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The Brazilian version of the effort-reward imbalance questionnaire to assess job stress
Chor, Dóra;Werneck, Guilherme Loureiro;Faerstein, Eduardo;Alves, Márcia Guimar?es de Mello;Rotenberg, Lúcia;
Cadernos de Saúde Pública , 2008, DOI: 10.1590/S0102-311X2008000100022
Abstract: the effort-reward imbalance (eri) model has been used to assess the health impact of job stress. we aimed at describing the cross-cultural adaptation of the eri questionnaire into portuguese and some psychometric properties, in particular internal consistency, test-retest reliability, and factorial structure. we developed a brazilian version of the eri using a back-translation method and tested its reliability. the test-retest reliability study was conducted with 111 health workers and university staff. the current analyses are based on 89 participants, after exclusion of those with missing data. reproducibility (interclass correlation coefficients) for the "effort", "'reward", and "'overcommitment"' dimensions of the scale was estimated at 0.76, 0.86, and 0.78, respectively. internal consistency (cronbach's alpha) estimates for these same dimensions were 0.68, 0.78, and 0.78, respectively. the exploratory factorial structure was fairly consistent with the model's theoretical components. we conclude that the results of this study represent the first evidence in favor of the application of the brazilian portuguese version of the eri scale in health research in populations with similar socioeconomic characteristics.
Effort-reward imbalance at work and cardiovascular diseases
Johannes Siegrist
International Journal of Occupational Medicine and Environmental Health , 2010, DOI: 10.2478/v10001-010-0013-8
Abstract: Working conditions and employment arrangements make a significant contribution to the burden of cardiovascular disease, in particular in modern societies where mental and emotional demands and threats are becoming widespread. Occupational research has identified health-adverse features of modern work with the help of theoretical models. One such model, effort-reward imbalance, has been developed by this author and his group and has been widely tested in epidemiological and experimental studies. The model claims that stressful experience at work is elicited by a lack of reciprocity between efforts spent at work and rewards received in return, where rewards include money, promotion prospects, job security, and esteem. Results demonstrate elevated risks of coronary heart disease among employees exposed to effort-reward imbalance. Moreover, in ambulatory and experimental investigations, elevated heart rate and blood pressure and altered secretion of stress hormones were observed under these conditions. Although additional scientific evidence is needed, available findings call for practical measures towards improving quality of work, most importantly at the level of single companies and organisations. This conclusion is supported by first results from intervention studies that are guided by this theoretical approach. In view of the burden of cardiovascular disease attributable to unfavourable working conditions, such efforts are well justified and need to be extended in order to promote healthy work.
Effort–reward imbalance and health in a globalized economy
Johannes Siegrist
SJWEH Supplements , 2008,
Abstract: Theoretical models are needed to identify the adverse health aspects of stressful psychosocial work environments. One such model, the effort–reward imbalance model, has been widely analyzed in different occupations and different countries. This contribution briefly reviews the theoretical bases of this model, its measurement, and the available evidence on adverse health effects derived from prospective epidemiologic studies. Against this background, new conceptual and methodological challenges are discussed that result from economic globalization, in particular a globalized labor market. It is concluded that meeting these challenges will improve the usefulness of the model in predicting health and in strengthening work-related interventions globally.
Effort-reward imbalance and overcommitment in employees in a Norwegian municipality: a cross sectional study
Bj?rn Lau
Journal of Occupational Medicine and Toxicology , 2008, DOI: 10.1186/1745-6673-3-9
Abstract: One thousand eight-hundred and three employees in a medium-sized Norwegian municipality replied to the ERI-Q, and health-related variables such as self-reported general health, psychological distress, musculoskeletal complaints, and work-related burnout were examined.Sound psychometric properties were found for this Norwegian version of the ERI-Q. When the two dimensions of ERI and overcommitment were analyzed in four types of employees, the results showed that employees characterized by a combination of high values on ERI and overcommitment had more unfavorable health scores than others. Employees with low effort-reward and overcommitment scores had more favorable health scores. Employees with scores on the overcommitment and the effort-reward scales that are supposed to have opposite effects on health (that is, the combination of low overcommitment with a high effort-reward score and vice versa), had health scores somewhere in between the two other groups.Satisfactory psychometric properties were found for most of the latent factors in the ERI-Q. The findings also indicate that it may be fruitful to explore health conditions among employees with different combinations of effort-reward and overcommitment.According to the effort-reward imbalance (ERI) model by Siegrist et al. [1], effort at work is part of a social contract that is reciprocated by adequate reward. Rewards are distributed by three transmitter systems: esteem, career opportunities, and job security. Failed reciprocity between efforts and rewards may enhance the activation of the autonomic nervous system and influence the risk of coronary heart disease [2-4]. According to the model, adverse health effects can also be triggered by an individual's exhaustive coping style, known as overcommitment. More specifically, this model consists of three hypotheses [5]: (1) The ERI hypothesis: The mismatch between high effort and low reward (no reciprocity) produces adverse health effects, (2) The overcommitment hy
Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study  [cached]
Tzeng Dong-Sheng,Chung Wei-Ching,Lin Chi-Hung,Yang Chun-Yuh
BMC Health Services Research , 2012, DOI: 10.1186/1472-6963-12-309
Abstract: Background Taiwan’s National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. Methods We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. Results The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. Conclusions There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.
A comparison between the effort-reward imbalance and demand control models
Aleck S Ostry, Shona Kelly, Paul A Demers, Cameron Mustard, Clyde Hertzman
BMC Public Health , 2003, DOI: 10.1186/1471-2458-3-10
Abstract: Self-reports for psychosocial work conditions were obtained in a sample of sawmill workers using the demand/control and effort/reward imbalance models. The relative predictive validity of task-level control was compared with effort/reward imbalance. As well, the predictive validity of a model developed by combining task-level control with effort/reward imbalance was determined. Logistic regression was utilized for all models.The demand/control and effort/reward imbalance models independently predicted poor self-reported health status. The effort-reward imbalance model predicted the presence of a chronic disease while the demand/control model did not. A model combining effort-reward imbalance and task-level control was a better predictor of self-reported health status and any chronic condition than either model alone. Effort reward imbalance modeled with intrinsic effort had marginally better predictive validity than when modeled with extrinsic effort only.Future work should explore the combined effects of these two models of psychosocial stress at work on health more thoroughly.A strong body of evidence indicates that exposure to adverse psychosocial work conditions is a major hazard for the health of workers in modern economies. Much of this evidence, accumulated over the past two decades, is based on the demand/control model [1] in which task-level work conditions characterized by low control and high demand have been shown to predict high rates of cardiovascular disease as well as high rates of sickness absence [2,3].One of the criticisms of this model is its reliance on "objective" measures of the work environment only [4]. According to many critics, workers will respond differently to the same constellation of control and demand conditions leading to varied biological outcomes so that a measure of individual worker differences, specifically in coping style, must therefore be included in any job strain model.In the early 1990s, the effort-reward imbalance model
Effort-reward imbalance and its association with health among permanent and fixed-term workers
Mariko Inoue, Shinobu Tsurugano, Mariko Nishikitani, Eiji Yano
BioPsychoSocial Medicine , 2010, DOI: 10.1186/1751-0759-4-16
Abstract: Our study subjects were 709 male workers aged 30 to 49 years in a suburb of Tokyo, Japan. In 2008, we conducted a cross-sectional study to compare job stress using an effort-reward imbalance (ERI) model questionnaire. Lifestyles, subjective symptoms, and body mass index were also observed from the 2008 health check-up data.The rate of job stress of the high-risk group measured by ERI questionnaire was not different between permanent and fixed-term workers. However, the content of the ERI components differed. Permanent workers were distressed more by effort, overwork, or job demand, while fixed-term workers were distressed more by their job insecurity. Moreover, higher ERI was associated with existence of subjective symptoms (OR = 2.07, 95% CI: 1.42-3.03) and obesity (OR = 2.84, 95% CI:1.78-4.53) in fixed-term workers while this tendency was not found in permanent workers.Our study showed that workers with different employment types, permanent and fixed-term, have dissimilar sources of job stress even though their degree of job stress seems to be the same. High ERI was associated with existing subjective symptoms and obesity in fixed-term workers. Therefore, understanding different sources of job stress and their association with health among permanent and fixed-term workers should be considered to prevent further health problems.In the past decade, the changing labor market seems to have diminished the traditional standards of employment and a variety of non-standard forms of work have emerged in their place. To overcome recession and a high unemployment rate, national labor market policy began to support work sharing, deregulation of employment, and flexibility of work in developed countries [1]. These non-standard forms of work are known as precarious employment (or contingent work, firstly introduced by Freedman [2]). World Health Organization Commission on Social Determinants of Health, Employment Conditions Knowledge Network, described precarious employment as
Measurement of Rehabilitation Services Staffs Job Satisfaction Using the Effort Reward Imbalance Model in Saudi Arabia
I. Devreux,A. Jacquerye,F. Kittel,A. Almazrooa,B. Al-Awa
Research Journal of Medical Sciences , 2012, DOI: 10.3923/rjmsci.2012.87.92
Abstract: To evaluate the level of work satisfaction of staff working in rehabilitation services based on the Effort-Reward Imbalance Model. A cross-sectional study among rehabilitation services staff working in 10 healthcare facilities in Jeddah. Total of 166 therapists and assistants working in the departments of physical, occupational and respiratory therapy are recruited from 10 healthcare facilities of the Jeddah area. The effort-reward imbalance and staff job satisfaction were measured using self-administered survey questionnaires. A comparatively higher effort reward imbalance ratio and low satisfaction in work is seen for foreign nationals, respiratory therapists and night schedule workers. The age, higher educational levels of the therapists and adult, geriatric and inpatients caseloads are also positively associated with a high effort reward imbalance ratio. Job satisfaction of rehabilitation services staff based on the Effort Reward Imbalance Model is significantly correlated to the variables of age, nationality, rehabilitation specialty, work schedule and the type of patients treated which reflects an increased work stress for these professional categories. Workload, professional growth and financial benefits are essential determinants of job satisfaction of rehabilitation services staff.
Determinants of Rehabilitation Services Staffs Job Satisfaction (By Effort Reward Imbalance) and Variations in Teaching, Profit Making and Non Profit Hospitals
I. Devreux,A. Jacquerye,F. Kittel,K. Mamdouh,B. Al-Awa
Research Journal of Medical Sciences , 2012, DOI: 10.3923/rjmsci.2012.154.158
Abstract: To evaluate the level of work satisfaction based on the Effort-Reward Imbalance Model of staff working in rehabilitation services of different categories (in teaching, profit making and non-profit making hospitals). Participants were 166 therapists and assistants working in the Departments of Physical, Occupational and Respiratory Therapy from 10 hospital centers classified per three different categories in the Jeddah area. Effort-Reward Imbalance and staff satisfaction with intrinsic and extrinsic variables were measured by a self-administered questionnaire. There is a significant difference of level of job satisfaction measured by effort and reward imbalance between the therapists and assistant therapists working in the teaching, private or non-profit making health care facilities. In comparison by hospital type, the surveyed rehabilitation staffs presented a higher mean effort-reward imbalance in the teaching hospitals but higher job satisfaction with their salary, their perception of salary comparatively to others, yearly performance appraisal grading and affective commitment. In the rehabilitation services of non-profit making hospitals, the surveyed therapists and assistant therapists had the lowest mean Effort-Reward Imbalance ratio explained by their satisfaction with the variables of patient/staff ratio and emotional attachment to the organization. In the profit making healthcare facilities, the surveyed staffs are comparatively more satisfied with the variables of doctors respect, involvement in quality improvement or educational lectures and transportation to/from work. Rehabilitation services staffs working in teaching hospitals and profit making hospitals had in general a higher effort-reward imbalance ratio with work stress and low satisfaction in work compared to the non-profit hospital facilities. Job satisfaction of rehabilitation staff varies per hospital type and mission of the health care facility.
Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees
Anne Kouvonen, Mika Kivim?ki, Marianna Virtanen, Tarja Heponiemi, Marko Elovainio, Jaana Pentti, Anne Linna, Jussi Vahtera
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-24
Abstract: Based on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational -level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m2, and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models.After adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors.This study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.The Effort-Reward Imbalance (ERI) model, a recent model of occupational s
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