Skip to main content

Advertisement

Log in

Effort–reward imbalance at work and job dissatisfaction in Chinese healthcare workers: a validation study

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Objective: The aim of this study was to test the reliability and validity of the Chinese version of the 23-item effort–reward imbalance (ERI) questionnaire and to analyze its association with job dissatisfaction in a sample of Chinese healthcare workers. Methods: A self-reported survey was conducted, in university hospitals of China, among 192 male and 608 female healthcare workers. Results: Appropriate internal consistencies of the three scales: effort, reward, and overcommitment, were obtained. Exploratory factor analysis replicated the theoretically assumed structure of the ERI construct in men and women. Evidence of criterion validity was obtained from cross-correlations of the scales and from their correlations with gender, education and job dissatisfaction. Finally, all three scales were associated with an elevated odds ratio of job dissatisfaction, and the effect was strongest for the ERI ratio as predicted by theory. Conclusion: Based on the results of this study the Chinese version of the ERI questionnaire is considered a reliable and valid instrument for measuring psychosocial stress at work. It is applicable to Chinese working populations and, in particular, to the healthcare sector.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bakker AB, Killmer CH, Siegrist J, Schaufeli WB (2000) Effort–reward imbalance and burnout among nurses. J Adv Nurs 31:884–891

    Google Scholar 

  • Callaghan P, Tak-Ying SA, Wyatt PA (2000) Factors related to stress and coping among Chinese nurses in Hong Kong. J Adv Nurs 31:1518–1527

    Google Scholar 

  • Cherniss C (1992) Long-term consequences of burnout: an exploratory study. J Organ Behav 13:1–11

    Google Scholar 

  • Christiani DC, Tan X, Wang X (2002) Occupational health in China. Occup Med 17:355–370

    Google Scholar 

  • Cooper CL (1998) Theories of organizational stress. Oxford University Press, Oxford

    Google Scholar 

  • Dunham J (2001) Stress in the workplace: past, present and future. Whurr, London

    Google Scholar 

  • Hanson EK, Schaufeli W, Vrijkotte T, Plomp NH, Godaert GL (2000) The validity and reliability of the Dutch effort–reward imbalance questionnaire. J Occup Health Psychol 5:142–155

    Google Scholar 

  • Karasek R, Theorell T (1990) Healthy work: stress, productivity, and the reconstruction of working life. Basic Books, New York

    Google Scholar 

  • Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B (1998) The job content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 3:322–355

    Article  CAS  PubMed  Google Scholar 

  • Kawakami N, Haratani T (1999) Epidemiology of job stress and health in Japan: review of current evidence and future direction. Ind Health 37:174–186

    CAS  PubMed  Google Scholar 

  • Kivimäki M, Leino-Arjas P, Luukkonen R, Riihimäki H, Vahtera J, Kirjonen J (2002) Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ 325:857–862

    Google Scholar 

  • Kuper H, Marmot M (2003) Job strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study. J Epidemiol Community Health 57:147–153

    Google Scholar 

  • Kuper H, Singh-Manoux A, Siegrist J, Marmot M (2002) When reciprocity fails: effort–reward imbalance in relation to coronary heart disease and health functioning within the Whitehall II study. Occup Environ Med 59:777–784

    Google Scholar 

  • Landsbergis PA (2003) The changing organization of work and the safety and health of working people: a commentary. J Occup Environ Med 45:61–72

    Google Scholar 

  • Lee S, Colditz G, Berkman L, Kawachi I (2002) A prospective study of job strain and coronary heart disease in US women. Int J Epidemiol 31:1147–1153

    Google Scholar 

  • Li J, Eum KD, Lee HE, Kim SS, Paek DM, Cho SI (2003) The reliability and validity of the Korean version of the effort–reward imbalance questionnaire among industrial workers. In: The 55th fall conference of the Korean society of preventive medicine, Pyong Chang, 23–25 October 2003

  • McLeod J, Smith GD, Heslop P, Metcalfe C, Carroll D, Hart C (2001) Are the effects of psychosocial exposures attributable to confounding? Evidence from a prospective observational study on psychological stress and mortality. J Epidemiol Community Health 55:878–884

    Google Scholar 

  • Nelson DL, Burke RJ (2002) Gender, work stress, and health. American Psychological Association, Washington

    Google Scholar 

  • Ostry AS, Kelly S, Demers PA, Mustard C, Hertzman C (2003) A comparison between the effort–reward imbalance and demand control models. BMC Public Health 3:10–19

    Google Scholar 

  • Perrewe P, Ganster D (2002) Historical and current perspectives on stress and health, vol 2. Elsevier, Oxford

  • Peter R, Alfredsson L, Hammar N, Siegrist J, Theorell T, Westerholm P (1998) High effort, low reward, and cardiovascular risk factors in employed Swedish men and women: baseline results from the WOLF study. J Epidemiol Community Health 52:540–547

    CAS  PubMed  Google Scholar 

  • Peter R, Siegrist J, Hallqvist J, Reuterwall C, Theorell T, SHEEP Study Group (2002) Psychosocial work environment and myocardial infarction: improving risk estimation by combining two alternative job stress models in the SHEEP Study. J Epidemiol Community Health 56:294–300

    Google Scholar 

  • Pikhart H, Bobak M, Siegrist J, Pajak A, Rywik S, Kyshegyi J, Gostautas A, Skodova Z, Marmot M (2001) Psychosocial work characteristics and self-rated health in four post-communist countries. J Epidemiol Community Health 55:624–630

    Google Scholar 

  • Schnall P, Belkic K, Landsbergis P, Baker D (2000) The workplace and cardiovascular disease. Occup Med 15:69–106

    Google Scholar 

  • Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions at work. J Occup Health Psychol 1:27–43

    Article  CAS  PubMed  Google Scholar 

  • Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, Peter R (2004) The measurement of effort–reward imbalance at work: European comparisons. Soc Sci Med 58:1483–1499

    Article  PubMed  Google Scholar 

  • Stansfeld SA, Bosma H, Hemingway H, Marmot MG (1998) Psychosocial work characteristics and social support as predictors of SF-36 health functioning: the Whitehall II study. Psychosom Med 60:247–255

    Google Scholar 

  • Stansfeld SA, Fuhrer R, Shipley MJ, Marmot MG (1999) Work characteristics predict psychiatric disorder: prospective results from the Whitehall II study. Occup Environ Med 56:302–307

    CAS  PubMed  Google Scholar 

  • Tseng HP, Cheng Y (2002) Reliability and validity of the Chinese demand–control–support model and effort–reward imbalance model questionnaires: a study among employees of the microelectronics industry (in Chinese). Taiwan J Public Health 21:420–432

    Google Scholar 

  • Tsutsumi A, Ishitake T, Peter R, Siegrist J, Matoba T (2001a) The Japanese version of the effort–reward imbalance questionnaire: a study in dental technicians. Work Stress 15:86–96

    Google Scholar 

  • Tsutsumi A, Kayaba K, Theorell T, Siegrist J (2001b) Association between job stress and depression among Japanese employees threatened by job loss in a comparison between two complementary job-stress models. Scand J Work Environ Health 27:146–153

    CAS  PubMed  Google Scholar 

  • van Vegchel N, de Jonge J, Meijer T, Hamers JP (2001) Different effort constructs and effort–reward imbalance: effects on employee well-being in ancillary health care workers. J Adv Nurs 34:128–136

    Google Scholar 

  • Weinberg A, Creed F (2000) Stress and psychiatric disorder in healthcare professionals and hospital staff. Lancet 355:533–537

    Google Scholar 

  • Xu L, Siegrist J, Cao W, Li L, Tomlinson B, Chan J (2004) Measuring job stress and family stress in Chinese working women: a validation study focusing on blood pressure and psychosomatic symptoms. Women Health 39:31–46

    Google Scholar 

  • Yu SF (1997) Introduction of instruments for occupational stress from western countries (in Chinese). Ind Health Occup Med 23:126–128

    Google Scholar 

  • Yu MY, Sarri R (1997) Women’s health status and gender inequality in China. Soc Sci Med 45:1885–1898

    Google Scholar 

Download references

Acknowledgments

The authors gratefully acknowledge Miss Lili Ding for her professional translation from German to Chinese, and Dr. Laiyong Tan and Dr. Zhijiang Zang’s back-translation to English during the development of the questionnaire. Last but not least, the authors thank the two referees for their helpful suggestions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sung-Il Cho.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, J., Yang, W., Cheng, Y. et al. Effort–reward imbalance at work and job dissatisfaction in Chinese healthcare workers: a validation study. Int Arch Occup Environ Health 78, 198–204 (2005). https://doi.org/10.1007/s00420-004-0581-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-004-0581-7

Keywords

Navigation