scholarly journals Changes in work stress among doctors in Norway from 2010 to 2019: a study based on repeated surveys

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037474
Author(s):  
Judith Rosta ◽  
Fredrik Bååthe ◽  
Olaf G Aasland ◽  
Karin Isaksson Rø
Keyword(s):  
Work Stress ◽  
Private Practice ◽  
Mixed Models ◽  
Short Form ◽  
Gender And Age ◽  
Effort Reward Imbalance ◽  
Marginal Means ◽  
Reward Imbalance ◽  
Hospital Doctors ◽  
Questionnaire Surveys

ObjectivesTo explore and discuss the changes in the levels of work stress for Norwegian doctors in different job positions (hospital doctors, general practitioners (GPs), private practice specialists, doctors in academia) from 2010 to 2019.DesignRepeated questionnaire surveys in 2010, 2016 and 2019, where samples were partly overlapping.SettingNorway.ParticipantsA representative sample of 1500–2200 doctors in different job positions. Response rates were 66.7% (1014/1520) in 2010, 73.1% (1604/2195) in 2016 and 72.5% (1511/2084) in 2019.Main outcome measureValidated 9-item short form of the ‘Effort–Reward Imbalance’ questionnaire. A risky level of work stress was defined as an effort/reward ratio above 1.0.AnalysesLinear mixed models with estimated marginal means of job positions controlled for gender and age. Proportions with 95% CIs.ResultsFrom 2010 to 2016 and further to 2019, GPs reported a significant increase in levels on the effort scale (ES: 2.96, 3.25, 3.51) and significant decrease in levels on the reward scale (RS: 4.27, 4.05, 3.67). No significant changes were reported by hospital doctors (ES: 3.13, 3.10, 3.14; RS: 4.09, 3.98, 4.04), private practice specialists (ES: 2.58, 2.61, 2.59; RS: 4.32, 4.32, 4.30) and doctors in academia (ES: 2.63, 2.51, 2.52; RS: 4.09, 4.11, 4.14). The proportion of doctors with risky levels of work stress increased significantly for GPs (10.3%, 27.7%, 40.1%), but did not significantly change for hospital doctors (23.0%, 27.3%, 26.9%), private practice specialists (8.2%, 12.7%, 9.4%) and doctors in academia (11.9%, 19.0%, 16.4%).ConclusionDuring a 9-year period, the proportion of risky levels of work stress increased significantly for GPs but did not significantly change for other job positions. This may be partly due to changes in expectations of younger GPs and several healthcare reforms and regulations.

scholarly journals Changes in work stress among doctors in Norway from 2010 to 2019: a study based on repeated surveys

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Rosta ◽  
O G Aasland ◽  
K Isaksson Rø
Keyword(s):  
Health Care ◽  
Sickness Absence ◽  
Work Stress ◽  
Time Pressure ◽  
Short Form ◽  
Age Groups ◽  
Good Health ◽  
Health Care Reforms ◽  
Reward Imbalance

Abstract Background Changes in the organization of health care can influence the doctors` working conditions, which may in turn impact on doctors` perception of work stress. Since high levels of work stress can affect both the doctors’ own health and the quality of patient care, it is of importance for public health. We studied changes in work stress among Norwegian doctors from 2010 to 2018-19, and the associations of high work stress with job positions, self-rated health and sickness absence in 2018-19. Methods The study populations consisted of representative samples of 1,500 to 2,200 doctors working as hospital doctors, general practitioners (GPs), private practice specialists and doctors in academia. Data were drawn from nationwide repeated postal surveys in 2010, 2016 and 2018-19 in Norway. Response rates were between 67%-73%. The main outcome measure was perception of work stress as measured by the validated short form of the Effort-Reward Imbalance Questionnaire (ERI). Linear mixed models, proportions with 95% confidence intervals and logistic regression model were used in the analyses. Results From 2010 to 2018-19, the scores on the effort items (time pressure, responsibility, demands) increased significantly and the scores on the reward items (recognition, job stability, promotion prospects, prestige) decreased significantly for GPs, but remained stable for doctors in other positions. The proportion of doctors with high levels of work stress increased significantly for GPs. In 2018-19, high levels of work stress were associated with being a GP as compared with other job positions, younger age groups, average or poor health vs. very good or good health, but not with sickness absence or gender. Conclusions During a nine-year-period, work stress increased significantly for GPs, but remained stable for other job positions. This may be partly due to several health care reforms. Less work stress may improve both the doctors` own health and the quality of health care. Key messages From 2010 to 2018-19 in Norway, the proportion of GPs with high levels of work stress increased, while it remained stable for doctors in other job positions. This study supports previous findings on the association between high levels of work stress and health.

scholarly journals ‘Life in the Travelling Circus’: A Study of Loneliness, Work Stress, and Money Issues in Touring Professional Golf

2017 ◽  
Vol 34 (2) ◽  
pp. 148-159 ◽  
Author(s):  
John Fry ◽  
Daniel Bloyce
Keyword(s):  
Social Support ◽  
Work Stress ◽  
Well Being ◽  
Decision Latitude ◽  
Personal Problems ◽  
Work Related ◽  
Effort Reward Imbalance ◽  
Reward Imbalance ◽  
Professional Golfers ◽  
Health And Well Being

This article examines the effects of globalization on the well-being of migrant professional athletes. Interviews with 20 touring professional golfers reveal that players experience many of the personal problems—such as loneliness, isolation, low decision latitude, low social support, and effort-reward imbalance—which have been identified as “strong predictors of mental ill-health” (Leka & Jain, 2010, p. 65). Feelings of loneliness and isolation developed as players were regularly apart from family and friends, and spent most of their time with other golfers whom they had somewhat superficial relationships with. These feelings coupled with, for many, uncertain income generated through golf added further to their work-related anxieties. Overall, results highlight the importance of considering how workplace anxieties and vulnerabilities impact on athlete migrants’ health and well-being.

scholarly journals Effort–reward imbalance at work, over-commitment personality and diet quality in Central and Eastern European populations

2016 ◽  
Vol 115 (7) ◽  
pp. 1254-1264 ◽  
Author(s):  
Sung-Wei Chen ◽  
Anne Peasey ◽  
Denes Stefler ◽  
Sofia Malyutina ◽  
Andrzej Pajak ◽  
...  
Keyword(s):  
Work Stress ◽  
Diet Quality ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Men And Women ◽  
Dietary Guideline ◽  
Effort Reward Imbalance ◽  
Unhealthy Diet ◽  
Reward Imbalance

AbstractThe aims of this study were to investigate the associations between work stress defined by the effort–reward imbalance (ERI) model and diet quality and to examine the potential role of over-commitment (OC) personality in ERI–diet relationships. A cross-sectional study was conducted in random population samples of 6340 men and 5792 women (age 45–69 years) from the Czech Republic, Russia and Poland. Dietary data were collected using FFQ. The healthy diet indicator (HDI) was constructed using eight nutrient/food intakes (HDI components) to reflect the adherence to WHO dietary guideline. The extent of imbalance between effort and reward was measured by the effort:reward (ER) ratio; the effort score was the numerator and the reward score was multiplied by a factor adjusting for unequal number of items in the denominator. Logistic regression and linear regression were used to assess the associations between exposures (ER ratio and OC) and outcomes (HDI components and HDI) after adjustment for confounders and mediators. The results showed that high ER ratio and high OC were significantly associated with unhealthy diet quality. For a 1-sd increase in the ER ratio, HDI was reduced by 0·030 and 0·033 sd in men and women, and for a 1-sd increase in OC, HDI was decreased by 0·036 and 0·032 sd in men and women, respectively. The modifying role of OC in ERI–diet relationships was non-significant. To improve diet quality at workplace, a multiple-level approach combining organisational intervention for work stress and individual intervention for vulnerable personality is recommended.

scholarly journals 1175Work stress and loss of years lived without chronic disease; an 18-year prospective cohort study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Jeppe K. Sørensen ◽  
Elisabeth Framke ◽  
Jacob Pedersen ◽  
Kristina Alexanderson ◽  
Jens P. Bonde ◽  
...  
Keyword(s):  
Cohort Study ◽  
Chronic Disease ◽  
High Risk ◽  
Life Expectancy ◽  
Work Stress ◽  
Job Strain ◽  
Low Risk ◽  
Effort Reward Imbalance ◽  
Reward Imbalance ◽  
Disease Free

Abstract Background Aim: To examine the association of work stress with future chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. Method A population-based prospective register-based cohort study of all employees aged 30-59 in 2000 in Denmark, without chronic diseases at baseline (n = 1,592,491). Using job exposure matrices, we assessed exposure to work stress by a combined measure of job strain and effort-reward imbalance. We estimated the risk of incident hospital-diagnosed chronic disease or death (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and corresponding chronic disease-free life expectancy. Results Individuals working in occupations with high risk of both job strain and effort-reward imbalance had a slightly higher risk of future incident chronic disease compared to those in occupations with low risk of both stressors. The hazard ratio was 1.04 (95% CI 1.02 to 1.05) in women and 1.12 (95% CI 1.11 to 1.14) in men. The corresponding loss in chronic disease-free life expectancy was 0.25 years in women and 0.84 years in men. Conclusion Working in occupations with a high risk of work stress was associated with a small loss of years lived without chronic disease compared to working in occupations with low risk of work stress. Key messages According to our findings, employees in occupations with high risk of work stress live slightly shorter lives free of chronic diseases compared to employees in occupations with low risk of work stress.

scholarly journals Work stress, migration background and risk of long-term sickness absence in Denmark

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Rugulies ◽  
J K Sørensen ◽  
I E H Madsen ◽  
M Nordentoft ◽  
K Sørensen ◽  
...  
Keyword(s):  
Sickness Absence ◽  
Work Stress ◽  
Migration Background ◽  
Self Report ◽  
Increased Risk ◽  
Effort Reward Imbalance ◽  
Reward Imbalance ◽  
Prevention Activities

Abstract Background Work stress may increase risk of long-term sickness absence, but little is known if this association differs by migration background. In this study, we examined the prospective association between effort-reward imbalance at work and risk of long-term sickness absence in individuals with and without migration background in the Danish workforce. Methods We included 59,468 respondents from a nationwide survey on work and health, 3,226 with a migration background (immigrants or first generation descendants of immigrants) and 56,242 without a migration background. Effort-reward imbalance was assessed by self-report. Migration background and long-term sickness absence (spells ≥6 weeks) were assessed by national register data. Using Cox regression, we estimated the association between effort-reward imbalance and onset of long-term sickness absence during 12 months follow-up separately for participants with and without a migration background, adjusted for age, sex, education and previous long-term sickness absence. Results The effort-reward imbalance score at baseline was similar for respondents with and without a migration background. The hazard ratio for long-term sickness absence during follow-up per 1 standard deviation increment in effort-reward imbalance at baseline was 1.26 (95% CI: 1.16-1.37) and 1.16 (95% CI: 1.13-1.20) for respondents with and without a migration background, respectively. Conclusions Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. Although the estimate was higher in workers with a migration background, confidence intervals overlapped indicating that associations were similar in both groups. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence should not be prioritized by migration background but should be offered to the whole workforce. Key messages Work stress, measured by effort-reward imbalance, is associated with an increased risk of long-term sickness absence in workers with and without a migration background in Denmark. The results suggest that prevention activities on effort-reward imbalance and long-term sickness absence activities should be offered to the whole workforce.

scholarly journals Effort-Reward Imbalance, Over-Commitment and Depressive Episodes at Work: Evidence from the ELSA-Brasil Cohort Study

2019 ◽  
Vol 16 (17) ◽  
pp. 3025 ◽  
Author(s):  
Tânia Maria de Araújo ◽  
Johannes Siegrist ◽  
Arlinda B. Moreno ◽  
Maria de Jesus Mendes da Fonseca ◽  
Sandhi M. Barreto ◽  
...  
Keyword(s):  
Latin American ◽  
Work Stress ◽  
Prevalence Ratio ◽  
Developed Countries ◽  
Additive Interaction ◽  
Cross Sectional ◽  
R Ratio ◽  
Effort Reward Imbalance ◽  
Reward Imbalance ◽  
Depressive Episodes

A growing burden of mental illness, and in particular depression, among workers is a concern of occupational public health. Scientific evidence has revealed consistent associations of work-related stress, as measured by theoretical models, with depression, but mostly so in developed countries. This contribution explores these associations in a developing Latin American country, Brazil, by applying an internationally established work stress model, the effort-reward imbalance (ERI). This model focuses on the work contract where unjust exchange between high efforts spent and low rewards received in turn contributes to stress-related disorders. The model’s extrinsic (‘effort’, ‘reward’) and intrinsic components (‘over-commitment’), as well as their combination, are hypothesized to be related to a higher risk of depressive episodes (DE). Using cross-sectional data from the ELSA-Brasil study, including 10,034 workers from the public sector, we observed increased prevalence ratio (PR) of DE according to ERI scales. The quartiles of highest ‘effort’ (PR = 1.85; 1.44–2.37), highest ‘over-commitment’ (PR = 3.62; 2.80–4.70) and lowest ‘reward’ (PR = 3.44; 2.55–4.64) were associated with DE, on adjusted models, as well was the E–R ratio (PR = 2.47; 1.92–3.17). An additive interaction was identified between the E–R ratio and ‘over-commitment’. The results support the use of ERI as a screening tool for work stress in the Brazilian context and will offer guidance for worksite health promotion programs.

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