Work and family roles in relation to women's well-being: a longitudinal study

Occupational Happiness of Civilian Nurses in China: a cross-sectional study

BACKGROUND

Civilian nurses have gradually become the main body of military nurses. Our study aimed to understand their occupational happiness and its influencing factors.

METHODS

This descriptive study was conducted with 319 civilian nurses working in 15 military hospitals in China. Based on literature review, expert consultation and combined with the characteristics of civilian positions, this study developed a questionnaire on occupational happiness of civilian nurses in military hospitals. The questionnaire includes 7 dimensions as follows: work emotion, salary, work environment, professional identity, work output, interpersonal relationship, well‑being. The demographic questionnaire and occupational well-being questionnaire of civilian nurses in military hospitals were analysed by t-test, analysis of variance and Pearson correlation analysis.

RESULTS

The occupational happiness score (3.83 ± 0.56, upper limit score: 5) was at the upper middle level. There were significant differences in occupational well-being by gender (t = -2.668, p = 0.008), age (F = 5.085, p = 0.007) and the type of city where the hospital was located (F = 15.959, p < 0.0001). The happiness score of females (3.94 ± 0.60) was higher than that of males (3.47 ± 0.54). Nurses who were over 41 years old had the highest occupational happiness. Compared with nurses younger than 30 years old, the p value was 0.004. The occupational happiness of nurses in hospitals in a "prefecture-level city" (p < 0.0001) and a "sub-provincial city" (p < 0.0001) was significantly higher than that of nurses in hospitals in a "municipality directly under the central government". Correlation analysis showed that the higher the nurses' satisfaction with professional identity, work output, work environment, salary, and interpersonal relationships, the higher their occupational happiness.

CONCLUSION

Occupational happiness of civilian nurses in Chinese military hospitals was above the medium level. Gender, age, and the type of city where the hospital was located had a very significant impact on the level of occupational happiness. In addition, "professional identity", "work output", "work environment", "salary", and "interpersonal relationships" were significantly correlated with the occupational happiness of civilian nurses. They can be improved with some future lines of research.

Can gender differences in psychosocial factors be explained by socioeconomic status?

Aims: The aims of this study were to examine (1) if associations between gender and psychosocial factors could be explained by socioeconomic status (SES) and (2) if associations between gender and psychosocial factors are more salient at lower levels of SES. Methods: Psychosocial factors such as decision latitude and social integration were studied in a cross-sectional study in two steps. In a public health survey, 4,086 randomly selected men and women aged 30—64 participated. Of these, 257 men and women also participated in an in-depth study. SES was measured in terms of education and occupation. Linear regression models were used to test associations between gender, SES, and a broad range of psychosocial factors. Results: Women reported lower scale scores on decision latitude, coping, and self-esteem, as well as more job strain, depression, and vital exhaustion, while men reported more cynicism (all p<0.05). Observed gender differences were still significant after control for effect of education, while after control for occupational status the effect of gender was lost for decision latitude and job strain. Significant interaction factors were found between gender and educational status for psychological demands, decision latitude, social integration, coping, and hopelessness. Conclusions: Gender differences, found for a broad range of psychosocial factors, could not be explained by SES. However, associations between gender and psychosocial factors were more salient at lower levels of SES. Psychosocial factors, especially decision latitude and social integration, may help explain why women with low SES experience poorer health.

Work Role and Health in a Sample of Spanish Women

In this study, the relationship between work role and health was analysed in a sample of 712 women from the Canary Islands. The women, who ranged in age from 18 to 65 years old (mean = 37.5; SD = 19.5), came from different socio-cultural and work backgrounds. The results of the study show that the most relevant variable in the well-being of these women was their work role satisfaction. The most satisfied women showed less anxiety and depression, and had higher self-esteem and a higher overall level of satisfaction. After adjusting for differences in age, no significant health differences remained among women with a different number of roles and different occupational status. We have concluded that a woman's well-being fundamentally rests in her opportunity to perform the work role she desires, without having to restrict herself to the traditional role of homemaker or being forced to become a high-achieving professional.

Gender specificity in the prediction of clinically diagnosed depression. Results of a large cohort of Belgian workers

BACKGROUND

The recent increase in the incidence of clinical depression represents a major public health and socio-economical burden. Depression has its roots in both professional and private domains but few epidemiological studies have looked at predictors of long term clinical depression as defined by a sick-leave of 28 days or more and a diagnosis by a general practitioner in both genders.

OBJECTIVES

To study baseline predictors of long term spells of clinical depression within the framework of a large prospective study, the Belstress Study, in 6,659 men and 2,737 women aged 35-59 years at baseline survey.

METHODS

Kaplan-Meyer survival curves and Cox regression models were used in order to relate long term clinical depression defined by a sick-leave of 28 days or more to baseline socio-demographic and work and non-work variables.

RESULTS AND CONCLUSIONS

Density incidence of long term clinical depression is 0.5 years and 1.1/1,000 persons/months for men and women respectively. In univariate analyses specific gender predictors were observed as for men predictors besides level of education, were work related: high job-strain OR 1.67 (CI 95% 1.03; 2.71) and work dissatisfaction OR 1.78 (CI 95% 1.09; 2.91) whereas for women baseline predictors are related to private life dissatisfaction OR 1.84 (CI 95% 1.16; 2.91) and to a lesser degree low social support from co-workers OR 1.50 (CI 95% 0.93; 2.40). In both genders baseline severe depression symptoms defined by a CES-D score of percentile 90 or above is a predictor of long term sick-leave for clinical depression. In multivariate analyses, in a model without baseline CES-D high job-strain and job dissatisfaction remain independent predictors for incident clinical depression in men whereas only private life dissatisfaction remains a significant predictor in women. When added to the model CES-D is the most powerful predictor of clinical depression in both genders. Together with level of education, work dissatisfaction remains borderline significant in men whereas private life dissatisfaction remains an independent predictor for clinical depression in women. In men baseline symptoms of depression alleviate the impact of high job-strain on incident clinical depression whereas in women, private life dissatisfaction remains an independent predictor of clinical depression.

Employment and health status changes among women with fibromyalgia: a five-year study

OBJECTIVE

To assess changes in health status of women with fibromyalgia (FM) over 5 years and determine whether baseline employment status influences health outcomes adjusting for other baseline factors.

METHODS

Two hundred eighty-seven women with FM were recruited from a national sample of rheumatologists and interviewed by phone at baseline and annually for 4 years. Data were collected on pain, fatigue, Center for Epidemiologic Studies Depression Scale and Modified Health Assessment Questionnaire (M-HAQ) scores, demographic characteristics, and employment status. At the end of the study, 211 participants remained. Data were analyzed using multilevel modeling techniques. Bootstrap methods adjusted for the cluster sampling.

RESULTS

The participants' mean +/- SD age was 47 +/- 11 years, their mean +/- SD education level was 14 +/- 2 years, 90% were white, 50% employed, 64% married, and their median household income was >or=$50,000. Mean +/- SD scores at baseline were 57.2 +/- 24 for pain, 75.4 +/- 22 for fatigue, 22.9 +/- 13 for depression, and 0.73 +/- 0.5 for the M-HAQ. Multilevel modeling indicated that all health status measures declined significantly over time except for pain. Rates of change varied from -1.22 for fatigue to -0.03 for the M-HAQ. Except for pain, patients who were employed at baseline had better health status over time. The employment and time interaction was not significant, indicating that health status changed at the same rate regardless of employment status. Other significant factors were age and income.

CONCLUSION

Employed women with FM have better health status at baseline and maintain that advantage over time. Employment does not seem to provide a protective health benefit.

Work and women's well-being: religion and age as moderators

Religion has been found to moderate the stress-strain relationship. This moderator role, however, may be dependent on age. The present study tested for the three-way interaction between work experience, age, and religiosity in the prediction of women's well-being, and predicted that work experience and religiosity will combine additively in older women, while in younger women religiosity is predicted to moderate the relationship between work experience and well-being. In a sample of 389 married Malay Muslim women, results of the regression analyses showed significant three-way interactions between work experience, age, and religiosity in the prediction of well-being (measured by distress symptoms and life satisfaction). While in younger women the results were in line with the predictions made, in the older women, both additive and moderator effects of religiosity were observed, depending on the well-being measures used. These results are discussed in relation to the literature on work and family, with specific reference to women's age, religion, as well as the issue of stress-strain specificity.

Zur Analyse der Koordination von Tätigkeitssystemen

Zusammenfassung. Die Diskussion um Work-Life-Balance betrifft unter anderem die Frage, wie Menschen ihr Handeln in unterschiedlichen Lebensbereichen koordinieren. Die Untersuchung dieser Frage setzt vielfältige methodische Zugänge voraus. In Studien etwa zum Verhältnis von Beruf und Familie werden jedoch fast ausschließlich Fragebögen verwendet, die meist allgemeine Merkmale der Familienhaushalte wie etwa die Kinderzahl erfassen oder subjektive Bewertungen erheben. Der im vorliegenden Beitrag vorgeschlagene methodische Ansatz beruht auf einer ausführlichen Erhebung und Bewertung der konkreten Tätigkeiten einer Person. Auf Grundlage handlungsregulatorischer Überlegungen werden drei Merkmale der Tätigkeiten bzw. ihrer Ausführungsbedingungen abgeleitet, die die Stabilität und Flexibilität des Tätigkeitssystems einer Person bzw. seine Koordinierbarkeit kennzeichnen: Erhaltungsrelevanz, zeitliche Gebundenheit und Eigendynamik. Ihre Erfassung erforderte die Weiterentwicklung eines vorliegenden handlungstheoretisch fundierten Verfahrens zur Analyse von Alltagstätigkeiten. Zur Veranschaulichung werden Erfahrungen aus einer Fallstudie berichtet. Sie sprechen dafür, dass der erweiterte Verfahrensentwurf eine solche Erhebung und die Differenzierung zwischen unterschiedlich gut koordinierbaren Tätigkeitssystemen der untersuchten Personen erlaubt.

Employment and Quality of Life Outcomes Among Women with Fibromyalgia Compared to Healthy Controls

The purpose of this study was to assess the effects of paid employment on health related quality of life among women with fibromyalgia compared to a group of women who were otherwise healthy. Participants were recruited from 118 rheumatology practices randomly sampled from the membership of the American College of Rheumatology. Three hundred and sixty-five patients were referred to the study and 287 completed a telephone interview. At the end of each interview, participants were asked to nominate 2 individuals to serve as control subjects. Because of lagging enrollment of control subjects, we initiated an additional method of asking control subjects to nominate controls. Of 381 control subjects nominated for the study, 286 or 75% completed the initial interview. As with patients, controls completed a computer assisted phone interview with a trained interviewer similar to that of the patient. The mean age of women with FMS was 47 years, most were married (59.6%), 87.8% were of white race and non-Hispanic ethnicity, 47.7% were employed, had an average of 14 years of education and household annual incomes generally exceeded $20,000, with 40.4% having incomes in excess of $50,000. There we no significant differences between women with FMS and those without FMS on these characteristics. Women with FMS had significantly worse physical and mental health related quality of life measured by SF-12 Physical (PCS) and Mental (MCS) Component Summary Scores; those who were not employed had significantly worse PCS scores but there were no differences by employment for MCS. Ordinal regression analysis adjusting for demographic characteristics showed that there were significant main effects for condition and employment on PCS in that those with FMS and those who were not employed had worse PCS scores. Initially, we also found an interaction effect between condition and employment in that the beneficial effects of employment was restricted to the FMS cases. However, when adjustments were made for the double nesting design, the interaction effect was no longer significant. For MCS, FMS cases had significantly worse health related quality of life, but there were no main effects for employment and no interactions were significant. Our results concur with findings in community studies that employed women report better quality of life than those not employed, but only for the physical dimension of quality of life. The findings regarding MCS are intriguing in that women with FMS are not very different from controls and that employment has little effect on the mental health component of quality of life.

Generation shift in family vs. working conditions as most important influence on women's mood? The Prospective Population Study of Women in Gothenburg, Sweden

OBJECTIVE

To find out whether family or working conditions is most important for mood in different ages in women.

DESIGN

Prospective study.

SETTING

Göteborg, Sweden, population about 430,000.

SUBJECTS

Representative samples of a general population of women, born in 1930 (n = 276), 1942 (n = 93) and 1954 (n = 61), examined both in 1980-81 and 1992-93.

MAIN OUTCOME MEASURES

Associations between "mood" and different social factors indicated by correlation coefficients and studied cross-sectionally and longitudinally.

RESULTS

In younger women, the variable "mood" was associated with variable work situation but not family situation (correlation coefficient 0.47, p <0.001, and correlation coefficient 0.26, not statistically significant, respectively), while in older women "mood" was associated with variable family situation as well as work situation (correlation coefficients 0.45 and 0.41, p <0.01 both). Changes in the mood variable between 1980-81 and 1992-93 were associated with changes in working conditions in the younger cohort, but with changes in variable family conditions in the older cohort.

CONCLUSIONS

In the latest born cohort, the importance of women's paid work outside the home was increased as an influential factor on mood in comparison with the importance of the family situation, while the situation was the opposite in the earlier born cohorts.

"The very best of the millennium": longitudinal research and the demand-control-(support) model

This study addressed the methodological quality of longitudinal research examining R. Karasek and T. Theorell's (1990) demand-control-(support) model and reviewed the results of the best of this research. Five criteria for evaluating methodological quality were used: type of design, length of time lags, quality of measures, method of analysis, and nonresponse analysis. These criteria were applied to 45 longitudinal studies, of which 19 (42%) obtained acceptable scores on all criteria. These high-quality studies provided only modest support for the hypothesis that especially the combination of high demands and low control results in high job strain. However, good evidence was found for lagged causal effects of work characteristics, especially for self-reported health or well-being outcomes.

Coping and subjective wellbeing in women with multiple roles

BACKGROUND

Married, working women experience a considerable amount of strain from their multiple roles. At the same time, studies indicate that they enjoy a high level of wellbeing. While the nature of employment and the level of spousal support have been examined in relation to wellbeing, the role of coping styles has not received much attention.

AIM

To examine the role of work-related factors, availability of support and coping styles as predictors of wellbeing.

METHOD

Sixty married, working women were individually interviewed with regard to reasons for employment and support availability, and administered the Coping Checklist and Subjective Wellbeing Inventory.

RESULTS

On stepwise multiple regression analysis, greater use of social support seeking and less use of denial as coping styles, absence of multiple role strain, working to be financially independent, availability of support and refusal of job promotion were significant predictors of wellbeing.

CONCLUSION

In working women with multiple roles, enhancing problem and emotion focused coping by strengthening the use of the support network is important for wellbeing.

Role occupancy, role quality, and psychological distress in Chinese women

This study explored the associations between role occupancy, role quality, and psychological distress in 897 Chinese women in Hong Kong. Results showed that employed as compared to nonemployed women reported a lower level of psychological distress. Never married as compared to married women, and mothers as compared to childless women, did not differ in their levels of psychological symptoms. Correlation results indicated that a net gain of rewards over concerns about social roles was negatively related to psychological distress. The number of social roles was related to the balance between rewards and concerns between social roles, but had no significant association with mental health status of women. Results of the hierarchical regression analyses showed that good mother role quality and the occupancy of the paid worker role were significant predictors of a low level of psychological distress. Findings based on a subsample of employed mothers failed to support the compensatory and spillover hypotheses. Limitations and implications for future studies were discussed.

Work-family conflict, locus of control, and women's well-being: tests of alternative pathways

The author tested for the 3 possible pathways (i.e., direct, moderator, and mediator effects) in which locus of control can influence the relationship between work-family conflict and well-being. The author predicted that work-family conflict would be negatively correlated with well-being. In a sample of 310 Malaysian employed women with families, work-family conflict was a significant predictor of both job satisfaction and distress--negatively related to job satisfaction and positively related to symptoms of distress. More important, the results provided support for the effects of all 3 pathways of control on the relationship between work-family conflict and well-being, depending on the outcome measure: For job satisfaction, locus of control had direct effects, acted as a partial mediator, and played a significant moderating role. In contrast, only the direct effect of locus of control predicted distress. The author discusses those findings with reference to the literature on work-family conflict, locus of control, and the issue of stress-distress specificity.

Chronic stress and the social patterning of women's health in Canada

Existing research on the social patterning of women's health draws attention to the significance of social roles and socioeconomic position. Although we know a great deal about health differences according to the occupancy of these positions, we know a lot less about why such patterns exist. This paper addresses this gap by examining the pathways through which social structure is linked to health using data from a 1994 Canadian national probability sample of women, aged 25-64 years. We begin by charting differences in women's self-rated ill-health, distress, and reports of long-standing health conditions by socioeconomic position and social role occupation. We then assess the extent to which these patterns can be understood in relation to the chronic stress arising from these social locations. Socioeconomic position, assessed by housing tenure, education, and household income, was positively related to health. Employment enhanced women's health, as did being currently married and a mother living with children. The ongoing stressors that distinguish the experiences of various structural locations accounted for some of the health effects of social structure, particularly for socioeconomic position. However, chronic stress was largely irrelevant to the pathways linking social roles to health. In fact, employed women and parents living with children enjoyed better health despite their greater stress.

Work-related stress and depressive disorders

The 1980s and 1990s has seen a considerable change in the workforce structure in industrialised economies. Employees are commonly faced with greater demands and less job security, both of which are likely to be stressful, thus psychological disorders especially depression may increasingly be caused by work-related stressors. An issue of this journal in 1997 (Vol. 43, No. 1) was indeed devoted to stress in the workplace and since then, these workplace changes have progressed and a review seems timely. Because interpreting results of cross-sectional studies is limited by a potential reciprocal relation between work stressors and depression (since "effort after meaning" can influence how "distressed" individuals report stressors at work), this review largely focuses on prospective or predictive studies to minimise this bias. Not surprisingly, the findings from occupational stress research is consistent with the more general life event stress literature showing that specific acute work-related stressful experiences contribute to "depression" and, more importantly perhaps, that enduring "structural" occupational factors, which may differ according to occupation, can also contribute to psychological disorders. There are significant implications for employees, their families, employers and indeed the wider community.

The impact of psychosocial work factors on musculoskeletal pain: a prospective study

A prospective cohort study investigated how psychosocial work factors predict musculoskeletal pain. A total of 721 workers at 226 automobile repair garages answered two questionnaires distributed with a 1-year interval. The predictor variables were psychological demands, decision authority, social support, and management support. The outcome variables were neck pain, low back pain, and an index of pain from seven different parts of the body in the past 30 days. The best predictors were low decision authority and management support. Low decision authority predicted neck pain, low back pain, and total musculoskeletal pain when adjusted for the effect of the respective musculoskeletal pain measured in the first survey, for age, and for gender. Low management support predicted both low back pain and general musculoskeletal pain. The study indicates that psychosocial factors at work may predict musculoskeletal pain.

Influence of women's work status on the well-being of Indian couples

BACKGROUND

In urban India, working women are expected to continue to discharge their traditional domestic duties; the likely result is compromised well-being due to role strain. Husbands of working women may also experience pressures and hence poorer well-being. Well-being in working couples, particularly husbands, is little researched in developing countries.

METHOD

The Subjective Well-Being Inventory was administered to 46 'one-working, (only husband employed) and 51 'both-working' (both spouses employed) randomly selected urban, middle-class couples.

RESULTS

In one-working as well as both-working families, wives experienced less well-being than their husbands. Working wives experienced more confidence in coping than non-working wives. Husbands in both-working families experienced better social support but less social contact, less mental mastery, and poorer perceived health than husbands in one-working families. Few or no sociodemographic variables were associated with well-being.

CONCLUSIONS

Employment may benefit women but stress their husbands.

Problematizing gender, work and health: the relationship between gender, occupational grade, working conditions and minor morbidity in full-time bank employees

It is commonly asserted that while women have longer life expectancy than men, they have higher rates of morbidity, particularly for minor and psychological conditions. However, most research on gender and health has taken only limited account of the gendered distribution of social roles. Here we investigate gender differences in morbidity whilst controlling, as far as possible, for one major role, namely participation in paid employment. There is substantial segregation of the labour market by gender; men and women typically work different hours in different occupations which involve varying conditions and differing rewards and costs. Here, we examine men and women working full-time for the same employer. This paper reports on a postal survey of employees (1112 men and 1064 women) of a large British bank. It addresses three main questions: do gender differences in minor morbidity remain if we compare men and women who are employed in similar circumstances (same industry and employer)? What is the relative importance of gender, grade of employment within the organisation, perceived working conditions and orientation to gender roles for minor morbidity? Finally, are these factors related to health differentially for men and women? There were statistically significant gender differences amongst these full-time employees in recent experience of malaise symptoms, but not in physical symptoms or GHQ scores. Controlling for other factors did not reduce the gender differences in malaise scores and produced a weak, but significant, gender difference in GHQ scores. However, gender explained only a small proportion of variance, particularly in comparison with working conditions. Generally similar relationships between experience of work and occupational grade and morbidity were observed for men and women. Throughout the paper, we attempt to problematize gender, recognising that there are similarities between women and men and diversity amongst women and amongst men. However, we conclude that the gendered nature of much of adult life, including paid work, continues to shape the experiences and health of men and women at the end of the twentieth century.