Work experiences among nurses and physicians in the beginning of their professional careers - analyses using the effort-reward imbalance model
Department of Community Medicine and Rehabilitation, Division of Physiotherapy, Umeå University, Sweden Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Sweden Umeå Centre for Gender Studies, Umeå University, Sweden.Scandinavian Journal of Caring Sciences (Impact Factor: 0.89). 04/2012; 27(1). DOI: 10.1111/j.1471-6712.2012.00997.x
The aim of the study was to scrutinise how nurses and physicians, employed by the county councils in Sweden, assess their work environment in terms of effort and reward at the start of their career. The aim was also to estimate associations between work satisfaction and the potential outcomes from the effort-reward imbalance (ERI) questionnaire. The study group, 198 nurses and 242 physicians who graduated in 1999, is a subsample drawn from a national cross-sectional survey. Data were collected in the third year after graduation among the nurses and in the fourth year after graduation among registered physicians. The effort-reward imbalance questionnaire, together with a question on work satisfaction, was used to evaluate psychosocial factors at work. The results reveal that nurses scored higher on effort, lower on reward and experienced higher effort-reward imbalance, compared with physicians. Women scored higher on work-related overcommitment (WOC) compared with men. Among the physicians, logistic regression analysis revealed a statistically significant association between WOC and ERI, sex, effort and reward. Logistic regression analysis also revealed a statistically significant association between WOC and ERI and between WOC and effort among the nurses. Dissatisfaction with work was significantly higher among those who scored worst on all three ERI subscales (effort, reward and WOC) and also among those with the highest ERI ratios compared with the other respondents. In conclusion, to prevent future work-related health problems and work dissatisfaction among nurses and physicians in the beginning of their professional careers, signs of poor psychosocial working conditions have to been taken seriously. In future work-related stress research among healthcare personnel, gender-specific aspects of working conditions must be further highlighted to develop more gender-sensitive analyses. © 2012 The Authors. Scandinavian Journal of Caring Sciences
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ABSTRACT: Objective: Work stress among physicians is a growing concern in various countries and has led to migration. We compared the working conditions and the work stress between a migrated population of German physicians in Sweden and a population of physicians based in Germany. Additionally, specific risk factors for work stress were examined country wise. Method: Using a cross-sectional design, 85 German physicians employed in Sweden were surveyed on working conditions and effort-reward imbalance and compared with corresponding data on 561 physicians working in Germany. Multiple linear regression analyses were applied on both populations separately to model the associations between working conditions and effort-reward ratio (ERR), adjusted for a priori confounders. Results: German physicians in Sweden had a significantly lower ERR than physicians in Germany: mean (M) = 0.47, standard deviation (SD) = 0.24 vs. M = 0.80, SD = 0.35. Physicians in Sweden worked on average 8 h less per week and reported higher work support and responsibility. Multivariate analyses showed in both populations a negative association between work support and the ERR (β = -0.148, 95% CI -0.215 to (-0.081) for physicians in Sweden and β = -0.174, 95% CI -0.240 to (-0.106) for physicians in Germany). Further significant associations with the ERR were found among physicians in Sweden for daily breaks (β = -0.002, 95% CI -0.004 to (-0.001)) and among physicians in Germany for working hours per week (β = 0.006, 95% CI 0.002-0.009). Conclusion: Our findings show substantial differences in work stress and working conditions in favor of migrated German physicians in Sweden. To confirm our results and to explain demonstrated differences in physicians' work stress, longitudinal studies are recommended.International Archives of Occupational and Environmental Health 09/2014; 88(4). DOI:10.1007/s00420-014-0978-x · 2.20 Impact Factor
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ABSTRACT: Objective To describe the psychosocial environment of health professionals in public health in primary and hospital care, and compare it with that of the general Spanish working population, as well as to evaluate the effect of psychosocial risk factors on symptoms related to perceived stress. Design Cross-sectional study with stratified random sampling. Setting Health care workers in the province of Granada, distributed in 5 hospitals and 4 health districts. Participants A total of 738 employees (medical and nursing staff) of the Andalusian Health Service (SAS) were invited to take part. Main measurements CopSoQ/Istas21 questionnaire developed for the multidimensional analysis of the psychosocial work environment. Stress symptoms were measured with the Stress Profile questionnaire. Results The response rate was 67.5%. Compared with the Spanish workforce, our sample showed high cognitive, emotional, and sensory psychological demands, possibilities for development and sense of direction in their work. Primary care physicians were the group with a worse psychosocial work environment. All the groups studied showed high levels of stress symptoms. Multivariate analysis showed that variables associated with high levels of stress symptom were younger and with possibilities for social relations, role conflict, and higher emotional demands, and insecurity at work. Conclusions Our findings support that the psychosocial work environment of health workers differs from that of the Spanish working population, being more unfavorable in general practitioners.Atención Primaria 10/2014; 54(6). DOI:10.1016/j.aprim.2014.09.003 · 0.95 Impact Factor
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ABSTRACT: The effort-reward imbalance (ERI) model and scale are well-established in the human services literature as useful and valid mechanisms for studying the mismatch between employees’ perceptions of the amount of effort expended on work tasks and the rewards received for those efforts. In the almost 20 years since its introduction, the ERI scale structure has been analyzed by a number of researchers from inside and outside the human service fields, with those analyses contributing to the theoretical and practical evolution of the ERI model and scale. However, the collective results also have substantial differences that remain unresolved. This study aims to determine the first steps in finding a resolution for the practical differences between existing factor analyses and the resulting theoretical implications for human services literature and practice. This study identi fies an existing factor structure that offers the best fit to the data with the addition of a second-order factor. Model results and implications for theory and future research are discussed.
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