Margot van der Doef

The Job Demand-Control (-Support) Model and psychological well-being: A review of 20 years of empirical research

The Job Demand-Control (JDC) model (Karasek, 1979) and the Job Demand-Control-Support (JDCS) model (Johnson, and Hall, 1988) have dominated research on occupational stress in the last 20 years. This detailed narrative review focuses on the JDC(S) model in relation to psychological well-being. It covers research from 63 samples, published in the period 1979-1997. In the review a distinction is drawn between two different hypotheses prevailing in research on the models. According to the strain hypothesis of the JDC model, employees working in a high-strain job (high demands-low control) experience the lowest well-being. The buffer hypothesis states that control can moderate the negative effects of high demands on well-being. Translating these hypotheses to the expanded JDCS model, the iso-strain hypothesis predicts the most negative outcomes among workers in an iso-strain job (high demands-low control-low social support/isolation), whereas the buffer hypothesis states that social support can moderate the ne...

The Leiden Quality of Work Questionnaire: its construction, factor structure, and psychometric qualities.

Based on two leading models in occupational stress research, the Job Demand-Control-Support model and the Michigan model, a comprehensive quality of work questionnaire, was constructed—the Leiden Quality of Work Questionnaire. The factor structure of this questionnaire was assessed and cross-validated in two subsamples of 2,000 men and women from a large sample of the Dutch working population. Analysis indicated that the questionnaire measures 11 work characteristics of Skill Discretion, Decision Authority, Task Control, Work and Time Pressure, Role Ambiguity, Physical Exertion, Hazardous Exposure, Job Insecurity, Lack of Meaning-fulness, Social Support from Supervisor and Social Support from Coworkers, and the outcome variable of Job Satisfaction in a reliable way.

Daily worrying and somatic health complaints: Testing the effectiveness of a simple worry reduction intervention

This study examines whether worry is prospectively associated with somatic complaints and whether a worry reduction intervention can decrease these complaints. One hundred and seventy-one high school students (16–17 years old) kept a log of their worry duration and frequency for 6 days, of whom half were instructed to try to postpone worrying to a special 30-min worry period each day (‘postponers’). Somatic symptoms during ‘the last 3 days’ were assessed before and after the 6 days. At follow-up, postponers reported fewer complaints than controls, controlled for baseline. This reduction appeared to be mediated by worry duration, and pertained to, amongst others, lower back pain, neck pain, coughing/bronchitis, breathing difficulties and stomach pains. Thus, daily worry appears to be prospectively related to a broad set of somatic complaints, and its effect might be reversed by a simple intervention. Possible underlying mechanisms include prolonged physiological activity and illness-related perseverative cognition.

Exploring the burden of emergency care: predictors of stress-health outcomes in emergency nurses.

AIMS This paper is a report of a study that examines (1) whether emergency nurses differ from a general hospital nursing comparison group in terms of job and organizational characteristics and (2) to what extent these characteristics predict job satisfaction, turnover intention, work engagement, fatigue and psychosomatic distress in emergency nurses. BACKGROUND The work environment and job characteristics of nurses are important predictors of stress-health outcomes. Emergency nurses are particularly exposed to stressful events and unpredictable work conditions. METHODS This cross-sectional study (N = 254) was carried out in 15 emergency departments of Belgian general hospitals in 2007-2008 by means of the Leiden Quality of Work Questionnaire for Nurses, the Checklist Individual Strength, the Utrecht Work Engagement Scale and the Brief Symptom Inventory. RESULTS Emergency nurses report more time pressure and physical demands, lower decision authority, less adequate work procedures and less reward than a general hospital nursing population. They report, however, more opportunity for skill discretion and better social support by colleagues. Work-time demands appear to be important determinants of psychosomatic complaints and fatigue in emergency nurses. Apart from personal characteristics, decision authority, skill discretion, adequate work procedures, perceived reward and social support by supervisors prove to be strong determinants of job satisfaction, work engagement and lower turnover intention in emergency nurses. CONCLUSION Emergency departments should be screened regularly on job and organizational characteristics to identify determinants of stress-health outcomes that can be the target of preventive interventions.

Job Stress in the Nursing Profession: The Influence of Organizational and Environmental Conditions and Job Characteristics.

The aim of the present study was to examine the influence of organizational and environmental work conditions on the job characteristics of nurses and on their health and well-being. The sample consisted of 807 registered nurses working in an academic hospital. The direct influence of work conditions on outcomes was examined. Mediation of job characteristics in the relationships between work conditions and outcomes was tested by means of regression analyses. The results indicated that job characteristics, such as demands and control, mediated the relationship between work conditions, such as work agreements and rewards, and outcomes. By managing organizational and environmental conditions of work, job characteristics can be altered, and these in their turn influence nurses’ job satisfaction and distress.

An examination of the job demand-control-support model with various occupational strain indicators

Abstract In this study the Job Demand-Control-Support model is examined using four occupational strain indicators: (psycho) somatic complaints, psychological distress, job dissatisfaction, and absenteeism. In two samples from the Dutch working population (total n=4000), the results of three strain indicators support the iso-strain hypothesis: high time pressure, low control, and low social support are associated with lower well-being. For absenteeism the iso-strain hypothesis is not confirmed, as this outcome is only associated with low control and low social support. Analyses examining the potential buffering effects of control and support on the impact of high demands indicate that various forms of control can moderate the impact of high demands, but only consistently do so in circumstances of high supervisor support. The main conclusion on the basis of these results is that the focus should not exclusively be on job control. The social support dimension should be included in future research on occupational stress, as well as in efforts to create ‘healthier work’.

Job conditions, job satisfaction, somatic complaints and burnout among East African nurses

AIMS To describe job conditions, job satisfaction, somatic complaints and burnout of female East African nurses working in public and private hospitals and to determine how these well-being outcomes are associated with job conditions. BACKGROUND Insight into job conditions, health and well-being status and their interrelation is virtually lacking for East African nurses. DESIGN Cross-sectional survey of 309 female nurses in private and public hospitals in Kenya, Tanzania and Uganda. METHODS Nurses completed a survey assessing job conditions and job satisfaction (the Leiden Quality of Work Life Questionnaire-nurses version), somatic complaints (subscale of the Symptom CheckList) and burnout (Maslach Burnout Inventory). RESULTS The East African nurses show high levels of somatic complaints, and nearly one-third of the sample would be labelled as burned out. In comparison with a Western European nurses reference group, the nurses score unfavourably on job conditions that require financial investment (e.g. workload, staffing, equipment and materials). On aspects related to the social climate (e.g. decision latitude, cooperation), however, they score more favourably. In comparison with private hospital nurses, public hospital nurses score similarly on aspects related to the social climate, but worse on the other job conditions. Public hospital nurses have a lower job satisfaction than private hospital nurses, but show comparable levels of somatic complaints and burnout. Strongest correlates of low job satisfaction are low supervisor support and low financial reward. Burnout is mainly associated with high workload and inadequate information provision, whereas somatic complaints are associated with demanding physical working conditions. CONCLUSIONS Improvement in job conditions may reduce the high levels of burnout and somatic complaints and enhance job satisfaction in East African nurses. RELEVANCE TO CLINICAL PRACTICE Efforts and investments should be made to improve the job conditions in East African nurses as they are key persons in the delivery of health care.

Occupational coping self-efficacy explains distress and well-being in nurses beyond psychosocial job characteristics.

Aim: The main purpose of the present study was to extend the Job Demand Control Support (JDCS) model analyzing the direct and interactive role of occupational coping self-efficacy (OCSE) beliefs. Background: OCSE refers to an individual’s beliefs about their ability to cope with occupational stressors. The interplay between occupational stressors, job resources, and self-efficacy beliefs is poorly investigated. The present research attempts to address this gap. Design: Cross-sectional survey. Method: Questionnaire data from 1479 nurses (65% response) were analyzed. Hierarchical regression analyses were used to test the direct and moderating role of OCSE in conjunction with job demands (i.e., time pressure), and two job resources: job control (i.e., decision latitude and skill discretion) and social support (i.e., supervisor support and coworker support) in predicting psychological distress and well-being. Results: Our findings indicated that high demands, low job control, and low social support additively predicted the distress/well-being outcomes (job satisfaction, emotional exhaustion, depersonalization, psychological distress, and somatic complaints). Beyond the main effects, no significant interactive effects of demands, control, and support were found. OCSE accounted for an additional 1–4% of the variance in the outcomes, after controlling for the JDCS variables. In addition, the results indicate that OCSE buffers the association between low job control and the distress dimensions emotional exhaustion, depersonalization, and psychological distress. Low control was detrimental only for nurses with low OCSE. Conclusion: Our results suggest expanding the JDCS model incorporating individual characteristics such as OCSE beliefs, for predicting psychological distress and well-being. Limitations of the study and practical implications are discussed.

How changes in psychosocial job characteristics impact burnout in nurses : A longitudinal analysis

Aims: The main aim of this longitudinal study was to test the Job Demand-Control-Support (JDCS) model and to analyze whether changes in psychosocial job characteristics are related to (changes in) burnout. Background: Previous studies on the effects of JDCS variables on burnout dimensions have indicated that the iso-strain hypothesis (i.e., high job demands, low control, and low support additively predict high stress reactions) and the buffer hypotheses (i.e., high job control and/or social support is expected to moderate the negative impact of high demands on stress reactions) have hardly been examined concurrently in a longitudinal design; and that the effects of changes of psychosocial job variables on burnout dimensions have hardly been analyzed. Design: This two wave study was carried out over a period of 14 months in a sample of 217 Italian nurses. Method: Hierarchical regression analyses were used to test the cross lagged main and interactive effects of JDCS variables, and to analyse the across-time effects of changes in JDCS dimensions on burnout variables. Results: The Time 1 job characteristics explained 2–8% of the variance in the Time 2 burnout dimensions, but no support for the additive, or the buffer hypothesis of the JDCS model was found. Changes in job characteristics explained an additional 3–20% of variance in the Time 2 burnout dimensions. Specifically, high levels of emotional exhaustion at Time 2 were explained by high levels of social support at Time 1, and unfavorable changes in demands, control, and support over time; high depersonalization at Time 2 was explained by high social support at time 1 and by an increase in demands over time; and high personal accomplishment at Time 2 was predicted by high demands, high control, interactive effect demands × control × social support, at Time 1, and by a decrease in demands over time. No reversed effects of burnout on work characteristics have been found. Conclusion: Our findings suggest that the work environment is subject to changes: the majority of employees experienced considerable changes in all job conditions over time. These changes impacted employee burnout. Limitations and implications of the study are discussed.

Preferences for condom placement in stores among young Dutch men and women: relationships with embarrassment and motives for having sex.

BACKGROUND Condom purchasing is an important preparation for condom use. The present study examined if products surrounding condoms in the store play a role in preferences for where to buy condoms among young people. METHODS Sixty-nine men and 111 women (<30 years) completed an online questionnaire on their preferences for condom placement, associated embarrassment with these placements, and motives for having sex. RESULTS Fifty percent of men and 70% of women indicated the counter as least preferred placement. Two-fifths of men and women preferred the sensual context, including among sex toys and lubricants; however, the remainder of participants, particularly women, preferred other less sexual contexts. Both the counter and sensual placement were strongly associated with embarrassment, and this, in turn, was predictive of placement preference. Finally, the motive for having sex to experience intimacy was negatively related to counter preference, and the motive for having sex to experience pleasure was negatively related to the neutral placement and the female personal care placement preferences. CONCLUSION The findings suggest that using multiple and alternative placements for condoms in stores may encourage condom purchasing behaviour among young people.