stress. Like most psychosocial phenomena, perceived stress is a complex construct, one that is difficult to measure and correlate with health outcomes. Further research is necessary to examine what role, if any, perceived stress may have in the etiology of UECTDs.

Reliability and validity of the French version of the 18-item Karasek job content questionnaire

Previous studies have shown that job strain, a combination of high psychological demands and low decision latitude, may be involved in the development of cardiovascular diseases and other health outcomes. In 1985, Karasek recommended a standard questionnaire to measure psychological demands (nine items) and job decision latitude (nine items). The internal consistency, factorial validity, discriminant validity, and 1-year stability of the French version of this instrument were evaluated in a population of 8263 white collar workers. Participants filled out the questionnaire during working hours in the context of a larger cardiovascular study. A subgroup of the study population completed the questionnaire again 1 year later (n = 953). Internal consistency was adequate: .74 for men and .73 for women for psychological demands and .83 for men and .81 for women for decision latitude. The results of the factor analysis were consistent with the two dimensions expected from the theory, although some items had high loading on two factors. Variations in the means of psychological demand and decision latitude scores and variations in the prevalence of high job strain by gender, job category, and age support the discriminant validity. These results were generally comparable to those observed with the English version. The percentages of workers remaining, after 1 year, in the same category of psychological demands, decision latitude, and job strain were 86.6, 86.1 and 75.2% respectively. These data provide evidence of the reliability and validity of the French version of these psychological demand and decision latitude scales