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Applying the effort-reward imbalance model to household and family work: a population-based study of German mothers.

ABSTRACT: BACKGROUND: This paper reports on results of a newly developed questionnaire for the assessment of effort-reward imbalance (ERI) in unpaid household and family work. METHODS: Using a cross-sectional population-based survey of German mothers (n = 3129) the dimensional structure of the theoretical ERI model was validated by means of Confirmatory Factor Analysis (CFA). Analyses of Variance were computed to examine relationships between ERI and social factors and health outcomes. RESULTS: CFA revealed good psychometric properties indicating that the subscale 'effort' is based on one latent factor and the subscale 'reward' is composed of four dimensions: 'intrinsic value of family and household work', 'societal esteem', 'recognition from the partner', and 'affection from the child(ren)'. About 19.3% of mothers perceived lack of reciprocity and 23.8% showed high rates of overcommitment in terms of inability to withdraw from household and family obligations. Socially disadvantaged mothers were at higher risk of ERI, in particular with respect to the perception of low societal esteem. Gender inequality in the division of household and family work and work-family conflict accounted most for ERI in household and family work. Analogous to ERI in paid work we could demonstrate that ERI affects self-rated health, somatic complaints, mental health and, to some extent, hypertension. CONCLUSIONS: The newly developed questionnaire demonstrates satisfied validity and promising results for extending the ERI model to household and family work.

SUBMITTER: Sperlich S

PROVIDER: S-EPMC3293094 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundHealthcare workers, who protect and improve the health of individuals, are critical to the success of health systems and achieving national and global health goals. To respond effectively to the healthcare needs of populations, healthcare workers themselves must be in a good state of health. However, healthcare workers face various psychosocial pressures, including having to work night shifts, long working hours, demands of patient care, medical disputes, workplace violence, and emotional distress due to poor interactions with patients and colleagues, and poor promotion prospects. Constant exposure to these psychosocial hazards adversely impacts healthcare workers' health. Consequently, this study aimed to examine the influence of effort-reward imbalance, job satisfaction, and work engagement on self-rated health of healthcare workers. The results would be conducive to providing policy guidance to improve the health of healthcare workers.MethodsWe analysed the data of 1327 participants from The Chinese Sixth National Health and Services Survey in Sichuan Province that was conducted from August 2018 to October 2018. Structural equation modelling was used to test the hypothesized relationships among the variables.ResultsOnly 40.1% of healthcare workers rated their health as 'relatively good' or 'good'. Effort-reward imbalance had a significant negative correlation with self-rated health (β = - 0.053, 95% CI [- 0.163, - 0.001]). The associations of effort-reward imbalance and work engagement with self-rated health were both mediated by job satisfaction (95% CI [- 0.150, - 0.050] and [0.011, 0.022]), and work engagement mediated the relationship between effort-reward imbalance and self-rated health (95% CI [- 0.064, - 0.008]).ConclusionIn order to improve the health of healthcare workers, administrators should balance effort and reward and provide opportunities for career development and training. In addition, health managers should help healthcare workers realize the significance and value of their work and keep them actively devoted to their work through incentive mechanisms.

Project description:Objective/backgroundAssociations between exposure to effort-reward imbalance at work (eg, high time pressure/low appreciation) and risk of sleep disturbances have been reported, but the direction of the effect is unclear. The present study investigated changes in effort-reward imbalance and risk of concomitant and subsequent onset of sleep disturbances.MethodsParticipants with sleep disturbances at baseline were excluded. We included participants from a population-based cohort in Denmark (n = 8,464, 53.6% women, mean age = 46.6 years), with three repeated measurements (2012 (T0); 2014 (T1); 2016 (T2)). Changes in effort-reward imbalance (T0-T1) were categorized into 'increase', 'decrease' and 'no change'. Self-reported sleep disturbances (difficulties initiating or maintaining sleep, non-restorative sleep, daytime tiredness) were dichotomized (presence versus absence). We regressed concomitant (T1) and subsequent (T2) sleep disturbances on changes in effort-reward imbalance (T0-T1) and calculated odds ratios (OR) and 95% confidence intervals, adjusted for sex, age, education and cohabitation.ResultsAt follow-up, 8.4% (T1) and 12.5% (T2) reported onset of sleep disturbances. Increased effort-reward imbalance was associated with concomitant sleep disturbances (T1) (OR = 3.16, 2.56-3.81), whereas decreased effort-reward imbalance was not (OR = 1.22, 0.91-1.63). There was no association between increased effort-reward imbalance and subsequent sleep disturbances (T2) (OR = 1.00, 0.74-1.37). Results were similar for men and women.ConclusionsIncreased effort-reward imbalance was associated with a three-fold higher risk of concomitant onset of sleep disturbances at two-year follow-up, but not subsequent onset of sleep disturbances at four-year follow-up, indicating that changes in effort-reward imbalance have immediate rather than delayed effects on sleep impairment. It is possible that the results from the two-year follow-up were to some extent affected by reverse causality.

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Applying the effort-reward imbalance model to household and family work: a population-based study of German mothers.

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