Putting PhD students front and center: an empirical analysis using the Effort-Reward Imbalance Model

Introduction

A doctorate is associated with numerous challenges for many PhD students, including financial insecurities, little support from supervisors, and time pressure. The present study explores well-being of PhD students via the Effort-Reward Imbalance (ERI) model as well as the potential protective factor resilience.

Method

A web-based questionnaire survey was conducted among 1,275 PhD students from Germany. Data was collected at two measurement points over a six-week follow-up period.

Results

As hypothesized, overcommitment was found to mediate the relationship between ERI and perceived stress while no mediation effect was found for work engagement. Resilience strengthened the relationship between ERI and overcommitment, especially for an increasing unfavorable ERI, and counterintuitively did not act as a protective factor.

Discussion

Theoretical and practical implications are discussed, providing a deeper understanding on the ERI model and the negative coping pattern overcommitment in the context of PhD students.

Too Committed to Switch Off-Capturing and Organizing the Full Range of Work-Related Rumination from Detachment to Overcommitment

Work-related thoughts during off-job time have been studied extensively in occupational health psychology and related fields. We provide a focused review of the research on overcommitment-a component within the effort-reward imbalance model-and aim to connect this line of research to the most commonly studied aspects of work-related rumination. Drawing on this integrative review, we analyze survey data on ten facets of work-related rumination, namely (1) overcommitment, (2) psychological detachment, (3) affective rumination, (4) problem-solving pondering, (5) positive work reflection, (6) negative work reflection, (7) distraction, (8) cognitive irritation, (9) emotional irritation, and (10) inability to recover. First, we apply exploratory factor analysis to self-reported survey data from 357 employees to calibrate overcommitment items and to position overcommitment within the nomological net of work-related rumination constructs. Second, we apply confirmatory factor analysis to self-reported survey data from 388 employees to provide a more specific test of uniqueness vs. overlap among these constructs. Third, we apply relative weight analysis to assess the unique criterion-related validity of each work-related rumination facet regarding (1) physical fatigue, (2) cognitive fatigue, (3) emotional fatigue, (4) burnout, (5) psychosomatic complaints, and (6) satisfaction with life. Our results suggest that several measures of work-related rumination (e.g., overcommitment and cognitive irritation) can be used interchangeably. Emotional irritation and affective rumination emerge as the strongest unique predictors of fatigue, burnout, psychosomatic complaints, and satisfaction with life. Our study is intended to assist researchers in making informed decisions on selecting scales for their research and paves the way for integrating research on the effort-reward imbalance and work-related rumination.

Individual and Work-Related Predictors of Exhaustion in East and West Germany

Chronic exhaustion is a consequence of detrimental working conditions and demands, as well as inadequate coping techniques, potentially resulting in burnout. Previous research has studied occupational environment and individual factors as predictors of exhaustion. Although these differ between former East and West German states, the regional distinction regarding exhaustion has been neglected. To fill this gap, we used the Copenhagen Burnout Inventory in a representative German sample from 2014 to assess the burnout symptom exhaustion. Estimating ordinary least squares regressions, important burnout predictors were compared between the former East and West German states. Regional differences concerning occupational environments were related to the associations between individual factors, situational aspects of technostress and exhaustion. Associations between individual factors (e.g., female sex, lower working hours, age, partnership status, and household income) and exhaustion were stronger in East Germany, whereas technostress (strain of internet use, number of e-mails during leisure time, and social pressure to be constantly available) was more strongly associated with exhaustion in West Germany. Despite lower financial gratification and a higher social pressure to be constantly available in the East, West Germans were more afflicted by exhaustion. Individual factors and technostress should thus be considered when focusing on job-related mental health issues.

Higher allostatic load in work-related burnout: The Regensburg Burnout Project

BACKGROUND

Burnout and chronic work stress have been linked to various negative health outcomes. While the mechanisms underlying this interplay are still unclear, the allostatic load (AL) model was suggested to demonstrate a possible biological pathway. However, previous studies provided divergent results regarding the association between burnout and AL, probably also due to the heterogeneity of selected samples. Therefore, the aim of the present study was to examine differences in AL between a conceptually strictly specified group of individuals suffering from burnout (BO group) and a healthy comparison group (HC group).

METHODS

After a multi-stage recruitment procedure with strict inclusion criteria based on burnout symptomatology and pathogenesis, the BO group (n = 56) was compared to the HC group (n = 65) regarding an index of AL. The AL-index included 14 parameters: high-sensitivity c-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), fibrinogen, d-dimer, plasminogen activator inhibitor 1 (PAI-1), glycosylated hemoglobin (HbA1c), high-density lipoprotein (HDL) cholesterol, total cholesterol to HDL cholesterol ratio (TC/HDL), dehydroepiandrosterone-sulphate (DHEA-S), systolic blood pressure (SBP), diastolic blood pressure (DBP), waist-hip ratio (WHR), and body fat percentage.

RESULTS

The BO group showed significantly higher AL-scores in comparison to the HC group. This effect remained significant after adjusting for sex, age, and smoking status. Additionally, burnout symptoms (assessed with the Maslach Burnout Inventory; MBI), MBI-subscales emotional exhaustion and depersonalization as well as chronic work stress (assessed with the effort-reward imbalance questionnaire) were significantly associated with higher AL-scores.

CONCLUSIONS

Consistent with our hypothesis, we detected higher AL-scores in the BO compared to the HC group, indicating a greater cumulative physiological burden in individuals suffering from burnout. Given the high heterogeneity in individuals experiencing burnout symptoms, future studies may focus on well-specified subgroups, when examining the association between burnout and psychophysiological dysregulations.

Application of Psychological Contract Theory in Mental Health and Professional Development of University Teachers

Mental health is an important element of human public health. To investigate the respective causes of and the relationship between effort-reward imbalance and psychological anxiety of university teachers, the author, after making a targeted survey of more than 2000 questionnaires and conducting statistics and analysis of the survey data, discovers that the effort-reward imbalance has a significant effect on the anxiety of university teachers and meanwhile, effort-reward imbalance will indirectly affect the anxiety of university teachers through the breach of psychological contracts and thus directly affect the mental health of university teachers. To solve this problem, the author takes advantage of the psychological contract theory and designs a mental health improvement system for university teachers, that is, to pay more attention to the feeling of effort-reward balance of young university teachers, to give more care and help to teachers who have imbalance feelings, to take the maintenance of psychological contracts as an important starting point of the ideological work of young teachers in universities, and so on. Through the implementation of relevant systems, colleges and universities have effectively strengthened their ability to fulfill contracts, established convenient and unobstructed communication channels, prevented breach of psychological contracts of teachers, and prevented teachers from working at high exhaustion at the cost of their physical and mental health, which can finally improve the job satisfaction and professional development of university teachers and enable them to be devoted to higher education in better health.

Stressful work in primary health care and mental health: The role of gender inequities in Brazil

BACKGROUND

This study aims to analyze the association between occupational stressors, evaluated by the Effort-Reward Imbalance Model (ERI), and the occurrence of common mental disorders (CMD) among healthcare workers (HCW), additionally considering mediation by over-commitment from work (OW) and mediation of gender effects by work stressors.

METHODS

Cross-sectional study, including a random sample of 3343 HCWs, from six municipalities of Bahia, Brazil. The ERI scale measured the occupational stressors (main exposure), and the Self-Reporting Questionnaire (SRQ-20) was used to screen for CMD. Data analysis used Structural Equation Modeling techniques to understand the relationships between gender, occupational stressors, and the occurrence of CMD.

RESULTS

ERI and OW were associated with CMD. OW mediated the negative effect of ERI on the mental health of HCW. Female workers had higher levels of ERI, OW, and CMD prevalence; the total gender effect on CMD prevalence was mediated by ERI and OW.

CONCLUSIONS

The findings highlight the association of work psychosocial stressors and CMD among HCW, including partial mediation by OW. Gender inequalities persisted among HCW, with women most exposed to occupational stressors and CMD. ERI and OW partially mediated the effect of gender on CMD.

Development and Initial Validation of the Korean Effort and Reward Scale (ERS-K) for Use in Sport Contexts

Background: Applying Siegrist’s (1996) effort-reward imbalance model to athletes, the current study aimed to develop a measure that can evaluate athletes’ effort and reward, and verify its reliability and validity. Methods: The survey was conducted on 530 athletes from universities in Seoul, South Korea. Among the collected data, 276 datasets were used for exploratory factor analysis, 200 for confirmatory factor analysis, and 30 for test-retest reliability analysis; data from surveys that were incomplete or incorrectly answered were excluded. The initial questionnaire was completed based on prior research, expert meetings, and evaluation by the evaluation group. The collected data were subjected to question analysis, exploratory factor analysis, confirmatory factor analysis, reliability analysis, and criterion-related validity analysis. Result: Four factors of the construct of effort were extracted: training strengthening efforts, interpersonal efforts, nutrition management efforts, and cognitive psychology strengthening efforts. Additionally, three factors of the construct of reward were extracted: future stability, social support, and positive growth. Thus. the effort measurement tool was finalized with 14 questions from four factors, and the reward measurement tool was finalized with 14 questions from three factors, with all items rated on a 5-point Likert scale. Conclusions: Siegrist’s efforts to measure job stress and athletes perceived efforts differed somewhat, but were found to be consistent with those reported for Australian occupational jockeys. In addition, athletes’ perceived rewards had similar results to those for Siegrist and Kathleen et al. studies. Based on this study, subsequent studies can more effectively determine whether the effort-reward imbalance model is applicable to athletes.

The Effort-Reward Model and Its Effect on Burnout Among Nurses in Ecuador

Burnout has harmful consequences for individuals and organizations. The study of its antecedents can help us to manage and prevent it. This research aims to explore the role of the effort-reward imbalance (ERI) model as well as the mediation of the working experience in the burnout processes. For this purpose, we have conducted a study in 629 employees from two hospitals in the city of Guayaquil (Ecuador). For this study, the Spanish version of the Maslach Burnout Inventory was applied, as well as the ERI Questionnaire, along with other socio-demographical and occupational variables. A statistical analysis was performed with the obtained data, using structural equation models (SEMs). Results showed that employee effort has a stronger and statistically significant direct effect on emotional burnout, whereas the perception of the obtained reward also had this effect but indirectly in a negative sense, with job experience as a mediating variable.

A person-centered perspective on the factors associated with the work recovery process

BACKGROUND AND OBJECTIVES

This research identified profiles characterized by distinct levels of overcommitment, rumination, psychological detachment (Studies 1 and 2), and need for recovery (Study 2). This research also considers the role of hindrance demands and resources in the prediction of profile membership, and the outcomes of these profiles.

METHODS

These objectives were addressed in two empirical cross-sectional studies relying on self-reported questionnaires. Study 1 relies on a convenience sample of French workers from a variety of occupations. Study 2 relies on a convenience sample of French nurses and nursing assistants.

RESULTS

Latent profile analyses revealed four identical profiles in both studies (High Ability to Achieve Recovery, Moderately High Ability to Achieve Recovery, Moderately Low Ability to Achieve Recovery, and Low Ability to Achieve Recovery), accompanied by an additional (Normative) profile in Study 2. The results from both studies revealed well-differentiated outcome associations, which generally matched the theoretical desirability of the identified profiles. Likewise, hindrance demands were associated with a decreased likelihood of membership into the High Ability to Achieve Recovery profile, as well as an increased likelihood of membership into the Low Ability to Achieve Recovery profile across studies.

CONCLUSIONS

Theoretical contributions and implications for practice are discussed.

The influence of operating room nurses' job stress on burnout and organizational commitment: The moderating effect of over-commitment

AIMS

To determine job stress among Chinese operating room nurses, test the mediating effect of burnout and verify the moderating effect of over-commitment between job stress and mental health.

DESIGN

A descriptive, cross-sectional study.

METHODS

A multistage sampling method was adopted. First, a random sampling method was used to select 30 tertiary hospitals in Beijing, after which 509 operating room nurses were selected by convenience sampling from March-June 2017. Self-administered questionnaires were used to evaluate job stress, burnout, and organizational commitment among participants. Multiple-group path analysis was used to test the mediating effect and the moderating effect.

RESULTS

Of all nurses, 70.3% were in a state of job stress, which had negative effects on organizational commitment mediated by emotional exhaustion and depersonalization. The result of multiple-group path analysis showed that the path coefficients are different between the low and high groups of over-commitment. When facing job stress, operating room nurses with low over-commitment were more likely to have emotional exhaustion (β = 0.750 vs. 0.602), while those with high over-commitment were more likely to have low organizational commitment (β = -0.641 vs. -0.594).

CONCLUSION

The job stress of operating room nurses in China was high. Burnout played a mediating role between job stress and organizational commitment. Over-commitment played a moderating role in the relationship among job stress, burnout, and organizational commitment.

IMPACT

This study analysed the relationship among operating room nurses' job stress, burnout, and organizational commitment. The findings provided confirmatory support on the mediated effect of burnout between job stress and organizational commitment and the moderation effect of over-commitment. Different measures are needed to reduce job stress, as for easing burnout and improving organizational commitment among different groups of nurses.

Assessment und Vorhersage von Burnout gemäß des Effort-Reward Imbalance-Modells bei Medizinischen Fachangestellten

Zusammenfassung. Psychosoziale Arbeitsbelastungen und Burnout haben eine zentrale Bedeutung für die Gesundheit der Erwerbstätigen im Gesundheitswesen. Das Copenhagen Burnout Inventory (CBI) hat sich als generisches Instrument zur Erfassung von Burnout-Indikatoren in der psychosozialen Gesundheitsforschung etabliert. Ziel dieser Arbeit ist die Analyse des Zusammenhangs zwischen Burnout und dem Effort-Reward Imbalance-Modell (ERI) in einer Stichprobe von n = 1 438 Medizinischen Fachangestellten (MFA). Das CBI kann theoriekonform konfirmatorisch modelliert werden. Für den ERI müssen für das Konstrukt Reward 3 Subfacetten Arbeitsplatzsicherheit, Beruflicher Aufstieg und Anerkennung und Gehalt definiert sowie 3 Items eliminiert werden, da keine eindeutige Konstruktzuordnung möglich ist. Für beide modifizierten Modelle kann eine akzeptable bis gute Modellpassung nachgewiesen werden. Mittels eines Strukturgleichungsmodells kann die Varianz der Ausprägung von Burnout zu 46 % durch die ERI-Dimensionen aufgeklärt werden. Die Erfassung der Konstrukte und die theoriebasierte Modellierung der Merkmalszusammenhänge bieten einen Ansatzpunkt zur Diagnostik und zum Verständnis Burnout-bezogener Aspekte der Arbeitssituation von MFA.

Factors affecting job performance: an integrative review of literature

Purpose

Job performance is an important variable, which primarily affects outcomes at three levels: the micro level (i.e. the individual), the meso level (i.e. the group) and the macro level (i.e. the organisation). This paper aims to identify, analyse and synthesise factors that affect job performance.

Design/methodology/approach

Through an extensive integrative review of literature, this study identifies and classifies the factors that affect job performance. A synthesised model based on the schema of demands, resources and stressors is also developed.

Findings

The demands identified are grouped into physical, cognitive and affective. Stressors adversely affecting job performance are classified at an individual level, job level and family level. Finally, resources are classified at an individual level, job level, organisational level and social level.

Research limitations/implications

This review enhances the job demands-resources (JD-R) model to job demands-resources-stressors (JD-R-S) model by identifying a separate category of variables that are neither job demands nor resources, but still impede job performance.

Practical implications

The subgroups identified under demands, resources and stressors provide insights into job performance enhancement strategies, by changing, managing or optimising them.

Originality/value

This study helps in better understanding the factors that go on to impact job performance differentially, depending on the group to which they belong. It gives a holistic picture of factors affecting job performance, thereby integrating classifying and synthesising the vast literature on the topic.

Effects of workload on teachers' functioning: A moderated mediation model including sleeping problems and overcommitment

This study investigated the mediating role of sleeping problems in the relationship between workload and outcomes (emotional exhaustion, presenteeism, job satisfaction, and performance), and overcommitment was examined as a moderator in the relationship between workload and sleeping problems. We conducted an empirical study using a sample of 884 teachers. Consistent with our predictions, results revealed that the positive indirect effects of workload on emotional exhaustion and presenteeism, and the negative indirect effects of workload on job satisfaction and performance, through sleeping problems, were only significant among overcommitted teachers. Workload and overcommitment were also directly related to all four outcomes, precisely, they both positively related to emotional exhaustion and presenteeism and negatively related to job satisfaction and performance. Theoretical contributions and perspectives and implications for practice are discussed.

Burnout Study of Clinical Nurses in Vietnam: Development of Job Burnout Model Based on Leiter and Maslach's Theory

PURPOSE

This study aimed to create a Vietnamese version of both the Maslach Burnout Inventory-General Survey (MBI-GS) and Areas of Worklife Scale (AWS) to assess the burnout state of Vietnamese clinical nurses and to develop a causal model of burnout of clinical nurses.

METHODS

We conducted a descriptive design using a cross-sectional survey. The questionnaire was hand divided directly by nursing departments to 500 clinical nurses in three hospitals. Vietnamese MBI-GS and AWS were then examined for reliability and validity. We used the revised exhaustion +1 burnout classification to access burnout state. We performed path analysis to develop a Vietnamese causal model based on the original model by Leiter and Maslach's theory.

RESULTS

We found that both scales were reliable and valid for assessing burnout. Among nurse participants, the percentage of severe burnout was 0.7% and burnout was 15.8%, and 17.2% of nurses were exhausted. The best predictor of burnout was "on-duty work schedule" that clinical nurses have to work for 24 hours. In the causal model, we also found similarity and difference pathways in comparison with the original model.

CONCLUSION

Vietnamese MBI-GS and AWS were applicable to research on occupational stress. Nearly one-fifth of Vietnamese clinical nurses were working in burnout state. The causal model suggested a range of factors resulting in burnout, and it is necessary to consider the specific solution to prevent burnout problem.

Dual role as a protective factor for burnout-related depersonalization in oncologists

PURPOSE

This study compared self-reported burnout between dual-role oncologists (oncologists who also do psychosocial work) and single-role oncologists, to explore if dual role is protective against or a risk factor for burnout.

METHODS

Dual-role oncologists from across China (n = 131) were consecutively recruited via the Chinese Psychosocial Oncology Society and asked to identify single-role oncologist peers (n = 168) working in the same institution. Participants completed an anonymous online questionnaire, which included measures of demographic and work characteristics, Maslach Burnout Inventory-Human Services Survey, the Short Version Effort-Reward Inventory, the Job Demands-Resources (JD-R) Scales, and Work and Meaning Inventory. Fully adjusted multivariate analyses compared burnout scores for the 2 groups.

RESULTS

Group analysis revealed single-role participants' scores indicated significantly poorer performance than dual-role participants for depersonalization (DP), work-family conflict (JD-R demands scale), and decision authority (JD-R scale). Single-role participants showed an increased risk of DP. Higher effort-reward imbalance ratio predicted greater DP in single-, dual-role and pooled participants, and emotional exhaustion (EE) in pooled- and dual-role participants. Overcommitment was independently associated with EE in all 3 groupings, with JD-R scores among pooled- and dual-role groups, while higher decision authority scores were associated with decreased EE. Work and Meaning Inventory was associated with a decreased risk of DP among pooled and dual-role participants.

CONCLUSION

Differences in burnout-related DP scores between dual- and single-role oncologists are consistent with a protective effect from a psychosocial orientation in oncologists.

Effort-reward imbalance and organisational injustice among aged nurses: a moderated mediation model

AIM

To test the effort-reward imbalance model among older nurses, expanding it to include the moderation of overcommitment and age in the stress-health complaints relationship, mediated by organisational injustice.

BACKGROUND

The theoretical framework included the effort-reward imbalance, the uncertainty management and the socio-emotional selectivity models.

METHOD

Employing a two-wave design, the participants were 255 nurses aged 45 years and over, recruited from four large hospitals in Spain (Madrid and Basque Country).

RESULTS

The direct effect of imbalance on health complaints was supported: it was significant when overcommitment was low but not when it was high. Organisational injustice mediated the influence of effort-reward imbalance on health complaints. The conditional effect of the mediation of organisational injustice was significant in three of the overcommitment/age conditions but it weakened, becoming non-significant, when the level of overcommitment was low and age was high.

CONCLUSIONS

The study tested the model in nursing populations and expanded it to the settings of occupational health and safety at work.

IMPLICATIONS FOR NURSING MANAGEMENT

The results of this study highlight the importance of effort-reward imbalance and organisational justice for creating healthy work environments.

Associations of Extrinsic and Intrinsic Components of Work Stress with Health: A Systematic Review of Evidence on the Effort-Reward Imbalance Model

Mainstream psychological stress theory claims that it is important to include information on people’s ways of coping with work stress when assessing the impact of stressful psychosocial work environments on health. Yet, some widely used respective theoretical models focus exclusively on extrinsic factors. The model of effort-reward imbalance (ERI) differs from them as it explicitly combines information on extrinsic and intrinsic factors in studying workers’ health. As a growing number of studies used the ERI model in recent past, we conducted a systematic review of available evidence, with a special focus on the distinct contribution of its intrinsic component, the coping pattern “over-commitment”, towards explaining health. Moreover, we explore whether the interaction of intrinsic and extrinsic components exceeds the size of effects on health attributable to single components. Results based on 51 reports document an independent explanatory role of “over-commitment” in explaining workers’ health in a majority of studies. However, support in favour of the interaction hypothesis is limited and requires further exploration. In conclusion, the findings of this review support the usefulness of a work stress model that combines extrinsic and intrinsic components in terms of scientific explanation and of designing more comprehensive worksite stress prevention programs.

Effort-reward imbalance and perceived quality of patient care: a cross-sectional study among physicians in Germany

Background

Work stress may impair physicians’ ability to provide high quality patient care. Prior research remains however sparse and has insufficiently explored explanations for this relationship. It has been suggested that physicians’ poor mental health is one potential explanatory factor. We drew on a well-established model to measure work stress (the effort-reward imbalance [ERI] model) in order to test this hypothesis. Further, to address another research gap and to potentially inform the development of better-targeted interventions, we aimed to examine associations of individual ERI constructs with the quality of care.

Methods

We used cross-sectional data, which had been collected in 2014 among 416 physicians in Germany. ERI constructs (i.e. effort, reward, the ERI ratio, and overcommitment) were measured by the established 23-item questionnaire. Physicians’ perceptions of quality of care were assessed by a six-item instrument inquiring after poor care practices or attitudes. Physicians’ mental health was operationalized by the state scale of the Spielberger's State-Trait Depression Scales. We used both continuous and categorized dependent and independent variables in multivariable linear and logistic regression analyses.

Results

Both an increasing ERI ratio and increasing effort were associated with poorer quality of care while increasing rewards were related to better care. Physicians’ depressive symptoms did not affect these associations substantially. Associations with overcommitment were weak and attenuated to non-significant levels by correction for depressive symptoms. The level of overcommitment did not modify associations between the ERI ratio and quality of care.

Conclusions

Our study suggests that high work-related efforts and low rewards are associated with reports of poorer patient care among physicians, irrespectively of physicians’ depressive symptoms. Quality of patient care may thus be improved by concurrently reducing effort and increasing rewards among physicians.

Internal and External Factors Related to Burnout among Iron and Steel Workers: A Cross-Sectional Study in Anshan, China

Background

Burnout is a syndrome of emotional exhaustion, cynicism and reduced professional efficacy, which can result from long-term work stress. Although the burnout level is high among iron and steel workers, little is known concerning burnout among iron and steel worker. This study aimed to evaluate the burnout and to explore its associated internal and external factors in iron and steel workers.

Methods

A cross-sectional survey was conducted in iron and steel workers at the Anshan iron-steel complex in Anshan, northeast China. Self-administered questionnaires were distributed to 1,600 workers, and finally 1,300 questionnaires were returned. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey (MBI-GS). Effort-reward imbalance (ERI), perceived organizational support (POS), and psychological capital (PsyCap) were measured anonymously. A hierarchical regression model was applied to explore the internal and external factors associated with burnout.

Results

Mean MBI-GS scores were 13.11±8.06 for emotional exhaustion, 6.64±6.44 for cynicism, and 28.96±10.39 for professional efficacy. Hierarchical linear regression analysis showed that ERI and POS were the most powerful predictors for emotional exhaustion and cynicism, and PsyCap was the most robust predictor for high professional efficacy.

Conclusions

Chinese iron and steel workers have a high level of burnout. Burnout might be associated with internal and external factors, including ERI, POS, and PsyCap. Further studies are recommended to develop an integrated model including both internal and external factors, to reduce the level of ERI, and improve POS and workers’ PsyCap, thereby alleviating the level of burnout among iron and steel workers.

Burnout among psychosocial oncologists: an application and extension of the effort-reward imbalance model

OBJECTIVES

Burnout is a significant problem among healthcare professionals working within the oncology setting. This study aimed to investigate predictors of emotional exhaustion (EE) and depersonalisation (DP) in psychosocial oncologists, through the application of the effort-reward imbalance (ERI) model with an additional focus on the role of meaningful work in the burnout process.

METHODS

Psychosocial oncology clinicians (n = 417) in direct patient contact who were proficient in English were recruited from 10 international psychosocial oncology societies. Participants completed an online questionnaire, which included measures of demographic and work characteristics, EE and DP subscales of the Maslach Burnout Inventory-Human Services Survey, the Short Version ERI Questionnaire and the Work and Meaning Inventory.

RESULTS

Higher effort and lower reward were both significantly associated with greater EE, although not DP. The interaction of higher effort and lower reward did not predict greater EE or DP. Overcommitment predicted both EE and DP but did not moderate the impact of effort and reward on burnout. Overall, the ERI model accounted for 33% of the variance in EE. Meaningful work significantly predicted both EE and DP but accounted for only 2% more of the variance in EE above and beyond the ERI model.

CONCLUSIONS

The ERI was only partially supported as a useful framework for investigating burnout in psychosocial oncology professionals. Meaningful work may be a viable extension of the ERI model. Burnout among health professionals may be reduced by interventions aimed at increasing self-efficacy and changes to the supportive work environment.

Promoting Shared Leadership

Shared leadership is considered a promising concept that meets the increased complexity of working life. Researchers and practitioners therefore need to know which factors might advance the development of shared leadership. Contributing to the yet limited amount of empirical research on shared leadership antecedents, this study investigates the impact of variables from different types of antecedents suggested in literature (i.e., intrinsic and extrinsic facilitators and vertical leadership). It relies on data from 328 team members nested in 67 work teams and their respective team leaders. Multilevel analyses confirmed that each team member’s perceptions of psychological empowerment as an intrinsic factor, and perceptions of being fairly rewarded as extrinsic factor, were associated with shared leadership. At the team level, the team leader’s behavior had differential effects on shared leadership within the team: Team members seem to adopt leadership behavior demonstrated by their team leader only as long as they perceive this team leader to be prototypical of the team. Results provide conclusions for practitioners and indicate starting points for future empirical research.

Work stress and quality of life in persons with disabilities from four European countries: the case of spinal cord injury

BACKGROUND

Evidence on the adverse effects of work stress on quality of life (QoL) is largely derived from general populations, while respective information is lacking for people with disabilities. We investigated associations between work stress and QoL and the potentially moderating role of socioeconomic circumstances in employed persons with spinal cord injury (SCI).

METHODS

Cross-sectional data from 386 employed men and women with SCI (≥18 work h/week) from the Netherlands, Switzerland, Denmark, and Norway were analyzed. Work stress was assessed with the 'effort-reward imbalance' (ERI) model and the control component of the 'demand/control' model. QoL was operationalized with five WHOQoL BREF items. Socioeconomic circumstances were measured by years of formal education and perception of financial hardship. We applied ordinal and linear regressions to predict QoL and introduced interaction terms to assess a potential moderation of socioeconomic circumstances.

RESULTS

Multivariate analyses showed consistent associations between increased ERI and decreased overall QoL (coefficient -1.55, p < 0.001), domain-specific life satisfaction (health -1.32, p < 0.001; activities of daily living -1.28, p < 0.001; relationships -0.84, p = 0.004; living conditions -1.05, p < 0.001), and the QoL sum score (-2.40, p < 0.001). Low job control was linked to decreased general QoL (0.13, p = 0.015), satisfaction with relationships (0.15, p = 0.004), and QoL sum score (0.15, p = 0.029). None of the tested interaction terms were significant.

CONCLUSION

ERI was consistently related to all indicators of QoL, while associations with job control were less consistent. Our results do not support the notion that unfavorable socioeconomic circumstances moderate the association between work stress and QoL among persons with SCI.

Does equity sensitivity moderate the relationship between effort-reward imbalance and burnout

The model of effort-reward imbalance (ERI) received considerable research attention in the job stress literature. However, very scarce research investigated individual differences as moderators between ERI and stress. The present study is aimed at examining the combined effects of ERI, overcommitment (OVC), and the interaction between ERI and overcommitment on burnout (i.e., emotional exhaustion, cynicism, and inefficacy) and the moderating role of equity sensitivity. A questionnaire measuring ERI, burnout, and equity sensitivity was administered to 159 employees. Regression analyses were conducted to test the proposed relations and moderating hypotheses. ERI was negatively related to inefficacy and overcommitment was positively related to emotional exhaustion and cynicism. In addition, equity sensitivity was found to moderate the effect of overcommitment on emotional exhaustion and inefficacy. The findings emphasize the detrimental effect overcommitment may have on employee's mental health and suggest that the ERI model components may be closely related to perceptions of organizational justice.