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Original article

Vol. 142 No. 2122 (2012)

Effort-reward and work-life imbalance, general stress and burnout among employees of a large public hospital in Switzerland

  • Oliver Hämmig
  • Rebecca Brauchli
  • Georg Friedrich Bauer
DOI
https://doi.org/10.4414/smw.2012.13577
Cite this as:
Swiss Med Wkly. 2012;142:w13577
Published
20.05.2012

Summary

INTRODUCTION: Effort-reward imbalance (ERI) and work-life imbalance (WLI) are recognised risk factors for work stress and burnout but have not been investigated conjointly so far and compared with each other in this regard. The present cross-sectional study provides initial evidence by studying associations of ERI and WLI with general stress and burnout simultaneously.

METHODS: The study was based on survey data collected in 2007 among the personnel of a large public hospital in the canton of Zurich covering a random sample of 502 employees of all professions and positions. Prevalence rates, correlation coefficients, standardised regression coefficients and odds ratios were calculated as measures of association.

RESULTS: Concerning the main research question and relating to the entire study sample, WLI was found to be more strongly associated with general stress and burnout than ERI. As stratified analyses with regard to burnout have shown, this applied especially to nursing, technical care and emergency staffs who account for more than three fifths of the study population. But for other professional categories like physicians, therapists and medical-technical personnel the opposite of a stronger association of ERI with burnout was found. Results also suggested that general stress plays a (rather minor) mediating role in the relationships between ERI and burnout and particularly between WLI and burnout.

CONCLUSION: For the prevention of chronic stress and burnout one should consider both high efforts put into work as well as all job demands that are competing and interfering with family responsibilities or other private activities.

References

  1. Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav. 1981;2:99–113.
  2. Maslach C, Leiter MP. Early predictors of job burnout and engagement. J Appl Psychol. 2008;93(3):498–512.
  3. Innstrand ST, Langballe EM, Espens GA, Falkum E, Aasland OG. Positive and negative work-family interaction and burnout: A longitudinal study of reciprocal relations. Work & Stress. 2008;22(1):1–15.
  4. Ahola K, Toppinen-Tanner S, Huuhtanen P, A. K, Väänänen A. Occupational burnout and chronic work disability: An eight-year cohort study on pensioning among Finnish forest industry workers. J Affect Disorders. 2008;115(1–2):150–9.
  5. Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen burnout inventory: A new tool for the assessment of burnout. Work & Stress. 2005;19(3):192–207.
  6. Shirom A. Burnout in work organizations. In: Cooper CL, Robertson IT, eds. International Review of Industrial and Organizational Psychology. New York: John Wiley & Sons; 1989: 25–48.
  7. Schaufeli WB, Greenglass ER. Introduction to special issue on burnout and health. Psychol Health. 2001;16(5):501–10.
  8. Peltzer K, Mashego T-A, Mabeba M. Short Communication: Occupational stress and burnout among South African medical practitioners. Stress Health. 2003;19:275–80.
  9. Karasek R, Theorell T. Healthy work: stress, productivity, and the reconstruction of working life. New York: Basic Books, 1990.
  10. Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1:27–41.
  11. Greenhaus JH, Beutell NJ. Sources of conflict between work and family roles. Acad Manage Rev. 1985;10(1):76–88.
  12. Netemeyer RG, Boles JS, McMurrian R. Development and validation of work-family conflict and family-work conflict scales. J Appl Psychol. 1996;81(4):400–10.
  13. Carlson DS, Kacmar KM, Williams LJ. Construction and initial validation of a multidimensional measure of work-family conflict. J Vocat Behav. 2000;56(2):249–76.
  14. Gutek B, Searle S, Klepa L. Rational versus gender role explanations for work-family conflict. J Appl Psychol. 1991;76(4):560–8.
  15. Hämmig O, Gutzwiller F, Bauer GF. Work-life conflict and associations with work- and nonwork-related factors and physical and mental health outcomes: a nationally representative cross-sectional study in Switzerland. BMC Public Health. 2009;9:435.
  16. Calnan M, Wadsworth E, May M, Smith A, Wainwright D. Job strain, effort-reward imbalance, and stress at work: competing or complementary models? Scand J Public Health. 2004;32(2):84–93.
  17. de Jonge J, Bosma H, Peter R, Siegrist J. Job strain, effort-reward imbalance and employee well-being: a large-scale cross-sectional study. Soc Sci Med. 2000;50:1317–27.
  18. Weyers S, Peter R, Boggild H, Jeppesen HJ, Siegrist J. Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort-reward imbalance model. Scand J Caring Sci. 2006;20:26–34.
  19. Buddeberg-Fischer B, Stamm M, Buddeberg C, Bauer G, Hämmig O, Klaghofer R. Work stress, health and satisfaction of life in young doctors: results of a longitudinal study in Switzerland. Deut Med Wochenschr. 2008;133:2441–7.
  20. Sakata Y, Wada K, Tsutsumi A, Ishikawa H, Aratake Y, Watanabe M, et al. Effort-Reward Imbalance and Depression in Japanese Medical Residents. J Occup Health. 2008;50:498–504.
  21. Tsutsumi A, Kayaba K, Theorell T, Siegrist J. Association between job stress and depression among Japanese employees threatened by job loss in a comparison two complementary job-stress models. Scand J Work Env Hea. 2001;27(2):146–53.
  22. Tsutsumi A, Kawanami S, Horie S. Effort-reward imbalance and depression among private practice physicians. Int Arch Occ Env Hea. 2011; Epub ahead of print.
  23. Bakker AA, Killmer CH, Siegrist J, Schaufeli WB. Effort-reward imbalance and burnout among nurses. J Adv Nurs. 2000;31:884–91.
  24. Klein J, Grosse Frie K, Blum K, Siegrist J, von dem Knesebeck O. Effort-reward imbalance, job strain and burnout among clinicians in surgery. Psychother Psych Med. 2010;60:374–9.
  25. Schulz M, Damkröger A, Heins C, Wehlitz L, Löhr M, Driessen M, et al. Effort-reward imbalance and burnout among German nurses in medical compared with psychiatric hospital settings. J Psychiat Ment Hea Nurs. 2009;16:225–33.
  26. Unterbrink T, Hack A, Pfeifer R, Buhl-Griesshaber V, Müller U, Wesche H, et al. Burnout and effort – reward-imbalance in a sample of 949 German teachers. Int Arch Occ Env Hea. 2007;80:433–41.
  27. Allen TD, Herst DEL, Bruck CS, Sutton M. Consequences associated with work-to-family conflict: A review and agenda for future research. J Occup Health Psychol. 2000;5(2):278–308.
  28. Hammer TH, Saksvik PO, Nytro K, Torvatn H, Bayazit M. Expanding the psychosocial work environment: Workplace norms and work-family conflict as correlates of stress and health. J Occup Health Psychol. 2004;9(1):83–97.
  29. Smith Major V, Klein KJ, Ehrhart MG. Work time, work interference with family, and psychological distress. J Appl Psychol. 2002;87(3):427–36.
  30. Burke RJ, Greenglass ER. Hospital restructuring, work-family conflict and psychological burnout among nursing staff. Psychol Health. 2001;16:583–94.
  31. Brauchli R, Bauer GF, Hämmig O. Relationship between time-based work-life conflict and burnout: A cross-sectional study among employees in four large-scale Swiss enterprises. Swiss J Psychol. 2011;70(3):165–73.
  32. Montgomery AJ, Panagopolou E, Benos A. Work-family interference as a mediator between job demands and job burnout among doctors. Stress Health. 2006;22:203–12.
  33. Demerouti E, Bakker AB, Bulters AJ. The loss spiral of work pressure, work-home interference and exhaustion: Reciprocal relations in a three-wave study. J Vocat Behav. 2004;64(1):131–49.
  34. Hämmig O, Bauer GF. Work-life imbalance and mental health among male and female employees in Switzerland. Int J Public Health. 2009;54:88–95.
  35. Jansen NWH, Kant I, Kristensen TS, Nijhuis FJN. Antecedents and consequences of work-family conflict: A prospective cohort study. J Occup Environ Med. 2003;45(5):479–91.
  36. Franche R-L, Williams A, Ibrahim S, Grace SL, Mustard C, Minore B, et al. Path analysis of work conditions and work-family spillover as modifiable workplace factors associated with depressive symptomatology. Stress Health. 2006;22:91–103.
  37. Kinman G, Jones F. Effort-reward imbalance, over-commitment and work-life conflict: testing an expanded model. J Manage Psychol. 2008;23(3):236–51.
  38. Willis TA, O’Connor DB, Smith L. Investigating effort-reward imbalance and work-family conflict in relation to morningness-eveningness and shift work. Work & Stress. 2008;22(2):125–37.
  39. Knecht M, Bauer GF, Klaghofer R, Buddeberg-Fischer B, Stamm M, Hämmig O. Work-life conflict and health among Swiss physicians – in comparison with other university graduates and with the general Swiss working population. Swiss Med Weekly. 2010;140:w13063.
  40. Siegrist J, Peter R. Measuring effort-reward imbalance at work: Guidelines. Düsseldorf: University of Düsseldorf, 1996.
  41. Niedhammer I, Tek M-L, Starke D, Siegrist J. Effort-reward imbalance model and self-reported health: cross-sectional and prospective findings from the GAZEL cohort. Soc Sci Med. 2004;58(8):1531–41.
  42. Elo A-L, Leppänen A, Jahkola A. Validity of a single-item measure of stress symptoms. Scand J Work Env Hea. 2003;29(6):444–51.
  43. Schaufeli WB, Leiter MP, Maslach C, Jackson SE. The Maslach Burnout Inventory – General Survey (MBI-GS). In: Maslach C, Jackson SE, Leiter MP, eds. Maslach burnout inventory manual. Palo Alto: Consulting Psychologists Press; 1996:19–26.
  44. Kristensen TS, Hannerz H, Høgh A, Borg V. The Copenhagen Psychosocial Questionnaire – a tool for the assessment and improvement of the psychosocial work environment. Scand J Work Env Hea. 2005;34(6):438–49.
  45. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–82.