Synergistic interaction between job control and social support at work on depression, burnout, and insomnia among Japanese civil servants.

PURPOSE: To elucidate whether low job control and low social support at work have synergistic interaction on mental health. The synergistic interaction was also analyzed after stratification by high and low job demands. METHODS: Participants were 2,121 local government employees in Asahikawa city, Japan. The Brief Job Stress Questionnaire was used to assess job demands, job control, and social support. Depression was assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to assess burnout. Insomnia was assessed using the Athens Insomnia Scale. Possible confounder-adjusted logistic regression analyses were performed to obtain odds ratios for depression, burnout, and insomnia, and synergy indices between job control and social support at work were assessed. RESULTS: The synergy indices among men and women, respectively, were 2.08 (80 % confidence interval: 1.01, 4.27) and 1.98 (0.67, 5.89) for depression, 1.79 (1.28, 2.51) and 2.62 (1.07, 6.40) for burnout, and 1.92 (1.22, 3.02) and 2.77 (0.43, 18.01) for insomnia. Men with high job demands had higher synergistic interaction on depression and burnout, compared to men with low job demands, and women with low job demands had higher synergistic interaction between job control and social support at work on burnout and insomnia, compared to women with high job demands. CONCLUSIONS: There were more-than-additive interactions of job control and social support at work on depression, burnout, and insomnia. After stratification by job demands, the synergistic interaction may be different between men and women. To assess job stress, it is necessary to consider the interactive effect of not only job demands and job control but also job control and social support at work.

Effects of work burden, job strain and support on depressive symptoms and burnout among Japanese physicians.

OBJECTIVES: Days off, on call, night duty, working hours and job stress can affect physicians' mental health, and support from supervisors and co-workers may have a buffering effect. This study elucidates whether job strain and job factors affect physicians' mental health, and whether support from supervisors and co-workers has a protective effect on their mental health. MATERIAL AND METHODS: The subjects included 494 physicians. The Brief Job Stress Questionnaire (BJSQ) was used to evaluate job demand, job control and support. High job strain was defined as a combination of high job demand and low job control. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory-General Survey was used to evaluate burnout. Possible confounder adjusted logistic regression analyses were performed to obtain odds ratios for depressive symptoms and burnout. RESULTS: As per the analysis, high job strain had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for depressive symptoms. High job strain and having only 2-4 days off per month (compared to > 8 days off per month) had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for burnout. CONCLUSIONS: High job strain was related to depressive symptoms and burnout, and support from co-workers had a buffering effect on depressive symptoms and burnout. An inadequate number of days off was related to burnout. Assessment of job strain may be a good tool to measure physicians' mental health, and a sufficient number of days off may be needed to prevent burnout.

Job stress and burnout among urban and rural hospital physicians in Japan.

OBJECTIVE: To elucidate the differences in job stress and burnout status of Japanese hospital physicians between large cities, small cities, and towns and villages. DESIGN: Cross-sectional study. SETTING: Postal self-administered questionnaires were distributed to 2937 alumni of Asahikawa Medical University. PARTICIPANTS: Four hundred and twenty-two hospital physicians. MAIN OUTCOME MEASURES: The Brief Job Stress Questionnaire was used to evaluate job demand, job control and social support. The Japanese version of the Maslach Burnout Inventory-General Survey (MBI-GS) was used to evaluate burnout. An analysis of covariance was conducted on the mean scores on the Brief Job Stress Questionnaire and the MBI-GS scales after adjusting for sex, age and specialties. RESULTS: In adjusted analyses, the job demand score was significantly different among physicians in the three areas. In Bonferroni post-hoc tests, scores in large cities was significantly higher than those in small cities and towns and villages. The job control score showed a significant difference and a marginally significant trend, with large cities associated with lower job control. There were significant differences in support from supervisors and that from family/friends, and scores in large cities was significantly higher than those in small cities in the post-hoc test. There was a significant effect on the exhaustion scale of the MBI-GS, with large cities associated with higher exhaustion, and scores in large cities was significantly higher than those in small cities. CONCLUSIONS: Urban hospital physicians had more job demand, less job control and exhaustion caused by burnout, and rural hospital physicians had less social support.

Effects of a worksite stress management training program with six short-hour sessions: a controlled trial among Japanese employees.

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of a multi-component worksite stress management training (SMT) program among employees belong to Japanese steel company. METHODS: Five workplaces were assigned to an intervention group and two workplaces to a control group. SMT with monthly 30-min sessions were provided to the intervention group for 6 mo. Intention-to-treat analyses were conducted among respondents of the intervention (n=96) and control groups (n=53). RESULTS: Significant favorable intervention effects were found on knowledge (p<0.001) and marginally significant ones on professional efficacy (p=0.074) at one-month after completing the program. No significant intervention effects were observed on psychological distress, physical complaints, or job performance (p>0.05). However, in per-protocol analyses of those who attended all sessions, significant favorable effects were observed on psychological distress and job performance, as well as knowledge and professional efficacy (p<0.05). In addition, subgroup analyses revealed that those with initial low job control showed a favorable intervention effect only on knowledge (p<0.001), whereas those with initial high job control showed favorable intervention effects on knowledge (p<0.001), professional efficacy (p=0.023) and anxiety (p=0.033). CONCLUSIONS: The results suggest that the multi-component SMT program is effective at improving knowledge and professional efficacy, although job control appeared to moderate the effect of the program on professional efficacy. The program may also be effective at reducing psychological distress and increasing job performance, if participants complete all sessions.

Burnout and risk factors for arteriosclerotic disease: follow-up study.

OBJECTIVES: The purpose of this longitudinal study was to investigate the effects of burnout on risk factors for arteriosclerotic disease. METHODS: Baseline data were collected from 442 male middle managers working for a manufacturing company in Japan. All participants had a physical health check-up and completed the Japanese Maslach Burnout Inventory-General Survey. We calculated the Japanese-specific cut-off points of the MBI-GS and applied "exhaustion +1" criterion to define subjects as healthy or burnout at baseline. Follow-up measures were collected 4-5 yr later for 383 middle managers. Changes in the subjects' waist circumference, body weight, body mass index (BMI), blood pressure, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, fasting blood sugar, fasting insulin, HOMA-R, and HbA1c over a time period of 4 to 5 yr were compared between the healthy and burnout groups. New cases of large waist circumference, high BMI, metabolic syndrome, hypertension, hypercholesterolemia, high triglycerides, low HDL cholesterol, high LDL cholesterol, and impaired fasting glucose were detected at follow-up. RESULTS: Changes in waist circumference, body weight, and BMI were significantly greater in burned-out managers than in healthy managers. Furthermore, compared to other variables (age and health behaviors such as smoking), burnout was a significant explanatory variable. The odds ratio of the burnout group was 2.80 for hypercholesterolemia with statistical significance after adjusting for age. After adjusting for age, health behaviors, and baseline total cholesterol, the results were similar. CONCLUSIONS: Burnout, which results from prolonged exposure to chronic work stress, may be associated with risk factors for arteriosclerotic disease.

Relationship between stress coping and burnout in Japanese hospital nurses.

AIM: The purpose of this study was to examine the relationship between stress coping and burnout in Japanese hospital nurses. BACKGROUND: Findings on effective stress management training are required in order to reduce nurse's stress and prevent it from becoming chronic. METHODS: The study included 1291 nurses who completed the General Coping Questionnaire and the Japanese version of the Maslach Burnout Inventory-General Survey. The data were analysed using structural equation modelling. RESULTS: In women, a frequent use of cognitive reinterpretation predicted low exhaustion and cynicism and high professional efficacy. In men, a frequent use of problem solving predicted low cynicism and high professional efficacy. Although for women, a frequent use of problem solving predicted high professional efficacy that was similar to men, there was also a concurrent high exhaustion. CONCLUSION: These findings suggested that enhancement of cognitive coping skills for women and problem-solving skills for men could contribute to a reduction of burnout in nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Our findings suggested that effective intervention strategies in order to prevent hospital nurse's stress from becoming chronic might be different between men and women. This difference should be taken into account in nursing management.

A cross-sectional study on the relationship of job stress with natural killer cell activity and natural killer cell subsets among healthy nurses.

The present study investigated the effects of job stress on cellular immune function, such as NK cell activity and NK cell subsets. The participants were 61 female nurses aged 23-59, who worked in a public psychiatric hospital in Ishikawa, Japan. Each subject completed the Nursing Job Stressor Scale (NJSS) and their NK cell activity and lymphocyte surface antigens (CD16+56+) were evaluated as immune system parameters. The NJSS has seven subscales: conflict with other nursing staff, nursing role conflict, conflict with physicians or autonomy, conflict with death or dying, quantitative work load, qualitative work load and conflict with patients. Factors influencing NK cell activity, and the proportion and cell counts of CD16+56+ lymphocytes were evaluated. Increase in quantitative work load significantly decreased NK cell activity. Conversely, no linear relationship was observed between qualitative work load and immunological variables, with the highest percentage of CD16+56+ lymphocytes observed among participants in the medium work load group. The other five NJSS subscales did not relate to immune parameters. In conclusion, the results suggest that perceived job strains, particularly quantitative work load, decreased NK cell function.

[Validation of a Japanese research version of the Maslach Burnout Inventory-General Survey].

The purpose of this study was to validate Japanese research version of Maslach Burnout Inventory-General Survey (MBI-GS), a newly developed measure intended for persons of every occupation. The Japanese MBI-GS was administered to a sample of hospital workers. Exploratory factor analysis found three factors, as in original MBI-GS. Confirmatory factor analysis largely supported MBI-GS structure of three subscales, but the correlation between two subscales was unexpectedly high. To examine its construct validity, the subscale scores were then examined in relation to selected work characteristics. Conservation of resources theory was successful in its predictions of different patterns of effects among the correlates and three burnout subscales. The successful predictions suggested that meaning of each subscale was quite distinct. In all, our examination showed that Japanese MBI-GS assessed the same three dimensions as the original measure for human service workers.