Michiel A. J. Kompier

Psychosocial factors at work and musculoskeletal disease.

The objective of this review is to establish whether the epidemiologic literature presents evidence of an association between psychosocial work factors and musculoskeletal disease. In a hypothetical model it is suggested that individual characteristics and stress symptoms can modify this relationship. The reviewed studies do not present conclusive evidence due to high correlations between psychosocial factors and physical load and to difficulties in measuring dependent and independent variables. Nevertheless, it is concluded that monotonous work, high perceived work load, and time pressure are related to musculoskeletal symptoms. The data also suggest that low control on the job and lack of social support by colleagues are positively associated with musculoskeletal disease. Perceived stress may be an intermediary in this process. In addition, stress symptoms are often associated with musculoskeletal disease, and some studies indicate that stress symptoms contribute to the development of this disease.

The Very Best of the Millennium: Longitudinal Research and the Demand-Control-(Support) Model

This study addressed the methodological quality of longitudinal research examining R. Karasek and T. Theorells (1990) demand-control-(support) model and reviewed the results of the best of this research. Five criteria for evaluating methodological quality were used: type of design, length of time lags, quality of measures, method of analysis, and nonresponse analysis. These criteria were applied to 45 longitudinal studies, of which 19 (42%) obtained acceptable scores on all criteria. These high-quality studies provided only modest support for the hypothesis that especially the combination of high demands and low control results in high job strain. However, good evidence was found for lagged causal effects of work characteristics, especially for self-reported health or well-being outcomes.

The relationships between work characteristics and mental health: Examining normal, reversed and reciprocal relationships in a 4-wave study

This longitudinal study examined the causal relationships between job demands, job control and supervisor support on the one hand and mental health on the other. Whereas we assumed that work characteristics affect mental health, we also examined reversed causal relationships (mental health influences work characteristics). Further, the topic of the appropriate time lag for testing causal relationships was addressed. Our hypotheses were tested in a 4-wave study among a heterogeneous sample of 668 Dutch employees using structural equation modelling. The results provide evidence for reciprocal causal relationships between the work characteristics and mental health, although the effects of work characteristics on well-being were causally predominant. The best model fit was found for a 1-year time lag. Compared to earlier—predominantly cross-sectional—results, the present study presents a stronger case for the effects of work characteristics on the development of strain. The results also emphasize the need for a dynamic view of the relationship between work and health; the one-directional viewpoint in many work stress models does not seem to fully capture the relations between work characteristics and well-being.

Work-home interaction from a work psychological perspective: Development and validation of a new questionnaire, the SWING

Abstract This paper reports on the stepwise development of a new questionnaire for measuring work-home interaction, i.e. the Survey Work-home Interaction—NijmeGen, the SWING). Inspired by insights from work psychology, more specifically from Effort-Recovery Theory (Meijman & Mulder, 1998), we defined work-home interaction by differentiating between the direction and quality of influence. Four types of work-home interaction were distinguished and measured by using 22 (including 13 self-developed) items. By using data from five independent samples (total N=2472), validity evidence was provided based on the internal structure of the questionnaire. The results showed that the questionnaire reliably measured four empirically distinct types of work-home interaction, and that this four-dimensional structure was largely invariant across the five samples as well as across relevant subgroups. Validity evidence was also provided based on the relations with external (theoretically relevant) variables (i.e. job characteristics, home characteristics, and indicators of health and well-being). The results generally supported the hypothesized relationships of these external variables with negative work-home interaction. Less support was found, however, for the hypothesized relationships with positive work-home interaction. This contributes to current literature as it employs a relatively broad conceptualization of work-home interaction and offers a promising tool that measures its multiple components across a wide variety of workers.

A critical examination of the Demand-Control-Support Model from a work psychological perspective.

The most striking development in modern work organizations is the changing nature of work itself and its increased mental and emotional workload. Since the early sixties, many attempts have been made to gain more insight into the particular relationship between work-related psychosocial risks and employee health by means of theoretical models. One of these models is the Demand-Control-Support (DCS) Model. The DCS Model distinguishes itself from other work stress models by its simplicity and the extent to which it has gained a paradigmatic function in research in the field of work and health. The aim of the current paper is to examine its theoretical and empirical status from a work psychological perspective. Studies into the DCS Model can roughly be divided into (1) epidemiological studies, (2) cross-sectional, homogenous, or heterogenous studies, (3) psychophysiological studies, and (4) intervention studies. It is concluded that (1) epidemiological studies offer the most support for the DCS Model, (2) its interaction hypothesis is not often supported, and (3) examples of carefully examined evaluations of interventions are rather scarce. Furthermore, nine critical comments on the model are discussed. In conclusion, although there are various relevant comments on the model, the core structure of the model still holds. Directions for future research are depicted.

Specific relationships between psychosocial job conditions and job-related stress: A three-level analytic approach

This cross-sectional questionnaire study presents a multi-level analysis on 2565 workers in 188 departments in 36 organizations in the Netherlands. A three-level model is used in which individual workers are nested within departments, which in turn are nested within organizations. Research questions concern (1) the amount and distribution of variance in job-related stress explained for the three levels in the study (individuals, departments, organizations), and (2) the specificity of relationships between psychosocial job demands and job-related stress in the three-level model. Well-being showed slightly more raw variance to be explained at supra-individual levels than strain. The full regression model explained about 35% of the total variance in both work-related strain and well-being. Psychosocial job conditions did not exceed the expected amount of 10 to 15% contribution to this explained variance. These results do not differ from comparable studies that do not use multi-level analysis. The variance distribution in the full model, however, showed unexplained variance to be located at the individual level for both strain and well-being, and at the departmental level only for well-being. This last finding shows a direction for possible improvement of work stress models. Specificity of relationships was also shown: psychological job demands were more strongly related to strain, whereas job content variables (i.e. job variety, job control) were more strongly related to well-being. Results also suggested that social support was more strongly associated with well-being than with strain. Well-being appeared to have a more widely varying range of predictors than strain.

Cases in stress prevention: the success of a participative and stepwise approach

Stress prevention programmes are predominantly reactive and aimed at individuals. Four factors that may contribute to this current status are discussed: the opinions and interests of company management, the nature of psychology, the difficulty of conducting methodologically ‘sound’ intervention studies and the denominational segregation of stress research. To increase the impact of organizational level interventions, the effects need to be demonstrated on matters that appeal to company management, such as quality of products and services, organizational flexibility, productivity and sickness absence rates. The demonstration of examples of good preventive practice is considered as a conditio sine qua non for developing effective stress prevention procedures and for the involvement of both social partners in this field. Therefore, 10 Dutch projects from several branches of industry, aimed at the reduction of work stress, physical workload and sickness absenteeism, were selected, analysed and compared. The results show that in most cases sickness absenteeism was reduced and that the benefits exceeded the costs of the interventions. Five factors seem to be at the heart of a successful approach: (1) its stepwise and systematic nature, (2) an adequate diagnosis or risk analysis, (3) a combination of measures (i.e. both work-directed and person-directed), (4) a participative approach (i.e. worker involvement) and (5) top management support. In conclusion, the projects suggest that stress prevention may be beneficial to both the employee and the organization.

Linear and nonlinear relations between psychosocial job characteristics, subjective outcomes, and sickness absence : baseline results from SMASH

This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company-administrated sickness absence). Hypotheses were tested in a heterogeneous sample of 1,739 employees from a 3-year prospective cohort study called SMASH (Study on Musculoskeletal Disorders, Absenteeism, Stress, and Health). Baseline results showed that a linear additive model was superior for job satisfaction, psychosomatic health complaints, and sickness absence, whereas a curvilinear model was superior for emotional exhaustion and depression. It is concluded that, first, there was no evidence of interactive effects. Second, it seems sensible to pay more attention to curvilinear relationships in future research. Finally, the DCS model was not supported using a more objective outcome measure.

A Multiple Case Study Approach to Work Stress Prevention in Europe

Work stress has become a major issue among European employees. The current practice of its prevention seems disappointing, as work stress prevention programmes are predominantly reactive and biased to the individual. The lack of organization-level intervention studies is a barrier to progress in reducing work-related stress. In addition to the “true experimental approach”, multiple case studies may provide an adequate research strategy for addressing the potential impact of stress interventions in organizations. The study aim was to obtain more knowledge with respect to evidence-based work stress prevention in Europe, by focusing on both content (cause-effect relationships) and process (“how”). Therefore it was decided: (1) to collect from each European Union member state a work stress intervention study; (2) to analyse each of these cases as to content and process factors; and (3) to systematically compare these studies in a step-by-step approach. Through a network approach, 11 cases were identified. Nine projects received an acceptable methodological standard and were included in this study. Evaluation of these cases reveals that stress prevention is no “one time event”, nor merely a technical process. It is concluded that “true prevention” (i.e., preventive measures that are based on an adequate diagnosis identifying risk factors and risk groups, which theoretically and logically fit in with the problems, and which are introduced and implemented in a proper way) may be beneficial to both the employee and the organization.

A hard day's night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue

This prospective four‐wave study examined (i) the causal direction of the longitudinal relations among job demands, job control, sleep quality and fatigue; and (ii) the effects of stability and change in demand–control history on the development of sleep quality and fatigue. Based on results of a four‐wave complete panel study among 1163 Dutch employees, we found significant effects of job demands and job control on sleep quality and fatigue across a 1‐year time lag, supporting the strain hypothesis (Demand–Control model; Karasek and Theorell, Basic Books, New York, 1990). No reversed or reciprocal causal patterns were detected. Furthermore, our results revealed that cumulative exposure to a high‐strain work environment (characterized by high job demands and low job control) was associated with elevated levels of sleep‐related complaints. Cumulative exposure to a low‐strain work environment (i.e. low job demands and high job control) was associated with the highest sleep quality and lowest level of fatigue. Our results revealed further that changes in exposure history were related to changes in reported sleep quality and fatigue across time. As expected, a transition from a non‐high‐strain towards a high‐strain job was associated with a significant increase in sleep‐related complaints; conversely, a transition towards a non‐high‐strain job was not related to an improvement in sleep‐related problems.