Effort-reward and overcommitment at work and psychiatric symptoms in healthcare professionals: The mediation role of allostatic load.

Background: Despite decades of advancement to support interventions for managing work-related stress, mental health issues have significantly escalated among healthcare professionals. Effort-reward imbalance (ERI) and overcommitment in the workplace are linked to several psychiatric disorders. However, the underlying biological mechanisms remain unclear. This study investigated whether ERI and overcommitment among healthcare professionals were linked to Allostatic Load (AL) and whether AL mediates the relationship between ERI, overcommitment and mental health issues. Methods: One hundred forty-two nursing workers (n = 142; 90.1 % female, mean age: 39.5 ± 9.6) were randomly recruited from a university hospital in Sao Paulo, Brazil, and applied the ERI scale that assesses work effort, reward, and overcommitment. The Perceived Stress Scale (PSS), The Beck Depression Inventory (BDI), and the Self-Report Questionnaire for psychiatric symptoms (SRQ-20) evaluated the mental health outcomes. Ten neuroendocrine, metabolic, immunologic and cardiovascular biomarkers were analyzed, and values were transformed into an AL index using clinical reference cutoffs. Results: Linear regression adjusted for covariates showed that higher scores for overcommitment were associated with higher AL indexes, which in turn were associated with higher SRQ-20, but not with PSS and DBI scores. As expected, higher scores for effort, lower for reward, and higher ERI were associated with higher scores for PSS, SRQ-20, and DBI, but not with AL index. Direct effect estimates showed that overcommitment was directly associated with higher SRQ-20 scores, and indirectly via AL. Conclusion: Our study reveals that overcommitment, rather than ERI, was linked to increased AL in healthcare workers. Additionally, AL mediates the relationship between overcommitment and higher psychiatric symptoms, highlighting a key mechanism by which work stress can lead to mental health problems. Individual's responses to high work demands need to be considered when designing predictive models and interventions for mental health issues.

The effects of effort-reward imbalance on the job, overcommitment, and income on life satisfaction in Germany from a longitudinal perspective.

BACKGROUND: The effort-reward imbalance at work model offers a theoretical and analytical framework to estimate the subjective perception of work-related stress. High demands and low rewards in return can harm mental and physical health, well-being, and life satisfaction. According to the theory, overcommitment partially explains why employees endure such straining jobs. In Germany, cultural and economic aspects of labor differ between East and West. Incomes are lower in the East, while work centrality there is higher. In this article, the effects of effort-reward imbalance, overcommitment, and income on life satisfaction as well as their interactions with region were analyzed to gain a clearer picture of regional disparities regarding life satisfaction and the generality of this work stress model in Germany. METHODS: Data from 3848 participants from 2006 to 2011 of the German Socio-Economic Panel were analyzed. Within-between models were estimated, including fixed and random effects of the continuous form of effort-reward imbalance to predict subjective life satisfaction. Time-variant covariates - e.g., overcommitment or income - as well as time-constant variables - e.g., region, sex, education - were integrated. Differences in regional labor markets between East and West Germany were considered. RESULTS: Easterners exhibited higher imbalances and overcommitment than Westerners, indicating worse working conditions. Higher imbalances and overcommitment were associated with lower life satisfaction within and between participants, whereas for income only random effects were supported. While region did not moderate the effect of work stress, East Germans' life satisfaction benefitted more from a higher income. CONCLUSION: The importance of internal work structures in terms of recognition, adequate pay, advancement opportunities, or time pressure were underlined. As compared to the West, Easterners' life satisfaction benefitted more from higher income but not more from a lower imbalance or lower overcommitment. The interplay between materialistic and nonmaterialistic rewards at work should be focused on in the future.

Associations of effort-reward imbalance at work and quality of life among workers after stroke: a one-year longitudinal study in Thailand.

Stroke incidence is increasing among working-age population, but the role of psychosocial stress in the workplace in predicting quality of life (QoL) after stroke onset is understudied. This longitudinal study aimed to investigate the relationship between work stress, measured by the effort-reward imbalance (ERI) model, and QoL over one-year period among 103 Thai workers who had experienced a stroke. The study evaluated the effort (E)-reward (R) ratio and over-commitment, the extrinsic and intrinsic components of the ERI model, before discharge; QoL was repeatedly measured at baseline, six months, and 12 months after discharge, respectively, using the Short Form Version 2 (SF-12v2) indicators of physical and mental health composite scores. Generalized estimating equations were used to examine longitudinal relationships between work stress at baseline and QoL over one year by testing the hypotheses that E-R ratio and over-commitment would have direct effects on QoL, and potential moderating effects of over-commitment on E-R ratio and QoL. The results supported the ERI model partially, as over-commitment was significantly associated with poor mental health (coefficient - 8.50; 95% CI: -13.79, -3.20) after adjusting baseline sociodemographic, behavioral, and clinical characteristics, while the E-R ratio was not significantly associated with physical or mental health; the interaction between the E-R ratio and over-commitment was also not significant. These findings suggest that more attention should be paid to workers' personal coping skills and ability to handle work-related problems and prioritize interventions that address over-commitment to promote long-term mental health among workers with stroke.

Psychosocial Work Stress and Occupational Stressors in Emergency Medical Services.

Emergency medical service (EMS) professionals often experience work stress, which escalated during COVID-19. High job demand in the EMS profession may lead to progressive decline in physical and mental health. We investigated the prevalence of psychosocial job stress in the three levels of EMS: basic, advanced, and paramedic, before and during the COVID-19 pandemic. EMS professionals (n = 36) were recruited from EMS agencies following the Institutional Review Board approval. Participants took surveys on demographics, personal characteristics, chronic diseases, and work schedules. Job stress indicators, namely the effort-reward ratio (ERR) and overcommitment (OC), were evaluated from survey questionnaires using the effort-reward imbalance model. Associations of job stress indicators with age, sex, body mass index, and working conditions were measured by logistic regression. Psychosocial work stress was prevalent with effort reward ratio > 1 in 83% of participants and overcommitment scores > 13 in 89% of participants. Age, body mass index, and work hours showed strong associations with ERR and OC scores. The investigation findings suggested that a psychosocial work environment is prevalent among EMS, as revealed by high ERR, OC, and their correlation with sleep apnea in rotating shift employees. Appropriate interventions may be helpful in reducing psychosocial work stress in EMS professionals.

Stressed, Lonely, and Overcommitted: Predictors of Lawyer Suicide Risk.

Suicide is a significant public health concern, and lawyers have been shown to have an elevated risk for contemplating it. In this study, we sought to identify predictors of suicidal ideation in a sample consisting of 1962 randomly selected lawyers. Using logistic regression analysis, we found that high levels of work overcommitment, high levels of perceived stress, loneliness as measured by the UCLA loneliness scale, and being male were all significantly associated with an increased risk of suicidal ideation. These results suggest that interventions aimed at reducing work overcommitment, stress, and loneliness, and addressing gender-specific risk factors, may be effective in reducing the risk of suicidal ideation among lawyers. Further research is needed to expand upon these findings and to develop and test interventions specifically tailored to the needs of this population.

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.

Dyadic effects of work overcommitment on depression in dual-earner couples: based on the actor-partner interdependence model.

In this study, we aimed to examine the actor and partner effects of overcommitment on depression in dual-earner couples and the potential mediating role of emotional exhaustion at the actor and partner levels. With a cross-sectional design, 172 dual-earner couples in Chongqing, China, completed the measures of overcommitment, emotional exhaustion, and depression. The results showed that (a) overcommitment has a significant actor effect on depression for the husband and wife, and there were gender differences in the partner effects; that is, a wife's overcommitment has a significant partner effect on the husband's depression, while a husband's partner effect was not significant; (b) emotional exhaustion mediated the effects of overcommitment on depression for both husbands and wives at the actor level, while at the partner level, only a wife's exhaustion mediated the partner effect of a wife's overcommitment on a husband's depression. Focusing on couples' interdependence, these results enriched the understanding of the relationship between overcommitment and depression within dual-earner couples.

Psychometric properties of the effort-reward imbalance scale in Chinese version for university students.

Objective: The main purpose of the study was to translate the Effort-Reward Imbalance Scale for University Students (ERIUS) and assess its psychometric properties in the Chinese cultural context. Methods: We translated the original English version of the ERIUS into Chinese and undertook exploratory and confirmatory factor analysis using data collected from university students. The Stress Scale for College Students was selected as the criterion measure to examine the association between psychological stress and effort-reward imbalance. The validity and reliability of the translated version of the ERIUS were also assessed, and a sub-sample of participants (n = 120) completed the measure twice, with a two-week interval to assess test-retest reliability. Result: Results of the exploratory factor analysis using data from 314 students showed that the Chinese version of the ERIUS had 14 items and 3 factors: effort, reward and overcommitment. Confirmatory factor analysis using data from 584 students showed that the Chinese version of the ERIUS had adequate structural validity (χ 2 = 107.10, df = 32, RMSEA = 0.08, NFI = 0.90, CFI = 0.91, GFI = 0.90, PGFI = 0.62). Conclusion: The Chinese version of the Effort-Reward Imbalance Scale for University Students has adequate psychometric properties in the Chinese cultural context and can be used as an effective tool to measure psychosocial stress of university students in China.

Work stress, overcommitment personality and alcohol consumption based on the Effort-Reward Imbalance model: A population-based cohort study.

Work stress has been extensively supported to predict health outcomes like health behaviors. Evidence has linked work stress and personality independently to health, but the interrelationships between work stress and personality and their joint effects on health might deserve more attention in research. This study attempts to integrate recent developments in psychological research (diverse roles of personality in stress processes) into the well-established Effort-Reward Imbalance (ERI) model for work stress. Based on the ERI model, this population-based cohort study aims to investigate the relationships between work stress, personality and alcohol consumption; it particularly focuses on potential roles of overcommitment (OC) personality in ERI-drinking relations, including modifying, antecedent, mediator or direct effects. This two-wave cohort study was conducted in population samples of 3782 men and 3731 women (aged 45-69 years) from Czech Republic, Poland and Russia. Alcohol consumption was assessed by three drinking outcomes: binge drinking, heavy drinking and problem drinking. To assess modifying effect of OC in ERI-drinking relations, logistic regression was used. To assess antecedent or mediator role of OC in ERI-drinking relations, path analysis with the autoregressive and cross-lagged model was conducted. The results showed that OC had no significantly modifying effect in ERI-drinking relations. OC and ERI might have bidirectional relationships in the average follow-up period of 3.5 years; the effect of OC on ERI was remarkably stronger than the reversed causation. Antecedent role of OC in ERI-drinking relationship was significant, but mediator role of OC was not. In conclusion, our findings imply that "antecedent role" of OC in ERI-drinking relations is significant and promising as a potential target for individual intervention; future interventions are suggested to identify and target potential cognitive-behavioral mechanisms via which personality might influence work stress and subsequently health behaviors.

Influence of occupational stress on mental health of medical staff: mediating effect of affective commitment and moderating effect of overcommitment / 环境与职业医学

Background Occupational stress has been shown to be an important factor affecting the mental health of workers. The role of affective commitment to the organization and overcommitment to work cannot be ignored. However, there is a lack of research on this topic in China. Objective To explore a potential mediating effect of affective commitment on how occupational stress affects the mental health of medical staff and a potential moderating effect of overcommitment on the mediating effect of affective commitment. Methods A total of 1372 health care workers in a tertiary Grade A hospital in Lanzhou City were selected as study subjects for a cross-sectional survey. The occupational stress, emotional commitment, and psychological distress of the subjects were evaluated by the Effort-Reward Imbalance Scale, Affective Commitment Scale, and Kessler 10 Scale. SPSS 26.0 was used for correlation analysis, mediation analysis, and moderated mediation analysis. Common method bias wasevaluated by Harman one-factor test. Results A total of 1372 questionnaires were distributed, of which 1277 valid questionnaires were returned, with a valid recovery rate of 93.08%. The mean occupational stress score was 1.14±0.23, the mean overcommitment score was 20.26±3.21, the mean affective commitment score was 20.25±3.34, and the mean psychological distress score was 26.26±7.90. The Spearman correlation analysis results showed that occupational stress among medical staff was positively correlated with overcommitment and psychological distress (r=0.153, 0.410, P＜0.01) and negatively correlated with affective commitment (r=−0.341, P＜0.01); overcommitment was negatively related to affective commitment and positively related to psychological distress (r=−0.107, 0.312, P＜0.01); affective commitment was negatively related to psychological distress (r=−0.464, P＜0.01). The positive effect of occupational stress on psychological distress of medical staff was significant (b=0.41, t=15.42, P<0.001); affective commitment presented a partial mediating effect on the relationship between occupational stress and psychological distress (effect value=0.13), accounting for 31.71% of the total effect; overcommitment moderated the process of occupational stress-affective commitment-psychological distress (P＜0.01). Conclusion Affective commitment of medical staff has a partial mediating effect on the relationship between occupational stress and psychological distress, and overcommitment plays a significant role in moderating the process of occupational stress-affective commitment-psychological distress.

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.

Psychosocial work characteristics and low back pain in daycare (nursery) workers in Japan: a prospective cohort study.

BACKGROUND: Low back pain (LBP) is one of the most common musculoskeletal problems affecting daycare (nursery) workers. We aimed to identify the psychosocial factors influencing LBP in daycare workers. METHODS: We conducted a prospective cohort study with a one-year observation period. The baseline sample was a convenience sample of 444 daycare workers from 34 daycare facilities in Nagoya, Japan, and its suburbs. All the data were collected through a questionnaire survey. The question "Where are you currently feeling LBP?" was used to determine whether the subjects suffered from LBP. We examined the prospective relationships of the psychosocial work characteristics, i.e., high job strain, low social support, effort-reward imbalance, and overcommitment, at baseline and LBP after one year. We used multiple logistic regression analyses to calculate the odds ratios of psychosocial work characteristics for the persistence and onset of LBP, adjusted for age, sex, body mass index, smoking, employment status, occupation, and working schedule. RESULTS: At baseline, 270 (60.8%) subjects suffered from LBP. Of 208 who also gave information on LBP one year later, 176 (84.6%) suffered from the persistence of LBP. Low social support at baseline was significantly related to persistent LBP one year later. The incidence of persistent LBP was 89.9% and 80.0% among those with and without low social support at baseline, respectively. The adjusted odds ratio (95% confidence interval) of low social support at baseline for the persistence of LBP was 2.43 (1.01-5.87). Of 150 who were without LBP at baseline and provided information on LBP one year later, 45 (30.0%) suffered from the onset of LBP. None of the psychosocial work characteristics showed significant relationships with the onset of LBP one year later. CONCLUSION: Low social support was related to the persistence, but not to the onset of LBP in a prospective cohort analysis among daycare workers in Japan. High job strain, ERI, or overcommitment did not show a significant prospective effect on LBP.

The Impact of Quality of Work Organization on Distress and Absenteeism among Healthcare Workers.

The quality of work organization may be responsible not only for reduced productivity but also for an increased risk of mental and physical disorders. This study was aimed at testing this hypothesis. Workers of a local health unit in Italy were asked to fill out the Work Organization Assessment Questionnaire (WOAQ) during their periodic medical examinations in the second half of 2018. On the same occasion, they also completed the Demand/Control/Support (DCS) measure of job strain, the Effort/Reward Imbalance (ERI) questionnaire, and the General Health Questionnaire (GHQ12) to assess psychological health. A total of 345 workers (85.8%) completed the survey. Linear regression analysis showed that the quality of work organization was inversely proportional to psychological health problems (p < 0.001). Occupational stress, measured both by job strain and ERI, was a moderating factor in this relationship. The relationship between the WOAQ and psychological health, moderated by job strain or ERI, remained highly significant even after adjustment for sex, age, social support, and overcommitment. Regression models explained over 40% of the shared variance of the association between quality of work organization and psychological health. The quality of work organization significantly predicted the risk of sickness absence for musculoskeletal disorders (OR = 0.984, CI95% 0.972-0.996) and for other health problems (OR = 0.977, CI95% 0.967-0.988). A continuous improvement of work organization must consider not only the clients' or production needs but also the well-being of workers.

Occupational Stress and Insomnia Symptoms Among Nurses During the Outbreak of COVID-19 in China: The Chain Mediating Effect of Perceived Organizational Support and Psychological Capital.

Background: Nurses play an important role in medical and health services and insomnia symptoms were relatively high among nurses, especially during the epidemic of 2019 coronavirus disease. Insomnia not only damages the physical and mental health of the individual, but also reduces the efficiency of their work and the quality of care, ultimately impacting on patient care. Objective: The purpose of this study was to explore the role of perceived organizational support and psychological capital in the relationship between occupational stress and insomnia among Chinese nurses. Methods: A cross-sectional study has been carried out in a tertiary grade A hospital in Shandong Province, China from March 2021 to May 2021. The self-administered questionnaires were distributed to 810 nurses, which including Chinese Effort-Reward Imbalance Scale, Athens Insomnia Scale, Perceived Organizational Support Questionnaire, Chinese Psychological Capital Questionnaire, gender, age, education level and other demographic characteristics. Effective respondents were 658 (81.2%). Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analyses, ordinary least-squares regression and the bootstrap method were used for data analysis. Results: The prevalence of insomnia symptoms in this study was found to be 57.3%. There were significant differences in insomnia symptoms in weekly working hours (t = -2.027, P = 0.043), with chronic disease (t = -2.825, P = 0.005), negative life events (t = -5.340, P < 0.001), departments (F = 3.077, P = 0.006) and position (t = 2.322, P = 0.021) among nurses. Overall, the serial-multiple mediations of perceived organizational support and psychological capital in the relationship between occupational stress and insomnia were found to be statistically significant. Conclusions: The prevalence of insomnia symptoms was comparatively high among Chinese nurses, and occupational stress had direct negative influence on it. Perceived organizational support and psychological capital acted as chained mediating factor could partially relieve insomnia symptoms related to occupational stress. Supportive working environment should be provided, and improving psychological capital levels to help nurses coping with insomnia symptoms.

Exhaustion in Healthcare Workers after the First Three Waves of the COVID-19 Pandemic.

This study aims to identify the determinants of exhaustion of frontline and second-line healthcare workers (HCW) during the third wave of the COVID-19 pandemic. A case−control study was conducted based on an anonymously distributed questionnaire, which was completed by 1872 HCW. Exhaustion was assessed with a validated Romanian questionnaire. The Siegrist questionnaire was used to determine workload, reward and overcommitment. Frontline HCW reported significantly more frequent longer working hours (p = 0.0009) and a better perception of the management of the risk for infection (p = 0.0002) than second-line HCW. The effort and overcommitment scores were higher in frontline HCW (9.51 + 1.98 vs. 8.45 + 21, p < 0.001 and 16.34 ± 2.80 vs. 15.24 ± 2.94, p < 0.001, respectively) and the reward scores were lower (5.21 ± 1.522 vs. 5.99 ± 1.44, p < 0.001). In the fully adjusted regression model, age, imbalance between effort and reward, overcommitment and management of the risk of infection in the workplace were associated with the exhaustion score in each category of HCW. The number of working hours was correlated with exhaustion in frontline HCW and occupation in second-line HCW. There were more similarities than differences between frontline and second-line HCW. Even if frontline HCW had a higher risk of exhaustion, the risk was not negligible for all HCW.

Effort-Reward Imbalance at Work and Prescription Drug Misuse-Prospective Evidence from Germany.

This study examines how work stress affects the misuse of prescription drugs to augment mental performance without medical necessity (i.e., cognitive enhancement). Based on the effort-reward imbalance model, it can be assumed that a misalignment of effort exerted and rewards received increases prescription drug misuse, especially if employees overcommit. To test these assumptions, we conducted a prospective study using a nationwide web-based sample of the working population in Germany (N = 11,197). Effort, reward, and overcommitment were measured at t1 and the 12 month frequency of prescription drug misuse for enhancing cognitive performance was measured at a one-year follow-up (t2). The results show that 2.6% of the respondents engaged in such drug misuse, of which 22.7% reported frequent misuse. While we found no overall association between misuse frequency and effort, reward, or their imbalance, overcommitment was significantly associated with a higher misuse frequency. Moreover, at low levels of overcommitment, more effort and an effort-reward imbalance discouraged future prescription drug misuse, while higher overcommitment, more effort, and an imbalance increased it. These findings suggest that a stressful work environment is a risk factor for health-endangering behavior, and thereby underlines the importance of identifying groups at risk of misusing drugs.

Psychosocial Work Stress and Health Risks - A Cross-Sectional Study of Shift Workers From the Hotel and Catering Industry and the Food Industry.

Purpose: Psychosocial work stress, and shift and night work are considered risk indicators for impaired health. Using the effort-reward (ER) model, it was possible to examine which relationships exist for shift workers between clusters (CL) of different levels of psychosocial work stress and overcommitment (OC) and cardiovascular or psychological health indicators, and which predictive value is evident in individual health indicators to explain the clusters. Methods: The data were collected as part of an occupational health prevention program. The analysis sample consisted of 199 shift workers from alternating shift systems with and without night work (43%) (average age: 40 ± 12 years, men: 47%). Psychosocial work stress was recorded using the ER imbalance (ERI) questionnaire. To determine the clusters, ERI and OC were entered into a cluster analysis. Blood pressure, body mass index, waist-hip ratio, PROCAM score (risk of a heart attack within the next 10 years), sporting activity, and smoking were included as cardiovascular indicators, psychological wellbeing (GHQ-12) and inability to recovery (IR) (FABA) as psychological health indicators. Shift system, sex, and age were entered into the statistical analyses as control variables. Multinomial logistic regression models were used to identify health-related predictors to explain the ER-OC clusters. Results: Three different ER-OC clusters emerged: low-stress: 36%, normal: 44%, risk: 20%. While normal psychosocial work stress is present in the low-stress and the normal CL, in the risk CL 28% of the shift workers show a health-endangering ERI and 48% show an excessive OC. No significant cluster-specific differences were determined for the cardiovascular health indicators. Rather, the known sex and age effects were confirmed and the shift system had no significant effect. Significantly more shift workers in the risk CL had impaired psychological health (18 vs. 1/6%) and an IR (52 vs. 0/12%) than in the low-stress and normal CL. IR turned out to be the strongest predictor of the explanation for the ER-OC clusters (49%). Conclusion: IR could be assigned an independent diagnostic value for the assessment of psychosocial work stresses and discussed as a new component of occupational health screening concepts for shift workers. Independently of this, the health indicators signal an urgent need for occupational health prevention and care.

Gender-Specific Aspects of Teachers Regarding Working Behavior and Early Retirement.

Worldwide, a significant proportion of teachers retires prematurely for health reasons or at their own request. The study examines whether male and female teachers differ in terms of working conditions and coping with high work demands as well as individual factors that promote early retirement. A cross-sectional study was conducted to collect data from 6,109 full-time teachers in high schools (56% women). Weekly working hours from a four-week working time record and psychosocial work stress (effort-reward model, ER ratio) were used as workloads. In addition, emotional exhaustion (Maslach Burnout Inventory) and coping strategies that endangered health were recorded in the form of overcommitment and inability to recover. Also, the teachers gave a prediction and reasons for early retirement and made their own suggestions on how to prevent this. The results show that both workloads and emotional exhaustion are comparable between the genders, but women have a greater tendency than men to overcommit and be unable to recover. As ER ratio and emotional exhaustion increase, the chances for both genders to reach the regular retirement age decrease significantly; for health-endangering coping strategies, the relationship is somewhat weaker. The majority of male and female teachers (79%) indicates excessive workloads as the main reason for leaving the profession early. In order to protect teachers from high workloads, measures at the organizational, social, and individual level are necessary. Proposals for schools and policy makers are critically discussed on the basis of teacher recommendations.

Moderating and Mediating Effects of Over-Commitment on the Association Between Effort-Reward Imbalance (ERI) with Upper Back and Hand/Wrist Disorders in Municipal Solid Waste Collectors.

PURPOSE: Despite repetitive activities and the frequency of high workload for municipal solid waste (MSW) collectors, the risks of work-related stress on upper extremity pain are inconclusive. The objective of this study is to assess the moderation and mediation effect of effort-reward imbalance (ERI) and over-commitment (OC) on upper back and hand/wrist disorders in MSW collectors. METHODS: A cross-sectional study was conducted with MSW collectors from two cities in Taiwan. Each participant was asked to anonymously fill out a structured questionnaire. Work-related stress, including ERI and OC, was assessed by a Chinese version of the Job Content Questionnaire (C-JCL). Upper back and hand/wrist disorders were assessed using the Nordic musculoskeletal questionnaire. Multivariate analysis was used to assess moderation and mediation effect of OC and ERI on upper extremity pain. RESULTS: The moderation effect of ERI and OC on upper back and hand/wrist disorders in MSW collectors was found. Disorders were higher in the group with both ERI ≥1 and high OC (OR (odds ratio) = 3.25 and OR = 3.00) than in the group with ERI ≥1 and low OC (OR = 2.66 and OR = 1.87) and in the ERI <1 and high OC group (OR = 2.27 and OR = 1.26). Synergy indexes were 0.77 and 1.77, respectively. Using multivariate analysis after adjusting for covariates, the mediation effect of OC was significant for the association between ERI and upper back and hand/wrist pains. The indirect effects of OC for upper back and hand/wrist pains accounted for 35% and 42%, respectively, and OC appears to mediate the relationship between ERI and upper back and hand/wrist disorders in MSW collectors. CONCLUSION: Work-related stress measured ERI and OC may play a role in moderating and mediating effects on upper extremity pain. Encouraging provisions of work modification and stress management is needed to mitigate the occurrence of upper extremities pain in MSW collectors.

Are there differences between officers and ratings on merchant vessels concerning effort-reward imbalance: a cross-sectional maritime field study.

PURPOSE: Today, measures to economise in the operation of ships can cause either an effort-reward imbalance or health impairments. The goal of this study was to assess the risk of effort-reward imbalance including overcommitment among officers and ratings on merchant vessels during their assignments and to evaluate lifestyle factors of seafarers as well as the health-promoting conditions on board. METHODS: A study sample of 308 male seafarers was examined during a total of 20 sea voyages on German container ships (participation rate 91.9%). RESULTS: Only 11 seafarers were identified as having an increased health risk of an effort-reward imbalance (ER ratio > 1). Officers tended to have a higher risk of an elevated ratio than ratings (4.4% vs. 3.1%) and also showed a significantly higher risk of an ER ratio above the median (58.8% vs. 41.8%; p = 0.022). Compared to land-based populations, the average overcommitment score of seafarers was high (17.9)-particularly among officers (20.3 vs. 16.5; p = 0.031). This corresponded to an elevated risk of overcommitment among officers compared to ratings (OR 2.14; 95% CI 1.78-2.37). This elevated risk remained significant after adjustment for age (OR 2.11; 95% CI 1.76-2.35) and job-related stressors. CONCLUSION: Although an elevated risk of effort-reward imbalance was only observed in few seafarers, this study revealed a high prevalence of overcommitment particularly among officers. In the course of time, overcommitment can lead to mental exhaustion. Therefore, shipboard health-promoting conditions need to be optimised.