How are social stressors at work related to well-being and health? A systematic review and meta-analysis.

BACKGROUND: Social relationships are crucial for well-being and health, and considerable research has established social stressors as a risk for well-being and health. However, researchers have used many different constructs, and it is unclear if these are actually different or reflect a single overarching construct. Distinct patterns of associations with health/well-being would indicate separate constructs, similar patterns would indicate a common core construct, and remaining differences could be attributed to situational characteristics such as frequency or intensity. The current meta-analysis therefore investigated to what extent different social stressors show distinct (versus similar) patterns of associations with well-being and health. METHODS: We meta-analysed 557 studies and investigated correlations between social stressors and outcomes in terms of health and well-being (e.g. burnout), attitudes (e.g. job satisfaction), and behaviour (e.g. counterproductive work behaviour). Moderator analyses were performed to determine if there were differences in associations depending on the nature of the stressor, the outcome, or both. To be included, studies had to be published in peer-reviewed journals in English or German; participants had to be employed at least 50% of a full-time equivalent (FTE). RESULTS: The overall relation between social stressors and health/well-being was of medium size (r = -.30, p < .001). Type of social stressor and outcome category acted as moderators, with moderating effects being larger for outcomes than for stressors. The strongest effects emerged for job satisfaction, burnout, commitment, and counterproductive work behaviour. Type of stressor yielded a significant moderation, but differences in effect sizes for different stressors were rather small overall. Rather small effects were obtained for physical violence and sexual mistreatment, which is likely due to a restricted range because of rare occurrence and/or underreporting of such intense stressors. CONCLUSIONS: We propose integrating diverse social stressor constructs under the term "relational devaluation" and considering situational factors such as intensity or frequency to account for the remaining variance. Practical implications underscore the importance for supervisors to recognize relational devaluation in its many different forms and to avoid or minimize it as far as possible in order to prevent negative health-related outcomes for employees.

Caught Between Autonomy and Insecurity: A Work-Psychological View on Resources and Strain of Small Business Owners in Germany.

While research on personality factors and economic success of entrepreneurs has flourished over the years, studies on their specific working conditions and their impact on health and career are surprisingly scarce. This study used a qualitative approach to comprehensively mirror the working situation of German small business owners. To reflect the broadness of this employment type and avoid sampling bias, we applied a quota sampling strategy based on a preliminary typology of solo self-employed respondents we derived from a large quantitative survey. We investigated 29 small business owners who reported, for example, on health complaints, recovery opportunities, and obstacles and resources while running their businesses. Thematic analysis was employed to develop a specific frame model for small business owners based on established work-related stress theories which allowed us to derive concrete hypotheses for further quantitative research. The main results emphasized the meaning of active actions and the workers' own responsibility for creating working conditions and enabling autonomy. Besides personal preferences regarding the chosen career path, marketability, flexibility, and social networks played a role and explained health and career issues. When it came to practical implications, voluntariness played an essential role for selecting this specific career path. Those being pushed into self-employment as their only viable job opportunity should receive particular support through career counseling to sustain their health.

The workday of hospital surgeons: what they do, what makes them satisfied, and the role of core tasks and administrative tasks; a diary study.

BACKGROUND: Many surgeons report passion for their work, but not all tasks are likely to be satisfying. Little is known about how hospital surgeons spend their days, how they like specific tasks, and the role of core tasks (i.e. surgery-related tasks) versus tasks that may keep them from core tasks (e.g., administrative work). This study aimed at a more detailed picture of hospital surgeons' daily work - how much time they spend with different tasks, how they like them, and associations with satisfaction. METHODS: Hospital surgeons (N = 105) responded to a general survey, and 81 of these provided up to five daily questionnaires concerning daily activities and their attractiveness, as well as their job satisfaction. The data were analyzed using t-tests, analysis of variance, as well as analysis of covariance and repeated measures analysis of variance for comparing means across tasks. RESULTS: Among 14 tasks, surgery-related tasks took 21.2%, patient-related tasks 21.7% of the surgeons' time; 10.4% entailed meetings and communicating about patients, and 18.6% documentation and administration. The remaining time was spent with teaching, research, leadership and management, and not task-related activities (e.g. walking between rooms). Surgery was rated as most (4.25; SD = .66), administration as least attractive (2.63; SD = .78). A higher percentage of administration predicted lower perceived legitimacy; perceived legitimacy of administrative work predicted job satisfaction (r = .47). Residents were least satisfied; there were few gender differences. CONCLUSIONS: Surgeons seem to thrive on their core tasks, most notably surgery. By contrast, administrative duties are likely perceived as keeping them from their core medical tasks. Increasing the percentage of medical tasks proper, notably surgery, and reducing administrative duties may contribute to hospital surgeons' job satisfaction.

Interruptions, Unreasonable Tasks, and Quality-Threatening Time Pressure in Home Care: Linked to Attention Deficits and Slips, Trips, and Falls.

BACKGROUND: In industrial countries, home care of community dwelling elderly people is rapidly growing. Frequent injuries in home caregivers result from slips, trips, and falls (STFs). The current study tests attentional cognitive failure to mediate the association between work stressors and STFs. METHODS: A sample of 125 home caregivers participated in a questionnaire study and reported work interruptions, unreasonable tasks, quality-threatening time pressure, conscientiousness, attentional cognitive failures, and STFs. RESULTS: In structural equation modeling, the mediation model was shown to fit empirical data. Indirect paths with attentional cognitive failures as the link between work stressors and STF were all significant in bootstrapping tests. An alternative accident-prone person model, that suggests individual differences in conscientiousness to predict attentional cognitive failures that predict more frequent work stressors and STFs, showed no significant paths between work conditions and STFs. CONCLUSION: To prevent occupational injury, work should be redesigned to reduce work interruptions, unreasonable tasks, and quality-threatening time pressure in home care.

Time Pressure, Time Autonomy, and Sickness Absenteeism in Hospital Employees: A Longitudinal Study on Organizational Absenteeism Records.

BACKGROUND: Although work absenteeism is in the focus of occupational health, longitudinal studies on organizational absenteeism records in hospital work are lacking. This longitudinal study tests time pressure and lack of time autonomy to be related to higher sickness absenteeism. METHODS: Data was collected for 180 employees (45% nurses) of a Swiss hospital at baseline and at follow-up after 1 year. Absent times (hours per month) were received from the human resources department of the hospital. One-year follow-up of organizational absenteeism records were regressed on self-reported job satisfaction, time pressure, and time autonomy (i.e., control) at baseline. RESULTS: A multivariate regression showed significant prediction of absenteeism by time pressure at baseline and time autonomy, indicating that a stress process is involved in some sickness absenteeism behavior. Job satisfaction and the interaction of time pressure and time autonomy did not predict sickness absenteeism. CONCLUSION: Results confirmed time pressure and time autonomy as limiting factors in healthcare and a key target in work redesign.

Impaired sleep predicts onset of low back pain and burnout symptoms: evidence from a three-wave study.

In a three-wave questionnaire study of 405 working participants, who were initially free of low back pain (LBP) and emotional exhaustion, sleep problems were evaluated as a potential risk factor for the development of LBP and burnout up to three years later. Prospective risk paths were compared between the sexes and between two age-groups (18 to 45 years and older than 45 years). A longitudinal structural equation model showed a good fit with empirical data (RMSEA = .04, SRMR = .06, CFI = .97). Prospective risk paths between the latent constructs showed sleep problems to significantly predict self-reported LBP (ß = .15, p = .011) and burnout (ß = .24, p < .001) two years later. Sleep problems also predicted the occurrence of burnout three years later (ß = .18, p = .002). Sleep-related risk of burnout after two years was greater in older than younger participants (ßolder = .42 vs. ßyounger = .13, p < .001). Sleep problems seem to precede LBP and burnout in working individuals. Health promotion initiatives should use sleep quality as an important early risk indicator, and interventions should focus on promoting better quality sleep, in an attempt to reduce the incidence of LBP and burnout.

Teacher's sleep quality: linked to social job characteristics?

Besides dealing with high workload, being a teacher is challenging with respect to the social context. There is increasing evidence that adverse social job characteristics challenge sleep quality. The current study tests whether restraint sleep quality (defined as worse sleep quality before than during vacation) is related to time-related job stressors, job resources, and social job characteristics. Forty-eight elementary school teachers (42% women) participated both during the last week before and the first week after vacation. Before vacation, teachers were asked for demographics and working conditions with reference to the last 30 d, and sleep quality with reference to the last 7 d. After vacation sleep quality during vacation was assessed and used as reference for working time sleep quality. Results showed mean levels of sleep quality increased during vacation. In teachers with restrained working time sleep quality (38%), experiences of failure at work, social exclusion, and emotional dissonance were more frequent than in teachers with unrestrained working time sleep quality (Ps<0.05). Groups did not differ in time-related stressors, time control and social support from supervisors. Emotion work, social exclusion and individual experience of failure seem to challenge sleep quality in teachers.

The More, the Better?! Multiple vs. Single Jobholders' Job Satisfaction as a Matter of Lacked Information.

In recent decades, the working world has changed dramatically and rising demands on flexibility make the coordination of personal and professional life more difficult. Therefore, it is important that the incumbents are in possession of all necessary information concerning their job. This might be a key issue to remain satisfied. Simultaneously, atypical forms of employment have substantially increased in the labor market; one such form is holding more than one job. While the motives might differ from needing an additional income to broadening job opportunities, practicing several jobs requires coordination and thus, being informed. Building on research regarding organizational constraints and role ambiguity, we hypothesize that the paucity of information is negatively related to (dimensions of) job satisfaction. This effect should be stronger for multiple as compared to single jobbers; specifically when considering the job satisfaction with the social climate, given that being informed by others is an important factor in the coordination of several jobs. Data taken from the BiBB/BAuA-Employment-Survey provide a sample of 17,782 German employees (54% women), including 1,084 multiple jobbers (59% women). Job satisfaction was measured as employees global satisfaction and their satisfaction with facets dimensions: the social climate, structural working conditions, personal growth opportunities, and material incentives they receive for their work. Paucity of information was measured by the frequency of lacked information. Our study indicated that paucity of information was negatively related to both, global and all facets dimensions of job satisfaction. Multiple regression analyses further revealed interaction effects of paucity of information and form of employment. Specifically, the negative correlation of paucity of information with global as well as satisfaction with the social climate was stronger for employees' holding more than one job. These results were independent of age, gender, organizational tenure, working hours, socioeconomic occupational status, as well as important working conditions (workload and autonomy). Incumbents with less paucity of necessary job-related information are more satisfied, especially when they hold multiple jobs. Supervisors and colleagues are advised to provide all necessary information and to ensure that employees retain it.

Thirst at Work Implies More Than Just Inadequate Facilities for Breaks.

Early signs of dehydration, such as headaches, are not unusual in the working population. Even slight deficiencies of water intake may have negative effects on both health and performance. However, little is known about work-related fluid intake. We expect the daily experience of interruptions to distract from perceived thirst, resulting in reduced daily fluid intake. This effect may be more pronounced when the workload is generally less predictable due to the assignment of tasks that are beyond the definition of the worker's professional role (unreasonable tasks). Data were gathered from 29 female service employees across five workdays. Multilevel analyses revealed daily work interruptions to be negatively associated with fluid intake, especially when there were frequent unreasonable task-assignments. Results suggest that interruptions at work might reduce daily fluid intake. However, adequate allocation of tasks by managers can protect employees against insufficient drinking.

Stress at School? A Qualitative Study on Illegitimate Tasks during Teacher Training.

What do I expect when stating that "I am going to be a teacher"? Social roles, including professional roles, often become part of people's identity and thus, of the self. As people typically strive for maintaining a positive sense of self, threats to one's role identity are likely to induce stress. In line with these considerations, Semmer et al. recently (e.g., Semmer et al., 2007, 2015) introduced "illegitimate tasks" as a new concept of stressors. Illegitimate tasks, which are defined as unnecessary or unreasonable tasks, threaten the self because they signal a lack of appreciation regarding one's professional role. Teacher training is a phase of role transition in which the occurrence of illegitimate tasks becomes likely. A holistic understanding of these tasks, however, has been missing up to now. Is there already a professional role identity during teacher training that is vulnerable to threats like the illegitimacy of tasks? What are typical illegitimate tasks in the context of teacher training? In order to close this research gap, 39 situations taken from 16 interviews with teaching trainees were analyzed in the present study on the basis of qualitative content analysis. Seminars and standing in to hold lessons for other teachers were identified as most prevalent illegitimate tasks. More specifically, unnecessary tasks could be classified as sub challenging, inefficient and lacking in organization (e.g., writing reports about workshops no one will ever read). Unreasonable tasks appeared overextending, fell outside responsibility, and lacked supervisory support. Training interventions focusing upon task design and supervisory behavior are suggested for improvement.

Social stress at work and change in women's body weight.

Social stressors at work (such as conflict or animosities) imply disrespect or a lack of appreciation and thus a threat to self. Stress induced by this offence to self might result, over time, in a change in body weight. The current study investigated the impact of changing working conditions--specifically social stressors, demands, and control at work--on women's change in weighted Body-Mass-Index over the course of a year. Fifty-seven women in their first year of occupational life participated at baseline and thirty-eight at follow-up. Working conditions were assessed by self-reports and observer-ratings. Body-Mass-Index at baseline and change in Body-Mass-Index one year later were regressed on self-reported social stressors as well as observed work stressors, observed job control, and their interaction. Seen individually, social stressors at work predicted Body-Mass-Index. Moreover, increase in social stressors and decrease of job control during the first year of occupational life predicted increase in Body-Mass-Index. Work redesign that reduces social stressors at work and increases job control could help to prevent obesity epidemic.

Occupational role stress is associated with higher cortisol reactivity to acute stress.

We investigated whether occupational role stress is associated with differential levels of the stress hormone cortisol in response to acute psychosocial stress. Forty-three medication-free nonsmoking men aged between 22 and 65 years (mean ± SEM: 44.5 ± 2) underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience. We assessed occupational role stress in terms of role conflict and role ambiguity (combined into a measure of role uncertainty) as well as further work characteristics and psychological control variables including time pressure, overcommitment, perfectionism, and stress appraisal. Moreover, we repeatedly measured salivary cortisol and blood pressure levels before and after stress exposure, and several times up to 60 min thereafter. Higher role uncertainty was associated with a more pronounced cortisol stress reactivity (p = .016), even when controlling for the full set of potential confounders (p < .001). Blood pressure stress reactivity was not associated with role uncertainty. Our findings suggest that occupational role stress in terms of role uncertainty acts as a background stressor that is associated with increased HPA-axis reactivity to acute stress. This finding may represent a potential mechanism regarding how occupational role stress may precipitate adverse health outcomes.

Illegitimate tasks associated with higher cortisol levels among male employees when subjective health is relatively low: an intra-individual analysis.

OBJECTIVES: Illegitimate tasks refer to tasks that do not conform to what can appropriately be expected from an employee. Violating role expectations, they constitute "identity-stressors", as one's professional role tends to become part of one's identity. The current study investigated the impact of illegitimate tasks on salivary cortisol. We analyzed data on an intra-individual level, that is, by examining fluctuations in illegitimate tasks and cortisol within individuals. Furthermore, we investigated the moderating role of perceived health, expecting that illegitimate tasks evoke stronger reactions when perceived health is relatively poor. METHODS: Illegitimate tasks, salivary cortisol, and perceived health were assessed in each of three waves (time lag: 6 months) in a sample of 104 male employees. Data were analyzed by multilevel analysis using group mean centering. RESULTS: Controlling for social stressors, work interruptions, and emotional stability, the experience of more illegitimate tasks was associated with increased cortisol release if personal health resources were low compared to one's mean value of perceived health. Results cannot be explained by inter-individual differences. CONCLUSIONS: This is the first study showing that illegitimate tasks predict a biological indicator of stress, thus confirming and extending previous research on illegitimate tasks. The moderating role of perceived health confirms its importance as a personal resource, implying augmented vulnerability when perceived health is below its usual value. It is plausible to assume that increased stress reactions due to relatively poor health may further weaken available personal resources. Both avoiding illegitimate tasks and restoring personal health seem to be crucial.