Correlation analysis of occupational stress and metabolic syndrome among employees of a power grid enterprise in China.

BACKGROUND: Being in a state of high occupational stress may disrupt the metabolic balance of the body, thus increasing the risk of metabolic diseases. However, the evidence about the relationship between occupational stress and metabolic syndrome was limited. OBJECTIVES: To explore the association between occupational stress and metabolic syndrome (MetS) in employees of a power grid enterprise. METHODS: A total of 1091 employees were recruited from a power grid enterprise in China. Excluding those who failed to complete the questionnaire and those who had incomplete health check-ups, 945 subjects were included in the study. Assessment of occupational stress was used by job demand-control (JDC) and effort-reward imbalance (ERI) questionnaires, respectively. The information on body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were collected. The levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and fasting blood glucose (FBG) in the fasting venous blood samples were measured. Logistic regression analysis and multiple linear regression methods were used to analyze the correlation between JDC and ERI models of occupational stress, metabolic syndrome, and its components, respectively. RESULTS: The prevalence of MetS was 8.4% and 9.9% in JDC and ERI model high occupational stress employees, respectively. ERI model occupational stress and smoking are significantly associated with the risk of MetS. ERI ratio was significantly associated with lower HDL-C levels. Gender, age, marital status, smoking, high-temperature and high-altitude work were significantly associated with metabolic component levels. CONCLUSION: Our study revealed a high detection rate of occupational stress in both JDC and ERI models among employees of a power grid enterprise. ERI model occupational stress, demanding more attention, was associated with the risk of MetS as well as its components such as HDL-C.

The relationship between effort-reward imbalance and quality of working life among medical caregivers: mediating effects of job burnout.

Background: To determine the relationship between effort-reward imbalance (ERI) and quality of working life (QWL) among medical caregivers and the mediating role of job burnout. Methods: This was a cross-sectional survey. A total of 787 medical caregivers at seven hospitals from Sichuan and Chongqing, China, between May to September 2023 were included in this observational study. The General Information Questionnaire, Effort-Reward Imbalance Questionnaire (ERI), Maslach Burnout Inventory-General Survey (MBI-GS), and Quality of Working Life Scale (QWL7-32) were used for data collection. SPSS 26.0 and PROCESSv3.3 were used for all data analyses, including descriptive statistics. Results: A total of 820 questionnaires were distributed, of which only 787 were valid (return rate; 95.98%). The QWL score of medical caregivers was 126.94 ± 16.69. However, QWL scores were significantly different depending on age, number of children, family support status, department, years of experience, night shift status, number of night shifts per month, number of hours worked per day, monthly income, and occurrence of errors or adverse events (p < 0.05). Furthermore, job burnout and ERI were negatively correlated with QWL (p < 0.01). Job burnout mediated (95% CI = -0.365, -0.260) the relationship between ERI and QWL, accounting for 58.65% of the total effect. Conclusion: Medical caregivers have a medium level of QWL. Job burnout partially mediates the relationship between ERI and QWL. Medical caregiver managers can improve QWL by directly intervening in occupational stress and indirectly intervening in job burnout.

The burdens and benefits of managing and engaging: a diary study approach to person-centred risk assessment of top executives and works council members.

The present diary study investigates the impact of daily effort-reward imbalance (ERI), subjective stress and the cortisol awakening response (CAR) as an objective measure on work engagement of top managers and high-level works council members (N = 45) on three consecutive working days. In the scope of psychosocial risk assessment, we argue that focusing on ERI as a generalized work characteristic might be more suitable for work re-design of higher leadership positions because of their highly dynamic and unpredictable psychosocial work characteristics, while at the same time having more access to job resources. The analyses reveal that both baseline and daily ERI, as well as subjective stress, influence work engagement. Our results suggest that interventions to reduce daily levels of ERI may improve the work environment of top managers and works councils by promoting work engagement and related positive health outcomes in the scope of person-centred risk assessment.

Incidence of effort-reward imbalance among nurses: a systematic review and meta-analysis.

Introduction: To systematically evaluate the incidence of effort-reward imbalance among nurses. Method: PubMed, Web of Science, Embase, CNKI, WanFang Data, and VIP databases were searched to collect studies on the incidence of effort-reward imbalance among nurses. The search timeframe was from database construction to December 2023. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. The meta-analysis was performed using Stata 17.1 software. Results: A total of 60 studies, including 79,644 participants, were included. The prevalence of effort-reward imbalance among nurses was 52.3% (95% CI: 44.9-59.7%). In terms of time, the incidence of effort-reward imbalance among nurses before 2010 (26.6, 95%CI: 6.8-46.4%) and in 2010-2015 (42.4, 95%CI: 32.1-52.8%), 2016-2020 (60.2, 95%CI: 49.6-70.7%), and 2021-2023 (65.0, 95%CI: 51.5-78.4%) continued to increase. Geographically, Asia (57.4, 95%CI: 51.8-63.1%) nurses had a relatively higher prevalence of effort-reward imbalance. In terms of department, the incidence of effort-reward imbalance among nurses was relatively higher in operating rooms (71.8, 95%CI: 64.5-79.0%), ICU (64.6, 95%CI: 27.7-100.0%), emergency (68.7, 95%CI: 62.9-74.5%), and pediatrics (65.8, 95%CI: 32.2-99.3%). Discussion: The prevalence of nurse effort-reward imbalance is high, and there are differences in its prevalence across time, geography, department. Hospital administrators should actively take measures to effectively prevent and reduce the effort-reward imbalance for nurses, especially for nurses in Asia, operating rooms, emergency pediatrics and ICU departments. Systematic review registration: PROSPERO (CRD42023452428).

Impact of Effort-Reward Imbalance and Burnout on the Compliance with Standard Precautions among Nurses and Midwives in Lebanese Hospitals.

BACKGROUND: Effort-reward imbalance (ERI) refers to the situation where there is a mismatch between the effort that healthcare workers (HCWs) put into their work and the rewards they receive in return. Burnout, on the other hand, is a psychological syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. This study aimed to assess the impact of ERI and burnout on the compliance with standard precautions (SPs) among nurses and midwives in Lebanese hospitals under the economic crisis and after the COVID-19 pandemic. METHODS: Cross-sectional correlational study, based on self-administered questionnaire data, measuring the compliance with SPs, ERI, and burnout, in addition to the relationship between these factors, was performed among 409 nurses and midwives, working in Lebanese hospitals. RESULTS: ERI was significantly associated with exposure to burnout among nurses and midwives, and burnout was found to be a significant predictor of nurses and midwives' self-reported adherence with SPs. CONCLUSIONS: This study highlights the contribution of ERI and burnout to the chain of infection by decreased adherence to infection control SPs of nurses and midwives.

Effort-reward imbalance and common mental disorders among public sector employees of Iran: a cross-sectional analysis.

BACKGROUND: The effort-reward imbalance (ERI) model is a widely used theoretical model to measure stress in the workplace. The objective of this study was to investigate the relationship between ERI and three common mental disorders: major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). METHODS: In this cross-sectional analysis, the study sample consisted of 4453 baseline participants of the Employees' Health Cohort Study of Iran (EHCSIR). Trained psychologists utilized the Persian version of the Composite International Diagnostic Interview (CIDI-2.1) during the baseline assessment to identify common mental disorders. Additionally, the validated Persian version of the 23-item ERI questionnaire was employed to assess effort, reward, overcommitment, and effort-reward ratio. To examine the association of ERI components with three common mental disorders (MDD, GAD, and OCD) over the past twelve months, multiple logistic regression analyses were conducted. RESULTS: The prevalence of effort-reward imbalance in the study sample was 47.1%. Higher ERI score was significantly associated with MDD (OR: 3.43, 95% CI: 2.30-5.13), GAD (OR: 2.42, 95% CI: 1.27-4.63), and OCD (OR: 2.23, 95% CI:1.19-4.19). The study participants who reported higher scores on work overcommitment had a higher likelihood of having MDD (OR: 1.16, 95% CI:1.10-1.23), GAD (OR: 1.07, 95% CI: 1.01-1.14), and OCD (OR: 1.19, 95% CI: 1.09-1.29). CONCLUSIONS: According to the study's findings, work-related stress, as determined by the ERI model, is a significant factor in the development of common mental disorders among employees in the public sector.

The Relationship Between Work-Related Stress and Depression: A Scoping Review.

Objectives: Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge. Methods: We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria. Results: Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified. Conclusion: The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

Work stress and changes in heart rate variability among employees after first acute coronary syndrome: a hospital-based longitudinal cohort study.

Background: Work stress is considered as a risk factor for coronary heart disease, but its link with heart rate variability (HRV) among heart attack survivors is unknown yet. The aim of this study was to investigate associations between baseline work stress and the changes of HRV over one-year after onset of acute coronary syndrome (ACS). Methods: Hundred and twenty-two patients with regular paid work before their first ACS episode were recruited into this hospital-based longitudinal cohort study. During hospitalization (baseline), all patients underwent assessments of work stress by job strain (JS) and effort-reward imbalance (ERI) models, and were assigned into low or high groups; simultaneously, sociodemographic and clinical data, as well depression, anxiety, and job burnout, were collected. Patients were followed up 1, 6, and 12 months after discharge, with HRV measurements at baseline and each follow-up point. Generalized estimating equations were used to analyze the effects of baseline work stress on HRV over the following 1 year. Results: After adjusting for baseline characteristics and clinical data, anxiety, depression, and burnout scores, high JS was not associated with any HRV measures during follow-up (all p > 0.10), whereas high ERI was significantly related to slower recovery of 5 frequency domain HRV measures (TP, HF, LF, VLF, and ULF) (all p < 0.001), and marginally associated with one time domain measure (SDNN) (p = 0.069). When mutually adjusting for both work stress models, results of ERI remained nearly unchanged. Conclusion: Work stress in terms of ERI predicted lower HRV during the one-year period after ACS, especially frequency domain measures.

The overall fractions of coronary heart diseases and depression attributable to multiple dependent psychosocial work factors in Europe.

OBJECTIVES: The literature is nonexistent on the assessment of overall fractions of diseases attributable to multiple dependent psychosocial work factors. The objectives of the study were to calculate the overall fractions of coronary heart diseases (CHD) and depression attributable to multiple dependent psychosocial work factors in 35 European countries. METHODS: We used already published fractions of CHD and depression attributable to each of the following psychosocial work factors: job strain, effort-reward imbalance, job insecurity, long working hours, and workplace bullying. We took all exposures and their correlations into account to calculate overall attributable fractions. Wald tests were performed to test differences in these overall attributable fractions between genders and between countries. RESULTS: The overall fractions of CHD and depression attributable to all studied psychosocial work factors together were found to be 8.1% [95% CI: 2.0-13.9] and 26.3% [95% CI: 16.2-35.5] respectively in the 35 European countries. There was no difference between genders and between countries. CONCLUSION: Our study showed that the overall fractions attributable to all studied psychosocial work factors were substantial especially for depression. These overall attributable fractions may be particularly useful to evaluate the burden and costs attributable to psychosocial work factors, and also to inform policies makers at European level.

Evaluating the association between effort-reward imbalance and suboptimal health status among hospital nurses: a cross-sectional study.

OBJECTIVES: Occupational stress is a common complaint in nurses, who perceived more sense of effort-reward imbalance (ERI). Suboptimal health status (SHS) is a state between health and disease. However, the correlation between ERI and SHS is unclear. Therefore, the aim of this study was to examine the prevalence of SHS and ERI and evaluate the relationship between ERI and SHS in clinical nurses by a cross-sectional study. MATERIAL AND METHODS: The current cross-sectional study was conducted through an online survey at Dongping People's Hospital in China. A total of 633 completed surveys were received. Effort-reward imbalance was measured by subscales of the ERI questionnaire. SHS was measured by the Suboptimal Health Status Questionnaire - 25 (SHSQ-25). The relationship between ERI and SHS in nurses was subsequently assessed by Spearman's correlation coefficient and logistic regression model. RESULTS: The mean age of the optimal health status (OHS) group (M±SD 26.3±7.3 years) was younger than the SHS group (M±SD 30.3±6.9 years). The prevalence of SHS was 54.5% (345/633). Female nurses aged ≥30 years, a junior college or university graduate educational level, smokers, and nurses without regular exercise were at a higher risk of SHS. In Spearman's correlation analysis, ERI reflected by the effort-reward ratio was correlated with SHSQ-25 score (r = 0.662, p < 0.001). In logistic regression, ERI was strongly associated with SHS after potential confounding factors adjusting (OR 27.924, 95% CI 22.845-34.132). CONCLUSIONS: The prevalence of SHS was significantly high in clinical nurses. Administrators should pay more attention to health status of female nurses aged ≥30 years, with a junior college or bachelor's degree, smoking, and without regular exercise to reduce the SHS and ERI. Int J Occup Med Environ Health. 2024;37(2):166-75.

Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress.

BACKGROUND: Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers. METHODS: A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components. RESULTS: A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG. CONCLUSIONS: The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

Association between organizational justice and serious psychological distress among hospital nursing staff during the COVID-19 pandemic: A cross-sectional study.

AIM: Amidst the COVID-19 pandemic, the association between organizational justice and psychological distress among hospital nursing staff is underexplored. Thus, this cross-sectional study, conducted in Fukuoka Prefecture, Japan, examined the relationship between organizational justice and serious psychological distress (SPD) among hospital nursing staff during COVID-19. METHODS: The study surveyed 783 hospital nursing staff using the Organizational Justice Questionnaire and Effort-Reward Imbalance Questionnaire. The Kessler K6 scale was used to measure SPD. Sociodemographic and occupational characteristics were controlled for as potential confounders. RESULTS: The prevalence of SPD was 14.4%, with a mean K6 score of 6.5. Moderate procedural justice (odds ratio [OR] = 2.38, 95% confidence interval [CI] = 1.14-4.94, p = .021) and low distributive justice (effort-reward imbalance) (OR = 3.66, 95% CI = 2.01-6.67, p < .001) were associated with SPD, even after adjustment for confounders. Interactional justice showed significance only in the crude model. Effort-reward imbalance had the strongest association with SPD. CONCLUSIONS: The findings showed that moderate procedural justice and low distributive justice were associated with SPD, highlighting the need for organizational interventions to address these factors. Imbalances in effort/reward had the greatest impact, highlighting the critical role of distributive justice in mental health. Thus, in the context of a pandemic, extreme procedural justice is not necessarily associated with mental health, and efforts to ensure distributive justice are critical to improving the mental health of hospital nursing staff. Moreover, organizational stressors should be addressed during disruptive conditions such as infectious disease outbreaks.

The effect of students' effort-reward imbalance on learning engagement: the mediating role of learned helplessness and the moderating role of social support.

Introduction: To explore the predictive effect of effort-reward imbalance on students' learning engagement and to elucidate the underlying mechanism, 796 students were selected for a survey. Methods: The participants were required to complete four scales: the Effort-reward Imbalance Scale, the Learning Engagement Scale, the Learned Helplessness Questionnaire, and the Perceived Social Support Scale. Results: (1) Students' effort-reward imbalance significantly and negatively predicts their learning engagement; (2) Learned helplessness serves as a mediator in the relationship between students' effort-reward imbalance and learning engagement; (3) Social support plays a moderating role in the association between effort-reward imbalance and learned helplessness. High levels of social support can buffer the impact of an effort-reward imbalance on learned helplessness, and the protective effect of social support is more obvious when the effort-reward imbalance is low. Discussion: The present study revealed how an effort-reward imbalance affects learning engagement among students through the dimensions of learned helplessness and perceived social support. The constructed model not only further clarifies the mechanism underlying the relationship between effort-reward imbalance and learning engagement but also holds significant implications for guiding students' education.

Occupational Stress Levels among Radiologists and Radiographers in Hungary during the COVID-19 Era.

The COVID-19 pandemic has heightened stress levels, potentially affecting the occupational wellbeing of radiographers and radiologists. Our study aimed to assess occupational stress levels within the radiology department and identify contributing factors. A cross-sectional survey was conducted between September and November 2022, with participants comprising radiographers and radiologists affiliated with the Hungarian Society of Radiographers and the Hungarian Society of Radiologists. The online survey collected socio-demographic and COVID-19 data, and the participants completed an effort-reward imbalance questionnaire. The analysis of 406 responses revealed significantly higher effort-reward imbalance (ERI) levels among the radiologists compared to the radiographers (p < 0.05). The healthcare professionals with over 30 years of experience exhibited significantly lower ERI levels than those with 1-9 years, 10-19 years, or 20-29 years of experience (p < 0.05). Additionally, the individuals aged 31-40 demonstrated higher ERI levels compared to their counterparts aged 19-30, 41-50, and over 51 (p < 0.05). The respondents cohabiting with a spouse/partner reported significantly higher stress levels than their single colleagues (p < 0.05), while the dog owners exhibited significantly lower ERI levels (p < 0.05). Elevated occupational stress highlights specific groups requiring targeted interventions to reduce stress and mitigate burnout among radiologists and radiographers.

The effects of effort-reward imbalance on the job, overcommitment, and income on life satisfaction in Germany from a longitudinal perspective.

BACKGROUND: The effort-reward imbalance at work model offers a theoretical and analytical framework to estimate the subjective perception of work-related stress. High demands and low rewards in return can harm mental and physical health, well-being, and life satisfaction. According to the theory, overcommitment partially explains why employees endure such straining jobs. In Germany, cultural and economic aspects of labor differ between East and West. Incomes are lower in the East, while work centrality there is higher. In this article, the effects of effort-reward imbalance, overcommitment, and income on life satisfaction as well as their interactions with region were analyzed to gain a clearer picture of regional disparities regarding life satisfaction and the generality of this work stress model in Germany. METHODS: Data from 3848 participants from 2006 to 2011 of the German Socio-Economic Panel were analyzed. Within-between models were estimated, including fixed and random effects of the continuous form of effort-reward imbalance to predict subjective life satisfaction. Time-variant covariates - e.g., overcommitment or income - as well as time-constant variables - e.g., region, sex, education - were integrated. Differences in regional labor markets between East and West Germany were considered. RESULTS: Easterners exhibited higher imbalances and overcommitment than Westerners, indicating worse working conditions. Higher imbalances and overcommitment were associated with lower life satisfaction within and between participants, whereas for income only random effects were supported. While region did not moderate the effect of work stress, East Germans' life satisfaction benefitted more from a higher income. CONCLUSION: The importance of internal work structures in terms of recognition, adequate pay, advancement opportunities, or time pressure were underlined. As compared to the West, Easterners' life satisfaction benefitted more from higher income but not more from a lower imbalance or lower overcommitment. The interplay between materialistic and nonmaterialistic rewards at work should be focused on in the future.

Prospective Association of High Effort and Low Reward Imbalance at Work with Risk of Diabetes: A Cohort Study in US Workers.

BACKGROUND: The contribution of psychosocial stress in the workplace to development of type 2 diabetes mellitus (T2DM) is not well investigated. As most studies were conducted in Europe, a further test from the USA seems well justified. The objective of the current investigation was to examine prospective associations of work stress based on the effort-reward imbalance model with risk of T2DM in a national sample of US workers. METHOD: Using data from the national population-based Mid-life in the United States (MIDUS) study with a prospective cohort design and a 9-year follow-up period, the effects of a ratio combining data on effort and reward at work (ER ratio) at baseline on risk of T2DM at follow-up were examined in 1493 workers who were free from diabetes at the baseline survey, applying multivariable Poisson regression analysis. RESULTS: During the follow-up, 109 individuals (7.30%) reported onset of diabetes. The analyses demonstrated a significant association between continuous data of the E-R ratio and risk of diabetes (RR and 95% CI = 1.22 [1.02, 1.46]), after adjustment for modifiable and non-modifiable risk factors at baseline. A dose-dependent response was observed with trend analysis when using quartiles of the E-R ratio. CONCLUSION: In the US workers, high effort in combination with low reward at work was significantly associated with elevated risk of T2DM 9 years later. The risk profiles of diabetes should be adapted in consideration of psychosocial work environment and taken into account by conceptualizing prevention programs of chronic non-communicable diseases.

Work engagement and associated factors among Japanese registered dietitians and dietitians: a cross-sectional study.

Healthcare services provided by registered dietitians and dietitians have been changing because of evolving lifestyles and population dynamics, leading to subsequent changes in the occupational status and experiences of these professionals. However, few studies have examined occupational stress among registered dietitians and dietitians. This study involved a cross-sectional survey to investigate the status and associated factors of work engagement among registered dietitians and dietitians, whose professions differ based on licensing processes and scope of work. A total of 3,593 questionnaires were distributed, 1,890 responses were received, and 1,654 valid questionnaires were analyzed. Work engagement was measured using the Utrecht Work Engagement Scale. Multiple regression analysis was conducted to examine the associations between work engagement and each factor. The work engagement scores of dietitians were significantly lower than those of registered dietitians. Further, work engagement was associated with age, workplace, coworker support, and effort-reward ratio for both registered dietitians and dietitians. However, exercise habit was a significant factor associated with work engagement only among dietitians. Work engagement among registered dietitians was comparable to that of typical Japanese workers, whereas it was lower among dietitians. The findings highlight the importance of considering associated factors to improve work engagement further, especially among dietitians.

Perceived stress and psychological disorders in healthcare professionals: a multiple chain mediating model of effort-reward imbalance and resilience.

Background: Healthcare professionals have shown more psychological disorders such as anxiety and depression due to the nature of work, which can cause job burnout, decrease the quality of medical services, and even endanger medical safety. The aim of the study is to explore the serial multiple mediating role of effort- reward imbalance and resilience between perceived stress and psychological disorders among healthcare professionals. Methods: A cross-sectional study was conducted in China from February to April 2023. A total of 2098 healthcare professionals at a tertiary general hospital was investigated by the following self-reported questionnaires: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), The Effort-Reward Imbalance (ERI), Healthcare professionals Resilience Scale (MSRS). Results: Anxiety and depression are interrelated (r = 0.362, p < 0.01), and they were positively related to perceived stress (r = 0.640/0.607, p < 0.01) and ERI (r = 0.422/0.383, p < 0.01), and negatively related to resilience (r = -0.343/-0.320, p < 0.01). After controlling demographic factors, the variance in anxiety and depression was explained by perceived stress was 37.7 and 35.0%. Bootstrap analyses examining the pathway of perceived stress-ERI-resilience-anxiety revealed significant direct effects [B = 0.560, 95%CI (0.528, 0.591)], as well as indirect effects mediated independently by ERI [B = 0.045, 95%CI (0.029, 0.060)], resilience [B = 0.031, 95%CI (0.017, 0.047)], or a combination of both [B = 0.004, 95%CI (0.002, 0.007)]. Similarly, in the path of perceived stress-ERI-resilience-anxiety-depression, significant direct effects were found [B = -0.310, 95%CI(0.265, 0.351)], along with indirect effects mediated individually by ERI [B = 0.033, 95%CI(0.013, 0.052)], resilience [B = 0.014, 95%CI (0.001, 0.028)], and anxiety [B = 0.218, 95%CI (0.190, 0.246)], or by both or three together (B = 0.032). Conclusion: This study proved the hypothesis that ERI and resilience played a mediating role in perceived stress and psychological disorders, revealed the potential mechanism of anxiety in stress and depression, and proposed a solution for perceived stress to psychological distress, which can provide a basis for the intervention of healthcare professionals in the face of mental health crisis.

Associations of effort-reward imbalance at work and quality of life among workers after stroke: a one-year longitudinal study in Thailand.

Stroke incidence is increasing among working-age population, but the role of psychosocial stress in the workplace in predicting quality of life (QoL) after stroke onset is understudied. This longitudinal study aimed to investigate the relationship between work stress, measured by the effort-reward imbalance (ERI) model, and QoL over one-year period among 103 Thai workers who had experienced a stroke. The study evaluated the effort (E)-reward (R) ratio and over-commitment, the extrinsic and intrinsic components of the ERI model, before discharge; QoL was repeatedly measured at baseline, six months, and 12 months after discharge, respectively, using the Short Form Version 2 (SF-12v2) indicators of physical and mental health composite scores. Generalized estimating equations were used to examine longitudinal relationships between work stress at baseline and QoL over one year by testing the hypotheses that E-R ratio and over-commitment would have direct effects on QoL, and potential moderating effects of over-commitment on E-R ratio and QoL. The results supported the ERI model partially, as over-commitment was significantly associated with poor mental health (coefficient - 8.50; 95% CI: -13.79, -3.20) after adjusting baseline sociodemographic, behavioral, and clinical characteristics, while the E-R ratio was not significantly associated with physical or mental health; the interaction between the E-R ratio and over-commitment was also not significant. These findings suggest that more attention should be paid to workers' personal coping skills and ability to handle work-related problems and prioritize interventions that address over-commitment to promote long-term mental health among workers with stroke.

Erratum: Self-rated health and its related influencing factors among emergency department physicians: a national cross-sectional study.

[This corrects the article DOI: 10.3389/fpubh.2023.1147403.].