Synergistic Interaction between Job Stressors and Psychological Distress during the COVID-19 Pandemic: A Cross-Sectional Study.

Psychosocial job stressors increase the risk of mental health problems for the workers in health and social services (HSS). Although previous studies suggest that the accumulation of two or more stressors is detrimental to mental health, few studies have examined the synergistic interaction of accumulating job stressors. We examined survey responses from 9855 Finnish HSS workers in a cross-sectional study design from 2021. We conducted an interaction analysis of high job demands, low rewards and low workplace social capital on psychological distress, focusing on the relative excess risk due to interaction (RERI). Additionally, we analysed the interaction of job demands, low rewards and COVID-19 burden (extra workload and emotional load). Our analysis showed that the total RERI for the job stressors on psychological distress was considerable (6.27, 95% CI 3.14, 9.39). The total excess risk was caused by two-way interactions, especially between high demands and low rewards and by the three-way interaction of all stressors. The total RERI for job demands, low reward and COVID-19 burden (3.93, 95% CI 1.15, 6.72), however, was caused entirely by two-way interaction between high demands and low rewards. Mental health interventions tackling high demands, low rewards and low social capital are jointly needed.

Association between work ability and work stressors: cross-sectional survey of elderly services and health and social care service employees.

BACKGROUND: Work in the health and social care services (HSS) is very stressful and sickness absences are high. Nevertheless, little is known about their work stressors and work ability. The first aim of this study is to describe the prevalence of different work stressors and their accumulation among eldercare workers compared to general HSS workers. Second aim is to analyze associations between different work stressors and work ability and thus provide information on factors that are important in enhancing work ability. METHODS: This cross-sectional survey examined HSS employees in Finland in 2020. The response rate was 67% (N = 22,502). Descriptive analyses were used to describe the control variables and the differences between the work stressors of general HSS and eldercare employees. After this, multinomial logistic regression analysis revealed the association between work stressors and work ability. RESULTS: Eldercare employees experienced more often moral distress than HSS employees in general, and this further lowers their work ability. Single work stressors--Karasek's strain, Siegrist's ERI, organizational injustice and moral distress--increased the odds of low work ability (OR range 1.4-2.5) in comparison to no work stressors. However, the association with single stressors was roughly one third of that with the accumulation of all four work stressors (OR = 6.8). Thus, the accumulation of several stressors was most harmful for work ability. CONCLUSIONS: This study provides novel information on the accumulation of work stressors in relation to work ability. The results suggest that in order to enhance work ability, HSS organizations should pay more attention to preventing several stressors from accumulating. Eldercare organizations in particular need to develop effective measures for lowering moral distress.