Psychological Job Strain Research Articles

Response to NIOSH Request for Information on Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health.

The root causes of health care worker strain and depression include excessive job demands, extended work schedules, little decision-making opportunity, assault, bullying, and fear of injury. Potential links between working conditions and opioid overuse have also been discussed, beginning with psychological job strain or with physical pain leading to medication use. Promising solutions have been identified and many would be cost-effective, as enhanced working conditions could improve workers' mental health, job satisfaction, retention, and patient outcomes. Considering the number of health care workers leaving work during the global COVID-19 pandemic, it is urgent to address preventable root causes. In 2021, the US Congress called for educating health workers and first responders on the primary prevention of mental health conditions and substance use disorders. The CDC issued a Request for Information; this submission summarized research from CPH-NEW, a NIOSH Center of Excellence in Total Worker Health®, supplemented by a selective literature review.

Toddler teacher job strain, resources, and classroom quality

ABSTRACT Early care and education (ECE) settings are influential in shaping children’s early experiences. Informed by the Job Demands-Resources model, this study had two aims. First, we examined how ECE teachers’ physical (i.e. muscular skeletal strain and infectious disease experience) and psychological (i.e. depression and job dissatisfaction) job strain was associated with the quality of their interactions with children. Second, we tested whether job resources, including supervisor and co-worker support, buffered these associations. We examined survey responses from 44 toddler teachers working in centre-based classrooms with children aged 15–36 months and assessed the quality of the classroom using the Classroom Assessment Scoring System – Toddler (CLASS-T; La Paro et al. 2012. Classroom Assessment Scoring System (CLASS) Manual, Toddler. Baltimore, MD: Paul H. Brookes). Results indicated that teachers experienced a range of physical and psychological job strain. Co-worker and supervisor support were not significant moderators of the ECE teachers’ job strain- classroom quality association. However, contrary to the mechanisms theorised within the Job Demands-Resources model, a main effect of co-worker and supervisor support on classroom quality, such that higher levels of perceived social support was related to higher classroom quality. Due to the significance of classroom quality for young children, understanding ways to create a work environment of rich social support stands to benefit teachers and the toddlers in their care.

Are We Really as Happy as We Think We are? A Critical Examination of Work Satisfaction in a University Pediatric Hospital

Despite numerous reported deficits and an increasingly tense working environment in German hospitals, employees themselves often assess their job satisfaction as being high to very high. Hence, the board of directors does not have important arguments for sustainable improvement of working conditions. This discrepancy between working conditions and subjective satisfaction was the motivation for this work. Data were acquired via an attitude survey at the University Hospital for Children and Adolescents Leipzig, with employees sub-divided into medical, nursing and administrative/technical staff. The subjective satisfaction was examined by means of classical global ratings almost exclusively used by companies vs. the much more modern cognitive-emotional concept of the 'Schweizer Modell' describing qualitative job satisfaction. In addition, working hours, work-related effects on mental health, willingness to quit the job and actual dropout rate were compared. A rather high level of job satisfaction was revealed while interpreting the classical global ratings. In contrast, the qualitative analysis showed that only 1 in 4 employees was really satisfied with his or her job, amongst doctors even only 1 in 10. Altogether there are four categories of satisfaction. Significant differences between occupational categories were seen when stratifying the data according to age profiles and the evaluation of the consequences of psychological job strain. These differences were not seen in willingness to quit the job. Reports of high job satisfaction in hospitals in numerous publications can be mostly explained by employees who are resignedly satisfied. This is the psychodynamic outcome of strain compensating. This is not measurable with the concept of classical global ratings. Furthermore, the constructively dissatisfied employees, who are an often-underestimated resource for companies, are neglected. The reduction of strain in these people then mostly results in job changes.

Psychological job strain, social support at work and daytime secretion of dehydroepiandrosterone (DHEA) in healthy female employees: cross-sectional analyses.

Evidence is limited concerning the influences of high psychological job strain and low social support at work on daytime secretion of dehydroepiandrosterone (DHEA), which demonstrates anti-cortisol effects. We carried out a cross-sectional study to examine the associations of job strain and social support with daytime secretion amounts of DHEA and cortisol and daytime variation of the cortisol-to-DHEA ratio (C/D ratio) in healthy female workers. Study subjects comprised 115 healthy female nursery school teachers. Area under the curve with respect to ground (AUCG) of salivary DHEA, cortisol and C/D ratio was calculated for estimation of daytime secretion and variation. Social support scores were negatively associated with daytime DHEA secretion (standardized partial regression coefficient = −0.343, P < 0.001 by multiple linear regression analysis). This association remained significant when daytime cortisol secretion was additionally adjusted. Social support was not associated with daytime variation of the C/D ratio. Significant association between social support and daytime cortisol secretion was not confirmed. Job strain was not associated with DHEA, cortisol or the C/D ratio. In summary, we found that daytime DHEA secretion was increased in healthy workers with low social support, perhaps independent of daytime cortisol secretion.

Occupation-specific screening for future sickness absence: criterion validity of the trucker strain monitor (TSM)

Monitoring psychological job strain may help occupational physicians to take preventive action at the appropriate time. For this purpose, the 10-item trucker strain monitor (TSM) assessing work-related fatigue and sleeping problems in truck drivers was developed. This study examined (1) test-retest reliability, (2) criterion validity of the TSM with respect to future sickness absence due to psychological health complaints and (3) usefulness of the TSM two-scales structure. The TSM and self-administered questionnaires, providing information about stressful working conditions (job control and job demands) and sickness absence, were sent to a random sample of 2000 drivers in 1998. Of the 1123 responders, 820 returned a completed questionnaire 2 years later (response: 72%). The TSM work-related fatigue scale, the TSM sleeping problems scale and the TSM composite scale showed satisfactory 2-year test-retest reliability (coefficient r=0.62, 0.66 and 0.67, respectively). The work-related fatigue, sleeping problems scale and composite scale had sensitivities of 61, 65 and 61%, respectively in identifying drivers with future sickness absence due to psychological health complaints. The specificity and positive predictive value of the TSM composite scale were 77 and 11%, respectively. The work-related fatigue scale and the sleeping problems scale were moderately strong correlated (r=0.62). However, stressful working conditions were differentially associated with the two scales. The results support the test-retest reliability, criterion validity and two-factor structure of the TSM. In general, the results suggest that the use of occupation-specific psychological job strain questionnaires is fruitful.

Moderating Effects of Psychological Job Strain on the Relationship between Working Hours and Health: An Examination of White‐Collar Workers Employed by a Japanese Manufacturing Company

The effects of working hours on health were examined taking psychological job strain into account. White-collar workers employed at the main office of a Japanese manufacturing company provided data for analysis done in 1997. The eligible subjects were 286 workers aged 20-39. Causal relationships between working hours, health, and psychological job strain were examined by covariance structure analyses. The main findings were as follows: Not only working hours but also sleeping hours and vacations affected the workers' effort to deal with work as a work-related hour factor. Decision authority and skill discretion of Karasek's psychological job strain items significantly constituted a discretion in the work factor, and this factor moderated the effects of the work-related hour factor on health. The effects of psychological job strain, especially discretion, must always be taken into account in examinations of working hours and health.

Stressful Work, Psychological Job Strain, and Turnover: A 2-Year Prospective Cohort Study of Truck Drivers.

Based on a model that combines existing organizational stress theory and job transition theory, this 2-year longitudinal study examined antecedents and consequences of turnover among Dutch truck drivers. For this purpose, self-reported data on stressful work (job demands and control), psychological strain (need for recovery after work and fatigue), and turnover were obtained from 820 drivers in 1998 and 2000. In agreement with the model, the results showed that strain mediates the influence of stressful work on voluntary turnover. Also in conformity with the model, job movement to any job outside the trucking industry (i.e., interoccupational turnover) resulted in a larger strain reduction as compared to job movement within the trucking industry (intraoccupational turnover). Finally, strain was found to stimulate interoccupational turnover more strongly than it stimulated intraoccupational turnover. These findings provide a thorough validation of existing turnover theory and give new insights into the turnover (decision) process.

Job strain as a risk factor for occupational accidents among hospital nursing staff

In a cross-sectional questionnaire study the influence of psychological job strain and nine other factors on the occurrence of accidents at work were examined. Data were collected by a national survey of nursing personnel in Germany. The sample of this study consists of 874 nurses working in acute care hospitals. Job strain was operationalised according to Karasek's demand-control model and measured by a self-developed questionnaire. 32 % had experienced at least one accident during the 12 months preceding the survey (mostly accidental cuts or needle punctures). No association with accident risk was found for age, sex, professional status (supervising function) and hours of overtime work. The six factors significantly associated with accident risk in univariate analyses were entered into a logistic regression model: high job strain, working in a functional unit (e. g. laboratory), full-time work, less than 3 years of occupation in the present department, having children of less than 3 years of age and being a single parent. In the multivariate analyses high job strain turned out to be the most important risk factor for occupational accidents (odds ratio: 2.4, 95 % C.I.: 1.7-3.3). Significantly elevated risks were found for full-time work, less than 3 years of occupation in the present department and being a single parent (odds ratios between 1.5 and 1.8). Having at least one child of less than 3 years of age was a protective factor (odds ratio 0.5, 95-% C.I.: 0.4-0.8).

The trucker strain monitor: an occupation-specific questionnaire measuring psychological job strain.

To develop and validate a short and user-friendly questionnaire measuring psychological job strain in truck drivers. In cooperation with an occupational physician in the Dutch road transport industry we developed items on the basis of face validity and information of existing questionnaires on the subject. These items were pilot-tested, by means of interviews, in 15 truck drivers. Study I examined the factorial structure of the initial 30-item trucker strain monitor (TSM) in a sample of 153 truck drivers. Subsequently, number of items per factor was reduced on the basis of reliability analyses (Cronbach's alpha). Study II examined construct and criterion validity of the TSM in a randomly selected group of 2,000 truck drivers, of whom 1,111 participated (adjusted response = 63%). Additionally, sensitivity and specificity were assessed by examining the ability of the TSM to identify truck drivers with or without self-reported sickness absence in the past 12 months because of psychological complaints. Factor analyses of the initial 30-item TSM revealed a two-factor solution. Item reduction resulted in a six-item work-related fatigue scale and four-item sleeping problems scale with high internal consistency. Results of study II confirmed the internal consistency of the TSM scales and provided support for construct and criterion validity. The composite, work-related fatigue, and sleeping problems scale had a sensitivity of 83%, 80% and 71% respectively, in identifying truck drivers with prior sickness absence because of psychological complaints. Specificity rates were 72%, 73% and 72% respectively. Despite methodological limitations, the results suggest that the TSM is a reliable and valid indicator of psychological job strain in truck drivers. In particular, the composite and work-related fatigue scale identified drivers with prior absenteeism because of psychological complaints, quite accurately. Future longitudinal research in specific sub-groups of truck drivers including both self-reported and objective psychological health measures should evidence whether (1) the distinction between two indicators of psychological job strain is useful, and whether (2) the TSM can be used in screening out truck drivers at risk of developing psychological health problems.

Social network, social support and the prevalence of neck and low back pain after retirement. A population study of men born in 1914 in Malmö, Sweden.

In this study we investigated the importance of social network and social support systems outside the workplace and workload and psychological job strain in former work for the prevalence of daily neck and low back pain. The study population (n = 621) comprised a random half of all male residents in Malmö, Sweden, born in 1914, of whom 500 (80.5%) participated. Two of the social network and social support indices (social anchorage and availability of material and informational support) were independent of life-style factors (leisure time physical activity, smoking and alcohol consumption) related to daily neck and back pain after retirement (OR = 2.0, 95% CI 1.2-3.4 and OR = 1.7, 95% CI 1.0-2.7, respectively), while the psycho-social and physical factors in former work were not. As no conclusion about the direction of the association can be drawn, prospective studies are needed to further explore these findings.